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Proposed Spending Cuts Will Sacrifice Lives in Africa

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So much for pro-life. Hal Rogers, chair of the House Appropriations Committee, has put forward a plan of life-ending, community destroying cuts -- crowing how they're the biggest in history -- just month after House Republicans insisted it was absolutely essential to cut taxes on millionaires and billionaires.

Among these cuts is a plan to slash more than $1 billion from global health programs including over $800 million from AIDS programs.

By my calculations these cuts -- made when we're half way through the year -- will kill over a million people in Africa.

While it can be hard to directly attribute impact for some cuts, AIDS and TB treatment in Africa is already only reaching people those in immediate need. These are people who will be dead before the next fiscal year comes around without treatment. Thus 1 million deaths is likely a conservative estimate of the cuts Republicans are proposing. Specifically:

Cuts to the Global Fund alone, based on an analysis of the current portfolio, would result in:
  • 483,000 people likely to die without AIDS treatment
  • 68,000 babies born with HIV because their mothers didn't receive prevention drugs
  • 12 million families without bed-nets to prevent malaria and 434,000 people will risk death without TB treatment.
PLUS cuts to the PEPFAR program (President's Emergency Plan for AIDS Relief) would mean a halt and reversal of treatment scale up which, based on last year, would at least mean:
  • 700,000 people die without AIDS treatment and millions of new infections result

As far as I can tell, nobody voted this year for a Republican plan to sacrifice over one million lives in Africa. Despite polls showing that "foreign aid" as an idea is unpopular (surprise, surprise) when you drill down we find out that Americans are actually very much in favor of spending on global health and support the fight against HIV/AIDS.

President Bush and the Republicans created PEPFAR in a rare demonstration of bipartisan ability to address a massive global problem. Their analysis at the time was that besides being the right thing to do, it was good public policy to prevent destabilization that accompanies the death of millions and millions of working-age adults in Africa.

But it seems the House Republican leadership has jettisoned this logic--preferring malicious cuts that will cost the lives of some of the poorest people on the planet. Of course, this comes with similar cuts throughout the U.S. social welfare system--cutting housing, health care, senior's programs, and more. It's not news for politicians to cut services for poor people. But what is new is such a drastic policy reversal with such clear outcomes. This is not just a question of some imagined future set of services, but instead a budget for the year we're already in. Indeed, if these cuts were enacted clinics currently operating would have to shut down and send patients home to die.

Not only is this a cold-hearted move, but it's massively short-sighted. As new analyses and exciting new science are increasingly showing, we can bend the curves in the AIDS pandemic if we act now. AIDS treatment is helping prevent new infections and, combined with other interventions like condoms and male circumcision, can save hundreds of billions of dollars in the long run. But not if we stop now.

From here the proposal goes to the rest of the House, where we'll see if the Republicans as a whole have decided they value life so little that they indeed prefer balancing the budget with the lives of people living with AIDS. I'm at least mildly hopeful this will be seen as the radically cynical proposal that it is, once it comes into the light of day.