In The War Of Words Against HIV/AIDS Funding, No One Wins

03/18/2010 05:12 am ET | Updated May 25, 2011

Rather than resorting to harmful disease politics - which make great headlines but lousy health policy - we need to support the testing of viable healthcare delivery systems for poor people and focus on advancing sound prevention efforts for HIV and other illnesses.

Over the past few weeks, Dr. Ezekiel Emmanuel, a White House bioethicist, and other critics have voiced concerns over the amount of funds that the U.S. and other nations are spending to test and treat people living with AIDS in comparison to other global health tragedies like dysentery.

While this criticism has captured many headlines (particularly around World AIDS Day) in the International Herald Tribune and other influential forums, it is misguided for several reasons.

First, from a public health and finance perspective, the major weakness in our nation's global HIV and AIDS funding strategy is not that we have over-invested - in fact, it is the opposite. We continue to under-invest in prevention, particularly syringe access and female-controlled prevention programs and devices.

At a recent talk at the Council of Foreign Relations, Mark Dybul, who previously oversaw PEPFAR, the major source of US AIDS and HIV international funding in the Bush Administration, estimated that the program pays for 3 of the 4 million people worldwide who are taking AIDS medication.

Nonetheless, more people are infected each day with HIV than are tested and put on treatment.

So, absent a cure - which seems at best 10 years away - these folks will need to be on medication for the rest of their lives. Simply said, we cannot "treat" our way out of HIV globally and we need to invest more heavily in prevention now to avoid more deaths, more AIDS orphans, more decimated work forces and more unsustainable global pharmaceutical costs.

No one wins when we pit one disease group against another -- least of all the poor and marginalized of the world that are disproportionately represented among people living with HIV as well as vulnerable to dysentery. President Obama has shown great leadership in placing PEPFAR under Secretary Clinton and seeing AIDS in the context of all of our international aid; we haven't figured out how to deliver sound disease prevention and health care to poor people - whether they live in Washington, D.C. or Johannesburg, South Africa.

Amidst the arguments, one would hope we can all agree that it is a shameful tragedy to think we have to choose between what diseases we care about the most or which deserves the most attention. The bottom line is that AIDS and all other illnesses are great friends to poverty, inequality and lack of healthcare systems.