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At the most crucial moment to bring an end to the worst epidemic in recent history, President Obama has failed. Over 33 million people around the world live with HIV or AIDS and more than half of the individuals who could benefit from treatment lack access to HIV/AIDS medications. Furthermore, there have been major breakthroughs in the science of HIV prevention and treatment in the past two years. A number of studies have demonstrated the effectiveness of treatment to prevent transmission, specifically the ability of pre-exposure prophylaxis to eliminate infection, and the cost effectiveness of investing now so that spending on treatment can begin to drop in just three years. The volume and persuasiveness of all of this evidence led many, including Secretary Clinton and President Obama, to declare that the end of the epidemic is in sight. Last December, on World AIDS Day, AIDS activists applauded President Obama’s announcement that he would increase the U.S. treatment target from 4 million people to 6 million by 2013 as he declared his commitment to an AIDS free generation.
But AIDS activists, and the millions who are affected by the disease around the world, were soon met with disappointment. The President’s fiscal year 2013 budget proposed a cut of $562.9 million in bilateral HIV/AIDS spending through the President’s Emergency Plan for AIDS Relief, slashing the program’s budget by 12.3 percent. This is not the first time that advocates have been disappointed with the President on this issue. In 2007, Obama (then a candidate) promised to increase AIDS funding every year he was in office, to a total of $50 billion over five years by 2013. But in the years he has been in office, funding for these programs has flat lined. His most recent proposal to cut AIDS funding represents an abandonment of the fight against the AIDS epidemic. PEPFAR has been incredibly effective in providing treatment to millions of people, and the President’s failure to sustain funding levels for this program signifies a betrayal to the millions who need treatment but still lack access to essential medicine. These steep cuts may even mean that funding to continue treatment for individuals currently receiving medication will dry up. Furthermore, these cuts will likely lead to highly increased mortality due to AIDS within the next year, an increase in vertical HIV transmission (from mother-to-child), as well as an increase in the number of children orphaned due to the disease. At this crucial moment when we are finally becoming capable of treating those currently afflicted with HIV/AIDS and bringing an end to the epidemic in sight, President Obama has given up.
The void in political will from the executive branch has sadly been met with silence from Massachusetts’ legislative delegation, contributing to the stagnating progress in fighting the AIDS epidemic. The outpouring of global health research and information from within Massachusetts has situated the state as a leading locus of knowledge and work in this field. However, it does not seem that this focus has been reflected in the priorities of our legislators. As chairman of the Senate Committee on Foreign Relations, Senator John Kerry (D-MA) has had the opportunity to leverage his influential position to be a true advocate for AIDS funding. In recent years, though his private voice has supposedly been strong on this issue, his public voice has been virtually nonexistent. Senator Kerry’s annual statement on World AIDS Day has become an empty tradition—supported by the best of intentions, but reinforced by no concrete action to ensure the expansion of AIDS treatment and prevention measures to those who need it most. As the Obama administration has continually flat-lined or slashed bilateral AIDS funding, Senator Kerry has neglected to sign on to two recent “Dear Colleague” letters in the Senate—one submitted in 2009 and one submitted in 2010—calling for the restoration of funding levels. In recent meetings with members of Senator Kerry’s policy team, we have been assured of Kerry’s private leadership on the issues, but now is the time for urgent, committed, and public leadership. With the end of the AIDS pandemic in sight, Senator Kerry must find his voice again.
Despite the failures of two would-be leaders in the fight against AIDS, there is still hope that positive political action might emanate from this Commonwealth. Senator Scott Brown (R-MA), who fashions himself a maverick, has the perfect opportunity to step up and fill the void left by President Obama and Senator Kerry. He can reclaim the Republican legacy for PEPFAR, which was founded in 2003 by President George W. Bush. In the coming weeks, the Senate Appropriations Committee will work on a fiscal year 2013 budget. Now is the time for Senator Brown to bring attention to the need for the U.S. to continue its commitment to ending AIDS, just as he has done for issues regarding human trafficking. There are myriad reasons for Senator Brown to use his voice to renew the U.S. fight against AIDS, not least of which is the fact that millions of lives are on the line.
Lily H. Ostrer '14 is a Social Studies concentrator in Kirkland House. Darshali A. Vyas '14 is a Social Studies concentrator in Quincy House. Mythili Prabhu '13 is a Government concentrator in Mather House.
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