In fulfillment of a pledge made this January in his State of the Union speech, President Bush has signed a bill which authorizes $15 billion of expenditure on HIV in Africa and the Caribbean over the next five years.
The act recommends that 55% of the money goes to treatment programmes, 20% to prevention, 15% to palliative care and 10% to schemes designed to assist children orphaned by HIV. Ambitious targets have been set for the expenditure, which the US Congress hopes will prevent 7 million new infections, as well as providing 2 million people with antiretroviral therapy, and care for 10 million.
If fully implemented, the act will see $3 billion a year allocated to international HIV programmes for the next five years, with $1 billion going to the Global Fund to Fight AIDS, TB and Malaria.
UNAIDS has welcomed the legislation, particularly the allocation of funds to antiretroviral therapy. However, director Dr Peter Piot said that the US money still meant that there was a considerable shortfall in resources and urged other nations to “meet the financial and leadership challenges presented by this global epidemic.”
Bush’s signature on the act will put pressure on other rich nations to commit additional funds to international HIV efforts, and the US President is reported to have urged the US Congress to have finalised legislation before the G8 summit of the world’s richest nations in France in early June.
Aid agencies are also putting pressure on the G8 countries to increase their international HIV expenditure, in the ‘Fund the Fund’ campaign.
Even with Bush’s signature on the legislation, the additional US funding is by no means guaranteed, and is dependent upon Congressional approval for the next five years through the appropriations process. Even though the act calls for $3 billion dollars to be allocated in 2004, only $1.7 billion has been allocated in the federal budget, and it is feared that the promised funding could fall victim to calls for increased expenditure on defence and security. What’s more, the $1 billion pledged to the Global Fund is contingent upon the pledges of other countries. G8 spending on the Global Fund can be viewed here.
Concern was also expressed by the Stephen Lewis, UN Special Envoy on HIV and AIDS to Africa that the $15 billion of pledged funding could largely by-pass the Global Fund. Speaking this week he said: "It is true that President Bush has launched a laudable $15 billion AIDS initiative over five years, $10 billion of which is new money. And it is equally true that other G8 nations have yet to make an equivalent gesture... but what is crucial to
understand is that there is no guarantee that the Global Fund - the best
international financial instrument we've had in years... will receive
an appropriate portion of the money."
The passage of the bill through Congress also saw controversy, with religious conservatives amending the legislation to ensure that a third of prevention funding goes to programmes which promote sexual abstinence as the primary method of HIV prevention.
Further information on this website
Bush pledges tripling of US resources for global AIDS response - news story January 2003