In his January 28th "State of the Union" address, U.S. President George W. Bush announced a new plan to increase funding to fight AIDS in Africa, and suggested a change in the direction of U.S. policies toward the global fight against the HIV/AIDS pandemic. He promised $15 billion over 5 years, or $3 billion per year. And he suggested that the U.S. would stop opposing African access to cheaper generic versions of anti-AIDS drugs. Within weeks, however, the White House had reneged on the promises that the President made. While Bush's initial proposal surprised many, receiving wide media coverage and considerable praise, his administration's subsequent backtracking has largely been ignored.

What the president described as "a work of mercy beyond all current international efforts to help the people of Africa," has been exposed as a cynical ploy at the expense of the lives of 30 million Africans living with HIV/AIDS, as well as 12 million more people around the world. President Bush's inclusion of an AIDS initiative in his national address must now be seen as a public relations effort to present a veneer of American compassion within a speech devoted to pushing for war on Iraq. And now that the war is on, scant attention is being given to the most deadly of all global threats that AIDS represents, or to Africa, the region most devastated by the pandemic.

It is crucial to note that the President's proposed "Emergency Plan for AIDS Relief" came in response to rising and effective pressure from Africa advocacy groups, AIDS activists and faith community workers who have fought for a greater U.S. response to the global HIV/AIDS pandemic. Frustrated with the slow pace and small scale of Congressional efforts, over 200 organizations mounted a sustained campaign since last year explicitly targeting George Bush and demanding a new initiative from the President.

This pressure was the catalyst for forcing senior administration officials to craft a new plan that Bush was to unveil on his scheduled visit to Africa in January. Because the trip was callously cancelled, the initiative was instead featured prominently in Bush's longest speech aimed at making Americans comfortable about the war to come.

The Smoke

Many activists anticipated the announcement but were worried that the funding levels would remain low, that the U.S. would continue to undermine the main multilateral mechanism for fighting AIDS - the Global Fund. They also feared that Washington would still place pharmaceutical companies' patented profits over people's lives. In each case, our worst fears have been realized.

Bush's plan states that its objectives are to 'treat at least two million people with life-extending drugs, prevent seven million new HIV infections and provide care for millions of people living with AIDS and children orphaned by AIDS.' These would be appropriate targets for a new U.S. initiative and would represent a considerable contribution to the fight against AIDS. But to achieve these objectives, the U.S. would need to start spending at least $3 billion a year immediately, and most of the funding would need to go through the Global Fund to Fight AIDS, Tuberculosis and Malaria - the year old "war chest" for the fight against AIDS.

In his speech, Bush said "I ask the Congress to commit $15 billion over the next five years, including nearly $10 billion in new money, to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean."

The president clearly wanted the public to believe that he was asking Congress for $3 billion a year over five years to fight AIDS, specifically in Africa and the Caribbean. That would represent a tripling of current U.S. spending of $1 billion a year on all international AIDS efforts. By suggesting that a total of $15 billion would be devoted to African and Caribbean countries, the President mercilessly exploited popular American misperceptions about Black people's helplessness and America's generosity.

In fact, the initiative and its $15 billion price tag is not only for Africa and the Caribbean, but includes all U.S. funding for AIDS worldwide. The White House's subsequent "clarifications" on this point leave no doubt about the administration's crass intent to manipulate Africa's suffering in the speech. AIDS is a global pandemic and does not discriminate by race, gender or geography. But at present, it is mostly killing Black people.

Africa is the epicenter with 75% of the world's people living with AIDS, and some 60% of HIV infected Africans are women. A U.S. contribution of $3 billion a year would be an appropriate start just for support to HIV/AIDS programs in Africa. Beyond that, clearly more funding would be required for the U.S. to give its fair share contribution to similar programs elsewhere in the world, particularly in India, China and Russia - the three most populous countries projected to become the most impacted by the "second wave" of the AIDS pandemic.

The White House fact sheets and follow-up briefings identified 12 African countries and 2 countries in the Caribbean as the proposed recipients of the $10 billion described as "new" money. But later the administration acknowledged that the list could change and other regions could be added. It also admitted that the governments of these 14 countries had not been consulted on the plan (not to mention African civil society and organizations of people living with AIDS) and that most of this new funding wouldn't even be requested until 2006 and beyond. The reformulation of the initiative away from its stated Africa focus represents the first broken promise.

The Enron-style accounting on the numbers represents the second broken promise. The White House was able to claim such a large number by projecting the bulk of the initiative's funds into 2005 and beyond. George Bush's current term in office ends January 2005. Though the president referred to his initiative as an "emergency plan", the White House refused to ask Congress to increase money for AIDS immediately in the 2003 omnibus funding bill that was being voted upon within weeks of the speech.

During the week following the President's address, the White House submitted its budget for 2004 which included only $450 million of the "new" money. Finally, as The New York Times noted, the increase in AIDS funds comes partly by cutting nearly $500 million from international child health programs. Money was even taken from the president's own Millennium Challenge Account - touted as an important new vehicle for increased development funding to poor countries - in order to make this marginal increase in AIDS funding. Robbing one meager account intended to support various development priorities of poor nations to create another meager account for global AIDS, makes a third broken promise.

The Mirrors

The more one examines the fine print of the president's plan, the more gaps appear. And there is no guarantee that funding for AIDS will not be edged out of future budgets by rising costs of war in Iraq. One important question is how the HIV/AIDS money will be spent. While the Global Fund to Fight AIDS is facing bankruptcy, the president's proposal calls for only $200 million a year for the Fund, essentially freezing U.S. contributions at the level of previous years. The bulk of the new funds apparently will be channeled either through the notoriously cumbersome USAID bureaucracy or through some new bilateral mechanism yet to be established - a further reflection of this administration's preference for "going it alone." This despite the fact that U.S. Secretary of Health and Human Services, Tommy Thompson, was "elected" Chair of the Board of the Global Fund. As activist Asia Russell pointed out at the Board's meeting in Geneva, "If the U.S. is going to buy the presidency of the Board, it could at least use real money."

To the extent that such U.S. unilateralism prevails this year, the global response to AIDS will be further weakened and delayed. Some activists also fear that distribution of the funds may also be used to advance right-wing religious agendas (e.g. the international "gag rule" preventing support for many reproductive health programs) or as leverage for other U.S. diplomatic aims. Clearly, the Millennium Challenge Account pursues this kind of unilateralist approach and will be used to impose economic and political conditions upon the handful of countries who will be given pieces of the $1.3 billion pie on offer in 2004, of whom three might be African countries.

Although President Bush acknowledged that affordable antiretroviral drugs are necessary, as of early March it remained highly doubtful that U.S. policy would in fact help countries to import such drugs or build manufacturing capability. A common-sense approach would be for rich countries and the Global Fund to work closely together to help African countries import drugs from Brazil, India, and Thailand and begin treating people immediately. Instead, U.S. trade representatives were still blocking even an agreement in principle on implementation of the 2001 Doha agreement that called for loosened patent rules to facilitate such exports. Negotiators freely admitted to journalists that the pharmaceutical company lobby was driving the U.S. resistance to generics.

The response to the AIDS pandemic will be the most telling indicator of U.S. and global response to African priorities. If past patterns prevail, Congressional debate on the U.S. budget for fiscal 2004 may well continue into early 2004. Yet the Global Fund does not have sufficient funds for a third round of proposals in October 2003. The next summit of the G-8 will be held in June in France. The question is whether AIDS will even be on the agenda, and, if so, whether it will bring only new promises or real resources.

Activists here have to learn not to be used as amplifying mirrors by the Bush White House as it seeks to mislead the public about its "acts of mercy", using this as partial cover for its acts of aggression internationally. We cannot become so desperate for progress that we are willing to accept lies!