AHF members urge Congress to honor AIDS funding commitment

Five AIDS treatment clients and medical care providers from Uganda are visiting Washington, DC for a series of over 50 meetings this week on Capitol Hill with Senate and Congressional leaders to lobby Congress to honor the US' landmark commitment to PEPFAR (the President's Emergency Plan for AIDS Relief), the successful US global AIDS program. The group, all of whom are treatment clients or medical health care providers of AIDS Healthcare Foundation (AHF), which provides AIDS medical care to more than 138,000 individuals in 23 countries worldwide, will lobby Congress to increase PEPFAR funding to ensure that funding for PEPFAR's lifesaving efforts comes closer to the full $48 billion authorized by Congress in 2008; to urge legislators to demand accountability so that PEPFAR countries operate their AIDS treatment programs in the most cost effective ways by reducing the amount permitted to be spent on overhead and bureaucracy; and to immediately eliminate caps on the number of people allowed in PEPFAR-funded treatment programs in hard-hit countries like Uganda and elsewhere.

“provide at least $50 billion by 2013 for the global fight against HIV/AIDS . . . in order to at least double the number of HIV-positive people on treatment and continue to provide treatments to one-third of all those who desperately need them.”

"As both a health care provider and client at one of AHF's African clinics, I stand here today in Washington as living proof that antiretroviral treatment saves lives if people have access to them," said Uganda's Grace Akampumuza, who has also been trained by, and works as an HIV Medic for, AHF's Uganda CARES. "I urge the U.S. Congress to reconsider this crucial AIDS funding and continue to honor the commitment the US has made on funding lifesaving treatment through PEPFAR. In Uganda, most of my close relatives, including my husband, have died of AIDS. He left me with three children. I was lucky enough that my children are HIV negative, but when my own health started deteriorating and I decided to go for an HIV test, my test result was positive. My health failed; I was not able to walk or do anything for myself and I knew for sure I was going to die. After some care and treatment at a private clinic, I heard about AIDS Healthcare Foundation, this organization that was giving free ARVs in Masaka. In June 2003, I started getting free ARVs from the AHF/Uganda CARES clinic. Since that time my life has changed, I live with the virus on a daily basis, every day I am confronted with the real thing. Treatment has saved my life. I take my pills at the right time, in the right way and the right dose. I am happy to see my children grow, because I was otherwise going to die when they were still very young."

Not only is Akampumuza one of the client success stories of AHF's free AIDS treatment clinics in Uganda, she has also become an integral part of AHF's Uganda-CARES team of health care providers. Akampumuza, who had formerly been an accountant, was trained by AHF to become an "HIV Medic," a treatment extender and community health worker who performs routine, but time-consuming tasks such as taking a patient's blood pressure and medical history, which frees up valuable time for doctors and nurses to see and treat more patients. AHF's HIV Medic training program is an innovative approach by AHF to address the urgent need for AIDS care providers in Africa and elsewhere in the developing world.

Background on PEPFAR

President Bush created PEPFAR in 2003 with unanimous, bi-partisan support. PEPFAR has been a resounding success, providing lifesaving AIDS treatment to over 2.4 million people (resulting in a 10.5% reduction in the HIV death rate in partner countries), preventing millions of new HIV infections, and providing care to over 3.6 million orphans and vulnerable children. Building on this success, Congress reauthorized PEPFAR in 2008 with expanded goals for treatment, prevention, and care. When campaigning for President, then-Senator Obama promised to "provide at least $50 billion by 2013 for the global fight against HIV/AIDS . . . in order to at least double the number of HIV-positive people on treatment and continue to provide treatments to one-third of all those who desperately need them."

The U.S. Retreat on its Commitment To Fight Global AIDS

Despite the strides PEPFAR has made, the fight against AIDS is in retreat. PEPFAR is not fully funded, and the administration has disregarded laws that would ensure that programs are cost effective and treat the most people possible. Inefficient and wasteful practices continue, denying care to millions. The catastrophic impact of this retreat is under way. Treatment programs in Uganda, Mozambique, Botswana and Nigeria have instituted caps on treatment slots and are turning people away or experiencing drug shortages.

Solutions—AIDS drugs cost less than $100 per person per year; the money already authorized by Congress is enough to treat everyone who needs it, if it is spent effectively. To achieve this, AHF proposes the following:

• PEPFAR should spend no more than $350 per person per year for treatment. Waste and overhead pushes average PEPFAR treatment costs per patient to over $1,100 per year. There is no reason for this, when AIDS drugs, the most expensive part of care, cost less than $100 per year. Capping expenditures at $350 (many programs provide care for less than this) will ensure that all people who need it can access care.
• Increase funding for PEPFAR by at least $1 billion for FY 2011 and each year thereafter. Increases of at least $1 billion over each of the next 3 years will ensure that funding approaches the full $48 billion authorized by Congress.
• Remove waste by limiting administrative overhead for contractors to 10% and all indirect costs to 20%. Too much PEPFAR money is going to bureaucrats and middlemen, money that should be going to treatment. Domestic AIDS programs limit administrative costs to 10%. PEPFAR contractors should be held to the same standard.
• Require that 75% Of All PEPFAR Funds Be Spent On AIDS Treatment. Current law requires that half of all PEPFAR funds be spent on care and treatment. It is increasingly clear that treatment not only saves lives, it is the most effective prevention tool available. To ensure there are sufficient funds for treatment, and to finally reduce new infections, a floor for funding for treatment should be set at 75%.

The United States, working together with the world, has the ability and resources to control AIDS globally. To retreat now, after all the progress that has been made, would be an unnecessary catastrophe.

AIDS Healthcare Foundation (AHF) is the largest global AIDS organization. AHF currently provides medical care and/or services to more than 137,000 individuals in 23 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia Pacific Region and Eastern Europe. www.aidshealth.org

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