From the U.S. it is hard to imagine the misery of the African continent, where 22.4 million people are living with HIV, and AIDS is the number one cause of death. Africa has the highest rates of tuberculosis (TB) in the world and 90 percent of all deaths from malaria occur on this continent. Before his death in 2008, California Congressman Tom Lantos fought to extend America’s hope to those suffering around the world. As a survivor of the Holocaust, he understood personally the impact U.S. involvement could make on the outcomes of a global tragedy like these deadly infectious diseases in Africa—in the form of infections prevented and lives saved.
The last major piece of legislation Lantos authored was the U.S. Leadership Against HIV/AIDS, TB and Malaria Act of 2008. In this bi-partisan effort, Lantos and his Republican colleague Illinois Congressman Henry Hyde worked to reauthorize the President's Emergency Plan for AIDS Relief (PEPFAR). It has been one of the most successful global health programs in history. Like the Marshall Plan, which restored the devastated continent of Europe after World War II, PEPFAR, commonly known as Lantos-Hyde, put the global AIDS program on a path that has built greater local capacity to respond to communities in crisis. This landmark law is a rare bipartisan success story. It was championed by majorities in both the House and Senate, with strong backing from then-Senators Barack Obama and Joe Biden.
Tom Lantos was proud of the leadership role the U.S. played in expanding access to the blessing of HIV/AIDS treatment to those around the world who would otherwise needlessly suffer and die. Before PEPFAR, hospitals were clogged with AIDS patients. Instead of going to school, children, mainly girls, were obliged to stay home to care for their dying relatives. Tom Lantos believed treatment would save the lives of many HIV-positive African teachers and nurses at risk of dying of AIDS—and it did. He saw treatment as a way to avoid the enormous suffering, death and financial cost that results when millions of children are left to fend for themselves as orphans and when entire communities collapse. It contributed to prevention by making people who are living with the HIV virus less infectious to others. Lantos-Hyde called for a major expansion of prevention services, including prevention of HIV transmission from mother to child and greater access to proven, effective measures like circumcision for men.
For Tom, investment in HIV treatment and prevention was a wise and worthy investment for America to turn the tide, prevent death and suffering, and address the looming global impact of the AIDS pandemic in the future. Before he died, he spoke often about the Lantos-Hyde law, because he saw HIV/AIDS as a defining moral issue for our time. He called the lack of access to treatment a “fundamental injustice.”
But, today, the legacy of a bold and hopeful vision for the future for millions suffering from and affected by HIV, left to us by Tom Lantos and Henry Hyde, is faltering.
The global financial crisis has undoubtedly left the world in a state of uncertainty about our economic future. Nevertheless, among the difficult choices that have to be made, underfunding Lantos-Hyde should not be one of them.
Last December, Senators Barbara Boxer and Johnny Isakson, joined by six Senate colleagues, sent a letter to President Obama warning that “the success of our HIV/AIDS program is potentially compromised by a proposed slowdown in funding.” Another letter from nearly 300 physicians and scientists to the House Appropriations Committee leadership characterized the President’s FY11 budget as a “retreat” in the fight against AIDS. In May, a report from Doctors Without Borders showed a dramatic deceleration in the expansion of AIDS treatment, due in part to a decline in the pace of U.S. global AIDS funding.
Right now, the number of people in need of AIDS prevention, treatment and care services greatly exceeds the supply. Without a serious, scaled up response by the U.S. and other major global donors, the health delivery infrastructure put in place to provide life-saving drugs,
vaccines, and other critical health services for people with HIV as well as communities at large, especially in African countries, will begin to erode under the weight of millions of sick and dying men, women and children.
The U.S. has a moral imperative to re-assume its leadership role in the fight against HIV– by scaling up treatment and prevention investment, and rededicating our efforts towards the goal of universal access of HIV medications to all in need.
To some, scaling up HIV treatment and prevention is seen as a burden on the U.S. taxpayer. Instead, it should be seen as an investment that has already paid for itself many times over in good will towards our country and hope restored in African communities. Unfortunately,
Congress is now on course to provide little or no funding increase to AIDS programs.
TB stands out as being woefully underfunded. It is the biggest killer of people living with HIV/AIDS, and Lantos-Hyde requires the Administration to set forth a bold strategy on the disease. Currently, the administration is supporting a TB plan with treatment goals lower than those mandated by Lantos-Hyde.
The Obama administration’s $63 billion Global Health Initiative (GHI) calls for a “rebalancing” of the global health portfolio and is an important signal of the intention of the U.S. government to expand its leadership on global health. It is commendable. Unfortunately, the proposed funding will not accommodate both the scope of Lantos-Hyde and provide the additional funding proposed for neglected tropical diseases, reproductive, maternal and child health, and health system strengthening support.
The U.S. is retreating from its formidable leadership role in the war against the ravages of disease on vulnerable societies. This is a war in which all of humanity is a winner. It is worth the investment and the sacrifice.
Inadequate funding will pit disease against disease and patient against patient. A tiny fraction of the U.S. budget is needed to fully fund the programs authorized by Lantos-Hyde. Maintaining this level of commitment to the international fight against misery provides a clear example to the international community. This is the type of leadership that Tom Lantos, Henry Hyde, and all the supportive Democratic and Republican congressmen and congresswomen envisioned.
The U.S. must remain steadfast, courageous, and committed to defeating the AIDS pandemic and mitigating its heartbreaking implications for children and families. President Obama and Congress need to join together to put America back on course to keeping its promises.
