Celebrity campaigns hide the real problems

Although AIDS only accounts for 5 per cent of deaths in low and middle income countries, it receives about 25 per cent of all international healthcare aid, as well as a good portion of domestic spending.  This is not enough, according to Carla Bruni, who is spearheading a big NGO-backed campaign designed to raise more tax money for the disease. 

Ms Bruni has authored a series of opinion articles currently appearing in the international media which rehearse the NGO talking points that are familiar to anyone who follows global health: Hundreds and thousands of patients currently on AIDS treatment will die if governments take their foot off the funding accelerator and that mother-to-child transmission can be eliminated if enough money is spent.

Despite the rhetoric, this is not necessarily the best way to spend the scarce resources available for global health.  Many more children die from easily preventable conditions caused by dirty water and insanitary living conditions than AIDS.  Thousands of women die from complications related to childbirth and pregnancy. The age-old scourge of tuberculosis is making a major comeback.  And many of the poorest countries are now starting to suffer widely from chronic conditions such as cancer and heart disease.

“I am lending my voice to women and children in particular because, in many parts of the world, their voices are the softest,” Ms Bruni tells us. Maybe so, but why single out this particular disease when money might save many more lives if spent on improving primary healthcare, thereby increasing access to the basic vaccinations, antibiotics and treatments which are so often lacking?

The AIDS industry has a powerful lobby, and has always been able to call on major cultural and political figures to back its cause. The tragedy of AIDS is not in doubt and it remains a serious problem in a handful of southern African countries. But it is time to integrate AIDS treatment into wider health system improvement rather than treating it as a special case.  The thousands of children who needlessly die of pneumonia and diarrhoea each year – who can’t call on the star power of Ms Bruni et al – depend upon it.