It is a good bill. It had broad support in Congress and in the aid community. But it is also expensive: $48 billion over five years. At a time when automobile companies and financial institutions and a growing number of unemployed American workers are coming hat-in-hand to Washington, it might be tempting to look at that number and decide not to fully fund the authorized amount for PEPFAR.
That would be a huge mistake. For starters, any backsliding in the fight against HIV and AIDS is going to be costly. It is much more expensive to play catch-up than to keep the momentum going. Part of this is medical: If someone goes off of antiretroviral treatment, the virus adapts. Starting treatment again requires a more expensive drug regimen. Part of it is logistical: If the current structure built to fight HIV and AIDS is not strengthened and extended but instead allowed to crumble, rebuilding it will cost much more.
Part of the reason is that it makes good foreign-policy sense. The HIV epidemic is one of the main stumbling blocks that developing countries face as they seek economic improvement. Untreated, the disease's spread kills the productive adults in a society, leading to lethargy, fatalism and despair, enemies of the modernization these countries need. Such despair is a breeding ground for the kind of chaos that leads to international insecurity. Funding PEPFAR lets the people of these countries know that the United States is on their side.
But the main reason for fully funding PEPFAR is that it is the right thing to do. This horrible pandemic is affecting the poorest people in the world, those least able to address the ravaging effects of this disease. If we do not help them, we will cede the moral authority that the United States needs to lead the world in the 21st century.
Ken Hackett is president of Baltimore-based Catholic Relief Services. His e-mail is president@crs.org.
