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USA: Action Alert / Failing the Test on Global AIDS
USA: Action Alert / Failing the Test on Global AIDS
Date distributed (ymd): 010510
Document reposted by APIC
Africa Policy Electronic Distribution List: an information
service provided by AFRICA ACTION (incorporating the Africa
Policy Information Center, The Africa Fund, and the American
Committee on Africa). Find more information for action for
Africa at http://www.africapolicy.org
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Region: Continent-Wide
Issue Areas: +economy/development+ +health+
+US policy focus+
SUMMARY CONTENTS:
This posting contains an action alert and report card on the Bush
administration's AIDS policy, from the Health Gap Coalition
(http://www.globaltreatmentaccess.org). The alert calls for
immediate messages to U.S. Secretary of State Colin Powell, in
advance of Friday's expected announcement of only token U.S.
contributions to the new global fund for AIDS. Messages will
continue to be relevant after Friday, as the pressure builds for US
and international response before the UN General Assembly Special
Session in June and the Genoa G-7 summit in July.
Although this alert is particularly aimed at U.S. constituencies,
the Bush administration's failure (reflected in the F's awarded by
the Health GAP Coalition, the lowest grade - for failure - in the
most common school grading system in the U.S.) warrants the
expression of outrage not only from those in the U.S. but from
around the world.
+++++++++++++++++end profile++++++++++++++++++++++++++++++
Health GAP Coalition
Thursday, May 10, 2001
ACTION ALERT
CALL SECRETARY POWELL TODAY AND TOMORROW (5/10 5/11)
Telephone: 202-647-5291
FAX: 202-647-2283
Email: [email protected]
(please call or fax in addition to email
if you are in the United States)
For more information on the Bush AIDS disaster, read Health GAP'
report card on the first 100 days of the Bush Administration [below
and aat
http://www.globaltreatmentaccess.org or email
[email protected]]
"The more time I spend on this, the worse it gets." - Colin Powell,
Senate Testimony on AIDS in Africa, March 2001
Bush, Powell to Undermine UN AIDS Fund:
Shameful Announcement Friday at White House
- After flat-funding Ryan White [for domestic AIDS funding],
Administration then puts less than drop into bucket towards global
AIDS fight.
- Bush and Powell are failing people with AIDS in the United States
and around the world.
Secretary of State Powell is preparing to go to Africa at the end
of May "to highlight US concerns over the AIDS pandemic."
But first, he will join President Bush and HHS [Health and Human
Services] Secretary Thompson in the White House Rose Garden Friday
afternoon to announce the shameful proposal for a mere $200 million
supplemental budget request towards the new UN AIDS trust fund - a
fund which seeks 7 - 10 BILLION dollars to confront the escalating
global AIDS crisis.
$200 million is less than 1% of the proposed $1.35 trillion tax cut
that will largely benefit the richest citizens of the richest
nation in the world. It's a fraction of the $40 billion defense
allocation for faulty Osprey helicopters.
It sends a message to other wealthy nations that this UN trust fund
- and the lives it could save -- are not worth the investment.
The United States is failing people with AIDS worldwide - people
who will die without funds for treatment and care.
Powell has consistently said that he cares deeply about the
escalating African AIDS crisis. Yet, recent announcements and
foot-dragging throughout the Bush Administration indicate that he,
his boss and other leaders are not addressing this crisis with
meaningful funds, policies, or standards. Underfunding of the UN
initiative is a shameful indictment of the Administration.
CALL COLIN POWELL TO DEMAND REAL FUNDS TO FIGHT GLOBAL AIDS
Telephone: 202-647-5291 FAX: 202-647-2283
Call/Fax Secretary of State Colin Powells TODAY AND TOMMOROW
(Thursday, May 10 and Friday, May 11) to demand immediate action.
Powell must:
- Publicly demand a $2 Billion US contribution to the UN fund at
Friday's press conference
- Require allocations to have equivalent support for both treatment
and prevention
- Fight for full debt cancellation to enable countries to redirect
resources to fighting AIDS
- Support global AIDS drug distribution and procurement at
lowest-prices, including access to generics
The global AIDS crisis and the first 100 days of George W. Bush's
Administration
A REPORT CARD FROM THE HEALTH GAP COALITION
May 10, 2001
After threatening to revoke all Clinton Executive Orders, the Bush
Administration garnered international attention with its decision
to retain the Executive Order that affirmed the rights of subSaharan
African countries to manufacture and import affordable
generic medication without facing sanctions from the US, as they
had in the past.(1)
However, more recent Administration comments and policy positions
reveal a lack of leadership, racist stereotypes about the capacity
for HIV treatment compliance in Africa, and a particular
unwillingness to move beyond lip service in the arena of the US
response to the crisis in lack of access to HIV treatment in poor
countries.
The Bush Administration and new funds to fight the global AIDS crisis
overall performance: F
"[ The AIDS pandemic] is an economic crisis, a health crisis, a
security crisis. It's the destruction of families, cultures,
tribes, nations� all of that is there. The more time I spend on
this, the worse it gets." - Secretary of State Colin Powell,
testimony before the Senate Foreign Relations Committee, 8 March
2001
In an era in which well- sourced estimates of the costs of
adequately funding AIDS treatment, care, support, and prevention in
poor countries are made in tens of billions of dollars per year,
the Bush Administration's funding plan would turn drops of US
funding into a mere trickle� despite the �emergency- minded�
rhetoric of senior officials such as General Colin Powell, above.
While pushing a $1.3 trillion tax cut through Congress, Bush will
announce only two small funding commitments for global AIDS for
2002:
- a 10 per cent increase to the pre- existing $450 million LIFE
Initiative for HIV care and support;
- a mere $200 million toward UN Secretary General Kofi Annan�s
newly announced Global AIDS 'war chest.'(2) The UN hopes a �war
chest� would accumulate $7 to $10 billion for HIV prevention and
treatment, and for malaria and tuberculosis. Secretary General
Annan estimates that US contributions to UN joint assistance
programs such as this 'war chest' typically amount to 25 per cent
of the overall amount, or $1.75 to $2.5 billion.(3) By comparison,
the Osprey Aircraft Program currently costs $40 billion.
The Bush Administration intends to lobby for donations from
corporations, in an effort to deflect overall attention from the
paltry US contribution with an infusion of corporate charity.
Already the lack of commitment from the Bush Administration to the
UN Fund has had a chilling effect, as other G-8 nations have deemphasized
their support of the fund, or have announced significant
reductions in the amounts of earlier donation proposals.
The Bush Administration and access to AIDS treatment in poor countries
overall performance: F
"[ The official said that Africans] lacked a requisite 'concept of
time' implying that they would not benefit from drugs that must be
administered on tight time schedules." - The New York Times on
remarks made by an unnamed Department of Treasury official, 29
April 2001
"I mean, there's a whole question of prevention and education that
ultimately is going to be more important even than providing drugs
for those who are already infected." - Vice President Dick Cheney,
Meet the Press, 8 April 2001
For more than a decade the US response to the AIDS crisis in poor
countries has amounted to not much more than paltry funding for HIV
prevention and palliative care. Overt US policy has therefore been
to disregard the lives of more than 30 million people already
living with HIV who have little or no access to life extending
treatment. While the US government is finally grown capable of
mentioning HIV treatment as an acceptable part of the response to
the AIDS crisis, comments such as those above indicate a deep
resistance within the Bush Administration to mounting an adequate
response to the crisis in lack of access to desperately needed HIV
treatment and care.
Treatment access is not only a moral imperative - it is also a
pragmatic necessity: the success of HIV prevention efforts is
critically linked with the availability of HIV treatment. Rates of
HIV testing acceptance in high-risk populations are affected by the
presence of treatment access;(4) the viral control achieved through
effective HIV disease management is correlated with decreased rates
of perinatal(5) and sexual(6) HIV transmission. But the Bush
Administration is choosing to disregard the fundamental link
between prevention and treatment.
During a recent briefing on position and activities of the US
delegation to the upcoming UN General Assembly Special Session on
HIV/ AIDS (UNGASS), Department of State and Health and Human
Services officials argued that funding HIV treatment in poor
countries could do "more harm than good,"(7) and emphasized their
anxiety that the increased availability of life-extending treatment
access could create drug resistant HIV.
The Administration's paralyzing anxiety about fostering drug
resistant HIV is ill-informed and biased: Brazil's National AIDS
Program reports medication compliance rates equivalent to those
reported for patients in wealthy countries.(8) Moreover, widely
reported epidemic rates of drug- resistant HIV in treatment
experienced and newly infected patients in wealthy countries have
not resulted in calls to prohibit HIV treatment access and allow
people to die. Activists predict that the new Administration will
attempt to derail other countries' efforts during the UNGASS to
focus the UN response toward access to treatment for HIV disease,
effectively blocking attempts to formulate a cohesive response to
the devastation wrought by AIDS related death and suffering in poor
countries.
In the midst of complacency in response to the crisis in treatment
access, the Administration is also refusing to call for the World
Bank and the International Monetary Fund to use its own resources
to cancel the crushing debt owed by the world's poorest countries.
The countries that are being bled for billions of dollars every
year for debt servicing and debt repayment are the same countries
that could benefit most from funds freed up by debt cancellation
put toward effective, civil society driven AIDS treatment, care,
support, and prevention initiatives. The colossal failure of the
Administration on this issue ensures the continued devastation of
poor countries hardest hit by AIDS and debt burden.
The Bush Administration on intellectual property protection and
drug access
overall performance: F
HIV is a death sentence for millions of infected people who live in
poor countries, and a manageable illness for those who live in rich
countries. This unethical dichotomy has resulted in increasing
public outcry, and a search for affordable, generic alternatives to
unaffordable brand- name HIV drugs. The threat of generic
competition� even in poor countries where there is little or no
pharmaceutical market� has resulted in announcements of price
reductions from Big Pharma. In virtually all cases the price
reductions are too slight to create viable access, they are not
available in all countries or to any employer or charitable entity,
and still exceed the prices offered by generic companies. However,
the pressure and threat of generic competition has been spurring
major pharmaceutical companies to action.
Drug companies are finding a vocal supporter in the Bush
Administration, which is unfortunately endorsing a drug company
controlled solution to the problem of lack of drug access and high
prices, claiming that the piecemeal industry price reductions have
actually settled the question of drug pricing in poor countries.
Moreover, the US supports the dangerous idea that unchecked
intellectual property protection for pharmaceutical industry patent
holders has no impact on drug access in poor countries. In its
recent response to the UN Draft Declaration of Commitment on HIV/
AIDS, the Bush Administration denounced the UN recommendation that
intellectual property protection and international trade rules be
assessed for their negative impact on essential drug access.(9) The
US describes such recommendations as neither "relevant" nor
"productive," despite clear evidence that the regime of twentyyear
patent monopolies for pharmaceuticals for all WTO member
countries, regardless of income and development levels, is directly
blocking life- extending drug access.(10) The objectionable
position of the Administration - that drug companies will lower
their drug prices sufficiently, from a place of altruism, and that
a review of existing agreements on intellectual property is
counter-productive - must be reformed immediately.
Despite international acclaim for their National AIDS Program, the
cornerstone of which is free generic HIV medication, the Bush
Administration has chosen to pursue a dispute settlement before the
World Trade Organization (WTO) with Brazil regarding their domestic
patent laws, threatening Brazil's ability to do compulsory
licensing under their �local working� clause. While the US claims
the WTO case has nothing to do with the Brazilian HIV treatment
program, the US refuses to bring similar cases against several
wealthy countries who have local working clauses similar to
Brazil's. Brazilian health officials assert that the US's WTO case
will threaten the health of their program and of generic drug
access in Brazil.
The US Trade Representative (USTR) went so far as to rebuke Brazil
in its 2001 301 Watch List regarding the dispute, attacking Brazil
for - among other things - its pattern of blaming "only the
pharmaceutical companies, without fully examining the many issues
involved in addressing the AIDS crisis."(11) Brazil's national
response to AIDS has resulted in more than 50 per cent drop in
death rate since 1996 while saving more than $422 million. Clearly
their focus on the issue of drug pricing and pharmaceutical
industry monopolies has saved lives and therefore demands the
wholehearted support and respect of USTR and all Administration
branches, not outrageous attacks.
Finally, when news emerged that the government of Brazil intended
to table a non-binding resolution at the April 2001 UN Human Rights
Commission that linked access to medication with the human right to
the highest attainable standard of health, the US government
responding by pressuring Brazil to abandon the resolution. Despite
the pressure, Brazil presented their resolution and received the
support of all country members of the Commission� with the marked
exception of the US, which abstained. Shortly thereafter, the US
was booted off the Human Rights Commission altogether.
The Bush Administration and HIV prevention
overall performance: D-
Although often effective as political rhetoric, abstinence-only HIV
prevention efforts largely fail those populations at greatest risk
of HIV infection.(12) Despite the facts, the Bush Administration is
prioritizing abstinence as a prevention strategy in multiple fora.
The US delegation to the UNGASS has already insisted that
abstinence be included in the UN Draft Declaration of Commitment on
HIV/ AIDS.(13) The US has also rejected UN efforts to focus HIV
prevention by clarifying categories of high-risk populations
including injecting drug users, women, displaced persons, and
adolescents.(14)
In the early weeks of the Administration, Bush reinstated the
federal gag order outlawing US funding to all developing world
health care clinics that even mention abortion as a family planning
option. This policy further weakens HIV prevention efforts in poor
countries, as many clinics that provide voluntary HIV counseling
and testing, as well as STD prevention, education, and treatment
services, depend heavily on external funding from the US. These
vital clinics have lost significant portions of their budget as a
result of this dangerous and far-reaching Administration policy.
HEALTH GAP COLITION DEMANDS THE BUSH ADMINISTRATION:
- Allocate $2 billion in new US money to the UN fund for AIDS
treatment, care and prevention
- Allocate proportional financial support to both treatment and
prevention
- Support global AIDS drug distribution and procurement at lowest
prices, including access to generics
- Immediately call on the IMF and World Bank to use its own
resources to cancel debt owed by the world's poorest countries; the
US must also call on the World Bank to abandon its support for user
fees for health care and education
- Immediately end the WTO dispute against Brazil's over compulsory
licensing and Brazil's domestic patent law
- Support the creation of health exceptions to trade agreements,
such as the Agreement on Trade Related Aspects of Intellectual
Property Rights (the TRIPS Agreement).
Footnotes:
1 McNeil, Donald. "Bush Keeps Clinton Policy on Poor Lands' Need
for AIDS Drugs," The New York Times, 22 February 2001.
2 Phillips, Michael M. "Bush Administration Weighs Donation of $200
million to UN AIDS Fund." Wall Street Journal, 4 May 2001
3 Ibid.
4 eg, Goemaere, Eric. "South Africa: how access to treatment helps
prevent the spread of HIV." Access to Essential Medicines Campaign
Dossier 3, July 2000.
5 Goedert, J. J. et al. "Perinatal Transmission of HIV-1 from
Pregnant Women with RNA Viral Load Less than 1000 Copies/ml."
Abstract 517. 8th Conference on Retroviruses and Opportunistic
Infections.
6 Quinn, Thomas C. Viral Load and Heterosexual Transmission of
Human Immunodeficiency Virus Type 1. The New England Journal of
Medicine, 342 (13). March 2000.
7 U. S. Government for NGO and industry briefing on the UN General
Assembly Special Session on HIV/ AIDS 18 April 2001.
8 Rosenberg, Tina. "Look at Brazil." The New York Times Magazine.
28 January 2001.
9 US Response to UN Draft Declaration of Commitment on HIV/ AIDS,
May 2001.
10 eg Chirac, Pierre. "Patents in French-speaking Africa." Access
to Essential Medicines Campaign, Dossier 3, July 2000
11 Office of the USTR. Special 301 Watch List. 30 April 2001.
12 eg D. Kirby, et al, "Evaluation of Education Now and Babies
Later (ENABL): Final Report," Berkeley, CA, University of
California School of Social Welfare, Family Welfare Research
Group, 1995.
13 U. S. Government for NGO and industry briefing on the UN General
Assembly Special Session on HIV/ AIDS 18 April 2001.
14 Ibid.
This material is being reposted for wider distribution by
Africa Action (incorporating the Africa Policy Information
Center, The Africa Fund, and the American Committee on Africa).
Africa Action's information services provide accessible
information and analysis in order to promote U.S. and
international policies toward Africa that advance economic,
political and social justice and the full spectrum of human rights.
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