Don’t cut lifesaving health assistance

Five years ago, Richard Sianeza was on his deathbed, dying of AIDS. A farmer in Zambia, he had spent seven months unable to work and unable to support his family. A World Vision community caregiver paid Richard a visit and encouraged him to be tested for HIV.

“This is why I am alive today,” he says. “Imagine what would have happened if I didn’t go for voluntary counseling and testing.” He speaks knowledgably about his illness. “My CD4 count was 120,” well below a normal count between 500 and 1200. “But after being on antiretroviral drugs for more three years now, my CD4 count has shot up to 1,368.”

Richard is now healthy enough to work his farm, earn extra income by fishing, and inspire others in his community to be tested for HIV. Because Richard is healthy and working, his children are in school rather than an orphanage, preparing for their role in Zambia’s future.

Richard is just one of the millions of people alive today because of American leadership. Yes, U.S. foreign assistance is a primary reason Richard is alive and healthy today.

Unfortunately, just as prospects for millions of people like Richard are improving, American aid is being threatened with severe cuts, though it makes up less than one percent of the federal budget. Members from both political parties in both houses of Congress are considering drastic reductions in America’s foreign aid budget. If enacted, these cuts could send Richard’s health spiraling back to where it was five years ago.

This is a travesty, as American aid—particularly assistance for global health—has done so much good. Over the last decade, child deaths have decreased nearly 30 percent around the world. In addition, 3.2 million people like Richard are on antiretroviral therapy because of the President’s Emergency Plan for AIDS Relief (PEPFAR). Given the average number of children in such families, roughly 15 million kids live with their parents instead of an institution or distant relatives. More than 1.1 million lives in sub-Saharan Africa have been saved from malaria thanks, in large measure, to the President’s Malaria Initiative.

When we also consider food aid, disaster assistance, and economic development, it is clear that millions upon millions of people are able to live healthy, productive lives today because of the goodwill of everyday Americans.

But foreign assistance benefits the U.S., too. Research shows that the good health of a person living with HIV like Richard is actually linked to American jobs. Today, roughly half of all U.S. exports go to developing countries, such as Zambia, where Richard lives. For every 10 percent increase in those exports, there is a seven percent increase in U.S. jobs. Continuing to invest in emerging economies can pay real dividends down the line. South Korea and India are prime examples. Once recipients of U.S. assistance, they are now some of America’s biggest trading partners.

Aid to address health issues abroad has the added benefit of keeping Americans healthy at home. In this globalized world, deadly and debilitating diseases are just a plane ride away. Minnesota experienced its second measles outbreak this year when a one-year-old girl contracted the highly contagious disease during a family trip to Kenya. The cost of investigating and treating just one such outbreak in our own country can reach upwards of $1 million.

American aid has accomplished so much, yet it costs relatively little. Most Americans are surprised to learn that U.S. foreign aid is less than one percent of the US budget. This year, a World Public Opinion Poll found that most Americans assume foreign assistance represents 25 percent of federal spending, and they suggest an appropriate amount should be about ten percent.

Our country is facing unprecedented budget challenges. PATH and World Vision, along with our fellow members of the Washington Global Health Alliance, are fully aware of the enormous responsibility of Congress to reduce our deficit. But doesn’t this become a moral issue when you consider the implications for human life if we slash our foreign assistance?

We don’t think Americans are okay with budget decisions that will cut off the regular supply of lifesaving antiretroviral drugs for Richard and the other 3.2 million people like him who are alive today because of American compassion.

Just as we have a moral obligation to address the fiscal crisis we face at home, we cannot turn our backs on families whose lives—and productive futures—depend on the generosity of Americans.

It was American generosity that provided Richard and millions like him with renewed life.  A small investment in health reaps the benefits of life and hope for millions.  That’s an investment every American can support.

Christopher J. Elias, MD, MPH, is president and CEO of PATH and Richard Stearns is president of World Vision US.