Keep the Promise

Tomorrow, hundreds of students and community members will gather in Boston Common in honor of World AIDS Day. We will gather not only to remember the 25 million people whose lives have been taken by AIDS but also to hold our leaders accountable for the promises they made to fight this epidemic.

One such promise was made in 2007 by then-presidential candidate Barack H. Obama. In 2007, AIDS advocates politely went to town hall meetings in New Hampshire and Iowa during the presidential primary season, asking candidates to commit to spending $50 billion by 2013 for global AIDS programs. Through our concerted efforts, we managed to get Hillary R. Clinton, Joseph R. Biden, and Obama to all promise to dedicate $50 billion by 2013 to the President’s Emergency Plan for AIDS Relief and the Global Fund to treat and prevent global AIDS, including $1 billion in new money every year.

For the past two years, however, it has become increasingly clear that simply electing a leader who campaigned on a platform of hope, change, and increased AIDS funding is not enough. President Obama’s actions on global AIDS have fallen appallingly short of his campaign pledges. Though during his speeches he may have claimed to have “increased funding for AIDS,” his budget “increases” for the PEPFAR—the principal U.S. funding body for global health—have barely kept pace with inflation. He asked Congress for a $0.2 billion increase in 2009 and $0.1 billion increase in 2010—one-tenth of what he promised.

Many continue to claim that flat-lining funding to combat the AIDS pandemic was the best Mr. Obama could do given the global financial crisis. They say that there is no money in an already-tightened budget. However, money can easily be found for presidential priorities. For the New Start Treaty for nuclear weapons, the administration was able to find an extra $4 billion for weapon modernization at the drop of a hat last week, in addition to the $80 billion it had already promised for weapon modernization programs. Yet when asked to fulfill a campaign promise of a $1 billion increase to combat the global AIDS epidemic, the administration claims that there is no money. It is clear that the global AIDS epidemic is not a priority for President Obama like it was for candidate Obama.

We recognize that politicians often fail to deliver on campaign promises. But as university students committed to global health improvement, we are taking it upon ourselves to stand up at this pivotal moment and hold our government accountable for this devastating regression. We have served in communities around the globe and have witnessed, first-hand, the extent to which AIDS can destroy families and undermine economies. Millions of people with AIDS, including mothers and children, are deprived of life-saving treatment because of funding shortfalls. We are learning from studies, such as one published a recently in The Lancet, that global flat funding could lead to an additional seven million deaths and 14 million new HIV infections over the next 20 years. The cost of inaction is painfully high.

Increased funding for PEPFAR would not only save lives, but would also prevent the spread of AIDS. Studies showed that antiretroviral treatment reduces HIV transmission by 92 percent, making it the single most effective form of prevention. Further, treating AIDS comprehensively, as PEPFAR has shown is possible, improves care for other diseases like tuberculosis and sexually transmitted infections and has been shown to boost primary health care in even the most desperate settings. Rarely do we see something this close to a win-win in global health.

The neglect of AIDS and other global health inequities is the most pressing moral issue of our time—on par with slavery in the 19th century, and civil and women’s rights in the 20th century. But if we are to make fighting this epidemic a presidential and congressional priority, we must publicly hold our leaders to account for their bold promises. We therefore urge those who want to see a world free of HIV/AIDS to come to Boston Common tomorrow from 7 p.m. to 9 p.m. to stand in solidarity in support of those suffering from a treatable illness. Together, we will urge President Obama to ask Congress for increases in global AIDS funding and work to fulfill his campaign promise to dedicate $50 billion to global AIDS treatment by 2013.

Marguerite Thorp '11 is a member of the Harvard College Global Health and AIDS Coalition, Rumbidzai C. Mushavi '12 is the secretary of the Harvard African Students Association, and Krishna M. Prabhu '11 is a member of the Harvard College Global Health and AIDS Coalition.