Is it churlish to criticise Bush over his spending on AIDS?

July 22, 2004

This week's lead editorial reflects on the recent criticism levelled at the US $15 billion programme for tackling HIV/AIDS.

The ABC strategy (Abstinence, Be faithful, and Condoms) proposed by the US administration is viewed as 'an unobtainable position for many, if not most, women living in some of the poorest regions of the world. Here, violence and forced intergenerational sex are often the norm. In these settings, A-B-C is an ideal that cannot be attained, however much politicians might wish to shroud their argument in moral terms. Worse still, the Bush plan will duplicate many of the mechanisms, programmes, and policies of the Global Fund, wasting time and resources. Given that the existing gap between what is spent on AIDS programmes ($5 billion in 2003) and what is needed ($12 billion by 2005, rising to $20 billion by 2007) is so great, making sure that international financing mechanisms use these limited resources efficiently is a necessity. To that end, efficiency must be linked to effectiveness. The urgent need now is to ensure that the 12 billion condoms that are needed this year--and the 19 billion that will be needed by 2015--are made as widely and cheaply available as possible, without qualification.'

The editorial concludes: 'So, is it churlish to criticise President Bush for his spending on global AIDS? No, it is not churlish--it is important and necessary. UN Secretary-General Kofi Annan invited the USA to match its commitment to eradicating weapons of mass destruction with a similar effort for HIV/AIDS. French President Jacques Chirac called on donors to avoid "unnecessary competition" through their support of inappropriate bilateral aid projects. Governments needed to recognise that affected countries--not their donors--should have the principal responsibility for designing and implementing anti-HIV strategies, he said. Generic drug provision was a vital part of this strategy and using such an issue as a negotiating tactic in trade talks--a clear reference to the US administration--"would be tantamount to blackmail". Tobias, a former chief executive officer of Eli Lilly, has called on America to act "differently" in its fight against AIDS. His injunction has drawn the criticism of politicians and international diplomats alike. But leading scientists, physicians, and public-health advocates--such as Anthony Fauci, Director of the National Institute for Allergy and Infectious Diseases, and Richard Feachem, Executive Director of the Global Fund--have remained muted in their response. They have judged that the size of the US investment into AIDS renders President Bush immune from criticism. They are badly mistaken.'


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