Obama’s Decision to Keep HIV/AIDS Funding Flat Could Be Devastating

A group of AIDS advocates gathered yesterday in Washington, D.C. to talk about the President’s Emergency Plan for AIDS Relief (PEPFAR). The reason for the meeting was because the Obama administration recently decided to flatten funding for PEPFAR grants—the result could be the beginning of a devastating step back for AIDS treatment centers in Africa. One message was clear: if something isn’t done about PEPFAR funding soon, advocates are afraid that lack of treatment will lead to more deaths and major setbacks among HIV/AIDS patients in Africa.

The advocates at the table included representatives from Global AIDS Alliance, Shepherd Smith from the abstinence-only HIV/AIDS group Children’s AIDS fund, and representatives from United Nations AIDS and ONE. They had gathered to hear from Dr. Lydia Mungherera, board member of the Global AIDS Alliance and founder of the organization Mama’s Club in Uganda, about the effects she has seen from the change in funding and to discuss money for treatment on the ground in Uganda.

Because of the stagnation in PEPFAR funding, Mungherera has seen organizations and clinics in Uganda shut down or experience stock-outs, when that they don’t have enough drugs to actually distribute to everyone who comes in. As Ugandan HIV/AIDS advocates like Mungherera and other international health experts encourage more and more Ugandans to get tested for HIV, they’re worried that they won’t be able to treat patients who find out they are HIV-positive.

Clinics and treatment centers in Uganda are beginning to cap the number of patients enrolled in treatment due to the lack of increased funding. Other organizations are giving their patients lower doses of drugs than they actually need. Mungherera has observed family members sharing drugs because there just isn't enough to go around. All of this is adding up to what she gauges to be “a return to the hopelessness of the [19]80s.”

PEPFAR grants, a controversial program originated by the Bush administration for AIDS treatments and prevention abroad, go straight to non-governmental organizations. For this reason, Mungherera’s prefers the PEPFAR program to other types of AIDS funding because people and clinics often receive grants more quickly rather than funneling them through sometimes corrupt governments. “PEPFAR funding has given the best treatment on the ground,” Mungherera says.

PEPFAR’s original mission was to provide universal coverage for anyone who needed testing or treatment for HIV. But with the new funding crunches, some feel like Congress is going back on its original commitment.

“We’ve been relying so much on the PEPFAR program to provide treatment for us, and we’re really upset that this money isn’t coming, due to whatever reason,” Mungherera says. She reiterates that funding has to come back to being about treatment. “The point I’ll say is that when there were no health care systems, nothing. We gave treatment to save lives. … We’re going to lose the mothers of children; we’re going to lose children themselves."

Many of the complaints in the room of activists yesterday were chalked up to an administration that didn’t seem to be making AIDS a priority. Though President Obama has formed a Global Health Initiative, an interagency process that includes the Department of State, the Health and Human Services Department, and U.S. Agency for International Development and others that gives guidance on addressing global health issues, as a more comprehensive health policy that encourages fighting preventable disease, especially in children, representatives from Children’s AIDS fund and UN AIDS among others do not feel that AIDS is the priority it was in the George W. Bush White House.

Part of this, Smith says, is because Ambassador Eric Goosby, the appointed United States Global AIDS Coordinator, does not have access to the White House in the way that his predecessor, Mark Dybul, had during the Bush administration. Instead, Goosby reports to Secretary of State Hillary Clinton rather than to president or the president's chief of staff. Still, it remains to be seen how the Global Health Initiative will take shape and what its goals will really be. “Although we are very happy with the Global Health Initiative," Mungherera says, "we need funding for people to live. We need funding for drugs.”

Additionally, those concerned with women’s issues and useful HIV prevention strategies, like the International Women’s Health Coalition are critical of the implementation of PEPFAR under Bush and Dybul because of the ABC prevention plan—Abstinence, Be Faithful, Correct and Consistent Condom use, which is both ineffective and ignores realities like rape and sexual abuse, particularly for vulnerable women. Though Goosby’s five-year plan for the program has de-emphasized these elements of the PEPFAR prevention in exchange for more comprehensive reproductive health measures, it’s unclear how the new five-year plan will truly take shape.

Mungherera knows it’s going to take a serious advocacy effort to change the track the administration appears to be taking. “We need advocacy to get things back on track, and get the Congress here back to remembering that their duty in the first place was to save lives,” she says. "It doesn’t sound right—morally right—not to treat people who need treatment.”

Rebecca Foerg-Spittel is an editorial intern at Campus Progress and a junior at the College of Holy Cross.

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