Obama’s FY 2011 Global Health Initiative Budget Missing The Mark

Obama’s FY 2011 Global Health Initiative Budget Missing the Mark

-          HIV/AIDS Services Cannot Be Treated Separately From Reproductive and Child Health

It is impossible to separate HIV/AIDS treatment and prevention from the issue of Reproductive, Maternal, Newborn, and Child Health however; it appears the President’s FY 2011 Foreign Affairs budget is attempting to do just that.  It is also impossible to separate these issues from women’s rights as human rights.  The basic human right to life is at stake with respect to HIV/AIDS as is the basic human right to health care.  Women’s health and education are the foundation of development.  Hillary Clinton testified before the House Appropriations Subcommittee on State, Foreign Operations, and Related Programs and characterized the urgency of targeted development investments in fragile societies, “which, in our interconnected world, bear heavily on our own security and prosperity”.  [Clinton]  President Obama made a campaign promise of $50 billion for AIDS services over 5 years plus the full U.S. fair share of the Global Fund.   This all sounded quite promising and those closest to the issues could not help but be encouraged.   However, closer inspection of the resulting budget, which is actually before the House and Senate, reveals troubling details.  With respect to funding for the Global Health Initiative, the budget includes an overall increase from $7.8 to $8.5 billion.  On the surface this seems positive however, there are significant issues.  In the case of maternal and child health and nutrition the President’s budget includes a significant increase in funding.  What is startling is that funding for key HIV/AIDS related services received a nearly insignificant increase compared to the levels generally considered to be required.  Key facts that the proposed budget fails to consider include: “HIV/AIDS programs are an important maternal, child, reproductive, and primary healthcare intervention.”  Current studies reveal that HIV is a leading cause of maternal death, in Zimbabwe for example, “HIV is the culprit in one of every four maternal deaths while in South Africa the figure is half” of all maternal deaths.   Additionally, women receiving treatment for HIV are more likely to take advantage of antenatal care, deliver their children in proper healthcare facilities, and seek out proper vaccination services and routine care.  A very significant detail, which seems to also be overlooked, is the fact that only 38% of children have access to the level of treatment required, with just a fraction of children of HIV-positive mothers tested. [theglobalhealthinitiative.org]

In order to reach the global goal of universal access, UNAIDS estimates that approximately $172 billion will be needed in the six years covered in the Obama Global Health Initiative and also argues that the U.S. should lead the world by giving the previously pledged one-third, or $57 billion, of this total need.  To put the issue in an even graver context consider the fact that the FY2010 budget put global AIDS funding far below these levels and as a result, “significant catch-up will be needed in FY2011”. [theglobalhealthinitiative.org]  A shortfall in the FY 2010 budget followed by a meager increase in funding in the FY 2011 budget likely does not qualify as the “significant catch-up” envisioned.

Reducing proposed funding for HIV/AIDS services in developing countries, where the need is arguably greatest and having the potential to impact the basic right to life throughout the world, while increasing funding for maternal and child health, demonstrates an insufficient understanding of the integrated nature of these issues.   If we as a leading nation reduce funding for HIV/AIDS services we will be setting a dangerous example.  If the issue of women’s rights as human rights is to be fully embraced, as it clearly should be, then we need to embrace the urgency of HIV/AIDS with respect to women’s right to life.  Unless we can make the necessary progress against the leading cause of death in women in their productive years then there will not be a foundation from which to attack issues of child health, reproductive rights, education and women’s agency.  There are already reports from some AIDS service providers of limiting services owing directly to financial pressures.  A recent World Bank report estimates that treatment for over 1.7 million people could be at risk by year’s end. [theglobalhealthinitiative.org]  Other related issues, which should be considered, include the potential number of orphans, which may result from increased death rates of mothers.  It is an established fact that orphans receive a much lower level of care compared to non-orphans.  If HIV/AIDS services are reduced or care for new cases are eliminated due to financial pressures, the number of mothers with undetected HIV infections will increase and of those so infected, fewer will receive treatment necessary to prevent transmitting the infection to the child.  If mothers must live under the stress of inadequately or possibly un-treated HIV/AIDS, it is extremely unlikely that she will be able to contribute adequately to the care of the child.  In this case, even if the child was fortunate enough to be born without contracting HIV the limited resources, time or simple ability of the mother to care for the child, would put the child at risk for other diseases resulting from inadequate vaccinations, routine examinations, nutrition and hygiene.  The successes realized through aggressive funding of HIV/AIDS services are well known.  For example, Uganda, Botswana, and South Africa experienced decreases in infant and child mortality of as much as 83% thanks to improved parent survivability. [theglobalhealthinitiative.org]

What is required in order to reach the global goal of universal access? According to UNAIDS estimates, approximately $172 billion will be needed in the six years covered in the Obama Global Health Initiative of which one-third, or $57 billion, of this total need was promised by the Obama campaign and should be delivered.  Congress provided the authorization to reach this level of funding through the passage of the Lantos-Hyde Act in 2008, and President Obama’s campaign pledge to increase global AIDS funding by $1 billion per year was also consistent with funding needs.  Now the Obama administration and Congress just need to act before the catch-up required is out of reach.  Millions of lives are at stake.

Works Cited

• THE FUTURE OF GLOBAL HEALTH: Ingredients for a Bold & Effective U.S. Initiative Report – October 2009, http://www.theglobalhealthinitiative.org
• Secretary of State Hillary Rodham Clinton, Congressional Testimony, State Appropriations Committee, Subcommittee on State and Foreign Affairs, February 24, 2010

© 2010, Steven_Jeffries. All rights reserved.

This entry was posted on Wednesday, April 21st, 2010 at 5:25 PM and is filed under 2010, 3rd Article, Development, Health, WPHR Students. You can follow any responses to this entry through the RSS 2.0 feed.