There are two different stories being told about the global AIDS crisis. The first is told by President Bush and his appointees. In January, Bush made headlines with his State of the Union promise of $15 billion over five years to fight global AIDS. He accepted praise for the pledge of "a work of mercy beyond all current international efforts to help the people of Africa," and endorsed an authorization of $3 billion for 2004.
But now Bush is quietly backing away from the promise.
When explaining to Congress why Bush now supports nearly $1 billion less for the first year of his five-year plan, the president's aides cite a lack of "absorptive capacity" as making it impossible for the full amount to be spent. Randall Tobias, the former Eli Lilly CEO and Bush's appointee to head the U.S. Emergency Plan for AIDS Relief, adheres to the Bush story line. Tobias told senators a lack of infrastructure, not money for life-saving medicine, is the main obstacle in confronting the crisis of infectious disease in developing countries.
During a recent visit to Indianapolis, Winstone Zulu told a different story, one where all four of his brothers are now dead from tuberculosis. "I lost my brothers not because of a lack of infrastructure, but because of a lack of drugs," he says. "TB drugs only cost about $10 for a full course of six months of treatment. I lost all of my brothers because my government couldn't afford that."
Zulu is a Zambian who has been living with HIV/AIDS since 1990. Like so many other HIV patients, his compromised immune system led him to struggle with tuberculosis as well. After he took the unimaginably courageous step of being the first person in all of Zambia to acknowledge being HIV-positive, friends helped Zulu get drugs to control the HIV and cure the TB.
But Zulu's pharmaceutical good fortune is rare in Africa, and even in his own family. When Zulu hears Bush appointees talk about a lack of capacity to spend money to buy life-saving treatment in Africa, it sounds like the echo of decades of rhetoric used to justify inaction while AIDS built into the worst pandemic in recorded history.
"There have been so many excuses for not helping," Zulu says. "In the past, when it came to providing antiretroviral drugs, there was an argument that in Africa the water is not clean so people could not take the medicines, or that we could not take medicines because we can not read time.
"This idea that there is not capacity to absorb the treatment is another excuse. Why not use some of those billions to build the capacity? The U.S. has put people on the moon, they are rebuilding Iraq, they are rebuilding Afghanistan.
"But even before then, there are places in Africa where they can already start. Where I come from, there is an airport where 747s land, there are Holiday Inns, there are facilities. There are many places in Africa where the infrastructure and the personnel are there."
Sen. Richard Durbin (D-Illinois) agrees, and has sponsored several amendments to Senate spending bills that would restore the missing $1 billion in global AIDS funding. Particularly appropriate was the Durbin proposal to divert to the AIDS fight $1 billion of the $87 billion extra that Bush requested for Iraq operations. "When you consider that 17,000 people die every day from three diseases - malaria, tuberculosis and HIV - there can never be a worse enemy, a worse terrorist, than those three," Zulu says.
Durbin's amendments have been defeated, with Sen. Evan Bayh supporting the amendments and Sen. Richard Lugar opposing them. But last week, both senators did join in an 89-1 majority vote to increase the 2004 AIDS funding to$2.4 billion, $400 million more than Bush wants.
Even in the face of indifference to the deaths of his family and neighbors, Zulu and other activists press on. Why? "Because doing nothing is not an alternative," he says. "This is a disaster going on, and you can't say we should wait until the structures are in place."
Fran Quigley is a contributing editor to NUVO, where this article originally appeared - ...