In the two decades since AIDS began sweeping the globe, it has often been labelled as the biggest threat to international health.

But with revised numbers published last year downsizing the pandemic  — along with an admission that AIDS peaked in the late 1990s — some AIDS experts are now wondering if it might be wise to shift some of the billions of dollars of AIDS money to basic health problems like clean water, family planning or diarrhea.

Some experts want to divert AIDS money to clean water, family planning or diarrhea treatments in places like this slum in Soweto, South Africa, which is lacking basic health needs.
(CBC)

"If we look at the data objectively, we are spending too much on AIDS," said Dr. Malcolm Potts, an AIDS expert at the University of California in Berkeley, who once worked with prostitutes in Ghana.

Problems like malnutrition, pneumonia and malaria kill more children in Africa than AIDS, he said.

"We are programmed to react quickly to small children with AIDS in distress," Potts said. "Unfortunately, we don't have that same reaction when looking at statistics that tell us what we should be spending on."

The world invests about $8 billion US to $10 billion US into AIDS every year, more than 100 times what it spends on clean water projects in developing countries.

Yet more than two billion people do not have access to adequate sanitation, and about one billion lack clean water.

In a recent series in The Lancet, experts wrote that more than one-third of child deaths and 11 per cent of the total disease burden worldwide are due to mothers and children not getting enough to eat — or not getting enough nutritional food.

"We have a system in public health where the loudest voice gets the most money," said Dr. Richard Horton, editor of The Lancet. "AIDS has grossly distorted our limited budget."

AIDS activists say progress would be lost

But some AIDS experts argue that cutting back on fighting HIV would be dangerous.

"We cannot let the pendulum swing back to a time when we didn't spend a lot on AIDS," said Dr. Kevin De Cock, director of the AIDS department at the World Health Organization. "We now have millions of people on treatment and we can't just stop that."

Still, De Cock once worked on AIDS projects in Kenya, his office just above a large slum.

"It did feel a bit peculiar to be investing so much money into anti-retrovirals while the people there were dealing with huge problems like water and sanitation," De Cock said.

Part of the issue is advocacy. From celebrity ambassadors to red ribbons, other diseases have been left by the wayside.

"No one is beating the drum for basic health problems," said Daniel Halperin, an AIDS expert at the Harvard University's School of Public Health.

Aside from southern Africa, most of the continent has relatively low rates of HIV, and much higher rates of easily treatable diseases like diarrhea and respiratory illnesses. Yet much of the money from the West, especially from the United States, goes into AIDS.

President George W. Bush has requested another $30 billion US for the next five years for AIDS, mostly to be spent in Africa, and the leading Democratic candidates have proposed that figure be bumped up to $50 billion US.

In comparison, the President's Malaria Initiative, launched in 2005, aims to reduce malaria deaths by half in 15 African countries. Its five-year budget is an estimated $1.2 billion US.