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USA/Africa: Health Budget Falls Short
Feb 5, 2008 (080205)
(Reposted from sources cited below)
United States President George W. Bush has asked Congress to vote
an U.S. $30 billion for the President's Emergency Plan for Aids
Relief (Pepfar) over the next five years. .. But critics say this
is only maintaining the current funding levels when large
increases are still needed. Physicians for Human Rights, for
example, has called for U.S. $59 billion to fund the fight against
Aids, tuberculosis, malaria and other global health programs. And
Aids-Free World co-director Stephen Lewis has pointed out that the
war in Iraq is taking far more: up to $108 billion a year.
This AfricaFocus Bulletin contains two updates on budget proposals
by President Bush and by Congress on global health, and a call for
organizational signatures on a letter to members of Congress to
support a draft bill proposing to increase the president's proposal
from $30 billion to $50 billion. Organizations, both in the United
States and elsewhere, are being asked to sign on by the end of the
day on February 6, in time for the congressional committee vote
expected on February 7. See below for the text of the letter and
the e-mail address to send endorsements.
Another AfricaFocus Bulletin sent out today contains an update on
a new study showing that anti-malaria interventions, if applied on
a national scale, can have dramatic effects in reducing
hospitalization and deaths from malaria in children. See
For previous AfricaFocus Bulletins on health issues, visit
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Bush Releases FY 2009 Budget With Funding for Global,
Domestic HIV/AIDS Programs
February 5, 2008
President Bush on Monday released his $3.1 trillion fiscal year
2009 budget proposal, which allocates funding for global and
domestic HIV/AIDS programs, the AP/Google.com reports (Taylor,
AP/Google.com, 2/5). Under Bush's budget proposal, $4.8 billion
would be allocated for the Global HIV/AIDS Initiative, which
forms the bulk of funding for the President's Emergency Plan for
AIDS Relief. Bush's total request for PEPFAR funding is $6
billion in FY 2009. In addition, the budget would allocate $1.6
billion for child survival and health programs. The budget
proposal would allocate $200 million for the Global Fund To
Fight AIDS, Tuberculosis and Malaria within the Global HIV/AIDS
Initiative account. The Global Fund also would receive $300
million within the National Institute of Allergy and Infectious
Diseases account. The budget proposal would provide $300 million
for the President's Malaria Initiative and ongoing malaria
programs worldwide. Bush also requested $2.2 billion for the
Millennium Challenge Corporation, a program meant to encourage
economic and political reforms in developing countries
(President's FY 2009 budget, 2/4).
Bush Proposes More Funds for Aids Fight
29 January 2008
By Brian Kennedy and Katy Gabel
AllAfrica.com, Washington, DC
[reposted with permission]
United States President George W. Bush has asked Congress to vote
an extra U.S. $30 billion for the President's Emergency Plan for
Aids Relief (Pepfar) over the next five years.
In his final State of the Union address, delivered to Congress
Monday night, Bush said: "We can bring healing and hope to many
more. So I ask you to maintain the principles that have changed
behavior and made this program a success ... I call on you to
double our initial commitment to fighting HIV/AIDS by approving an
additional $30 billion ..."
According to the White House, 1.4 million people have benefited
from the Pepfar program. In an interview with USA Today last week,
President Bush called Pepfar "a strategy that is working" and one
that "has made a difference in over a million people's lives in a
relatively quick period of time."
Bush says millions more lives can be saved with Pepfar funding. But
David Bryden of the Global Aids Alliance accused him of obscuring
the issues around HIV/Aids funding through the ambiguous use of
language, stating that HIV/Aids funding is actually "flat-funding."
"The President has proposed 'doubling' spending to $30 billion, but
the reality is that his proposal would not double current spending
at all," said Bryden.
According to Bryden, the U.S. is spending U.S. $6 billion on
HIV/Aids in 2008. Over five years, the total would be U.S. $30
billion, equaling the amount of spending Bush calls for.
Physicians for Human Rights echoed Bryden's desire for more
funding, calling in a statement for U.S. $59 billion to fund the
fight against Aids, tuberculosis, malaria and other global health
programs. The advocacy group also called for more programs targeted
"He should fund it like his life depended on it - millions of other
lives do," said John Bradshaw, the group's director of public
In a recent speech at Harvard Medical School, Aids-Free World
co-director Stephen Lewis pointed out the difference in spending
between HIV/Aids and Iraq.
"The [United States] administration spends, conservatively, up to
$108 billion a year on the war in Iraq, and perhaps $5 billion in
an entire year on HIV/AIDS," said Lewis. "Those priorities are so
skewed as to be obscene."
Joining Bush's wife, Laura, in Congress for the State of the Union
was Tanzanian Tatu Msangi and her daughter, Faith Mang'ehe. Msangi
is HIV-positive, but her daughter does not have HIV because of a
Prevention of Mother-to-Child Transmission program supported by
Pepfar, according to a White House statement.
Addressing the fight against malaria, Bush told Congress: "With
your help, we are working to cut by half the number of
malaria-related deaths in 15 African nations." Earlier this week he
called for an expansion of the Presidential Malaria Initiative.
Bryden, however, said that without additional money, "flat-funding
may even affect malaria programs."
Bush also called for full funding for the Millennium Challenge
Account, an aid program introduced by the Bush administration in
2002 to distribute foreign development assistance by following a
corporate model. "This program strengthens democracy, transparency,
and the rule of law in developing nations," the president said.
He did not limit his focus on Africa to health-related funding.
"America is opposing genocide in Sudan," he said. He also called
for "supporting freedom" in Zimbabwe, where elections are scheduled
Karen Hirschfeld, Sudan campaign director for Physicians for Human
Rights, called his statement on the country "empty rhetoric" that
should be replaced with real action.
Last week, the White House announced that Bush will travel to five
African countries from February 15 to February 21.
Organizational Sign-On Letter
[More than 50 organizations have already signed. Please send
organizational endorsements by 5 p.m. U.S. east coast time to
For more information contact:
Paul Davis , Health GAP (Global Access Project)
email@example.com +1 215.833.4102 (mobile)
February 2, 2008
Dear friends in the fight against global AIDS,
February 7th is a momentous event in the history of the fight
against global AIDS. On that day, the U.S. House of
Representatives' Committee on Foreign Affairs will introduce and
vote on the second five years of U.S. Efforts to fight global AIDS.
Right now, the draft bill contains $50 billion - a TWENTY BILLION
INCREASE over what the outgoing President has requested. It sets
some historic high water marks for commitment to support AIDS
treatment and prevention, but also goes a long way to move from
emergency to sustainability, with important new sections on health
workforce, health systems, TB and malaria, coordination and
integration, and very substantial new new support for women and
girls and evidence-based prevention.
The excitement around this bill is also allowing several other very
important and overdue initiatives that have not passed on their own
to be attached to this bill, including much of the Microbicides
Development Act and a repeal of the shameful U.S. travel ban
against people with HIV.
[NOTE: endorsements must be received by 5 p.m. U.S. east coast
time. Please send to firstname.lastname@example.org]
Feb 7, 2008
Dear Members of the House Committee on Foreign Affairs,
We write as members of the worldwide movement of organizations
concerned about AIDS and global health. We urge you to support
passage of Chair's text of the U.S. Global HIV/AIDS, Tuberculosis,
and Malaria Reauthorization Act of 2008 - a renewed and improved
version of the President's Emergency Plan for AIDS Relief (PEPFAR).
This bill continues and builds on the progress made by current U.S.
Global health initiatives, and affirms U.S. commitments made to
achieve universal access to AIDS treatment, prevention and care, as
well as meeting targets pledged against tuberculosis and malaria.
In addition to providing assistance for prevention of new HIV
infections and treating and caring for people living with HIV/AIDS,
the bill also aims to transition U.S. global AIDS programs from an
emergency phase to a sustainable one. The bill increases
flexibility in budget programming, Allows a more comprehensive
approach to prevention including new activities to address the
vulnerabilities of women and children, strengthening health systems
by providing technical and financial support to countries to
develop and implement health workforce plans and support for
training and retaining necessary new health workers, supporting
scientific research for new vaccines, microbicides and prevention
technologies and strengthens coordination efforts across U.S.
agencies on HIV/AIDS, TB, and malaria programs.
The bill establishes in legislation a U.S. malaria program,
continuing and building upon the President's Malaria Initiative
that has already contributed greatly to improvements in the fight
to eradicate malaria. It also includes assistance for activities
aiming to prevent and stop the spread of tuberculosis - a disease
that knows no borders as witnessed by the MDR-TB case in the U.S.
There is a continued need to scale up access to treatment and to
get important new first and second line regimens to more of the
people in clinical need. And to succeed sustainably, impoverished
countries must be substantially supported significant increases the
number of health workers trained -- and supported so they can do
their jobs in their countries of origin. The bill also affirms the
U.S. commitment to support the multilateral Global Fund to fight
AIDS, Tuberculosis and Malaria.
To achieve the goals in prevention, treatment, care and to ensure
a holistic approach to HIV/AIDS, TB, and malaria and the health
workforce necessary to keep U.S. commitments, a minimum of
$50-to-$59 billion is needed over five years.
To demonstrate continued U.S. commitment to partners in the
developing world and to show that Americans intend to sustain work
against AIDS worldwide through increased investments and sound
policies on global health, we urge that you support passage of this
legislation with at least $50-$59 billion over five years, and all
of the policies and improved program targets in the current draft
[NOTE: some of these program targets may be added to the final text
of this letter. See summary below.]
Thank you for your consideration.
Summary of Key Provisions in The U.S. Global HIV/AIDS, TB, Malaria
Reauthorization Act of 2008
Known as "The Global AIDS bill"
- Establishes a comprehensive, integrated five-year global
strategy to fight HIV/AIDS, Tuberculosis, and Malaria
- Supports treatment for three million people with HIV, prevents
12 million new infections, care for 12 mn PWHIV
- NEW pieces on TB, malaria, health workforce and health systems,
microbicide development, AIDS-related nutrition, protections for
women and youth
Policy Planning and Coordination:
--develops a five year comprehensive strategy to combat HIV/AIDS
- A comprehensive, evidence-based approach to prevention
- Specific linkages to food and nutrition, other basic health and
- Include prevention and treatment services for injection drug
- Medical, social, and legal services for victims of violence
Research, including incentives for HIV vaccine development and new
- Greatly improves US interagency coordination across a spectrum of
USG agencies for reviewing progress in host countries towards
HIV/AIDS prevention, care and treatment objectives; identifying
countries; reviewing policies that may be obstacles to reaching
prevention, treatment and care goals; and coordinating with other
U.S. foreign assistance particularly in the areas of health and
- Improves coordination with other donors and development partners
at the country level, improves transparency and accountability
- Continues U.S. commitment to the Global Fund, including a
contribution of $2 billion for 09 and '10, such sums as necessary
- Retains 33% contribution
- Continues the ABC model aimed at prevention with strong emphasis
on delay of sexual debut, abstinence, partner reduction, and
life-skills programs, particularly for women and girls.
- Eliminates the abstinence earmark and enhances abstinence as a
part of the ABC strategy. Conscience clause is retained, so that no
PEPFAR contractor is required to deliver condoms.
- Eliminates the prostitution pledge and strengthens language on
countering HIV/AIDS for victims of trafficking.
- Also includes counseling and testing including counseling to
prevention sexual transmission of HIV; education and outreach
- Calls on addressing specific barriers to treatment services
- Supporting one-third of the people with HIV/AIDS in clinical need
and three million people
- Access to psychosocial support systems
- Calls for purchasing drugs at the lowest price available
- Calls for integration and coordination within HIV/AIDS
prevention, treatment and care and across global health and
- Includes nutrition as a key component of treatment, including
important new Body Mass Index target to ensure people with HIC are
eating and able to adhere to medications.
Health Systems/Health Care Workers
- Supports country-led five year health workforce plans to train
and retain new health workers
- strengthens health systems in host countries including hospitals,
clinics, medical equipment, laboratories, supply chain management
systems, and capacity building.
- Provided technical and financial support, with countries and
other development partners to achieve WHO-minimum health workforce
densities of 2.3 doctors, nurses and midwives per thousand
- Substantial enhancement of programs to prevent mother-to-child
transmission of HIV with new coverage targets to reach 80% of
pregnant women in countries most affected by HIV/AIDS
HIV TRAVEL BAN:
Eliminates the HIV/AIDS travel ban that prohibits
people with HIV from entering the United States.
Authorization of Appropriations:
Authorizes a total of $10 billion annually to combat AIDS, TB,
malaria, support the GFATM, launch stronger PMTC and AIDS-related
nutrition programs, health workforce training and retention
measures and health systems strengthening, and support for orphans
and vulnerable children under the Act for FY 2009 to 2013.
- Incorporates H.R. 1567, the Stop Tuberculosis (TB) Now Act of
2007 sponsored by Mr. Engel.
- Creates linkages and requires patient referrals between HIV/AIDS
and TB programs.
- Creates new strategy to stop TB by enhancing testing and
treatment in countries with high TB rates.
- Creates new strategies for attacking MDR and XDR forms of
- Provides assistance for the World Health Organization Stop
Tuberculosis Partnership to meet WHO goals to cut TB deaths and
infections in half by 2016.
- Authorizes $4 billion in funding for stop TB programs for FY
2009-2013 out of the overall amounts authorized by the Act.
- Requires the President to develop a comprehensive 5- year
strategy to combat malaria globally and strengthen United States
leadership against this disease.
- Creates a new Coordinator of United States Government Activities
to Combat Malaria Globally.
- Authorizes United States contributions to the WHO Roll Back
Malaria Partnership to improve capacity of countries with high
rates of malaria to address the disease.
- Supports Center for Disease Control and National Institutes of
Health clinical research for new diagnostics, treatments and
interventions to prevent, cure and control malaria.
- Authorizes $5 billion in funding for programs to combat malaria
for FY 2009-2013 out of the overall amounts authorized by the Act.
- Incorporates many parts of the Microbicides Development Act,
which better coordinates US research efforts towards microbicide
Calls for comprehensive U.S. strategy to address the
vulnerabilities of women and girls
AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with
a particular focus on U.S. and international policies. AfricaFocus
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