Thanks to activism, years of investment, and scientific advances, ending AIDS is within reach. But seizing this pivotal moment will not be possible without political will to mobilize the resources that are needed to fund the fight.
As of 2021, 1 in 4 people living with HIV lack access to life-saving treatment. Despite the significant treatment gap that remains and global commitments to scale up the response, donor government funding for the AIDS response has been flatlining or declining in recent years. And while the share of the response paid for by low- and middle-income countries has been steadily increasing, many national governments in the global South are still not investing as much as they should to fight HIV. A dramatic increase in funding is needed from all sources if the world is going to successfully expand access to quality HIV treatment and evidence-based prevention services to all who need them.
Health GAP is one of the few global advocacy organizations boldly fighting for expanded global HIV investments on several fronts.
In the U.S., Health GAP makes the case for increased government investment in the global AIDS response directly to elected officials and policymakers on Capitol Hill and in Congressional Districts across the country. We believe that the U.S. has a moral obligation to invest in the global HIV response, not out of charity, but because communities in the global South have been made more vulnerable through decades of U.S. trade and other international policy decisions. We take an inside-outside strategy approach to our U.S. government advocacy work. On Capitol Hill, we bring our expertise to bear in policymaking processes by engaging decision makers inside government while simultaneously building and sustaining a grassroots movement that increases the pressure on elected officials and policymakers in-district. Using these combined forces, we advocate for increased funding from a policy standpoint and raise the stakes for those who have outsize power in the federal budget process. Our policy experts work in coalition with domestic and global AIDS advocacy organizations and build relationships with policymakers. Our grassroots network across the country regularly calls, writes, and meets with elected officials to demand increased funding for global AIDS and takes bold action to hold policymakers accountable for the commitments they make to fund the fight.
Health GAP works to strengthen and support movements in low- and middle-income countries as local activists put pressure on their governments to increase investments in their national HIV responses. Low- and middle-income countries now pay for nearly 57% of the global HIV response, and have been consistently increasing their contributions over the past decade. However, most countries can and should do more. For example, many African countries have still not delivered on the Abuja Declaration promise of allocating 15% of government funding towards health. Health GAP also supports activists and civil society organizations in identifying and advocating for the implementation of progressive innovative financing mechanisms for HIV and health services more broadly.
President Trump’s first budget proposal included a deadly request: he proposed Congress cut $1 billion from the U.S. global AIDS response – a plan that experts say would have killed 1 million people around the world. Even before the budget was released, we began fighting back. On December 1, 2016, in coalition with global and domestic HIV allies, ten activists were arrested outside the offices of Speaker of the House Paul Ryan as they attempted to deliver a letter to him and Congressman Tom Price, then the Trump administration’s Secretary of Health and Human Services (HHS) nominee. In an act of peaceful civil disobedience, the activists sat down and refused to leave Ryan’s office until he committed to reverse course on budget plans that would be deadly for people living with HIV.
Although AIDS activists successfully beat back Trump’s deadly budget plan in 2017, Congress countered the proposed cuts with yet another year of flat funding. And in early 2018, Trump’s second budget proposal sought more than $1 billion in cuts to U.S. global AIDS programs. Today, as we continue to fight for increased funding for the fight, the U.S. investment in PEPFAR remains well below 2011 levels, undermining the AIDS response and leaving people living with HIV to die waiting for life-saving antiretroviral medicines. Trump’s deadly proposals are particularly callous given the fact that a $2 billion increase in annual U.S. global AIDS funding is needed by 2020 in order to end the epidemic by 2030 – a goal that the international community, including the United States, has agreed to multiple times.
While people’s lives are on the line, Health GAP has an important role to play by relentlessly demanding that Congress invest the necessary resources to end AIDS as a pandemic and never backing down based on what is perceived to be politically viable. Our sustained activism on key targets has helped to achieve results. Earlier this year, Vermont Senator Patrick Leahy proposed an additional $50 million in funding for PEPFAR, the core bilateral program through which the U.S. is fighting global AIDS. We are now mobilized to ensure that funding increase is adopted as part of the next enacted federal budget and those much-needed resources can be put to work meeting the needs of people living with HIV around the world.