CIAO DATE: 08/04

Broken Promises & Betrayals: Africa Action Talking Points on President Bush's AIDS Policies

September 2003

Africa Policy Information Center

Abstract

Since his State of the Union address in January 2003, President Bush has reaped great public relations benefits by parading himself as a compassionate conservative, committed to helping the people of Africa defeat AIDS. But the reality is very different.

When he traveled to the continent in July 2003, Bush repeatedly emphasized how much his Administration was doing to fight the AIDS crisis. And on the domestic front, the President has said that his Administration remains committed to confronting AIDS in the U.S. But President Bush's track record on AIDS policy reveals a litany of broken promises and betrayals.

The President has misrepresented the actions of his Administration. He has misled the American public, and he has failed the people of Africa. Bush's broken promises are costing thousands of African lives every day.

The following talking points include quotes from the President, promising leadership in the war on AIDS. These are followed by facts about the reality of his Administration's policies.

Emergency Plan For AIDS Relief

Promises:

"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...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." (State of the Union address, January 28, 2003)

"Next week, I will go to Africa to meet with leaders of African countries and with some of the heroic men and women who are caring for the sick and are saving lives...They deserve our help, without delay. And they will have our help." (White House news conference, July 7, 2003)

Reality:

• The AIDS plan announced in the State of the Union address in January 2003 was not an "emergency" plan - President Bush requested NO new money for this initiative for the entire year of 2003.

• President Bush promised $15 billion over 5 years, or $3 billion a year, for his new AIDS initiative. But in his budget request for 2004, unveiled the week following his promises, Bush asked for less than half a billion dollars ($450 million) for next year for this initiative.

• Instead of the $3 billion per year over 5 years that was promised, most of the money for the AIDS plan will not even be requested until 2005 and beyond. This is after Bush's term in office will have ended, so there is no guarantee this will be requested at all. Even more importantly, this deadly delay will cost millions of African lives.

• The focus of the new AIDS initiative is not really on Africa and the Caribbean. The White House has clarified that the $15 billion will include all U.S. funding for AIDS globally. In July 2003, President Bush said the initiative he announced in January was "to fight AIDS abroad", breaking his own promise that it would be for Africa and the Caribbean. This means that whatever amount of money is appropriated for AIDS, Africa will get far less than promised.

• In July 2003, the White House specifically asked Congress to limit AIDS funding for next year. President Bush intervened during the budget process to urge Congress not to spend the $3 billion that was being considered at that time. This was after Bush had returned from Africa, where he had seen first-hand the devastation caused by AIDS and where he had repeatedly promised U.S. support for African efforts to fight AIDS.

The Global Fund To Fight HIV/AIDS, Turberculosis & Malaria

Promises:

"The devastation across the globe left by AIDS, malaria, tuberculosis, and the sheer number of those infected and dying is almost beyond comprehension...The United States is committed to working with other nations to reduce suffering and to spare lives. And working together is the key. Only through sustained and focused international cooperation can we address problems so grave and suffering so great." (Rose Garden Ceremony, with United Nations Secretary General Kofi Annan and Nigerian President Olusegun Obasanjo, May 11, 2001)

Reality:

• In 2001, President Bush supported the creation of the Global Fund to fight HIV/AIDS, Tuberculosis and Malaria. But his Administration has consistently undermined the effectiveness of this important vehicle by refusing to pay the U.S.' fair share, leaving it severely under-funded.

• The U.S. has contributed only an average of $200 million a year to the Global Fund since it was created in 2001. An equitable contribution to the Global Fund from the U.S., based on the U.S. share of the global economy, would be $3.5 billion per year. In contrast, the U.S. is spending more than $1 billion a week on the war and occupation in Iraq.

• President Bush said in January 2003 that the U.S. was committed to leading the world in the fight against AIDS. But he continues to neglect the best way to address the AIDS crisis - the Global Fund to fight HIV/AIDS. Bush has pledged only $200 million per year over the next 5 years to the Global Fund as part of his "Emergency Plan for AIDS Relief".

• U.S. Secretary for Health and Human Services, Tommy Thompson, is chair of the Board of Directors of the Global Fund. Yet the Global Fund is running out of money because the U.S. is failing either to contribute its share of resources or to act responsibly as Board chair and implement a fundraising plan for this crucial vehicle.

• To coordinate his new AIDS initiative, President Bush is creating a new U.S. government bureaucracy that will compete directly with the Global Fund. This bilateral approach breaks Bush's earlier promise to support multilateral efforts to fight AIDS. This new U.S. agency will take money away from the Global Fund. It is also less efficient, with ten times as much "overhead", or administrative costs, as the Global Fund. It is to be headed by a former Drug company executive, Randall Tobias, of Eli Lilly & Co.

• While President Bush's AIDS plan is unlikely to be up and running until at least 2005, the Global Fund is already operational and it can save lives NOW. U.S. contributions to the Global Fund will leverage billions of dollars from other donors. By refusing to support the important work of the Global Fund, President Bush is undermining international efforts to defeat AIDS and betraying those on the frontlines fighting this pandemic in Africa.

HIV/AIDS Treatment

Promises:

"Anti-retroviral drugs can extend life for many years. And the cost of these drugs has dropped from $12,000 a year to under $300 a year - which places a tremendous possibility within our grasp." (State of the Union address, January 28, 2003)

"We'll work quickly to get help to the people who need it most by purchasing low-cost anti-retroviral medications and other drugs that are needed to save lives." (White House Ceremony, announcing the appointment of the new Global AIDS Coordinator, The Roosevelt Room, July 2, 2003)

Reality:

• In 2001, the member countries of the World Trade Organization (WTO), including the U.S., adopted the Doha Declaration, which declared that patents on drugs should not be allowed to hinder poor countries' access to essential medicines. But since this time, the U.S. has consistently blocked efforts to relax patent rules and facilitate African countries' access to anti-AIDS drugs and other essential medicines. The agreement reached in Geneva in August 2003 still imposes extremely complicated procedures designed to protect patent rights, which leave enormous obstacles to overcome before affordable medicines are actually made available in Africa.

• The Bush Administration's close ties to the pharmaceutical industry have meant that U.S. policies continue to support the interests of the powerful pharmaceutical lobby to keep their profits high. This betrays the efforts of African countries to secure affordable access to essential HIV/AIDS treatments for their people. The pharmaceutical industry is one of the largest contributors to the Republican party.

• President Bush named a pharmaceutical executive, Randall Tobias, as the Coordinator of the new AIDS initiative that was announced earlier this year. Tobias has no experience in public health or international affairs - he represents the pharmaceutical industry, which has sought to deny Africans access to essential drugs. One prominent example of such was the lawsuit brought against Nelson Mandela by several major pharmaceutical companies in the 1990s, which sought to prevent the South African government gaining access to essential anti-AIDS treatment for its people. This suit was only withdrawn in 2001 under international pressure.

• The choice of Randall Tobias by Bush reveals his allegiance to the pharmaceutical companies and breaks the promise he made that the U.S. would promote low-cost anti-AIDS drugs.

• In June 2001, the Administrator of USAID, Andrew Natsios, said that AIDS treatments would not work in Africa because "Africans don't know what Western time is." He used this racist and ignorant logic to oppose the provision of essential treatments to people living with HIV/AIDS in Africa. Africa Action wrote to Secretary of State Colin Powell (Natsios' boss) to demand a retraction, and to call for Natsios' dismissal. But the Bush Administration issued no retraction or apology.

• The Bush Administration continues to stall on providing low-cost AIDS treatments to African countries, claiming that inadequate infrastructure means that funding for treatment must wait. But treatment programs throughout Africa need money now. The solution to weak infrastructure is urgent investments to improve capacity. These delays in extending treatment access are costing thousands of African lives every day.

• The Bush Administration supports conservative measures that undermine a comprehensive response to the AIDS crisis in Africa. These include emphasizing abstinence-only measures, prioritizing prevention over treatment, and opposing the use of condoms. This emphasis on fundamentalist ideology over science and public health represents a dangerous step backward in the fight against AIDS.

Domestric HIV/AIDS Programs

Promises:

"We have confronted, and will continue to confront, HIV/AIDS in our own country." (State of the Union address, January 28, 2003)

Reality:

• As the HIV/AIDS crisis in the U.S. continues to grow, the Bush Administration is failing to show leadership to address this urgent situation. For the past 3 years, the Bush Administration has essentially flat-funded domestic HIV/AIDS prevention and treatment programs.

• The CDC has stated that there are more than 40,000 new HIV infections in the U.S. each year, half of these under the age of 24. A 2003 study from Emory University has said that failure to reduce HIV infections by 50% in the next two years could cost this country more than $18 billion. President Bush's budget request for 2004 cut $4 million from domestic HIV/AIDS prevention programs.

• The 2004 budget request flat-funded the Minority AIDS Initiative, which provides essential funding to organizations addressing the HIV/AIDS crisis in communities of color across the U.S. There is a growing demand for funding for this initiative, but the Bush Administration continues to ignore this reality. More than half of all new HIV infections in this country are occurring among Black people.

• President Bush's budget request for 2004 proposed only a small ($5 million) increase in the Housing Opportunities for People with AIDS (HOPWA) program, although the demand for this program has grown dramatically, and more funding is needed urgently. The CDC estimates that there are currently 900,000 people living with HIV/AIDS in the U.S. The total number of people living with HIV domestically increased by 33% between 1996 and 1999.

• The 2004 budget request contained an inadequate increase (only $100 million) for the AIDS Drug Assistance Programs (ADAP), but this is far less than what is needed. Already 13 of these programs around the country have had to limit access to anti-retroviral treatments or close enrollment to new clients altogether because of inadequate funding. Another 7 programs have reported they are likely to have to undertake similar measures in the next year.

• The Bush Administration remains committed to an "abstinence only" policy when it comes to education about HIV/AIDS and STDs. Many AIDS advocacy and AIDS service organizations have expressed grave concerns about an approach that places political ideology over science and public health. Public health experts emphasize that a comprehensive approach to HIV/AIDS prevention must include education about condom use.

• The federal ban on funding for needle exchange programs denies thousands of injecting drug users in the U.S. access to a lifesaving medical intervention. Access to sterile needles can help prevent thousands of HIV infections every year. At present, injecting drug users account for more than one-third of all new HIV infections in the U.S. Federal funding for needle exchange programs is needed to expand these programs to control the spread of HIV and save thousands of lives.