Last month, President Trump belligerently stated, “We have to start winning wars again.” Yet his administration has clearly forgotten a key war that the United States is already engaged in, both abroad and at home. Since the peak of the HIV epidemic, the federal government has led the fight against this deadly and complex disease. Despite the United States’ critical role in decreasing the burden of the disease and making treatment more accessible around the world, the Trump administration is planning to slash the foreign aid budget — which includes global health funding. As the administration pushes to shift almost $54 billion in funding toward defense and security spending, the world is faced with the disastrous prospect of losing a key ally in the battle against HIV/AIDS.
Since 2000, the United States has been the impetus for enormous change in the HIV/AIDS fight. Among children, the number of new HIV infections has declined by 50 percent, and the U.S. government has contributed heavily to this effort. Furthermore, the United States has worked with other governments and organizations to reduce the cost of HIV antiretroviral medication to just 1 percent of its initial price, making treatment more accessible. The President’s Emergency Plan for AIDS Relief, established by former President George W. Bush, has been a critical government fund, decreasing the burden of HIV/AIDS worldwide. Currently, PEPFAR supports approximately 11.5 million people on life-saving antiretroviral therapy. Other programs that are largely funded by the United States — such as the Global Fund to Fight AIDS, Tuberculosis and Malaria — provide eight million people access to antiretroviral therapy and combat the infectious diseases and comorbidities that afflict under-resourced nations. The United States has been a champion for global health funding, accounting for over a third of global health funding that comes from governments around the world. Though these funds clearly have had a substantial global impact, this contribution only amounts to 1 percent of the federal budget.
Despite the progress made in terms of prevention and treatment, there is still a global HIV prevalence of 0.8 percent. While that may not seem like a large figure, in reality 36.7 million people are living with HIV/AIDS worldwide, of which 20 million are currently without treatment. For sustained progress, the United States — along with other governments — must continue their active involvement in HIV/AIDS prevention and treatment.
To ensure that the U.S. government maintains its commitments to global health and HIV/AIDS, chapters across the Partners in Health Engage network are working to increase, or at least maintain, global health funding for the 2018 fiscal year. PIH is asking for an annual increase of $667 million for PEPFAR funding to put it on track to meet its goal of $2 billion in increased funding by 2020; the overall budget for the Global Fund to remain at $1.475 billion (only a portion of which is federally funded) and the provision of $450 million for bilateral tuberculosis funding. These increases in funding are vital to improving health indicators around the world.
Here in Rhode Island, we call upon U.S. Sen. Jack Reed, D-RI, U.S. Sen. Sheldon Whitehouse, D-RI, U.S. Rep. David Cicilline ’83, D-RI and U.S. Rep. Jim Langevin, D-RI to incorporate these three asks onto their wish lists and sign onto our Dear Colleague letter. This letter, which is being circulated among elected representatives by U.S. Rep. Barbara Lee, D-CA, calls for bipartisan support for this scaled-up funding. Some of our local representatives have yet to take a public position on this year’s letter, but we encourage them to sign on to this well-intentioned and progressive letter. In addition, we call upon fellow students and other Rhode Island community members to contact our elected representatives; constituent phone calls and letters can be important tools to remind them that the world cannot afford to lose U.S. participation on the global health stage.
In the same speech, Trump went on to say, “We never lost a war.” But this might soon change if the Trump administration follows through on its ill-advised plans. It is essential that we hold the current government accountable to its international commitments and ensure that the health needs of the global community are not sidelined. The fight against HIV/AIDS is not over — we have not yet won the war.
Ariana Pather ’18 and Taing Nandi Aung ’19 are advocacy co-leads for Partners in Health Engage at Brown. They can be reached at firstname.lastname@example.org and email@example.com, respectively. Please send responses to this opinion to firstname.lastname@example.org and other op-eds to email@example.com.