Kaiser Daily HIV/AIDS Report Rounds Up Recent Public Opinion on Global AIDS Issues
Following last week's conference on AIDS in Abuja, Nigeria, and the call by U.N. Secretary General Kofi Annan for a "Global Superfund" to fight the epidemic, several newspapers have run opinions on how to address the problem of funding for HIV/AIDS prevention and treatment efforts. Here is a sampling of the commentary:
- New York Times: "The public attention given in recent months to Africa's AIDS crisis has not been matched with money," a New York Times editorial states. The $1 billion spent on AIDS is developing nations last year "will not even buy adequate prevention campaigns, much less health infrastructure, care for AIDS orphans and necessary medicines for the sick," it continues. Annan's call for an AIDS trust fund of $7 billion to $10 billion a year "lays out a solid basis for a global attack on AIDS, tuberculosis and malaria." Most of the money will initially go toward building health infrastructure, the editorial states. A declaration signed last week at the Abuja AIDS conference is a "welcome sign that African leaders are taking AIDS and health issues more seriously," the editorial continues. But any global effort against AIDS is "likely to be handicapped by a lack of leadership from the United States. While Bush administration officials speak about AIDS as a catastrophe, the president's 2002 budget adds less than 10% to this year's spending for AIDS overseas, raising it to $480 million," the editorial states. Former President Bill Clinton suggested at the Abuja conference that the United States should provide a fourth of the proposed global AIDS fund, but Bush's projections "fal[l] more than $1 billion short of that," the editorial concludes (New York Times, 5/2).
- New York Times: "No one thinks treatment alone is the solution to the AIDS epidemic. We need a comprehensive approach that combines prevention, care and research," Ana Oliveira, executive director of Gay Men's Health Crisis, writes in a New York Times letter to the editor. She adds, "Successful prevention, care and research programs will need a vast mobilization of resources." Oliveira and her group "call on the United States to join other industrialized nations and make a significant commitment toward the $7 billion to $10 billion needed for the new global fund to combat this epidemic" (Oliveira, New York Times, 5/4).
- Washington Post: "HIV/AIDS is no longer just a health problem but a global development problem, threatening to reverse many of the development gains made over the past half-century," World Bank President James Wolfensohn writes in a Washington Post op-ed. Wolfensohn agrees with Annan that a "war chest and a war strategy" are needed to fight HIV/AIDS in the developing world. "Money alone will not solve the problem, but it is a vital part of the solution," he writes. The World Bank and UNAIDS estimate that creating a basic HIV/AIDS program in every African nation will cost in total between $3 billion and $4 billion a year. Although the World Bank has successfully provided $300 million to African nations since last September through the Multi-Country HIV/AIDS Program, "no one on his own ... can provide the money and support needed to engage HIV/AIDS at the global and country level and ultimately prevail," Wolfensohn writes. "For this reason, the bank supports the calls for the establishment of a global fund" to fight HIV/AIDS "within the context of meeting a series of key targets known as international development goals," he continues. Leadership is another "essential element" in the "war strategy," he writes. More African leaders need to "break the silence" surrounding HIV/AIDS. "Let us join with the G-7 and the U.N. system to commit to a global fund. Let us make this a pivotal moment in the fight against HIV/AIDS," he concludes (Wolfensohn, Washington Post, 4/28).
- Wall Street Journal: High drug prices "have nothing to do" with the lack of HIV/AIDS treatment in Africa, Holman Jenkins writes in the "Business World" column in the Wall Street Journal. "Without a delivery infrastructure and a broad range of support services, lower prices are meaningless," he continues. If Africans and others in developing nations have been "left out" of drug therapies, "it's not because of 'corporate greed' but because there is no price at which they would become customers for antiretroviral therapy," he writes. AIDS drug therapy is "highly complex" requiring patients to take somewhere in the neighborhood of 20 pills a day and adhere to a "rigid schedule." Some of the pills come with "stringent dietary restrictions" as well, which may prove difficult to follow in African nations where adequate food and clean water are scarce. A study by San Francisco General Hospital found that "anything less than 95% compliance can raise to 50% the chances of treatment failing and a resistant virus emerging," Jenkins writes. "Playing on stereotypes of 'greedy' business spares [activists] the hassle of having to explain to young people which side they're on. Corporation = evil is an unquestioned catechism. How this advances a medical solution to AIDS is the unsolved mystery," he continues. Without patent protection, pharmaceutical research "will come to a screeching halt ... because recovering these costs would become impossible. And somewhere down the road lies a drug that would really help save African lives," he concludes (Jenkins, Wall Street Journal, 5/2).
- Chicago Tribune: The "state of emergency" declared by African leaders at last week's summit is "already obvious," a Tribune editorial states, adding, "What's new is that the rest of the world is finally catching on." The editorial states that U.S. Secretary of State Colin Powell and HHS Secretary Tommy Thompson are working on a "Marshall Plan" to fight HIV/AIDS in sub-Saharan Africa. Thompson is gathering opinions from drug firms and is "exploring international resources to find how to best fight the disease," the editorial states. Thompson says his plan could include funding for building roads and hospitals, to purchase and distribute drugs, or to let physicians "inspire a global effort." The editorial suggests that the plan should make prevention a "key priority" and should offer anti-AIDS drugs at reduced prices in "poverty-stricken places." Meanwhile, leadership from African and other developing nations is "essential" as well, the editorial states, concluding, "Until African leaders speak with one voice, without equivocation, about the AIDS crisis and how to combat it, no global effort will succeed" (Chicago Tribune, 4/29).
- Philadelphia Inquirer: "Clearly, a global effort is needed to stop the death and dying in Africa and in other countries" where AIDS "is becoming the grimmest new reaper," the Philadelphia Inquirer says. As African leaders are promising to make AIDS their foremost health priority, "[n]ow the rest of the world must bear its share of the AIDS responsibility as well." As "the world's mightiest power," the United States should "minimally contribute 20% of a proposed $10 billion world AIDS fund -- or $2 billion. And President Bush should quickly rise to the bully pulpit to become a powerful cheerleader for the fund," the editorial concludes (Philadelphia Inquirer, 5/4).
- Newsday: A Newsday editorial states that nations hoping to receive U.N. funding to fight HIV/AIDS "must ... show a full commitment to treatment programs," as well as evidence that they "are using their money efficiently and honestly." The editorial notes that within three years, AIDS "will become the worst scourge in history, surpassing the toll of the Black Plague in the 14th century." And while a "meticulous drug program" will help "ease widespread economic destabilization" and is "crucial" to protecting the health of infected persons, nations should not "confuse it with a solution," the editorial concludes (Newsday, 4/30).
- Minneapolis Star Tribune: "Unfortunately, with patent issues dominating the global AIDS debate, scant attention has been given to the critical question of direct funding of the purchase of drugs and treatment," Sen. John Kerry (D-Mass.) and Bruce Lehman, president of the International Intellectual Property Institute, write in a Star Tribune op-ed. Kerry and Lehman state that the "divide between rich and poor nations is tragic," noting that the United States has managed to reduce its AIDS-related mortality rate by 75% while 95% of those infected with HIV live in developing nations. They write, "Patients in poor countries will not survive without funding by the governments of developed countries for these therapies. Current levels of foreign assistance are not even remotely adequate to address needs from the manufacture and use of generic pharmaceuticals to deeply discounted drugs made available under license from patent holders." The authors state that U.S. foreign policy priorities need to be re-evaluated in the wake of the epidemic. "As it considers its foreign policy options and moral obligations, the Bush administration should revisit a shortsighted and woefully inadequate program of humanitarian assistance. For the United States, it's a major test of our most cherished values. For the world's developing countries, it may be something more important: Our investment may be their only hope for survival," they conclude (Kerry/Lehman, Minneapolis Star Tribune, 4/30).