NATIONAL NGOs
Africa Action, USA
Africa Faith and Justice Network, USA
AIDS Treatment Activist Coalition (ATAC), USA
AIDS Treatment Data Network, USA
AIDS Treatment News, USA
AIDS.ORG, USA
AIDSPAN, USA
American Jewish World Service, USA
American Medical Student Association, USA
Artists Against AIDS Worldwide, USA
Center for Health and Gender Equity (CHANGE), USA
Center for Policy Analysis on Trade and Health (CPATH), USA
Essential Action, USA
GayPoz.com, USA
Global AIDS Alliance, USA
Health GAP (Global Access Project), USA
Isaac Hayes Foundation, USA
Jubilee USA Network, USA
KAIPPG/International, USA
Keep A Child Alive, USA
National Association of People With AIDS (NAPWA), USA
National Organization for Women (NOW), USA
National Coalition of 100 Black Women, USA
Operation USA, USA
Physicians for Human Rights, USA
Presbyterian Church, USA
Queers For Peace And Justice Network, USA
Rainbow/PUSH Coalition, USA
Robert F. Kennedy Memorial Center for Human Rights, USA
Share International, USA
Sisters of St. Joseph of Carondelet, St. Louis Province, USA
Student Global AIDS Campaign, USA
Sexuality Information and Education Council of the US (SIECUS), USA
South Africa Development Fund, USA
Title II Community AIDS Action Network, USA
Treatment Action Group, USA
TrueMajority, USA
Twana Twitu, USA
Unitarian Universalist Association of Congregations, USA
United Methodist Church, General Board of Church and Society, USA
Washington Office on Africa, USA
Women's Environment and Development Organization, USA


NATIONAL NGOs
Africa Action, USA
Africa Faith and Justice Network, USA
AIDS Treatment Activist Coalition (ATAC), USA
AIDS Treatment Data Network, USA
AIDS Treatment News, USA
AIDS.ORG, USA
AIDSPAN, USA
American Jewish World Service, USA
American Medical Student Association, USA
Artists Against AIDS Worldwide, USA
Center for Health and Gender Equity (CHANGE), USA
Center for Policy Analysis on Trade and Health (CPATH), USA
Essential Action, USA
GayPoz.com, USA
Global AIDS Alliance, USA
Health GAP (Global Access Project), USA
Isaac Hayes Foundation, USA
Jubilee USA Network, USA
KAIPPG/International, USA
Keep A Child Alive, USA
National Association of People With AIDS (NAPWA), USA
National Organization for Women (NOW), USA
National Coalition of 100 Black Women, USA
Operation USA, USA
Physicians for Human Rights, USA
Presbyterian Church, USA
Queers For Peace And Justice Network, USA
Rainbow/PUSH Coalition, USA
Robert F. Kennedy Memorial Center for Human Rights, USA
Share International, USA
Sisters of St. Joseph of Carondelet, St. Louis Province, USA
Student Global AIDS Campaign, USA
Sexuality Information and Education Council of the US (SIECUS), USA
South Africa Development Fund, USA
Title II Community AIDS Action Network, USA
Treatment Action Group, USA
TrueMajority, USA
Twana Twitu, USA
Unitarian Universalist Association of Congregations, USA
United Methodist Church, General Board of Church and Society, USA
Washington Office on Africa, USA
Women's Environment and Development Organization, USA

LOCAL/REGIONAL
ACT UP Atlanta, GA
ACT UP Cleveland, OH
ACT UP East Bay, CA
ACT UP New York, NY
ACT UP Paris, France
AIDS Action Baltimore, Inc, MD
AIDS Foundation of Chicago, IL
AIDS ReSearch Alliance, West Hollywood, CA
Allied Productions, Inc., NY
Americans Mobilized Against Spread of AIDS in Africa (AMASAA), NY
AMSA (American Medical Student Association), Loyola Chapter, IL
Artists for a New South Africa, CA
Bay Area Jubilee Debt Cancellation Coalition, CA
Bioethics Interest Group (BIG), Loyola Chapter, IL
Brown University Center for AIDS Research, RI
Cambridge Cares About AIDS, Inc. MA
Capuchin JPE Commission, Midwest Province, MI
Center for Economic Justice, NM, DC
Coalition of Labor Union Women (CLUW), PA
DuPage Global AIDS Action Network, IL
END AIDS NOW!, NY
Episcopal Misión San Juan Bautista, NY
Fellowship of Reconciliation, WA
Florida AIDS Action, FL
Foundation for Integrative AIDS Research, NY
Franciscan Friars of St. Barbara Province, JPIC Office, CA
Georgetown University AIDS Coalition, DC
Global Justice Columbia Chapter, NYC
Harvard AIDS Coalition, MA
Hawaii Solidarity Committee, HI
HIV and Hepatitis.com, CA
Housing Works, NY
International AIDS Empowerment, TX
International Health Interest Group, Brown University Medical School, RI
International Women's Health Coalition, NY
INTERSECT, NY
Jubilee NorthWest Coalition, WA
Justice Committee of the Congregation of St. Joseph, OH
Kansas National Action Network, KS
Kentucky Refugee Ministries, KY
Metro Justice Rochester, NY
Nebraska AIDS Project, NE
Neoyorquinos Socialistas, NY
North Central Independent Living services Inc, MT
NW Coalition for AIDS Treatment in Africa (NCATA), WA
NW International Health Action Coalition (NIHAC), WA
NYC Student Initiative for AIDS , NY
Philadelphia NOW (National Organization of Women)
Physicians for Human Rights (PHR), Loyola IL Chapter
Priority Africa Network, CA
Resources For Survival, NY
San Francisco Bay Area Jubilee Debt Cancellation Coalition, CA
Search for a Cure, MA
Sisterhood Mobilized for AIDS/HIV Research & Treatment (SMART), NY
Sex Workers Project at the Urban Justice Center, NY
Sisters of the Holy Cross, IN
Society for the Protection of East Asians' Human Rights (SPEAHR), NY
St. Joseph Health System, CA
STOP AIDS Project, CA
Students for International Change, AZ
Students for International Change, CT
Student National Medical Association (SNMA) Loyola Chapter, IL
Students Teaching AIDS to Students (STATS), Loyola Chapter, IL
The Women's Center, Montefiore Medical Center, NY
United Church of Christ Network for Environmental and Economic
Responsibility, MD
United Trauma Relief, MA
University of South Florida Student Global AIDS Campaign, FL
Washington Biotechnology Action Council, WA
Wesleyan Student Global AIDS Campaign, CT
Wesleyan Women's Resource Center, CT
Women At Risk, CA

INTERNATIONAL NGOs, multi-country
Agency for Cooperation and Research in Development (ACORD), Int'l
AIDS Empowerment and Treatment Int'l (AIDSETI), Int'l
Dignitas, Int'l
European AIDS Treatment Group, Int'l
African Women Economic Policy Network (AWEPON), Int'l
Global Network of People with AIDS (GNP+) International
Health Action International, Int'l

INTERNATIONAL NGO'S
Agua Buena Human Rights Association, Costa Rica
AIDES, France
Canadian HIV-AIDS Legal Network, Canada
Centers of Excellence, HIV/AIDS & Substance Abuse, East Timor
Centers of Excellence, HIV/AIDS & Substance Abuse, India
CHAIN Project (Community Health And Information Network), UK
Church and Society - Livingstonia Synod, Malawi
Fondazione Villa Maraini, Italy
Foundation for Children's Rights, Malawi
Friends of Canon Gideon Foundation (FOCAGIFO), Uganda
Ghana AIDS Treatment Access Group (GATAG)
Grenada Association of Pharmacists, Grenada
Grupo Português de Activistas sobre Tratamentos de VIH/SIDA (GAT), Portugal
GTZ-HIVAIDS Project, Malawi
HAI Asia, Sri Lanka
HAI Latin America (AIS), Peru
Health Action International - Africa, Kenya
Ada Women's Development Action Council, Ghana
Helpless Rehabilitation Society, Nepal
Hope for African Children Initiative, Zambia (HACI)
Immigrating Women in Science Project, Society for Canadian Women in Science and Technology, Canada
International AIDS Empowerment, El Paso, TX
AIDS Law Unit, Legal Assistance Centre, Namibia
Inter-Religious Council of Uganda
KAIPPG/Kenya, Mumias, Kenya
Kiota for Womens Health and Development, Tanzania
Lesbian and Gay Human Rights Federation, South Korea
Living Hope Organization, Nigeria
Local Area Development Support Project (LDP), Thailand
Lynx Africare Network (LAN), Ghana
Massive Effort Campaign, Switzerland
Kiota for Womens Health and Development, Tanzania
Lesbian and Gay Human Rights Federation, South Korea
Living Hope Organization, Nigeria
Local Area Development Support Project (LDP), Thailand
Lynx Africare Network (LAN), Ghana
Massive Effort Campaign, Switzerland
Metro Justice Rochester, NY
Mother Africa Child Care Organization (MACCO), Ghana
National Forum of People Living with HIV/AIDS Networks and Associations, Uganda
NekoTech Center, Ghana
Norwegian Church Aid, Ethiopia
People's Health Coalition For Equitable Society, South Korea
Positive Art, South Africa
Positive Women's Network, South Africa
Princess Asie Foundation, Ghana
Progressive Organization of Gays in the Philippines
Save a Million Lives Project, Ghana
SEULTO (Group for People with HIV), South Korea
Sexual Health & Family Planning, Australia
Society for Advancement of Women, Malawi
Society for the Advancement of Women, Malawi
Society of Women against AIDS in Africa (SWAA), Mali
Solidarity and Action Against the HIV Infection In India (SAATHII)
Students for International Change, Tanzania
Sudan Council of Churches, Khartoum, Sudan
The Freedom Foundation, India
UK Coalition of People Living with HIV/AIDS (UKC), UK
UKIMWI Orphans Assistance, Tanzania
Women fighting AIDS by Fighting Poverty, Ghana
Women's Union of the Presbyterian Church of Egypt

 

WHY ARE THESE 9 STEPS CRUCIAL TO STOP AIDS?

 

1. Donate the Dollars: at least $30 billion to fight global AIDS between 2004 and 2008

 

Experts have detailed the costs of mounting a credible initiative to control the global pandemics of AIDS, tuberculosis and malaria. In addition to out-of-pocket spending and cash outlays from poor country governments, at least $14 billion dollars annual investment from wealthy nations is needed by 2005 and $18 billion by 2007 according to international agencies.[1] The cost of investment in infrastructure, essential for scaling up of effective interventions and healthcare systems, has been calculated to be $13.6 billion to $15.4 billion by 2007.[2] At 34.8% of the global economy, the United States should contribute at least 33% of these sums annually, totaling $30 billion for years 2004-2008.[3]

 

Adequate investment and commitment, on par with the spread of HIV and its effects to societies and economies, during the next five years could effectively stop the world's most disastrous pandemic. Without it, the U.S., other donor countries, and affected nations will face exponentially larger costs in the future.

 

Instead, the Bush Administration has been cutting some existing bilateral programs (including the Mother-to-Child-Transmission initiative), which need immediate increases. The new Emergency Plan for AIDS Relief is promising, but will take several years to reach a significant scale.

 

The Global Fund faces an immediate budgetary crisis, thanks to chronic underfunding from the Bush administration and other donor countries. The Global Fund must to be funded at a level that will enable a one-year surplus over projected needs—a safety cushion to ensure that high quality applications are not turned away due to a lack of resources. The success of the Fund will complement efforts of the U.S. bilateral program, once launched, to build programs integrated with national healthcare systems. Accordingly, the Global Fund should receive a third to one-half of all contributions designed to fight the three diseases.

 

Candidates must commit at least $30 billion to fight global AIDS between 2004 and 2008, and to provide challenge incentives to other wealthy countries to contribute commensurately.[4] By 2007, annual contributions by the U.S. should reach at least $7 billion to fight AIDS, TB, and malaria.[5] Payments to the Global Fund should be made annually at levels equal to at least 33% of the Fund's projected needs plus additional contributions towards creating a 12-month safety margin beyond projections. The guiding principles of these expenditures should be the rapid utilization of existing capacity, investment in medical infrastructure, systems, and personnel, and a rapid rollout of universal coverage at the national level.

 

 

2. Treat the People: commit to treat those in immediate clinical need

 

In mid-2003, over 43 million people are living with HIV, 95% in developing countries. In these poor countries, fewer than 5% of people with full-blown AIDS have access to the medicines that have dramatically reduced mortality in wealthier nations. Although the pandemic's current locus is sub-Saharan Africa where over 30 million people are infected, this viral holocaust is inexorably shifting to the North and East; thus, it is estimated that five populous countries– Nigeria, Ethiopia, Russia, India, and China—will, by themselves, have between 50 and 75 million infected people by 2010.[6]

 

In May 2003, the World Health Organization (WHO) estimated out of the 38 million people living with HIV in developing countries, 6 million people are in immediate clinical need of anti-HIV medications. However, as of that date, only 300,000 people with HIV in developing countries had access to antiretroviral therapy, nearly a third of whom live in one country, Brazil.

 

The WHO has projected that, with adequate resources, it is feasible to provide anti-AIDS treatment for at least three million people by 2005. According to UNAIDS, there is existing treatment capacity for another 600,00-700,000 persons in treatment today—a performance gap that could be closed in months while programmatic capacity continues to expand in the future. In addition, more and more developing countries are evidencing a commitment to national prevention, care, and treatment programs as represented by the historic announcement of the South African cabinet on Friday, August 8, 2003, that it will undertake a national AIDS treatment plan, including antiretroviral therapy.

 

Although President Bush pledged that the U.S. would treat 2 million people with HIV by 2008, that number is a small portion of the 8-10 million who should be on therapy by that time. Current Global Fund projects from Rounds One and Two will treat another 500,000 during that time period, but that number too will fall far short of achievable WHO/UNAIDS goals. More investment is needed from the U.S. and other donors immediate to utilize and expand existing treatment capacity.

 

The benefits of such treatment will be enormous and cost effective. For example, the World Bank has recently concluded that it is significantly more cost effective to treat AIDS than not to do so, especially in an era of plummeting drug prices. Moreover, "Large scale comprehensive treatment will reduce the growing orphan problem, benefit the health sector, and reduce pain and suffering.[7]"

 

Candidates should pledge to commit the resources and personnel required to lead a global initiative utilizing the Global Fund as well as other bi- and multilateral initiatives to provide treatment for the WHO goal of at least three million people with HIV by 2005, the UNAIDS target of 7 million by 2007, and working towards universal treatment for all people with HIV/AIDS in developing countries by 2012[8].In order to reach coverage targets, the U.S. should urge countries with an historic bias against funding antiretroviral therapy in developing countries to earmark a portion of existing bilateral programs, up to $7.5 billion globally by 2007 for treatment and care.[9]

 

 

3. Medication for Every Nation: trade policies that ensure access to affordable generic drugs

 

Although Administration officials have recently pledged that countries that receive funding from the U.S. bilateral initiative will not be prohibited from legally obtaining low-cost quality drugs, including generics, the current Administration has consistently obstructed poor nations' efforts to gain access to affordable generic medicines needed to address public health. Backpedaling away from the World Trade Organization's Ministerial Declaration on the TRIPS Agreement and Public Health ("Doha Declaration"),[10] the U.S. has attempted through multilateral, regional, and bilateral negotiations to restrict access to affordable medicines. Ongoing negotiations to address the export of medicines to poor countries with little or no manufacturing capacity[11] have been stymied by the Bush administration. Moreover, regional and bilateral agreements pursued by the U.S.—for example the U.S.-Chile, U.S.-Singapore, U.S.-Jordan, and U.S.-Morocco Free Trade Agreements, and the Free Trade Area of the Americas and South African Customs Union agreements—seek more stringent patent protection than is required by the TRIPS Agreement. These provisions advanced by the U.S. will have the effect of reducing or eliminating generic competition, the most important factor for guaranteeing continued downward pressure on the prices of drugs and for enhancing the ability of developing countries to provide access to affordable medicines.

 

Candidates must commit that the U.S. will cease seeking provisions in bilateral and regional trade agreements that limit countries' ability to take appropriate measures to address HIV/AIDS and other public health problems. The U.S. must exclude intellectual property from negotiations over any such agreement. The World Trade Organization's agreement on trade-related aspects of intellectual property (TRIPS) already sets a minimum global standard for intellectual property protection; countries should not be required to do more than they are already obligated to do under TRIPS. Countries must not be prevented from exporting generics medicines to countries that have issued a compulsory license to meet public health needs, or where no patent is in effect.

 

 

4. Drop the Debt

 

In the face of human suffering, it is immoral to hold communities hostage to odious debt, much of it accumulated by corrupt cold war alliances and questionable mega-investment projects.

 

Sub-Saharan Africa pays international financial institutions such as the World Bank and the International Monetary Fund approximately $15 billion each year in debt repayments. These debts incurred by often-departed governments far exceed the entirety of all foreign assistance payments combined. Further, the discredited and failed economic policies such as health and education user fees imposed by the lending institutions have made it impossible for the sick to afford clinic visits and for families to send their children to school. Given the crushing burden of poverty combined with the ferocious onslaught of the AIDS crisis, these debts can never be repaid, and must be dropped immediately. Instead the money saved can be utilized for more productive public health purposes. For example, Uganda, as a result of limited debt relief, was able to increase health spending by 270%. $1.3 million of Uganda's debt relief has been specifically earmarked for their national HIV/AIDS plan.

 

We require that candidates pledge to use the power of the U.S. Treasury, as the largest donor to the IMF and the World Bank, to fully cancel the debts of the world's poorest countries, and put an end to the imposition of structural adjustment policies such as user fees and privatization of health care, education, and water.

 

 

5. Science, not politics, should govern prevention policies

 

Forty five million new adult HIV infections are projected to occur between now and 2010. President Bush's Emergency Plan for AIDS Relief promises to prevent 7 million new HIV infections by 2008 but does not go far enough in committing the U.S. to bring to scale necessary the combination of science-based and proven prevention interventions.[12] According to experts, "Implementation of the comprehensive prevention package by 2005 would reduce the total number of infections by 29 million (63%) between 2002 and 2010, lowering the annual incidence of new infections in adults to about 1·5 million per year once the package has been implemented fully."[13]

 

Extremists have misconstrued the facts about effective HIV prevention, promoting irresponsible policies that place religious ideology over science. Attempts to require global AIDS programs to adopt abstinence-only approaches reflect a new willingness to utilize foreign aid as an instrument of religious coercion. While abstinence is part of any comprehensive sex education program, the American Medical Association, World Health Organization, National Institutes of Health, UNAIDS, and other experts have issued reports detailing research in support of comprehensive sexuality education–education that includes information about abstinence, faithfulness, and contraception in the prevention of HIV. The Allan Guttmacher Institute found that the balanced approach of the ABC model (Abstinence, Be Faithful, Condoms) was the reason for Uganda's success in turning around the HIV pandemic—and that abstinence may have played the smallest role.

 

Donor countries and national governments of affected countries should commit to scaling up programs that can reduce by half the risk of vertical transmission of HIV from mother to child. The U.S., as an endorser of the United Nations Declaration of Commitment on HIV/AIDS, should mobilize resources and leadership to meet the goals of reducing the proportion of infants infected with HIV by 50% by 2010 by providing at least 80% coverage to pregnant women access to short-course treatment of antiretroviral drugs, counseling, and prenatal services.[14]

 

The U.S. should commit adequate resources and ensure access to a global supply of HIV prevention commodities and programs to meet the goal of averting 29 million of the 45 million new adult HIV infections projected between now and 2010. In addition to ceasing the promotion or requirement of abstinence-only programs, the U.S., as the world's most influential donor should avoid supporting strategies such as mandatory HIV testing, isolation of people with HIV/AIDS, or other coercive measures curtailing the rights of individuals and compounding the problems of stigma.

 

 

6. Stop the crisis amongst orphans and vulnerable children

 

HIV/AIDS has a devastating impact on children. According to UNICEF, 13.4 million children already have lost one or both parents to AIDS, including 11 million in sub-Saharan Africa. The number of AIDS orphans will soon swell by additional millions who are now living with sick and dying parents. The projected total number of children orphaned by the disease will nearly double to 25 million by 2010.[15]

 

These children lose not only their families, but also the possibility of education and future livelihood. Indeed, orphans are at greater risk of HIV infection, discrimination, violence, exploitation, and sexual coercion than children from stable families. The United States must do more to directly address this growing crisis, both for the sake of the children, and for the stability of the countries which do not have the current capacity to prevent the destabilizing effects of huge populations of children growing up without homes or hope.

 

The best interventions to reduce the number of orphans is for the U.S. to support national comprehensive prevention and AIDS treatment programs that could avert the deaths of children's parents and caregivers. According to a study by experts in South Africa, the number of orphans could be reduced by almost 30% if voluntary counseling and testing coupled with availability of AIDS treatment for people living with HIV/AIDS were available.[16] Of course, in addition to treating parents, the U.S. must commit to identifying and treating HIV-positive children as comprehensively as possible.

 

While President Bush has pledged to provide care for 10 million HIV-infected individuals and AIDS orphans by 2008[17], more should be done to support communities grappling with growing numbers of AIDS orphans and children expected to lose parents to AIDS.[18] The U.S., working with other nations, should ensure the implementation of national policies and strategies to provide total support to orphans and children infected and affected by AIDS through universal enrollment in school, housing, and access to health and social services by 2005, according to U.N. agreements.[19]

 

Candidates should commit billions of additional U.S. spending for addressing the needs of orphans and vulnerable children to provide necessary basic services to ensure the health, social and economic well being of 15 million children

 

 

7. Invest in the empowerment of women and girls

 

Women and girls are especially vulnerable to infection of HIV and the onslaught of AIDS and currently represent 58% of people living with HIV/AIDS in Africa according to UNAIDS.

 

The U.S. should support strategies to empower women and girls to protect themselves from HIV infection. "Abstinence-only" is not an option for the millions of women worldwide that are expected to be sexually available to their partners on demand. Therefore, the U.S. should support science-based interventions that provide for a combination of prevention information and technologies including female and male condom use. A minimum of $35 million annually should be spent by the U.S. to increase women's access to female condoms. Also, the U.S. should support through increased funding for research, the development by 2008 of effective vaginal microbicides that can be used to prevent sexual transmission of HIV. [20]

 

The U.S. should work towards expanding access to HIV, STD and reproductive health information and health services including pre- and post-natal care and access to programs preventing maternal-to-child transmission while ensuring treatment for mothers themselves.

 

The U.S. should support policies to reduce gender violence, sexual coercion, stigma, and discrimination in its own and in other countries. National policies and practices including child marriage, widow inheritance, dowry, laws against land rights and the disregard of the rights of women in prostitution must be changed. The U.S. should also support policies that promote economic and social empowerment by increasing women's access to education and training and formal labor markets, and other productive resources.

 

Candidates should pledge U.S. support for policies to reduce the vulnerability of women and girls to infection and needless death such as: greater access to female condoms; the development of vaginal microbicides to prevent sexual transmission of HIV by 2008; greatly expanded access to HIV, STD and reproductive health services; and programs preventing maternal-to-child transmission while ensuring treatment for mothers themselves.

 

 

8. Fight tuberculosis and malaria as part of a comprehensive plan to combat HIV/AIDS

 

TB is the single greatest curable infectious killer globally and the leading killer of people living with HIV. One-third of the people with HIV/AIDS are estimated to be co-infected with TB, and up to half of those living with HIV/AIDS can be expected to develop TB in their lifetime. TB treatment for individuals co-infected with TB and HIV can increase people's life span from weeks or months to years. Expanding effective TB treatment is crucial to controlling the spread of TB in communities with high levels of HIV/AIDS, including protecting health care workers. The World Health Organization recently estimated that some 70 percent of persons co-infected with HIV and TB in Africa do not even have access to effective anti-TB drugs (costing $10 for a full course of treatment).

 

Benefits of scaling up TB and malaria treatment would include not only significantly reducing morbidity and mortality associated with these diseases and coinfection with HIV, but also the potential to use expanded DOTS (directly observed therapy) programs and malaria initiatives as a point of entry to HIV counseling and means for identifying patients for scaling up AIDS treatment. According to WHO projections, by identifying patients treated under DOTS who are co-infected with HIV/AIDS, some 500,000 people who are prime candidates for ARVs could be quickly identified for AIDS treatment programs–as a key part of reaching the 3 million people on treatment by 2005.

 

New treatments are also essential. Although tuberculosis and malaria each kill close to 2 million people every year, new novel treatments have been not been developed for almost 30 years.[21] Drug resistance will continue to hinder efforts to curtail deaths from AIDS because the rate of co-infection is high in developing countries. Already the leading killer of people with AIDS, multi-drug resistant (MDR) strains of TB will exact a huge toll unless better treatments are developed and made widely available.

 

Candidates must uphold the targets set out with leaders of other wealthy nations in the G8 Okinawa 2000 agreement: to reduce tuberculosis deaths and prevalence of the disease by 50% by 2010 and to reduce the burden of disease associated with malaria by 50% by 2010.[22] For successful treatment of malaria, the U.S. should finance the implementation of artemisinin-based combination therapy (ACT) in areas of high resistance to first-line treatments.[23]

 

 

9. Research and Development

 

The National Institute of Health's[24] must scale-up efforts to develop and evaluate treatment regimens, lower-cost ARVs and fixed-dose combinations, and strategies for changing treatment regimens. The NIH should support the development of clinical management approaches appropriate for resource-constrained settings including simpler diagnostic methods such as novel, affordable, simple, rapid, robust, point-of-care tests for monitoring antiretroviral therapy, including CD4+ T-cell counts, viral load, and measures of drug toxicity. The NIH should also support the evaluation of strategies for promoting treatment adherence and different models of delivery, e.g., AIDS care linked to STD programs/TB programs versus stand-alone approaches; community-based versus healthcare worker-based monitoring of therapy. Finally, the NIH must increase funding for research, development, and clinical testing of vaccines against AIDS. Thereafter, the U.S. must work in partnership with other governments and international organizations to make credible commitments to purchase AIDS vaccines, when licensed, so that they are readily available internationally.

 

The U.S. must expand funding for AIDS, TB, and other neglected disease research,[25] for international clinical trials, and for expanding laboratory research capacity of AIDS treatments, vaccines, and microbicides in developing countries. In particular, the U.S. should plan to meet commitments made at the G8 Summit in Okinawa in 2000: "to increasing our support at the global level for the research and development of the international public goods such as AIDS vaccines; treatment drugs of AIDS, TB and malaria; microbicides; and other health commodities."[26] U.S. scientists should work on simplifying and streamlining clinical research in developing world settings, especially important for large studies for vaccines and microbicides, while at the same time ensuring continuing access to appropriate therapies for trail participants.

 

Candidates must commit to considerable new resources towards developing effective vaccines, microbicides, simplified antiretroviral treatment and monitoring tools adapted for use in resource-poor settings as well as novel and adaptive treatments for tuberculosis and malaria.