Sustaining the battle against HIV/AIDS: the road ahead

Last week the president called on Congress to renew and expand our global AIDS program, the President’s Emergency Plan for AIDS Relief (PEPFAR), through 2014 at a cost of $30 billion. Unfortunately, missing from this important announcement was an acknowledgement that the U.S. must at the same time increase our commitment to the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Since its creation five years ago, the Global Fund has grown into the leading institution in the fight against AIDS, TB and malaria and a strong partner with PEPFAR. While PEPFAR provides critical targeted resources in the fight against HIV/AIDS in 15 countries, the Global Fund provides broader support to 136 countries — countries that have delivered results that are measurable, tangible and very real.

According to a report released by the Global Fund on Friday, to date more than one million people living with HIV have been treated with antiretroviral treatment, nearly 30 million people have been provided with insecticide-treated bed nets to prevent malaria and nearly three million people have been treated with effective anti-tuberculosis drugs. A total of 1.8 million lives have been saved through Global Fund programs.

As we begin to consider the next phase of PEPFAR, we must also ensure that our commitment to the Global Fund is strengthened. Under the leadership of its new executive director, Dr. Michel Kazatchkine, the Global Fund has laid out a plan of operation for the next several years and stands ready to rapidly scale up its activities and take the next step toward achieving the goal of universal access to care and treatment for all. That goal, however, cannot be accomplished in a vacuum. It will require the commitment of the international community, and it will require our leadership.

As one of the lead authors of the law that created PEPFAR in 2003 and of the law that helped establish the Global Fund in 2000, I believe that we must continue to pursue and expand both our bilateral and our multilateral global HIV/AIDS programs to get us to the goal of universal access. Indeed, in each of the last four years, with broad bipartisan support, Congress has repeatedly provided more funding for PEPFAR and the Global Fund than the president has requested.

The fact is that the Global Fund receives nearly one-third of its funding from the United States. In order to dramatically expand its programs, by 2010 the Global Fund will need between $6 billion and $8 billion annually. As a major partner in the fight, this would require at least $2 billion a year from the U.S., understanding that for every $100 million provided to the Global Fund, 11,000 people can be put on AIDS treatment, 80,000 can be treated for TB and 630,000 bed nets can be distributed to prevent malaria. We must meet this challenge.

A good first step in that direction would be for Congress to provide $1.3 billion to the Global Fund for fiscal year 2008. 
This funding will allow the Global Fund to maintain its current programs and add new ones with the availability of additional grants.

Beginning today, Congress will take up the appropriations bills that will determine next year’s funding levels for our foreign assistance programs. The commitment that we make to PEPFAR and the Global Fund during this process will send a strong message about where we intend to take these programs over the next five years.

Five years ago, we led the world in responding to three of the deadliest diseases of our time — AIDS, TB and malaria — by creating the Global Fund and launching PEPFAR. The results to date have been very encouraging, but if we truly want to achieve sustainable change and reach the goal of universal access, we must now plan the next phase of the global response to these diseases. I am confident that under the leadership of committees’ Chairman Dave Obey (D-Wis.) and Chairwoman Nita Lowey (D-N.Y.), Congress will respond in a bipartisan manner to expand our commitment to PEPFAR and ensure that the Global Fund remains an integral component of our fight against HIV/AIDS.