Across the pond, pundits are beginning to speculate what the President-Elect’s cabinet picks will mean for US support for international development, with some pessimistically suggesting that America First may literally translate as America Not Overseas.
In particular, concerns have been voiced about a potential break from the bipartisan consensus that has existed for many years on the need to address HIV. Let us not forget that it was Republican George W Bush who founded the President’s Emergency Plan for AIDS Relief, the largest programme by any nation to combat a single disease internationally which over 13 years has saved millions of lives from HIV and AIDS.
Here too, in the UK, concerns have been raised about our government’s commitment to tackling infectious disease overseas. Only a fortnight ago, Stephen Twigg, Chair of the House of Commons’ International Development Committee, wrote to the Secretary of State for International Development to highlight the need for increased UK political leadership to end the epidemics of HIV and TB.
TB, the world’s leading infectious killer, is responsible for one in three HIV deaths and so it is clear that the deadly duo must be tackled in tandem. Earlier this year, working with international partners, RESULTS UK produced a report setting out concrete steps that are needed from international donors.
In his letter, Mr Twigg rightly commended the new Government on its historic pledge of £1.1 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The Global Fund has an important role to play and the total sum realised from its recent replenishment, at which the UK was the second largest donor, will help save 8 million lives over the next three years.
Indeed, ahead of World AIDS Day, UNAIDS reported that one million more people have access to HIV treatment than in January this year. While this is incredibly welcome, we are far from reaching the Global Goals’ target to end the epidemic by 2030: around 20 million people living with HIV are without access to treatment and 1.1 million people continue to die from AIDS each year.
As Mr Twigg noted in his letter, ‘political and programmatic focus on HIV and TB’ is vital to ensure that the UK - and the US and other international partners - work towards realising the Global Goals’ target they signed up to only last year.
Of course, ensuring access to effective diagnosis and treatment (for example, through the Global Fund or bilateral programmes) is only part of the solution. The theme of this year’s World AIDS Day is prevention and part of that must be investing in the research and development of new vaccines - for no epidemic has been ended without a vaccine. Consecutive UK Governments have recognised this, for example, by investing in public private partnerships, such as IAVI and AERAS, which are working to develop such vaccines.
In 2015 the Conservatives went further by including a manifesto commitment to ‘lead a major new global programme to accelerate the development of vaccines and drugs to eliminate the world’s deadliest infectious diseases’ and, after winning the General Election, followed through with the creation of the Ross Fund - a commitment to spend £1 billion over five years on just that.
Since taking office in July, Secretary of State for International Development Priti Patel has stated that tackling global challenges – including infectious disease – is one of her three major priorities. Confronting the world’s leading infectious killers must be at the forefront of these efforts.
Within the first months of taking office, Ms Patel attended the Global Fund’s replenishment conference and then a special session of the UN General Assembly on Antimicrobial Resistance – another issue that the UK has shown political leadership on and which is pertinent to TB and HIV, with rising levels of drug resistance potentially having devastating human and economic costs in the years to come if left unaddressed.
The UK has been - and can continue to be - a world leader on tackling infectious disease, with consecutive governments demonstrating an appetite to end the epidemics. To realise the ambition, however, this government must display clear political leadership by ensuring others – including the US - remain at the table. Only by working together to ensure access to effective vaccines, diagnosis and treatment, can we end the epidemics for good and keep our promise to the world.