Monday, September 13, 2010
Given the nonstop attacks this summer on President Barack Obama's spending habits, you may be surprised to hear that he has proposed cutting back on his commitment to add $1 billion to the Global Fund designed to fight AIDS in Africa and other developing nations.
Of course, global health experts are outraged that a Democratic president is failing to follow through on a 2008 campaign promise for a very good cause. They're getting ready to blister the president next week when he attends the United Nations' conference on global health.
It is these sorts of dilemmas that age presidents prematurely. Obama can't pretend that he has unlimited funds to distribute. But he also must show leadership to the rest of the world in addressing an important global issue. Every dollar contributed to the Global Fund by the United States is matched 2-to-1 by other donors.
The president should consider an alternative: agree to fully fund the program, but only if Congress commits to finding a way to trim back spending on foreign aid in other areas to keep the overall impact on the budget neutral.
Obama shouldn't have trouble lining up support to accomplish that goal. More than 100 members of Congress have already signed a letter imploring him to give the Global Fund full funding. That's a hundred lawmakers who should be ready to step up to leadership in finding other areas to make the necessary cuts.
The value of the Global Fund is inarguable.
Since it was created in 2004 with the support of the Bush administration, it has provided HIV/AIDS treatment for 2.8 million.
As Desmond Tutu noted in an op-ed written for The New York Times, the number of African patients with access to AIDS drugs has jumped tenfold because of the fund, and the AIDS-related mortality rate in sub-Saharan Africa has dropped 18 percent. Equally important, Tutu wrote, the support of the outside world has led more African nations to invest in the public health systems necessary to distribute the drugs donated by the Global Fund.
This is no time to be slowing down the program's progress. The Global Fund estimates that mother-to-child HIV transmission can be virtually eliminated by 2015 if the current rates of progress can be maintained. The number of AIDS deaths among children peaked in Africa in 2005 and has been on the decline. But only a sustained effort by the United States and its world partners will overcome the catastrophic effects of the past decade.
Despite all of the progress, sub-Saharan Africa remains home to two-thirds of all people infected with HIV and 90 percent of all HIV-positive children. Uganda, Zimbabwe and Nigeria each have an estimated 1 million orphans who lost one or both of their parents to AIDS.
But the United States has its own set of domestic problems and a budget that needs to be brought under control.
Obama can show the type of global leadership on AIDS prevention Americans expect from their president -- but only if Congress can help him do so in a fiscally responsible way.
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