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In early January, Tennessee
Senator Dr. Bill Frist, a physician and the new Senate majority
leader, called for intensifying the fight against the spread
of HIV in Africa and improving domestic health care for African
Americans and other minorities. Secretary of State Colin L.
Powell has long been outspoken on the need for nations to
spend more to fight AIDS, which he cites as being more threatening
than terrorism.
“Today, on the continent
of Africa, nearly 30 million people have the AIDS virus including
three million children under the age 15. There are whole countries
in Africa where more than one-third of the adult population
carries the infection. More than four million require immediate
drug treatment. Yet across that continent only 50,000 AIDS
victims—only 50,000—are receiving the medicine they need,”
President Bush, State of the Union Address, 2003
AIDS victims. I thought we
left that phrase in the 1980s, but obviously I was mistaken.
Mr. Bush, since we have victims, do we also have the “AIDS
guilty?” You know, those communities and nations that are
deserving of AIDS. I digress.
Bush pledged $15 billion
to the global AIDS effort over the next five years. This is
not to be interpreted as a commitment to the Global Fund,
established in 2001 by United Nations Secretary-General Kofi
Annan. Under the Bush pledge, $200 million would go to the
Global Fund each year, a decrease over this year’s $380 million.
Food for thought: evangelical
Christians have taken the AIDS epidemic in Africa and the
Caribbean as their calling and are establishing missions in
Africa; the administration prefers abstinence only, no condom
and no birth control for HIV prevention efforts; U.S. Secretary
of Health and Human Services Tommy Thompson was “elected”
as chairman of the Global Fund. Call me cynical, but maybe
the administration has other plans for the Global Fund. Will
HIV prevention Bush-style emerge as a 21st century form of
neo-colonialism?
Bush also announced his intention
to ask for a $100 million increase in funding for the AIDS
Drug Assistance Program (ADAP) beginning with fiscal year
2004. This is a good thing. However, for the third consecutive
year, the Administration is flat funding the Ryan White CARE
Act. This means no increase in funding for medical and other
services for HIV-positive individuals. In addition, the budget
actually reduces the funding by $858,000 for the domestic
HIV prevention programs supported by the Centers for Disease
Control and Prevention (CDC). These are really bad things.
The administration also announced
plans to revamp the current Medicaid system. Under the Bush
plan, states would have the flexibility to make almost any
changes in coverage of some 15 million beneficiaries who are
considered “optional” under Medicaid law, including increasing
the costs patients must pick up, and eliminating certain benefits,
as well as being selective about who receives benefits. While
the administration says it hopes states would use the plan
to expand coverage, how can this possibly occur given the
fact that nearly every state is operating with massive budget
deficits. Rather than truly reforming the Medicaid system
and providing an increase of federal matching funds for Medicaid,
the administration has proposed a plan that would leave an
outdated, broken system in place and state governments left
holding the bill.
While we as a nation “police”
and “care” for the world, we must not lose sight of the fact
that here in the U.S. for the first time since highly active
antiretroviral therapy (HAART) became available, thousands
of uninsured Americans living with HIV/AIDS are having difficulty
obtaining care, treatment, or medicines to combat the side
effects and metabolic complications associated with HIV disease,
in addition to housing and other mental health services.
This issue of Positively
Aware takes a brief view of HIV/AIDS conditions, treatment,
care and prevention efforts currently underway in South Africa,
Haiti, China, Ecuador and Mali. To quote again from Bush’s
speech, “In an age of miraculous medicines, no person should
have to hear those words [‘We have no medicines.’]. AIDS can
be prevented …Seldom has history offered a greater opportunity
to do so much for so many.”
Be Strong. Stay Safe.
Charles E. Clifton
Executive Director / Editor
Send comments and reactions
to ed@tpan.com
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