Just in Time for World AIDS Day

Just in time for world AIDS day, a global day of action aimed at increasing awareness around the critical disease that continues to claim millions of lives each year, several advocacy organizations have issued Barack Obama a report card on his commitment to battling HIV transmissions and bolstering AIDS programs around the world. The U.S. president has earned a grade of a D+, hardly passing in his promises to combat the pervasive disease that affects so many people around the world, and making small strides in a positive direction. The grade was issued by the Global Access Project, Africa Action, the Treatment Action Group, and Global AIDS Alliance, and is based on the campaign promises that Obama had made prior to coming into office, taking into account all of the efforts he has put henceforth: the good, the bad, and the lackadaisical.

The main points of focus for Obama's performance assessment were global AIDS funding levels, scale-up of treatment, prevention efforts, and the expansion of global health efforts. Hopes had been built high prior to his presidency with a promise to double funding for AIDS programs around the world and to do the same for the number of HIV positive individuals receiving treatment, yet these goals have fallen to the wayside and his commitment to public health has wavered. And while there are some points of redemption in Obama's AIDS policy, particularly in his focus on prevention efforts and reproductive health, advocates around the world are questioning whether Obama may live up to earning his potential high marks.

In the face of rising treatment costs around the world, our president has chosen to flat-line spending on AIDS programming and research throughout the world, keeping the global funding levels set at what his predecessor had established. And although funds are being supplied for prevention efforts and care, critical treatment such as TB testing for all HIV positive individuals was not included. And because of a lack of proper funding, basic healthcare efforts such as doctors visits and medications for HIV are being stifled. By increasing access to antiretroviral medications so as to decrease individual infectiousness, and by facilitating access to healthcare clinics providing HIV-specific treatment and counseling, the Obama administration would have a significant impact not only on the lives of those living with HIV and AIDS around the world, but on the number of new transmissions each year. But according to his judges, Obama's lack of funding for these programs has "undermined his commitment to fund the U.S. fair share of the AIDS treatment burdern."

But our president's marks do improve in the realm of HIV prevention efforts, specifically as they are related to reproductive health and to substance use. In a monumental move, President Obama rescinded the ludicrous Bush-era Gag Rule within his first month in office. The Gag Rule was a global AIDS funding policy set up by the Bush Administration to prohibit the U.S. dollars from being used to bolster any reproductive health research or clinic that did not promote an abstinence-first paradigm. Obama should be congratulated for removing this measure which was completely out of touch with the real issues at hand, and his efforts to incorporate realistic reproductive health considerations into tackling HIV transmission reflect a highly refreshing perspective; especially in light of the World Health Organization's assertion this week that HIV is the #1 killer of women of reproductive age around the world.

And Obama is making large strides in the field of substance use as a primary contributor to HIV transmission, as well, having vowed to retract the federal measures which prohibited funding for needle-exchange programs. This matter hits close to home for Obama, as Washington, D.C. is one of the cities which has suffered most under this ban on funding programs which, in other cities like New York, have saved countless lives. D.C. is also one of the cities with the highest rates of HIV, with a staggering 3 to 5% of the population being identified as HIV positive. These issues are right at Barack Obama's backdoor, and his attention to them is critical.

But despite these various steps toward progress, President Obama has not yet fully fulfilled the U.S. pledge to expand its global health investments, contrary to the "Global Health Initiative" that was launched earlier this year in the White House. And while he had talked extensively about doubling the fiscal budget for AIDS-related spending, the levels of the Obama Administration remain constant with those of the Bush Administration, which essentially cripples the fight against global AIDS. And as Barack Obama had campaigned about setting the budget for AIDS research and prevention efforts, so far he has not. With hundreds of billions being spent on banks and on war, the proposed expanded budget for HIV would be just a tiny drop in the mighty American bucket. And with millions of people dying each year of this devastating disease, there simply is just no excuse for ignoring it.