International AIDS funding vs. Domestic AIDS funding; POTUS must act NOW!

When the President's Emergency Plan for AIDS Relief, or PEPFAR, was enacted in 2003 under President George W. Bush, there was an international AIDS crisis facing the world. However, people living with HIV/AIDS (PLWHAs) in the United States were not immune from it because they were facing potential funding cuts to HIV/AIDS programs, as well as growing waiting lists under the AIDS Drug Assistance Program (ADAP). Today the story is unchanged; in fact, the AIDS crisis in America hasn’t been as dire since the epidemic began 30 years ago. How is it that America can spend BILLIONS in U.S. taxpayer dollars on overseas initiatives under PEPFAR, but cannot find approximately $100 million to alleviate the current ADAP crisis in the United States? Have American PLWHAs have fallen by the wayside under the Obama Administration’s handling of our domestic AIDS crisis, most notably with ADAP waiting lists reaching record high levels?

The outcries from numerous organizations, PLWHAs, their friends, family and loved ones have grown into one voice...one movement...with one goal. Their purpose is to bring awareness to the AIDS crisis in America with the achievable goal of ENDING the ADAP crisis now! When will POTUS and other leaders in Washington recognize the problem and finally ACT on it in a substantial and meaningful way?!? The crisis is not going away, and neither are HIV/AIDS advocates!

So, what is PEPFAR?

Launched in 2003 by President George W. Bush with strong bipartisan support, PEPFAR is America’s commitment to fighting the global HIV/AIDS pandemic. Through shared responsibility and smart investments, PEPFAR is saving lives, building more secure families and helping to stabilize fragile nations.

No one is questioning the need for PEPFAR!

How is PEPFAR funded?

With the generous support of the American people (through taxpayer dollars), the U.S. Government has committed nearly $46 billion to bilateral HIV/AIDS programs, the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, and bilateral TB programs through fiscal year (FY) 2012.

PEPFAR’s success is measured in lives improved and saved.

➢ In fiscal year 2010, PEPFAR directly supported life-saving antiretroviral treatment for more than 3.2 million men, women and children worldwide, up from less than 2.5 million in 2009.
➢ PEPFAR directly supported antiretroviral prophylaxis to prevent mother-to-child HIV transmission for more than 600,000 HIV-positive pregnant women in fiscal year 2010, allowing more than 114,000 infants to be born HIV-free.
➢ Through its partnerships with more than 30 countries, PEPFAR directly supported 11 million people with care and support, including nearly 3.8 million orphans and vulnerable children, in fiscal year 2010 alone.

PEPFAR is making smart investments to improve lives, build more secure families and help stabilize fragile nations. With continued support from the U.S. Congress, PEPFAR will be able continuing working towards the goals of treating more than 4 million people, preventing more than 12 million new HIV infections, and caring for more than 12 million people, including 5 million orphans and vulnerable children.

➢ For FY 2011, President Obama has requested nearly $7.0 billion, including nearly $5.74 billion for bilateral HIV/AIDS programs, $1 billion for the Global Fund, and $251 million for bilateral TB programs.
➢ For FY 2012, the President is requesting nearly $7.2 billion, including nearly $5.6 billion for bilateral HIV/AIDS programs, $1.3 billion for the Global Fund, and $254 million for bilateral TB programs.

While international efforts are laudable, and the ROI is huge, domestic funding for HIV/AIDS services and supports are severely underfunded. If POTUS does not act, then many PLWHAs fear a flashback to the 80’s...people dying. This time not because there are no medicines to treat the disease, but because we have insufficient funding to put these medicines in the hands of the people who need them. This is unconscionable, and begs the question...is this American?

And no one is questioning the need for America to fund PEPFAR!

CLICK HERE to read "THE INTERNATIONAL vs. NATIONAL DEBATE: Is the President’s Emergency Plan for AIDS Relief (PEPFAR) international commitment to combating HIV/AIDS succeeding at the expense of those people living with the disease in the United States?"

Is PEPFAR is an unfit parent who feeds her neighbors as her own family goes hungry?

Through FY2012 under PEPFAR, U.S. taxpayers will have spent 46 billion to support this initiative. Is it wrong to think that the U.S. could have funneled some of that money over the past 9 years into domestic HIV/AIDS initiatives, such as treatment, prevention, research, and other services for PLWHA under the Ryan White Program? Increasingly, many PLWHAs are asking this very question!

Federal appropriations for the Ryan White Program FY2012 equate to $1.3 billion, and AIDS advocates are asking for an increase of $106 million just to maintain ADAP; though this would not be enough to end the ADAP wait-lists. An increase of $360 million is needed to maintain ADAP programs and fill the structural deficits that have built up over the last several years. Is 7.2 billion in taxpayer money appropriated under PEPFAR and $1.3 billion under the Ryan White program fair? Why would U.S. taxpayers, and especially American PLWHA not be outraged?

Further egregious, last week in an effort led by New York's junior Senator Kirsten Gillibrand, 18 U.S. Senators sought to immunize the Global AIDS funding from cuts threatened by the impending showdown over the national budget and deficit committee. The letter is signed by Kirsten Gillibrand, Richard Durbin (D-NY), Barbara Milkulski (D-MD), Daniel Akaka (D-HI), Dianne Feinstein (D-CA), Barbara Boxer (D-CA), Ron Wyden D-OR), Mary Landrieu (D-LA), Charles Schumer (D-NY), Frank Lautenberg (D-NJ), Bernard Sanders (I-VT), Sheldon Whitehouse (D-RI), Tom Udall (D-NM), Ben Cardin (D-MD), Jeff Bingaman (D-NM) and Christopher Coons (D-DE).

Do they know that this is the 30th year of the AIDS epidemic in America? Are they aware of the domestic AIDS crisis? Are they aware that the impending funding cuts could put the lives of PLWHAs in America at risk? Are they aware of the rich history of AIDS in America and the advocates who marched...who protested...who fought for future generations; all the while watching dozens upon dozens of friends die, and they themselves on the brink of death?

So again, is it wrong for Americans living with HIV/AIDS to look in their own ‘backyards’ before looking overseas?

Inaction and silence WILL = death of countless PLWHA in America. Mr. President, 1.2 million Americans living with HIV/AIDS, their friends, family, and countless advocates; with one resounding voice they ask you to intervene in this crisis, the time to ACT is NOW!

Please sign the petition on change.org requesting that the POTUS and Congress work together to divert 15-20 percent of PEPFAR funds to domestic HIV/AIDS programs: http://www.change.org/petitions/divert-15-of-international-aids-relief-money-to-help-american-plwha.

Blog by Kevin Maloney, ADAP Advocacy Association member from Clifton Park, NY

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Sources:

http://www.pepfar.gov/documents/organization/80161.pdf
http://www.adapadvocacyassociation.org/pdf/2009_Domestic_AIDS__04.06.pdf
http://www.nastad.org/Docs/100316_FY2012%20Ryan%20White%20Funding%20Needs%20B.pdf
http://www.dailykos.com/story/2011/09/22/1018932/-Senator-Gillibrand-Leads-18-Senators-To-Protect-Global-AIDS-Funding