No one now disputes either the catastrophic proportions of the global AIDS pandemic or the United States’ responsibility to do something about it. But few claim to be greater champions in the battle against global AIDS than our own President Bush. This summer Bush traveled to Africa, the epicenter of the AIDS crisis, to tout his unprecedented five-year, $15 billion AIDS initiative, which he announced in his last State of the Union Address. The trip was billed as a veritable victory lap of the continent, a chance to put a more compassionate face on the administration’s foreign policy.
Since Bush’s announcement, the global AIDS crisis has not diminished. Each day, approximately 14,000 people are infected with HIV and over 8,000 die from AIDS. What has diminished is Bush’s commitment to fighting the crisis. One might assume that a $15 billion promise over five years would translate into $3 billion per year. But even though Bush authorized $3 billion in AIDS spending for the coming year, his administration has maneuvered to ensure that less than $2 billion will actually be spent. This kind of manipulation has become a signature of the administration: publicize a commendable, “compassionate” new initiative only to let it wither on the Congressional vine for lack of support.
Bush’s claim that the additional funding cannot be effectively disbursed through existing channels is patently disingenuous. The Global Fund to Fight AIDS, Tuberculosis and Malaria—a multilateral institution that marries private-sector efficiency with scientific expertise—lacks the support it needs to fund grants for AIDS-devastated nations. Bush requested only $200 million for the organization from Congress next year—barely half of this year’s spending. And congressional Republicans two weeks ago struck down a proposal by Senator Dick Durbin, D-Ill., that would have earmarked $1 billion for the fund.
As part of his $15 billion AIDS initiative, Bush recognized the importance of low-cost AIDS drugs as a tool for fighting the global pandemic. Cheaper generic versions of brand name drugs make it possible to reduce the cost of treating AIDS patients from $12,000 per year to $300 per year. As Bush acknowledged, “seldom has history offered a greater opportunity to do so much for so many.”
Pharmaceutical companies, however, wary of competition from generic drugs, have sought to extend their patent protection. These patents grant them exclusive drug monopolies that translate into substantially higher prices and put the drugs out of reach for the vast majority of AIDS victims around the world.
The administration’s trade policy has placed a premium on the protection of intellectual property rights across the globe, at the expense of the world’s poorest. In its negotiations of bilateral and regional trade agreements, and most prominently through its influence in the World Trade Organization (WTO), the administration has relentlessly pressured developing nations to adopt stricter patent regimes. It has done so at the direct behest of the pharmaceutical lobby, which spends millions of dollars in political donations and lobbying expenses every year.
But the State of the Union Address provided false hope that the administration had come around to the position that global health activists have been advocating for years—that pharmaceutical companies should not be permitted to profiteer while millions die in the poorest parts of the world. At the end of August, the U.S. orchestrated a WTO resolution which was trumpeted as a means to ensure the health of developing countries, while protecting pharmaceutical industry profits. But the new resolution effectively penalizes those nations that lack the capacity to manufacture their own generic drugs—invariably, those that are most impoverished—because it creates additional obstacles to the importation of life-saving medicines.
Bush has misrepresented his AIDS policy, using the misery of millions for political gain. Before he canonizes himself in the church of compassionate conservatism, Bush should follow through on his rhetoric and capitalize on this historic opportunity “to do so much for so many.”
Alexander J. Post ’05 is a social studies concentrator in Adams House. He is a member of the Harvard AIDS Coalition.