AIDS Pandemic Spreads

World AIDS Day demonstrates the ongoing funding crisis

Several Democratic presidential contenders re-leased plans to combat the worldwide spread of AIDS on December 1, World AIDS Day, as Tommy Thompson, Secretary of Health and Human Services, visited Zambia and committed U.S. resources in an effort to curtail the disease that is devastating Africa.

Accompanying Thompson were Richard Holbrooke, the former ambassador to the United Nations, who is president of the Global Business Coalition for HIV/AIDS, Dr. Lee Jong-Wook the new director general of the World Health Organization, Peter Piot, head of UNAIDS, the primary organizational agency responsible for coordinating the global effort to fight AIDS.

Randall Tobias, Pres. Bush’s recently appointed AIDS coordinator also joined Thompson.

The Global Coalition takes a moderate position in the ongoing debate over how American money should be spent to fight AIDS in foreign countries. Of the $15 billion that the U.S. has thus far pledged, 20 percent is slated for prevention measures.

In China, where the AIDS epidemic continues to emerge as the Asian giant’s most pressing health issue, The New York Times reported on December 3 that the government has decided to finally mount an open and direct assault on the disease in light of evidence that the general population, not intravenous drug users, prostitutes or their clients, is now the primary target. The paper reported that experts predict that China could have 10 million people infected with HIV by 2010 and that currently 1 million people are estimated to be infected with HIV, with only 80,000 thus far having actually been tested. A pilot program that dispenses antiretroviral drugs now only treats 5,000 people.

Meanwhile, Democratic presidential contenders issued plans calling for doubling the amount of money the Bush administration has committed in a five-year plan to fight AIDS.

The campaigns of former Gen. Wesley Clark, former Gov. Howard Dean of Vermont, Sen. John Kerry of Massachusetts and Rep. Richard Gephardt of Missouri, all leading candidates in the ten-person field, called for spending $30 billion up to 2008.

On December 1, Clark spoke at an HIV treatment facility in Florida. “America is not just the world’s greatest military force, but also its greatest force for good,” said Clark. Clark, like Dean, has advocated financing an increase in global AIDS spending by rescinding last year’s tax cuts for the wealthiest Americans.

The unanimity of all four candidates in doubling the expenditure in AIDS funding clearly appeals to a more liberal segment of the Democratic party, which includes many gay and lesbian voters. However, spending plans put forth by candidates at thus stage of the election season are mere conjecture considering how far removed such measures are from the caustic Congressional battles that typically resolve AIDS appropriations.

Sub-Saharan Africa is home to more than 26 million of the estimated 46 million people worldwide living with HIV. According to the Global Coalition on HIV/AIDS, only about 1 percent of HIV-positive people in the developing world has access to life- prolonging drugs available in places like North America and Europe.

The statistics on Africa alone are staggering. In Zambia, UNAIDS estimates that 22 percent of adults are infected with the disease. Across the continent, nearly 11 million children have been orphaned by the disease.

Thompson is chair of the Global Fund to Fight AIDS, Tuberculosis and Malaria, a Geneva-based international organization established to coordinate the global effort to stem those three leading killers, even though meager U.S. support for that fund has been controversial globally.

Thompson signed an agreement pledging $2.5 million assistance from the U.S. Centers for Disease Control in HIV prevention and care in Zambia.

This past summer, federal appropriations for worldwide AIDS funding was hotly debated in the House of Representatives by the Foreign Operations Subcommittee of the Appropriations Committee. The chair of that subcommittee is a gay Republican from Arizona, Jim Kolbe. A press spokesperson from his office, said that earlier this year the congressman visited Haiti to witness how the Global Fund is addressing the AIDS crisis in that nation, the poorest in the Western Hemisphere. Kolbe has also visited Mali, Ethiopia, and Mozambique.

Kolbe found himself at the center of a political firestorm this past July after Pres. Bush completed a tour of African nations hit hard by the AIDS crisis. The $15 billion five-year commitment that the president had mentioned in his State of the Union address in January became a political tug-of-war during budget negotiations between fiscal conservatives and those favoring increased AIDS funding.

Ultimately, the Congress appr-opriated $2.4 billion for this fiscal year with some accusing the administration of having squelched on $600 million in aid.

Democrats in Congress and celebrities like the rock star Bono, who has taken a frontline advocacy role in the fight against AIDS and spent this World AIDS Day in South Africa with former President Nelson Mandela, accused the administration of abandoning the developing world in the wake of domestic budget wrangling caused by a faltering U.S. economy.

“Everyone assumed that because the president said $15 billion that that meant $3 billion a year,” said Stanley. “The $15 billion commitment will be kept and Congressman Kolbe will work to ensure that.” Stanley said that until the appointment of Randall Tobias this past July as the global AIDS coordinator, Republicans on the foreign operations subcommittee were wary of bestowing large sums of relief money on underdeveloped nations.

“We’re ramping up for next year,” Kolbe’s spokesperson said. However, she would not provide a projected figure for the next fiscal year’s appropriation. “Every year since 1985 when $36 million was appropriated, it has been ramping up.”

Nita Lowey, a New York Democrat, is the ranking member on the foreign operations subcommittee. An attempt on her part to pass an amendment to increase the global expenditure $3 billion ultimately failed, an aide said.

Meanwhile, in the United States, AIDS activists are praising legislation introduced by a bipartisan coalition of lawmakers that advocates consider a proactive step in early intervention. Hillary Clinton, a New York Democrat and Gordon Smith, an Oregon Republican are leading the effort in the Senate, while Nancy Pelosi, a California Democrat who is the minority leader and Jim Leach, a Republican centrist from Iowa, are lining up sponsors in the House of Representatives. Called the Early Treatment of HIV Act, the measure would increase the number of HIV-positive people eligible to receive Medicare and amend federal regulations which now determine when a person living with AIDS is able to receive life-saving care.

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