Questions remain over US HIV effort

US President George W. Bush has signed into law a Bill authorising US$15 billion to fight HIV/AIDS in Africa and the Caribbean. The initiative was previously announced in his State of the Union address in January.

“In the face of preventable death and suffering, we have a moral duty to act, and we are acting,” Bush said during a signing ceremony at the State Department in Washington DC on 27 May, calling HIV/AIDS “one of the most urgent needs in the modern world.” Promising that the US would provide “unprecedented resources” to the effort to fight HIV/AIDS, the President also signalled that the US would challenge other wealthy countries to follow the United States’ lead at the G8 summit in France.

US Secretary of State Colin Powell told the signing ceremony, which was attended by ambassadors from the 14 countries being targeted by the bill, of the need to respond to HIV/AIDS not just for humanitarian, but also for economic and security reasons. The spread of HIV/AIDS was “more devastating than any army, any conflict, or any weapon of mass destruction,” he said.

The President has claimed that the money will prevent seven million new infections, care for 10 million infected people and AIDS orphans, and provide antiretroviral [1]A medication or other substance which is active against retroviruses such as HIV. treatments for two million.

But questions are being asked about the degree of commitment being offered by Washington to come up with the money and about the ways in which it will be allocated and spent. Despite the bill calling for US$3 billion a year over five years, the Bush administration’s 2004 budget proposal allocates only $1.7 billion for the initiative, according to a report in the San Francisco Chronicle.

The bill has also been criticised for sidelining the Global Fund to Fight AIDS, TB and Malaria, which has been promised just $1 billion of the funds.

There is concern within the international community at changes to the bill made during its progress through Congress. Significant amounts of the allocated funds will now be used to provide debt relief for countries hardest-hit by HIV/AIDS, not for direct funding of programs. And in a move designed to appease conservative members of Congress, one third of the funds allocated to prevention are to be set aside for abstinence-promotion programs.

The bill recommends that 55 percent of the money go to treatment programs, 20 percent to prevention, 15 percent to palliative care and 10 percent to assisting children who have lost one or more parents to AIDS.