Please note that you can not support one point in this letter without
supporting the other seven points. Also note that a recent vote was
taken for a bill that incorporate some these points, it was defeated,
I will post a reply with the voting record of each representative as
a reply.

PHR Letter to President Bush re: AIDS Policy

This letter is from;
http://www.phrusa.org/campaigns/aids/letter061902.html

June 18, 2002

The Honorable George W. Bush
President of the United States
The White House
Washington, DC 20509

Dear President Bush:

As physicians and nurses who are committed to the prevention of
HIV/AIDS and the care and treatment of patients with HIV/AIDS in the
United States and abroad, we welcome reports that you will announce
this week a major new initiative on the global epidemic. Yet we
confront a modern plague that has far outstripped our worst fears and
has reversed the health and demographic improvements of the last four
decades. If unchecked, the global HIV/AIDS epidemic will be the
greatest health disaster in human history. New attention and recent
new funding initiatives, while welcome, are clearly insufficient to
prevent that disaster, already well under way, from fully
materializing. On the basis of our medical and scientific experience
with the HIV/AIDS pandemic, we believe there are eight essential
components in the effort that are urgently needed now. We
respectfully offer them as suggestions for the global leadership your
new program can achieve.

First, we appeal to you to announce a multi-year commitment of at
least $2.5 billion annually to the Global Fund to Fight AIDS,
Tuberculosis, and Malaria, beginning this year. The Secretary General
of the United Nations has called for up to $10 billion annually for
the Global Fund. We believe that greater amounts will soon be
necessary to prevent new infections and treat those infected with the
disease as it spreads exponentially in China, India, Russia, and in
the countries of Africa, Eastern Europe and the former Soviet
republics. We are dismayed at the growing gap between the funds that
are required to comprehensively address the epidemic and the funds
that are available. The United States could help close this gap by
offering to the Global Fund, twenty-five percent, or $2.5 billion, of
the $10 billion needed this year and every year, in keeping with the
assessed US contribution to other international endeavors.

Second, we urge that the US announce a major new bilateral HIV/AIDS
initiative to support, expand, and train the human health
infrastructure in poor countries. Doctors, nurses, AIDS educators and
counselors, and health workers in poor countries are the only hope
for stopping the greatest public health disaster in human history,
but they themselves are succumbing to the disease, and to
psychological trauma from the overwhelming disease burden they are
attempting to address. We urge that your new proposal include
generous new bilateral funding that is specifically designated for
the support of today's health workers. We also urge accelerated
recruitment and training of a new generation of nurses, doctors, and
other health workers. A considerable portion of this funding should
be designated for under-served slum and poor, rural areas.

Third, we urge that the United States on an urgent basis assist AIDS-
afflicted countries with the purchase of pharmaceuticals for
infectious disease, including antiretrovirals, at best world prices.
We strongly support the flexibility afforded to developing countries
facing public health emergencies, as agreed at the Doha Trade Round,
and urge that providing AIDS drugs at affordable prices be a priority
for the Bush Administration's AIDS programs. We recommend that the US
provide a capacity building component in the area of pharmaceutical
purchase, dissemination, quality control, monitoring, and information
management.

Fourth, we strongly support comprehensive mother-to-child-
transmission (MTCT) prevention programs, and urge that all such
programs include a family treatment component. Existing MTCT
infrastructure should be expanded to include treatment of mothers and
all other infected family members, as well as the nurses, doctors, or
other health care workers administering the programs, and their
family members. A new program, called MTCT Plus, funded by 8 private
foundations is developing the model on which such global programs can
be built. We encourage you to support selected MTCT prevention sites
by providing assistance, training, drugs and diagnostics, and
laboratory and operational support to develop material and human
infrastructure with which to administer comprehensive prevention,
care and treatment programs.

Fifth, we appeal to you to help insure that prevention efforts are
strengthened in parallel with a significant expansion of treatment of
infectious diseases, including AIDS. It is now widely understood and
endorsed by health professionals most experienced in combating
HIV/AIDS that prevention is most successful when it is paired with
treatment, and that treatment must include education and counseling
components to prevent erosion of prevention infrastructure and
development of viral resistance to drugs. Treatment facilitates
prevention through ongoing delivery of prevention messages to the
highest risk populations. A range of support services are also
important to maximize the ability to stay in care and benefit from
lifesaving therapies.

Sixth, we urge your Administration to address forthrightly women's
inability to protect themselves from unwanted and/or unprotected sex.
We respectfully urge you to include a major new assistance program
aimed at upgrading women and girls' legal and economic status,
enlarging women and girls' access to health care (including
reproductive health care) and assisting governments in preventing and
prosecuting rape. We strongly support funding for the development of
microbicides and dissemination of female condoms. We urge a concerted
diplomatic initiative, as well, to stigmatize those governments whose
officials are complicit in the violent transmission of HIV/AIDS,
including rape by soldiers and participation in sex trafficking and
child prostitution.

Seventh, we appeal to you to enlarge existing foreign aid programs
that benefit the poor, particularly women and children. New resources
for the Global Fund should not be provided at the expense of other
bilateral maternal and child health programs. We recommend that
a "fire wall" be built around current poverty alleviation programs,
and that new initiatives be launched with new resources.

Eighth, we respectfully urge you to consider the development of
an "AIDS Corps" of Americans (and foreign nationals resident in the
US) to encourage direct collaboration between US-based and developing
country health and medical personnel. American doctors, nurses,
public health workers, and other health professionals could
collaborate with their counterparts in countries hard-hit by HIV/AIDS
and other infectious diseases. Doctors, nurses, and public health
figures in many countries may welcome the support, training, and
technical assistance of U.S. experts in prevention, treatment,
pharmaceutical purchase, and information management. In turn, Western
doctors could profit greatly from the experiences of their
counterparts who are battling AIDS and other diseases in resource-
deprived settings. We would caution against diverting vitally needed
resources from African, Asian, and European health workers themselves
to their American counterparts. Thus we urge that such an initiative
be funded under the auspices of the Peace Corps or some other agency
that does not compete for funds with the GFATM or bilateral poverty
reduction programs.

In closing, we wish to assure you that in addition to providing
professional, medical assistance to the US government as it forms a
comprehensive response to the global AIDS pandemic, we also offer to
help you educate the American public about the need for the U.S.
foreign aid required to finance such an endeavor.

Sincerely,

Carol Baker, M.D.
Baylor College of Medicine

Alen Berkman, M.D.
Columbia University

Donald S. Burke, M.D.
Johns Hopkins Bloomberg School of Public Health

Joseph Colagreco MS, APRN, BC, ANP-C
Division of Nursing, New York University

Paul Farmer, M.D., Ph.D.
Harvard Medical School

Joyce Fitzpatrick, Ph.D., R.N.
Case Western Reserve University

H. Jack Geiger, M.D.
City University of New York

Eric Goosby, M.D.
Pangaea Global AIDS Foundation

Ashley Haase, M.D.
University of Minnesota

Howard Hiatt, M.D.
Brigham & Women's Hospital

Jim Yong Kim, M.D., Ph.D.
Partners in Health

Peter Lamptey, M.D., Dr.P.H.
Family Health International

Robert Lawrence, M.D.
Johns Hopkins Bloomberg School of Public Health

Richard Marlink, M.D.
Harvard AIDS Institute

Joia Mukherjee, M.D.. M.P.H.
Partners in Health

Allan Rosenfield, M.D.
Columbia University

Ronald Waldman, M.D., M.P.H.
Columbia University