The Common Good
May-June 2003

The Devil's in the Details

by Adam Taylor | May-June 2003

Will the AIDS initiative make a difference?

Proverbs tells us that where there lacks vision, the people perish. The United States has lacked vision in the fight against global HIV/AIDS, the greatest health crisis in human history. For the majority of the 42 million people infected in the world, AIDS still represents a death sentence. More than 12 million orphaned children in Africa alone interrogate our response and demand that we do more.

In his State of the Union address this winter, President Bush outlined a bold role for the United States by pledging $15 billion over five years to fight HIV/AIDS in Africa and the Caribbean. The initiative promises to provide life-prolonging treatment to 2 million people and to prevent 7 million new infections. In addition to this desperately needed new money, the president stated a principle that activists and people of faith have embraced in the fight against HIV/AIDS. "In an age of miraculous medicines," Bush said, "no person should have to hear" the words, "‘You've got AIDS. We can't help you. Go home and die.'"

With Bush's plan the devil lies in the details. The political landscape around HIV/AIDS will be defined by how this new commitment is implemented. The advocacy battle must turn to getting the details right. While the details may not generate the same degree of outrage, they will determine how many lives are lost or saved.

In the AIDS initiative, Bush exacerbates a ongoing streak of the United States going it alone in addressing global crises. In the first year, only 10 percent—$200 million—of the new money will go through the Global Fund for HIV/AIDS, Malaria, and Tuberculosis. The Global Fund represents a new multilateral mechanism designed to pool money from wealthy nations and deliver it to scientifically sound and fiscally accountable programs in countries most heavily impacted by HIV/AIDS. The fund represents one of our best hopes, because it significantly depoliticizes aid and gives both the donor and recipient country a say in how money is used. A pledge of only $200 million would mean a significant step backward in U.S. leadership toward the fund and could cripple the fund in the future. And the World Health Organization conservatively estimates that a fair U.S. share of AIDS assistance would be at least $3.5 billion a year, while the Bush initiative includes less than $2 billion in its first year.

ALONG WITH THE exponential spread of HIV, the world has also witnessed the rapid growth of public pressure and activism. Students, health professionals, and churches have mobilized in a manner reminiscent of the civil rights movement—through letter-writing, lobbying, op-eds, and demonstrations—to pressure Congress and the Bush administration on the issue. The Student Global AIDS Campaign, for example, educates, trains, and mobilizes college students to serve as advocates in the spirit of the Student Nonviolent Coordinating Committee.

The longer our nation waits to address the crisis with the urgency and priority it deserves, the more lives will be lost and the more costly it becomes to turn back the course of the epidemic. The war against HIV/AIDS must be wrapped around underlying issues of poverty, inequality, and marginalization. HIV disproportionately impacts "the least of these" in relation to both color and class. And along with aid, the administration should support full debt cancellation for poor nations in order to free up desperately needed resources for health.

It was not coincidental that the president outlined the new act immediately before building a case for military intervention against Iraq. The AIDS initiative lends a more compassionate face to what has become an increasingly unilateral and bellicose U.S. foreign policy.

In 1963 President John Kennedy urged Congress to take steps to end the evil of segregation. Civil rights organizers viewed this breakthrough as an opportunity for escalated mobilization. A few months later the movement assembled 300,000 people for the historic March on Washington to turn Kennedy's words into reality.

We stand at a similar crossroads in the fight against HIV/AIDS. We have the tools of prevention, treatment, and care to stop this deadly epidemic. What is needed most is the personal, societal, and political will. To paraphrase Rabbi Hillel: If not now, when? If not people of faith, who? —Adam Taylor

Adam Taylor is executive director of Global Justice, which mobilizes students around public policy issues.

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