Eliminating PEPFAR would lead to 601,000 HIV-related deaths, 565,000 new HIV infections, and would increase population-level healthcare expenditure by $1.7 billion due to increased HIV prevalence and a less healthy population over the next decade. And this is in South Africa alone.
This is according to an analysis that projected the impact of funding cuts to PEPFAR (the President’s Emergency Plan for AIDS Relief), a US program whose investments in curbing the global HIV/AIDS epidemic have already saved over 25 million lives. America’s first criminal president, convicted felon Donald Trump, issued an executive order that immediately froze all funds to PEPFAR programs in 55 supported countries.
The analysis – “Potential Clinical and Economic Impacts of Cutbacks in the President’s Emergency Plan for AIDS Relief Program in South Africa : A Modeling Analysis” by Aditya R. Gandhi, Linda-Gail Bekker, A. David Paltiel, Emily P. Hyle, Andrea L. Ciaranello, Yogan Pillay, Kenneth A. Freedberg, and Anne M. Neilan – was published in the Annals of Internal Medicine.
The analysts used the CEPAC model, a microsimulation model that projects lifetime health and economic outcomes on an individual and population level.
Some of the key findings included:
- Over 10 years, a 50% decrease in funding would lead to 315,000 HIV-related deaths, 286,000 new HIV infections, and decrease the average life expectancy of people living with HIV in South Africa by 2.02 years.
- A 100% decrease in funding would lead to 601,000 HIV-related deaths, 565,000 new HIV infections, and decrease average life expectancy by 3.71 years over the same time frame.
- Under decreased spending scenarios, individual healthcare expenditure among people with HIV would decrease by negligible amounts of up to $1,140 over a lifetime, because of people with HIV dying sooner. Population-level healthcare expenditure, however, would increase by up to $1.7 billion over 10 years due a population that is sicker due to lack of access to routine HIV care and a significant increase in HIV prevalence.
“Under the current 90-day freeze in PEPFAR aid disbursements, a disruption that was implemented with no warning, people living with HIV in the 55 PEPFAR-supported countries will face barriers in accessing regular treatment as well as testing and prevention,” the analysts stressed.
They added that abrupt stoppages mean that clinics are not staffed for people to pick up their medication, even if those medications are available, and healthcare workers cannot work. “People living with HIV become sick and may die, and transmission of HIV across the community will skyrocket, with substantial risk for transmission of treatment-resistant virus. Many of these impacts are irreversible.”
