The G8 and G20: Broken Promises on Global AIDS

Stephen Lewis

In the United States, the President’s Emergency Plan For AIDS Relief (PEPFAR) is being flat-lined, for at least the next two years. That this should happen under President Obama seems inconceivable.

At the Gleneagles G8 Summit in 2005, the G8 countries committed themselves to providing Africa with $25 billion additional dollars by 2010.

Three reports have emerged in the last short time assessing the actual achievements.

According to the Muskoka Accountability report, released this week by the G8 itself, the commitment has fallen short by at least $7 billion. The report is so self-serving and opaque that it’s frankly impossible to divine the exact figure, but even taking it at its best, it means that the G8 will fall short by almost 30 percent.

According to the DATA report 2010, put out by the ONE campaign, co-founded by Bono, the G8 has fallen short by at least $8.9 billion (using a slightly different form of calculation). That represents a shortfall of almost 40 percent. Bono and company do their best to flatter the contributions of the G8, but even they are forced to say that the increases from 2005 to 2010 “have fallen far short of what was promised.”

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Finally, according to the “Africa Progress Report 2010,” published by a unique panel of internationalists, chaired by Kofi Annan, when the $25 billion commitment comes due at the end of this year, the G8 will have fallen short by at least $9.8 billion. This report, by far the most thoroughly prepared of the three, calls it a “staggering shortfall.”

This background is merely to underscore the betrayal of Africa to which the G8 is congenitally addicted.

It should come as no surprise then to learn that now, the G8 is explicitly cutting back on funding for HIV/AIDS.

I see no point in beating around the bush. In the United States, the President’s Emergency Plan For AIDS Relief (PEPFAR) is being flat-lined, for at least the next two years. That this should happen under President Obama seems inconceivable. It not only negates the pledge that the President (and Hillary Clinton) made during the campaign; it even fails to take advantage of the willingness of Congress to support extra funding.

Worse, the rationale hides behind intellectual sophistry. The argument is that AIDS has had too much money, and additional funds should go to other health imperatives like maternal and child health. No one in his or her right mind would argue with broader financial support for all aspects of global health. But to diminish the dollars that might be available for AIDS, rather than enlarging the financial pie overall is so wrong-headed as to defy rational analysis.

And let no one doubt the consequences. Right at the moment when we know how to treat large numbers; right at the moment when we have five million people in treatment; right at the moment when another nine million require treatment now; right at the moment when hope is finally alive, PEPFAR is flat-lining the budget. Médecins Sans Frontières (MSF) recently released a report documenting cut-backs, portending grievous consequences, in Uganda, Malawi, Zambia and Mozambique. There are AIDS projects, run by other NGOs, where new patients cannot be enrolled unless someone dies: indeed, the cutbacks have become so disastrous in places that HIV-positive pregnant women are being turned away, as are people so sick they’re coming to the hospital in wheelbarrows.
Surely we’ve had enough of the ravenous carnage of AIDS. Let’s be clear: we’re threatened with another outbreak of death akin to the ghastly pattern of the early years of this decade. It cannot be allowed to happen. Someone has to get to the President and tell him that his advisors, decent and honourable though they may be, are taking Africa down a deadly path.

But that’s just the half of it. The Global Fund to Fight AIDS, Tuberculosis and Malaria has a replenishment conference this fall, seeking $20 billion over three years. The Global Fund has performed magnificently in a number of areas, and yet there’s every prospect that they’ll fall up to $7 billion short.

Again the spectre of death will stalk the land.

If the G8 and G20 are to do more than dissemble, they have to match their actions to their commitments. This time, they must put up the money that’s required for Africa along with a timetable for delivery, and then they must keep their promises by sticking to that timetable. They have to understand that maternal and child health are inextricably tied up with HIV/AIDS. If you don’t address the pandemic, you’ll never decisively reduce maternal and child mortality in Africa. For the proof, simply note that maternal deaths in sub-Saharan Africa increased by 61,000 last year, almost all of it due to AIDS.

HIV/AIDS is the ultimate nemesis.

And for those weeping willows who use the financial crisis as the mother of all excuses, just pause a moment to think of corporate bailouts and corporate bonuses.

Something is completely out of whack.

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