“Globally, HIV is the leading cause of death among women aged 30-49.”
When I read that in a recent issue of Response magazine (a publication of United Methodist Women), I thought, “That just can’t be right.”
Tuberculosis has become the leading infectious killer worldwide – killing more people than AIDS and malaria combined. A couple of years ago, Rwanda declared the first year since the beginning of the AIDS epidemic that no babies were born HIV-positive in the whole country – ZERO! We have made enormous strides against this disease, so how can that statement possibly be true?
I did a little research. All of these apparently conflicting statements are valid.
For women age 30-49, HIV/AIDS is, indeed, the No. 1 cause of death. “Maternal conditions” ranks as No. 3; tuberculosis, No. 6. For younger women, age 15-29, “Maternal conditions” comes in at No. 1; HIV/AIDS, No. 4; tuberculosis, No. 5.
The World Health Organization lists maternal conditions, HIV/AIDS and TB together among “communicable, perinatal and nutritional conditions.” Co-infection is the lethal link. When a woman dies of infection related to childbirth, or is too weak to survive the pregnancy and birth, that is a “maternal condition.”
Her HIV status may have weakened her or made her more susceptible to infection, but she didn’t die of AIDS. When someone dies of TB, that goes on the death certificate. But TB is a common co-infection with HIV.
Another common co-infection is malaria. After years of decline, malaria is on the rise again. Almost every year new countries are declared malaria-free. Yet in Africa, especially, the trifecta of AIDS, TB and malaria rank together in the top 10 causes of death for both sexes and all ages.
India is on track to be AIDS-free by 2024; yet it ranks near the top for TB and malaria infections and death. Eastern Europe increasingly bears the world’s heaviest burden of multi-drug-resistant TB.
Combining these three killers, you can see that the battle continues on many fronts, with a need for different strategies around the world.
The good news is that we have a powerful weapon against all three diseases. The Global Fund to Fight AIDS, Tuberculosis and Malaria unites the funding and efforts of governments (both donor and investment partner countries), NGOs, private charities and foundations like the Gates Foundation and Bono’s (RED) campaign, along with faith-based organizations. Since The Global Fund’s creation in 2002, the number of people dying from the three targeted diseases has been cut by one-third!
The fund partnership provides direct interventions like antiretroviral therapy for HIV/AIDS, nets and seasonal chemoprevention for malaria, and treatment for TB. Even more important, it works toward testing and quick diagnosis of the diseases to prevent spread. It develops programs for education and prevention, and helps partner governments and communities build their own programs, measure the outcomes and share “best practices” with one another.
The bad news is that the world is losing ground in the fight. Wavering political commitment, drug and insecticide resistance, and funding shortfalls give the advantage to disease. Instead of closing in on an end to these three epidemics, eliminating them as significant public health threats, we face stagnation and, at best, a stalemate.
In early February, The Global Fund partners met in New Delhi to set goals for the next three years. An increase of 15 percent in funding to a total of $14 billion (U.S. dollars) would start to turn the battle. U.S. appropriations in line with past investment would be $1.6 billion each of the next three years. You can find “The Case for Investment” at www.theglobalfund.org.
The U.S. has always been a leader in the Global Fund and a powerful partner through The President’s Emergency Plan for AIDS Relief (PEPFAR), created by George W. Bush. Congress, including our Wyoming delegation, has always pushed forward with these commitments, even in the face of proposals to cut aid. And Congress needs to act now.
Donor countries and organizations meet this fall to make pledges at The Global Fund’s Replenishment Conference in Lyon, France. But Congress is already at work on appropriations for the coming fiscal year, so we need to commit NOW.
You can make the commitment now. Be sure friends and co-workers understand now and through the year what is at stake. Write or call NOW to tell Congress that they have the power to defeat the greatest infectious killers in the world. And be sure to let them know you stand with them in this fight!
Ann Erdmann is the group leader for RESULTS Cheyenne, a grassroots movement of people advocating for policies that will bring an end to poverty. Email: email@example.com.