Obama, AIDS, and the world
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THE GLOBAL HEALTH spending plan unveiled by President Obama last week would break new ground in treating children's infectious diseases, even as it falls short of campaign promises for major increases in overseas funding for HIV/AIDS. Advocates for more AIDS spending have criticized the president, but United States can save more lives for less money in developing countries by broadening its health safety net. The challenge will be to get Congress to approve the ambitious spending Obama has proposed.
Obama has called for $63 billion for global health over six years, with $51 billion dedicated to the AIDS, tuberculosis, and malaria program that President Bush initiated to great acclaim in 2003. Another $12 billion would help countries deal with diarrheal infections, infant pneumonia, and other diseases that lead to infant mortality.
During the presidential campaign, however, Obama promised to spend $50 billion on AIDS, TB, and malaria within five years. He also pledged to increase the outlay for these diseases by $1 billion each year. Last week's plan included an increase of just $366 million for the coming year.
Immediately, officials from advocacy organizations like the Global AIDS Alliance and the Center for Global Health Policy faulted the president for reneging on his promises at a time when the economic downturn is forcing many of the nations most affected by AIDS to reduce their own healthcare spending. But Obama's plan is an overdue acknowledgement that those nations need assistance in addressing a raft of diseases and health threats.
The broader approach to international public health was the focus of a 2008 article in the Journal of the American Medical Association. "By extending funds to simple but more deadly diseases, such as respiratory illnesses and diarrheal illnesses, the US government could save more lives - especially young lives - at substantially lower cost," Colleen C. Denny and Dr. Ezekiel J. Emanuel wrote. Emanuel is the older brother of Obama's chief of staff, Rahm Emanuel.
The differences between the president's campaign pledges and last week's proposal will pale in significance if Congress reacts to the mounting budget deficits by throwing a brake on foreign aid. There are signs it might: Its budget resolution, passed last month, sets overall foreign assistance at $51 billion, $2.8 billion less than Obama requested. All advocates of US global health spending should rally around the Obama plan, to make sure that Americans' commitment to prevent and treat deadly diseases overseas does not fall victim to the ebb and flow of the world's economy.
