Africa: Bush Aids Pledge Stirs Hope and Questions

30 January 2003

Washington, DC — The announcement by President George Bush of an additional $10 billion in funding "to turn the tide against Aids in the most afflicted nations of Africa and the Caribbean" came as a surprise, even to close supporters like the new Senate Majority Leader, Bill Frist from Tennessee.

"I was blown away," Frist told National Public Radio Wednesday morning. But it was not a last minute idea, according to Dr. Jendayi Frazer, senior director for African affairs on the National Security Council staff. The president had been slated to unveil the funding boost during his trip to Africa, which was scheduled for earlier this month before being postponed.

"We had to take the 'lesser' venue of the State of the Union," she joked during an appearance today at a forum organized by the Africa Society. The president's concern for Africa should not be in doubt, Frazer said, even though critics and media reports regularly attribute ulterior motives to any Africa-related initiative he takes. She said the president has always been willing to fund a workable strategy for combating HIV/Aids.

In his address, the president said his Emergency Plan for Aids Relief will prevent seven million new infections, treat some two million people with anti-retroviral drugs, and "provide humane care for millions of people suffering from AIDS, and for children orphaned by Aids." The entire cost over the next five years will be $15bn, "including nearly $10bn in new money." Funding will begin with $2bn in fiscal year 2004.

Money for the president's emergency plan will be targeted to a dozen African nations - Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia - as well as Haiti and Guyana in the Caribbean.

To underline the new initiative, the White House selected Dr. Peter Mugyenyi, "one of the leaders in the battle to combat the global AIDS pandemic," to sit next to First Lady Laura Bush in her special box for invited guests. Mugyenyi, who established an Aids clinic in Kampala, "was one of the first African physicians to insist that his patients were capable of complying with the complicated daily regimen of medicines that was revolutionizing treatment of HIV/Aids in the U.S., according to a Wall Street Journal profile by Michael Waldholz published last year.

"This is an unprecedented commitment," Frist said, adding that legislation to enact the proposal would receive quick Senate action. The president's statement was also welcomed by Rep Donald Payne (D-NJ), the ranking minority member of the House Africa subcommittee and the point person on Africa for the Congressional Black Caucus. "We believe this is a step in the right direction, but we have to do more," he told the Africa Society forum.

The Africa Society, in conjunction with Foreign Policy magazine and the Program on International Policy Attitudes, released a poll Wednesday showing broad American support for engaging with and assisting Africa. One-third of those polled said they favor an increase in aid to Africa, and the survey suggests that support for an increase would be substantially higher, if respondents knew the current level of aid. To the question: "How many of your tax dollars would you be willing to have go to economic and humanitarian aid for African countries," the median response was $20, compared with the current actual figure of $3. In addition, 80 percent said they would favor an increase if they had confidence that aid "would really help the people who need it."

On the issue of HIV/Aids, when asked if the U.S. government should seek to stop poor countries from importing generic Aids drugs, 86 percent of respondents said the government should not take that action to protect the patents of the major pharmaceutical firms.

Dr. Frazer, the president's senior Africa advisor, said in response to a question at the forum that the U.S. government does not oppose the use of generic drugs by countries facing an Aids emergency. In a policy statement issued a month ago by U.S. Trade Representative Robert Zoellick, the administration announcement its willingness to permit countries "to override patents on drugs produced outside their countries in order to fight HIV/Aids, malaria, tuberculosis, and other types of infectious epidemics, including those that may arise in the future."

Positive reaction

Reaction to the president's announcement in the anti-Aids community has been generally positive. "President Bush tonight saved millions from the certainty of death by pledging treatment and the money to purchase life-sustaining drugs," said Michael Weinstein, President of Aids Healthcare Foundation, which calls itself the largest organization of Aids care providers. Dr. Paul Zeitz, executive director of the Global Aids Alliance, called the statement "a watershed moment" in American foreign policy.

"It opens the floodgates of hope," said Stephen Lewis, the United Nations special envoy for HIV/Aids in Africa. At a news conference in Johannesburg, Lewis said that Bush's remarks were "the first dramatic signal from the U.S. administration that it is now ready to confront the pandemic and to save or prolong millions of lives." He said the announcement is a challenge to other industrialized nations to follow suit.

A major concern for anti-HIV campaigners is how the money is to be allocated. Prega Ramsamy, executive secretary of the Southern Africa Development Community, said the money should be dispersed to small-scale community projects if it is to have any real effect on people's lives. "We need to make sure that it filters down to the level of people that most need it," he said.

Lewis stressed the importance of channeling funds through the Global Fund to Fight Aids, Tuberculosis and Malaria, established at the urging of UN Secretary General Kofi Annan to stimulate and coordinate the massive international resources required for an effective anti-Aids effort.

The White House says $1bn of the additional $10bn will go to the Global Fund. Zeitz, of the Global Aids Alliance, fears that would mean serious underfunding of an organization that is equipped to handle "real proposals from countries where the need is greatest." The Global Fund needs $2.2bn from the United States this year to meet its targets, said Zeitz. "We are concerned that the U.S. initiative not undermine the international effort represented by the Global Fund."

Salih Booker, executive director of Africa Action, a U.S. lobby group campaigning for significant increases in U.S. assistance, agrees. He criticizes the president's plan for failing to include any increased funding this year. "Large numbers for 2007 are meaningless to people who will die this year without access to essential medicines," he said.

Some critics believe the administration's record raises questions about the seriousness of its intentions. Sen. John Kerry (D-MA), who is running for the Democratic nomination to oppose Bush in 2004, said Bush "pulled the rug out from under Bill Frist and me last fall when he had the chance to make America the world's leader in fighting that pandemic," referring to a bipartisan bill to increase U.S. funding for fighting Aids that the White House opposed.

Leon Spencer, executive director of the church-sponsored Washington Office on Africa, questioned whether the new stated policy on generic drugs is genuine. "There are no grounds to trust this administration if a choice must be made between drug patents and African lives," he said.

Spencer said the only way the president's math works - preventing seven million infections and treating two millions infected people, is by using generics. "If that means he accepts the wisdom of provision of generic drugs" and is prepared to support the multinational efforts of the Global Fund, Spencer said, "his remarks last night deserve our congratulations."

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