The President's Emergency Plan for AIDS Relief: Stepping Up to the Global Challenge

U.S. Global AIDS Coordinator, Ambassador Randall L. Tobias emphasized the importance of prevention, treatment, and stigma reduction in this Director's Forum which was also his first major speaking engagement open to the public. Tobias spoke about the President's $15 billion initiative to combat AIDS over the next three years, and he called on the Senate to pass the omnibus spending bill, which includes AIDS funding.

Congress approved Tobias' nomination only two months ago and he was sworn in on October 6, 2003. He is to oversee all U.S. international assistance for AIDS and coordinate efforts of many U.S. agencies abroad. Tobias reports directly to Secretary of State Colin Powell.

Since his swearing in, he has traveled to Africa twice to view first-hand the areas most ravaged by HIV/AIDS. Most recently, Tobias visited Zambia, Rwanda, Kenya, and Uganda. He commented both on the difficulties facing world society as well as the "amazing work being carried out in partnerships among communities, non-governmental organizations, governments, and donors."

In Uganda, Tobias observed a prevention program in primary schools designed to ensure students "be abstinent until marriage, don't associate with people who will harm you or try to convince you to do the wrong things, and be a strong person and stick to what you know will keep you safe and healthy." Also, he viewed treatment programs administered by both the Centers for Disease Control and a local community organization called TASO.

While Tobias noted that treatment was a key part of the plan, he regarded prevention as the most important goal. Furthermore, he saw testing as the key component and emphasized the need to reduce the stigma of AIDS as well as the fear of knowing whether or not one has the disease. Currently, 40 million people worldwide are infected, but most are unaware.

"We must find new, more effective ways to make it both acceptable and desirable for people to want to know their status," stated Tobias. He also expressed that people in leadership positions should be tested themselves. At many of the facilities he visits, for example, he gets tested himself.

Tobias noted that in 2002, 3 million people died because of the AIDS virus, and at the same time 5 million more people became infected. He went on to stress that because most infected are between the ages of 15 and 45, the most productive segment of the population, this destroys advances in development and initiatives to reduce poverty, increase life expectancy, and promote economic stability.

However, in response to these threats Tobias saw that the "global community is coming into alignment" against HIV/AIDS "as never before." The President's plan is meant to supplement a global effort, providing over $2 billion in fiscal year 2004 and a planned total of $15 billion over the next five years.

Tobias thanked representatives from over 100 organizations who attended the forum, noting that they "brought voice to the devastation of this pandemic, helped develop strategies to combat the disease, and provided armies of women and men serving people and communities in need."

He delineated five target areas where proposals are currently being accepted between now and the first of the year: (1) prevention including abstinence and behavior change for youth; (2) expansion of antiretroviral therapy programs; (3) strengthening safe blood programs; (4) supporting orphans and vulnerable children affected by AIDS; and (5) programs to reduce transmission through unsafe medical practices.

Tobias closed noting that by 2010, at the current rates, 85 million people will be infected by HIV/AIDS, with a loss of human life to AIDS of 100 million by 2020. To illustrate the devastation, he noted that the 8,500 people killed daily from AIDS would be equivalent to 20 Boeing 747s crashing every day.