The White House Council of Economic Advisors last week published the 2005 Economic Report of the President, a 300 page tome discussing the principal economic challenges facing the US. Chapter 7 (of eight chapters) is dedicated exclusively to global HIV / AIDS. It provides a concise portrait of the global epidemic, its economic consequences, and strategies towards prevention and care. While it breaks little new ground, the Report does emphasize new market approaches to encouraging vaccine development, an idea that is receiving increased attention.

While there is full agreement that an AIDS vaccine will be vital in combatting AIDS in the future, there appears to be a shift in approach to vaccine development. Current funding for vaccine research is tightening, while simultaneously many advocates are calling for new "market incentives" to encourage private sector involvement. The United Kingdom, currently heading the G8, has said that advance purchase commitments would be on the agenda in June's meeting in Gleneagles. As background on this issue, the Center for Global Development has published an excellent primer on Advance Markets for Vaccines in two forms: a consultation draft (which will be followed by a full book) and a 3 page brief.

Kudos to the British charity Avert for providing excellent information resouces on global HIV/AIDS. While the web site covers many topics that are well-discussed elsewhere online, it also includes informative sections on US Government programs that are not well-presented on other sites. The PEPFAR page is more detailed than anything provided by PEPFAR itself; it even includes reference to the SCMS program (remember that -- the world's largest AIDS program nobody has ever heard of?). The PEPFAR page also includes an excellent bibliography at the end.

If one searches on "SCMS" on the USAID web site, there are zero citations. Thanks to Avert for helping fill the gaps.

Last week's joint announcement by the major AIDS donors of reaching 700,000 people in developing countries with ARV is a welcome sign of (at least modest) progress in the 3x5 effort. What becomes more confusing is when individual donors start claiming direct credit for subsets of those numbers. For example, PEPFAR claims credit for "support" of treatment of 155,000 people, although that figure includes the entire ARV population of nine countries, despite many of those patients paying privately or receiving ARV prior to PEPFAR. An excellent analysis by Bernard Rivers of Aidspan digs deeper into the claims:

The explanation for these strange figures is that some of the funding provided by PEPFAR does not go to local projects that "put pills in people's mouths."  Instead, it goes to national projects – e.g. training of medical staff, or provision of lab facilities – that PEPFAR believes indirectly benefit all people who are on treatment in that country.  It may be that the Global Fund takes a similar position regarding some of its own grants.

Kudos to donors for increasing ARV. Trying to claim individual credit, however, only diverts attention from important infrastructure and cooperative efforts. In the future they should give ARV totals, describe their own programs, but not try to tease out individual numbers.

How can one help a struggling village in a developing country without actually visiting in person? A new service called Nabuur.com provides a venue in which individual villages list principal needs, and then volunteers from around the globe can organize work groups to assist. A search on "AIDS" lists many needs: a home for AIDS orphans in Kwandengezi, South Africa; education programs for street children in Pune, India; and AIDS refugee issues in Kigoma, Tanzania. Despite the site's sizable ambitions, it does a good job through photos, descriptions and profiles of feeling local and accessible. As the service grows larger, it also offers the potential for significant donor coordination, consistent monitoring & evaluation, and other issues which challenge traditional development efforts.