Promises Broken, Lives Cost

In his State of the Union address a year ago President Bush announced an Emergency Plan for AIDS Relief. In it he promised $3 billion a year in funding focused primarily on Africa and the Caribbean. Within weeks he broke that promise by seeking no new funding for 2003 and by requesting less than half a billion for the new effort in his 2004 budget. On the domestic front the Administration has proposed flat funding of the AIDS portfolio, which amounts to a decrease in funding and has diverted resources from HIV research. And instead of supporting the existing Global Fund to Fight AIDS, Tuberculosis, and Malaria, the White House is establishing a new bureaucracy to manage the president's initiative and has appointed a former pharmaceutical company executive with no AIDS experience to run it. This doesn't augur well for people who are dying of AIDS complications and without access to treatment. Africa is ground zero of the global AIDS crisis. SubSaharan Africa is home to just over 10% of the world's population, but it has more than 75% of the world's HIV cases. Less than 1% of people with HIV in Africa have access to lifesaving treatments. Africa has been hit hardest by HIV because poverty has left its people most vulnerable and because resistance among rich Western countries has impeded an urgent international response. In the United States it is also black people who have been disproportionately affected by HIV. While the availability of anti-HIV treatments has cut the death rate in recent years, infection rates remain especially high among people of color. Though African-Americans represent only an estimated 12% of the U.S. population, they make up almost 38% of all HIV cases reported in this country. Yet the Bush administration continues to provide less money than is needed to combat AIDS domestically, especially among African-Americans, who live in high concentrations of poverty and who are at risk of losing access to treatment because of funding cutbacks. The theme of this past World AIDS Day was the elimination of stigma and discrimination. This is sadly appropriate, for it is now clear that while AIDS can be beaten, the world is losing the battle because of these prejudices. By stigmatizing people who have HIV, societies seek to distance themselves from the disease, rejecting the notion that this is everyone's problem. It is blatant discrimination'on the basis of race, class, gender, and sexual orientation'when governments deny the urgency of this crisis because of who the victims are. It is the same factors that fuel the AIDS crisis everywhere. Poverty and inadequate access to health care leave particular communities vulnerable. Discrimination and racism enforce double standards that devalue the lives of people living with the disease and those at greatest risk. AIDS has become the 'black' plague. For while it is a global threat that does not differentiate by race or class and is not confined by borders, the fact is that it is mainly killing black people. Peter Piot, undersecretary-general of the United Nations and executive director of the U.N.'s Joint Programme on HIV/AIDS, has put it this way: 'If this had happened with white people, the reaction would have been different.' AIDS will not be beaten without a strong global commitment and a massive infusion of resources. This must be directed to support the efforts of the people most affected by the pandemic, particularly in Africa, the epicenter of the global crisis. In the United States that means focusing on people of color, particularly African-Americans. Years from now people will ask about AIDS'as with the Holocaust''How could the world have known and failed to act?' Tragically, it appears the answer will be 'Because those most affected were black.' Wilson is executive director of the Los Angeles'based Black AIDS Institute. Booker is executive director of Africa Action, the oldest Africa advocacy organization in the United States.