TNR editorial-Bush's cynical AIDS relief policy confirmed

[LiviaOlivia]

Drug Test
by the Editors
Post date: 04.01.04

In January 2003, when President Bush announced his ambitious Emergency Plan for Aids Relief--which called for spending $15 billion over the next five years to put two million people in 14 African and Caribbean countries on lifesaving antiretroviral therapy--the reaction from many on the left was predictably negative. Act up Philadelphia's Katie Krauss griped that not enough of the $15 billion would go to the appropriate recipients and warned that "aids can only be stopped when the United States contributes adequate amounts to worthy programs regardless of political considerations, ideological goals, or geographical boundaries." Salih Booker of Africa Action questioned the Bush administration's sincerity, declaring, "They have become very good at the soft rhetoric but not the hard policy." Other liberals (including this magazine), by contrast, set their cynicism aside and took Bush at his word. "Inspiring and clearly heartfelt," said Sandra Thurman, who served as the Clinton administration's top aids official and now runs the International Aids Trust, of Bush's announcement. "His plan can save millions of lives."

Alas, some 14 months after Bush announced his aids plan, it seems the left's cynicism was warranted. As it has so many times before--whether with the No Child Left Behind Act or the Iraq war--the Bush administration's implementation has betrayed those liberals who gave the president's early rhetoric the benefit of the doubt. The problems with Bush's plan come down to two fundamental issues, the first of which is money. As The New Republic has noted before (see "Talk Is Cheap," July 21, 2003), initially the Bush administration strongly implied it would spend $3 billion per year over five years to fight aids in Africa and the Caribbean. But the White House's 2004 budget request asked Congress for only $2 billion (after some Democrats made a stink, Congress ultimately voted to spend $2.4 billion), and its 2005 budget proposal, now before Congress, calls for only $2.8 billion for its aids plan. The administration responds that it is merely "ramping up" the funding for its aids program and that, beginning with the 2006 budget, it will spend more than $3 billion per year. But, with budgetary pressures sure to increase in the next few years and with Bush having already pocketed the political capital he received from his aids proposal, it's dubious the full funding will ever come.

Second, there is the matter of generic drugs. Shortly after the president's announcement, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and a chief architect of the aids plan, told reporters that the administration would recommend that the 14 nations receiving money under the plan use some of those funds to purchase generic aids drugs manufactured by the Indian company Cipla, which can be one-third the price of brand-name drugs manufactured in the United States. This constituted a serious policy reversal, since only two months earlier the administration had lobbied the World Trade Organization--at the behest of the U.S. pharmaceutical industry, many believed--to confine generic knockoff drugs to domestic markets.

But, in March, the administration informed the first organizations to receive money from its aids plan that they could not spend the funds on foreign-made generic drugs until those drugs undergo further evaluation--even though they have been tested and approved by the World Health Organization, which uses the same principles as the Food and Drug Administration. In the meantime, these groups must buy the much more costly U.S.-made, name-brand drugs. Which means that many aids patients in the developing world will have to wait longer to initiate antiretroviral therapy--until either the Bush administration approves the use of generic drugs or it allocates more money so these patients can afford the pricier brand-name ones. As the University of California-San Francisco's Dr. David Bangsberg recently told National Public Radio, "The choice is between generic therapy and no therapy." All of which has led some liberal critics of Bush's aids plan to conclude that the administration devised the plan--which is being run by former Eli Lilly CEO Randall Tobias--purely as a gift to U.S. drug companies. "They are trying to hand the U.S. global aids plan over to Big Pharma," Health GAP's Sharonann Lynch recently complained to The Washington Post. Once, we'd have said that charge was ridiculous. No longer.
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http://tnr.com/doc.mhtml?i=20040412&s=editorial041204

[Turbineguy]

1. It's like all Bush's programs.

it's designed to do something else.