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The head of the non-profit organization, the Global AIDS Alliance, is calling on President Bush to make a few changes in his Emergency Plan for AIDS Relief. Mr. Bush announced the proposal during his State of the Union Address in January.
Dr. Paul Zeitz says it’s not the amount of money the President wants to spend – rather it’s how he wants to spend it. The Emergency Plan for AIDS Relief calls for 15-billion dollars – including 10—billion in new money – to be spent over a five-year period. Mr. Bush calls it “a work of mercy beyond all current international efforts to help the people of Africa.”
Dr. Zeitz calls the proposal “encouraging, even historic.” But he criticizes a method of allocation he calls “backloading.”
He says, "We’re only seeing a very small increase in next year’s budget. Five percent of the total new spending is pledged for next year. And you don’t really see the more significant increases until 2006, 2007, 2008. And we’re concerned by that backloading because, as you know, in Africa the dying is happening now. And if it was truly an emergency plan we would have seen three billion dollars at least going in even this year.”
His second criticism is that not enough money is being given to the Global Fund to Fight AIDS, Tuberculosis and Malaria.
He says, "He is planning to send 90 percent of the money through US government agencies, such as USAID, CDC (Centers for Disease Control) and NIH (National Institutes of Health) – and only 10 percent of the money through the Global Fund. We’re also concerned about that because historically US government agencies have not been able to move the money very fast. And they also have some limitations. They’re not able usually to pay for the recurrent costs of programs. And they’re usually not very efficient in procuring essential commodities, like drugs."
For its part, USAID says since 1986, it’s “provided more than two-point-three billion dollars for the fight against the global AIDS pandemic, more than any other public or private organization in the world.” USAID says, this year, “with a budget of 510-million dollars, it will assist more than 50 countries with HIV/AIDS programs.”
Nevertheless, Dr. Zeitz says the Global Fund is “independent of the World Bank and the United Nations, has civil society representation, and has only a three percent overhead rate.” In addition, he says it carefully screens proposals to make sure money goes directly toward programs proven to work.
He says, "The US agencies have a certain comparative advantage in bringing technical expertise and innovations, capacity building and systems development efforts. However, the Global Fund has a comparative advantage in moving large sums of money into programs and in procuring commodities. So, we need to find the right balance between these two approaches."
He says unless the rich nations pour a lot more money into the Global Fund this year, it may not be able to fund the grants it approves.
The executive director of the Washington DC-based Global AIDS Alliance says another factor that could affect how US AIDS money is spent is the issue of abortion. The Bush administration wants to extend what’s called the Mexico City Policy, first introduced in 1984 by President Ronald Reagan. It prohibits US government funds from going to organizations that provide information on abortion or actually deliver abortion services, even if done with their own money. Dr. Zeitz says the Bush administration wants to expand the Mexico City Policy beyond family planning to organizations providing HIV/AIDS programs.
A 1997 joint resolution of the US Congress, then under Republican control, says the United States has no business funding elective abortions in other countries, especially when the world opinion is that abortion should never, ever be promoted as a method of birth control. The resolution also says the United States has no business funding abortions in countries in violation of those countries’ laws.
Dr. Zeitz says he fears the political debate over abortion will prevent much needed money from reaching grassroots organizations fighting HIV/AIDS.