Thread by @Laurie_Garrett

It's World AIDS Day: time to take stock. Because there is no #HIV #vaccine and women can't compel men to use condoms, people continue to get newly infected. And because the majority of them live in poor parts of the world, the undeclared #pandemic is very expensive.
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2/AIDS
Inside the USA federal spending on HIV/AIDS $7.6 billion/year.
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3/AIDS
Of that, about $780 million goes to the @CDCgov for prevention programs -- and much of that is passed onto the States.
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4/AIDS
The USA spends a nearly equal amount fighting HIV/AIDS overseas, thru @PEPFAR -- funding for which grew from $2.2B in FY 2004 to $7B in FY 2022; includes bilateral HIV efforts + $1.6 billion for multilateral, mainly the @GlobalFund .
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5/AIDS
Hard to guess how much private $ is spent on HIV/AIDS in USA. A 2017 study reckoned >370,000 HIV+ people were in the country; about 7,000 of them died/year. Costs beyond Fedl funds were >$30K/yr/persn: total US burden $10.7B above official nos.
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ncbi.nlm.nih.gov/pmc/articles/P…

6/HIV
Total global spending for HIV/AIDS hit $21.5 billion/year by the end of 2020. @UNAIDS reckoned that needed to top $29 B/yr by 2025. As of today private + govt pledges to @GlobalFund have only reached $15.7billion, spread over the coming 5 years.
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indicatorregistry.unaids.org/export-to-pdf/…

7/HIV
The #Biden administration has asked #Congress to increase funding for #HIV/AIDS, #TB, #malaria and #COVID19 -- at home and abroad. But #Republicans have blocked COVID support, and seem disinclined to up foreign aid for global health, as well.
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whitehouse.gov/briefing-room/…

8/HIV
At least 20 million people worldwide now live, infected with HIV.
In wealthy countries death rates peaked in 1995, at around 16 deaths/100K population/yr -- now below 1.4/100K/yr. We haven't brought deaths down to that level in SS Africa.
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9/HIV
@UNAIDS says the issue is subjugation of women:
“In areas of high #HIV burden, women subjected to intimate partner violence face up to a 50% higher chance of acquiring HIV. Across 33 countries from 2015-2021 only 41% of married women aged 15-24 could make their own..."
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10/HIV
"...decisions on sexual health. The only effective route map to ending AIDS, achieving the sustainable development goals and ensuring health, rights and shared prosperity, is a feminist route map."
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unaids.org/en/resources/p…

11/HIV
And, says @UNAIDS, too many children aren't getting treated for #HIV :
"In 2021, children accounted for only 4% of all people living with HIV but 15% of all AIDS-related deaths. Closing the treatment gap for children will save lives."
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12/HIV
In 2021, @UNAIDS says, 650,000 people died of AIDS & 1.5 million newly acquired #HIV.
“What world leaders need to do is crystal clear. In one word: Equalize. Equalize access to rights, equalize access to services, equalize access to the best science and medicine."
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13/HIV
On this World AIDS Day we need to consider what these #HIV numbers tell us about the future of the #COVID19 #pandemic and the lessons of costs and global inequalities. What will the global sickness, death and financing burdens of COVID be in 2025? 2030? 2040?