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AIDS and those who loved them, who spoke up, demanded action. Activists in Brazil, Thailand, South Africa, Uganda and elsewhere shamed their countries, the world into action. international AIDS programs ... were swept into place by the force of the voices crying out for justice only a few years ago. It is almost 10 years later and we're in danger of losing everything we've achieved on AIDS this decade." - Greg Gonsalves
This AfricaFocus Bulletin contains the transcript of a talk by veteran AIDS activist Greg Gonsalves, warning of the danger of pitting funding on AIDS against other health expenditures, instead of mustering the political commitment to do both. It also contains a related opinion piece by Dr. Steven Gloyd and Rep. Jim McDermott.
Both were posted on the Healthgap listserv.
Also posted today on the AfricaFocus web site, but not sent out by e-mail, are two related Bulletins. One is a press conference by U.S. Global AIDS Coordinator Dr. Eric Goosby, in which he presents the transition of U.S. international AIDS programs from "emergency" to a more "sustainable" phase, and tries to answer questions from journalist seeking a response to critics of administration plan for funding levels.
See: USA/Africa: AIDS - Yes, We Can? (web-only)
http://www.africafocus.org/docs09/hiv0912b.php
The other contains several updates, a summary report on the new UNAIDS annaul report, a joint press release by PEFPAR and the Global Fund, and the AIDS day speech by South African President Jacob Zuma.
See Africa: HIV/AIDS 2009 Update (web-only)
http://www.africafocus.org/docs09/hiv0912c.php
More details on proposed budget numbers and an evaluation by activist groups of the first-year record of the Obama administration are availed at:
The groups rate the administration's first-year record as very disappointing, with a grade of D+ on a scale from A (best) to F (failure). But they stress that one year is a short time and there is still much opportunity to improve if there is political will to do so from both the administration and Congress.
For a new policy brief and chartpack, from the Kaiser Family Foundation, provide a detailed breakdown of the U.S. budget for the global health programs in President Obama's new Global Health Initiative, announced in May 2009, see
http://www.kff.org/globalhealth/8009.cfm
The brief provides an overview of the projected budget for the Global Health Initiative, including the $8.6 billion proposed by the Administration in its pending fiscal year 2010 request and the $8.4 billion approved in fiscal year 2009. It examines the different U.S. programs that would fall under the Global Health Initiative over time, tracking data back to fiscal year 2001. The supplemental chartpack includes additional breakouts and budget trends over time.
For previous AfricaFocus Bulletins on AIDS and other health issues, visit http://www.africafocus.org/healthexp.php
No, We Can't: Barack Obama's New Global AIDS Strategy
Remarks by Gregg Gonsalves, International Treatment Preparedness Coalition at the symposium on HIV Scale-Up and Global Health Systems, hosted by Columbia University's International Center for AIDS Care and Treatment Programs
1 December 2009 New York, NY
Email: gregg.gonsalves@gmail.com
I miss George W. Bush. Well, not really. He was a terrible President in so many ways. However, he was exceptional in one.
The President/s Emergency Plan for AIDS Relief, despite its flaws, saved millions of lives around the world.
People seem to forget what the world was like before PEPFAR and its multi-lateral sister effort, the Global Fund to Fight AIDS, Tuberculosis and Malaria, arrived on the scene. Before the turn of this decade, the fight against AIDS in the developing world was a joke. Great leaders like Nelson Mandela failed to understand and react to the gravity of what was emerging in his newly free republic. President Clinton for all his heralded work since he left office did absolutely nothing when he was in office to stem the rising tide of death and new infections across the globe. Even the World Health Organization ignored the epidemic ravaging dozens of countries wholesale in Africa, exploding in specific populations in other nations on other continents.
It was ordinary people, people living with AIDS and those who loved them, who spoke up, demanded action. Activists in Brazil, Thailand, South Africa, Uganda and elsewhere shamed their countries, the world into action. The establishment of the Global Fund, the World Health Organization's effort called 3x5 to get 3 million people on AIDS treatment by 2005, were all swept into place by the force of the voices crying out for justice only a few years ago.
It is almost 10 years later and we're in danger of losing everything we've achieved on AIDS this decade. For the past two years, there has been a pernicious and false rhetoric rising up in academic journals, in think-tanks, and now in governments and international agencies that goes something like this: the fight against AIDS has misdirected our energies towards broader goals in health and development; the provision of antiretroviral therapy is a folly, it's too expensive and isn't worth the money to continue its expansion; efforts against AIDS are destroying health systems and promoting unnecessary deaths from other simpler-to-treat diseases and conditions such as childhood diarrhea. One of the most vocal proponents of these ideas sits in the White House advising the President: Ezekiel Emanuel, a doctor and bioethicist, whose November 2008 paper in the Journal of the American Medical Association has become a key document in what I call the "AIDS backlash." But there are others, such as Bill Easterly at NYU, and a mysterious fellow named Roger England who seems to be quite the favorite of the editor of the British Medical Journal. Even Newsweek gets into the act this week, with their call to scale-back PEPFAR.
Many of the people making these charges of course are the people who did little to stem the tide of AIDS and TB in the 1990s. They posit that the fight against AIDS has been a malevolent force in public health and development, while ignoring the fact that before AIDS supposedly came along to suck all the air out of the room, other areas of health - for instance, maternal health and childhood immunization in Africa - languished terribly under their watch.
They conveniently refuse to acknowledge that chronic underinvestment in health, structural adjustment policies that crippled the public sector in many developing countries, corruption at the highest levels and other factors decimated health systems across the world. AIDS has become the new bogeyman - deflecting attention from the culpability of national governments in the North and South for the long-standing crisis in health and development around the world.
We've made great strides in fighting AIDS, but now as a recent report by the Nobel Prizing winning organization, Doctors without Borders has suggested, the world is about to punish success. Some are now calling for a redistribution of funds, to cut up the current pie of global health money, so that other illnesses and conditions profit from the largesse lavished on AIDS. The problem is that the pie of current funding for AIDS still represents a fraction of what is needed to combat the epidemic - asking for a redistribution of funds is akin to starting a fight for crumbs from the table of our national leaders. The true scandal is that in the age of bank bailouts, fiscal stimulus packages and multi-million dollar bonuses, it isn't AIDS that is overfunded, it's the fact that the USA and other donor nations have systematically underfunded health and development overall for decades. Justice isn't cutting up a too small pie into more evenly distributed smaller pieces, but is putting more money on the table for global health and development.
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