On Saturday, I joined 50 Harvard and Dartmouth undergraduate and medical students to interrupt President Obama’s speech during a Democratic rally. We did so because we believed we had to help the President remember that his promise two years ago to dedicate $50 billion over five years to fight global AIDS was a heroic and life-saving plan—and his failure to actually do so threatens to derail the fight against AIDS worldwide.
It took a lot for me to stand up and interrupt the President. I’ve been a fervent supporter, volunteering for him in Iowa, home to my family and the politically important Iowa Caucuses. The first vote I cast was for Obama. I even attended his inauguration, which represented the pinnacle of hope and the American promise. Many of my fellow students at Harvard and Dartmouth supported Candidate Obama because of the politics of change and social justice that he stood for. Most of all, we were encouraged by his pledges to redress poverty and health inequities around the world—to prove that the United States would fight on behalf of the ten million poor people who will die this year from diseases for which safe, effective, and affordable cures exist because the dignity of every human being demands it. We hoped this would be true even amidst a global recession because we had faith that Obama would be more than a fair weather fan.
But President Obama’s actions have fallen appallingly short of Candidate Obama’s campaign pledges and professed values. When we stood up, holding signs, he responded—saying he has “increased funding for AIDS.” But as the Kaiser Family Foundation shows his budget “increases” for the President’s Emergency Plan for AIDS Relief (PEPFAR)—the principal US funding body for global health—have not even kept pace with inflation in Africa. He asked Congress for a $0.2 billion increase in 2009 and a $0.1 billion increase in 2010—one-tenth of what he promised, and less than 15% of the amount George W. Bush increased spending his last two years in office.
Just this month we were excited when we heard the US would make a multi-year pledge to the Global Fund to Fight AIDS, TB, and Malaria. But when it over $1 billion short of the U.S. share to just keep the Global Fund on its current trajectory we were deeply disappointed. We know what it will mean for the Global Fund to have to slash plans to scale up access to AIDS drugs and reject plans from countries to fight TB and Malaria for lack of funds—and so do the President’s advisors.
Many folks tell us we need to give him a break—we have to understand that the global economy has taken a hit. But that strains credulity. How is it we can spend $2-3 billion per week on wars in Iraq & Afghanistan, but cannot find an extra half a week’s worth of war funding to to keep the President’s campaign promise to save millions of lives by funding AIDS? Why can the President—winner of the Nobel prize—find room in his budget for a multi year plan to increase spending on nuclear weapons from $6.4 billion to $8 billion a year but not to make a multi-year pledge of far less for the Global Fund?
And it’s not just that the U.S. is flat-funding global AIDS—the rest of the world is watching. Last year, for the first time ever, AIDS funding for developing nations actually dipped—just as we’re seeing such successes in the fight. I would have hoped President Obama would have been leading the charge to reverse this—publicly and privately cajoling world leaders to ensure he is the president who puts us on track to defeat HIV. But not so far.
This past summer I worked in a South African public hospital in an area where 40% of people are living with HIV and AIDS. I saw first hand how effective getting AIDS drugs to people is—saving countless lives. But I also saw students my age dying from a disease that was treatable and preventable without access. My mentors have described how HIV-positive mothers, children, and fathers aren’t able to get effective antiviral treatment because of a lack of funds in Uganda, Nigeria, and Zambia.
Globally, 70% of the people who most urgently need HIV treatment are not receiving it. We recognize that politicians often make promises without fulfilling them. But, the reason we will continue to hold President Obama to account for this broken promise is because of the human suffering that will happen in much of sub-Saharan Africa if his campaign rhetoric continues to remain empty. Our encounters with patients living in developing countries remind us that keeping this promise is truly a matter of life or death.
And what is so terribly urgent is that we sit on a precipice: exciting new science is showing us if we act now we can put ourselves on a course to end the AIDS crisis. Studies this year showed that antiretroviral treatment could HIV transmission by 92% in couples. Further, treating AIDS comprehensively, as PEPFAR has shown is possible, improves care for other diseases like tuberculosis and sexually-transmitted infections, and has been shown to boost primary health care in even the most desperate settings. Rarely do we see something this close to a win-win in global health.
But HIV is a virulently infectious disease. If we wait, we don’t just delay but we lose huge ground. A recent Lancet study announced that if funding levels remain flat, an additional seven million people will die from AIDS and there will be 14 million new infections in the next twenty years. The cost of inaction is painfully high.
As we were escorted out of the premises during the Boston rally, President Obama warned the crowd that if Republicans took Congress, that they would “cut AIDS funding.” That would be a tragedy that is certainly worse than current flat-funding. But the President used to have a bigger, bolder, better vision—one that would not just lose less ground but would put us on path to defeating AIDS. He has to return to that leadership—not just play defense. Millions are depending on him. We urge him to remember why he entered politics in the first place. We urge Obama to fulfill his promises by increasing funding for global AIDS to $50 billion over five years.
Krishna Prabhu is a senior at Harvard College pursuing an honors degree in Social Studies. He is a member of the Harvard College Global Health and AIDS Coalition and has spent the past three summers researching and volunteering in the public health sector in Southern Africa.