Bill & Melinda Gates Foundation

An Impatient Optimist's View of HIV

November 30, 2011

In 1981, I was a surgeon in training at Massachusetts General Hospital in Boston. I still remember the day we learned about a strange, new, deadly infection that presented on the West Coast. A little over a year later, we learned it was caused by a virus transmitted in the blood, a vital fact for a doctor performing surgery every day.

As I watched the epidemic grow from a handful of cases to a few hundred to several million, I also witnessed the cases grow in biblical proportions in less developed nations, namely across Africa. While I served in the Senate, I volunteered on annual mission trips to do surgery in villages ravaged by civil war. In these forgotten corners of the world, I witnessed how HIV was hollowing out societies.

Drawing on these firsthand experiences, as the Senate Majority Leader I encouraged and supported both the PEPFAR program and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

The Global Fund, a multilateral institution with the U.S. as the leading contributor, leverages $2 for every single dollar given, all to combat this trilogy of diseases that disproportionately attack children and young adults in the poorest nations on the planet.

The remarkable news is that millions of lives have been saved by these investments. Thanks to the Global Fund, over 3.2 million people living with HIV are on lifesaving treatment.

I am proud to have been part of a government whose leadership, acting on behalf of the American people, has led the world and literally saved the lives of millions of people globally.  

In 2008, I co-chaired the ONE Campaign’s ONE Vote ’08 Campaign. We brought a delegation of Republicans and Democrats to Rwanda to see firsthand the good work being done by the funding of the Global Fund, PEPFAR, and the President’s Malaria Initiative.

In Eastern Rwanda we visited the inspiring Rwinkwavu Clinic, run by Dr. Paul Farmer’s Partners in Health. With 110 beds and eight health centers, this clinic provides essential medicines, supplies, and equipment and recruits, trains, and retains staff to ensure a sustainable infrastructure for the future.

But without Global Fund funding, the Rwinkwavu Clinic could not provide health care services to the people of Rwanda. This is true for so many organizations and clinics worldwide.

And it’s unfortunate that even though we see investments pay off, lives saved, and economies grow, the Global Fund was forced to cancel its round 11 funding. This means clinics like Rwinkawvu will only be able to support those currently on HIV treatment and not add any new patients. This is alarming because in low-income countries half of people living with HIV are not receiving treatment.

At a time when our own economy is faltering, and our national debt is growing unacceptably, we have to tighten our belts. To do so, we need to decide where we make smart investments and where we do not.

The fact is that the American people spend less than one-quarter of 1% of our federal budget on global health and fighting global epidemics like HIV, tuberculosis, and malaria. With this little sliver of the pie, the Global Fund’s return on investment means more sustainable economies, less global instability, and healthier families. For less than a penny to the dollar spent on all foreign aid, we are investing in the lives of children, mothers, and our own national security.

On the horizon is excellent news for HIV. New evidence suggests male circumcision, microbicides, and quicker AIDS treatment will markedly decrease the disease. Combined with known prevention methods like condoms and nevirapine, we are on the right track to substantially halt the growth of HIV/AIDS.

I’m an optimist, an impatient optimist. We will win the war on HIV, tuberculosis, and malaria.  Our investments have worked. The end is in sight. We just have to be smart enough to continue to invest wisely, using health as a currency for peace around the world.

 
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