Bill Gates. Picture: EPA/FACUNDO ARRIZABALAGA
Bill Gates. Picture: EPA/FACUNDO ARRIZABALAGA

Potential cuts to foreign aid threaten the world’s chances of ending poverty and eradicating diseases by 2030, with particularly dire consequences for Africa’s HIV/AIDS efforts, Microsoft founder Bill Gates has warned ahead of the upcoming UN General Assembly in New York.

A 10% cut in funding for HIV/AIDS could lead to the deaths of 5.6-million people by 2030, he said ahead of Wednesday’s release of a report from his philanthropic foundation on how the world is progressing towards 18 of the health and poverty-related targets set out in the Sustainable Development Goals (SDGs).

South African officials are anxiously watching to see whether US president Donald Trump’s proposed budget cuts to foreign aid are passed by Congress, as such a move could reduce both the bilateral and indirect support that it provides to South African HIV/AIDS programmes.

SA is also vulnerable to a reduction in other countries’ contributions to international agencies such as The Global Fund to Fight AIDS, Tuberculosis and Malaria.

The US is the world’s biggest contributor to the global fight against HIV/AIDS, and in 2016 contributed $4.9bn through bilateral programmes and international efforts. Trump’s proposed 2018 budget would shave almost $1bn off the US contribution to the figure, including a $222m cut to its contribution to the Global Fund.

"The world really did step up … with an incredible level of generosity, which has meant that AIDS-related deaths have fallen by almost half since the peak in 2005. This commitment to get the drugs to be cheaper and get them out to everybody has made a huge difference. But … we see countries that are considering possible funding cuts," said Gates.

Such cuts would be a big setback to Africa, which is poised for a large increase in the number of people aged between 16 and 24 years, the population most at risk of getting HIV, he said.

Gates said he thought it unlikely that the US Congress would approve Donald Trump’s proposed budget cuts. But in the report, he and his wife, Melinda Gates, expressed concern that shifting priorities could lead the world to waver in its commitments, risking back-sliding on the progress that has been made to cut deaths and improve people’s health and wellbeing.

"This report comes at a time when there is more doubt than usual about the world’s commitment to development. Take it from the point of view of justice, or take it from the point of view of creating a secure and stable world: development deserves our attention," they wrote.

The Bill and Melinda Gates Foundation commissioned the US Institute for Health Metrics and Evaluation to project the likely range of outcomes for selected SDG indicators. It found that the world was on the right track when it came to combating child mortality: 6-million fewer children died in 2016 than in 1990, and if efforts continue at the current pace, the number of children under five years old who die each year could halve, by 2030.

However, progress in tackling malaria deaths looked less promising, unless there were significant new innovations, it warned. It also looked at the effects of missing the SDG targets, and the gains that would be made if they were exceeded.

The Goalkeepers Report is to be released every year until 2030 to coincide with the UN Special Assembly, to hold world leaders to account on progress towards the SDGs, the foundation said.

The report not only showed where the world was falling short, but also highlighted success stories such as Ethiopia’s progress in cutting maternal deaths by getting more women to deliver their babies in health facilities, and Senegal’s work to increase the use of modern contraceptives.

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