Obies’ Global AIDS response to State of the Union

To the Editors:

In President Bush’s State of the Union address on January 28, 2003, he recognized the moral urgency of the global AIDS epidemic, and he began the process of matching that urgency with real money and action. For the Student Global AIDS Campaign’s vision of a world free from AIDS to be realized, President Bush’s plan must be made concrete. In finalizing the details of his plan, he must consider the following elements of a comprehensive response. Should his budget not contain these elements, the Congress must heed the spirit of his pledge by expanding his proposal to include them.
President Bush’s plan includes funding to address AIDS in twelve African countries and two states in the Caribbean. The Sub-Saharan Africa alone includes 48 nations-including some, like Malawi and Cameroon, with already-devastating and expanding AIDS epidemics. Moreover, AIDS is raging beyond Africa. The fastest-growing epidemics are now in Russia, India and China, where they could threaten tens of millions of lives in the coming decades.
Effective AIDS plans and programs exist that are capable of absorbing major increases in funds. If, as the preliminary outline of the President’s plan suggests, only two billion is made available in 2004, then a vital opportunity will be lost forever. By appropriating $3.5 billion in 2004, and channeling at least $2.2 billion of this to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (nearly a quarter of which is urgently needed to cover the shortfall from insufficient funding in 2003), the President can demonstrate conviction behind his words. Furthermore, Bush must stand by his promise that two thirds of the commitment represents new money; it must not be taken from child survival programs, the Millennium Challenge Account, or other existing (and desperately needed) initiatives. The President has already slashed funding for core child survival programs by 62 million dollars from FY2002 levels. Such programs represent easy interventions that could save millions of children each year.
The Global Fund to Fight AIDS, Tuberculosis and Malaria represents the world’s best hope to control the world’s leading infectious killers. By funding plans created by recipient countries themselves, the Fund ensures that money goes where it will do the greatest good. The Bush Administration publicly endorses the Fund: it provided the Fund’s first donation, describes it as “up, operational, and effective,” and recently secured a position for Secretary of Health and Human Services Tommy Thompson as the Fund’s chair.
However, the United States’ total contribution to date of $500 million over two years still lags behind Europe’s contribution of $1.2 billion-even though the U.S. economy is larger than all Europe’s combined. Because of the flood of sound proposals from countries facing health crises, the Fund’s Executive Director has called for the United States to donate $2.5 to $3 billion to the Fund this year.
The current draft of the President’s plan allocates 10 percent of the new money to the Global Fund-only $0.2 billion per year for the next five years. If these numbers are not multiplied significantly, urgently needed resources will be denied and the Global Fund will be bankrupted within three years of its creation. The world cannot afford such a failure. The Global Fund represents a revolutionary approach to foreign aid: it demands results for its money, it safeguards against loss of funds to corruption, it uses a streamlined structure to reduce the cost of delivering programs and it leverages contributions from other nations for every dollar contributed by the United States. Moreover, its multilateral system ensures that donors and recipients cooperate to avoid duplicating one another’s efforts-joining to fight AIDS, rather than competing for scarce money. The Global Fund gives voice to young people and other members of key communities in the creation and implementation of projects, and ensures that money reaches the ground. The Global Fund warrants at least $2.2 billion in FYA 2004 as U.S. fair share contribution. Without U.S. leadership the Fund projects that it will not be able to fund new project during its third round of proposals.
Each day, 8,000 deaths mark the world’s failure to extend access to treatment to all. Yet as President Bush noted, the drop in prices of antiretroviral medicines fundamentally alters our ability to respond to AIDS, and new formulations make it easier to comply with treatment regimens. By ensuring that no policy impedes the rights of countries to produce, import, or export low-cost generic versions of these drugs, the United States can pave the road to changing AIDS from a death sentence.
Half of all new HIV infections occur among young people and, increasingly, children are forced to lead households and take care of siblings as their parents die. At the same time, despite new responsibilities and burdens, youth are fighting back against the pandemic with extraordinary courage. Thousands of scientists around the world have worked hand in hand with youth and other AIDS-affected communities to create and document effective prevention programs. These initiatives have turned around the AIDS epidemics in countries such as Brazil, Thailand and Senegal, saving thousands of lives. Lessons drawn from these models are needed for a serious response to the spread of HIV. President Bush’s plan must support science - based, comprehensive approaches to HIV prevention. Domestic politics must not interfere with the rights of affected communities to be enlisted as partners in prevention, given access to condoms and instructions in their use, and made fully aware of their sexual rights.
In 2001, African governments paid $14.6 billion in debt service payments to the IMF, the World Bank and wealthy creditors. These re-payments continue to drain resources from already tight budgets and in many cases force countries to pay more for debt servicing than on health care for their people.
The administration must support full debt cancellation as a means to increase the capacity of African, Caribbean, and other developing-country governments to mount an effective response to fight HIV/AIDS. In line with the recommendations of the Jubilee USA network, debt cancellation must not be conditioned on harmful structural adjustment programs.

—Noah Heller
College senior