Fight AIDS Around the World

More than 40 million are living with HIV worldwide, and each year more than three million people die from AIDS. By 2010, there will be as many as 20 million children orphaned by AIDS. The infection rates in some impoverished countries are greater than 33%, and the impact of AIDS poses major humanitarian challenge to the United States. Within the United States, HIV/AIDS is disproportionately affecting people of color, and prevention and treatment are still underfunded; strong leadership is needed to defeat the epidemic. Global health diplomacy provides one key opportunity to renew internationally our ties to the world community. America's place in history will be determined by how well we respond to this still-expanding crisis at home and abroad.

To address HIV/AIDS and the factors underlying the epidemic, the undersigned organizations urge the President of the United States and other U.S. political leaders to:

1. Keep the promise of universal access to prevention, care and treatment [1] by providing at least $50 billion by 2013 for the fight against HIV/AIDS [2], including at least doubling the number on treatment supported by the U.S. to four million (one-third of the people estimated by UNAIDS to be in immediate need of medicine to survive) and contributing the U.S. fair share of the budget of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) [3];

2. Fund these HIV/AIDS programs as part of a commitment to direct at least an additional one percent of the U.S. budget toward meeting basic needs and fighting poverty in impoverished countries [4];
3. Invest new resources to strengthen public health systems and to train and retain the numbers of health workers needed to meet and sustain international health goals the U.S. has committed to by 2015 and achieve minimum health workforce densities of 2.3 doctors and nurses per thousand residents in selected countries [5]. This investment should be accompanied by new policies to address brain drain by expanding health training in the U.S. [6] and by discouraging active recruitment from impoverished countries;
4. Support trade policies that protect and expand poor countries' right to affordable quality-assured [7] generic drugs for important health needs. Adopt humanitarian licensing policies that ensure drugs developed with taxpayer resources are available off-patent in developing countries;
5. Implement comprehensive, integrated and evidence-based prevention policies that explicitly address the needs of all at-risk populations, including funding and technical support for universal access to male and female condoms, voluntary male circumcision, HPV vaccinations and prevention equipment and treatment for injection drug users as well as new expanded research on effective microbicides and vaccines; integrate sexual and reproductive health services with AIDS programs
6. Meet the needs of children orphaned and made vulnerable by AIDS through community-based support, including ensuring children a loving permanent home, food to nourish them, free public schools, laws and systems in place that protect them, access to medical care and training programs to learn how to make a living as adul;
7. Promote the political and economic empowerment of women and girls by securing property and inheritance rights, access to universal education, and freedom from violence;
8. Drop 100% of the debt of 67 of the most impoverished countries, while removing harmful conditions that delay relief, and reform policies that deny access to the poor and limit poor countries' national investments in health and education, including public sector wage caps, user fees and other policies barriers to access;
9. Fight tuberculosis and malaria as part of a comprehensive plan to combat HIV/AIDS. The U.S. must work to achieve targets agreed by G8 leaders to reduce tuberculosis deaths and prevalence by 50% and reduce the malaria-related disease by 50% by 2010 [8];
10. Create an independent poverty-focused cabinet-level agency to ensure that poverty alleviation at home and abroad is as much a priority as defense or diplomacy. This agency would prioritize investments to reduce suffering in the most impoverished nations and communities, coordinating efforts between developing countries, local governments, other donors and multilateral institution.

1. As part of universal health care initiatives, develop a plan to provide universal access to HIV prevention, treatment, care & support in the US by 2010, as promised at the UN in 2001 and 2006;

2. Ensure lifesaving HIV treatment and care for all people living with HIV through universal health care initiatives, utilizing 2005 recommendations on HIV care expansion from the Institutes of Medicine, including a $7B care expansion for low-income PLWHAs;
3. As an interim step towards universal health care, expand Medicaid nationwide through passage of the Early Treatment for HIV Act; end all ADAP waiting lists through full funding of the Ryan White CARE Act; and plan for incorporation of RWCA programs in universal initiatives;
4. Reduce new HIV infections by investing at least $1 billion a year for science-based HIV prevention strategies through the CDC; ensure all HIV testing initiatives include a link to guaranteed HIV treatment and prevention services;
5. Eliminate funding for ineffective abstinence-only-until-marriage programs, while creating a dedicated funding stream for comprehensive sex education by supporting the REAL Act;
6. End the ban on federal syringe exchange funding;
7. Increase funds for HOPWA AIDS housing programs and care coordination and support initiatives; build support at all levels of government for strong and consistently accessible AIDS housing efforts;
8. Boost American leadership in HIV/AIDS research for a cure and more effective prevention and treatment options through a 10%-plus-inflation increase for the National Institutes of Health (NIH) and its AIDS research programs each year of your first term; pass the Microbicide Development Act and commit to funding a diverse portfolio of HIV prevention research in the US;
9. Ensure opportunities for work and self-support, medical privacy, conformance with the 1983 Denver Principles and full human rights for people living with HIV/AIDS;
10. Address the prison-related AIDS epidemic by reducing the number of people living with and at risk for HIV in the criminal justice system by half, starting with changing the federal penalty for crack-cocaine to equal the current amount for powder cocaine and supporting H.R. 460;
11. Ensure HIV treatment, prevention and services for high-impact/high-need communities including Blacks & Latinos, men of color who have sex with men, African American women, youth, people who are incarcerated, homeless and/or active substance users and other marginalized populations.