Linda Bilmes on Bush's AIDS initiative:
Posted by DeLong at July 7, 2003 11:22 AM | TrackBackFT.com Home US: ...The figure of $15bn continues to be repeated. Last week, for example, Mr Bush reiterated it in a White House briefing with African journalists. "There is tremendous suffering on the continent of Africa," he said. "And we will put a strategy in place that effectively spends $15bn over five years to help ease the suffering from HIV/Aids."
In reality, nothing like $15bn will ever be spent. In the Byzantine world of the US budget process, Congressional "authorisation" by itself means little. What really counts is the annual appropriation that approves the federal budget and without which nothing can be spent. Using this yardstick, the programme is already falling woefully short of the $15bn rhetoric.
The culprit for this shortfall is not Congressional budget-cutting but the president's failure even to ask for the amounts needed to fulfil his pledge. His 2003 budget requested only $1.9bn - an increase of just $450m on what was spent in 2002 and a third less than the $3bn a year implied by the State of the Union promise.
In January, Mr Bush promised to make a contribution of $1bn over five years to the Global Fund to Fight Aids, Tuberculosis and Malaria. But the budget earmarks only the minimum $200m - far less than the $350m the US contributed to the fund last year. Nor is that all: even that $200m is made conditional on European nations matching every $1 that the US chips in with at least $2 of their own.
The president's budget also imposes new restrictions on how existing US funds can be used. For example, there is a provision that directs a third of bilateral HIV/Aids money - about $130m - to be spent on "abstinence- until-marriage" programmes. Such programmes may well have a role to play. But leading HIV/Aids medical groups, such as Physicians for Human Rights, have expressed concern that restrictions such as these will impede the overall prevention programme.
The only significant item of new spending - at a cost of $450m - is a new programme at the State Department to co-ordinate all US assistance on HIV/Aids. This programme will hire personnel to consolidate initiatives that are currently scattered among government departments, including Health and Human Services, Defence, State and the Agency for International Development. In other words, the only genuinely new money is being spent not on drugs or health clinics but on bureaucratic reshuffling back in Washington.
That is bad news for field organisations, which urgently need more resources and are fully capable of absorbing them. According to the International HIV Treatment and Access Coalition - a well respected group of pressure groups, foundations, research institutes and medical centres - more than 4m Aids sufferers in Africa need retroviral drug treatment immediately. Only 1 per cent have access to such drugs now. Field organisations are well set up to provide this service. Mr Bush's own Aids plan calls for treating 2m HIV-infected people, as well as preventing 7m new HIV infections, and caring for 10m HIV-infected individuals and orphans. The United Nations Aids organisation estimates that treating and preventing Aids in Africa will cost $10bn in the next two years. The need is enormous - and immediate.
Of course, Congress has yet to approve the budget and priorities may well get reordered. But the widening federal budget deficit, and Congress's usual parsimony with foreign aid, mean it will be difficult for Congress to produce an HIV/Aids budget higher than the president requested...
Imagine my surprise. Africa support groups in America have been telling us for months that much of the supposed AIDS funding was not there and what will be there will be limited by "moral" restrictions insisted on by the religious right. There it is, folks!
Posted by: emma on July 7, 2003 11:31 AMSee Orcinus posting that Brad referred to, below.
These people are not only shameless but also the most fundamentally dishonest folks to occupy the white house since the nixon group - where, as safire so engagingly reminds us this morning, some of the key thinkers of Bush II got their start....
Posted by: howard on July 7, 2003 11:46 AMMeanwhile, the FT reports that a majority of Americans think Saddam used chemical weapons during this last epidode of the Gulf war. Now, after that, try to imagine this majority's ignorance (and complete indiference) regarding AIDS in Africa. Fortunately, FOX channel etc. are busy educating these folks... "Good night, stay safe, stay aware."
Posted by: Jean-Philippe Stijns on July 7, 2003 12:00 PM"Imagine my surprise. Africa support groups in America have been telling us for months that much of the supposed AIDS funding was not there and what will be there will be limited by "moral" restrictions insisted on by the religious right. There it is, folks!"
I can't recall where I read this from but I believe African development experts expect whatever AIDS funding to basically come at the expense of other humanitarian programs like turberculosis and malaria treatment programs etc. Think about it: it's brilliant marketing. Nothing less to expect from an MBA administration...
"more than 4m Aids sufferers in Africa need retroviral drug treatment immediately. Only 1 per cent have access to such drugs now. Field organisations are well set up to provide this service. "
Unfortunately, this does not seem to be true. The buzz at the International Health Economics Association meeting in San Francisco a couple of weeks ago was that even if the money comes through, health sector infrastructure is woefully inadequate to provide treatment at the moment. Highly Active Anti-Retroviral Therapy (HAART) is difficult to administer at the moment, while doctors, nurses and clinics are difficult to find in Africa (and dying off due to AIDS or fleeing to better pay in Europe). Botswana, with more resources at hand for mass therapy than anywhere else in Africa, has been very slow in scaling up therapy. Brazil is finding that resistance management makes treatment much more expensive than just the drugs. I hate to be a pessimist, but I think even estimates of $10 billion over two years are naive.
While we're Bush-bashing, let's remember that our European neighbors haven't even matched the pittance the US has garnered. If we think our own administration is hopeless, can we get a better response out of Europe or Japan?
Posted by: Russell Green on July 7, 2003 12:36 PMAgreed! Europe, Japan, Australia, south east Asia, where is there real support for Africa? Try getting Europe to allow more flower imports from Kenya. Try getting Europe to encourage other agricultural trade with Africa. There is blame to go round, but there is blame and we should note that.
Posted by: anne on July 7, 2003 12:43 PMRe the preceding comments:
Contacts within the AIDS Bureau of HHS say
that this effort is being used to funnel money to
conservative Christian groups for anti-gay
campaigns and for religious proselytizing.
Call it "faith-based" medicine.
A further problem is a witch hunt against
people dealing with the realities of human
sexual behaviour. Remember this article from
N. Kristof in the NY times?
A witch-hunt over AIDS
NEW YORK Most AIDS scientists are terrified these days. They describe witch-hunts by neo-Puritans in and out of the Bush administration, and many are so nervous that in e-mail and research abstracts they avoid using words like "gays," "homosexuals," "anal sex" or "sex workers."
.
So scientists at the National Institutes of Health, or NIH, and elsewhere are devising their own code. I won't give it away, but one term stands for "gay" or "homosexual," another for "anal sex" and so on.
.
"I would recommend avoiding all electronic communication to any NIH office," one scientist warned in one of many e-mail notes buzzing among AIDS researchers. "Phone communication does not appear tapped at this time. Even so, I am advising staff to speak 'in code' unless an NIH staff member indicates you can speak freely. In short, assume you are living in Stalinist Russia when communicating with the United States government."
.
One detail: I read that 24% of Americans believe Iraq used WMD in the US invasion. 40% or so believe we've found WMD.
The new head of the AIDS to Africa initiative is the ex-head of Eli Lilly, which is a pretty big clue that the whole thing is another huge handout to the pharmaceutical companies, as clues go.
There's only so long you can watch a street game of Three Card Monte. That's actually my motto for the Bush administration.
This may, oddly enough, backfire on Bush. While the Internet-connected surburban Republicans will learn that his foreign-aid promises are hollow, the Fox News/Dittohead crowd will hear "15 billion for Africa, 3 billion for Pakistan" and be p&ssed off.
A twofer- upset your base and the swing voters.
anne: flour, perhaps?
A different chris,
from
http://www.pan-uk.org/pestnews/pn39/pn39p15.htm
"[...] Kenya exports 35,000 tonnes of cut flowers to Europe, putting it only behind Colombia and Israel for global flower exports, and giving it 60% of the US$165 million African flower trade. Flowers make up a major part of Kenya's horticultural industry, the fastest growing sector of the economy, and fourth behind coffee, tea and tourism.
[...]"
DSW
A different chris,
from
http://www.pan-uk.org/pestnews/pn39/pn39p15.htm
"[...] Kenya exports 35,000 tonnes of cut flowers to Europe, putting it only behind Colombia and Israel for global flower exports, and giving it 60% of the US$165 million African flower trade. Flowers make up a major part of Kenya's horticultural industry, the fastest growing sector of the economy, and fourth behind coffee, tea and tourism.
[...]"
DSW
In case it hasn't been noticed, Africans can't vote in the Iowa Caucus. If they could, they would get as much money as corn growers.
Posted by: Will Allen on July 8, 2003 10:02 AM"While we're Bush-bashing, let's remember that our European neighbors haven't even matched the pittance the US has garnered. If we think our own administration is hopeless, can we get a better response out of Europe or Japan?"
And perish the thought that we might actually bash the governments of those African countries. For example, it obviously can't be Thabo Mbeki's fault that he spouts nonsense like HIV does not cause AIDS, or that AZT *does* cause AIDS. After all, he's a poor black man, suffering from oppression by nasty whites.
http://www.iol.ie/~gittons/aids/mbeki.htm
Above all, G@d forbid that we even *think* that Africans might have to take responsibility for contenting themselves with monogamous relationships. Only the worst kind of racist would think that. :-/
Posted by: Mark Bahner on July 8, 2003 02:31 PM"For example, it obviously can't be Thabo Mbeki's fault that he spouts nonsense like HIV does not cause AIDS, or that AZT *does* cause AIDS. After all, he's a poor black man, suffering from oppression by nasty whites. "
These claims over AIDS and AZT were not Mbeki invention, but from people in our society.
As for monogamy, well as long as divorce is allowed, such claims are a farce.
DSW
Posted by: Antoni Jaume on July 9, 2003 04:44 AM