As world leaders gather in London to grasp for solutions to the economic meltdown, the future of vital US foreign assistance is on the line in the US Senate. The amount of funding allocated to the International Affairs Budget, which includes global health, is being debated by the Senate this week. Although President Obama requested $53.8 billion for the FY10 International Affairs Budget, the Senate Budget Committee missed the mark by $4 billion--merely approving the same amount that was allocated last year.
However, funding at the levels proposed by the Senate Budget Committee will seriously jeopardize vital global programs in health and development. It means potentially freezing the rosters of programs that provide life-saving treatment for people with HIV/AIDS, which will prevent us from fulfilling our commitments in PEPFAR. Though Congress authorized significant increases when it reauthorized PEPFAR last year, those increases did not make it into the budget this year. Funding stayed flat and people on the ground have already felt the repercussions.
Uganda's Dr. Peter Mugyenyi, who was recently on Capitol Hill with Physicians for Human Rights, explained the challenges that Uganda and other countries in sub-Saharan Africa are facing due to the budget uncertainty surrounding global AIDS funding. Without new funds, clinics are now being forced to cap their patients, according to Dr. Mugyenyi, who is the largest PEPFAR implementer in Africa.
PEPFAR was created in 2003 and provided $18.8 billion to support HIV prevention, care and treatment in its first five years. Since its launch, the number of people living with HIV on antiretroviral therapy in sub-Saharan Africa has increased from 50,000 to 3 million, of whom 2.1 million are supported by PEPFAR. Such historic success has created a need for additional resources and an opportunity to capitalize on previous investments to ensure that the 5 million living with HIV in sub-Saharan Africa who need treatment can gain access.
Advocates are rallying support for an important amendment offered by Senators Kerry (D-MA) and Lugar (R-IN) to return the International Affairs budget to the level requested by the President and on track to double US foreign assistance by 2012--a pledge the President made during the campaign trail.
Some have questioned the size of the President's request but the truth is the entire International Affairs Budget is a mere 1.4% of the total FY10 Budget representing only 0.35% of GDP--a small price to pay for restoring America's image abroad. The International Affairs Budget strengthens America's capabilities and energizes our outreach to the world through vigorous public diplomacy and development including support for life-saving global health initiatives such as PEPFAR. According to a recent National Intelligence Council report, efforts focused on global health could simultaneously help advance economic development, foster diplomacy, and improve overall health worldwide.
National security and foreign policy experts agree that a strong International Affairs Budget is an essential component of national security--and health is a key area of engagement for foreign policy. Defense Secretary Gates has said: "What is clear to me is that there is a need for a dramatic increase in spending on the civilian instruments of national security - diplomacy, strategic communications, foreign assistance, civic action, and economic reconstruction and development."
In December 2008, 217 Members of Congress--including 51 Senators and 166 Representatives--signed bipartisan letters urging a robust FY10 International Affairs Budget. "America has a proud history of bringing hope to millions of people who live under oppressive poverty, face starvation, battle HIV/AIDS, malaria and other diseases and suffer the consequences of conflict and insecurity. Continued investments in diplomatic, economic, democracy, and development programs are critical to building global stability and saving lives" the letter said.
The global economic crisis makes foreign assistance an even greater priority when you consider the impact it has on the health of the poor and most marginalized. It is our moral obligation to maintain leadership to address global health crises and the US must not shy away from commitments to the developing world.