At the 15th International AIDS Conference in Bangkok, Thailand, the influence of President Bush was felt in powerful ways, but not in a manner that would give hope and comfort to the 6 million people with AIDS throughout the world who are expected to die in the next two years without treatment.
Prior to the opening of the conference, the Bush administration dramatically scaled back the U.S. delegation scheduled to attend. Cancelled were presentations from some of the world's most knowledgeable experts in the field who work for the Centers for Disease Control and the National Institutes of Health.
While critics cite this snub to the AIDS conference as yet another example of the president's go-it-alone handling of the AIDS epidemic, it certainly isn't the most damaging of the administration's actions. That is reserved for its treatment of the Global Fund to Fight AIDS, Tuberculosis and Malaria, the funding mechanism perhaps most essential in the struggle to rein in these killer diseases, which together claim more than 6 million lives a year.
The Global Fund was launched in 2002 as a public-private partnership to marshal and distribute resources to health projects that show great potential in the fight against AIDS, TB and malaria. In its first two years, the fund has awarded 310 grants and a total of $3 billion to projects in 128 countries. As a result of projects approved in the first four rounds of grant-making, 1.6 million people will receive antiretroviral treatment for AIDS and 52 million people will receive voluntary testing and counseling for HIV-AIDS. In addition, in just the first two rounds, 2 million additional TB patients will be treated.
The president's bilateral AIDS initiative targets 14 countries in Africa and the Caribbean, with Vietnam as the lone country in Asia. This recent AIDS conference in Bangkok highlighted the dangerous growth of the AIDS epidemic across Asia - and demonstrated the importance of the Global Fund's work in these "next wave'' countries.
The Global Fund's work with tuberculosis is also critically important in efforts to keep people with AIDS from dying. Up to half of those with AIDS in developing countries will die of TB, and a person with AIDS who develops active TB has a life expectancy of just a few weeks or months. Using drugs costing as little as $10 a person, however, the TB can be successfully treated and life-expectancy extended by several years. For those on the lengthy waiting list to receive antiretroviral treatment for AIDS, having access to TB treatment is a matter of life and death.
In order to renew previous grants and approve two new rounds of grants next year, the Global Fund would need $3.6 billion in 2005. The United States' share would be $1.2 billion. Shockingly, the administration recommended only a $200 million contribution, the same as it suggested the year before. Congress, much to its credit, is expected to ignore White House wishes and approve funding a little above the half-billion-dollar level. But even that won't be enough to sustain the tremendous progress of the Global Fund.
At the end of June, the Global Fund board, citing insufficient pledges from donors to accommodate new proposals, would not set a date for a fifth round of grants, essentially bringing the momentum of efforts to reverse these killer diseases to a grinding halt.
For the donor representatives of the board, this was a somewhat cowardly act. Instead of urging their respective governments to increase their contributions to the Global Fund, they elected to slam the door on millions of the world's most desperate people. Rather than letting the real need determine the level of funding they would seek to raise, the Global Fund board is providing cover for donors who have failed to respond in an appropriate way.
In the latest round of grant approval by the Global Fund, several countries - Cote d'Ivoire, Ghana, Kenya, Burkina Faso, Vietnam and others - submitted large proposals to scale up antiretroviral treatment. Those applicants were rejected for the fourth round, but encouraged to resubmit for the fifth. The postponement of Round Five, however, means that these proposals may not be considered until 2007. The 6 million people who need AIDS treatment now and the children who stand to be orphaned by this plague, can't afford to wait that long.
With White House attempts to undercut the Global Fund, the best hope for millions struggling to survive now lies in the hands of the U.S. Congress. We must provide full funding for the Global Fund. When a disaster strikes and an emergency exists, we find the money to respond. More than 6 million deaths a year from these diseases is off the charts, as far as disasters go. What are we waiting for?
[Joanne Carter (firstname.lastname@example.org) is legislative director for RESULTS, a US-based citizens lobby working to end hunger and poverty. This article first appeared in early August in The Times of Trenton, The Daily Oklahoman, and other US publications.]