President Bush's cut to AIDS prevention in Africa would be devastating

President Bush claims to have tripled US aid to Africa, yet he has set the Global Fund on a course to disaster. While promising to back the Fund, the cut he has proposed to the US contribution to the Fund could lead to a massive reduction in HIV/AIDS prevention and care for orphans.

"Zambia, Ethiopia, and other countries have made real strides in HIV prevention," said Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance. "But, if the President's cut is approved we could lose significant ground. It would also be devastating to efforts where the virus is rapidly expanding, such as in Russia, Eastern Europe, and Asia."

Last week, $100 million was cut from the US contribution. The cut was made by the Labor, Health and Human Services Subcommittee, headed by Rep. Ralph Regula (R-OH).

Later this week, the lead decision-maker on the Fund in Congress, Rep. Jim Kolbe (R-AZ), along with his colleagues, will set the US contribution to the Fund for 2006. It is unclear whether he will approve the total Bush request ($300 million, a 30% reduction from FY 2005), provide the US share of the cost of renewing expiring grants ($600 million), or provide the contribution requested by the Fund ($1.2 billion).

With the cut President Bush has proposed, and if other countries were unable or unwilling to make up for the shortfall, the Global Fund would be forced to carry out what the Fund's Director, Richard Feachem, recently called "triage." This would involve preserving grants that are saving lives immediately, such as AIDS treatment, while cutting back on other programs.

Besides AIDS treatment, the Fund is supporting many well-performing blood safety programs, voluntary counseling and testing programs, programs that provide comprehensive information about sexual transmission, and programs that prevent transmission of the HIV virus from mother to child.

The triage would also lead to postponing the next round of additional grantmaking, known as Round Five. 500,000 people typically receive AIDS treatment as a result of a round of Global Fund grantmaking, yet if their treatment is postponed they could die.

Critically-needed programs whose grants would be allowed to expire, without renewal, could include the following:

• In Ethiopia, Global Fund money is being used for blood safety programs, voluntary counseling and testing, clinical management of prevention of mother to child transmission, and promoting behavior change.
• In Zambia, Global Fund resources have been used by the Churches Health Association to mobilize the faith-based community and increase access to services. Funded programs are well-coordinated and include important voluntary counseling and testing programs.
• Haiti is using Global Fund money to scale up prevention programs. These prevention activities include voluntary counseling and testing services to reach as many as 300,000 people each year.
• The Philippines is using Fund resources to scale up its voluntary testing and counseling centers in four urban areas identified as risk sites.
• Thailand is using Global Fund money to work with vulnerable populations, including young people, to prevent the further spread of AIDS. Activities include increasing the number of schools and workplaces actively engaged in HIV/AIDS work.

Fund resources are also delivering medical services, education and community care to over 1 million orphans, yet these programs may also be cut. Malaria and tuberculosis programs could also be affected.