If approved by Congress, the overall five-year, $15 billion program would provide money for AIDS programs worldwide, Drs. Joseph O'Neill and Anthony Fauci, respectively directors of the White House Office of National AIDS Policy and the National Institute of Allergy and Infectious Diseases and the National Institutes of Health told reporters Wednesday in a teleconference.
The $10 billion increase would be focused on programs in Botswana, Cote d'Ivoire, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia, a senior administration official told reporters. These countries contain the lion's share of the world's AIDS victims and participated in the administration's earlier program to prevent transmission of the virus from mother.
"If you look at these countries they actually constitute 50 percent of the HIV infections in the world and 70 percent of the infections in all of Africa," Fauci told reporters Wednesday.
Half of the money would go toward education and AIDS prevention the later based on guidelines set by the World Health Organization -- including the use of condoms, he said.
Fifty percent of the funds would be used to buy anti-retroviral drugs, Fauci said, enough the administration estimates to treat 2 million people. Because of the high cost of anti-retroviral drugs and the challenges of treatment in poor areas few in Africa have been able to obtain treatment. Only 50,000 people in Africa are currently being treated with anti-retrovirals, Bush told Congress Tuesday.
Despite the advances that the money would enable, the administration's own estimations show there would be another 2 million people in need of immediate drug treatment. There are 30 million people infected with the HIV virus in Africa.
The remainder of the funds, about 33 percent of the total, will be spent on prevention with about 15 percent earmarked to care for infected individuals and AIDS orphans.
The program would run through central hospitals that are linked to a network of secondary treatment and education centers. These secondary centers are in turn linked to a third level of health facilities reaching deep into rural areas. The program is based on the approach used successfully by Uganda to reduce progression of the virus within its borders.
"(The plan) relies on well-organized centers of excellence and referral hospitals within the capital extending the services through the satellites," Dr. Peter Mugyenyi, head of the Joint Clinical Research Center in Kompala, Uganda, told reporters.
"We're tremendously encouraged by the president's announcement, but the devil is in the details," said David Bryden, communications director of the Global Aids Alliance.
Bryden expressed concern that the money was being distributed mostly on a bilateral basis and not through the Global Fund, saying that it was not fair to all countries.
"We are putting extra strong emphasis, in this case, on bilateral initiatives," said Fauci. "We would hope, as the program matures, that other countries will continue to give additional money to the Global Fund. The Global Fund was intended, as you know as a compliment to and not a substitute for bilateral assistance."
To ensure accountability in spending of the money the president is proposing that a new special coordinator for international HIV/AIDS assistance be established at the State Department. That coordinator would have the status of an ambassador.
(With additional reporting by Rick Tomkins)
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