I put up a piece this morning under the perhaps-surprising title of George W. Bush brings his awesomeness on AIDS Day. I’m, um, not a huge George W. Bush fan. But PEPFAR was a genuinely great thing. Of course there’s a Nixon-to-China aspect of a Republican president taking leadership in the fight against AIDS. Many others deserve credit. The bottom line is that Bush cared about it and was able to get this done. He’s also doing a great service advocating for sustained global health aid when so many Congressional Republicans (and, shamefully, some Democrats too) have supported and enacted punishing cuts to programs that save literally millions of lives around the globe.
As New York Times reported: “America’s budget crisis at home is forcing the first significant cuts in overseas aid in nearly two decades.” House Republicans propose deep cuts in the State Department and in foreign aid. Many of these cuts fall on evidence-based health and development assistance. As the Washington Post’s Michael Gerson described these cuts earlier this year: “If the goal of House Republicans is to squander the Republican legacy on global health, they are succeeding.” The same thing is happening in other wealthy democracies facing hard economic times.
My TIE post left one thing out: the immediate consequences of donor cuts to HIV programs. Alanna Shaikh at UN Dispatches provides a powerful column on this:
In the face of [great scientific and clinical opportunities], the global community responded in one voice, “Forget it. We don’t care.” Things are hard all around, you know, and foreigners with HIV don’t vote in domestic elections. The Global Fund to Fight AIDS, TB, and Malaria just canceled its next round of grants. The WHO is laying off staff. Bilateral donors are cutting aid to global health. Instead of breaking the cycle of HIV transmission, developing nations will be lucky if they can protect the people they already have on treatment.
That may sound dramatic, but look at the numbers. The Global Fund asked donors for $20 billion. It received $11.5. Everyone from Germany to the USA reneged on their pledges of support.
What a predictable, infuriating, and short-sighted development. Shaikh notes that we’ll be apologizing to our children for this. The people to whom apology is really owed won’t hear it. Many will soon be dead.