Last Wednesday, hundreds of global AIDS activists rallied at New York’s Dag Hammarskjold Plaza outside United Nations headquarters, chanting the phrase “15 by 15.” They were demanding that 15 million people receive access to HIV/AIDS treatment by 2015. That’s exactly what officials pledged last week at the United Nations General Assembly high-level meeting on global AIDS, representing a huge victory for the global health activist community. The benefits are likely to be felt in sub-Saharan Africa, the region most vulnerable to HIV/AIDS.
UN member countries promised to allocate some $24 billion for global AIDS treatment in developing countries by 2015, according to a UN press release.
This positive outcome suggests that world leaders are confronting the urgency of the AIDS crisis. A 2010 UN report assessing the Millennium Development Goals revealed that the number of new infections was outpacing the expansion of treatment, meaning the number of untreated people was growing rapidly.
Indeed, calls for expanding access to treatment have been bolstered by new research showing that treatment reduces the likelihood of HIV transfer to a sexual partner by 96%. That figure suggests that treatment effectively amounts to prevention, a dynamic that should go a long way toward ending the treatment vs. prevention debate in the global health community. In particular, the findings repudiate the arguments of some proponents of prevention who dispute that access to antiretroviral drugs is the top priority for fighting global AIDS.
There is not only a moral but an economic justification underlying the need for immediate treatment. Providing funding for access to treatment right now is far more cost-effective than waiting years to do so. The longer the world delays such funding, the more expensive treatment will inevitably become, simply because there will be more infected people in need.
Treating HIV/AIDS sets the foundation for permanent medical systems in developing countries. Thus, funding from wealthy countries shouldn’t be perceived as perpetuating dependency, but rather as a steppingstone to long-term medical infrastructure.
The U.S. has exerted its leadership on global health with former President George W. Bush’s establishment of the President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003. Yet President Barack Obama, citing the economic crisis, flat-lined funding for PEPFAR. One result was that thousands of people in Uganda were denied treatment because the PEPFAR funding shortfall meant they could be treated only after another patient died.
Obama’s decision, however, perpetuates the fallacy that lives can be sacrificed during an economic crisis. Foreign assistance accounts for less than 1% of the federal budget — mere pennies compared to the public’s estimation of roughly 20% in a recent national poll.
The perception that global AIDS funding is a significant part of the federal budget may only continue as Republicans talk incessantly about spending cuts on the campaign trail. What Republican presidential candidates should keep in mind is that a president from their own party established PEPFAR, in no small part because of Christian values about helping the poor.
The candidates will be hearing from students affiliated with the Student Global AIDS Campaign (SGAC), who will demand a specific yes-or-no answer from the candidates as to whether they will provide the necessary funding levels for PEPFAR.
The student global AIDS movement appears to be stronger than ever, characterized by an inclusiveness I observed at SGAC’s conference at Harvard University in January. No longer is this movement comprised only of people affected by AIDS. It is fueled by students who recognize that the AIDS crisis is inextricably linked to the struggle for social justice. That explains why our campaign, on a broader level, is aimed at building a permanent constituency of activists who are ready to respond to any global health challenge that may arise — and our clout will leave our political leaders with no choice but to take action.
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