Bow to Global AIDS Reality

In the late 1980s, life expectancy in Zimbabwe was 63 years. Today it’s 33. The reason is HIV, which has infected 35% of its adults and orphaned 900,000 children. As James Morris, executive director of the U.N. World Food Program, told the Senate last week after a visit to the southern African country, “It’s not uncommon to see ... a grandmother in her 70s, very slight, often looking after 20 or 30 children. And she has nothing.”

Worldwide, HIV and AIDS have orphaned 14 million children and infected more than 40 million people. Often governments (like Zimbabwe’s) ignore and deny the problem, furthering the spread of the disease.

Money, huge amounts of it, is necessary to tackle the crisis. But so are broad, cost-efficient networks for prevention and treatment. Among the most effective is the Global Fund to Fight AIDS, Tuberculosis and Malaria, a public-private multinational organization that works with the World Health Organization. Created three years ago by U.N. Secretary-General Kofi Annan, the Global Fund has infectious-disease specialists working in 100 countries.

The United States, by default, is a major supplier of anti-AIDS funding worldwide, and President Bush has pledged $15 billion over five years. However, he also proposes spending the lion’s share on bilateral programs set up by a U.S.-controlled organization, the Millennium Challenge Account, that grants aid only to nations meeting various economic, social and political ideals.

The General Accounting Office, the research arm of Congress, last year found the program riddled with problems, such as lack of guidance to countries trying to participate and, for lack of local infrastructure, an inability to get services to people who need it. The Millennium Challenge Account’s recipient list also excludes large Asian nations such as India, which Global Fund officials last week said was facing a “catastrophic epidemic” of AIDS, and African nations with the biggest AIDS and other health problems.

The administration’s “go it alone” approach was also evident in its otherwise laudable announcement Sunday of an expedited process to approve low-cost anti-AIDS drugs. As Joanne Carter, the director of a global infectious-disease relief group called RESULTS, asked, “Why is the White House setting up a new, unilateral approval process overseen by the [Food and Drug Administration] when WHO already has a good, multilateral one?”

Two years ago, Sens. John F. Kerry (D-Mass.) and Bill Frist (R-Tenn.) co-sponsored bipartisan legislation to provide a $2.5-billion annual investment in fighting AIDS, TB and malaria, with half of the money going directly to the Global Fund. The measure failed, and Kerry and Frist are unlikely to strike up a similar alliance in this partisan election year. The fact remains that the Millennium Challenge Account is not proving effective against the worldwide AIDS epidemic, and the Bush administration should bow to that reality.