Death in Delay: Call White House on AIDS Today

Date: Thu, 12 Dec 2002 11:35:15 -0800 (PST)

Dear All,

Since I started this list, I have sent a number of messages on the HIV/AIDS pandemic. It becomes ever clearer that this pandemic, perhaps more than anything else, will shape – and without a dramatic change in its course, will severely disfigure – the face of humanity for decades to come. Tragically, even as the pandemic worsens and spreads, our government’s response has remained minimal. The longer we wait, the more difficult the challenges facing heavily AIDS-burdened countries will be, and so the more difficult stopping the pandemic will be. When it comes to the AIDS pandemic, no ingredient in the recipe for failure in addressing this crisis is more harmful than delay.

The particular urgency of this moment manifests itself, in part, in the US budget process. Money alone will not end the AIDS crisis, but the crisis cannot end without investments of far more money. Today, the Administration is already working on its budget for fiscal year 2004, which it will be complete early next year. If it reflects previous budgets, then absent Congressional will to go far beyond what the President asks for – will that has thus far been lacking – AIDS funding for the next two years will have essentially been decided in the next several months. (Funding for fiscal year 2003 will be set in an omnibus bill before Congress in January, Congress having adjourned last month before passing most appropriations bills. International AIDS spending for 2003 is expected to be the same as, or only slightly greater than, funding in 2002.)

More than 300 organizations from the United States and abroad have urged the President to announce a bold new initiative when he travels to Africa next month, including at least $2.5 billion in new money for fiscal year 2004. (The money must be new to development spending – in the past, some AIDS money has been taken from child survival and maternal health programs.) Other organizations have called for more, including at least $3.5 billion. This latter number comes from an estimate from the World Health Organization’s Commission of Macroeconomics and Health that $14 billion per year is required (, though even this is a conservative estimate, and asking for one-quarter of this figure from the United States ($3.5 billion) does not reflect the full economic strength of the United States.

Today (December 12) has been designated a national call-in day to ask President Bush to take the lead in stopping global AIDS. If you receive this e-mail too late to call on December 12, that is no problem – call or fax whenever you receive this e-mail. The President will present his budget for fiscal year 2004 in the opening months of 2003, so it will be possible to influence his fiscal year 2004 budget for several months yet. More information is below on the action you can take – whom to call and fax, and exactly what you can say. (Note that White House operators won’t ask you questions about the issues – they just take down what you say – so don’t feel intimidated about calling them!) The White House must hear directly from the American people. Without significant pressure, it will continue to drastically underfund HIV/AIDS initiatives.

The budget process is not the only source of urgency; so too is the nature of the AIDS crisis itself. Time is against us in the global struggle against HIV/AIDS. The astronomical death tolls (3.1 million people this year), grieving families, destitute orphans, and suffering that pervades communities and countries are the saddest part of the AIDS pandemic. But perhaps the scariest thing about the pandemic is what lies ahead. The potential numbers of dead and infected, especially in Asia, are horrific. India, China, Nigeria, and Ethiopia could all have 10 million or more people living with HIV/AIDS by 2010, with Russia not far behind. ( And between 2000 and 2025, India and China might each experience 30 million cases of HIV/AIDS – and possibly even 100 million or more. (

A dark future is already beginning to take shape, and the longer we wait, the darker it promises to be. As is becoming apparent in sub-Saharan Africa, very high HIV prevalence is creating a downward spiral. The farther along we allow ourselves to get in this pandemic, the more difficult it will be to reverse the growing death and destruction. Consider the relationship between AIDS and hunger, AIDS and health, and AIDS and education:

Many of you have probably heard about the mass hunger in Southern Africa. More than 14 million people in six countries in Southern Africa face starvation. The situation results from a variety of factors, but a World Food Programme mission concluded that HIV/AIDS is the most “fundamental, underlying cause of vulnerability in the region.” ( One reason for this is that AIDS kills farmers. Since 1985, the 25-hardest hit African countries have lost 7 million agricultural workers, but the future could be even worse: 16 million more could die by 2020. ( The hunger – a chronic state of food insecurity, perhaps – that this loss causes will further exacerbate HIV/AIDS, for malnutrition increases people’s vulnerability to the disease. And since malnutrition increases the speed with which the disease progresses from the time of infection to the time of death, mass hunger increases the speed at which it kills agricultural workers (and everyone else who is infected). The agricultural workers who die leave behind children who would ordinarily learn farming skills from their parents. But now this knowledge will perish with the parents. Tomorrow's farmers are being lost today. (For more, see

Perhaps the largest challenge facing the health sector in Africa is a shortage of medical personnel. Absent intervention, the shortage will get worse. Many doctors and nurses are leaving for better opportunities in wealthier nations, and HIV/AIDS is killing health care workers. The longer the world waits to address the causes of this shortage – including HIV/AIDS itself – the more difficult it will be to address the health needs of Africans including, of course, needs related to HIV/AIDS. Besides there being fewer doctors and nurses to attend to patients, there are fewer people who can train and supervise community health care workers, whose role in fighting HIV/AIDS and other diseases is quite important.

And then there is the education system. Out of the education system will come people with skills to be doctors and nurses, to be the government officials who must figure out of how to deal with AIDS and its manifold consequences, to be business people who can bring economic growth and investment to desperately poor regions, and of course, to be teachers. Educated women have more economic independence than their sisters who receive little or no schooling, which in turn gives them more control over their sexual lives. Education helps provide women the means and the mindset to stand on the frontlines of efforts to empower women, which in turn will empower societies. Yet as teachers die from AIDS faster than they can be replaced, as orphans and children in AIDS-affected families drop out of school to work or because they or their families can no longer afford it, education systems will find themselves educating fewer children, and quite possibly providing a lower quality education to those whom it is educating. The downward spiral accelerates.

Please see below for more information on calling and faxing the White House, and remember that these actions are just as critical and effective after December 12 as they are today. Please act. Call or fax now, and then do it again and again, tomorrow and the next day and the day after that. And please encourage your friends, families, and colleagues to act too. Thank you,



[Forwarded information]

President Bush must announce a bold, compassionate and comprehensive initiative to scale up our response to a level commensurate with these global plagues. President Bush must include in his 2004 budget an adequate response to the global AIDS crisis, including at least $2.5 billion ($3.5 billion) new dollars, of which at least 50% ($1.2 billion) should be directed towards the nearly-bankrupt Global Fund to Fight AIDS, Tuberculosis and Malaria.

Right now, the Bush Administration is working on its 2004 budget request to send to Congress. Please take a moment to call the White House Comment line at (202) 456-1111. Follow the prompts to leave your message with a live operator. You can also send a fax to (202) 456-2461. (The White House currently has months of unopened mail, so US mail is not recommended.)

Our calls and letters will show the Bush Administration that AIDS must be a priority. Please consider following up your phone call by faxing a personal letter, using the sample letter below as a starting point.

Sample phone message:

  • AIDS, TB and malaria are killer diseases and threaten our national security.
  • We must fund solutions that can save lives NOW.
  • I urge President Bush, when he goes to Africa in January, to announce a bold, comprehensive US initiative for 2003 that provides at least $2.5 billion ($3.5 billion) to combat AIDS, TB and malaria with at least $1.2 billion of that for the Global Fund to fight AIDS, TB and malaria.
Sample letter (to be faxed):

President George W. Bush
The White House
1600 Pennsylvania Avenue, NW
Washington, DC 20500

Dear President Bush:

I am writing to urge you to lead a global initiative to stop the global AIDS crisis. As Secretary Powell stated correctly on November 12th of this year, AIDS is the biggest problem facing the world today. We need you to display the same leadership in the fight against AIDS that you have exercised in the war on terror.

Before your journey to Africa, I implore you to launch a comprehensive new initiative addressing care, prevention and treatment for the millions of people worldwide living ­ and dying from AIDS. The new initiative should include at least $2.5 billion ($3.5 billion) of new money for global AIDS programs is needed to begin a credible plan to control this plague that is destabilizing the globe, with at least 50% directed to the Global Fund to fight AIDS, TB and Malaria. Experts report that it is feasible to provide treatment to at least three million people by the end of 2005, and that with strong prevention measures, the infection rate can be reduce by more than 50% over the next several years. These prevention and treatment targets will not be possible unless your Administration puts up enough cash to implement a plan to reach them.

Strong leadership is needed from the United States to turn the tide against an epidemic that crosses all boundaries and borders.



"I have only dreams: to build a better world, a world of harmony and understanding, a world in which it is a joy to live. This is not asking for too much." -- Yitzhak Rabin

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