AIDS-Free World (Gloucester)
28 January 2008
document
Boston — Excerpt of a speech by Stephen Lewis, Co-Director, AIDS-Free World, to the Third Annual Student AIDS Conference, Harvard Medical School, Boston
Recently, there has been a spate of news stories in which scientists and academics claim that too much money is going for AIDS, leaving crumbs from the donor table for other international health imperatives. Those of us at AIDS-Free World think they're dead wrong. And they do a great disservice to the legitimate, insistent clamour for more foreign aid.
The argument has been sharpened because of UNAIDS' revision of the numbers of people living with the virus from nearly 40 million in the last estimate to 33 million today. Thank you UNAIDS. This embarrassing correction of epidemiological miscalculation has predictably given dissenters a hook on which to challenge the money being spent for AIDS. And when UNAIDS soon revises the financial requirements downwards --- as they must, if there are between six and seven million fewer cases --- then we'll get yet another burst of controversy over what should be allocated for HIV/AIDS versus all the pressing health priorities.
But the argument is really straightforward. On the basis of the former estimate of the number of people infected, UNAIDS calculated that we'd need $41 billion annually by 2010 to reach full universal access to treatment, prevention and care (including orphans and program costs and a pittance for violence against women) and $52 billion by 2015, coincident with the Millennium Development Goals. If you make a straight reduction in those figures to reflect the percentage reduction in the number of cases, you'd need roughly $34 billion in 2010and $43 billion in 2015. (Those are the real and accurate figures with which I fully agree. But there were other scenarios presented to water down total costs so as not to scare off the donors. We reject them utterly. It's time to stop bargaining over human life because donors betray their promises).
Last year, 2007, we spent, overall, a little more than $10 billion on HIV/AIDS worldwide. The shortfall this year will be enormous … in the billions. So, too, 2009; so, too, 2010; so, too, every year thereafter. The struggle for AIDS funding remains a monumental challenge. The people who beat the drums about too much for AIDS and not enough for other health priorities; who suggest reapportioning AIDS monies to other health concerns are unwittingly compromising the lives of millions.
What they should be saying is "Where is the additional money for everything from water to sanitation to nutrition to education to health systems to human resources to neglected diseases to everything that is needed to ameliorate the human condition?"
The American contribution to foreign AID for developing countries remains abysmal. The Administration spends, conservatively, up to $108 billion a year on the war in Iraq, and perhaps $5 billion in an entire year on HIV/AIDS. Those priorities are so skewed as to be obscene. And now that the United States is in economic crisis, you can be sure that foreign aid will again emerge the beggar when future appropriations are made.
We should never forget that as a percentage of GNP, the United States occupies virtually the bottom rung of the ladder amongst all the industrial nations, let alone the G8. In 2006, the last year for which figures are available, the Development Assistance Committee of the OECD reported that only Greece was below the United States of the 23 countries listed. Greece spends 0.17% of GNP on foreign aid; the United States spends 0.18%. The average for all countries is 0.31% of GNP … virtually double the expenditure of the United States. The target, of course, is 0.7%, almost quadruple the US current contribution.
The scientists and academics who argue for redistribution of HIV/AIDS monies simply capitulate, ignobly, to the dreadful levels of ODA (official development assistance). They rationalize this position by arguing that we must be pragmatic: there's no more money forthcoming or available. Of course, that's a counsel of despair. We don't need detractors; we need advocates who will hammer away at government until the pendulum swings and the resources are extracted.
To make HIV/AIDS pay the price for governmental negligence is the ultimate irony. Talk about robbing Peter to pay Paul. Peter and Paul are both in life and death struggles. Those who would sacrifice one on the altar of the other have been reading Milton Friedman, not the Bible.
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