30 January 2003 (New York) Doctors Without Borders/Médecins Sans Frontierès (MSF) welcomed the commitment made by US President George W. Bush in his State of the Union address to ask Congress for a dramatic increase in the US government's financial contribution to fighting the global AIDS pandemic. MSF was encouraged by the President's clear emphasis on increasing the availability of affordable anti-retroviral medicines. But the organization cautioned that this and past US administrations have a history of reneging on promises made to the international community related to increasing access to treatment, and warned that if the US takes a unilateral approach to fighting the global AIDS crisis, funds will be squandered and lives will be lost.

"Instead of continuing to offer meager sums and prevention-only initiatives, President Bush has stated clearly that his administration has changed its position on AIDS treatment?this is an important step," said Rachel Cohen of MSF's Campaign for Access to Essential Medicines. "But fighting AIDS requires a coordinated global effort, and the President's plan largely bypasses existing international funding mechanisms, in particular the Global Fund to Fight AIDS, Tuberculosis and Malaria. We hope that the US will redirect more of the promised funds to existing multilateral funding bodies, rather than waste time and money on creating new ones. It is also important for the US to immediately press other wealthy countries to dramatically increase their contributions."

By stating that the drop in price of antiretroviral therapy to under $300 per patient per year makes large-scale treatment possible, President Bush has clearly recognized the critical importance of generic competition in mounting an effective response to the pandemic. "The price of AIDS medicines dropped below $300 because of generic drug competition, and we know that this price can come down even further, to as little as $50 per patient per year," said Cohen. "But, up until last week, the US was still leading a fight at the World Trade Organization to restrict countries from having the maximum flexibility to take advantage of international trade rules that allow them to produce and export the cheapest medicines possible. This is either a major shift in US policy on this issue, or sheer hypocrisy."

MSF also raised concern about the pace at which the funding will be made available and the scope of the President's "Emergency Plan for AIDS Relief," which will provide funding for just 14 countries in sub-Saharan Africa and the Caribbean. "People with HIV/AIDS in poor countries cannot wait until the next fiscal year to get access to life-saving antiretroviral therapy," continued Cohen, referring to a White House statement explaining that funding from the President's plan will begin to be available in fiscal year 2004. "And should people with HIV/AIDS in Asia, Latin America, Eastern Europe, and African countries not included in the President's plan like Malawi be asked to wait for treatment?"

MSF urges the US to make use of existing international mechanisms, such as the Global Fund, to ensure the money is used in the most coordinated, effective manner possible. In addition, MSF calls on other wealthy countries, particularly the European Union and Japan, to take up this challenge and at least triple their contributions to fighting AIDS as well as other killer diseases like TB and malaria well before the Group of Eight (G8) meeting in France in June 2003.