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United States’ Fight Against AIDS

On May 27, 2003, Bush signed a law committing $15 billion dollars to fight AIDS in fourteen of the most afflicted countries with this disease over the next five years ([1]&2). AIDS is a global problem that affects everyone in some way or another. Therefore, everyone benefits when someone fights this problem. The AIDS problem has grown so much that organizations and funds are no longer able to handle this problem by themselves. This has become a global problem and now states are the ones who need to take charge in fighting this issue.

This is exactly what the US is doing. The new ill will give much needed assistance to these fourteen countries that are hard hit by AIDS. The objectives are to “prevent 7 million new HIV/ AIDS infections, treat 2 million HIV-infected people, and care for 10 million HIV-infected individuals and AIDS orphans. 2” However, there are two important problems that arise from the aid the US is giving. The first problem is that there will be problems in coordination between the US and other developed nations in giving aid to countries that are hard hit by AIDS.

Other developed countries have an incentive to “free ride” on the US assistance. To solve this, there has to be coordination by multinational organizations such as the UN that will punish those nations that do not contribute money to this cause. Second, there are structural problems in the countries where the aid is going. The problems arise especially when corrupt government officials try to take advantage of the goods the US provides. For example, when the US sends block grants to these governments, corrupt officials can steal huge amounts of money.

To solve this problem the US should rely on international organizations such as UNAIDS and World Health Organization to go to the countries and actually mplement themselves the necessary aid instead of relying on the governments to do so by themselves. Thus the countries receiving the aid must allow for these international organizations to come into their countries and do the work. If these changes can be implemented the US assistance will be effective and good. Furthermore, a structure will be built by solving these two problems by which stronger foundations will stand on so that it will be easier to fight AIDS in the future.

Bush said in his statement regarding the aid given, “AIDS is a significant threat to global development and stability, the US is backing p that understanding with a commitment to substantial new resources. 2” One of the reasons why the US is helping these countries is morality. The US is the most powerful economy in the world and the countries that most suffer from AIDS are among the poorest of the world. Thus, it makes sense that the US should help these states. Nevertheless, there are benefits besides these moral ones that will benefit the US.

The first is that this bill will “highlight the softer side of US foreign policy in the wake of a sharp break with some traditional allies – including France, Germany, Canada and Mexico – over the war in Iraq. ” The economic assistance given will soften countries that are currently against the US and its foreign policies. This legislation will also calm international pressure that wants the US to increase the aid they currently give to these countries. Also, the countries the US will help will owe allegiance to the US. By giving this assistance, the US is creating allies all over the world.

Domestically the Republican Party will benefit because they are the main sponsors of this bill (as both congress and the president are republicans) as people like giving assistance to those who are worse off. This bill ill be especially popular among the African-American population. Furthermore, it will benefit the whole world. It is important to combat AIDS itself. One of the main arguments for fighting AIDS is that governments with, for example, one out of three adults is infected with AIDS become unstable and this becomes a major threat to the whole world, as terrorist organizations or civil wars could take over.

Furthermore, there is the threat that this disease will keep spreading and will eventually reach all over the world. Already this is proving to be a problem in the US and Europe. AIDS is one of the major threats to world stability. People who are infected by this disease will surely die within fifteen years. Therefore people who are infected should be taken care of. However, at this point it is more important to stop the disease from spreading any more. Also we must care for the AIDS orphans who will be left to their own means to survive.

On another note, experts argue that containing the AIDS epidemic today will cost the world a small fraction of the world’s wealth. If developed countries gave as little as one dollar per citizen annually, there would be enough wealth to provide testing, harm reduction interventions, and HIV ducation and prevention programs for the whole world. “The goal must be to immediately marshal sufficient resources to… effectively reverse the epidemic by decade’s end. [2]” As things are now, most of the capital that countries afflicted with AIDS spend on is “treatment, care and support” rather than “preventive measures. 3]”

This is dangerous, as this does not stop the epidemic from growing. Some examples of this are that in sub- Saharan Africa only six percent of people have access to AIDS testing and only one percent of pregnant women have access to “treatment to prevent other-to-child transmissions. [4]” In the Caribbean, most homosexuals do not have information about AIDS[5]. Coordination: One of the biggest threats of the US giving so much economic assistance to the AIDS problem is that other developed countries will stop contributing to this cause and “free-ride” on US assistance[6].

This is not only a problem for the US, but also for the world. The reason is that the US cannot amount for the whole cost of fighting AIDS and thence if other nations do not contribute, there will not be enough resources to fight AIDS properly. To give an idea, in 2002 3. billion dollars were needed to pay for prevention spending and also for care and support spending of AIDS. However, in 2005 it is expected that prevention costs will increase to 5. 7 billions and care and support costs to 5. 5 billions.

In 2007 the increases will be more dramatic, prevention will cost 6. 6 billions and care and support will cost 8. 5 billions. Obviously the new law will not be able to cover the total costs, or even a third of the costs presented here. Thus if other countries free ride on the assistance of the US the whole world will suffer, as the AIDS problem will not be addressed s it should be. AIDS is commonly regarded as a global problem; especially when it strikes in sub-Saharan Africa and other regions in the world that are low-income countries.

Everyone feels they should help this cause; however, seeing that the US is giving so much money other states will want to stop giving a part of their capital to this cause. Furthermore, many countries charge that since the US has such an overwhelming wealth it should contribute most or all of the international aid given to AIDS stricken countries[7]. One of the initial ways the US tried to combat the free-rider problem s that there is a part of the part of the new law states that the “maximum amount the U. S. can contribute… to the global fund… is limited to 33% of all contributions. 8]”

Thus with this the US tries to stop the free- rider problem in the fact that unless the rest of the world can match the other 66. 6% of the necessary money, the US will not give the total amount it is supposed to, but only the percentage that is 33% of the total. This is a good incentive to make other countries stop free riding. But even with this, other countries will free ride on the 33% that the US is paying. Therefore, there needs to be another way to fight free riding. The answer to this problem is to have multinational organizations make sure that all countries contribute to this cause.

The best way to do this is by having organizations such as the UN or the World Bank enforce penalties on those countries that do not contribute to the cause. The punishment might come in form of economic sanctions or grants or so on, but the main point is that the costs of the punishment have to be greater than the amount of money they have to pay, that way they will have an incentive to pay for this cause. Therefore this way it is ensured that no one will free-ride as costs will be established at the beginning and surely most countries will want to pay rather than face the sanctions.

As a matter of fact the US president is already pursuing this fact as he is lobbying other countries to contribute to the problem. The AIDS epidemic should be handled multilaterally, he said. “The US leader said he would deliver that message when he attends the June 1-3 Group of Eight summit in Evian, France, and comes face-to-face with leaders of the world’s seven major industrialized nations plus Russia. 9]” Thus unless there is coordination by an international organization in the coordination of giving aid, there will not be a maximization of the way that we will fight AIDS, and this will ultimately hurt the whole world.

Structural Problem: “The US president said that [his proposed] plan [to combat AIDS] would prevent seven million new HIV infections, treat at least two million with life-extending drugs, and provide care for millions who already have AIDS or were orphaned by the disease. 2” For the US to reach these goals it will have to overcome several structural problems in the countries receiving the id to effectively fight AIDS. Government obstructionism and indifference have proven to be the greatest deterrent in making a significant advance in combating AIDS in Africa[10].

According to Richard Tren, director of South Africa’s “Africa Fighting Malaria” organization, “Fifty [sic] percent of medical resources are stolen[11]” and corrupt government officials keep the block grants given by the US to fight AIDS. He further states that there is a lack of human capital and physical capacity in these countries. For example, there are not enough doctors to administer tests to see who has AIDS or even if there are, there are no buildings where they can administer the medicines. In some countries the governments have underplayed the threat that AIDS has on their population.

Government corruption is a major threat to the expedient and efficient effects of this law that hopes to combat AIDS. The harshest critics of programs to help the AIDS problem argue that “Western assistance to Africa often does more harm than good, owing to corrupt and inept governments, which are the recipients of this aid. [12]” They argue that giving these block grants to these countries makes it easy or government officials to steal goods. Relating to structural problems are social customs that are unlikely to change unless there is an active interest by the government or organizations into changing this.

For example, it is known that most HIV transmissions stem from heterosexual sexual behavior[13]. However, young women 15-24 are twice as likely as young men from being infected with AIDS. Furthermore, women account for 58% of all HIV infections. This is largely due to the fact that women can be raped or that women cannot force their male partner to use a condom in Africa. This important social inequality akes AIDS difficult to combat. Only by education will people learn the dangers of having unprotected sex. However, since there is not an active fighting of these norms, there will be no changes.

Besides the problems already listed, there are physical and industrial problems that will never be overcome if the capital by the US is not invested properly. An easy example is the difficulties of producing enough condoms and delivering them to the afflicted regions. “According to UNAIDS, the six to nine billion condoms that are distributed each year constitute as little as one quarter of what is needed to reach those in eed. [14]” First of all, factories would have to be built that would produce condoms that will stop AIDS.

Second, there must be a distribution system to get the condoms to the places they need to go. This is a difficult task but it can be solved if the governments are willing to help. Another example is that at this moment only 50,000 people in Africa are receiving AIDS-related quality treatment, and to increase this number to half a million in a short term, and 2 million in five years, there will need to be much training of doctors and much building of clinics. A large nvestment would have to be made to upgrade the medical infrastructure.

You cannot create doctors from one day to another, nor the hospitals or clinics they will work in, it will take time and money but it is possible if the money given is used correctly. Thus we see that there are many problems that must be overcome. However the proper solution to this is to have the governments that are affected by this allow organizations to come in and work themselves to solve these problems instead of relying on the governments to do so. Thus UNAIDS should get access to the countries and build the necessary uildings, train the necessary people, and educate where necessary.

There has to be an active participation in overlooking that all the money spent will go to the proper places. Furthermore, the UNAIDS can send its own doctors to administer tests or medicines if there are none in the countries. Only by making sure that the aid gets through will the money be used effectively to what it is meant to be. Otherwise we should not expect that we would meet Bush’s expectations. Fifteen billion dollars is a very large amount of money for African government officials to steal. However, t is even worse that the people who have AIDS do not get to enjoy its benefits.

Furthermore, not fighting the problem today will cause a global problem that may be uncontrollable in the future. If the US can overcome these structural problems this will maximize the amount and quality of aid given to AIDS stricken countries. Conclusion: The US spent approximately one billion dollars in 2002 in funding for HIV/ AIDS interventions in developing countries[15]. As it is, the “measure Bush signed would triple the annual [United States’] AIDS-fighting budget2” to three billion a year. Thus with this new measure we hope that the US will increase its effectiveness in fighting AIDS.

The AIDS epidemic is a global problem that must be solved, especially in those countries where the percentages of HIV infected people are very high. However, to effectively combat AIDS the US must overcome the coordination and the structural problems. I believe that coordination is a very important factor that must be overcome to effectively fight AIDS. The free-rider problem poses a huge threat to properly fighting AIDS. We need a multilateral effort whereby developed countries will contribute to this cause.

The best way to ensure that this gets done is by having an organization, such as the UN or the World Bank, make sure that developed countries pay a certain amount to combat the disease or they will suffer some punishment. Thus there needs to be a coordination in the world community to make sure that everyone plays its part in fighting this disease. The price of treating AIDS is rapidly increasing. Thus there is an urgent need to tackle this problem as soon as possible. Furthermore, there needs to be a way to overcome the structural problems that are caused by having the governments receiving aid not using t properly.

Only when organizations such as the UN or WHO come in and implement the programs themselves can we be sure that the assistance is getting through. Furthermore, if this can be properly executed, things will become easier in the future. Thus, for example if we build a condom factory today, it will work for many years to come; the same applies with building hospitals and training doctors. Thus paying a structural price today will help the future. Fighting AIDS is a good investment as it benefits everyone.

It is better to treat the problem now that the epidemic is still manageable than couple of years down the road when we will be unable to do anything. The US has taken an active step in fighting AIDS. However, we need to make sure that the problems of coordination and structure are faced so that the aid given is actually implemented to benefit those afflicted by the disease. Critics to giving this sort of aid to afflicted countries contend that giving aid to these countries is not sustainable. Only when these countries become democracies that embrace capitalism will they overcome the problem.

By having an open government and industry, a mass media, an ducational system, and all the other benefits that capitalist countries enjoy, the problem will be dealt with from within and eradicated more efficiently than if done by sporadic aid from abroad. This is definitively true but we need to see that these countries will not change from one day to another. Thus at this point, developed countries must take an active role in fighting the epidemic and also trying to open up and liberalize these countries. If we become passive in helping these countries out the AIDS problem might become too big for even the developed nations to handle.

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