For all the dignitaries on the schedule at the International AIDS Conference this week in Washington, including Secretary of State Hillary Clinton, Microsoft Corp. co-founder Bill Gates and former President Bill Clinton, it’s the absence of one that has activists talking.
With the conference being held in the U.S. for the first time in 22 years, President Barack Obama is out of town campaigning and raising money for his re-election. His only presence is a 50-second cameo in a three-minute video welcoming delegates. Republican candidate Mitt Romney’s only appearance is in a video message to a meeting on the sidelines of the conference on the role of the faith community.
“It’s a huge missed opportunity,” said Matthew Kavanagh, head of policy for Health GAP, an advocacy organization on AIDS. “The people who are touched by HIV in this country and who care about HIV are potential core constituents for the president.”
Adding to the ire of activists is Obama’s proposed 2013 budget, which would cut funding for the President’s Emergency Plan for AIDS Relief, an initiative started by President George W. Bush, by seven percent compared with 2010 levels.
Part of the calculus for Obama is that the economy, the federal budget deficit and the cost of health care are the dominant issues in his race with Romney. At the same time, public concern about HIV/AIDS has waned.
A survey by the Washington Post and the nonprofit Kaiser Family Foundation found 10 percent of Americans identified HIV/AIDS as the most urgent health problem facing the U.S., behind cancer, which was mentioned by more than a third, obesity, diabetes, heart disease, insurance and health costs. In 1995, 44 percent named it as the most pressing health issue.
Obama’s stops this week, at the Veterans of Foreign Wars convention on July 23 in Reno, Nevada, and the National Urban League Conference today in New Orleans, give him a chance to address issues that will loom larger in November.
HIV/AIDS is “not high on the list of what most voters care about,” said Wendy Schiller, a political science professor at Brown University in Providence, Rhode Island. “But those that would be sympathetic to the movement to reduce AIDS, whether it’s the increase in African-American men or how it affects young children in Africa, are the same people he needs to get out the door and vote for him in November.”
Still, she said it makes sense for Obama to spend his time in front of broader constituencies, including the National Urban League, a century-old civil rights organization.
“The National Urban League is going to be like President Obama’s army, so if you have to make a choice between the Urban League and the International AIDS Conference you go with your solid, loyal troops,” Schiller said.
For many activists, the bigger issue than Obama’s attendance at the conference is his administration’s commitment to funding global treatment for the disease.
Bush more than tripled U.S. funding for global treatment during the last five years of his administration through the program known as Pepfar. With that increase, the U.S. accounted for about 59 percent of all donations for international AIDS relief, according to Jennifer Kates, director of global health and HIV policy for the Kaiser Family Foundation, of Menlo Park, California.
The U.S. has spent about $46 billion since 2003 combating the disease internationally through Pepfar, which primarily funds the purchase and distribution of antiretroviral drug treatments for people in developing nations.
In 2010, the Pepfar budget was $6.9 billion, including money to combat tuberculosis, the leading killer of AIDS patients. If Obama’s current budget plan is enacted, the funding will fall to $6.4 billion in fiscal 2013.
“It’s ironic but Bush, I think, when it came to HIV/AIDS, understood the public health issue better than Obama,” said Jessica Reinhart, a grassroots manager with the AIDS Healthcare Foundation, a Los Angeles-based group that provides AIDS treatment. “The fact that Obama’s going to cut funding for Pepfar could possibly increase new infections.”
Human immunodeficiency virus, or HIV, causes AIDS. The virus attacks the immune system and leaves the body vulnerable to a variety of life-threatening infections and cancers.
A record 34.2 million people worldwide are living with HIV/AIDS according to the World Health Organization. In South Africa alone, a country where almost 1 in 3 people survive on less than $2 a day, 18 percent of those ages 15 to 49 are infected, the data shows.
Wearing a tee-shirt emblazoned with a stop sign and the message “Stop Pepfar Cuts,” Reinhart, who led a protest from the convention to the White House on July 23, said she’ll continue supporting the president. Her enthusiasm has diminished, though.
“He’s upset a lot of the AIDS community, and it could be detrimental to his candidacy,” Reinhart said.
Still, total spending on HIV/AIDS programs has increased during Obama’s term. It would rise to $28.4 billion in fiscal 2013, up from $27.7 billion in 2012 and $27 billion in 2011, according to data from the Kaiser foundation.
Administration officials defended the president’s priorities and his attention to the issue.
Eric Goosby, Obama’s Global AIDS Coordinator, said the U.S. wants other countries to carry a larger portion of the financial load.
“The United States can’t be ministries of health for all of these countries,” Goosby said in an interview. “Our best chance at not having the United States be the predominant resource motor for HIV treatment and HIV/TB treatment on the planet is to bring others to the table to put their resources to it.”
Caitlin Hayden, a spokeswoman for Obama’s National Security Council, said in an e-mail that “the most important metric for Pepfar is lives saved, not dollars spent, and through smart investments we are delivering results.”