February 3, 2001
AT HOME ABROAD
Bush and AIDS
By ANTHONY LEWIS
LONDON -- The most
profound and immediate
threat to life on earth is the
AIDS epidemic. According to
the National Institutes of
Health, more than 36 million
people in the world now have
H.I.V. or full-blown AIDS.
Every day about 15,000 are newly infected with
H.I.V., the virus that causes AIDS.
The grimmest figures are in developing
countries; in sub-Saharan Africa 8.8 percent of
people 15 to 49 years old are H.I.V.-infected.
But the United States and other Western
countries are hardly going to be immune from
the consequences of the plague. As millions die
around the world, leaving millions of orphans —
as whole societies crumble — our moral
posture will be challenged. So will our economic
outlook, based as it is on global prosperity.
Those realities made it shocking that George
W. Bush, in his first major decision as
president, took an action that will increase the
spread of AIDS. That was his decision to deny
U.S. aid to family-planning organizations abroad
that inform women about medical options
including abortion.
Mr. Bush's press secretary, Ari Fleischer,
explaining the decision, said, "The president
does not support using taxpayer funds to
provide abortions." But that was a non sequitur.
Government funding of abortions abroad has
been prohibited by law since 1973. The Bush
rule says that clinics in developing countries
will lose U.S. funds if they even discuss
abortion with their patients.
What it means on the ground is this: A woman
who has AIDS comes to a clinic somewhere in
Africa or Asia. Drugs to prevent transmission
of the disease to newborn infants are not
available there. She desperately wants to avoid
bearing the child. But the doctor or nurse
cannot advise her on a safe, legal abortion if
the clinic wants to keep its American funds.
Many family planning groups, knowing that
women will not understand a refusal to discuss
abortion, will decide to give up U.S. support.
That will have drastic consequences, because
U.S. dollars may provide most of the
contraceptives.
The result? Families will not get
contraceptives. Without them, more people will
be infected with H.I.V. — and in due course
develop AIDS.
The gag rule on discussing abortion, first
imposed by President Reagan, was dropped by
President Clinton. But otherwise the Clinton
administration's record on fighting the
worldwide menace of AIDS was unimpressive.
The most shameful action of the Clinton years
in this regard was the pressure Vice President
Al Gore put on South Africa to keep it from
going ahead with a plan to impose compulsory
licensing on drugs made by the big international
drug companies, so others could make and sell
them far more cheaply.
The drug issue remains a crucial test of
American understanding — and honor. It was
explored by Tina Rosenberg in The New York
Times Magazine last Sunday in one of the most
moving and important articles I have read in
years.
In the United States and Europe, the
anti-retroviral drugs that have made AIDS a
containable disease for many sufferers cost
either the patient or the society $10,000 to
$15,000 a year. It has been widely assumed
that poorer countries cannot afford them, and
in any event do not have health systems that
could use them effectively.
Ms. Rosenberg showed that those assumptions
are false. Brazil now makes the drugs itself
and has cut the cost by nearly 80 percent;
government commitment has produced clinics
to supervise the treatment effectively. Many
lives, and much money, have been saved.
The big drug companies are frantically
resisting the precedent. And they have great
lobbying power in the United States, achieved
by campaign donations.
Will George W. Bush find it in him to resist the
drug companies? To lead a great American
campaign to get treatment for the H.I.V. and
AIDS sufferers around the world?
The example of the abortion gag rule gives
little ground for hope. There, in the name of
life, he imposed a policy that will produce more
death: terrible death.
I doubt that he did it with knowledge of the
consequences. He just wanted to please his
anti-abortion supporters. So perhaps, on the
larger issue, he may still decide that
compassion and self-interest both demand
serious American action to fight the AIDS
epidemic.
nytimes.com |
