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US/Africa: Broken Promises & Betrayals
Africa Policy E-Journal
September 20, 2003 (030920)
US/Africa: Broken Promises & Betrayals
(Africa Action document)
This coming week the 13th International Conference on AIDS and STIs
in Africa (ICASA) convenes in Nairobi, Kenya from September 21-26,
under the theme "Access to Care." [see
http://www.icasanairobi2003.org/index.php]. On September 22, the
United Nations convenes a high-level meeting on the implementation
of the 2001 Declaration of Commitment on HIV/AIDS [see
Meanwhile, the U.S. Senate, under pressure from President Bush, has
rejected an amendment to provide $3 billion instead of $2 billion
for the first year of President Bush's promised $15 billion
HIV/AIDS initiative. The U.S. is currently spending an estimated $1
billion a week in Iraq, and Congress is currently considering a
request from President Bush for an additional $87 billion for the
occupution of Iraq and Afghanistan.
This posting contains a set of talking points released earlier this
week by Africa Action, detailing the broken promises of the Bush
administration on HIV/AIDS. Attached for additional background
is a report from Kaiser Daily HIV/AIDS Report on the latest U.S.
Senate action. Another posting today contains excerpts from several
documents and additional links related to access to treatment. See
also "The Daily Mis-lead" for September 16, 2003: President Bush
Shortchanges Funding for His Own Emergency AIDS Program on
Additional Links on Cancun Aftermath:
Interview with outgoing African Union Commissioner for Trade,
Industry, and Economic Affairs, Vijay Makhan
"We in Africa will have to take a political decision, whether it is
worthwhile to stay in an organization that is not proving its
worth. Look at the cotton producers. We managed to put that item of
the agenda and everybody thought just by putting it on the agenda
we would be satisfied. No. We want the issue to be addressed."
Botswana Trade and Industry Minister Jacob Nkate, who headed the
African, Caribbean and Pacific group at the WTO talks, tells US not
to adopt a "childish or sulking" attitude after the breakdown of
Cancun talks. He said it had been important for developing states
to have stood up to the richer nations. "We felt we were being
shoved to the side," he suggested.
Broken Promises & Betrayals
Talking Points on President Bush's AIDS Policies
September 19, 2003
Since his State of the Union address in January 2003, President
Bush has reaped great public relations benefits by parading himself
as a compassionate conservative, committed to helping the people of
Africa defeat AIDS. But the reality is very different.
When he traveled to the continent in July 2003, Bush repeatedly
emphasized how much his Administration was doing to fight the AIDS
crisis. And on the domestic front, the President has said that his
Administration remains committed to confronting AIDS in the U.S.
But President Bush's track record on AIDS policy reveals a litany
of broken promises and betrayals.
The President has misrepresented the actions of his Administration.
He has misled the American public, and he has failed the people of
Africa. Bush's broken promises are costing thousands of African
lives every day.
The following talking points include quotes from the President,
promising leadership in the war on AIDS. These are followed by
facts about the reality of his Administration's policies.
Emergency Plan for AIDS Relief (2003)
"To meet a severe and urgent crisis abroad, tonight I propose the
Emergency Plan for AIDS Relief a work of mercy beyond all current
international efforts to help the people of Africa...I ask the
Congress to commit $15 billion over the next five years, including
nearly $10 billion in new money, to turn the tide against AIDS in
the most afflicted nations of Africa and the Caribbean." (State of
the Union address, January 28, 2003)
"Next week, I will go to Africa to meet with leaders of African
countries and with some of the heroic men and women who are caring
for the sick and are saving lives...They deserve our help, without
delay. And they will have our help." (White House news conference,
July 7, 2003)
- The AIDS plan announced in the State of the Union address in
January 2003 was not an "emergency" plan President Bush requested
NO new money for this initiative for the entire year of 2003.
- President Bush promised $15 billion over 5 years, or $3 billion
a year, for his new AIDS initiative. But in his budget request for
2004, unveiled the week following his promises, Bush asked for less
than half a million dollars ($450 million) for next year for this
- Instead of the $3 billion per year over 5 years that was
promised, most of the money for the AIDS plan will not even be
requested until 2005 and beyond. This is after Bush's term in
office will have ended, so there is no guarantee this will be
requested at all. Even more importantly, this deadly delay will
cost millions of African lives.
- The focus of the new AIDS initiative is not really on Africa and
the Caribbean. The White House has clarified that the $15 billion
will include all U.S. funding for AIDS globally. In July 2003,
President Bush said the initiative he announced in January was "to
fight AIDS abroad", breaking his own promise that it would be for
Africa and the Caribbean. This means that whatever amount of money
is appropriated for AIDS, Africa will get far less than promised.
- In July 2003, the White House specifically asked Congress to
limit AIDS funding for next year. President Bush intervened during
the budget process to urge Congress not to spend the $3 billion
that was being considered at that time. This was after Bush had
returned from Africa, where he had seen first-hand the devastation
caused by AIDS and where he had repeatedly promised U.S. support
for African efforts to fight AIDS.
The Global Fund to fight HIV/AIDS, Tuberculosis & Malaria
"The devastation across the globe left by AIDS, malaria,
tuberculosis, and the sheer number of those infected and dying is
almost beyond comprehension...The United States is committed to
working with other nations to reduce suffering and to spare lives.
And working together is the key. Only through sustained and focused
international cooperation can we address problems so grave and
suffering so great." (Rose Garden Ceremony, with United Nations
Secretary General Kofi Annan and Nigerian President Olusegun
Obasanjo, May 11, 2001)
- In 2001, President Bush supported the creation of the Global Fund
to fight HIV/AIDS, Tuberculosis and Malaria. But his Administration
has consistently undermined the effectiveness of this important
vehicle by refusing to pay the U.S.' fair share, leaving it
- The U.S. has contributed only an average of $200 million a year
to the Global Fund since it was created in 2001. An equitable
contribution to the Global Fund from the U.S., based on the U.S.
share of the global economy, would be $3.5 billion per year. In
contrast, the U.S. is spending more than $1 billion a week on the
war and occupation in Iraq.
- President Bush said in January 2003 that the U.S. was committed
to leading the world in the fight against AIDS. But he continues to
neglect the best way to address the AIDS crisis the Global Fund to
fight HIV/AIDS. Bush has pledged only $200 million per year over
the next 5 years to the Global Fund as part of his "Emergency Plan
for AIDS Relief".
- U.S. Secretary for Health and Human Services, Tommy Thompson, is
chair of the Board of Directors of the Global Fund. Yet the Global
Fund is running out of money because the U.S. is failing either to
contribute its share of resources or to act responsibly as Board
chair and implement a fundraising plan for this crucial vehicle.
- To coordinate his new AIDS initiative, President Bush is creating
a new U.S. government bureaucracy that will compete directly with
the Global Fund. This bilateral approach breaks Bush's earlier
promise to support multilateral efforts to fight AIDS. This new
U.S. agency will take money away from the Global Fund. It is also
less efficient, with ten times as much "overhead", or
administrative costs, as the Global Fund. It is to be headed by a
former Drug company executive, Randall Tobias, of Eli Lilly & Co.
- While President Bush's AIDS plan is unlikely to be up and running
until at least 2005, the Global Fund is already operational and it
can save lives NOW. U.S. contributions to the Global Fund will
leverage billions of dollars from other donors. By refusing to
support the important work of the Global Fund, President Bush is
undermining international efforts to defeat AIDS and betraying
those on the frontlines fighting this pandemic in Africa.
"Anti-retroviral drugs can extend life for many years. And the cost
of these drugs has dropped from $12,000 a year to under $300 a year
which places a tremendous possibility within our grasp." (State of
the Union address, January 28, 2003)
"We'll work quickly to get help to the people who need it most by
purchasing low-cost anti- retroviral medications and other drugs
that are needed to save lives." (White House Ceremony, announcing
the appointment of the new Global AIDS Coordinator, The Roosevelt
Room, July 2, 2003)
- In 2001, the member countries of the World Trade Organization
(WTO), including the U.S., adopted the Doha Declaration, which
declared that patents on drugs should not be allowed to hinder poor
countries' access to essential medicines. But since this time, the
U.S. has consistently blocked efforts to relax patent rules and
facilitate African countries' access to anti-AIDS drugs and other
essential medicines. The agreement reached in Geneva in August 2003
still imposes extremely complicated procedures designed to protect
patent rights, which leave enormous obstacles to overcome before
affordable medicines are actually made available in Africa.
- The Bush Administration's close ties to the pharmaceutical
industry have meant that U.S. policies continue to support the
interests of the powerful pharmaceutical lobby to keep their
profits high. This betrays the efforts of African countries to
secure affordable access to essential HIV/AIDS treatments for their
people. The pharmaceutical industry is one of the largest
contributors to the Republican party.
- President Bush named a pharmaceutical executive, Randall Tobias,
as the Coordinator of the new AIDS initiative that was announced
earlier this year. Tobias has no experience in public health or
international affairs; he represents the pharmaceutical industry,
which has sought to deny Africans access to essential drugs. One
prominent example of such was the lawsuit brought against Nelson
Mandela by several major pharmaceutical companies in the 1990s,
which sought to prevent the South African government gaining access
to essential anti-AIDS treatment for its people. This suit was only
withdrawn in 2001 under international pressure.
- The choice of Randall Tobias by Bush reveals his allegiance to
the pharmaceutical companies and breaks the promise he made that
the U.S. would promote low-cost anti-AIDS drugs.
- In June 2001, the Administrator of USAID, Andrew Natsios, said
that AIDS treatments would not work in Africa because "Africans
don't know what Western time is." He used this racist and ignorant
logic to oppose the provision of essential treatments to people
living with HIV/AIDS in Africa. Africa Action wrote to Secretary of
State Colin Powell (Natsios' boss) to demand a retraction, and to
call for Natsios' dismissal. But the Bush Administration issued no
retraction or apology.
- The Bush Administration continues to stall on providing low-cost
AIDS treatments to African countries, claiming that inadequate
infrastructure means that funding for treatment must wait. But
treatment programs throughout Africa need money now. The solution
to weak infrastructure is urgent investments to improve capacity.
These delays in extending treatment access are costing thousands of
African lives every day.
- The Bush Administration supports conservative measures that
undermine a comprehensive response to the AIDS crisis in Africa.
These include emphasizing abstinence-only measures, prioritizing
prevention over treatment, and opposing the use of condoms. This
emphasis on fundamentalist ideology over science and public health
represents a dangerous step backward in the fight against AIDS.
Domestic AIDS Programs
"We have confronted, and will continue to confront, HIV/AIDS in our
own country." (State of the Union address, January 28, 2003)
- As the HIV/AIDS crisis in the U.S. continues to grow, the Bush
Administration is failing to show leadership to address this urgent
situation. For the past 3 years, the Bush Administration has
essentially flat-funded domestic HIV/AIDS prevention and treatment
- The CDC has stated that there are more than 40,000 new HIV
infections in the U.S. each year, half of these under the age of
24. A 2003 study from Emory University has said that failure to
reduce HIV infections by 50% in the next two years could cost this
country more than $18 billion. President Bush's budget request for
2004 cut $4 million from domestic HIV/AIDS prevention programs.
- The 2004 budget request flat-funded the Minority AIDS Initiative,
which provides essential funding to organizations addressing the
HIV/AIDS crisis in communities of color across the U.S. There is a
growing demand for funding for this initiative, but the Bush
Administration continues to ignore this reality. More than half of
all new HIV infections in this country are occurring among Black
- President Bush's budget request for 2004 proposed only a small
($5 million) increase in the Housing Opportunities for People with
AIDS (HOPWA) program, although the demand for this program has
grown dramatically, and more funding is needed urgently. The CDC
estimates that there are currently 900,000 people living with
HIV/AIDS in the U.S. The total number of people living with HIV
domestically increased by 33% between 1996 and 1999.
- The 2004 budget request contained an inadequate increase (only
$100 million) for the AIDS Drug Assistance Programs (ADAP), but
this is far less than what is needed. Already 13 of these programs
around the country have had to limit access to anti-retroviral
treatments or close enrollment to new clients altogether because of
inadequate funding. Another 7 programs have reported they are
likely to have to undertake similar measures in the next year.
- The Bush Administration remains committed to an "abstinence only"
policy when it comes to education about HIV/AIDS and STDs. Many
AIDS advocacy and AIDS service organizations have expressed grave
concerns about an approach that places political ideology over
science and public health. Public health experts emphasize that a
comprehensive approach to HIV/AIDS prevention must include
education about condom use.
- The federal ban on funding for needle exchange programs denies
thousands of injecting drug users in the U.S. access to a
lifesaving medical intervention. Access to sterile needles can help
prevent thousands of HIV infections ever year. At present,
injecting drug users account for more than one-third of all new HIV
infections in the U.S. Federal funding for needle exchange programs
is needed to expand these programs to control the spread of HIV and
save thousands of lives.
KAISER DAILY HIV/AIDS REPORT
Thursday, September 11, 2003
1. Senate Rejects Amendment To Add $1 Billion Global AIDS
Initiative, Amendment To Increase ADAP Funding
Access this story and related links online:
The Senate on Tuesday rejected 43-51 an amendment to the fiscal
year 2004 $137.6 billion spending bill for labor, health and
education services (HR 2660) that would have increased by $1
billion funding for the global AIDS initiative, the Washington
Post reports (Dewar, Washington Post, 9/10). The amendment,
sponsored by Sen. Richard Durbin (D-Ill.) would have added $1
billion to the roughly $2 billion appropriated by the Senate for
the initiative (Associated Press, 9/9). The House has approved
approximately $2 billion for the AIDS initiative in FY 2004.
Although the measure (HR 1298) supporting President Bush's
five-year, $15 billion initiative to fight AIDS in Africa and
the Caribbean authorizes $3 billion for the first year of the
program, the Bush administration has requested only $2 billion
(Kaiser Daily HIV/AIDS Report, 9/9). Additions to appropriations
bills that exceed budget limits must have 60 votes in order to
pass (Washington Post, 9/10). The Senate in July passed a
nonbinding resolution, called the Bingaman amendment, calling
for $3 billion to be appropriated in FY 2004 to fight AIDS
overseas, even if the amount exceeds the ceiling mandated in
Congress' annual budget resolution (Kaiser Daily HIV/AIDS
The Senate yesterday morning voted against an amendment,
proposed by Sen. Charles Schumer (D-N.Y.), that would have
provided additional funding for the Ryan White CARE Act,
including an increase in funding for the AIDS Drug Assistance
Program (SAVE ADAP release, 9/10). The federal-state ADAP
program provides free or low-cost medication to low-income
HIV-positive individuals who do not qualify for Medicaid or
other drug assistance programs. Many state ADAPs are
experiencing financial trouble due to high demand for the drugs,
soaring prescription costs and state budget shortfalls. Fifteen
states currently have waiting lists or access restrictions on
their ADAPs, and four more states anticipate having to impose
new or additional restrictions on their programs in fiscal year
2003. According to the ADAP Working Group, ADAP will require a
total of $214 million in new federal funding during FY 2004 in
order to restore stability and serve the people currently on
waiting lists, and the amendment would have fully funded ADAPs.
The Senate's labor and health spending bill would increase ADAP
funding by $25 million; the House version of the bill, which was
passed in July, includes about $39 million in new funding
(Kaiser Daily HIV/AIDS Report, 9/5).
"How could these Senators vote for the Bingaman amendment and
yet vote down a measure that would have actually provided the
funding?" Paul Zeitz, executive director of the Global AIDS
Alliance, said, adding, "Their hypocrisy is simply
breathtaking." Zeitz added, "[I]t's time to treat AIDS like a
real emergency, as the president himself rightly termed it just
nine months ago in his State of the Union address" (Global AIDS
Alliance release, 9/10). Terje Anderson, executive director of
the National Association of People with AIDS, expressed
"extrem[e] disappointment" at the "twin failures" of the Senate
to pass neither amendment. Anderson said, "Refusing to
adequately fund AIDS will not make it go away; in fact, the
Senate's action will do nothing except to make the work more
difficult and costly and will result in more death and more
suffering" (NAPWA release, 9/10). ....
The Kaiser Family Foundation yesterday released its annual
update of "Federal HIV/AIDS Spending: Budget Chartbook," which
provides a comprehensive overview of the most recent data on
federal funding for domestic and international HIV/AIDS
activities and spending trends since FY 1995. The document is
available online at http://www.kaisernetwork.org.
Date distributed (ymd): 030920
Issue Areas: +economy/development+ +health+ +US policy focus+
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