Bush's legacy on AIDS
HISTORIANS ARE not likely to be kind in judging the chaos President Bush has created in Iraq, or the damage he has done to international agreements like the Geneva Conventions and to civil liberties at home. But he will deserve high marks for his leadership in mobilizing US aid to fight AIDS overseas. On Wednesday, he asked Congress to spend an additional $30 billion in assistance over five years.
This would double the $15 billion Bush promised in 2003 when he first set up his President's Emergency Plan For AIDS Relief. That first five-year pledge came at a time when skeptics, including some in his own administration, wondered if it was even feasible to treat patients with AIDS drugs in developing countries with barely functioning public health systems. The president's plan addressed such problems and got life saving drugs to 1.1 million patients in Africa, Haiti, Guyana, and Vietnam, the plan's target areas.
The new goal is to bring the number of patients under treatment to 2.5 million and to prevent infections in another 12 million. Prevention would likely be more effective if Congress did not require that at least one-third of all prevention funding be spent on abstinence-only training. A recent study of such training among students in the United States showed it to have no impact on the age at which young people become sexually active or the number of partners they have. Congress' new Democratic leadership should waste no time in dropping this provision.
Prevention, the best way to curb the growth of the epidemic in the absence of a vaccine, is especially complicated in Africa. A study released this week by Physicians for Human Rights shows how discrimination against women and their subservient economic status leads to disproportionately high infection rates of women in Botswana and Swaziland. Progress toward the United Nations' millennium goals of development and education will help women avoid unequal marriages in which abstinence is not a realistic option.
The AIDS money goes not just to the president's plan but also to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, for which the United States is the largest single donor. Thanks to strong bipartisan support for the Global Fund in Congress, the US contribution has risen from $200 million in 2003 to $724 million this year.
The president's plan "is a promise the United States has kept," according to Dr. Michel Kazatchkine, executive director of the Global Fund. Continued support for the president's plan and the Global Fund will ensure that Bush's legacy includes this noble chapter.
