The fight against AIDS got a healthy boost Wednesday when the House passed a big new bill out of committee -- increasing funding for AIDS, TB and malaria to $50 billion and beginning to fix a lot of what doesn't work in the Bush AIDS plan. If it makes its way into law, this is going to keep a lot of people -- millions -- alive and healthy.
But as I sat in the overflow committee hearing room with about a hundred AIDS activists watching the hearing, my excitement got a serious reality check as the right wing showed up in force. Leading with culture-war politics and following quickly with the assertion that there's no money for AIDS (but plenty for war), a set of Republicans was successful in forcing the Democrats to "compromise" on several key elements.
Sitting there, I realized that US global AIDS policy is at a crossroads. We could take huge leaps forward -- or we could fumble. Even to just pass the current bill we're going to need a loud, powerful, progressive voice to counter some of the crazy lies (like that we're trying to turn Africa into "a network of abortion mills").
As the biggest humanitarian initiative of the US government is being re-written for the next five years, where are the presidential candidates? Nobody else has a platform right now that could so lift AIDS programming up -- it's even called the "PRESIDENT'S Emergency Plan"! It's a key moment to be presidential -- and I haven't heard a word from Senators Clinton, Obama, or McCain about their vision for what Congress should do.
On the right, there's no lack of loud voices. The past week saw Republicans and right-wing activists taking to the Capitol steps to label advocates of good AIDS policy (like the revolutionary idea that condoms work) as "abortionists."
Rep. Chris Smith (R-NJ) claimed Wednesday that AIDS service providers were the "friends of pimps and degraders of women" if they did not feel it an appropriate public health strategy to condemn prostitution when providing HIV prevention to sex workers (as US policy currently demands). This would be harmless rhetoric if he hadn't succeeded in eliminating from the bill a lot of good policies that would have put condoms, birth control, and integrated medical services in reach for millions who need them.
Meanwhile, Rep. Rohrabacher (R-CA) tried to claim the US should not spend so much on global AIDS when people in the US needed healthcare. Prompting one to wonder, of course, at where we can find the Republican plan to defund the war and fund Universal Healthcare. Nonetheless, the budget hawks have ensured that instead of $50 billion over five years for global AIDS, as is needed to even start to reverse the pandemic, that money will now have to be split with TB and Malaria programs as well.
So where are the champions? Where is the next president -- who could help sweep this aside and do what's right?
Senator Clinton, at least, mentioned AIDS this week in her speech at GW University and she recently introduced some key legislation on AIDS prevention to the Senate. But recently, besides mentioning what she "would" do as president, we are still waiting for her to engage on what's going on right now. With the national spotlight on her, she's got a key moment right now to stand up for her key issue of women's human rights -- but she hasn't weighed in publicly to stop the lies or lend her weight to those trying to stand up for good public health.
Senator Obama meanwhile has been even more noticeably absent. He has been fighting back against the idea that words don't matter. Right now, words could matter quite a bit on AIDS. Fear-mongering words are giving the right wing the power to force a literal "midnight compromise" to take out good public health language from the next five years of AIDS policy. On his website, Sen. Obama says [PDF] that our first priority should be to "rewrite much of the bill to allow best practices - not ideology - to drive funding for HIV/AIDS programs." Some of that powerful Obama rhetorical skill could go a long way right now toward empowering those trying to do just that. But we haven't seen a statement, speech, or intervention on the reauthorization of US global AIDS programs.
Senator Mc Cain, too, has been missing. On the stump he's called the PEPFAR program one of the best US foreign affairs initiatives and said he'll do everything he can to increase funding. He also has a history (if not very recent) of pushing back against the right wing of his own party. Now would be a good moment to make that happen--a little "straight talk" about the reality that this fight has nothing to do with abortion could be critical.
What has to happen? We need to increase funding to $59 billion to fully fund all the good programs discussed in this bill. We have to continue the previous US promise to treat 1/3 of people in need -- 4 million -- instead of copping out at a target of 3 million people. We need to replace vague language on prevention which gets used to fund ideological programs with a deep commitment to science-based efforts that will really save lives. There's much to celebrate in the new bill -- but still work to do. Work that might not be possible without a real champion.
Maybe I'm hoping for too much. They are in campaign mode and staying as far away from controversy as possible. But maybe we should be demanding that the "new" politics and "change" that they've all been talking about should start right now. Today, tomorrow, and this week decisions are being made about the next five years of AIDS policy that one of them will supervise.
On the war in Iraq, the Senators haven't hesitated. On the war to end the AIDS pandemic they say we have their support, but it's all in future promises.
This bill soon moves to the Senate -- and it'll be very clear whether these Senators-hoping-to-be-president will take action or watch.
We need AIDS leaders right now, not next year--where are they?
