Noise, not need, grabbing health aid dollars

HIV/AIDS is the world's most high profile disease. “World AIDS Day” garners an astonishing 32.3 million hits on Google. According to a 2007 poll conducted by the Kaiser Family Foundation, people questioned in eight out of ten sub-Saharan African countries consider AIDS to be their country's number one health priority. The same poll shows people in Asia also believe HIV should be a major priority for their governments, with those in India and Bangladesh putting it at the top.

In fact, HIV/AIDS causes only 5.7% of deaths in developing countries. Only eight countries have a severe AIDS crisis, all in sub-Saharan Africa. In India, the prevalence rate is a tiny 0.3%. Chinese respondents put it as the third-highest priority yet prevalence is 0.1% — a lot of people but is by no means a national emergency.

That HIV/AIDS is at the front of many peoples' consciousness is a result of decades of campaigning by international AIDS activists, perhaps the best organized and most powerful health lobby the world has ever seen. A staggering 24,000 delegates, many of them professional campaigners, attended 2008's biannual International AIDS conference in Mexico City—and that's just the ones who could afford the airfare and the US$1,200 entry fee.

Since the early 1990s, thousands of AIDS NGOs have sprung up all over the world, producing a constant stream of publicity and advocacy, holding public meetings and thrusting themselves in front of politicians. Major development pressure groups such as Oxfam and Save the Children have put AIDS at the heart of their lobbying. Big Western multinational companies have got in on the act too, most notably the “Red” campaign backed by Gap, American Express, Apple and Starbucks, among others.

As a result of this lobbying, the cash has poured in. AIDS spending rose from 3.4% of all health aid to developing countries in 1990 to 23.3% in 2007, from US$0.2bn to US$5.1 billion. President Barack Obama has pledged to increase spending on AIDS to 70% of all U.S. global health spending in 2010: USUS$8.6 billion, totaling USUS$63 billion over six years. AIDS also has the dubious distinction of being the only disease to have its dedicated U.N. agency, UNAIDS.

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