Bush AIDS Plan To Include Condom Distribution, Generic Drugs for African and Caribbean Nations
President Bush's announcement in Tuesday's State of the Union address of a five-year, $15 billion plan to fight HIV/AIDS in Africa and the Caribbean is a "marked change" from the administration's position shortly after he took office, the Washington Post reports. At that time, officials said that money should be used to prevent the disease and doubted whether African health systems could administer expensive drug treatments, according to the Post (Allen/Blustein, Washington Post, 1/30). However, the president's proposal triples the amount of money the United States would spend to fight HIV/AIDS in Africa and the Caribbean, and it allocates about one-third of the money to education programs promoting both condom use and abstinence and about 15% of the money to patient care, the Boston Globe reports (Donnelly, Boston Globe, 1/30). Bush's initiative, officially called the Emergency Plan for AIDS Relief, is designed to prevent seven million new infections; provide antiretroviral drugs, including generic formulations, for two million people; and care for 10 million HIV-positive people and children who have lost one or both parents to AIDS-related illness, according to a White House fact sheet. Such treatments and programs will be run through existing hospitals staffed with physicians who have "expertise" in treating HIV; independent medical centers that provide "basic medical care"; secondary satellite facilities to test and diagnose HIV and infectious diseases; and rural and mobile units that perform "standard clinical evaluations" and distribute medication refills (White House fact sheet, 1/28).
The plan's details came as a "surprise" to many, especially in light of the strong stance the United States has taken in favor of patent protection for drugs in the World Trade Organization's Doha negotiations, the San Francisco Chronicle reports. "The U.S. position before the WTO is completely contradictory to what President Bush said [Tuesday]," Robert Weissman, co-director of Essential Action, said (Russell, San Francisco Chronicle, 1/30). Although activists expressed surprise, Bush administration officials said the AIDS plan had been an "explicit" administration priority since June 2002, the New York Times reports. Secretary of State Colin Powell, HHS Secretary Tommy Thompson and Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who had all traveled to Africa, were "deeply moved" by the impact of the AIDS epidemic in that region, according to the Times. In addition, Senate Majority Leader Bill Frist (R-Tenn.) and National Security Adviser Condoleeza Rice also strongly support the initiative, the Times reports. Fauci said that in developing the plan, he brought in scientists from around the world, including Peter Mugyenyi, director of the Joint Clinical Research Center in Uganda, to "devise a cost-effective plan and prove that it could work to treat the infected" (Gay Stolberg/Stevenson, New York Times, 1/30).
"Astonished" African and Caribbean officials "welcomed" Bush's plan, the New York Times reports. Twelve countries in Africa -- Botswana, Namibia, Mozambique, Zambia, Uganda, Tanzania, Kenya, Ethiopia, Ivory Coast, Nigeria, Rwanda and South Africa -- as well as Haiti and Guyana in the Caribbean, will benefit under the plan, according to the Times. Prega Ramsamy, executive director of the Southern African Development Community, said, "My prayer is that when this funding comes we'll see a reduction of people being affected by AIDS." Dr. Jean Pape, director of the Gheskio Centers in Haiti, said, "It can have a huge impact. ... It is essential that we be able to offer care to those people" (Swarns, New York Times, 1/30). Dr. Nils Daulaire, president of the Global Health Council, said, "What this does is take AIDS from being a secondary concern, barely scraping along, to a potentially tide-turning approach," adding that the plan should quell the "endless and fruitless arguments over the last few years" over the necessity of treatment. However, some advocates said that the proposal is a "go-it-alone" approach, the Globe reports. "If [the United States] wants to leverage its money and get the world to spend $10 to $12 billion a year on AIDS, you can't do it unilaterally," Mark Malloch Brown, administrator of the United Nations Development Programme, said (Boston Globe, 1/30). In a statement, U.N. Secretary-General Kofi Annan said that the plan "will make a vital impact, not only in saving lives but also in staving off the very real threat to stability that AIDS represents in the worst affected regions. ... I hope that this example will encourage other governments to follow suit." He added that he is "pleased" with the $1 billion dedicated to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Annan statement, 1/20). However, some AIDS advocates said that the plan does not allocate enough money toward the Global Fund, the Chronicle reports. "One billion dollars (over five years) is absolutely unacceptable and sets the bar too low for other countries," Rachel Cohen, U.S. director of Doctors Without Borders' campaign for low-cost AIDS drugs, said (San Francisco Chronicle, 1/30). Annan has previously said that the U.S. contribution to the Global Fund should be about $2.5 billion annually, or one-fourth of the fund's $10 billion annual budget goal (Kaiser Daily HIV/AIDS Report, 1/29).
Frist, Kerry To Introduce Bill
In Congress, a bill by Frist and Sen. John Kerry (D-Mass.) that will be discussed next week in the Senate Foreign Relations Committee may "trump" the Bush plan with a higher contribution to the Global Fund, the Wall Street Journal reports. That bill, which last year passed the Senate but not the House, would authorize up to $3 billion to be spent next year, the Journal reports. Bush's plan would allot $2 billion next year but "ramp up" that amount over time, according to the Journal. The full Senate is expected to pass the bill in as soon as two weeks (Phillips/Zimmerman, Wall Street Journal, 1/30). The Globe reports that 36 sub-Saharan African nations -- including Zimbabwe, Lesotho, Swaziland and Malawi, all with "high" HIV infection rates -- were left off the list of countries slated to receive aid (Boston Globe, 1/30). White House officials said that "politics was not the major reason" for the AIDS initiative, instead saying it should remind voters of Bush's "compassionate conservative" claim and possibly improve the image of the United State in the international community (Washington Post, 1/30).
The following programs included coverage of reaction to Bush's proposal:
- ABCNews' "World News Tonight": The segment includes comments from Malloch Brown of UNDP (Jennings, "World News Tonight," ABCNews, 1/29). Video of the segment is available online in RealPlayer.
- NPR's "All Things Considered": The segment includes comments from Malloch Brown and Del. Donna Christian-Christensen (D-Virgin Islands), a member of the Congressional Black Caucus (Wilson, "All Things Considered," NPR, 1/29). The full segment is available online in RealPlayer.
- NPR's "Morning Edition": Rachel Swarns of the New York Times discusses Africans' reaction to the proposal (Edwards, "Morning Edition," NPR, 1/30). The full segment is available online in RealPlayer.
- NPR's "Talk of the Nation": The program today will include a discussion of the politics and economics of fighting HIV/AIDS, whether the proposal is "enough" and how the money should be spent (Inskeep, "Talk of the Nation," NPR, 1/30). The full segment will be available online in RealPlayer after 6 p.m. ET.
- PRI's "The World": The program yesterday interviewed U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis about Bush's proposal (Mullins, "The World," PRI, 1/29). The full segment is available online in RealPlayer.