An editorial in Saturday’s New York Times offers a concise explanation of the stranglehold seven senators now have on a bill that, if allowed to go to a vote, would reauthorize funding to fight three of the world’s deadliest diseases of poverty — AIDS, malaria and TB.

The bill, which has already passed the House by a 3-to-1 margin, is expected to similarly sail through the Senate and is supported by President Bush. But the seven are holding it a procedural hostage, saying they won’t allow it to go to the floor unless it’s rewritten to specify that a certain percentage go to treatment of AIDS vs. how much will go toward prevention.

This has become a classic syndrome in health care funding: the competition between prevention, care and treatment and finding a cure. New Mexico tries to deal with the competition for scarce funding with the Behavioral Health Collaborative.

A New Mexico example: Advocates of a therapeutic farm that would treat, train and care for the mentally ill compete for funds with those who would prefer to see funding go to research for a cure.

 

I was fortunate to sit in on a conference call this month with Paul Farmer, the world-famous founder of Partners in Health who has done so much to improve health services in some of the most challenging places on the planet, including Haiti and now, Rwanda, from where he was placing the call. Farmer and his work are profiled in the book, Mountains Beyond Mountains, by Tracy Kidder.

He said preventing disease and caring for those who already have it should not be in competition. There is too much attention on competition for scarce resources "and too few people saying the pie has to be bigger."

He said he has seen first-hand that funding for AIDS programs results in improvements in health care across the board — the proverbial tide lifting all boats.

The anti-hunger group RESULTS, which hosted Farmer’s call to members in Albuquerque and around the world, says of the AIDS funding:

 
 

For the past six years, through the President’s Emergency Plan for AIDS Relief, the United States has led the greatest humanitarian effort since the Marshall Plan. That effort has kept nearly a million and a half people with AIDS alive, over 60 percent of who are women and girls, and supported prevention of mother-to-child transmission of HIV in 10 million pregnancies. Combined with support for the Global Fund to Fight AIDS, TB and Malaria and bilateral programs to combat tuberculosis and malaria, that effort is now turning the tide in the long-fought battle to marginalize these diseases.





If passed, the $50 million funding in the stalled Senate would, over the next five years, treat 3 million AIDS sufferers, provide care for 5 million orphans, train 140,000 health care workers and potentially prevent 12 million AIDS infections.

If passed, it would also give President Bush a humanitarian package to take to the G-8 summit in Japan in July, which could spur giving by other nations. Bush announced AIDS relief as a priority in 2002.

Farmer said if he could personally talk to the seven senators holding up the bill, "I would introduce them to people whose lives have been transformed by this kind of funding. (AIDS funding measures) are reinforcing our goals and can strengthen the attack on poverty. We can strengthen treatment efforts. Lives are transformed for the better by this funding."

"We came to rural Rwanda .. assigned to a hospital that was abandoned after the genocide," he continued. "There were no doctors, no tools." Today, he said, AIDS victims are getting treatment, but at the same time, child survivorship is up and women are getting better health care.

 

 

AIDS funding coming into a community creates "a quality policy atmosphere" that allowed for other types of health care, plus micro-lending and other programs that strengthen the community, Farmer continued.

In the absence of aid, you have the "disease of poverty."

"When you have a cash-starved, resource-starved system, you have all these problems piling up on the poor."

Both of New Mexico’s senators, Republican Pete Domenici and Democrat Jeff Bingaman, have said they support the Lantos-Hyde Act to reauthorize AIDS-malaria-TB funding. But sometimes support isn’t enough.

What is needed is senators who will step up and say it’s time to act, and who will lead others to act.

It’s time for those in Congress to stop impeding and starting leading so we can start solving these problems of crisis proportions.