Despite a more than 53-fold increase in Aids funding in South Africa, the epidemic continues to outpace the rate at which programmes are delivering
Johannesburg - Nearly three million lives have been saved by HIV/Aids treatment but scarce resources are being misspent and stigma is still keeping the most vulnerable from seeking help, according to a new book by researchers commissioned by the UN.
The failings are particularly worrying at a time when worldwide recession and donor fatigue are hurting spending on Aids, the researchers say.
Their book, Aids: Taking a Long-Term View, was the focus of a discussion on Thursday at the offices of an independent development foundation set up by Nelson Mandela.
Since finishing his term, Mandela has campaigned to raise awareness about Aids in the country with the world's largest Aids burden. Mandela, now 92 and ailing, galvanised the Aids community in 2005 when he publicly acknowledged the disease killed his son.
The two dozen researchers involved in the book include Nelson Mandela Foundation chief executive Achmat Dangor. They were asked by the UN Aids agency three years ago to review how the world has tackled the disease.
The experts were also asked to determine what changes need to be made to radically reduce the number of infections and deaths by 2031, which will mark 50 years since the Aids virus was first reported.
53-fold increase in funding
The researchers, collectively known as the aids2031 Consortium, said it was "fair to ask whether the Aids effort has always achieved good value for its money."
"Despite a more than 53-fold increase in Aids funding in barely over a decade, the epidemic continues to outpace the rate at which programmes are delivering," they said.
The researchers said developing treatments and getting the drugs to the infected saved nearly three million lives between 1996 and 2008. Efforts to prevent infected mothers from transmitting HIV to their babies averted at least 200 000 new infections around the world between 1996 and 2008.
But every day, more than 7 000 people become infected, more than twice as many as are able to start Aids treatment.
The researchers called for a new focus on prevention, and criticised governments for ignoring research that could help guide efforts
For example, programmes in Uganda focused on young people while research has shown high rates of HIV among older adults in steady relationships in the East African country.
Changing society's attitude
Laws making homosexual sex a crime and harassment of intravenous drug users also keep those who need it most from seeking help, the researchers said.
Changing society's attitudes is a long-term project, without the quick, measurable results of increasing the spread of Aids treatment drugs, the researchers acknowledged.
They said the cost of a lifetime of treatment for millions of HIV-infected people in poor countries is unsustainable.
After Dr Aaron Motsoaledi took over as health minister in 2009, he said he was baffled by how much the government was spending to buy Aids drugs from private companies.
Late last year, Motsoaledi announced that by taking such steps as asking more companies to bid and demanding they provide costs breakdowns, he had cut costs by more than half.
The Global Fund to Fight Aids, Tuberculosis and Malaria, which endorsed aids2031's work, also has found that up to two-thirds of some grants it provides are lost to corruption.
The independent agency, backed by celebrity campaigners, is a major international funder of Aids programmes.