Invest in Health Not WarCall for Global Demonstrations on 24 June 2004 to Demand that the Bush Administration:
- Reduce Military Spending and War Actions: Spend More Money on AIDS, Tuberculosis, Malaria, Malnutrition and Poverty;
- Help Ensure that the World Health Organization's Plan to Treat Three Million People with AIDS by 2005 Receives the Resources it Needs to Succeed;
- Stop Undermining Public Confidence in Safe, Effective Anti-AIDS Medicines;
- Stop Using AIDS Money to Marginalise Minorities and Undermine Access to Condoms and Reproductive Choices;
- Stop Pursuing a Pseudo-Scientific Response to the HIV Epidemic;
- Stop Using Bilateral Pressure to Undermine the Doha Declaration on TRIPS and Public Health;
- Give the Promised $15 Billion for AIDS to the Global Fund to Fight AIDS, TB and Malaria (GFATM) - Not the US President's AIDS fund (known as PEPFAR).
We, the undersigned, are organisations from around the world that campaign for human rights, the alleviation of the HIV epidemic and women's rights to reproductive choices. We are deeply disturbed by the actions and policies of the Bush Administration that undermine the prevention and treatment of AIDS. The effect of the US government's unlawful war in Iraq has been to divert international attention away from global health and poverty. Hundreds of billions of dollars are being spent on the military instead of investing resources in the biggest threats to human security today: AIDS, TB, malaria, malnutrition and poverty.
In 2003, the United Nations estimated that 2.5-3.5 million people died of AIDS, one million of malaria and two million of TB, yet these diseases can be treated. An estimated 800 million people endured malnutrition, which continues to play a major role in half of the more than ten million annual child deaths in the developing world. In many countries women undergo back-street abortions and risk death because they are denied the right to make reproductive choices. Inappropriate moral judgments stigmatise condom use and distribution, thereby putting millions of people at risk of HIV and other sexually-transmitted infections. The spread of HIV is fuelled by the oppression of sexual minorities and draconian legislation aimed at sex workers and intravenous drug users. Successfully reducing HIV infections and giving more people with AIDS access to life-saving medicines requires the promotion of human rights and investment in developing world health systems. The World Health Organization (WHO) has called for three million people with AIDS to be treated with life-saving antiretroviral medicines by 2005, but the Bush Administration has shown little political will for promoting this objective or human rights.
In January 2003, the Bush Administration promised $15 billion over the next five years to alleviate the HIV epidemic. This was cautiously welcomed by human rights and AIDS organisations. Yet the expenditure approved by the US Congress as part of this commitment for 2004 is only $2.4 billion. The total amount of US aid money for 2004 is $17.55 billion. Yet the military budget approved for 2004 is already $368.2 billion, an amount that does not reflect the $87 billion war supplemental requested by the Bush Administration. Much of this military budget is being used to fight the so-called War Against Terror and to sustain the occupation of Iraq. We acknowledge the threat of terrorism. However, the most important and widespread threats to global security are the ones exacerbated by poverty and lack of development: the HIV, malaria and tuberculosis epidemics, as well as malnutrition. Alleviating these problems together with promoting human rights and negotiating solutions to world problems through international institutions is the best way to ensure long-term global security. This was partially recognised by the Clinton Administration when it declared AIDS a national and global security threat in late April 2000.
Unfortunately, the Bush Administration has shown insufficient regard for these problems, as well as for the expertise of international institutions such as the United Nations, the WHO and the GFATM. The Bush Administration's stance on key prevention and treatment issues contradicts the extensively researched positions of these international institutions. For example, a third of PEPFAR's prevention funds are earmarked for abstinence-until-marriage programmes. While promoting delayed sexual activity is an important part of life-skills education, this should not be framed in moral judgments concerning marriage or at the expense of condom promotion and distribution, especially to youth. The Bush Administration refuses to acknowledge the vital importance of access to and information about condoms in the general population and it has been party to unscientific actions and statements questioning the efficacy of condoms, for example removing information on condoms from the website of the US Centers for Disease Control. President Bush has also taken the extraordinary step of reinstating and extending the Reagan-era Global Gag Rule on family planning organisations, cutting US funding as well as donations of contraceptives when these organisations provide information on abortion to their patients. We are concerned that current US policy is informed by a religious fundamentalist agenda. Furthermore, obstacles continue to be placed in the way of accessing more affordable medicines, by blocking competition between generic medicines and patented brand-name drugs. In particular, the Bush Administration is blocking access to generic fixed-dose combination medicines that will allow more people with AIDS in the developing world to go onto life-saving antiretroviral treatment and reduce the number of pills they need to take on a daily basis.
The Bush Administration has placed religious fundamentalist convictions above science, undermining access to and use of condoms, reproductive choices and access to generic medicines. This has lead to a critical editorial in the prestigious medical journal The Lancet describing US policy on HIV/AIDS as "perhaps one of the best examples of ideology impeding sound public health policy."* While the South African government has been correctly criticised extensively for its unscientific approach to the HIV epidemic (which now seems to be changing slowly), it is the Bush Administration that now champions irrational responses to the epidemic.
We therefore call for an International Day of Action on 24 June 2004 to say to the Bush Administration: Invest in Health, Not War!
* Lancet Reference: 2002 Jul 13; 360 (9327): 97.
Questions and Answers
How much money did the Bush Administration pledge to alleviating AIDS in Africa and the Caribbean and how much has actually been given?
In his annual State of the Union address in January 2003, President Bush announced the provision of an additional $10 billion to AIDS programmes in Africa and the Caribbean. This should have brought to $15 billion the US government's total commitment following a $5 billion allocation under the Clinton Administration that had yet to be disbursed. The US Congress eventually appropriated $2.4 billion in 2004, and the total amount released so far is just $350 million.
To whom is the money being given?
Most of the money is intended for distribution through the bilateral President's Emergency Plan for AIDS Relief (PEPFAR), which currently targets 14 countries: Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia. A relatively small portion of the Bush Administration's pledge, just $1 billion over five years, is intended for the GFATM.
What is the GFATM?
The Global Fund to Fight AIDS, TB and Malaria (GFATM) is an independent, multilateral institution established in 2002 with the purpose of funding programmes in developing countries aimed at treating and preventing the three highest-mortality infectious diseases in the world. Its success is necessary for the WHO to meet its goal of treating three million people with AIDS by 2005. The GFATM aims to constitute a major source of the $27 billion in economic assistance to developing countries that the WHO Commission on Macroeconomics and Health has suggested is needed by 2007 (growing to $38 billion by 2015), yet the GFATM remains underfunded, receiving only $658 million so far in 2004. Partly this is due to the US government failing to commit sufficient funds to it, but the European Union, Canada, Australia and Japan all need to contribute more money to the Fund.
The trend of attempting to foil efforts to access cheaper generic medicines has continued over the past few months. Members of the Bush Administration have undermined public confidence in the safety and efficacy of fixed-dose combination (FDC) generic antiretroviral medicines approved by the WHO. These medicines are an essential, affordable tool for the treatment of HIV on a massive scale. The Bush Administration clearly would prefer to use PEPFAR money to pur