Bush Expected To Announce Vietnam Will Receive PEPFAR Funding During Speech on HIV/AIDS in Philadelphia
President Bush on Wednesday is set to announce that Vietnam will be the only country outside of Africa and the Caribbean eligible for funds through the President's Emergency Plan for AIDS Relief, Reuters reports. Vietnam will be designated as one of the program's "focus countries," according to Reuters (Entous, Reuters, 6/22). Currently, the five-year, $15 billion PEPFAR directs funding to 12 African nations -- Botswana, Ethiopia, Cote d'Ivoire, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia -- and Haiti and Guyana in the Caribbean (Kaiser Daily HIV/AIDS Report, 6/10). Bush, who is scheduled to speak on Wednesday about HIV/AIDS and "compassion" at Greater Exodus Baptist Church in Philadelphia, also is expected to announce that PEPFAR will release $500 million for new treatment and prevention programs in the focus countries, senior administration officials said, the Philadelphia Inquirer reports (Fitzgerald, Philadelphia Inquirer, 6/23). Vietnam could be a "somewhat controversial choice" because some lawmakers had called on the president to select India, which has twice the HIV/AIDS prevalence and 30 times the number of people living with HIV as Vietnam, KRT News/Newark Star-Ledger reports.
Vietnam vs. India
A senior administration official speaking on the condition of anonymity said that although India was considered, the administration chose Vietnam because the epidemic is "expected to grow more rapidly there," according to the KRT News/Star-Ledger (KRT News/Newark Star-Ledger, 6/23). During a White House background briefing on the announcement, senior administration officials who spoke on condition of anonymity said that the administration "considers that Vietnam is a place where the American people's money can really make a tremendous impact because it is on the brink of a very explosive epidemic." Although currently there are about 130,000 HIV-positive people in Vietnam, some analysts predict that number could increase eight-fold to one million people by 2010, according to a White House release. If the projections are correct, the increase would be greater than predicted increases in India, Russia or China, which are "three of the countries that have been referred to as the 'next wave' countries," according to the senior officials. The officials also said that although the administration considered choosing India, the country is "somewhat different" than the other focus countries because it has a growing middle class, a growing economy and it "really ha[s] the ability to make some trade-off decisions ... to prioritize more resources in this direction." The officials added that India's role in manufacturing generic drugs -- including antiretroviral drugs -- "did ... not have anything to do with this decision" (White House release, 6/22).
The senior administration officials also said that during Wednesday's scheduled speech, Bush will call for expanding research into an AIDS vaccine, increasing flexibility for AIDS funding and the necessity of implementing prevention strategies, according to KRT News/Star-Ledger (KRT News/Newark Star-Ledger, 6/23). The president also is expected to call for reauthorization of the Ryan White CARE Act, the federal law that authorizes spending for HIV/AIDS treatment and prevention programs in the United States, the Los Angeles Times reports (Kemper, Los Angeles Times, 6/23). The officials said that Bush is "committed" to reauthorizing the CARE Act, which is due for reauthorization in fall 2005. In pursuing reauthorization, Bush will focus on using federal resources to ensure that people who cannot afford antiretroviral drugs and care receive treatment; offering increased flexibility in targeting funds to ensure provision to communities that most need money; and measuring results and encouraging the participation of "any provider who can show those results" to ensure accountability, according to senior officials (White House release, 6/22). According to a White House fact sheet, Bush has committed $20 million in new funding "effective immediately" to deliver antiretroviral drugs to HIV-positive people living in states that have patients on waiting lists to receive medication through the AIDS Drug Assistance Program (White House fact sheet, 6/23). ADAPs -- which are supported with both state and federal Ryan White funds -- provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 4/2). Bush also "recognizes the dire need to promote prevention using proven methods" in the United States, including the "ABC" model of prevention -- Abstinence, Be Faithful, use Condoms -- the senior officials said (White House release, 6/22).
World Health Organization Vietnam Representative Dr. Hans Troedsson said, "This kind of funding before [HIV/AIDS] gets out of control is a very wise thing." He added that U.S. officials "realized that Vietnam has a lot of potential to absorb financial resources like this. They have a national strategy on HIV/AIDS, which is very comprehensive" (Toh-Pantin/Nhat Lam, Reuters AlertNet, 6/22). A congressional aide said, "We need to address some of these brush-fire countries before they get out of control" (Reuters, 6/22). However, some advocates are expected to demonstrate during the president's speech in Philadelphia because they say Bush is considering reducing the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria by more than 60%, according to the Times. Global AIDS Alliance Director Paul Zeitz said that funding for groups in the PEPFAR focus countries is "coming at the expense of multinational efforts," the Times reports (Los Angeles Times, 6/23). Zeitz said that Vietnam is expected to receive $44.7 million from the Global Fund, but Bush has proposed cutting the U.S. contribution to the fund by 64%. He added that the "world is looking to the United States to re-prioritize global cooperation over unilateralism," but he said that Bush "gives with one hand while taking away with the other" (GAA release, 6/22).
There are "too many gaps between the president's fine intentions" to fight HIV/AIDS and his administration's "actual deeds," a Philadelphia Inquirer editorial says. Although "it is good" that Bush has made HIV/AIDS one of his top international priorities, the president "needs to make a monetary commitment that's equal to his moral commitment," the editorial says. The Inquirer concludes that the HIV-positive people who the president "want[s] to help need more than [his] heartfelt words. They need [his] actions, in deeds and in dollars" (Philadelphia Inquirer, 6/23).
Federal Funding for Global HIV/AIDS Activities
Since the federal government began funding global HIV/AIDS activities in low- and middle-income countries in the mid-1980s, funding for such activities has increased significantly, especially over the past several years, according to a new policy brief released on Wednesday by the Kaiser Family Foundation. In addition, funding for global HIV/AIDS activities -- which is channeled through both bilateral and multilateral assistance -- has increased as a proportion of the overall U.S. HIV/AIDS budget. The brief, titled "U.S. Government Funding for Global HIV/AIDS Through FY 2005," includes charts providing detailed data on federal funding for global HIV/AIDS through fiscal year 2004, as well as the FY 2005 budget request (Kates/Summers, "U.S. Government Funding for Global HIV/AIDS Through FY 2005," 6/23). The policy brief, along with other reports and fact sheets on global HIV/AIDS funding, is available online.
White House Office of National AIDS Policy Director Carol Thompson will answer questions today at 5 p.m. ET in the online interactive forum "Ask the White House." Questions can be submitted at whitehouse.gov/ask/question.html. A transcript of the chat will be available online after the discussion.
NPR's "Morning Edition" on Wednesday featured a segment on the Bush administration's withdrawal of federal funding for the upcoming XV International AIDS Conference. The segment includes comments from HHS spokesperson Bill Pierce; Roland Foster, an aide to Rep. Mark Souder (R-Ind.); Joep Lange, International AIDS Society president and IAC co-chair; and Judy Auerbach, vice president of public policy at the American Foundation for AIDS Research (Knox, "Morning Edition," NPR, 6/23). The complete segment is available online in RealPlayer.