WASHINGTON, June 19 (UPI) -- A new bipartisan think tank task force has recommended increasing U.S. efforts to fight HIV/AIDS overseas, including doubling U.S. funding for the cause. The proposal, though broader and more ambitious, is in line with a new initiative by President George W. Bush that will allot $500 million over three years to fight the global AIDS pandemic, and with rising support on Capitol Hill for the cause.
The Bush plan emphasizes preventing transmission from mothers to infants with an inexpensive drug called nevirapine; the think tank initiative proposes a much larger increase in funding for prevention, treatment and vaccine development.
The task force's "Call to Action" -- a seven point, two-year plan -- focuses on "increasing U.S. and multilateral funding; expanding prevention, treatment and training programs; and appointing a U.S. HIV/AIDS policy coordinator," says a recent report from the think tanks group, which is sponsored by the Center for Strategic and International Studies.
The plan was released at the first official meeting of the task force June 13 in Washington. About 50 taskforce members, including the two senators who co-chair the effort and several ambassadors, were there. The CSIS taskforce is a collaborative effort that also includes the U.S. Centers for Disease Control and Prevention and the U.S. Agency for International Development.
"The pandemic is larger than was realized," said Stephen Morrison, the task force director and director of the CSIS Africa Program. "U.S. policy on HIV/AIDS has too often lacked a strategic vision of where we will be heading in the coming years. The task force seeks to help build that vision in its Call to Action."
"HIV/AIDS is the top global healthcare concern of the U .S. electorate," said a statement from the CSIS task force leaders. "Most Americans believe that increased U.S. spending will make meaningful progress in fighting the disease. The world is not ready to face AIDS' imminent spread to other parts of the globe, including China, Russia, Ethiopia and India."
This year, the United States is spending about $1 billion to prevent and treat AIDS in other countries. The CSIS proposal would increase U.S. global AIDS funding to $2 billion in 2003 and to $2.5 billion in 2004 -- a recommendation that parallels legislation passed by the Senate Foreign Relations Committee, which would increase U.S. spending on the global AIDS pandemic to $2 billion a year under a five-year plan. The legislation was introduced by Sen. John Kerry, D-Mass., who, along with Sen. Bill Frist, R-Tenn., co-chairs to CSIS task force.
"AIDS is the most significant health crises on this planet," said Kerry at the June 13 meeting. "With globalism, technology and terrorism on our minds, CSIS's response can be a grounding and unifying effort to bridge the divide and let our country show a different face to the world.
"We look for task force input in shaping our bill. We require added response from government and other countries. We need to engage community organizations in countries living with the pandemic."
"Though the current plan calls for a U.S. (funding) increase to $2 billion, the hard reality is that $7 billion to $10 billion annually is needed," he said. "We have to have the highest level of international U.S. engagement, other countries need to have it higher on their agenda, we need to put more into the treatment and care component, find a vaccine, push pharmaceutical companies into research, and find effective vaccine and care distribution methods."
"We're unlikely to see a cure within in the next few years, but we could reverse the trend," said Frist. "From a policy standpoint, there has not been a linkage between prevention, care and treatment."
The CSIS plan, incorporated into the Kerry bill, would add money to the already established HIV/AIDS Global Fund -- established with legislation in 2000 that allotted about $500,000 in U.S. funding for AIDS, tuberculosis, and malaria vaccine development; private programs for orphans in Africa; and disease prevention.
Along with more money, the United States must work with indigenous non-governmental organizations, or NGOs, in other countries in order to distribute treatment and care, said speakers at the meeting.
"We need to assist countries in developing ways to access money in the Global Fund," said Princeton Lyman, the executive director of the Global Interdependence Institute at the Aspen Institute, and the former U.S. ambassador to South Africa and Nigeria.
"We need incentives for companies to develop drugs and vaccines. We need a balance between governments and grassroots organizations and NGOs in the countries affected, and we need coordination between AIDS and other issues like poverty, drought and famine."
But one critic of the CSIS plan said the idea of the United States working with grass-roots organizations in other countries on the AIDS issue might just be rhetoric.
"There is an unfortunate tendency (in the United States) to display spasms of compassion, and a lot of money gets funneled out in a hurry through conventional government-to-government channels, and the funds don't necessarily get targeted in the right manner," said Tom Miller of the Cato Institute, a libertarian think tank in Washington.
"We need massive political and economic reforms in Africa, which is operating in a larger non-functional context; and it hasn't been the track record in the past of the United States to work with private, non-governmental channels that can best monitor the results," Miller said.
"If that vision can get carried out in practice, we'd see better results, but I'm afraid this is rhetoric that won't be followed up at the ground level."
Others are also critical of the CSIS plan, saying it is overly idealistic and misdirected.
"Is CSIS seeking funding for abstinence education in its fight against AIDS?" asked Pat Fagan of the conservative Heritage Foundation. "We've seen the biggest drop in HIV in Uganda, due to the change in behavior in young adult women. The success is due to abstinence education. If CSIS isn't funding abstinence education, is it really serious?"
"The CSIS task force will have a big problem with drug development, for both vaccines and treatments," said Jack Calfee, a resident scholar at the conservative American Enterprise Institute. "Drug companies are cutting back on research because it is difficult and expensive, and even if they do succeed, they will be attacked by AIDS activists for charging high prices. Merck, a pharmaceutical company in New Jersey, is the only one working on a vaccine, and what they have may work for only 70 percent of the people," Calfee said.
"The task force will have some progress in getting more money from the U.S. and other countries, but it will still have difficulty solving problems in sub-Saharan Africa, which is poorly run, and where it is hard to get treatment to people. Also, CSIS should put more emphasis on prevention," he said.
Even Patricia Thomas, who works with the liberal Century Foundation in New York and is author of the book, "Big Shot: Passion, Politics and Struggle for an AIDS Vaccine," criticized the CSIS plan.
"These folks (at CSIS) are proposing doing more internationally at the expense of realizing our problems at home," Thomas said. "U.S. HIV transmission is increasing among women of color, the poor and marginalized, and among young gay men. It's wrong in my view to act as though we do not have a problem here. We can't ignore the fact that poverty and political disenfranchisement and social instability, especially in the wake of Sept. 11, contributes to this disease.
"The CSIS plan also mentions using the U.S. military for education and programmatic improvement in the fight against AIDS," she continued. "But the Bush Administration shut down U.S. military AIDS research and transferred it to the National Institutes of Health. Colin Powell is the only one in the administration comfortable discussing HIV and AIDS."
