U.K. Finance Minister’s International Plan To Fight HIV/AIDS Has ‘Serious Flaws,’ Editorial Says

Although British Chancellor of the Exchequer Gordon Brown should be "congratulated for drawing attention to a catastrophe that has been too long ignored" with his international plan to combat the HIV/AIDS pandemic, the initiative has some "serious flaws," according to an editorial in the Jan. 22 issue of the journal Lancet (Lancet, 1/22). Earlier this month, Brown introduced a $10 billion international plan to fight the HIV/AIDS pandemic that includes dramatic funding increases for every front in the battle against the disease. Brown called upon wealthy nations to increase funding pledges to fight HIV/AIDS to ensure that countries most affected by the pandemic can make investments in sex education and hospitals and purchase antiretroviral drugs to save millions of lives in the future. His initiative aims to double the current $750 million spent worldwide annually on vaccine research and coordinate an international system so that scientific breakthroughs can be shared more widely. Brown's plan also would encourage pharmaceutical companies to speed up vaccine research by securing pledges from wealthy nations to purchase vaccine doses on behalf of African governments. In addition, Brown would ask countries to increase pledges to the Global Fund to Fight AIDS, Tuberculosis and Malaria by billions of dollars so that the organization can rely on a steady supply of cash to fund the rapid expansion of HIV/AIDS programs in impoverished countries. The plan also would combine HIV/AIDS programs with larger initiatives addressing poverty (Kaiser Daily HIV/AIDS Report, 1/13).

Flaws
According to the Lancet, by placing vaccine development at the "heart" of his plan, Brown has "ignore[d] the depressing reality that the long search" for an HIV/AIDS vaccine "has so far proved futile" because of the "baffling genetic complexity of the virus and [an] inadequate" basic understanding of how it functions. Moreover, there are "several" existing, "well-established" prevention programs that "can and should be implemented immediately," the editorial says. By implementing another global strategy -- in addition to the Global Fund to Fight AIDS, Tuberculosis and Malaria and the President's Emergency Plan for AIDS Relief -- there is an increased potential for "dilution and duplication of efforts, as well as ineffectiveness and waste," according to the Lancet. Before "more detailed procedures are constructed," a "rationale" for Brown's plan that includes "clear missions, boundaries and intended outcomes ... needs to be articulated," the editorial says. The "real core" of Brown's initiative "ought to be poverty reduction" because the "only way to solve the crisis of HIV/AIDS in Africa is to address the long-standing problems of poverty alongside treatment and care," according to the Lancet. "With this shift in emphasis, the vaccine debate can be left to the scientists, and the best of [Brown's] ideas can be transformed into action," the editorial concludes (Lancet, 1/22).