President Obama Must Not Withdraw From The War On AIDS

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By His Excellency Festus Mogae

Imagine if one in four Americans were living with HIV. That’s roughly the percentage of adults in Botswana who are infected with the disease.

Most HIV-positive people, of course, don’t live in the United States. About 97 percent live in developing regions, like Sub-Saharan Africa where AIDS is the leading cause of death of adults.

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They may not be American citizens, but they desperately need America’s help. Unfortunately, the Obama administration seems to be pulling back from the fight against AIDS at the very moment when the world has demonstrated what it is possible to achieve in this fight.

Africa is at a crossroads with AIDS-we can finish the job and win this fight with US support. But if US leadership wanes at this critical moment, we will see progress erode, an increase in preventable deaths and a return to the social and economic devastation of past decades.

AIDS has already killed more than 25 million people. Although AIDS has been converted from a killer disease to a chronic one in many of our African countries, for those without access to antiretroviral drugs, HIV/AIDS is too often a death sentence. In Botswana, an estimated 57,000 children have been orphaned by AIDS of which 49,400 have been registered.

The good news is that the distribution channels and public health wherewithal to defeat this disease exist-Botswana helped pioneer the provision of antiretroviral treatment in Africa, starting its national treatment program in 2002.

Now, across the developing world, more than five million individuals with HIV/AIDS have seen their lives transformed by the availability of treatment.  Drugs that once cost $12,000 per year can now be purchased for less than $100.  As drug prices have dropped precipitously, every dollar invested can have even greater impact.

In Botswana alone, roughly 151,695 people living with HIV/AIDS now have access to life-saving drugs, and our national goal of achieving universal access has come close to being achieved. 96 out of 100 Botswana infants born to HIV-positive mothers are now born AIDS-free.

A major catalyst for this success has been America’s ongoing leadership and generous investment.

In 2003, President Bush – with support from Republicans and Democrats alike – announced a plan to dramatically increase American efforts to fight AIDS across the globe. The US President’s Emergency Plan for AIDS Relief (PEPFAR) was a critical partner in Botswana’s AIDS treatment scale-up, as well as prevention efforts and the fight against tuberculosis, the biggest killer of people with AIDS.

As a key component of its AIDS initiative, the United States made a founding investment in the Global Fund to Fight AIDS, Tuberculosis and Malaria, an innovative organization that has helped massively scale up countries’ responses to the three diseases.  The Global Fund not only finances programs, but it also helps catalyze sustainable investments from governments in affected countries.

In just eight years, the Global Fund has allocated $18 billion in grants for health programs in 144 countries. Today, the Fund is responsible for one-fourth of global spending to combat AIDS and two-thirds of external financing for TB and malaria. A critical portion of that investment comes from the US.

I know that President Obama believes in these programs. While campaigning in 2008, he promised that, if elected, he would provide at least $50 billion by 2013 to fight AIDS globally, and fully fund the Global Fund.

But there remains a large gap between the president’s vision, and his administration’s budget. The president’s budget actually proposed cutting America’s contribution to the Global Fund by $50 million next year at the very time when the Global Fund needs to double its resources to truly reverse the AIDS, TB and malaria epidemics.

For many of the world’s poorest, the budgeting decisions made in Washington mean the difference between life and death.

Health care providers in some African nations have already been forced to turn away new patients. Some find themselves unable to provide medicine, even to those who have been served by long-running programs.

This is no time to retreat. The world is on the cusp of victory against one of its greatest killers.
Experts estimate that a $6 billion, three-year commitment by the United States to the Global Fund could have a domino effect that helps turn the tide against AIDS, as well as TB and malaria. Over 100 members of the U.S. Congress have called for a pledge at this level.

Historically, for every dollar the U.S. donates toward the Global Fund, the world matches with $2. What other investment generates a return of that size?  Africa needs President Obama’s strong leadership on this issue. Re-committing to the global fight against AIDS will encourage other nations to do likewise, and bring life and hope to millions in Africa.

Festus Gontebanye Mogae was the president of Botswana from 1998 to 2008.  He has received the Légion d’honneur from France and in 2008 was awarded the Ibrahim Prize for Achievement in African Leadership.  He is currently Chair of ‘Champions for an HIV-free Generation’ and a spokesman for the ‘Africa Champions for Health’ campaign of Friends of the Global Fund Africa, which encourages greater political and financial commitments of African Heads of State to health within Africa.


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