What is Health GAP (Global Access Project)?
Why was Health GAP formed?
Who formed Health GAP?
What does Health GAP do?
How is Health GAP structured?
Where does Health GAP's funding come from?
What does Health GAP's budget support?
How do I contact Health GAP?

The Health Global Access Project (Health GAP) is an action-oriented advocacy project created in early 1999 by U.S.-based AIDS and human rights activists, public health experts, fair trade advocates, and concerned individuals dedicated to expanding equitable access to treatment and care for people with AIDS worldwide. We do this by exposing and challenging obstructionist policies and practices of the U.S. government, the pharmaceutical industry lobby, multilateral agencies and multinational corporations which create structural barriers to access and frustrate efforts to address the global AIDS crisis comprehensively. We believe that fulfillment of the human right to life and health for all people living with HIV/AIDS and other life-threatening diseases must take precedence over all other considerations in the global response to AIDS.

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Nearly 40 million people worldwide are infected with HIV and 16,000 new infections occur every day. Developing countries bear more than 90 percent of the global burden of HIV/AIDS. Sub-Saharan Africa alone is home to 28 million infected people. HIV is exacerbating growing economic, governance and public health crises simultaneously fueled by the combined effects of socio-economic, cultural and gender inequalities, the impact on public infrastructures of structural adjustment programs (SAPS), and intensified corporate globalization in the post-colonial period. After two decades of the AIDS epidemic in Africa, HIV and other communicable diseases such as TB and malaria are leading causes of early death on the continent. Countries are now facing not only immediate daunting challenges of caring for huge numbers of people affected by HIV/AIDS, but long-term catastrophic economic development impacts on labor forces, educational systems, communities and families. Elsewhere in the developing world, the unchecked expansion of the AIDS epidemic could lead to similar catastrophic public health crises.

During much of the first two decades of the AIDS crisis, the dominant public health strategy for addressing the epidemic globally was almost exclusively focused on HIV prevention. But by the mid-nineties, at least in wealthy countries of Europe and North America, a paradigm shift began to occur. Antiretroviral drugs (ARVs) for HIV and associated opportunistic infections (OIs) had become standard treatment for HIV in Western Europe and North America. We began to witness dramatic decreases in rates of death and illness among PLWHAs in these countries. Confirmation that medical interventions could substantially reduce cases of mother-to-child transmission of HIV had been established. The public health prevention benefits of linking voluntary testing with care and treatment for infected persons had been clearly established. In essence, HIV prevention and provision of treatment and care for infected people began to enter strategic public health policy discussions as inevitably linked components of a comprehensive plan to end the AIDS epidemic.

But in the global South, no such shift occurred, despite the efforts of people with AIDS and treatment activists there to expand access to medicines. Instead, the AIDS epidemic continued its devastation in parts of Africa, Latin America and the Caribbean, and Asia. People with AIDS continued to suffer and die with no access to medicines and with grossly inadequate health care. Glaring global inequities in HIV disease burden were scarcely addressed in mainstream global AIDS policy discussions - neither by governments of wealthy donor nations nor by the multilateral institutions that they had created to lead the economic, political and public health development in the post-colonial global South. Rather, treatment delivery for the vast majority of the global population of people with AIDS was essentially dismissed as prohibitively expensive and logistically impossible. HIV prevention continued to be viewed as the only possible solution to the AIDS epidemic in the developing world. Serious efforts to challenge the incongruity of approaches to the epidemic in the global North and South were not advanced, and dominant public health responses to the escalating global AIDS crisis were notable primarily for their inertia.

By the summer of 1998, when the 12th International AIDS Conference convened in Geneva, people with AIDS from developing countries and allies from both the North and the South had found this inertia intolerable, and unjust. It had become immoral and unconvincing to talk about HIV prevention as the only solution to the global AIDS crisis when 40+ million people were already infected Ð most of who were in resource-poor countries where their illness and premature deaths were reversing decades of development and robbing those countries of any future development. Only treatment and care could intervene in that situation.

In Geneva, where conference participants gathered under the slogan "Bridging the Gap", access to treatment and care was addressed neither systematically nor comprehensively. Scientists and clinicians from the wealthy nations were barely present at sessions where AIDS in poor and developing countries were thematic, and plenary session debates were devoid of reference to expanding treatment access or even how the global pandemic could be slowed in light of new treatments. At the same time, the pharmaceutical industry, which to a considerable extent has underwritten these global gatherings for the past decade, again spent millions of dollars to entertain and influence doctors and researchers. The conference ended with no proposals on how to "bridge the gap" between the North and South.

People with AIDS who were being denied access to treatments and care, and their activist allies from around the world, faced with such inertia, realized that only social mobilization would spark an urgently needed shift in the global response to AIDS. It had, after all, been social activism which catalyzed advances in science, medicine and health care delivery which led to the introduction of treatments and care for people with AIDS in the North. A decade of sustained social and political pressure by people with AIDS on drug companies, public health institutions, and governmental agencies delivered ARVs and other effective medicines to infected people in Western Europe and North America. The science and medical interventions now existed, but it would take a worldwide social movement for challenging political and economic barriers to ensure that to equitable global access to treatment and care would become a reality.

The formation of Health GAP in early 1999 was the U.S.-based activist response to the international call for global social action.

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Health GAP was formed in early 1999 by Dr. Alan Berkman, a veteran civil rights activist and clinician in New York City, who brought together fair trade lawyers and economists, progressive clinicians, human rights activists, international health and development advocates, and direct action-oriented AIDS activists willing to confront U.S. government trade policies and the drug lobby. Individuals from groups and institutions including the Columbia Mailman School of Public Health, ACT UP New York, ACT UP Philadelphia, Doctors without Borders, The Consumer Project on Technology, Essential Action, AIDS Treatment News, Mobilization Against AIDS International, the International Gay and Lesbian Human Rights Commission, Search for a Cure, and others interested in forging a U.S.-based action-oriented strategy toward reducing barriers to equitable global access to treatment and care were initial founders of Health GAP. Together, and in dialogue with activists from the South, this group forged the basis of a new synergistic strategy toward the global epidemic rooted in ideals of the human right to life and health, and committed to social mobilization as key to confronting the epidemic. Health GAP's specific contribution to the global treatment access movement were identified as:

• educating others and building a broad-based social mobilization effort in the U.S. to challenge obstructionist U.S. policies of the U.S. government in particular,
• exposing U.S. government supported international trade policies at the multilateral level which were impeding access and advocating for policy alternatives,
• providing support for South-based activist campaigns and actions focused on their own government policies and practices, as well as the policies and practices of multinationals operating in their countries, and
• engaging with international treatment access activists in coordinated actions, activities and campaigns directed toward obstructionist multilateral policies, the pharmaceutical industry, or multinational corporations.



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What does Health GAP do?

We campaign for drug access and the resources necessary to sustain access for people with HIV/AIDS across the globe. We engage in direct action and grassroots mobilization, work with allies in the global South and in the G-7 countries to formulate policies that promote access, mobilize grassroots support for those policies, and confront governmental policy makers, the pharmaceutical industry, international agencies, and multinational corporations when their policies or practices block access.

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Advocating for AIDS treatment programs and the Global Fund to Fight AIDS, TB, and Malaria: This fund, first called for by U.N. Secretary General Kofi Annan, holds the promise of funding AIDS treatment programs in developing countries if adequately funded and operated on a policy which prioritizes filling the gaps. Much more needs to be done in order to address the historical and deadly neglect of multilateral and bilateral assistance in caring for those already infected with HIV. Since the beginning of the epidemic and, still to this day, a single U.S. government donated dollar has yet to be spent on antiretroviral treatment in Sub-Saharan Africa.

Reforming US and world trade policies: Health GAP has led a successful campaign to change U.S. trade policies that punished African countries that attempted to produce or import affordable generic AIDS drugs. In addition to targeting threatened use of trade sanctions, Health GAP has campaigned against the international intellectual property regime (the WTO TRIPS Agreement) and national patent laws that have restricted access to high quality affordable medicines. However, the US government continues to prioritize pharmaceutical profits and oppose generic competition through its influence over the WTO, United Nations institutions,as well as through bilateral trade agreements with poor countries: including the Chile Trade Agreement, Central America Free Trade Agreement (CAFTA), and Free Trade of the Americas (FTAA). The World Trade Organization, while recently reaffirming the primacy of public health over profits of pharmaceuticals, in its Doha Declaration, still needs to acknowledge and protect the rights of countries to manufacture and export generic versions of patented drugs into developing countries with limited production or market capacity whether they have patents or not.

Challenging Multinational Corporations to provide HIV/AIDS treatment: While Health GAP believes the onus of protecting public health is upon the public sector, the private sector has much to bear on the continued spread and neglect of HIV among communities in which they operate in developing countries. Corporations, such as Coca-Cola and the huge mining concern, Anglo-America, continue to flout the most fundamental need among HIV positive workers in the developing world: the urgent need for access to affordable, life-extending HIV treatment and care. Working with international and domestic allies Health GAP challenges multinational corporations to fulfil an obligation to implement comprehensive HIV/AIDS workplace policies that include a provision for AIDS treatment for workers and their dependents.

Fighting for debt cancellation: Foreign debt handicaps the ability of the most affected countries to confront the AIDS epidemic. We work with global allies to win full cancellation of debt owed the IMF and World Bank by poor countries, using the resources of those financial institutions. We oppose structural adjustment programs and similar requirements that weaken public health systems, obstruct treatment access, and accelerate the spread of HIV.

Pressuring drug companies: The pharmaceutical industry maintains its extraordinary profits in rich countries, and sabotages poor countries' efforts to produce or import affordable generic drugs--although drug companies generate little-to-no profit in poor countries. We expose and actively oppose these efforts and will build support for poor countries' right and responsibility to care for their people.

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Health GAP is a primarily volunteer-driven project led by a  consensus-driven National Steering Committee of 20-25 active "core"  individuals drawn from the U.S.-based AIDS activist, public health,  human rights, and fair trade communities. Health GAP core members  operate as a steering committee which meets through twice monthly  national conference calls and bi-annual strategic planning  meetings. Campaign, mobilization, advocacy and development  activities are coordinated by three salaried program directors.  Health GAP is a registered 501(c)3 non-profit AIDS advocacy  organization based in New York, NY. Program directors are based in  New York and Philadelphia. Health GAP's National Steering Committee  members are based in several East and West Coast states including  New York, Pennsylvania, Massachusetts, Washington D.C., Vermont and  California.

National Steering Committee:


• Brook Baker, Northeastern University, Boston
• Sean Barry,
   Community HIV/AIDS Mobilization Project (CHAMP), NYC
• Alan Berkman, MD, Mailman School of Public Health, NYC
• Aaron Boyle, ACT UP/NY
• Jen Cohn, ACT UP/Philadelphia
• T. Richard Corcoran, NYC
• Paul Davis, Health GAP, Philadelphia
• Jose De Marco, ACT UP Philadelphia
• Naina Dhingra, Advocates for Youth (AFY), DC
• Allison Dinsmore, ACT UP Philadelphia
• Mauro Guarinieri,
    Global Network of People Living with HIV/ AIDS (GNP+)
• Jamila Headley,
    Student Global AIDS Campaign (SGAC), VT
• Kris Hermes, San Francisco
• David Hoos, MD, Columbia University MTCT+, NYC
• Amanda Lugg, African Services Committee (ASC), NYC
• Sharonann Lynch,
    Medicins sans Frontieres (MSF), Lesotho
• Mark Milano, ACT UP/NY
• Donna Rae Palmer, Mobilization Against AIDS,
    International  (MAAI), San Francisco
• Jacqui Patterson, International Health Consultant, DC
• Asia Russell, Health GAP, Philadelphia
• Trish Siplon, Saint Michael's College, Burlington VT
• Eustacia Smith, ACT UP/NY
• Rob Weissman, Essential Action, DC

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Health GAP's activities are funded by private foundations, donor-advised giving, and individual contributors. It is Health GAP's policy to accept no funding from the pharmaceutical industry or from government sources. Current funders include: The Public Welfare Foundation, Sonya Staff Foundation, the Ford Foundation, and donor-advised funds from the Vanguard Charitable Trust. Numerous individual contributors also support our work as well. We are grateful for all such assistance as well as the in-kind support of our allies in the struggle for global treatment access.

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Health GAP's budget is $380,000.00 annually. Funds support staff costs including (3) full-time advocacy coordinators, (1)part-time program assistant, and short term campaign related contractors; program costs including communication costs, travel, direct assistance to South-based treatment advocates and direct action campaign costs. Over eighty-six percent of Health GAP funds go directly toward program-related expenses and to support our dedicated staff. Health GAP is committed to keeping administrative overhead and fundraising expenses as low as possible. Our breakdown of expenses by category is as follows:

42% staff and contractors
46% program expenses
7% administration
5% fundraising


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Health GAP staff contact information:

Paul Davis
Advocacy Policy Director
215-833-4102
Email: pdavis@healthgap.org


Asia Russell
International Policy Director
267-475-2645
Email: asia@healthgap.org


To request copies of publicly available financial statements, please write to:

Health GAP
20 E. 9th St., #18A
New York, NY 10003


You may also request information via email at info@healthgap.org



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The treatments that prolong life and relieve suffering are not available to the vast majority of those infected with HIV. Health GAP believes access to life-sustaining medication is a human right for all, not just those living in wealthy countries.

We believe that increasing treatment access will bring hope and help sustain the health of those infected and will promote health infrastructure, improve HIV prevention efforts and strengthen provisions for care and support.