A small but loud group of Yale students interrupted President Barack Obama’s speech at the rally for Democratic candidates in Bridgeport last Saturday. Their chants of “Broken Promises Kill” and “Fund Global AIDS” echoed similar protests by students of the Harvard College Global Health and AIDS Coalition on Oct. 16, when Obama spoke at a rally in Boston for Mass. Governor Deval L. Patrick.
While the Yalies’ protest was quickly rebuked with boos and chants of “O-ba-ma” by thousands of supporters, it raises two questions. First, do the Harvard and Yale student detractors have a case regarding Obama’s commitment to fighting global HIV/AIDS? Second, did their disruption, three days before Congressional elections, do much to advance their legitimate cause? Our first answer is a cautious “maybe,” but the protestors’ case is incomplete. Our second answer is a clear no.
The protestors’ gripe is that in November 2007, at the Global Summit on AIDS, Obama said that, if elected, he would provide $50 billion by 2013 to fight HIV/AIDS, and contribute to The Global Fund for AIDS, Tuberculosis and Malaria. But this was before the financial crisis. We all know the world has changed since 2007. The White House now approaches the issue with different numbers, and a different strategy.
All global health efforts are bundled under the umbrella of the Global Health Initiative (GHI), to be funded with a pledged $63 billion by 2016. It seeks to strengthen global health systems and move away from prior policy, which was fragmented and disease-specific. HIV/AIDS and malaria programs would continue, and investment in child and maternal health, family planning and other neglected tropical diseases would expand. Over $35.7 billion of the GHI would be allocated to fighting HIV and tuberculosis, and to providing support for The Global Fund.
With simple math, the protestors have a point: $50 billion isn’t going to HIV/AIDS alone. While the budget for global health has gradually been growing ($8.8 billion was provided this year, compared to $7.5 billion two years ago under Bush), critics argue that the GHI’s systemic focus leads to an overall loss of attention to HIV.
But, on the plus side, better coordination of various programs and systematic targeting of other diseases are expected to increase the effectiveness of these policies. In September, Obama also announced the first Global Development Policy showing Presidential leadership on improving the impact of funding in development programs like global health through good governance.
Moreover, with 1.1 million Americans living with HIV, the fight against HIV/AIDS can’t go global without starting at home. Obama’s new National HIV/AIDS Strategy and the general health care reform package should assist Americans with HIV/AIDs, including by preventing insurers from denying coverage to children with the disease.
Given the scale of the global HIV/AIDS epidemic, any state policy is likely to be found wanting. We side with those who’d like to see the administration invest more in global health rather then less. But the White House hasn’t done a complete backflip on pre-White House HIV/AIDS policy.
At the rally in Bridgeport, we asked several Yale protestors if they were Republican. They said “no” and indicated they generally supported Obama. It puzzled us. Here were privileged young adults, proudly championing their First Amendment rights to criticize the White House for an important global public health challenge. But they were doing so in an important electoral arena where each vote counted and three days before the midterm elections. While the students might have gotten an instant of fame and Presidential attention at a rally, they also offered media, Republicans and a hurting American public with an appetite for soundbites television coverage that could be used for unintended purposes — nothing to do with HIV/AIDS.
Now that the Democrats have lost the House, how easily will the President be able to convince the new Congress to approve the proposed increase in Global Health funding to $9.6 billion next year? We knew that 101 House Democrats had written to Obama in July urging him to give $6 billion to the Global Fund, noting that $4 billion was an increase, but not enough of one. They also wrote that a key part of the Republicans’ HIV/AIDs policy had been “Abstain, Be faithful and Change behavior,” which devalues the role of condoms. On Monday, before the elections, we phoned the Republican National Committee; we were told global HIV/AIDS has not been a big issue in this election. They don’t even have a specific platform.
There is a time for divergence and a time for solidarity when any social or political goals are sought. Three days before the midterm elections was the wrong time to diverge. If a more constructive HIV/AIDS policy is the end-goal, activists shouldn’t lose sight of who is more likely to provide traction. With the Congress having turned redder this past Tuesday, the global fight against HIV/AIDS has not become any easier.
Sergey Lagodinsky and Kala Mulqueeny are 2010 World Fellows.