Bill Clinton Was Right About Wasted HIV/AIDS Funding

"In too many countries too much money goes to pay for too many people to go to too many meetings, get on too many airplanes," proclaimed the former U.S. President Bill Clinton in a keynote address at one of those very meetings, the XVIII Annual International AIDS Conference which was held last week in Vienna. Clinton added, "Keep in mind that every dollar we waste today puts a life at risk." The meetings and airfare are only the tip of the iceberg. Dollars desperately needed to save lives of AIDS patients have never left Washington or have been wasted on unnecessary overhead around the world.

The kinds of people President Clinton had in mind are like Ninsiima Agatha, who was profiled recently in the Wall Street Journal. Ninsiima is a 20-year-old mother with two children in Uganda, a country once considered a model of success for HIV/AIDS relief efforts. Ninsiima entered a medical clinic a few months ago after finding out that her husband was HIV-positive. She was now also infected and in dire need of lifesaving treatment for her and her two children.

Without access to life-saving drugs, she knew her health would quickly deteriorate, and perhaps more importantly, she would likely pass the disease on to the baby she was breast-feeding. Tragically, however, the clinic had reached its quota of patients under its contract with the U.S. government. The article explains, "Ms. Agatha, sprawled on a hospital bed with a toddler and an infant, could barely move. 'I feel desperate,' she said."

AIDS Healthcare Foundation, the largest global AIDS organization, has seen its clinics in Uganda flooded with patients turned away by U.S. funded programs.

Despite billions of dollars annually to support global HIV/AIDS initiatives, the challenges we face remain daunting. As many as 33.4 million people are already infected with HIV and another 2.7 million become infected each year. Only 4 million are currently being treated, 2.4 million of which through the President's Emergency Plan for AIDS Relief (PEPFAR). More needs to be done to place greater emphasis on treatment as opposed to bloated administrative budgets and ineffective awareness campaigns.

Legislation introduced last week -- S.3627, The HIV/AIDS Save Lives First Act of 2010 -- renews our commitment to providing life-saving treatment to the millions of patients in need. This legislation increases the percentage of U.S. bilateral funding that must go directly toward treating patients, limits the administrative overhead of both government agencies and recipients of funding, and requires funding recipients to be more cost-effective. The bill will accomplish these goals within the existing budget of the program.

This legislation sets a treatment goal for the PEPFAR program of 5 million patients by 2013 -- twice the current number receiving treatment through the program -- while devoting the necessary resources to make this goal a reality. Further, this legislation provides for and sets the goal of completely eliminating baby AIDS -- mother to child transmission -- once and for all.

A renewed commitment to saving lives has never been more critical. Despite the significant success of the United States bilateral relief efforts the global fight against AIDS is now at risk of failure. Recent news reports in the Wall Street Journal and New York Times, respectively, have featured ominous titles such as "War on AIDS Hangs in Balance as U.S. Curbs Help for Africa," and "At Front Lines, AIDS War Is Falling Apart." Terrible reports of patients once promised treatment being denied care have been confirmed by U.S. officials. The Department of Health and Human Services advises their partners to support "an equitable system of triage for total ART [antiretroviral drug treatment] slots..."

This is unacceptable. We know that HIV/AIDS is a disease that we can diagnose, treat, and prevent. Not only does treatment save lives, it is the best prevention tool we have. Treatment lowers viral loads, which reduces the likelihood of individuals spreading the disease by as much as 92 percent. Treatment reduces transmission among partners, eliminates completely mother to child transmission, and keeps those with HIV in the medical system where they can receive proper counseling and care. And the availability of treatment is integral to promoting HIV/AIDS testing and early diagnosis.

America made a commitment to lead the global war against AIDS. There is no reason to retreat. In these difficult economic times every dollar not spent saving a life or preventing a new infection is a dollar misspent. Hopefully, President Clinton's remarks and the dire situation in Africa will encourage American and world leaders to take the necessary steps to prioritize saving lives.