WASHINGTON * The decade-old law that transformed the battle
against HIV and AIDS in developing countries is at a crossroads. The
dream of future generations freed from epidemic is running up
against an era of economic recovery and harsh budget cuts.
The President's Emergency Plan for AIDS Relief grew out of an
unlikely partnership between President George W. Bush and lawmakers
led by the Congressional Black Caucus. It has come to represent what
Washington can do when it puts politics aside and what America can
do to make the world a better place.
President Barack Obama, speaking at the recent dedication of
Bush's presidential library, praised the compassion Bush showed in
"helping to save millions of lives and reminding people in some of
the poorest corners of the globe that America cares."
House Democratic leader Nancy Pelosi of California said of Bush
in a statement that "while many events may distinguish his
presidency, his devotion to combating the scourge of HIV-AIDS will
certainly define his legacy."
The AIDS program's future, however, is uncertain. Obama has upped
the stakes, speaking in his State of the Union address this year of
"realizing the promise of an AIDS-free generation." But funding for
the relief plan's bilateral efforts has dipped in recent years and
it's doubtful that Congress, in its current budget-cutting mood,
will reverse that trend when the current five-year program expires
later this year.
The AIDS program is also trying to find a balance between its
goals of reaching more people with its prevention and treatment
programs and turning over more responsibility to the host nations
where it operates.
"This has been an incredible achievement," said Rep. Barbara Lee,
D-Calif., a senior Congressional Black Caucus member who played
major roles in passing the original 2003 act and its 2008 renewal
that significantly increased funding for AIDS, malaria and
tuberculosis treatment in Africa and other areas of the developing
world. She spoke of the more than 5 million people now receiving
life-saving antiretroviral treatment and 11 million pregnant women
who received HIV testing and counseling last year. "But I'm worried
that with any type of level-funding or cuts we'll go backward," she
The 2008 act more than tripled funding from the 2003 measure,
approving $48 billion over five years for bilateral and global AIDS
programs, malaria and tuberculosis. It also ended U.S. policy making
it almost impossible for HIV-positive people to get visas to enter
The AIDS program was the largest commitment ever by a nation to
combat a single disease internationally. According to the U.N.'s
UNAIDS and the Kaiser Family Foundation, in 2011 the United States
provided nearly 60 percent of all international AIDS assistance. …