May 19, 2001
The Honorable George W. Bush
Re: United States leadership in the fight against the global AIDS pandemic
Dear President Bush,
We, faculty and students of Yale University, are deeply concerned about the
global HIV/AIDS crisis. We write to express our conviction that the United
States must exhibit leadership at this critical juncture by coming forward
as the lead contributor to the Global Fund for HIV/AIDS, and by signing a
strengthened version of the Declaration of Commitment on HIV/AIDS at the
June 25-27 United Nations General Assembly Special Session.
We have worked internationally in the prevention and treatment of HIV/AIDS,
and in the formulation of laws, policies and ethics associated with
HIV/AIDS. Our response to the growing pandemic includes providing
comprehensive care to large numbers of adults and children with HIV/AIDS;
discovering antiretroviral drugs; leading the World Health Organization
Global Program on AIDS; initiating needle exchange programs; establishing
community-based prevention and treatment programs around the world;
addressing the human rights and legal implications of HIV/AIDS; serving on
the editorial boards of leading medical journals focused on HIV/AIDS; and
serving as consultants to the National Institutes of Health, Centers for
Disease Control and Prevention, National Academy of Sciences, President's
Commission on AIDS, and World Bank, among others. Most recently, Yale
University has taken strong action to address the issue of access to
treatment by negotiating with Bristol-Myers Squibb to relax the patent on
the antiretroviral drug d4T in South Africa.
The world is now poised to take dramatic steps to combat the HIV/AIDS
pandemic. United Nations Secretary General Kofi Annan has called for $7-10
billion annually for a Global Fund for HIV/AIDS. Two important conditions
for the effective use of such a fund have crystallized in the last year:
strong international and national leadership on HIV/AIDS, and a dynamic
spirit of public/private partnership. As countries around the world join
forces toward productive measures to combat the pandemic, the United States
appears to be moving in a disappointing direction, unworthy of our role as
a global leader. Even as the Administration has recognized AIDS as a threat
to our national security, we have not provided a commensurate response. The
United States has chosen to emphasize intellectual property rights over
human rights, and to pit prevention against treatment.
At this formative moment, the United States should support an approach to
combating the pandemic based upon two basic principles. First, treatment
and prevention are inextricably linked, and the United States should fully
support both. A false dichotomy between treatment and prevention will
prevent progress on both fronts. As the "Harvard Consensus Statement on
Antiretroviral Treatment for AIDS in Poor Countries" shows, treatment is
necessary to optimize prevention efforts, to sustain the fabric of
societies, and to continue global economic development. Second, increased
respect for human rights is a necessary part of the response to the
HIV/AIDS pandemic. Failure to protect the rights of people living with AIDS
and other members of societies affected by the pandemic undermines
prevention and treatment efforts, as well as prospects for healthy economic
and social development. We should use the United Nations General Assembly
Special Session to affirm respect for human rights as central to fighting
the pandemic.
Following these principles, the Administration should approach the United
Nations General Assembly Special Session with the following goals:
The United States should take the lead and support the Global Fund for
HIV/AIDS fully and immediately. Costs associated with HIV/AIDS have risen
exponentially, and every year it costs more to contain the crisis. An
international consensus is emerging that a global fund of $7-10 billion per
year is needed to fight AIDS, starting now. Recently, the Administration
announced that the United States will initially contribute only $200
million to the Fund, just two percent of the total needed. A reasonable
contribution, reflecting our share of the world's GNP and our firm
commitment to halting the pandemic, would be twenty-five percent of the
total, or $2.5 billion. This figure should be considered a sensible
investment, since the costs of confronting the epidemic will only increase
if we fail to act decisively now. The United States should also
significantly increase official development assistance to combat inadequate
education, poor nutrition, weak health care systems, and other aspects of
poverty that contribute to the devastation of HIV/AIDS.
The United Nations General Assembly Special Session on HIV/AIDS Draft
Declaration must be strengthened if it is to have any real impact. It must
reflect the urgent need for collective action to bring about substantial
and immediate change, and include explicit goals and timelines for
prevention and treatment that correspond at a minimum with those set in the
UNAIDS five-year plan.
The United Nations General Assembly Special Session gives you a unique
opportunity to demonstrate world leadership and to turn the tide of the
twenty-year HIV/AIDS pandemic. The sudden availability of low cost
anti-retroviral drugs in low-income countries has focused the world's
attention and provided an opportunity to raise the resources and achieve
the political commitment needed to stop HIV/AIDS. We will not have this
opportunity again. The United States must therefore take the lead in
building the Global Fund for HIV/AIDS and galvanizing a collaborative
international response to HIV/AIDS.
Sincerely,
Nadia Abdala, DVM, PhD
On behalf of the Yale AIDS Network.
cc:
President of the United States
1600 Pennsylvania Avenue, NW
Washington, DC 20500
Associate Research Scientist, Department of Epidemiology and Public Health
Yale School of Medicine
Susan S. Addiss, MPH, MurS
Lecturer in Health Policy and Administration
Department of Epidemiology and Public Health, Yale School of Medicine
Former Connecticut Commissioner of Health
Frederick L. Altice, MD, MPH
Director, HIV in Prisons Program
Yale AIDS Program, Yale School of Medicine
Warren Andiman, MD
Director of Pediatric AIDS Program
Professor of Pediatrics (Infectious Disease)
Professor of Epidemiology and Public Health
Yale School of Medicine
Nancy R. Angoff, MD, MPH, MEd
Associate Dean for Student Affairs
Yale School of Medicine
S. Kelly Avants, PhD
Associate Professor of Psychiatry, Division of Substance Abuse
Yale School of Medicine
David Bartlett, PhD
Dean of Academic Affairs
Lantz Professor of Preaching and Christian Communication
Yale Divinity School
Frank J. Bia, MD, MPH
Professor of Medicine and Laboratory Medicine, Department of Internal Medicine
Co-Director, International Health Program
Yale School of Medicine
Ann J. Biersteker, PhD
Associate Professor, Adjunct
Linguistics and African Studies, Yale University
Kim Blankenship, PhD
Associate Research Scientist, The Institution for Social and Policy Studies
Associate Director, Center for Interdisciplinary Research on AIDS
Yale University
John Booss, MD
Professor of Neurology and Laboratory Medicine, Department of Laboratory
Medicine
Yale School of Medicine
Elizabeth Bradley, PhD
Assistant Professor, Division of Health Policy and Administration
Yale School of Medicine
Martha Buitrago, MD
Director of HIV Services, Fair Haven Community Health Center
Clinical Instructor, Yale AIDS Program
Yale School of Medicine
Kent Buse, PhD
Assistant Professor, Division of Global Health
Yale School of Medicine
Dom Cicchetti, PhD
Senior Research Scientist, Child Study Center
Yale School of Medicine
Scott Clair, PhD
Associate Research Scientist, Department of Biostatists
Yale School of Medicine
Kamari Maxine Clarke, PhD
Assistant Professor, Department of Anthropology
Yale University
Elizabeth L. Cooney, MD
Assistant Professor of Medicine, Department of Internal Medicine
Medical Director, AIDS Program Clinical Trials Unit
Yale School of Medicine
Harlon L. Dalton, JD
Professor of Law, Yale Law School
Co-Director of CIRA Law, Policy & Ethics Core, Yale University
Robert M. Donaldson, Jr., MD
David Paige Smith Professor of Medicine Emeritus, Department of Internal
Medicine
Yale School of Medicine
Gail D'Onofrio, MD
Associate Professor, Section of Emergency Medicine
Yale School of Medicine
Michael R. Dove, PhD
Professor of Social Ecology, Yale School of Forestry and Environmental Studies
Ravi Durvasala, MD
Department of Internal Medicine, Yale School of Medicine
Margaret A. Farley, PhD
Gilbert L. Stark Professor of Christian Ethics, Yale Divinity School
Co-chair, Yale Interdisciplinary Bioethics Committee
William J. Foltz, PhD
H.J. Heinz Professor of African Studies and Political Science
Chair, International Affairs Council
Yale University
Brian Forsyth, MB, ChB
Director of Pediatric AIDS Family Support Program, Yale-New Haven Hospital
Associate Professor of Pediatrics, Yale School of Medicine
Jonathan M. Freiman, JD
Orville Schell Fellow, Yale Law School
Gerald Friedland, MD
Director of Yale AIDS Progam
Professor of Medicine and Epidemiology and Public Health
Yale School of Medicine
Catherine L. Gilliss, DNSc, RN, FAAN
Dean and Professor
Yale School of Nursing
Judith Bograd Gordon, PhD
Lecturer, Department of Psychiatry
Yale School of Medicine
Lauretta E. Grau, PhD
Associate Research Scientist, CIRA
Yale University
Robert Heimer, PhD
Associate Professor, Division of Epidemiology of Microbial Diseases
Yale School of Medicine
Michele E. Horne, MD
Fellow, Yale School of Medicine
Deena Hurwitz, JD
Robert M. Cover/ Allard K. Lowenstein Fellow in International Human Rights
Yale Law School
Keith A. Joiner, MD
Professor of Medicine, Cell Biology and Epidemiology
Chief, Section of Infectious Disease, Department of Internal Medicine
Yale School of Medicine
L. Serene Jones, MDiv, PhD
Associate Professor of Theology, Yale Divinity School
Gilbert M. Joseph, PhD
Farnam Professor of History, Yale University
Paul W. Kahn, PhD, JD
Robert W. Winner Professor of Law and the Humanities
Director, Orville H. Schell Jr., Center for International Human Rights
Yale Law School
David A. Kessler, MD, JD
Dean of the Yale School of Medicine
Former Commissioner of the United States Food and Drug Administration
Kaveh Khoshnood, PhD
Assistant Professor, Division of Epidemiology of Microbial Diseases
Yale School of Medicine
Ilona S. Kickbusch, PhD
Professor of Epidemiology & Public Health
Division Head for Global Health, Yale School of Medicine
Harold Hongju Koh, JD, MA
Gerard C. and Bernice Latrobe Smith Professor of International Law, Yale
Law School
Former Assistant Secretary of State for Democracy, Human Rights and Labor
Michael Kozal, MD
Assistant Professor of Medicine, Department of Internal Medicine
Yale AIDS Program, Yale School of Medicine
Jean E. Krasno, PhD
Executive Director, Academic Council on the United Nations System
Yale University
Anthony Townsend Kronman, PhD, JD
Dean and Edward J. Phelps Professor of Law
Yale Law School
Forrester A. Lee, MD
Associate Professor of Medicine
Assistant Dean for Multicultural Affairs
Yale School of Medicine
Andres Martin MD
Assistant Professor of Child Psychiatry and Psychiatry
Child Study Center
Yale School of Medicine
Peter McPhedren, MD
Faculty, Yale School of Medicine
Michael Merson, MD
Professor and Chairman, Department of Epidemiology and Public Health
Dean of Public Health, Yale School of Medicine
Director of CIRA, Yale University
Former Director, WHO Global Program on AIDS
Christopher L. Miller, PhD
Frederick Clifford Miller Ford Professor of African American Studies and French
Yale University
Alexander Ortega, PhD
Assistant Professor, Division of Health Policy Administration
Yale School of Medicine
A. David Paltiel, PhD
Associate Professor, Division of Health Policy and Administration
Yale School of Medicine
Yale School of Management
Kim-Thu C. Pham, MD
Assistant Professor, Division of Global Health
Yale School of Medicine
William H. Prusoff, MS, PhD
Professor Emeritus, Department of Pharmacology
Yale School of Medicine
Gustav Ranis, PhD
Frank Altschul Professor of International Economics
Henry R. Luce Director, Yale Center for International and Area Studies
Yale University
John K. Rose, PhD
Professor of Pathology, Cell Biology, and Biology, Department of Pathology
Yale School of Medicine
Letty M. Russell, PhD
Professor of Theology, Yale Divinity School
Mark Russi, MD, MPH
Director, Occupational Health, Yale-New Haven Hospital
Associate Professor of Medicine, Yale School of Medicine
Nancy L. Ruther, PhD, MA, MIA
Director of the Yale Center for International and Area Studies
Lecturer in Political Science, Yale University
Peter Salovey, PhD
Professor and Chair, Department of Psychology
Deputy Director, CIRA
Yale University
James C Scott, PhD
Eugene Meyer Professor of Political Science and Anthropology
Director of the Program in Agrarian Studies
Yale University
Kathleen J. Sikkema, PhD
Associate Professor of Psychiatry
Division of Prevention and Community Research
Yale School of Medicine
James J. Silk, MA, JD
Executive Director, Orville H. Schell, Jr. Center for International Human
Rights
Yale Law School
John G. Simon, LLB, LLD
Augustus E. Lines Professor of Law
Yale Law School
James Gustave Speth, MLitt, JD
Dean and Professor in the Practice of Environmental Policy and Sustainable
Development
Yale School of Forestry and Environmental Studies
Former Administrator of the United Nations Development Program
Lynn E. Sullivan, MD
Assistant Clinical Professor of Medicine, Department of Internal Medicine
Yale AIDS Program, Yale School of Medicine
Diana Swancutt, PhD
Assistant Professor of New Testament, Yale Divinity School
David P. Watts, PhD
Professor of Anthropology, Yale University
Margaret R. Weeks, PhD
Research Associate, Department of Psychology
Yale University
Madeline Wilson, MD
Director of Yale Internal Medicine Associates, Yale-New Haven Hospital
Faculty, Yale School of Medicine
Brian Wong, MD
Associate Professor of Medicine, Department of Internal Medicine
Yale School of Medicine
Eric Worby, PhD
Assistant Professor of Anthropology, Yale University
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