Politics & Policy

Biting The Hand That Feeds You

The U.S. is berated--for generously fighting malaria and AIDS.

To confirm the massive international bias (especially within the media) against the United States, one has only to examine the headlines about the recent major AIDS meeting in Tanzania. Most nations have failed to live up to their international obligations, whereas the U.S. has delivered on them. Yet, by some odd twist, the U.S. is criticized and the rest are not. It’s time for Americans to consider ignoring international forums (such as the Global Fund), partner with those who want to work with the U.S. (as they did in Iraq), and just save lives.

The Global Fund to Fight AIDS, Tuberculosis and Malaria was established by the U.N. in 2001 to provide drugs, insecticides, and other interventions to the poor countries of the world. Most of the money has been spent on HIV/AIDS, although increasingly a greater percentage is going to malaria control. Malaria has a high death rate–especially among children in Africa–but is curable, so the returns in terms of lives saved are much higher than for AIDS. Even so, there is controversy about prevention and treatment. Debates over whether bed nets or DDT are better for stopping mosquitoes from biting kids are as divisive for malaria control as the debates pitting abstinence against condoms, and brand-name drugs against generics, are for AIDS prevention.

The fund finished its board meeting in Tanzania just before Thanksgiving. Attended by four African presidents, with abundant smiles and large begging bowls, the meeting was supposed to announce a $3 billion anti-AIDS program for 2005. Instead, it has received pledges of only $900 million, and the fifth round of funding may be delayed by several months until the rest of the money is procured. Additionally, under congressionally imposed rules, the U.S. cannot commit more funds until the other parties also pledge more.

The current chairman of the Global Fund board is the U.S. Secretary of Health and Human Services, Tommy Thompson. When he announced that the fifth round of funding might be delayed by “five months,” the U.S. was immediately attacked by pressure groups for not doing enough. The Global AIDS Alliance accused President George W. Bush of crippling the fund by harboring “an irrational hatred toward all things U.N.-related.” European newspapers reported these attacks gleefully.

The U.S. has been the harshest critic of the fund’s failings. First, it has criticized other donors for not doing their part; more important, it has complained that the fund was failing to manage projects efficiently. But apparently good-faith, accurate criticism is not allowed in the world of do-goodery.

Add to this the fact that others’ criticism of the United States is certainly not in good faith. It is disingenuous of the media and activists to berate the one party that does not renege on an international agreement (i.e., the United States). The G-8 group of nations declared last year that the fund should get $3 billion a year, with French President Jacques Chirac proposing $1 billion from Europe, $1 billion from the United States, and $1 billion from other countries.

But since European nations have not donated their share, the U.S. has so far paid more than its share–its support has been as high as 37 percent and is currently at 35 percent, exceeding the originally proposed 33 percent. When Congress agreed to the funding, it capped U.S. support at a third of the total level, not wanting to end up funding the vast majority of a supposedly global effort. As Thompson says: “If other countries were as generous as [the U.S.], we would not be in the situation we are in right now.”

Europeans have defended their stinginess mainly by complaining about America’s faith-based approach. U.S. policymakers insist that abstinence and education are as important a part of disease control as condom delivery, and the evidence shows this to be true. But the truth has not stopped European activists from excusing their governments’ refusals to grant funding on the grounds that they object to American policies.

Such carping at American largesse and annoyance at U.S. demands for accountability demonstrate that the rest of the world is happy to pay lip service to AIDS relief, but is neither serious about funding it nor about making sure that the funded interventions work. If the U.S. pulled out of these joint ventures, U.S. policy administrators could get on with saving AIDS patients pursuant to their own standards of accountability–and saving themselves the hassle of answering to the hostile European media. U.S. non-participation would also show up the rest of the world for doing so little.

Dr. Roger Bate is a fellow at the American Enterprise Institute and a director of the health advocacy group Africa Fighting Malaria.


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