Doctors alarmed by cut in Aids funding

Cuts in Aids and HIV funding in Britain could lead to a dramatic rise in cases, with the work done in containing the epidemic lost, the British Medical Association warned yesterday.

The Government's decision to impose a 7.7 per cent cut in funding for Aids treatment, care and prevention while caseloads are expected to go up by 5.9 per cent would wreck an area of the National Health Service which had been "dramatically successful" the BMA's chairman Dr Sandy Macara said, describing it as "Alice in Blunderland" thinking.

The cut of pounds 10m comes at a time when new combination drug therapy is being introduced at an estimated cost of pounds 15-20m per year. PACT (the National Association of providers of Aids care and treatment) said the effect would be to undermine the care of patients, create inequality in treatment, reduce the availability of proven therapies and the help given to those at highest risk, such as prostitutes.

Treatment of other sexually transmitted diseases (STDs) could also be threatened and more pressure created elsewhere in the health service, for example on doctors treating conditions associated with Aids, such as pneumonia.

Professor Anthony Pinching, chairman of PACT, said yesterday: "I think there is a genuine risk that we will lose the containment [of Aids]." He said there were almost 20 million cases of HIV infection worldwide, and the epidemic was growing. He said the funding cut had been worked out on the basis that the projected Aids caseload was not as bad as previously estimated. The current projection is that there will be 3,690 cases of people living with Aids by the end of 1996 compared with a previous estimate of 4,130, and about the same number with severe HIV disease.

Professor Pinching claimed the real workload was still increasing by between 6 and 12 per cent. "We are being asked to do more for less," he said. "We do not think it is possible."

Professor Michael Adler, an epidemiologist and member of PACT, added: "Services are going to have to be cut, compromised or scaled down."

The move would have a "very profound effect" on Britain's ability to control the spread of HIV infection, he warned. He said that in London, where there is a concentration of Aids care, two centres were not replacing staff as a result of the cuts. One had also made redundancies.

But the Department of Health challenged PACT's figures, insisting that according to latest figures numbers of people with Aids and severe HIV infection in England and Wales were projected to fall by 10.6 per cent in 1996, and 8.2 per cent in 1997.

"Our money is given on the basis of projected cases. That is sensible because it means money can be used for other services," a spokesman said. "We have provided pounds 185m for the cost of treatment and care this year plus another pounds 51m for prevention."