In his second State of the Union address yesterday, US President George W Bush announced that he would seek backing from Congress to commit US$15 billion over five years to the response to AIDS in Africa and the Caribbean. This should fund ARV treatment for "at least two million people", alongside increased efforts on prevention and support for those affected by the epidemic. Around $10 billion would be "new" money, above that which the Administration would have expected to spend under existing plans and projections.
While only a limited part of this funding is directed through the Global Fund to fight AIDS, TB and Malaria, it should still transform the climate in which the Global Fund operates. The prospect of turning "pilot programmes" into full-scale provision in heavily affected countries becomes a real one. It sends a strong signal to other countries that they should give higher priority to global health needs, although the USA will continue to give a smaller proportion of its GNP in overseas aid than other leading economies. It offers the possibility for drug manufacturers to invest for scaled-up production with some confidence that there will be a market for treatments.
The relevant sections of the State of the Union speech and of the accompanying White House news release follow below. One particularly interesting implication of the speech is that for the projected two million people to receive treatment at the price mentioned, it appears likely that most of the drugs would have to be supplied by low-cost generic producers.
UNAIDS has welcomed the new commitment. 'President Bush's announcement is an encouraging sign of the US government's commitment to preventing the further spread of AIDS in two of the worst-hit regions and to offer urgently-needed care and treatment for those already infected with HIV,' said Dr Peter Piot, UNAIDS Executive Director. 'This initiative should spur other wealthy countries to increase their support for global AIDS efforts. AIDS is rapidly wiping out decades of development and contributing to regional instability. The case for increasing action against the epidemic has never been stronger or more urgent.'
Extract from the President's State of the Union address to Congress
'As our nation moves troops and builds alliances to make our world safer, we must also remember our calling as a blessed country is to make this world better.
'Today, on the continent of Africa, nearly 30 million people have the AIDS virus - including three million children under the age 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than four million require immediate drug treatment. Yet across that continent, only 50,000 AIDS victims - only 50,000 - are receiving the medicine they need.
'Because the AIDS diagnosis is considered a death sentence, many do not seek treatment. Almost all who do are turned away. A doctor in rural South Africa describes his frustration. He says, "We have no medicines. Many hospitals tell people, you've got AIDS, we can't help you. Go home and die." In an age of miraculous medicines, no person should have to hear those words. (Applause.)
'AIDS can be prevented. Anti-retroviral drugs can extend life for many years. And the cost of those drugs has dropped from $12,000 a year to under $300 a year - which places a tremendous possibility within our grasp. Ladies and gentlemen, seldom has history offered a greater opportunity to do so much for so many.
'We have confronted, and will continue to confront, HIV/AIDS in our own country. And to meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief - a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent seven million new AIDS infections, treat at least two million people with life-extending drugs, and provide humane care for millions of people suffering from AIDS, and for children orphaned by AIDS. (Applause.)
'I ask the Congress to commit $15 billion over the next five years, including nearly $10 billion in new money, to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean. (Applause.)
'This nation can lead the world in sparing innocent people from a plague of nature. And this nation is leading the world in confronting and defeating the man-made evil of international terrorism. (Applause.)'
News release (extract): Combating the International HIV/AIDS Pandemic
President Bush announced the Emergency Plan for AIDS Relief, a five-year, $15 billion initiative to turn the tide in the global effort to combat the HIV/AIDS pandemic. The HIV/AIDS pandemic has killed at least 20 million of the more than 60 million people it has infected thus far, leaving 14 million orphans worldwide.
Today, on the continent of Africa, nearly 30 million people have the AIDS virus – including three million children under the age of 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than four million require immediate drug treatment. Yet across that continent, only 50,000 AIDS victims are receiving the medicine they need.
The President’s Emergency Plan for AIDS Relief will help the most afflicted countries in Africa and the Caribbean wage and win the war against HIV/AIDS, extending and saving lives. The following countries will be the focus of the initiative: Botswana, Cote d’Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia.
In each of these countries, the United States will work with private groups and willing governments to put in place a comprehensive system for diagnosing, preventing and treating AIDS. Central hospitals will have laboratories, specialized doctors, and nurses to anchor the system. Satellite clinics will provide antiretroviral drugs and education on the prevention of AIDS. By truck and motorcycle, nurses and local healers will reach the farthest villages and farms to test for the disease and to deliver life-saving drugs.
The initiative is intended to:
- Prevent 7 million new infections (60 percent of the projected 12 million new infections in the target countries);
- Provide antiretroviral drugs for 2 million HIV-infected people; and
- Care for 10 million HIV-infected individuals and AIDS orphans.
The $15 billion virtually triples the current U.S. commitment to fighting AIDS internationally. It includes $10 billion in new funds, of which $1 billion is for the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria. Funding will begin with $2 billion in FY 04 and ramp up thereafter.