Security concerns and the increasingly likely military confrontation with Iraq dominated President George W. Bush's State of the Union Address Jan. 28. However, AIDS received its greatest prominence ever in such a presidential address.
The teaser came in the introductory moments when Bush said, 'We have the opportunity to save millions of lives abroad from a terrible disease.' The delivery came about halfway through the speech, immediately before focusing on terrorism and Iraq.
'Today, on the continent of Africa, nearly 30 million people have the AIDS virus—including three million children under the age of 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than four million require immediate drug treatment. Yet across that continent, only 50,000 AIDS victims—only 50,000—are receiving the medicine they need.'
Bush noted that the cost of combination therapy within those impoverished countries 'has dropped from $12,000 a year to under $300 a year—which places a tremendous possibility within our grasp.'
'Ladies and gentlemen, seldom has history offered a greater opportunity to do so much for so many. We have confronted and will continue to confront AIDS in our own country. And to meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief,' he said.
The combination of prevention and therapy will 'treat at least two million people.' He asked Congress 'to commit $15 billion over the next five years, including nearly $10 billion in new money, to turn the tide against AIDS in the most affected nations in Africa and the Caribbean.'
Patrick Guerriero, executive director of Log Cabin Republicans, said the plan and pending appointments of new members to the Presidential Advisory Council on HIV/AIDS make it 'clear that the Bush administration is fully committed to combating HIV/AIDS here and across the world.'
Paul Davis, with ACT UP Philadelphia, has been one of the most fervent advocates for access to treatment for Africa. That advocacy has led to his arrest outside the White House. Davis had kind words for the speech. 'Tonight, we applaud the President for acting to address the plague of AIDS in Africa, and we are particularly encouraged by his focus on getting treatment for 2 million people.'
'The President's announcement is a tremendously encouraging sign that he is taking this issue seriously, not just on a rhetorical level, but in terms of the budget,' said Paul Zeitz, executive director of the Global AIDS Alliance. 'We are especially delighted he so clearly recognized the urgent need for cost-effective AIDS treatment.'
AIDS activists were quick to criticize Bush's lack of emphasis on domestic AIDS issues. But Jan. 31, he also pledged to increase U.S. AIDS funding.
The Human Rights Campaign welcomed Bush's request that Congress increase much-needed funding to fight the AIDS epidemic in the United States.
'In America, far too many people are still getting infected with HIV or dying from the disease and we applaud the president for attempting to meet the challenge of effectively fighting AIDS at home, as well as abroad,' said HRC director Elizabeth Birch.
Bush said that the AIDS diagnosis 'still obviously brings tremendous grief and worries in parts of our society. And so the budget I've submitted and worked with Congress on—it will be a request for $16 billion for domestic HIV prevention and care and treatment, a 7 percent increase over '03. It's a $93 million increase for AIDS research, $100 million more to support the AIDS Drug Assistance Program. This is a program which provides funding to purchase AIDS-related medicines for those without health coverage. And we're going to help those abroad and we'll help those at home, as well.'
'We applaud President Bush for signaling a renewed commitment to increasing access to life-saving HIV medications in this country by requesting increased funding for the ADAP program—a program that is currently not able to meet the need in many states due to depleted funds,' said Birch.
Bush also pushed an initiative to increase HIV/AIDS testing in the U.S. 'We must also move quickly to increase the number of people who are tested for HIV,' said Bush. '... And so the Food and Drug Administration recently has approved a new HIV test, which can provide results in less than 30 minutes, with a 99.6 percent accuracy. ... The Department of Health and Human Services, after a lot of careful review, has waived regulations so that the test will soon be more readily available ... .'
Questions remain about the actual size of the budget increase—HRC said it is still unknown if Bush's number is a 7 percent increase over the fiscal year 2003 budget proposal or the fiscal year 2003 appropriated level, which has not yet been completed. If Bush is increasing the budget 7 percent from his fiscal year 2003 budget, then this request could contain a much smaller increase than 7 percent between fiscal year 2003 and fiscal year 2004 because Congress is most likely going to appropriate at least that much for fiscal year 2003 in the coming weeks.
HRC still has concerns about the administration's focus on abstinence-until-marriage education. HRC believes these programs are ineffective, omit lifesaving facts and ignore the needs of gay, lesbian, bisexual and transgender people—particularly GLBT youth.
The CDC reports the number of Americans living with AIDS in the U.S. increased 33 percent between 1996 and 1999. In 2001, 15,603 Americans died from AIDS; AIDS is now the leading cause of death for African Americans in the 25-44 age group.
