In his State of the Union address, President Donald Trump brought attention to a disease that has almost disappeared from the headlines: HIV/AIDS.
He pledged to end the epidemic in the United States by 2030, setting commendable, ambitious goals for domestic prevention and treatment efforts.
I support President Trump’s pledged investment in domestic public health but believe we must also continue to build on our nation’s 15 years of global leadership in combating HIV/AIDS. Around the world, there are still nearly 37 million people living with HIV, more than 900,000 AIDS-related deaths a year and nearly 1,000 adolescent girls and young women infected with HIV every day. We can and must lead the global fight to end this pandemic.
I have seen firsthand the devastation wrought by untreated HIV and AIDS. Before being elected to the Senate in 1994, I worked as a doctor and served on numerous medical missions in Kenya, Tanzania and Sudan at the height of the global AIDS epidemic. Clinics were overwhelmed with people seeking help, but medical supplies were limited and treatment was not available. Babies were born with HIV, even though treatments existed to prevent mother-to-child transmission. Entire communities were decimated.
At the time, more than 12 million people were living with HIV in Africa. It drained a community’s health, productivity and hope, leaving uncertainty and despair in their place. And it created unstable nations with broken family units and weakened economies that lacked able-bodied workforces.
In 2001, President George W. Bush made the founding US contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and in 2003 as Senate majority leader, I shepherded the legislation creating the President’s Emergency Plan for AIDS Relief(PEPFAR) through Congress. Since then, we’ve seen half as many AIDS-related deaths thanks to these two programs and the investments of affected countries themselves. Millions receive the treatment they need and are alive today as a result.
Today, PEPFAR and the Global Fund are the one-two punch against global AIDS, working together to make remarkable progress against the disease. HIV is no longer a death sentence. We have treatments that allow HIV-positive people to live full lives, and we have tools to prevent its spread. Ending the epidemic for good is within reach, but only if we continue funding and delivering proven solutions.
While Congress has protected PEPFAR and the Global Fund from proposed cuts in the past, the stakes are higher this year. The Global Fund, which is financed primarily by donor governments led by the United States, is heading into its fundraising cycle for 2020-2022.
Major donor governments pay close attention to US support for the Global Fund, knowing that, by law, US contributions need to be matched two-to-one by others. Other donors don’t want to leave US funding on the table, which is one reason most of them markedly increased their investment in 2016.
Quite simply, if the United States stays committed, other donor governments will step up, too. And if the United States backs away? US complacency could easily be used as an excuse to reduce investment.
US support for the Global Fund, PEPFAR, and other global health programs is only one quarter of 1% of the US budget, but they provide significant economic benefits to Americans. Eleven of the top 15 US export markets were once US foreign aid recipients, and five of 10 of the fastest-growing economies are in Africa.
Investments in global health such as the Global Fund also build health infrastructure, helping prevent emerging pandemics (such as Ebola) from raging out of control or reaching US shores. Additionally, global health investments are strongly associated with improved perceptions of the United States in countries around the world, better governance and rule of law, and, as testified to by numerous US ambassadors, stronger diplomatic engagement between nations.
I am proud of my colleagues in Congress who recently came together across the aisle to request an increased US pledge to the Global Fund. Now, to unlock support from other donors, Congress should take the next step and appropriate at least $1.56 billion to the Global Fund this year.
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This investment alone will help to save an additional 1.8 million lives, avert more than 26 million new infections or cases across AIDS, TB and malaria, and reinforce health security systems. It will also be an important first step to ensure that all the donors to the Global Fund enable it to reach a minimum of $14 billion at its replenishment later this year.
America has the opportunity to send a strong signal to the world that our leadership in the fight against AIDS continues, and that other donors should join us in an effort to end the biggest health threats once and for all, both at home and abroad.