This story appeared in the Boston Globe

Thirty years after AIDS made its deadly debut, a future without the disease is finally within reach. One of the biggest scientific breakthroughs of 2011 was the discovery that antiretroviral drugs don’t just prolong the lives of people with HIV, the virus that causes AIDS; they also render infected people virtually non-contagious. Putting people on these life-saving medicines early enough could effectively end the spread of HIV.

But just as science is on the verge of winning the battle, financial resources and political will are flagging. 2010 was the first year that HIV/AIDS funding around the world decreased, according to the Kaiser Family Foundation.

The Swiss-based Global Fund to Fight AIDS, Tuberculosis and Malaria – which supports 3 million people with HIV drugs – is so cash-strapped that it won’t provide any new grants until 2014. Due to the European financial crisis, Italy and Spain – once important donors – haven’t met their pledges. The fund has been forced to ask middle-income countries – including China, Brazil, and Mexico – to fend for themselves.

In the United States, the situation is slightly better, at least on the financial front. Congress cut funding for the President’s Emergency Plan for AIDS Relief by 2 percent – disappointing, but hardly the crushing blow that AIDS activists feared. The United States still plans to spend $4.5 billion on global AIDS relief, a pool of money that funds antiretroviral drugs for 4 million people in the developing world, at a cost of about $350 per person per year. President Obama announced last month that the United States would set a goal of providing drugs to an addition two million people, even if funding remains flat. Efficiencies – such as sending the drugs by boat rather than planes – have already allowed the United States to meet prior targets ahead of schedule.

Far more disturbing than the slight reduction in funds is a stipulation that Congress attached to the money: None can be spent on needle exchange programs. At a time when the global public health establishment is looking for proven, cost-effective ways to fight the spread of HIV, ideologically motivated limitations like this unnecessarily tie their hands. That mandate could be a death sentence for people in Ukraine and Vietnam, where the AIDS rate is fueled by intravenous drug use.