Are the USAID and other cuts going to lead to a new AIDS epidemic?

Small news roundup

There have been a flurry of stories recently about how cuts to “HIV” funding might unleash worldwide devastation. We’ll look at three today briefly. I won’t add much commentary; this is just to give you an idea of how, all of a sudden, AIDS is back in the news. What might this mean? Is it an optimistic sign—“them who are they” can no longer ignore the oddities of the HIV AIDS story? (What can I say, I’m a generally optimistic person.)

https://jamanetwork.com/journals/jama/fullarticle/2833406

Since 2015, global foreign aid has provided nearly 40% of HIV-related funding in low- and middle-income countries. With an anticipated 24% reduction in international aid—in addition to the potential discontinuation of the US President’s Emergency Plan for AIDS Relief (PEPFAR)—a modeling study estimates that 4.4 million to 10.8 million additional HIV infections will occur by 2030.

Ah yes, a “modeling study”—we’ve discussed at length the fact that models only output results based upon what you assume to be true—the model must have assumed that pulling funding would result in “more additional infections” and simply quantified it. However, the assumption itself is problematic, as we know.

The impact of the PEPFAR funding freeze on HIV deaths and infections: a mathematical modelling study of seven countries in sub-Saharan Africa

A 90-day funding freeze would result in 60 thousand [95% UI: 49–71 thousand] excess HIV deaths for the Executive order—proportional scenario. This number would increase to 74 thousand excess HIV deaths [95% UI: 63–89 thousand] for the Executive order—realistic scenario. Under a 4-week and 8-week waiver scenario, projected excess HIV deaths ranged between 21 thousand [95% UI: 15–28 thousand] and 28 thousand [95% UI: 22–36 thousand] respectively. Excess new infections ranged between 35 and 103 thousand for the different scenarios.

[…]

The sudden cessation of PEPFAR funding likely results in tens of thousands of HIV deaths and new infections. These losses of life and health should compel the United States government to rapidly and fully re-instate one of the most successful health programs in history.

Once again they are using models. As they say: “We used STDSIM, an established individual-based simulation model, and previously published quantifications for the seven countries.” I would sincerely love to see their actual data.

Doctor: The world should be “very afraid”

However, cuts to HIV treatment and prevention threaten to roll back this progress and endanger the lives and human rights of millions of people around the world. The Independent reports that disruptions in consistent antiretroviral supply may result in emerging resistance to first-line drugs.

This is the first I’ve heard about drug resistance. It’s curious that some of the mainstream sites say it’s OK to go on and off of PrEP (although ideally they’re expected to remain on it forever)—wouldn’t that, according to their own theory, cause a skyrocket in “drug resistance?”

However, the more pressing concern is of people not receiving medication at all. (Emphasis mine) Without antiretroviral medication to suppress the HIV virus to undetectable levels, people will quickly become unwell with preventable opportunistic infections taking advantage of their immunocompromised bodies. Hospitals will see a surge of people with Aids-related conditions that we should no longer see in this age of effective treatment. People being left untreated and with reduced access to testing and prevention tools will mean more transmissions, growing the epidemic.

It’s all just a giant scheme to sell drugs, isn’t it?

What do you think—are we going to see a 1980s style epidemic with cuts to PEPFAR and other “HIV” funding sources?