In the poem “The Cremation of Sam McGee“, the Canadian poet Robert A. Service wrote, “A promise made is a debt unpaid.” The poem is the tale of a Yukon musher keeping a promise he made to cremate his friend rather than let him be buried in the ice and snow.
I came across the quotation while preparing an announcement for my RESULTS Contra Costa County group meeting. I’ve gotten in the habit of starting my group’s monthly letter meeting with an inspirational quotation or two and I think the one from Service fits this month’s action: holding the U.S. government accountable for failing to fulfill its promise to fund the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
In October, 2010 the U.S. Administration pledged $4 billion over the next three years to the Global Fund. By making the pledge it took on a debt as surely as the musher in Service’s poem. While that pledge represented an increase in funding compared to past years it fell significantly short of the $6 billion that RESULTS and other organizations had been advocating the U.S. to contribute. At the time, to meet the world demand for AIDS, TB, and malaria treatments, the Global Fund would need to have about $18 billion. Since the U.S. comprises one-third of the world economy, it seems fair the U.S. should contribute one-third of the effort. Congress and the Administration supported this view by stipulating that the U.S. would provide up to one-third of the funding for the Global Fund.
Think of a large fire raging along the borders of three cities. To extinguish the fire requires 600 firefighters. Each city needs to contribute 200 firefighters to put out the fire. Due to a lack of understanding and misplaced priorities, however, each city is planning to contribute only 130 firefighters. Meanwhile, each city is actually contributing only 100 firefighters. Obviously, the fire will continue to spread and burn more buildings.
To put the matter in real terms, download and view the Core Pledges Contributions List provided by the Global Fund. On the Contributions worksheet, the list shows the U.S. pledged $1.05 billion for both 2010 and 2011. In 2010, however, the U.S. contribution was short by $264 million and in 2011 the contribution was short by $423 million. When including all sources of income (both public source like countries and private sources) since 2001, the donors have an unpaid debt of $2.2 billion on their promises.
Recognizing that $2 billion shortfall caused the Global Fund last month to announce it will suspend making additional grants until 2014. When Joanne Carter, executive director of RESULTS Educational Fund and a former member of the Global Fund Board, learned of the board’s decision, she wrote:
“This unprecedented decision to cancel plans to fund new grants for vital AIDS, TB, and malaria programs until 2014 has led to a crisis in the international response to these three [AIDS, TB, and malaria] global killers. This was a completely avoidable crisis, and it will leave millions of people without access to basic medical care. The terrible paradox is that it is unfolding just as we’ve turned the corner in the global fight against AIDS. The latest scientific evidence proves that treating patients for HIV early reduces the spread of the virus by 96 percent, halting AIDS in its tracks. At the same time, brand new TB diagnostics that can pave the way toward TB elimination have begun rolling off the shelves. And we’re on our way toward eliminating malaria in countries that were previously the most ravaged.
“It’s in this moment that the Global Fund has been incapacitated by its own donors. It’s as if the Allied Forces have landed in France and are marching into Germany, and the generals have called off the attack. It’s unfathomable. With World AIDS Day rapidly approaching on December 1, all eyes will be on President Barack Obama with the expectation that he’ll announce a historic emergency response that will snap the other donors out of their malaise and put us back on track to defeating AIDS, tuberculosis, and malaria.”
Shamefully, on December 1, President Obama in a speech at a World AIDS Day event in Washington sidestepped the issue of increased U.S. funding for international AIDS efforts by announcing higher targets of people treated financed by improved efficiencies in the delivery of treatment developed over the years.
Funding Priorities
A few days ago, I watched a show on the U.S. Navy’s newest submarine, the USS Virginia. (Once upon a time, I wanted to be a submariner. Unfortunately, the genes that dictate height sunk that dream as I became too tall for submarine service while still a teenager. I became a scuba diver instead.) The USS Virginia class submarines are designed for post-Cold War conflicts involving the need for covertly delivering SEAL teams and hunting down nearly silent electric powered submarines near shore. I bring this up because at the end of the show, the announcer said the Navy was planning to buy 30 of these submarines.
“Thirty submarines!”, I thought in shock. Why in the world would we need to have 30 of these new submarines? “How much would that cost?”, I wondered. I learned each submarine now costs about $2.3 billion, so the total cost would be about $60 billion–assuming the per submarine cost stays constant.
According to Wikipedia’s entry on the Virginia class submarine:
In December 2008, the Navy signed a $14 billion contract with General Dynamics and Northrop Grumman to supply eight submarines. The contractors will deliver one submarine in each of fiscal 2009 and 2010, and two submarines on each of fiscal 2011, 2012 and 2013.[10] This contract will bring the Navy’s Virginia-class fleet to 18 submarines. And in December 2010, the United States Congress passed a defense authorization bill that expanded production to two subs per year.[11] Two submarine-per-year production resumed on September 2, 2011 with commencement of SSN-787 construction.[12]
So what am I doing talking about submarines in a post about the Global Fund? I’m talking about priorities. In 2009 and 2010, while in the midst of national financial hardship, Congress decided that buying more submarines was of greater value than contributing more funding to the Global Fund. The way I see it, this is like the the city council in one of the cities I talked about above, deciding they need to buy an extra amount of better weapons for their police force rather than pay overtime to keep more firefighters fighting the fire destroying lives and buildings on their city limits.
Oh, I know buying more submarines provides more jobs for U.S. citizens in the shipyards and for all the workers making components for the submarines scattered across the U.S. and probably elsewhere. But I also understand that Congress’ failure to keep the promise President Obama made to the Global Fund will not only cost the lives of those overseas, it will cost the lives of U.S. citizens and billions of dollars when U.S. businessmen, world travelers, immigrants, and servicemen catch diseases overseas and bring them to the U.S. An outbreak of multi-drug resistant TB in New York in the early 1990s forced local and federal governments to spend over $1 billion to contain the outbreak. The cost of not treating AIDS, TB, and malaria overseas also costs the U.S. in lost trade opportunities and increased military spending to deal with failed states.
When there’s not enough money to buy every thing, the decision makers in Congress have to prioritize. Unfortunately, when the decision makers are ignorant or prioritizing their own needs ahead of others, we all suffer. So this Saturday, I’ll attend a RESULTS conference call and on Tuesday lead a letter writing meeting, and somewhere in between work to get information to one of my senators and try to lessen her and her constituents’ ignorance.
Like the musher in Service’s poem, I believe in keeping promises. I also believe it’s my responsibility as a citizen to shame my government accountable when it reneges on its promises and demand that it make good on the debt it incurred when making those promises.
More about the Global Fund
For an excellent overview of the Global Fund and how it operates, see this web page on AVERT’s’ web site. AVERT claims to be the “world’s most popular AIDS web site.” I don’t know if that’s true, but the overview of the Global Fund is quite good. I wish I’d written it myself.