Obama administration scales back on AIDS response

Timothy Kincaid

December 9th, 2009

The New York Times is reporting the Obama administration is scaling back the US’ response to the AIDS pandemic in favor of a new emphasis on pneumonia, diarrhea, malaria and fatal birth complications.

“I\’m holding my nose as I say this, but I miss George W. Bush,” said Gregg Gonsalves a long-time AIDS campaigner. “On AIDS, he really stepped up. He did a tremendous thing. Now, to have this happen under Obama is really depressing.”

The change in focus is being denied by Dr. Eric Goosby, the new global AIDS coordinator and chief of Pepfar, the man who also refused to consider whether the Ugandan “Kill Gays” bill should be considered when putting millions of taxpayer dollars under that country’s governmental control.

But the blame is being laid on perhaps a more powerful voice in the White House.

AIDS advocates complained bitterly that they had been betrayed and that the Bush administration\’s best legacy was being gutted — and they blame a doctor and budget adviser who is also the brother of the White House chief of staff, Rahm Emanuel.

And, indeed, the new policy does seem to adopt some of the assertions of Dr. Ezekiel J. Emanuel.

Some advocates for overall global health — in contrast to those lobbying for AIDS — expressed regret but said the administration was being practical by shifting to buying goods that save more lives for less money, like water filters, oral rehydration packets and generic antibiotics, rather than putting adults on antiretroviral drugs at a cost of $35 to $2,000 a year.

That was the position advocated by Dr. Emanuel in a paper he published in The Journal of the American Medical Association in November 2008, just as Mr. Obama was being elected.

Entitled “U.S. Health Aid beyond Pepfar,” it argued that spending $48 billion more on the $15 billion program first proposed by Mr. Bush in 2003 was “not the best use of international health funding.”

Paying for “simple but more deadly diseases, such as respiratory and diarrheal illnesses, the U.S. government could save more lives — especially young lives — at substantially lower cost,” he wrote.

Although the Bush administration must be credited for introducing and funding a response to the international AIDS pandemic, it is not without criticism. Tied to the humanitarian aid was a lot of social manipulation designed to impose the morality and culture of American social conservatives onto foreign populaces.

Yet it is disappointing that the Obama administration’s plan is not taking clear steps to correct these problems.

It is nearly silent on several controversial issues: how much Pepfar will emphasize abstinence, whether and how it will get condoms to patients of the many missionary hospitals that refuse to issue them, whether it will support women\’s health clinics that also do abortions, whether it will support giving clean needles or methadone to drug addicts, whether it will require groups working with prostitutes to oppose prostitution, and whether it will cut off countries that criminalize homosexual sex.

But we already have the administration’s answer on the last item.


December 9th, 2009

People here may not like my libertarian position, but American tax money should not be going overseas. We have enough unsolved problems in our own country.

Of course, those who want to make private donations for international charity are free to do so.

Kate Zeiss

December 9th, 2009

This might shed some light on how this is playing out – not a bad tactic, IMO.



December 9th, 2009

Foreign aid sounds great, but too often gets squandered by corruption, or comes with inane political strings attached (like you referenced with Bush).

And I do have to say, there is definitely more bang for the buck in treating those other basic things being pointed at now besides AIDS.

It’s a tough position, really, but if you really believe in it you ought to donate yourself.

Emily K

December 9th, 2009

And what exactly makes this a gay-related issue? I thought AIDS (especially in Africa) was NOT a “gay disease.”

Timothy (TRiG)

December 9th, 2009

Mark, spend cheap on healthcare, or spend expensive on defence. Your choice. Well actually, no, not your choice. Thank goodness.

Development aid is in direct service of international stability and goodwill. It’s a good thing.


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