In his State of the Union address last week, President Obama nominally reaffirmed his commitment to universal health care, citing the success of the Affordable Care Act. Despite his dedication to free and fair medical services for Americans, he failed to comment on the essential life-saving global medicine funding programs that heavily rely upon the support of the American government. Instead he touted upcoming trade deals, completely glossing over the fact that such deals could cut off access to generic medicines worldwide. Not once did the president mention HIV or AIDS.
The major funding sources for worldwide HIV/AIDS and tuberculosis treatment, diagnosis, prevention and social services are the President’s Emergency Plan for AIDS Relief and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. However, since 2009, the U.S. government’s fiscal commitment to these two programs has flatlined—funding has remained the same for the past five years.
Anti-retroviral therapy for HIV/AIDS reduces one’s risk of transmitting the disease by 96 percent, increasing life expectancy and decreasing the mortality rate. We cannot begin to tackle the HIV epidemic until the number of people on treatment exceeds the infection rate. Studies have also shown that for every dollar invested in HIV prevention, there is a $12 return (by preempting future infections and medical expenses).
There are currently 35.3 million individuals living with HIV/AIDS across the globe. As of 2013, 9.7 million people have been placed on treatment. This means that there are more than 25 million people around the world still in need of ART today, nearly 20 years after the introduction of the first effective HIV treatment.
A recent report found that if funding continues to stagnate, 3.9 million HIV infections that could have been prevented will occur in the next two years. The report found that the lifetime cost of these infections would exceed $47 million (including treatment, care, and labor lost).
Another serious threat to universal access to care, generic medicines, and other pharmaceutical must-haves on the global scale is the potential trade deal upon which President Obama only momentarily remarked: the Trans-Pacific Partnership Agreement.
Obama only noted that “new trade partnerships with Europe and the Asia-Pacific will help them create even more jobs.” In fact, the repercussions of this trade deal—at home and abroad—are much more immediate, with the potential to harm many people and put entire populations at risk.
The TPP is under secret negotiation through the office of the United States Trade Representative, along with 12 other countries, and the lack of transparency around the trade deal has drawn a great deal of press. And with plans to fast-track the TPP, there will be little opportunity for congressional input.
The deal has environmental activists, internet privacy protectors, and labor groups up in arms, but it has yet to draw attention commensurate with the devastating effects it would have on access to medicines. According to the community watchdog group Public Citizen, the TPP will “expand pharmaceutical monopoly protections and trade away access to medicines.”
The intellectual property provisions of the TPP will expand the scope of patent protection and extend pharmaceutical patent terms. In addition, it gives multinational corporations more control over know-how information and data regarding their products. Under the provisions, pharmaceutical companies can refuse to publicize clinical trial data, impeding generic companies from obtaining the regulatory approval needed to put their product on the market.
These provisions ultimately delay the introduction of affordable, essential medicines where they are needed most and place the interest of pharmaceutical corporations above the public health. It is no coincidence that half of the 12 biggest corporations in pharmaceutical industry are American. In an era where medicines are commodified and health can only be bought, trade deals like the TPP further devastate efforts made in providing universal access to care.
With the TPP in its final stages of negotiation, the time to act is now.
To wage a serious fight against the rapidly growing epidemics in the world today, universal access to medicines must become a priority to the U.S. government. It warrants a mention in the State of the Union, and a prominent place on our legislators’ lists of action items.
PEPFAR and the Global Fund must receive the increased attention and funding hikes commensurate with the threat of new infections and preventable deaths. While President Obama has taken great strides on the insurance front and the provision of non-discriminatory medical services domestically, the potential TPP deal could drastically change the treatability of modern epidemics.
Frozen funding for the two largest provisions (the Global Fund and PEPFAR) to combat HIV/AIDS, tuberculosis, and other illnesses could turn preventable, treatable illnesses into insupportable, incurable conditions. Policy and funding can make a real difference.
If our lawmakers won't face facts, it is up to students and constituents across the U.S. to make it known that they are, in the most urgent matters of life and death, continually falling short.
Kirin Gupta ’16 is a joint social studies and studies of women, gender, and sexuality concentrator in Winthrop House. India Perez-Urbano ’16 is a sociology concentrator in Pforzheimer House. They are members of the Harvard College Global Health & AIDS Coalition.
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