BALAJI: Secretary Kerry: Mr. Fix-it?

In this past State of the Union, President Obama called for an “AIDS-free generation.” Indeed, the United States is taking some great steps in fighting the global burden of disease. The appointment of John Kerry as the Secretary of State signifies one such paradigm shift, demonstrating the Obama administration’s increased focus on international relief. The appointment of Mark Dybul as the Executive Director of the Global Fund to Fight AIDS, Tuberculosis and Malaria also indicates the substantial efforts taken by the U.S. to control these issues. However, this positivity is slowly being replaced by growing concern. In light of the current budget crisis, are Secretary Kerry, President Obama and Congress slowly deprioritizing our commitment to combat HIV/AIDS, Tuberculosis and Malaria?

Of late, there’s s a rising concern that the U.S is attempting to wash its hands of the cycle of dependence it has created. Abandoning global health initiatives would follow a disturbing trend — a trend in which the United States abandons the projects abroad they once deemed noble and necessary, much like forest conservation, environmentalism and Middle East diplomacy.

Sequestration would slash almost half a million dollars from one of the United States’ most successful and popular bipartisan initiatives: the President’s Plan for Emergency AIDS Relief (PEPFAR). Currently, PEPFAR pays for anti-retroviral treatment for over three million HIV positive people worldwide. When PEPFAR loses funds, people lose access to lifesaving medication. According to the American Foundation for AIDS Research, cuts to PEPFAR would lead to over 60,000 additional AIDS-related deaths in just one year.

Cutting PEPFAR would not impact the deficit severely; in fact, it would result in a mere 0.63 percent of the total $109 billion required in deficit reduction for the fiscal year. I see no reason to reduce PEPFAR except for the sake of exploitative politics.

Although reducing PEPFAR spending does not really benefit the U.S., it has still been proposed. Clearly economics is not the driver of decisions — politics is the smelly fish to blame. Wherever the pressure to cut PEPFAR is coming from, it fails to comprehend the political economy of global disease. However, politics has never been deeply receptive.

Although there is a deeply ethical and humanitarian reason to focus greater efforts towards the Global Health Initiative (the umbrella organization that funds PEPFAR), there are more practical and utilitarian reasons to support the initiative, too. The GHI is probably the only interventionist endeavor that has actually been welcomed by other countries. It aims to increase the self-sufficiency of countries receiving aid by 2014 through supporting training more than 140,000 new health care workers. Cutting the funding to PEPFAR signals the beginning of a dismal end to an initiative in which the U.S. already has invested millions.

Nothing about cutting global health funding is sustainable. Do we need more people protesting outside U.S. embassies? Is that the image that a (debatably declining) superpower wishes to project — one that is slowly turning away from one of the only initiatives that is truly effective?

Will John Kerry fix this problem? Kerry was a driving force behind the establishment of the PEPFAR and the Global Fund (another GHI program), and stressed the importance of bilateral and multilateral efforts toward tackling global health issues. Even the global health activists, a picky lot, really appreciate him.

But I am concerned that Kerry will be just another Obama. Despite Obama’s vocal support for eradicating global health problems, numbers and facts disagree. While many newspapers, global health groups and relief organizations see Kerry as a Mr. Fix-it — a hero to save the apocalyptic fate of global health funding — I am still skeptical. History tells me to wait and watch.

Divya Balaji is a junior in Jonathan Edwards College. Contact her at divya.balaji@yale.edu .

Comments