I know this is a long blog post, but I wanted to keep everyone up to date on where we're at in our campaign to try and get the Obama Administration to keep their promise to fund global AIDS programs. Once you've read it, pick up the phone and call Senator Leahy and Representative Lowey, the Senate and House members responsible for funding for global AIDS, and tell them that they need to fight for full funding for global AIDS. You can find their numbers, and a script, at www.tinyurl.com/leahylowey.
Health GAP is just returning from the International AIDS Conference, where we joined with 200 organizations from around the world to organize a massive thousand-person march to the opening ceremony. We carried with us a strong message that people with AIDS and allies will not sit silently by while governments break their promises to fund AIDS programs. We declared, in our signs, banners, chants and speeches, "Broken promises kill! No retreat. Fund AIDS." And governments - especially the US government - took notice.
Last week, three members of the Obama Administration went to the media to try to prove that they are not backtracking on their promise to increase funding for global AIDS by $1 billion a year. Global AIDS Coordinator Eric Goosby said that Obama is "hurt" by our criticism of him, because "the global AIDS epidemic is a shared responsibility" with other governments. Gayle Smith, a member of the National Security Council, said on the White House blog that "there is no retreat" from funding promises. And Dr. Zeke Emmanuel, the brother of the White House Chief of Staff and a Senior Advisor to the Office of Management and Budget said "what counts are not dollars spent, but lives saved."
But, in all of this, they've missed one key point: While Obama proposed to increase funding for global AIDS in 2011, it was only by 2%, or $140 million. That's a far cry from the $1 billion per year increase that Obama promised on the campaign trail, and billions of dollars short of the funding levels Congress authorized in 2008. And it doesn't even keep pace with inflation in Africa.
This means that, on the ground, organizations are desperately searching for ways to fund treatment - even if it means cutting essential services like follow-up care. For the first time in ten years, doctors are reporting people traveling from far away to find medication. Some of those people are showing up in wheelbarrows, too sick to walk. Those that are lucky can still get medication. But stock-outs are happening increasingly frequently. Testing campaigns are slowing, because organizations can't afford to find more positive people who will need treatment. Until yesterday, clinics in Uganda were forbidden from enrolling new patients in treatment, unless an existing patient died or was lost to care. Thankfully, as a result of your pressure, the Administration has announced a retreat from its disastrous imposition of HIV treatment caps in Uganda. This would not have happened without your activism.
What they're missing is that it is about money - saving lives costs money. And taking money that was promised to go to AIDS programs and redirecting it towards other global health needs doesn't help anyone - if you avoid measles but then die of AIDS, a life is still lost. To save the most lives, what's needed is more money for global health overall. And we can afford it, too. Development spending in the US is still far less than 1% of the entire federal budget; fully funding global health wouldn't even put a dent in the federal budget!
It's no coincidence that the Administration is coming back at us, full force. They've taken notice of our campaign to get them to keep their promises. This August, Members of Congress will be in their districts, holding town halls and talking to their constituents (you!) about what you want them to do. Go to those town halls, and ask them why the US is retreating from our commitment to fund global AIDS, and what they're going to do to ensure the US keeps its promise to provide $48 billion over five years for global AIDS, as Congress promised in 2008. Trust me - if enough of us go to town halls and ask these questions, it will get back to the Administration.
All of this reminds me of that rather famous quote by Gandhi - "first they ignore you, then they laugh at you, then they fight you, then you win." The Obama Administration is fighting back against us. But with sustained pressure, we can tip the scale and make sure that HIV/AIDS, and indeed all global health priorities, get the funding needed to save the millions of lives that we can't afford not to save.