Bush Pledges $200 Million to Global AIDS Fund, But Critics Call Contribution ‘Too Little’

Making the United States the first nation to commit to the new global AIDS fund proposed last month by U.N. Secretary-General Kofi Annan, President Bush pledged on Friday an anticipated "initial" U.S. contribution of $200 million, saying that there would be "more (money) to follow as we learn where our support can be most effective," the Washington Post reports (DeYoung, Washington Post, 5/12). Noting in his announcement that the pledge could "reduce suffering and spare lives," Bush said, "In a part of the world where so many have suffered from war and want and famine, these latest tribulations are the cruelest of fates. We have the power to help" (Jelinek, AP/Washington Times, 5/12). According to Bush, a "worldwide consensus [is] forming on the basic elements" of the trust fund and how the $7 billion to $10 billion that Annan is asking for the fund would be used, noting an emphasis on prevention, treatment and transparency to ensure proper spending. He added that the fund should be endowed by "not only governments ... but also private corporations, foundations, faith-based groups and nongovernmental organizations." He also stressed that the fund "must respect intellectual property rights as an incentive for vital research and development."

Annan, UNAIDS Praise Bush
Speaking in the White House Rose Garden, Bush was accompanied by Nigerian President Olesegun Obasanjo and Annan, who called the pledge "a visionary decision that reflects your nation's natural leadership in the United Nations." Annan's comment was "clearly intended to soothe anger in Congress" after the U.N. Human Rights Commission voted the United States out of a council seat two weeks ago, the Post reports (Washington Post, 5/12). Annan said, "I wish to thank you, President Bush, for committing yourself today to placing the United States at the forefront of the global fight against HIV/AIDS. ... To defeat this epidemic that haunts humanity, and to give hope to the millions infected with the virus, we need a response that matches the challenge. ... And the resources provided must be over and above what is being spent today on the disease. ... This founding contribution by the United States with the promise to do more will encourage and energize others to act." Annan said he hopes the United States' donation will "set an example for other leaders," adding, "I believe today will be remembered as the day we began to turn the tide" (U.N. release, 5/11). UNAIDS also lauded Bush's pledge to the global AIDS fund, saying in a statement, "UNAIDS applauds the U.S. government's leadership in being the first country to respond to the call made by [Annan] ... last month for a global trust fund. ... UNAIDS hopes that this announcement will give significant momentum to the development of the fund. The U.S. announcement is particularly welcome in the run-up to both the U.N. Special Session on HIV/AIDS, to be held in New York from 25-27 June, and to the summit of the G8 group of countries, scheduled for Genoa, Italy, in July this year" (UNAIDS release, 5/11).

$200M Draws From 'Rainy Day' Fund
Meanwhile, others have continued to question where the administration's $200 million donation will come from. The Wall Street Journal notes that Republican congressional leaders have in recent weeks "rolled back" much of the Senate's proposed spending increases for AIDS assistance in an effort to "fall in with the president's fiscal policy." For example, in April the Senate had approved an amendment to its budget resolution that would have increased global AIDS funding by $200 million to about $700 million for the fiscal year beginning Oct. 1 and by an additional $300 million the following year. But the measure, which was supported by Sen. Bill Frist (R-Tenn.), was later dropped. And AIDS funding "could well face rougher going when Congress begins action on the 13 annual spending bills later this year," the Journal warns (McKinnon et al., Wall Street Journal, 5/14). In his announcement, Bush did not indicate where the United States would obtain the funding, but White House spokesperson Scott McClellan said on Friday that the money would be withdrawn in $100 million installments, from "existing" State Department and Health and Human Services accounts. He said, "We are going to work with Congress within the existing budget to meet all priorities and to fulfill this commitment to the new global fund while making sure that funds do not come from [international] poverty alleviation or HIV/AIDS" funds. The use of "carved out" funding disappointed a "number of prominent Democrats" and non-government organizations that had urged the White House to provide "new money," the Post reports (Washington Post, 5/12). In a press briefing on Friday, Frist said that the $200 million for the global AIDS fund would draw from a $500 billion "contingency trust fund," allocated in the budget passed by the Senate last Thursday. Frist described the contingency fund as a "rainy day fund," adding, "[T]his is the sort of initiative where you have the appearance of a new challenge, a challenge that affects people throughout the United States, but, indeed, throughout the world can be addressed. ... [T]hat's the purpose of that sort of fund" (Frist release, 5/11). State Department Spokesperson Richard Boucher stressed in a press briefing on Friday that U.S. global AIDS funding would not draw from money already earmarked for fighting AIDS or other diseases, or for other initiatives in developing countries. Boucher added, "[T]he money will come equally from the Department of State and the Department of Health and Human Services, and it doesn't come from the existing programs to fight disease. But exactly how we do this is something we have to discuss with the Congress" (State Department release, 5/11).

'Miserly' Donation?
Others "protested" that the $200 million was "too little," with the Health GAP Coalition of AIDS activists groups calling the pledge a "PR spectacle instead of desperately needed money for AIDS in Africa" (Washington Post, 5/12). Dr. Peter Lurie, deputy director of Public Citizen's Health Research Group, said that "even if every penny of this money went to AIDS, for the government of a country that produces 26% of the world's wealth to offer less than 10% of what U.N. AIDS experts say is needed to adequately respond to the epidemic is just miserly" (New York Times, 5/12). Even Annan and Obasanjo "gently prodded" for more funding, with Obasanjo estimating that $7 billion to $8 billion will be needed each year "to make an impression" on the epidemic. Harvard University economist Jeffrey Sachs said that although "there is no doubt in my mind that the $200 million is not sufficient," the donation's representation of a new approach to fighting AIDS was more important than its size (AP/Baltimore Sun, 5/12). But Eric Sawyer of ACT UP said the $200 million donation amounts to $7 per person with AIDS, noting, "That will buy lunch but it certainly won't buy treatment for those 35 million people and it [will] do nothing to mount effective prevention programs." Salih Booker of Africa Action concurred that the U.S. donation is "less than a drop in the bucket" and the equivalent of 0.2% of the tax cut Bush is "pursuing for just this year alone" (Rovner, "All Things Considered," NPR, 5/12).

'Seed Money'
But Annan stressed that Bush "made it clear" that the $200 million "is a founding contribution, seed money, ... and indicated that more will follow" (Siegel, "All Things Considered," NPR, 5/11). Frist concurred that the $200 million will be followed by more funding, "suggesting that this trust fund must be set up correctly, that it must be transparent, that it must be accountable and that it must accomplish the goals that are set out for that trust fund" (Frist release, 5/11).

Setting an Example
The Wall Street Journal Europe reports that the U.S. pledge for the global fund "has put pressure on Europe to follow suit, but many countries are hesitating because of differences over how such a fund would work." The global fund "has still not won widespread approval" among EU countries, the Journal reports, and Europeans feel they "already spend their fair share on aid," with 15 countries donating about $842 million in health aid to developing countries in 1999, compared to $425 million from the U.S. and $330 million from Japan. While the media continues to stress the need for cheaper AIDS drugs, E.U. countries say funds would be "better spent" on disease prevention initiatives and developing countries' general health infrastructure (Winestock, Wall Street Journal Europe, 5/14).

Other Funding Questioned
During the announcement, Bush made no mention of providing money for the existing World Bank AIDS Trust Fund, which Congress agreed last year to finance with $150 million in the Global AIDS and Tuberculosis Relief Act but thus far has only appropriated $20 million. Although Bush's budget, pending in Congress, calls for $480 million for AIDS treatment domestically and abroad, an 8% increase from FY 2001, he did not increase funding for the Ryan White CARE Act, instead focusing on vaccine development as part of a $2.5 billion AIDS research budget at NIH (New York Times, 5/12).