‘Initial Investment’ of U.S. Funds for HIV/AIDS Efforts in Africa ‘Too Low,’ Commentary Says

President Bush in January made a "stunning" $15 billion proposal to fight AIDS in Africa and the Caribbean, but the "generous pledge is guaranteed to give pause" to some HIV/AIDS advocates, Martha Frase-Blunt, a freelance writer specializing in health care issues, writes in a Washington Post commentary (Frase-Blunt, Washington Post, 3/9). The proposal, which Bush unveiled in his State of the Union address on Jan. 28, includes $10 billion in new funds for HIV/AIDS prevention and treatment programs in Africa and the Caribbean over the next five years (Kaiser Daily HIV/AIDS Report, 3/5). However, Frase-Blunt writes, only $1.6 billion is allocated for HIV/AIDS efforts in the fiscal year 2004 budget and the majority of the proposal's funds would not become available until 2007 or 2008. The "initial investment is too low, given the huge ramp-up costs involved" with prevention and treatment programs, Frase-Blunt writes, adding that the "logistics of offering consistent treatment to approximately 30 million HIV-positive Africans are far from trivial." According to Frase-Blunt, "curtailing Africa's AIDS crisis will take more than upgrading an inadequate health care infrastructure." She recommends that an HIV/AIDS prescription drug distribution program in Africa focus on HIV-positive patients with certain viral and immunity levels because medications "given too early in the course of treatment ... will be ineffective later; given too late, they won't work." Frase-Blunt concludes, "The critical elements -- funding, treatment and U.S. leadership -- seem to be aligning at last in favor of real change. ... And precious time will be wasted if the funding stream starts so slowly that any impact will take years to realize. The global AIDS community has a tremendous set of tasks before it: the first is making sure President Bush and the U.S. Congress remain as committed to the outcome as to the shining promise" (Washington Post, 3/9).

'Focus on Compassion'
Bush's pledge of financial support to fight the HIV/AIDS epidemic in Africa has "devolved into political symbolism" due to Congress' debate over whether to apply to the funding the "Mexico City" policy, which prohibits federal aid from going to groups that fund or discuss abortion, according to a St. Louis Post-Dispatch editorial. The editorial says that the lawmakers' debate is "far removed from the realities" of the epidemic in Africa, and Congress should not "consig[n] AIDS assistance into the morass of abortion politics." If Republican lawmakers are allowed to include limitations on the funding in the appropriations bill, it could "derail the whole" initiative, the Post-Dispatch states. The editorial concludes that the delay is "unnecessary and immoral" and lawmakers should "pu[t] politics aside and focu[s] on compassion" (St. Louis Post-Dispatch, 3/8).