Time to Fight the AIDS Backlash

Last week, Jina shared the disturbing news that those testing positive for HIV/AIDS across the developing world are being denied treatment. The immediate culprit for this? The Obama administration, which decided in 2009 to essentially flat-line its funding of HIV/AIDS programs.

But another community which has to confront its role in this phenomenon are global health advocates, many of whom in recent years have questioned whether the AIDS movement has distorted health system priorities and taken money away from other critical issues. AIDS treatment activists have even been painted as "bullies," rather than allies — and vital leaders — in a broader movement. Unfortunately, the global health movement has failed to move beyond this false debate, which pits disease against disease. The result is that our overall ability to pursue a bolder, collective push has been diminished.

In the face of the recent news on AIDS treatment, how should the global health community — from maternal health advocates to health system gurus -- respond? It should be clear to all: In this critical moment, we need to respond to this challenge by locking arms with AIDS activists.

Perhaps the most obvious reason to lock arms is because people do not live their lives in separate programmatic areas. An HIV/AIDS patient may be a mother, a malaria patient, a child. The AIDS "backlash" does little to acknowledge these connections.

AIDS activists — as they should — will keep fighting hard to continue increasing the treatment funding that can support new patients. It's possible that money could be shifted away from other priorities in the U.S. global health budget and directed towards AIDS treatment. Alternately, the status quo might not change, leaving new HIV/AIDS patients to die and jeopardizing many connected public health goals. 

But those aren't our only two options. Rather, global health advocates across the spectrum — including HIV/AIDS activists — should work together to push for a platform that addresses systemic issues (infrastructure, health workforce, etc.), while using the symbolic capital that the AIDS movement has successfully deployed over the past 15 years. Such a strategy would ensure that the overall pie expands as much as possible for everyone.

As global health advocates, we also need to be smarter about the kind of rhetoric we use. When we talk about recent funding increases for AIDS (and global health more broadly), we throw around a lot of dollar signs. But instead of talking simply about cost, a better way to focus on the numbers might be according to need: we're still only treating 4 million out of the 10 million that need AIDS treatment today. The money we've got is not nearly enough — not for AIDS, and not for other public health issues as well.

A global recession could push those who advocate on behalf of the sick to keep fighting each other over a relatively small amount of resources. Or we can use this challenge as an opportunity to stand together for a more united approach to global health.

It's time to make a choice.

Photo Credit: dominics pics