January 11, 2013
The Blueprint for an
AIDS-Free Generation released by Secretary of State Clinton in November makes a bold
declaration: We are at a tipping point
in this most devastating pandemic of our time. By scaling up core, effective interventions, HIV infection and death
rates can be brought down steadily in the coming years, and in relatively short
order the costs will begin to recede as well.
There are many reports on the topic of global health. This one deserves to be read and acted on – and funded. If you don’t
read the whole report, look at the pictures. Four graphs in the blueprint are based on mathematical modeling of the distinctly
different epidemics in Cambodia, Kenya, Uganda, and Zambia. In each case, as AIDS treatment reaches
people earlier in the course of disease, and as part of a combination of proven
interventions, HIV incidence falls more rapidly. A separate graph, for Uganda, shows the
dynamic effect of scaled up services leading to reduced resource needs within
just a few years. The same progress is
possible in the US epidemic, where some jurisdictions that have expanded
coverage of AIDS-related services have seen declining HIV infection rates.
could be a road map for accelerating the end of the global AIDS epidemic. Or it could be a political document that showed
us what could have been accomplished while instead we resigned ourselves to the
devastation of AIDS for decades to come.
outcome will be determined by the actions of Congress and the White House in
the coming weeks. Will budget
sequestration go into effect in early March, slashing global health along with
other discretionary spending? Will we
maintain critical investments in research to find a cure and a vaccine? And will the President’s fiscal year 2014
budget proposal, expected by March, ask for increased funding for PEPFAR and
the Global Fund to Fight AIDS, Tuberculosis and Malaria?
The strategic vision of the blueprint
cannot survive a major cut to PEPFAR, the popular and enormously successful
President’s Emergency Plan for AIDS Relief initiated by President George W.
Bush. The blueprint makes the business
case for investment now: not treading water, but more rapidly scaling up the
interventions that we know work. Doing so
will advance global health more broadly.
A recent study showed that investments in PEPFAR improved the overall strength
of health systems and increased life expectancy in recipient countries.
For President Obama, this is a legacy
issue. On domestic AIDS, the President
has demonstrated great leadership with passage of the Affordable Care Act and
creation of the National HIV/AIDS Strategy.
On the global epidemic, the President’s Administration has accelerated
scale up of effective services. With full
implementation of the blueprint, he can be the President who drove AIDS toward
Leadership is needed from Congress, too. PEPFAR is the premier example of a bipartisan
program at a time when those are hard to come by. Congress should remember that foreign aid is investment in global good
will and stability on the cheap. As
Graham said about foreign aid in volatile areas of the world, “The way I
look at it is, it’s national security insurance we’re buying.”
on global health is only about one quarter of one percent of the federal
budget. You can’t solve the federal debt
problem by slashing global health funding, but you can do enormous damage to millions
of children and adults and squander terrific opportunities in the process.
This winter and early spring, when lawmakers are making big decisions about our course
as a nation, we must act on the science, and on our humanitarian and diplomatic
interests. The President’s fiscal year
2014 budget should request increased funding for PEPFAR and the Global Fund,
along with increased investments in research and domestic AIDS programming.
President and Members of Congress, we have the plan to end AIDS. Now is the time to fund it.
Chris Collins is
vice president and director of public policy at amfAR, The Foundation for AIDS
Research. His email is firstname.lastname@example.org
This op-ed was originally published on the Huffington Post