10/29/2010 10:28 am ET Updated May 25, 2011

Why There is Much to Fear for Global Health this Halloween

Be afraid. Very afraid. My fears are not so much the ghouls and goblins that will roam my neighborhood this weekend. I'm scared because I took a long look at U.S. spending on global health this week and remembered the promises made not just by President Obama, but also by Vice President Biden and Secretary of State Clinton.

You see, this Halloween weekend marks the 3-year anniversary of a promise that each of them made as candidates for president: A commitment to spend $50 billion over five years on global AIDS programs.

The Global AIDS Alliance Fund was instrumental in organizing and securing these vows. As our ally Health GAP recalls in an alert this week, the candidates understood that without the pledge, activists would march to the Democratic debate in Philadelphia to demand their commitment.

Now, the three candidates sit in seats of power beholden to the promise. But they have fallen short, and I am afraid that millions of people will die unnecessarily due to a lack of funding by the Obama Administration on global health.

For instance, President Obama added only $155 million in his FY2011 request for PEPFAR, the signature U.S. program to fight AIDS, bringing it to $6.9 billion. That not only is well below the $1 billion per year he promised on the campaign trail, it would be the smallest increase in PEPFAR's 8-year history. The $2 billion difference between fully funding bilateral AIDS and the president's request means up to:
  • 1.3 million more people could receive treatment for HIV/AIDS,
  • 3.9 million more women could receive services to prevent mother-to-child transmission of HIV, and
  • 36 million more people could access programs to prevent sexual transmission of HIV.

In addition, overall pledges to the Global Fund this fall were only $11.7 billion, or $5.3 billion below maintenance levels and $8.3 billion below the amount needed to scale-up treatment. For its part, the United States fell $2 billion short of its fair share to scale up treatment.

The overall shortfall to the Global Fund for increased treatment means more than 3 million people infected with HIV will not receive life-preserving medication, 2 million orphans and vulnerable children will have to do without support, and a half million mothers won't receive treatment to prevent transmission of the disease to their babies.

To be honest, it's not just the future of global health that scares me. I also fear for our leaders. If they continue to overlook those who need our help most, what have we become? If we are willing to put a price tag on who lives and dies, what will become of us?

Be afraid. Be very afraid.

Dr. Paul Zeitz is executive director of the Global AIDS Alliance