Forces for LIFE
and Investment in Fighting
Global AIDS Initiative
Increasing the US Government investment in the global battle against AIDS
to begin to reflect the magnitude of this rapidly escalating pandemic.
Making a difference
in Africa and in other highly impacted areas requires broader political
commitment, enhanced community mobilization, and, most urgently, increased
resources. In 1998, spending on
AIDS in Africa totaled only $165 million. Compared to the ever-escalating need and other
health programs, this amount is woefully inadequate. For example, in 1998, over $500 million was
spent for basic childhood immunization programs in Africa. Based on our experience in those countries
that are starting to demonstrate success, such as Uganda and Senegal,
UNAIDS and donors now agree that a minimum of $600 million is needed in
sub-Saharan Africa per year for HIV prevention alone ($2 per adult per
we acknowledge the leadership role that the US plays globally and the
urgent need to act, clearly an effort to combat AIDS must be driven by
many actors including host countries, multi-lateral organizations, and
bi-lateral donors, to be successful.
In FY1999, the US Government spent $74 million in USAID prevention
and care in Africa and $38 million in HHS research and surveillance/prevention. But more remains to be done in sub-Saharan
Africa and in other seriously affected parts of the world.
The Administration proposes to commit an additional $100 million in FY2000
to the global battle against AIDS. This
initiative will enable us to move forward on four critically important
and interconnected fronts including:
the AIDS Pandemic ($48 million) Implement a variety of prevention
and stigma reduction strategies, especially for women and youth, including:
HIV education, engagement of political, religious, and other leaders;
voluntary counseling and testing; interventions to reduce mother-to-child
transmission (MTCT); and enhance training and technical assistance efforts,
including Department of Defense efforts with African militaries.
Home and Community-Based Care ($23 million) Deliver counseling,
support, palliative and basic medical care including treatment for sexually
transmitted diseases, opportunistic infections (OIs), and tuberculosis
(TB) through community-based clinics and home-based care workers. Enhance training and technical assistance efforts.
for Children Orphaned by AIDS ($10 million) Assist families, extended
families, and communities in caring for their children through nutritional
assistance, education, training,
health, and counseling support, in coordination with micro-finance programs.
Prevention and Treatment by Augmenting Planning, Infrastructure, and
Capacity Development ($19 million) Strengthen host country ability
to plan and implement effective interventions.
Strengthen the capacity for effective partnerships and the ability
of community based organizations to deliver essential services. Strengthen
surveillance systems to track the epidemic and target HIV/AIDS programs.
US Government assistance would be provided through AID ($55 million),
HHS ($35 million), and DoD ($10 million). The focus of this funding is HIV prevention,
and AIDS care and treatment. In
those areas, this initiative represents nearly a doubling of funding in
Africa from current levels ($81 million in FY99, which excludes research). The Administration recognizes the fight against
AIDS must be sustained to keep pace with this burgeoning epidemic, and
is committed to a multi-year effort in this critical area.
Building partnerships with other key stakeholders to maximize our
impact on the rapidly expanding pandemic.
US investment in the global battle against AIDS is critical, but is not
sufficient to achieve the outcomes needed. The commitment of in-country
political leaders and of various segments of civil society are key to
success. Moreover, resources provided
by the US Government need to help leverage, and to be coordinated with,
those of other donors, the private sector, and national governments to
ensure synergy and to maximize impact.
Building partnerships with key stakeholders in support of effective
action at the community level is our greatest hope for progress.
This initiative will pursue a variety of strategic opportunities for challenging
other partners to join in an enhanced effort, including:
Meeting On September 7, 1999, First Lady Hillary Rodham Clinton
will convene a meeting of key US officials, The World Bank, UNAIDS,
as well as heads of foundations, corporate CEOs, and others to discuss
how best to enhance AIDS prevention and treatment efforts in Africa
and around the world. The meeting will focus not only on leveraging
additional resources, but also on establishing priorities, identifying
effective public/private partnerships, and identifying targets for action
to combat the crisis of HIV/AIDS.
Leaders Summit We propose
hosting a high-level meeting with Africa government and community leaders
within the next ten months. This
meeting will highlight the critical role of leadership in arresting
the epidemic and will work to encourage increased leadership efforts.
Topics will include the economic impact of HIV/AIDS, examination of
models of success in reducing the transmission of HIV, and addressing
the need for increased investment in health programs. Additional topics
will include AIDS care and treatment and support for children orphaned
- UN Conference on Children Orphaned by AIDS
On December 1, 1999 (World AIDS Day), the United Nations in conjunction
with the National Black Leadership Commission on AIDS, The White House
Office of National AIDS Policy, The Magic Johnson Foundation and a variety
of NGOs, will organize a conference to focus attention on the growing
number of children orphaned by AIDS worldwide.
Special emphasis will be placed on assessing the needs of orphaned
children in sub-Saharan Africa and the Americas.
Participants will include noted experts on the priority issues
identified by UNAIDS, UNICEF, and other UN agencies.
- Business The Department of Commerce will
facilitate a meeting of business leaders active in Africa to encourage
them to increase their efforts to rise to the AIDS challenge. Given
the impact that AIDS is having on businesses as well as the overall
economic-impact on African countries, such a meeting will seek enhanced
business commitment and involvement in AIDS programs.
The Commerce Department
will work with American Chambers of Commerce abroad and other business
organizations to publicize the successful AIDS efforts of US firms
in Africa and to support others taking similar action. In addition,
the Department will direct work to promote closer coordination in
Africa between Commercial Service Offices, other USG agencies, the
business community, and African NGOs in a united effort to promote
corporate partnership in AIDS programs.
- Labor The Secretary of Labor will facilitate a meeting of US and
African labor leaders, and will be co-chaired by the AFL-CIO. The success of the AFL-CIO and its Solidarity
Center in South Africa (supported by USAID) in working with the South
African Trade Union Federations to include AIDS as a key labor outreach
and policy issue provides a model for similar action elsewhere. Outcomes include assisting labor organizations
in educating their members and securing commitments to develop workplace-based
AIDS education and prevention programs, including outreach to youth.
Leaders Summit The US government
will facilitate a meeting of African, American, and other religious
leaders to discuss the important role of communities of faith in the
fight against AIDS. In Uganda and Senegal, the involvement of religious
communities and leaders had a dramatic impact on the ability of these
two countries to reduce HIV incidence and to maintain it at low levels
over time. The outcome of such a meeting would be to increase attention
to the need for involving religious communities, to mobilize these organizations
and leaders in the fight against AIDS, and to identify ways to support
- Diplomatic Initiatives The Department
of State, NSC, and ONAP will work with US and African ambassadors to
increase attention to AIDS within the diplomatic community. The NSC, the Department of State, and USAID will work with G-8 and
other donors, and challenge them to match the increased investment put
forward in this initiative.