Winnie Byanyima is trying to hold onto hope in the face of what she calls unbelievable cruelty.
She is the director of UNAIDS, the United Nations agency that, until recently, was on track to meet its target of ending AIDS as a public health threat by 2030.
But now, as President Donald Trump’s second administration rapidly and dramatically scales back U.S. foreign aid contributions, UNAIDS is instead predicting in a new report that there will be six million new HIV infections and four million additional deaths within the next four years alone.
“It’s just so cruel,” Byanyima told As It Happens host Nil Kӧksal. “It was not necessary to withdraw funding for life-saving services so suddenly.”
But these dire predictions, she says, are not set in stone. The fight against HIV/AIDS can get back on track if the international community, including Canada, steps up.
Canada should lead the way, doctors say
In February, the U.S. abruptly severed ties with UNAIDS effectively halting two-thirds of all international financing for HIV prevention in low- and middle-income countries.
The latest report from UNAIDS — AIDS, Crisis and the Power to Transform — outlines how many of the countries impacted by those cuts have responded by increasing their own domestic HIV/AIDS treatment budgets and folding what was once the work of global charities into their local health-care systems.
“They’re all finding innovative ways of plugging the hole, but the hole is big,” Byanyima said. “Let’s not make mistakes about it. We do need all the countries of the world to maintain their support to fight and end this disease.”
Public health experts in this country say Canada should lead the way.
Dr. Eric Arts is the Canada Research Chair in viral control at Western University in London, Ont., where he also heads up the school’s partnership with the Joint Clinical Research Centre, a Ugandan research institute and health clinic.
Through that work, he’s seen first-hand the impact of the U.S. funding freeze: Mass layoffs, financial uncertainty, patients stopping and starting their treatment haphazardly based on the whims of faraway bureaucrats.
Still, he says it’s time to look inward, not outward.
“There’s always too much emphasis on blaming the U.S.,” Arts told CBC. “I mean, yes, they’re the root of the problem now. But we have a solution. And the solution is easy.”
Canada, he says, should double its funding to the Global Fund — the international organization that distributes funds worldwide to combat HIV, tuberculosis and malaria — and push other G7 countries to do the same.
In 2022, Canada increased Global Fund contributions by 30 per cent, pledged $1.21 billion for 2023 to 2025. But it’s still a drop in the bucket compared to the roughly $8 bllion the U.S. pledged at the same time, and which is unlikely to be renewed.
Dr. Julio Montaner, who is the physician-in-chief for the B.C. Centre for Excellence in HIV/AIDS, says that he is dumbfounded and devastated by the U.S. administration’s decision to cut funding for the U.S. Agency for International Development (USAID). Montaner says the decision will lead to a significant uptick in HIV cases across the globe.
‘An act of criminal negligence’
Dr. Julio Montaner, executive director of the B.C. Centre for Excellence in HIV/AIDS, agrees. He was one of the people who helped develop the multi-drug cocktail of antiretrovirals that have become the gold standard for HIV treatment, and he helped establish the criteria the UN uses for its 2030 target.
For a long time, he says, that “made in Canada” strategy was working worldwide. Fewer people were contracting HIV, and thanks to antiretrovirals, people living with HIV were not transmitting it.
A huge part of that, he says, was because of the funding from the President’s Emergency Plan for Aids Relief (PEPFAR), which has financed about 70 per cent of the global AIDS response since it was founded in 2003 by former president George W. Bush.
PEPFAR is also on the U.S. chopping block.
“Walking away from that commitment on a short notice and without a plan is an act of criminal negligence,” Montaner said.
“I demand that my country actually raises the flag and demonstrates that we can do it in Canada, and support the world. Because, in four years, the Americans are going to wake up. And if we don’t cover for the absence, the world is going to be much, much worse than it is today.”
Trump himself has called on other countries to pick up the slack from his cuts, which he described as “devastating.”
“The United States always gets the request for money,” he said in May. “Nobody else helps.”
A global disease needs a global solution: UN director
It’s not solely a matter of helping people in other countries, says Arts.
“If Canada or any other G7 country or G20 country thinks that we can do this and not have it reach our borders, then they’re crazy,” he said. “This will be another global pandemic if we can’t, we don’t, provide treatment.”
Global Affairs Canada was unable to respond to a request for comment before deadline.
Byanyima, meanwhile, is currently in South Africa, which she says has boosted its domestic budget for HIV/AIDS prevention and treatment in the face of U.S. cuts, and is working to establish a chronic medicine dispensing and distribution system.
Seeing that response, she says, gives her hope. But it’s not enough.
“This is a global disease. It is not a disease of one country,” she said. “A global problem needs a global solution.”