A Call to Action on World AIDS

This past Monday was World AIDS Day, a day to reflect upon the shameful inadequacy of our response to the greatest crisis of our time. This year alone, AIDS killed three million people, and five million more became infected with HIV—new records, both. Prevention efforts are falling far short; AIDS continues to spread unchecked through much of sub-Saharan Africa, and infection rates are rising at alarming speeds in countries such as Russia, India and China. Life-prolonging anti-retroviral drugs are all but unknown throughout most of the globe; in sub-Saharan Africa, treatment is inaccessible for more than 99 percent of those in need. A recent United Nations press release put the matter bluntly: “The global AIDS epidemic shows no sign of abating.” The worst is still to come.

Yet despite the enormity of the challenge, the odds are by no means insurmountable. There is much that can and must be done. Effective prevention models exist, but they must be expanded; potent treatments have been developed, but they must be made universally accessible. We have the know-how, and we have the resources. We are losing the fight against global AIDS for want of political will.

But you wouldn’t know it to listen to the Bush administration’s self-congratulatory rhetoric. In his last State of the Union address, President Bush announced a five-year, $15 billion initiative, marking a significant increase in U.S. AIDS spending. The initiative was a step in the right direction, and it received some deserved praise from AIDS advocates. Eager to make it a centerpiece of his “compassionate conservative” agenda, President Bush lauds the initiative every chance he gets. In his recent World AIDS Day Proclamation he called it a “work of mercy [that] will help overcome fear, stigma, and discrimination and create a cycle of hope and promise that will benefit millions.”

There’s only one problem; no sooner did Bush announce his initiative than he set about undercutting it. In his 2004 budget, he requested only $2 billion for global AIDS, $1 billion less than was authorized. While it now appears that the U.S. will spend $2.4 billion on AIDS next year, getting that extra $400 million required congressional Republicans—like Rep. Jim Kolbe, R-Ariz.—to break ranks with the administration. Indeed, since July, the White House’s Deputy Global AIDS Coordinator has written to Congress at least three times to try to hold them to the president’s $2 billion figure. To justify its strategy of slowly “ramping up” funding levels, the administration has argued that additional funds cannot be effectively spent at this time. But the fact is that they can, and the White House knows it. With thousands dying every day, the president’s dawdling is unacceptable. As Bush himself remarked last May: “Time is not on our side. Every day of delay means 8,000 more AIDS deaths in Africa and 14,000 more infections.” Bush actually overstates the case; Africa suffers closer to 6,300 AIDS deaths per day, with 8,700 new infections. But I think the point still stands.

One organization that is in desperate need of additional U.S. dollars is the Global Fund to Fight AIDS, Tuberculosis and Malaria, a highly efficient multilateral institution that funds grant proposals from countries afflicted with heavy disease burdens. Congress authorized $1 billion for the Global Fund in 2004, but will likely spend only $550 million—the Bush initiative is calling for just $200 million per year. The Global Fund needs our support now. But the administration is too busy passing the buck. They won’t contribute more, they say, until the European Union (E.U.). does. The E.U. makes the same retort. How convenient. It will take real leadership to break this deadlock; don’t hold your breath.

Even if it were fully funded, the Bush initiative would still be drastically insufficient. Those who continue to crow about Bush’s “unprecedented” commitment to fighting AIDS are sadly misinformed. All nine Democratic presidential candidates have already pledged to support at least $30 billion dollars in global AIDS spending over the next five years—including full funding for the Global Fund—a sum that is double the level of Bush’s initiative, and commensurate with the recommendations of health experts from the World Health Organization and other institutions.

Contrary to what the White House would have you believe, the Bush administration has not committed itself to the fight against global AIDS—far from it. Indeed, the administration’s trade policy exacerbates the epidemic by limiting the accessibility of cheap generic AIDS medications, putting pharmaceutical company profits before the lives of the world’s poorest.

But as President Bush prepares his 2005 budget, he has an opportunity to make some amends. Experts are calling for at least $5.4 billion in AIDS spending. We’ll soon see if the president gets the message.

The AIDS epidemic has put our nation’s values to the test. Next World AIDS Day, let’s be sure we’ve made the grade.

Sasha Post ’05 is a social studies concentrator in Adams House. His column appears on alternate Thursdays.