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End AIDS-Funding Politics

November 29, 2002

President Bush has not minced words about the global toll of AIDS and last June said its devastation "staggers the imagination and shocks the conscience." But urgent words do not amount to U.S. funding and action, the absence of which has repeatedly been criticized by international health officials. Dr. Jeffrey Sachs, the Harvard professor who is U.N. Secretary-General Kofi Annan's AIDS advisor, recently said the Bush administration had no coherent AIDS strategy.

In a conference call with journalists Wednesday, Deputy Assistant Secretary of State Jack Chow countered such charges by saying the administration planned to ask Congress for a $5-billion annual increase in development aid "to those countries that demonstrate progress [in] ... government efficiency, increase investment in public goods such as clinics, hospitals or roads and provide economic opportunities for people at the grass-roots level."

That sounds promising, but the administration has yet to detail how it will navigate the often bitter politics of international AIDS funding.

Here are three principles that can help the administration formulate a cohesive AIDS strategy before President Bush sets out Jan. 13 on a trip to sub-Saharan Africa, the epicenter of the epidemic:

* Don't abandon people who live in countries that have less-than-model governments. If mishandled, the development account could end up as little more than a cynical end run around the Global Fund, the international private-public partnership that works with nongovernmental groups like Doctors Without Borders to help fight AIDS, tuberculosis and malaria in the regions that need help the most, whether or not their governments epitomize modern democratic ideals.

* Significantly increase funding targeted at global AIDS. The U.S. government provides about $800 million a year to fight global AIDS, the smallest contribution of any wealthy nation as measured by percentage of gross domestic product. The U.N. estimates that African nations need $10 billion a year to stem HIV/AIDS.

* Press drug companies to agree that poor nations may make and import low-cost generic versions of expensive patented drugs for AIDS, tuberculosis, malaria and epidemics of similar gravity. Also, reject pressure from anti-trade activists, who at a summit last week in Geneva called on U.S. Trade Representative Robert Zoellick to give up legitimate intellectual property rights by allowing virtually any country to declare any ailment a "public health problem."

There won't be any chance of winning the war on AIDS until State Department officials in Washington avoid distributing funding only to those nations they like and until anti-trade activists, most of them in Europe, work with the pharmaceutical industry rather than simply demonizing it.

As a United Nations study so clearly shows, AIDS -- a scourge that infected 5 million people this year and kills 6,500 people each day -- is too grave a threat to world stability to be used as a political tool by anyone.

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