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WASHINGTON, December 1, 2009—Marking World AIDS Day 2009, the World Bank today urged countries and their development partners to intensify their efforts to prevent new HIV infections to curb the continuing spread of the disease, and reaffirmed its own commitment to fund effective HIV/AIDS prevention, care, and treatment programs in developing countries.
At a high-level World AIDS Day event this morning at Bank headquarters, a new study of HIV-infected adults in Haiti, supported by the Bank, showed that poor nutrition, aggravated by rising food prices, is reducing the effectiveness of life-saving AIDS drugs in adults who are chronically hungry and suffer from weak immune systems as a result.
World Bank Group President Robert B. Zoellick applauded the considerable achievements by countries and development partners in expanding access to HIV prevention, care, and treatment, while also noting the enormous challenges that remain. Preventing new infections, he said, remained vital to reach the Millennium Development Goal of halting and reversing the HIV/AIDS epidemic.
“Intensifying efforts to prevent new infections is essential if we are to ensure that AIDS treatment is sustainable. We have to reach more of those who are at greatest risk of contracting and transmitting HIV. A barrier to all our efforts against this disease is the stigma and discrimination experienced by people with HIV. This has been reduced—but it is not gone by any measure,” Zoellick said in opening remarks to a high-level audience that included the Honorable Jack Lew, U.S. Deputy Secretary of State; Michel Kazatchkine, Executive Director of the Global Fund to Fight HIV/AIDS, TB, and Malaria; and Ambassador Eric Goosby, US Global AIDS Coordinator and Head of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
Zoellick also reaffirmed the Bank’s sustained commitment to funding effective HIV/AIDS programs, and added that an important factor that has hindered progress on HIV has been the lack of food security,“because when people do not have enough food to eat, treatment is less effective.”
Reinforcing the links between nutrition and effective AIDS treatment, the new Haiti report shows that hunger further weakens the immune systems of HIV-infected adults and undermines the effectiveness of their life-saving AIDS treatment.
Dr. Bill Pape, who is Executive Director of Haiti’s GHESKIO Centers and Professor of Medicine at Cornell University’s Weill Medical College, said that the risk of developing AIDS and/or dying could increase by 36 percent in HIV-infected people with high levels of hunger and poor nutrition as compared to other infected adults with enough nutritious food. The new study, part of a larger research program by Cornell University, the Weill Medical College of Cornell University, and Haiti’s GHESKIO Centers, provides the first-ever clinical evidence linking hunger to immune dysfunction and lower numbers of white blood cells, showing the combined impact of poverty and hunger on people living with HIV.
Haiti, Afghanistan, and Somalia have the worst daily caloric deficit per person (460 kcal/day) in the world. With 56 percent of Haitians living on less than US$1 per day, many cannot afford to eat and malnutrition is widespread. Pape said that low baseline weight is an independent predictor of mortality in adult AIDS patients receiving antiretroviral treatment. Studies from Haiti and other countries also show that anemia is strongly associated with rapid HIV disease progression and death.
World Bank and HIV/AIDS
For its part, the World Bank has provided long-term support to countries since the mid-1980s for effective prevention of new HIV infections, care and treatment for infected people, and alleviation of the devastating social and economic consequences for affected families and communities. Over the past three years, the Bank has committed almost US$1 billion through grants, loans, and credits to HIV programs. Total Bank financing for HIV/AIDS since 1988 is more than US$4.2 billion. The Multi-Country HIV/AIDS Program (MAP) for Africa has made available US$1.9 billion to 35 countries, including five sub-regional (multi-country) initiatives.
The expansion of AIDS treatment in poor countries also has thrown a spotlight on the weak and fragile state of their health systems. With just over five years left for countries to achieve the Millennium Development Goals, the Bank and its development partners have mobilized to spur better health results through stronger health systems. Countries need better health systems to deliver more effective HIV/AIDS prevention, care, and treatment services; better detection and treatment of TB and other opportunistic infections; and better health services—including for pregnant women and to enable more women to deliver their infants safely, helped by skilled attendants.
To learn more about the World Bank Group’s development response to HIV/AIDS and to view Dr. Bill Pape’s new Haiti study, please click here.