5 - From God's mouth: messenger effects and donor responses to HIV/AIDS

Summary

In his 2003 State of the Union address, President George W. Bush called on the US Congress to fund PEPFAR, a five-year $15 billion emergency plan to combat HIV/AIDS in the developing world. In justifying PEPFAR, the president declared:

As our nation moves troops and builds alliances to make our world safer, we must also remember our calling as a blessed country is to make this world better … A doctor in rural South Africa describes his frustration. He says, “We have no medicines. Many hospitals tell people, you've got AIDS, we can't help you. Go home and die.” In an age of miraculous medicines, no people should hear those words.

The size and scope of the program left many in the advocacy community stunned. So why had the Bush administration done it? Was this announcement a calculated effort to deflect attention from the United States' imminent military action in Iraq? Was it driven by pharmaceutical companies? Could the decision have been motivated by moral concerns? This anecdote underscores a broader question: Why do some states give more than others to support international HIV/AIDS efforts? From the perspective of advocacy groups promoting efforts to address AIDS and other concerns, another question emerges: Why do some campaigns succeed in some places and fail in others?

In the twenty-five years since AIDS was first identified, more than 25 million people have died from the disease, mostly in developing countries. Tens of millions more will likely die.