Obama cuts HIV funding, risks 1m lives

The lives of millions of Africans living with HIV/Aids are at risk following President Barack Obama’s underfunding of bilateral HIV/Aids programmes — among them the crucial President’s Emergency Plan for Aids Relief (Pepfar) and the Global Fund to Fight HIV/Aids, Tuberculosis and Malaria.

The Obama administration’s $3.6 trillion budget, released on May 7, created a $3.3 billion hole in US bilateral support for global HIV/Aids funding, and global health activists are now pushing for a Pan African response to fix the funding gap in the US’s fiscal year 2010 budget, already submitted to Congress.

According to Dr Paul Zeitz, the executive director of the Global Aids Alliance, President Obama is sending the wrong message to world governments — that it is acceptable to underfund global health, in particular the Global Fund. The fund is already facing a financial gap and the US move will only make it worse.

On February 26, 2009, President Obama released part of his first budget request to Congress. For fiscal year 2010, he requested $51.7 billion for the 150 Account, which funds US foreign affairs priorities.

The foreign operations section funds most of the foreign assistance programmes of concern to the Global Alliance, including the global HIV/Aids Initiative, which supports US bilateral HIV/Aids programmes and a apportions US contribution to the Global Fund to fight Aids, Tuberculosis and Malaria.

The fiscal year 2010 budget also makes it impossible for the president to meet his stated target of doubling foreign assistance by 2012.

In essence, President Obama’s request has broken four campaign promises he made to the people of Africa, putting his administration’s moral leadership to question, say the global activists. He has broken his commitment to double foreign assistance by 2012.

The proposed fiscal year 2010 funding ignores the president’s campaign promises by including only $5 billion for Pepfar, the successful US bilateral HIV/Aids programme ($1.5 billion shortfall); $900 million for the Global Fund to Fight HIV/Aids, Tuberculosis and Malaria ($1.8 billion shortfall); and $700 million for global basic education ($1.3 billion shortfall).

The Global Aids Alliance estimates that as a consequence, one million people around the world will not receive treatment for HIV/Aids, while 2.9 million women won’t receive services to prevent mother-to-child transmission of HIV.

In addition, 27 million people will not access sexual disease transmission prevention programmes and 1.9 million orphans and other children affected by or vulnerable to /HIV/Aids will not receive care and support services.

“Underfunding these critical programmes will have grave consequences, especially during the current global economic crisis and at a point in time when the world may be in the early stages of a devastating flu pandemic,” said Dr Zeitz.

Although President Obama has promised to double US foreign assistance to $50 billion by 2012, his fiscal year 2010 budget request is well below what is required to keep this promise.

If the US increases spending on foreign affairs by only $4.4 billion each year, the average yearly increase as outlined in the president’s budget projections through fiscal year 2014, it will take until at least fiscal year 2017 to double foreign assistance.

Other promises made by the president, vice president and secretary of state that cannot be kept with the current budget request, including the fair-share contribution to the Global Fund to Fight HIV/Aids, Tuberculosis and Malaria.

In particular, Pepfar cannot be funded at the level authorised by Congress last year, which threatens to halt or even reverse its success.