Site Presented By
Saturday, Jul 11, 2009
President Bush claims he is leading the world in the fight against global AIDS. But he has been inexplicably stingy and slow to act -- and by placing religion over science, he's responsible for the loss of untold numbers of lives.
Jun 2, 2005 | When President Bush introduced his global AIDS initiative in January 2003 -- "a work of mercy beyond all current international efforts," he called it -- the plan certainly sounded promising. Bush pledged to spend $15 billion over five years to provide life-saving drugs to at least 2 million people with HIV, prevent 7 million new infections, and care for the sick and orphaned in 15 countries. Most of the money would go to sub-Saharan Africa, home to the majority of the world's nearly 40 million people living with HIV and AIDS. "I believe God has called us into action," Bush declared during a trip to Uganda in 2003. "We are a great nation. We're a wealthy nation. We have a responsibility to help a neighbor in need, a brother and sister in crisis."
Dubbed the President's Emergency Plan for AIDS Relief, or PEPFAR, the agenda provided the administration with much-needed P.R. at the very moment it was preparing to defy international will by invading Iraq. But from the start, Bush has been inexplicably stingy and mind-bogglingly slow to act.
Despite rhetoric about our moral duty to fight AIDS -- Bush has likened PEPFAR to the Marshall Plan, the Berlin airlift, and the Peace Corps -- the president has not committed the funds necessary to meaningfully tackle the crisis and even opposed attempts in Congress to fully fund his initiative. And much of the money Bush has provided is being derailed into moralistic and unproven programs that make abstinence the centerpiece of HIV prevention. Few Americans realize that the money flowing into disease-ravaged locales is being diverted to serve a right-wing political agenda -- at the cost of untold numbers of lives.
Bush requested only $2 billion for PEPFAR in its first year, at least a billion less than one might have expected, given his pledge. Then, when Congress decided to approve $400 million more than the president asked for, Bush unsuccessfully fought to block the increase. By the time the plan was fully implemented, nearly a year and a half had passed since the president had announced it -- a costly delay in fighting an epidemic that claims 8,500 lives every day.
As of this month, PEPFAR is expected to provide anti-retroviral treatment for an estimated 200,000 people, mainly in sub-Saharan Africa. "I think those numbers are cause for encouragement and optimism," Bush's global AIDS czar, Ambassador Randall Tobias, told me recently. "I think there's reason to believe this can be done." But in a region where 25.4 million people living with HIV are desperate for treatment, it's difficult to feel elated about our progress -- or our commitment.
Tobias, a former CEO of Eli Lilly and Co., has found himself under international fire as Bush's AIDS emissary. Last year, Tobias was booed at the International AIDS Conference in Bangkok by protesters carrying signs that read: "He's lying." And as a former pharmaceutical executive, he's taken heat for the administration's insistence on relying on brand-name AIDS drugs instead of generics that are two to four times cheaper. "There comes a moment in time," says Stephen Lewis, the U.N. secretary-general's special envoy for HIV/AIDS in Africa, "when you stop bowing to Big Pharma and recognize that the human imperative at stake of keeping people alive requires that we embrace low-cost generics because we can treat so many more people." Lewis rejects the administration's argument that generics are less safe and effective than brand-name drugs. "Everyone understands that the position which is taken [by the U.S. government] significantly supports major pharmaceutical companies," he said.
As it stands, what we're doing barely factors into the disease's devastating arithmetic. Twelve million people died of AIDS in Bush's first term. "Bush's initiative is going slow," says Dr. Paul Zeitz, executive director of Global AIDS Alliance. "We're not coming near meeting the need or what is possible. If I were Ambassador Tobias, I wouldn't be defending this current framework. I'd be going back to the president and saying: I know we have a role to play. Why not ramp this up so we can stop the dying?"
The truth is, we are doing something, but not nearly what we could be doing. Although other priorities dwarf Bush's AIDS program -- $136 billion in new corporate tax breaks, for example -- the United States is the largest single donor to the global AIDS fight. But it would be a tremendous embarrassment if we weren't: The United States accounts for one-third of the global GDP.
The administration insists it will meet its goals by 2008, saying it planned all along to gradually "ramp up" the program. This year, the United States is spending $2.8 billion on PEPFAR, and Bush has asked for $3.2 billion in 2006. But public-health experts say it looks increasingly unlikely that Bush will fulfill his promise of $15 billion over five years -- and that even if he does, the money will fall far short of what is needed.
According to UNAIDS, a partnership involving the World Bank and nine other international aid groups, the world needs to spend $20 billion a year by 2007 to wage an effective war against AIDS. What Bush proposes to spend annually, if funding remains constant, is less than half the $6.6 billion that America would be expected to contribute based on the size of its economy. "The fact that the United States can spend $300 billion on the wars in Iraq and Afghanistan but cannot find a relative pittance to rescue the human condition in Africa -- there is something profoundly out of whack about that," Lewis says.
