2003 State of the Union

2002 Bush's State of the Union Address Neglects AIDS

Thu Jan 31, 2002 * Commentary by Thomas Coates, Stephen Morin, Jeff Sheehy
Special to ABCNEWS.com

With 25 million people already dead and 40 million infected, the global HIV/AIDS epidemic is set to surpass the Black Death as the worst plague ever to afflict mankind.

Relentlessly, the virus continues its assault on the human race with 8,000 people dying every day. In the United States, the Centers for Disease Control and Prevention estimates that 40,000 people will become infected with HIV this year.

Yet, President Bush in pointing out the "unprecedented dangers" faced by the nation in his State of the Union address, somehow fails to mention HIV/AIDS.

Financial Neglect

It is a tragedy of these times that the president's superb leadership in the fight against terrorism is not mirrored in his response to HIV/AIDS. Almost daily announcements from this administration disappoint.

Scientists and economists have estimated that $10 billion a year could halt rising death tolls and infection rates in the developing world. UN Secretary-General Kofi Annan has established the Global AIDS Fund to collect and distribute the needed monies.

Monday's announcement from the Bush administration that the U.S. would contribute only $200 million is not only an embarrassment, but paltry support from the world's richest country almost certainly dooms the fund to failure.

Overseas Family Planning

Financial neglect is compounded by policy gaffes. For instance, one of Bush's first executive orders re-imposed the Mexico City Policy.

This policy prevents the federal government from funding overseas family planning efforts. This action obstructs attempts to tackle HIV/AIDS in the developing world.

HIV prevention and counseling for sexual and mother to child transmission are part of the constellation of family planning services. Additionally, many family planning clinics diagnose and treat sexually transmitted diseases (STDs).

Co-infection with STDs makes persons infected with HIV more infectious and uninfected persons more susceptible to HIV infection. Funding family planning clinics is an essential component of any plan to fight the epidemic.

Homeland Epidemic

Domestically, the situation is becoming dire. Last year, budget shortfalls caused 17 states to restrict access to the AIDS Drug Assistance Program (ADAP), which pays for life-saving anti-HIV medications.

With state budgets constrained by the slowing economy and the president calling on Congress to "restrain the federal budget," this state of affairs can only worsen.

Abstinence Based Programs

Hopes that Bush might base his HIV/AIDS policy on science were dashed by last week's announcement that Tom Coburn, a former congressman, will co-chair the President's Advisory Council on HIV and AIDS. Coburn is noted for his advocacy of abstinence-only HIV prevention programs.

This stance is contradicted by the surgeon general's report last year demonstrating that abstinence-only programs are ineffective.

Coburn couples this position with opposition to the use of condoms, which have proven effective in reducing HIV transmission. He is also opposed to needle exchanges, another effective prevention technique.

Coburn's opposition has extended to attempting to block community-based groups doing needle exchanges from receiving any federal funds for any prevention programs.

HIV prevention programs that are proven to save lives need to be implemented. They should not be held hostage to moral concerns.

In these strange times, the ultimate irony may be that while Bush is winning the war against terrorism spawned by religious fundamentalism, he is losing the war against HIV/AIDS by turning the conduct of it over to religious fundamentalists.


Thomas Coates, PhD, is a professor of Medicine and director of the AIDS Research Institute at the University of California, San Francisco.

Stephen Morin, PhD, is an associate professor of Medicine and Director of the AIDS Policy Research Center at the University of California, San Francisco.

Jeff Sheehy is deputy director of Communications for the AIDS Research Unit at the University of California, San Francisco.


2003 State of the Union [flabbergasted]


use back button on browser to return