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Note: This document is from the archive of the Africa Policy E-Journal, published
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Africa: Talk or Action on AIDS?
AFRICA ACTION
Africa Policy E-Journal
July 7, 2003 (030707)
Africa: Talk or Action on AIDS?
(Reposted from sources cited below)
As President Bush departs for Africa today, key questions about his
AIDS policy remain unanswered, including the level of funding that
will actually be appropriated. While $3 billion a year has been
authorized by Congress, the president has requested no additional
funds for this fiscal year and less than $2 billion for fiscal year
2004, including only $200 million instead of $1 billion for the
Global Fund to Fight AIDS. News reports say Republicans in the
House of Representatives are planning to approve even less than the
president's low request.
This postings contains (1) an action alert from the Washington
Office of Africa, focusing on the expected vote this week on
funding levels for AIDS, (2) a notice of today's send-off
demonstration for President Bush by the Student Global AIDS
Campaign and ACT UP, and (3) an update from South Africa's
Treatment Action Campaign on continued South African government
delays on AIDS treatment. Another posting today focuses on the
role of the pharmaceutical industy and the U.S. stance on the use
of generic medicines.
For additional documents on issues related to President Bush's trip
to Africa, see http://www.africaaction.org/desk
and
http://www.africafocus.org/docs03ej/chr03.php>
+++++++++++++++++end summary/introduction+++++++++++++++++++++++
The Washington Office on Africa:
An Urgent Action Alert
http://www.woaafrica.org
July 3, 2003
HIV/AIDS Funding to be Decided July 10 in the House Foreign
Operations Subcommittee
On July 10 the House Appropriations Foreign Operations Subcommittee
will decide the amount of money that the U.S. will give to
bilateral and multilateral HIV/AIDS programs for the fiscal year
2004. The U.S. Leadership Against HIV/AIDS, Tuberculosis and
Malaria Act of 2003, passed recently, authorized $3 billion for
these efforts, including "up to" $1 billion for the multilateral
Global Fund. What "Foreign Ops" sets is important in this next
stage of the appropriations process.
Discerning our actions: What we at WOA think
We believe that the House Foreign Operations Subcommittee should
appropriate $3.5 billion to fight global AIDS, TB, and malaria, at
least $1.75 billion of which should go to The Global Fund to Fight
AIDS, TB and Malaria. According to conservative estimates from the
WHO and UNAIDS, $14.2 billion is needed globally to combat and
treat AIDS, TB, and Malaria in fiscal year 2004. While the U.S.
should be contributing 34.8 percent (its share of the global
economy), we are requesting that the U.S. contribute at least 25
percent of the total, or $3.5 billion.
AIDS spending must be both bilateral and multilateral. Some U.S.
agencies have high administrative overhead, and more than twelve
months may pass before benefits from their programs are realized.
We believe that a high percentage of this funding should go to the
Global Fund to Fight AIDS, TB and Malaria, which is already
functioning well, despite being starved for funds. Countries can
turn to the Global Fund with written proposals that are a
collaborative efforts between governments, NGOs, and the private
sector. Unfortunately, President Bush has only proposed providing
$200 million for the Global Fund in 2004, which will cause many of
the grant requests to be turned away. The international community
is looking to the U.S. as a leader in the Global Fund - our funding
is necessary because it will help to encourage other donors.
In. addition, Congress should agree to appropriate only NEW money,
meaning that funds should not be taken from other accounts,
including health-related programs and the core HIV/AIDS accounts.
We believe that the House needs to appropriate more funding without
removing precious resources from other development and humanitarian
aid programs.
Action
We ask that you contact your member of Congress, urging that the
Foreign Operations Subcommittee ensure that fiscal year 2004
appropriations include adequate funds to fight global AIDS, with
$3.5 billion for all HIV/AIDS programs, of which $1.75 billion
should go into the Global Fund. As a minimum, the Subcommittee
should meet the call of the U.S. Leadership Against HIV/AIDS,
Tuberculosis and Malaria Act of 2003, of $3 billion, including $1
billion for the Global Fund.
If your member of Congress sits on the Foreign Operations
Subcommittee of the House Appropriations Committee, please contact
the district office during the July 4th recess, or in Washington,
as soon as possible with the message above. Remember that the
Subcommittee will "mark up" (revise and decide) on AIDS
appropriations on July 10! Membership includes:
Jim Kolbe, Arizona (chair)
Joe Knollenberg, Michigan
Jerry Lewis, California
Roger F. Wicker, Mississippi
Henry Bonilla, Texas
David Vitter, Louisiana Mark
Steven Kirk, Illinois
Ander Crenshaw, Florida
Nita M. Lowey, New York (ranking)
Jesse L. Jackson, Jr., Illinois
Carolyn C. Kilpatrick, Michigan
Steven R. Rothman, New Jersey
Marcy Kaptur, Ohio
If your member of Congress does not sit on the Subcommittee, ask
that he or she weigh in with the Chairperson or the Ranking
Minority Member, depending on party.
A sample message appears below, which we encourage you to adapt and
make your own.
Given security delays with regular mail, we suggest contacting your
Member of the House of Representatives by e-mail or fax. You can
access e-mail links, get district office and other contact
information by going to
http://www.house.gov/house/MemberWWW_by_State.htm or you can call
202/225-3121. Write to Members of Congress at the U.S. House of
Representatives, Washington, DC 20515.
Sample Message
Dear Representative (name):
The House Appropriations Foreign Operations Subcommittee will soon
be deciding the amount of HIV/AIDS bilateral and multilateral aid
given by the U.S. in fiscal year 2004. The U.S. Leadership Against
HIV/AIDS, Tuberculosis and Malaria Act of 2003, passed recently,
authorizes $3 billion for these efforts. A minimum of $3 billion
should be given to these efforts, but I urge that we go beyond this
figure to provide $3.5 billion. This is the U.S. fair share.
From this $3.5 billion, $1.75 billion should be given to the Global
Fund to Fight AIDS, TB and Malaria, a multilateral initiative
designed by the UN. As a minimum the U.S. should fully fund the $1
billion authorized by the U.S. Leadership Against HIV/AIDS,
Tuberculosis and Malaria Act of 2003. Our government's example of
giving will influence other countries to do the same.
I also request that the funding not be removed from other key
accounts that work on health and development issues. The core
HIV/AIDS accounts and other programs that promote global health are
necessary components to the fight against AIDS. According to
conservative estimates from the WHO and UNAIDS, $14.2 billion is
needed globally to combat and treat AIDS, TB, and Malaria in fiscal
year 2004, and we should be giving as much funding as possible.
Global HIV/AIDS is an issue that we must prioritize to ensure
global health, safety, and security, and I request that my tax
money be used to support the prevention and treatment efforts.
Thank you very much for your consideration.
For further information call us at WOA at 202/547-7503, or write to
us at 212 East Capitol Street, Washington, DC 20003. Our e-mail
address is woa@igc.org., and you might also consult our website,
http://www.woaafrica.org.
The Student Global AIDS Campaign and ACT UP
July 3, 2003
For Immediate Release Contact Micah Sucherman: (303) 641-2123
Sean Barry: (202) 361-8293 Alexander Post: (617) 230-7832
Grim Reapers Gather at White House
Bush Travels to Africa As Overworked Grim Reapers Protest AIDS
Policy
8500 Deaths per Day "Grim" Even by Their Standards
11:30 am meet at Office of National AIDS Policy (734 Jackson Place)
Followed by procession to White House Gate, arriving at 12:00 pm
On July 7th, dozens of Black-clad Grim Reapers wielding tall
scythes will gather at the White House gates to condemn President
Bush and his administration for an AIDS policy which has left them
harried and overworked. "Sure we're pro-death, but 8500 AIDS deaths
a day is ridiculous," complained a Reaper. "With over 14000 new
infections daily, this situation is grim even by our standards," he
added.
In January Bush took a significant step forward, pledging $15
billion dollars over the next five years to fight the global AIDS
pandemic. But after five months the President's promise has begun
to ring hollow. Despite signing and publicly endorsing the $3
billion AIDS authorization bill in May, it now appears that the
President will settle for the appropriation of only half that
amount - $1.52 billion - to pay for on-the-ground AIDS services. In
addition, the Bush Administration intends to gut funding for the
Global Fund to Fight AIDS, Tuberculosis, and Malaria, which experts
identify as the world's most potent institutional weapon against
the AIDS pandemic. The President's paltry $200 million request for
the Global AIDS Fund will leave the Global Fund unable to fully
fund worthy grants during its next round in October.
AIDS will not go away by itself - the virus will spread and sick
will die in overwhelming numbers until the United States begins
taking real steps to combat the disease. "Less rhetoric and more
action," the Reapers demand, "the AIDS pandemic is working us to
death!"
Photo Ops: AIDS activists and people living with AIDS dressed as
Grim Reapers carrying scythes, signs ("Too much AIDS - Too much
Work!") in front of White House.
AIDS Activists Demand that President Bush:
(1) DONATE THE DOLLARS: Request and ensure that Congress
appropriates the full $3 billion to fight global AIDS in 2004 that
was promised in the global AIDS bill President Bush signed. The
U.S. should provide at least $1 billion of this amount for the
super-efficient and effective Global Fund to Fight AIDS,
Tuberculosis, and Malaria.
(2) DROP THE DEBT: Implement the provision contained in his AIDS
Bill to deepen debt relief for poor countries, as well as countries
outside of HIPC - like Nigeria - thereby freeing up $1 billion in
debt service payments that could be re-directed to combat AIDS and
poverty.
(3) TREAT THE PEOPLE: Stop negotiating intellectual property
regimes in new free trade agreements which go beyond those
established by the World Trade Organization (WTO) meetings at Doha,
and thereby deny poor peoples access to essential life-saving
medications. Additionally, the President must ensure that his
emergency plan for AIDS relief allows countries the freedom to
procure generically manufactured drugs.
Treatment Action Campaign
http://www.tac.org.za
TAC Electronic Newsletter 1 July 2003
[excerpts; for full newsletter see TAC website]
To subscribe send a blank email to news-subscribe@tac.org.za To
de-subscribe, send a blank email to news-unsubscribe@tac.org.za
1 July 2003
A Treatment and Prevention Plan: Where do we stand with
Government? Where to from here for TAC?
In late April, TAC suspended its civil disobedience campaign
following our meeting with Deputy-President Zuma. However,
presently there is growing concern among TAC members and
volunteers that we have received very little in return from
government. A commitment to a treatment and prevention plan that
includes antiretroviral therapy is still far from certain. As one
activist explained in a meeting discussing civil disobedience in
Johannesburg, we can suspend the civil disobedience campaign, but
we cannot suspend the pain of people with HIV/AIDS and their
friends and families.
We are at a critical turning point in South Africa's response to
the HIV epidemic. TAC suspended its civil disobedience campaign
to give government the space and opportunity to commit, on its
own terms, to a treatment and prevention plan that includes
antiretroviral therapy. There were some positive signs that the
Cabinet would soon make such a commitment. We are aware that the
costing study conducted by the task team composed of members of
the treasury and health departments was completed and awaited
approval by Cabinet since April. Furthermore, the Treasury put
aside contingency money for treatment in the 2003/04 budget
clearing the way for a change in policy. The NEDLAC negotiations
were also to have resumed. TAC's meetings with the
Deputy-President on 25 April and with a number of Cabinet
ministers at the SANAC meeting on 14 June gave hope that there
were some leaders in government who recognised the urgency and
the moral and legal imperatives to extend access to
antiretrovirals to South Africa's poor as part of the national
response. In addition, the Western Cape MEC for Health recently
made it clear that it is a matter of time before government
begins rolling out an antiretroviral treatment programme. In
private discussions, this sentiment has been echoed by a number
of senior civil servants.
These were tangible reasons to be hopeful and to give government
the benefit of the doubt by suspending civil disobedience. It is
in all our interests for a treatment and prevention plan to be
attained via a voluntary change in government policy, rather than
via civil disobedience and litigation at the Constitutional
Court. If we have to resume the latter route, the treatment
programmes that will ultimately be implemented are unlikely to be
as successful as a plan implemented by a government that is
politically committed to treatment. Despite protest by government
that it has a "five year strategic plan", we still believe that
the existing plan is inadequate and that policy to treat has to
be much more rigorously monitored in its implementation if it is
to be successful.
But the TAC leadership is being continually reminded that there
is a limit to the patience of people confronting their own
mortality. Government cannot dither any longer. The timeframe for
decisions to be taken is now days, at most weeks, not months.
Every delay is measured not in inconvenience, but in death and
suffering. If TAC is being mislead and if government promises
have been in bad faith, the subsequent return to civil
disobedience will be more intense than before, involve much
larger numbers of people and will not be suspended or stopped
without the implementation of a treatment plan.
A report that appeared in the Star (27 June) is reprinted in this
newsletter. It points out serious government delays such as the
failure to date to sign the Global Fund agreements, the failure
to release the costing study on antiretroviral treatment which
merely needs the go-ahead from Cabinet and the failure to release
the latest antenatal clinic study. To this we can add the failure
to officially release the report that was produced at the HST
scientists conference last year. We hope that there are no longer
senior people in government who intend to scupper moves towards
treatment. However, if there are, we cannot appeal to your
conscience. We cannot ask you to consider the lives and suffering
of hundreds of thousands of your fellow citizens. Instead we must
appeal to your self-interest and ask: are you willing to risk the
sustained pressure of civil disobedience, international
embarrassment and litigation through to the April 2004 general
elections and beyond?
In the meanwhile, irrespective of which route government chooses
and as TAC prepares for its provincial and national congresses
over the next month, activists must prepare for a new phase in
TAC in which we consolidate our branches so that they are better
equipped to assist with the implementation of the government's
current programmes and any new ones that might become policy,
such as antiretroviral treatment. It would be wrong of TAC to
expect government to take sole responsibility for the health
interventions for which we have advocated. Our duty to ensure
their successful implementation is critical. Therefore, in this
issue of the electronic newsletter, we have included two
important discussion documents that are being circulated at TAC
branches. One, written by Zackie Achmat, examines the role and
responsibilities of TAC branches. The other, written by Sipho
Mthathi, gives concrete suggestions for how TAC branches can
ensure that people become educated about HIV issues.
Let us work together to implement a successful treatment and
prevention plan that will build a better health care system.
...
It's all talk, no action as people succumb to AIDS
By Lynne Altenroxel, The Star, 27 June 2003
Just a few days ago, time finally ran out for Jenny*, an
HIV-positive nurse who worked at a government hospital in
Southern Gauteng.
Ever since she started working at the hospital thee years ago,
she had seen deaths of countless Aids patients in her care. By
this year, five to 10 Aids patients were dying each week in the
medical wards where she worked. Witnessing their painful demise
made her fearful of her own fate. She knew, she said a few weeks
ago, that it was the same way she would go too. Jenny died at her
parents' home on June 12 without ever accessing the
antiretrovirals which could have spared her from an early death
at the age of 29. A short six months after passing her staff
nurse exams with distinction in November, she had become one of
the 600 South Africans dying daily as a result of HIV.
She died frustrated and angered by government delays in
implementing a programme to provide antiretroviral treatment to
people who needed it. "She was very, very angry. Up to the last
day she was very angry," a colleague recalled, describing how she
knew that Jenny was distraught by witnessing the deaths of the
people she nursed.
"I would see that she was really affected. She wouldn't want to
talk when she came out of there She wouldn't even want to eat
when she came out of dealing with a very sick patient."
Now, several days after Jenny's death, there is still no answer
to the question of whether the government will ever provide
anti-Aids drugs to people who cannot afford them. On Wednesday
the cabinet met again without discussing a report on the cost of
providing antiretroviral therapy - even though more than two
months have passed since the report was finalized. For people
living with HIV, it seems as if there is no sense of urgency
about dealing with an issue which, for them, is a matter of life
and death. Lifeline counselor Isaac Skosana, who is HIV-positive,
will tomorrow bury one friend who succumbed to the virus. On
Wednesday, as the cabinet met without discussing anti-Aids drugs,
he buried another.
"What I hear is only promises. Bt commitment and things that are
practical, I see nothing," said Skosana, who is healthy but
dreads the day when his immune system needs antiretrovirals to
prop it up. ...
...
For health professionals such as Sister Sue Roberts, head of Helen
Joseph Hospital's HIV clinic, the list of people in desperate need
of antiretrovirals is growing. The clinic diagnoses 80 to 90 new
HIV infections in patients each week. More than half of the HIV
patients on its database are in desperate need of treatment, with
less than 5% able to afford to buy the drugs themselves. "We've had
a lot of patients who could have done extremely well on drugs. And
a lot of them are no longer with us," Roberts said.
So many people are dying without treatment that nurses who
suspect they are HIV infected are reluctant to acknowledge that
they, too, have the virus. "One of the biggest problems with
healthcare workers is that they see that nothing is done for HIV,
so they don't come forward," Roberts explained. "They're
petrified of being identified as positive... because they're
seeing sick patients dying in front of them all the time."
* Names have been changed to protect identity.
+++++++++++++++++++++Document Profile+++++++++++++++++++++
Date distributed (ymd): 030707
Region: Continent-Wide
Issue Areas: +health+ +US policy focus+
The Africa Action E-Journal is a free information service
provided by Africa Action, including both original
commentary and reposted documents. Africa Action provides this
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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