Howard Dean's AIDS policy
For over two decades, HIV and AIDS have demanded our attention, spreading suffering and death both domestically and internationally. This is a medical condition that does not discriminate; it targets no nation over another, no gender over another and no sexuality over another. Last year alone, 3 million people worldwide died because of AIDS. Another 40 million people are now living with HIV or AIDS, and they will succumb to this disease unless they have access to life-saving treatment. The pace of new infections is accelerating dramatically, with 5 million more people becoming infected each year. This is a crisis of pandemic proportions and we must give it the attention it deserves.
Here at home, more than 800,000 men, women, and children have been diagnosed with AIDS and nearly a million more are living with HIV, the virus that causes AIDS. Each year, more than 40,000 Americans become infected with HIV, an average of one person every 13 minutes.
Today, AIDS is the leading cause of death in many parts of the world. As their parents die, millions of AIDS orphans — as many as 25 million by the end of this decade — will be left without the care and support they need. Global HIV/AIDS is both a public health and a national security issue. AIDS has the potential to create vast economic and political destabilization in many parts of the developing world. It is time to move beyond the rhetoric offered by President Bush and to focus on real results. The next wave of the AIDS crisis has already crashed on the shores of the most populous nations on Earth, bringing millions of infections to India, China, and Russia. We can’t afford to wait to respond to this pandemic.
In the State of the Union address, President Bush made a promise to the world that he would provide $15 billion to fight AIDS over five years. Instead of providing the $3 billion called for in the legislation he signed, the President only requested $2 billion in his budget. Only $200 million of these funds were earmarked for the Global Fund to Fight AIDS, Tuberculosis, and Malaria —far less than the $350 million the US contributed to the Global Fund last year. The Global Fund is critical because it is the first line of defense against the explosion of HIV/AIDS in much of the world, especially outside the 14 countries in Africa and the Caribbean that the President’s initiative primarily focuses on. Overcoming the aggressive opposition of the Bush Administration, Congress voted to make up some of the shortfall and increase total global AIDS funding. However, Congress has yet to vote on the final spending bill.
It is clear that the President has not only failed to live up to his promise to fight HIV/AIDS around the world, he has also failed to ensure access to life-prolonging medicines for Americans with HIV/AIDS.
As a physician, I understand disease, the need for medical and public health investments, and the role that untreated disease can play in devastating individuals, families, communities, and whole societies. I know the critical importance of prevention and early diagnosis and treatment. As President, I will not stand silent while this disease continues to claim victims. I will stand up for community-based organizations working on the front lines of this battle. I will work to change community norms which allow divisive rhetoric to further blame and stigmatize HIV/AIDS victims. Working in partnership with affected communities and nations, we can develop effective, appropriate responses to a disease that demands our attention. I will join the front lines to fight for real progress in combating this global health crisis of catastrophic proportions.
As President, I will address the domestic HIV/AIDS epidemic by:
Providing quality health care for every American. My plan to extend health insurance to all Americans is based on the lessons I learned as a practicing physician and as a governor. My plan offers health insurance to all uninsured Americans, at well under half the cost of President Bush's tax cuts. By covering those lacking health insurance, we can prevent and provide critical early treatment for serious illnesses such as HIV and AIDS.
Increasing funding for care and treatment. A Dean Administration will promote prevention, early diagnosis, and treatment of HIV. This is especially important for racial and ethnic minorities who are disproportionately affected by this pandemic and who often are diagnosed late or enter treatment later than recommended. A Dean Administration will increase funding for the Ryan White CARE Act. Increases in funding must match the increase in demand for the primary care, pharmaceutical purchasing, and social services this successful program supports. I will also preserve, protect, and defend the Medicaid entitlement and maintain the current enhanced federal Medicaid matching rate formula. Nearly half of Americans living with HIV/AIDS and 90% of children with AIDS rely on Medicaid for their health care. In addition, a Dean Administration will enact the Early Treatment for HIV Act, ensure the funds needed to provide drug treatment are available on demand, and add a prescription drug benefit to Medicare.
Promoting sensible and comprehensive prevention efforts. I have seen the power of prevention in saving lives. There is strong, compelling evidence that HIV prevention initiatives, including condoms, needle exchange programs, accessible testing and progressive education on safe behaviors can reduce the transmission of HIV. We must commit to a sustained reduction in the number of new infections by the end of the next Presidential term. To do so we must renew and reinvigorate our commitment to HIV prevention by fully funding community-based prevention programs and empowering communities to use the tools that work best for them. As President, I will also allow federal funds to support syringe exchange programs. We must invest more money in HIV prevention research to learn better how to sustain behavior change over a long period and to address the needs of new communities affected by the pandemic. A strong emphasis must be placed on prevention approaches focused on women, communities of color, adolescents, and young gay men.
Supporting research and development of treatment without political interference. Our national investment in AIDS research has resulted in new treatments that have dramatically reduced the number of deaths caused by AIDS and increased the length and quality of life of people living with HIV. We must remain focused on developing more effective drugs that are less toxic, easier to take, and less expensive. I strongly support the continued growth in our HIV research efforts at the National Institutes of Health; a cure, a vaccine, and an effective topical microbicide will not be realized if the scientific effort is starved for resources. A Dean Administration will oppose political interference in the scientific agenda of the NIH with regard to research, especially prevention research. Maintaining our commitment to AIDS research is fundamental to our goal of finding a cure for this disease.
As President, I will address the international HIV/AIDS pandemic by:
Restoring our role as a leader in the fight against HIV/AIDS. Fighting HIV/AIDS can no longer be relegated to a single presidential speech or a set of unfulfilled promises. As President, I will use the power of my office to focus national and international attention on the continuing threat of HIV/AIDS to our health, our safety, our communities, and our future. I will convene a Summit of Global Leaders on HIV/AIDS to bring together developed and developing countries to identify common challenges and establish a global agenda to put an end to this pandemic. I will also appoint key Cabinet and Sub-Cabinet officials who are knowledgeable about and committed to destigmatizing HIV.
Renewing the fight against Global AIDS. As President, I commit to providing $30 billion in the fight against AIDS by 2008 to help the Global Fund meets its resource requirements and to fund US bilateral global HIV/AIDS programs. With the right kinds of policies, in cooperation with our friends and allies around the world, we can save millions of lives each year. I will oppose any effort to restrict funding based on ideology not science; programs such as the “abstinence until married” initiative cannot dominate our fight to eliminate this disease, especially in Africa, where 80% of women with AIDS are married. I will also offer deeper debt relief to nations fighting the AIDS pandemic to allow for much needed health investments, beyond the legislation, which the President signed and his Administration has ignored. And I will reject the Bush Administration’s trade policies, replacing them with a trade policy that promotes developing nations’ access to essential medicines, including low-cost quality generic medication, without creating burdensome procedural roadblocks.
Improving the vital healthcare infrastructure needs of the world’s developing countries. Drugs cannot get to patients in the absence of a working healthcare delivery system. We must help place trained medical professionals in underserved areas in the developing world. With significant resources invested in developing and strengthening healthcare delivery systems and infrastructure, we can make the World Health Organization’s goal of 3 million people receiving life-saving treatment by 2005 viable, help ensure that 7 million people receive treatment by 2007, and move towards universal treatment by 2012.
Assisting orphans and children. Often forgotten are the millions of children orphaned or left vulnerable by their parents’ illness. As we work to stop the spread of AIDS, we must also provide basic care, support, and education for these children cast adrift by the AIDS pandemic. While George Bush’s plan does little for these victims of AIDS, I will support billions of dollars for AIDS orphans and lead a multilateral effort, working with our friends and allies, to meet the needs of these children.
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