Wednesday, 1 December 2010

Laurie Garrett, Council on Foreign Relations

December 1, 2010

Dear Friends and Colleagues;

The CFR Global Health Program devoted considerable time this year to the preparation of a Declaration and Statement for the UNAIDS High Level Commission on HIV Prevention. I chaired the Scientific Advisory Panel that painstakingly prepared the consensus documents. The Declaration was released today by the Commission, which is cochaired by Nobel laureates Desmond Tutu and Françoise Barré-Sinoussi.

· Declaration of the UNAIDS High Level Commission on HIV Prevention

· Press Release

· The Commissioners on World AIDS Day

Given recent successes in innovations for HIV prevention, there is hope that leaders worldwide can put attention and resources to pushing the pandemic backwards at a high pace.

Meanwhile, of course, there is great concern that the new Congress, taking their seats after the New Year in Washington, DC, will slash the budgets for foreign assistance, overall, and HIV treatment and prevention in particular. With this as background, former President George W. Bush penned an opinion piece in today's Washington Post, calling for continued support of HIV treatment and PEPFAR, the program he created during his first term.

As has been tradition in the United States since the presidency of George H. W. Bush, President Barack Obama issued a statement for World AIDS Day today.

Unfortunately, President Barak Obama did not mention prevention of the further spread of HIV. During his administration, Bush promoted the ABC's -- Abstinence, Be faithful, and as a last resort, use Condoms. This policy, which failed to stem the tide of spread of HIV, was not referred to in today's editorial. Former Bush speechwriter Michael Gerson and former PEPFAR Ambassador Mark Dybul co-authored another editorial of support for continued financing of HIV programs, appearing in Huffington Post.

Yesterday the Global Health Program convened an important meeting in New York regarding the impact of the world financial crisis on funding for global health, writ large, and HIV specifically. Dr. Christopher Murray presented the latest assessment of financing trends, from the Institute for Health Metrics (IHME). And Dr. Alexander Preker, Head Health Industry and Investment Policy Analysis for the Investment Climate Department at the World Bank, offered responding comments and analysis. Among the most important findings highlighted by Murray and Preker are:

- While support for global health in general, and HIV in particular, continued to grow in 2008 and 2009, despite the financial crisis, the rate of growth slowed. This trend overall is worrying.

- Globally, philanthropic and private giving dropped considerably, leaving a single player -- the Gates Foundation -- responsible for 57 percent of all nongovernmental support for global health. That is worrying because any policy changes executed by the Gates Foundation will have a disproportionate impact.

- Also globally, the United States was responsible for more than half of all government giving for global health, and a far more considerable percentage of HIV support. This renders the entire global health effort highly vulnerable to Congressional whims, budget cuts, or prioritizations.

IHME Report- Financing Global Health 2010: Development assistance and country spending in economic uncertainty


Laurie Garrett

Senior Fellow for Global Health

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