Over 33 million people are living with HIV worldwide, with at least 2.5 million new HIV infections in 2007 alone. Fifty percent of those new infections occurred in young people ages 15 to 24, and women are disproportionately affected. By 2010, as many as 20 million children will be orphaned by the epidemic, and infection rates in some impoverished countries are higher than 33%. The global impact of AIDS poses a major humanitarian challenge for the United States, and global health diplomacy provides a vital opportunity to renew our ties to the world community. Indeed, America's place in history will be determined by how well we respond to this still-expanding crisis at home and abroad.
The undersigned organizations and citizens urge members of the U.S. Congress to support the following policy changes within the President’s Emergency Plan for HIV/AIDS Relief (PEPFAR), which is now being reauthorized:
1. Keep the promise of universal access to prevention, treatment, and care by providing a minimum of $59 billion for HIV/AID, tuberculosis, and malaria by 2013 and at least doubling the number of people receiving HIV/AIDS treatment, without reducing funding for core health programs; and ensure that the U.S. contributes its fair share to the Global Fund to Fight AIDS, Tuberculosis and Malaria;
2. Invest new resources to strengthen public health systems and health care workforces. This includes building infrastructure to provide HIV/AIDS and other basic health services, and training and retaining the numbers of health workers needed to achieve the World Health Organization's (WHO) minimum health workforce densities of 2.3 doctors, nurses, and midwives per thousand residents in selected countries.
3. Implement comprehensive, integrated, and evidence-based prevention policies, including increasing the number of people reached by HIV/AIDS prevention programs from 7 million to 12 million, tailoring prevention programs to the needs of specific epidemics and populations, and designing them at the country level. To achieve this:
- Remove the one-third abstinence-until-marriage earmark and fund comprehensive, integrated, and evidence-based HIV prevention programs that promote and protect the health of women, youth, and vulnerable populations;
- Modify and/or expand the guidance on harm reduction in order to support prevention interventions for all drug users, not just among HIV-positive injecting drug users;
- Eliminate the anti-prostitution pledge and support programs that reduce stigma against marginalized populations and promote fundamental human rights; and
- Expand support for research on microbicides and vaccines, while ensuring that currently available prevention technologies are widely promoted, effectively programmed, and accessible.
4. Support trade and licensing policies that protect and expand poor countries' right to affordable generic drugs for important health needs, and ensure that drugs developed with taxpayer resources are available in developing countries.
5. Expand quality treatment and care programs to reflect the U.S. fair-share commitment to supporting one-third of WHO treatment targets, and increase access to palliative care and services, improving patient follow-up practices within PEPFAR.
6. Increase resource and programmatic coordination between PEPFAR-supported HIV prevention, treatment, and care services and other health and development services.
We, the undersigned organizations and citizens, urge members of the U.S. Congress to adopt the above commitments and policy changes in the reauthorization of PEPFAR:
American Jewish World Service, Washington, DC
American Medical Student Association, Washington, DC
American Public Health Association, Washington D.C.
Association of Nurses in AIDS Care, Akron, Ohio
Center for Health and Gender Equity, Washington, DC
Emory University Global Health Organization, Atlanta, Georgia
Global AIDS Alliance, Washington, DC
Global Youth Coalition on HIV/AIDS, New York, NY
Housing Works, Inc., Washington, DC
Student Global AIDS Campaign, Washington, DC
Students Partnership Worldwide, Washington, DC
TDICT Project Trauma Foundation, San Francisco General Hospital, San Francisco, CA
University Coalitions for Global Health, Washington, DC