Rethinking Global Health

Cross posted at Scoop44 and Daily Kos.

The past few weeks have produced positive results in the fight against the global proliferation of HIV/AIDS. The Bill and Melinda Gates Foundation announced that it has given a $7.3 million grant to Imperial College in London for the development of a rapid HIV test. While rapid HIV tests have been around for a few years, this test is unique in one way: it costs $2. That means that those developing nations (particularly the ones with a significant percentage of their population at risk for or infected with HIV) will be able to purchase the test.

In the early years of the AIDS epidemic, philanthropic foundations in the U.S. often devoted more money and resources to limit the spread of the HIV than any government was willing to commit. The Robert Wood Johnson Foundation, the Ford Foundation, and the Kaiser Family Foundation have been on the front lines of providing the funds necessary to combat the spread of HIV and to find a cure for AIDS. However, in recent years, many people thought that the U.S. government was finally stepping up to the plate when President Bush launched the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003.

PEPFAR has been well-received since it launched. The plan provides funding for prevention, treatment and care for those infected with HIV/AIDS. While some aspects of the plan are controversial (including the access it provides for religious organizations that preach abstinence to help in the AIDS prevention stage of the plan), Bush was commended for taking a legitimate and concrete stance in the global fight against AIDS. Since Congress reauthorized the act that provides the funding for PEPFAR in 2008, President Obama will have an enormous opportunity to expand on President Bush’s work.

However, there is a disturbing omission from PEPFAR: it has not provided funding for prevention, treatment and care for the domestic fight against HIV/AIDS. Millions are infected in the U.S., yet PEPFAR has almost exclusively focused on stopping the proliferation of AIDS in other countries. This omission in PEPFAR should be heavily criticized in light of the enormous racial disparities that exist among the HIV positive population in the U.S.; African Americans make up only 12% of the U.S. population, but “account for nearly half of all new HIV infections and almost half of all Americans living with HIV.”

The Obama administration has not made it clear how it will handle the worldwide HIV/AIDS crisis. Some have claimed that Obama’s proposed budget for the State Department indicates that he might be “rethinking…foreign priorities like global health,” and might want to shift his priorities (and funding) to fighting other infectious diseases like malaria or tuberculosis. If the Obama administration continues to have a vague stance on fighting HIV/AIDS, the philanthropic foundations that stepped up in the early years of the crisis might have to step up again - both internationally and domestically.