US President George W. Bush announced $15 billion to fight HIV and AIDS in his State of the Union address on January 28. The proposed funds are to be spent in the African countries of Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. Also included are the two Caribbean countries Guyana and Haiti.
Two thirds of the sum is new money, with the remainder being drawn from existing proposals. However, the move is far less generous than it first appears and has a definite and sinister ulterior motive.
In a deliberate snub, the United Nations Global Fund to Fight AIDS, Tuberculosis and Malaria will only receive $1 billion of the proposed aid over the next five years. The initial installment of $200 million will be given for the financial year 2004, which starts in October. This is less than this year’s pledge to the Global Fund of $380 million.
As a result, the Global Fund is in danger of going broke. Top fund official Anil Soni said; “We have a problem. We need to get new dollars in, so we can continue to fund programmes.” Approximately $6.3 billion is needed over the next two years to continue funding proposals. UN Secretary General Kofi Annan has stated the world would need to spend between $7 billion and $10 billion a year to effectively treat HIV/AIDS and other infectious diseases in underdeveloped countries.
Although it does not intend to finance the Global Fund, the Bush administration is determined to keep control of it. Tommy G. Thompson, the head of the US Health and Human Services Department, is the Fund’s chairman.
Rather than contribute to the Global Fund, Bush intends to allocate the new aid unilaterally through US government agencies, such as USAID and the Centers for Disease Control (CDC).
USAID is the major government body for distributing aid. Its role is to foster the strategic and economic interests of the US government. In the year 2004 around a quarter of its $8 billion budget will go to Israel, Egypt, Turkey and Pakistan. The CDC is the government body associated with public health controls but has connections, via its Chemical and Biological warfare role, with the National Security apparatus.
Prior to his announcement the Boston based Physicians for Human Rights (PHR) sent a letter to Bush signed by over a 100 leading health professionals, including Nobel prize winners, involved in the care and treatment of HIV patients. They urged Bush to respond to the HIV/AIDS pandemic and called on the US government to support the Global Fund and to provide debt relief for poor countries.
Following Bush’s speech PHR Director, Holly Burkhalter, said; “The funding of the new plan under the President’s budget would come too slowly. He has allocated only $2 billion in fiscal year 2004, still well short of the $3.5 billion that Physicians for Human Rights is calling for on an annual basis. The money for his plan should be front-loaded to pay for the most expensive initial investment: building health infrastructure. With infrastructure in place, the treatment costs will go down.”
They condemned the fact that “the vast bulk of the new money will be for US government programs.” They were particularly concerned at the creation of a new, high-level Special Coordinator for International HIV/AIDS Assistance at the State Department. They pointed out that neither the Department of Health and Human Services, which houses the CDC and the National Institute of Health, nor USAID has any experience in this area. USAID Administrator Andrew Natsios opposes treatment of AIDS with anti-retrovirals in poor countries.
The US based Global AIDS Alliance criticized the slow timetable of the funding which they considered, “inappropriate from a public health standpoint, because the epidemic is expanding exponentially now and there is extensive under funding of currently available programmes that are ready for scale-up.”
They also criticized the failure to provide funding to some of the countries most heavily affected by HIV/AIDS such as the Democratic Republic of Congo and Mali. They pointed out the obscenity of African countries having to pay debts to the west during the HIV pandemic. “In 2001, African governments paid $14.6 billion in debt servicing to the IMF, the World Bank and wealthy nation creditors. This extraction of local resources directly undermines all efforts to combat AIDS,” their statement read.
The American based AIDS and human rights group Health GAP (Global Access Project) criticized Bush’s attack on the UN Global Fund and went on, “USAID and CDC do not have the capacity nor the desire to implement the programmes called for by the president.”
Health GAP state bluntly that, “The funding levels are fraudulent. By accumulating numbers over arbitrary lengths of time and back loading until the distant future, the Administration makes a little look like a lot.”
Bush clearly intends to use the issue of AIDS funding to impose US policies, granting aid to those who toe the line and denying it to those regimes who fall short of the mark or find themselves out of favor.
He was originally going to announce the funding on his African trip at the beginning of this year and has had a team working on the plan for several months. Those involved are a strange group to be concerned in health matters. They include Dr Anthony Fauci a leading expert on bio-terrorism and vaccine research who talks to Bush on a regular basis, Joshua Bolton, head of national security and international affairs at the Office of Management and Budget, and Robin Cleveland, deputy national security adviser.
The choice of personnel is in line with two reports published last year, which discussed the HIV/AIDS pandemic as a security threat to the USA. The National Intelligence Council (NIC) which answers directly to Central Intelligence director, George Tenet, published one report, The Next Wave of HIV/AIDS. The other was produced by the Washington based Center for Strategic and International Studies (CSIS). Entitled The Destabilizing Impact of HIV/AIDS, the report’s preamble explains that it was produced to “highlight for military and security policy leaders the security challenges posed by rapidly spreading HIV/Aids and to propose concrete measures to strengthen the US response to these emerging challenges.”
Bush’s announcement is in line with this assessment. It demonstrates his administration’s determination to treat the HIV/AIDS epidemic as a matter of security not a health question or a humanitarian issue. The money will be used as an instrument of foreign policy to reward or punish underdeveloped countries and to tighten US control over them.