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Cruising with Lazarus
The $15,000,000,000 Question

By David Salyer

September/October 2003

David Salyer

In May of 2002, Senators John Kerry (D-MA) and Bill Frist (R-TN) introduced the U.S. Leadership Against HIV/AIDS, TB and Malaria Act of 2002, a bipartisan bill that would increase the U.S. government's funding of international HIV/AIDS efforts in 2003 and 2004. The bill also called for a five-year strategy, developed by the U.S., to reduce the spread of HIV worldwide. It was headed for approval until George W. Bush undermined bipartisan momentum for the bill, stole the entire concept and promoted it as his administration's own idea during his State of the Union address in January 2003.

"I ask the Congress to commit 15 billion dollars over the next five years, including nearly ten billion dollars in new money, to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean," commanded GWB, making it sound like it was all his idea. He conveniently failed to acknowledge Senators Kerry and Frist for their leadership and never mentioned that Congress had been working on an international HIV/AIDS package for six months already. Do you think GWB ever wrote a paper in college, or did he just have someone else do it for him?

Following his address, the Bush administration began aggressively pressuring senators from both political parties to abandon the Kerry/Frist global fund and create a new one that would appear to have been the result of GWB's call for action. In that same State of the Union speech, he summoned up his serious-furrowed-brow-Bush-face and told us that, "to meet a severe and urgent crisis abroad, tonight I propose the emergency plan for AIDS relief, a work of mercy beyond all current international efforts to help the people of Africa." Thanks to GWB, it then took Congress four more months to rewrite a global AIDS bill just for him. Does that sound like a "work of mercy" to you, or a self-serving stunt designed to make him seem like a leader?

Africa is the epicenter of the global AIDS pandemic. It is an emergency. So then why does it take five whole years to spend 15 billion dollars? We spent twice that in one month invading Iraq and bombing it back to rubble -- and how much is it going to cost to rebuild Iraq? Billions? Maybe GWB's so-called "emergency plan for AIDS relief" would get a jump start if some crazy African dictator started threatening us with weapons of mass destruction. We'd give them a bunch of HIV meds for sure then.

GWB, or whoever writes his speeches, failed to do some basic research about those HIV meds, too. Bush said, "Antiretroviral drugs can extend life for many years. And the cost of those drugs has dropped from $12,000 a year to under $300 a year, which places a tremendous possibility within our grasp." Yes, antiretroviral drugs can extend life. The rest of his declaration is complete fabrication -- a lie. There is no place on planet Earth where the cost of a year's worth of HIV meds has dropped to $300 a year. Even $12,000 is a conservative estimate. Most antiretroviral and protease inhibitor drug combinations cost considerably more. The most recently approved AIDS drug, Fuzeon, costs over $20,000 a year.

It's hard to get very enthusiastic about the Bush administration's "emergency plan for AIDS relief" when its successful implementation depends on the cooperation of America's pharmaceutical companies. Those companies have remained suspiciously out of the loop as Congress created and recreated a global AIDS bill GWB could call his own. U.S. pharmaceutical companies vehemently oppose production of cheaper, generic versions of their drugs, protecting their patents and lobbying Congress for trade policies that make the sale and distribution of their drugs a regulatory nightmare. It's doubtful they would suddenly embrace the concept of benevolence and willingly shower fifteen African and Caribbean countries with the ingredients for an AIDS cocktail. They didn't get to be the wealthiest corporations in the world by slashing prices. They did it bypassing capitalism and adopting principles commonly known as greed.

Nevertheless, last May Congress passed and GWB signed a global AIDS bill that authorizes spending $15 billion on prevention and treatment programs over the next five years. Countries scheduled to benefit from the package include Haiti and Guyana in the Caribbean, and Kenya, Rwanda, Tanzania, Zambia, Mozambique, Ethiopia, Botswana, South Africa, the Ivory Coast, Namibia and Nigeria in Africa. The bill envisions $3 billion a year in subsidies through 2008, but lacks details about the origin of that money and doesn't even take effect until 2004. The congressional appropriations process for next year is underway and lawmakers have already admitted they can't find the money in the budget.

Sen. Patrick Leahy (D-Vt.) claims the global AIDS bill "is, for all intents and purposes, like writing a check without enough money in the bank." Even Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance concedes, "This bill is a check given to countries fighting AIDS, but it will come back marked 'insufficient funds.'" "The devil is really in the details," observes Fred Dillon, policy director for the San Francisco-based Pangaea Global AIDS Foundation. "Between the tax cuts and all the money being spent on terrorism, there's little discretionary money left."

GWB himself calls this global AIDS bill "the largest, single up-front commitment in history for an international public health initiative involving a single disease." In five years, or maybe even next year, we'll know whether or not Bush and his Congress have lived up to that commitment. Let's see if the same lawmakers who found billions of dollars for war, "homeland security," and new ways to electronically frisk you at the airport are capable of funding a selfless humanitarian effort that could prevent the suffering and premature deaths of millions. If not, GWB's lofty political rhetoric might prove to be a global bitter pill.

David Salyer is an HIV-positive journalist and AIDS educator living in Atlanta, Georgia. He leads safer sex presentations for men and has facilitated workshops for people infected or affected by HIV since 1994. Reach him by e-mail at

This article was provided by AIDS Survival Project. It is a part of the publication Survival News. You can find this article online by typing this address into your Web browser:

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