Obama Administration in Retreat on AIDS

By Paul Zeitz

In recent weeks, some of President Obama’s strongest supporters have expressed frustration with his HIV/AIDS policies.  Unless the United States switches course and dramatically increases its funding for the global fight against AIDS, we could lose millions of lives and a generation of progress.

Many AIDS advocates and I have a sinking feeling the HIV/AIDS strategy in the Obama White House is not getting significant senior-level attention.  By contrast, I know that the AIDS crisis merited direct Presidential involvement during the Clinton and Bush administrations.


How times have changed.

In 2008, then-Sen. Obama voted in favor of spending $48 billion over 5 years on the global fight against HIV/AIDS. On the presidential campaign trail that same year, Obama made his position clear: If elected, he would “provide at least $50 billion by 2013 for the global fight against HIV/AIDS.”

There is little to explain the shift in President Obama’s priorities. But the shift is clear. The White House has fallen short in following through on its funding promises.

Take the White House’s own program, the President’s Emergency Plan for AIDS Relief (PEPFAR). Created in 2003, PEPFAR has provided $33 billion in funding thus far, making it the largest effort in history by a single nation to combat a single disease.

PEPFAR is one of the indisputable successes of the past decade, and President Obama pledged to increase funding for the program by $1 billion annually if elected. Last year, though, the White House recommended virtually no increase in funding — $6.7 billion, up from $6.6 billion. As it now stands, PEPFAR likely will receive only a nominal increase next year.

While campaigning for the presidency, Obama also pledged to dramatically increase America’s support for The Global Fund to Fight AIDS, Tuberculosis and Malaria, an international public-private partnership that’s leading the global fight against these diseases. However, since Obama came into office, U.S. donations to the Global Fund have flat-lined.

If funding remains at these levels, we could lose much of the progress we’ve made in the battle against HIV/AIDS. Marginal increases in funding and symbolic gestures just aren’t enough.

Africa is ground zero in the AIDS crisis. The continent is home to about 90 percent of all HIV-positive patients. But the tide is turning. Over the past 10 years, the number of AIDS cases in 21 out of 25 of the most affected African countries has decreased.

Additionally, modern anti-retroviral therapy (ARV) medicines are extremely effective at preventing parent-to-child HIV transmission. Normally, the risk of an HIV-positive mother passing on the disease to her child is as much as 45 percent. With intervention, that figure drops to below 5 percent. Too many African mothers, though, still don’t have access to these drugs. The disease is needlessly getting passed on to children. In 2008, less than half of all HIV-positive pregnant women in Africa received anti-transmission medication.

Drugs also are more widely available. In 2002, only 50,000 HIV-positive Africans had access to life-saving ARVs. The annual cost of an ARV regimen has fallen to less than $100 per patient from $12,000. An estimated 4 million HIV/AIDS patients now receive ARV treatments worldwide.  The result of this progress? New HIV infections declined by 17 percent from 2001 to 2008, according to a 2010 United Nations report.

Much of this progress is due to the work of PEPFAR and the Global Fund.

Congressional leaders have taken notice of how much ground we’ve gained. After attending the International AIDS Conference in Vienna, Austria, this summer, U.S. Rep. Barbara Lee (D-Calif), along with 100 of her colleagues, sent a letter to President Obama urging him to make a 3-year, $6 billion commitment to the Global Fund. A pledge of that size will allow the international community to build on the successes of the past and provide even more patients with the AIDS medications they desperately need.

Early next month, the Global Fund will meet at the U.N. headquarters in New York at which donor nations will make their financial pledges. President Obama will have an important opportunity to prove to his allies, detractors and the world community that AIDS funding is still a priority in America. He needs to take the opportunity to revise the White House’s position, and increase our country’s commitment to the fight against one of the world’s most devastating diseases.

Paul Zeitz is the executive director of the Global AIDS Alliance.

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