Leaders in Global Health to Obama: Keep the Promise on Global AIDS

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Leading academic, scientific, and public health leaders from around the world sent a letter to President Obama last night, urging him to maintain robust scale up of AIDS services as part of his Global Health Initiative.

“It is imperative that we save lives, families and communities, as well as stabilize developing nations, through continued scale-up of HIV prevention and treatment services,” the letter says. “U.S. global health policy now has an opportunity to leverage the success of the AIDS response by using accelerated scale-up of HIV prevention and treatment as a platform on which to build broader and more sustainable healthcare capacity in low-and middle-income countries.”

The signatories on the letter include a broad array of leading medical and health experts—Jim Yong Kim, president of Dartmouth College; Martin Blaser, chair of the Department of Medicine at New York University, David M. Serwadda, dean of the School of Public Health at Makerere University, and Paul Farmer, chair of the Department of Global Health and Social Medicine at Harvard University, to name a few.

The missive to Obama comes as the Administration hones a new approach to global health. Top government officials are putting the finishing touches on a new global AIDS strategy, which is set to be released on Dec. 1—World AIDS Day. But right now, signals from the White House indicate lukewarm support for the US global AIDS program. Dr. Eric Goosby, Obama’s global AIDS coordinator, recently said the Administration would flat-fund PEPFAR for at least the next two years, possibly longer

The White House is also crafting details of its all-important Global Health Initiative, which could come out in the next few months. And there’s the nomination—finally—of Dr. Rajiv Shah to head USAID.

Given all that activity, the focus on AIDS could not come at a more crucial moment, particularly as the Administration appears to be shifting its attention to other health problems, such as child and maternal health, without an apparent acknowledgement of the link between AIDS and the health of mothers and children.

As the letter notes, HIV/AIDS is the No. 1 cause of death among women aged 15-44, the virus remains a leading cause of maternal mortality in sub-Saharan Africa. “Globally, only one-third of pregnant women have access to antiretroviral drugs that can virtually eliminate the risk of perinatal transmission,” the signers note. “Twelve million children have lost one or both parents to AIDS and the number of orphans continues to rise.”

The letter argues we cannot effectively address other health threats by pitting AIDS funding against other health needs, as some in Washington seem to be advocating.

“Today, some argue that we cannot increase the so-called “treatment mortgage” or that HIV resources should be shifted to other health care priorities,” the letter says. “We reject the notion that urgent health conditions should be pitted against one another. Narrow conceptions of cost–effectiveness, or the cost of a given intervention in isolation, cannot become the litmus test to compare interventions for different diseases or to prioritize U.S. global health funding.”

Click here to read the full text and see a complete list of signatories or below for a PDF.

Final_Letter to President on AIDS scale up 11 18 09 (2)

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