Are we having fund yet?

From the point of view of scaling up treatment access, Stephanie Nolen [“Global Fund and Games,” January 2003] says all the right things. How the Global Fund is playing out in reality is another story. Many of its approved proposals ask for only enough money to cover antiretroviral treatment for 100 to 300 people with HIV in the fund’s first and second years, in countries where thousands of people need treatment now. According to my own estimates, only about 5 percent of all monies asked for and approved by the fund are for antiretrovirals. This is not the fault of the fund’s structure or the donor sources. Governments in many developing countries don’t want to treat people because it doesn’t generate bureaucracy and salaries. They don’t want to spend money on pills when they can use it to employ friends and relatives to carry out “programs.” Most people with HIV in developing countries are poor people, victims of prejudice who continue to be “expendable,” with or without millions of available dollars. The Global Fund has not addressed this issue.

-- Richard Stern Director,
Agua Buena Human Rights Association
San José, Costa Rica

“Global Fund and Games” reported Uganda’s “flagrant violation of the fund’s principles”—its initial plan to divert Global Fund money from health care to other government departments. What the article neglected to report was that the International Monetary Fund (IMF) and World Bank impose spending caps on  the health-care budgets of developing countries like Uganda in order for them to receive highly conditional grants and loans. IMF structural adjustment programs impose fiscal austerity and forbid the use of foreign funds for “recurrent” public health costs. Fortunately, these pressures were exposed last year, and the  public health absurdity of rejecting Global Fund grants to Uganda and Tanzania was reversed.

To defeat AIDS, substantially more money must be spent on medical training, clinic construction, equipment, drug distribution systems and human expertise. This can’t happen if misguided principles of fiscal austerity retard the reconstruction of public health systems already decimated by discredited IMF and World Bank policies.

-- Brook K. Baker, JD
Northeastern University School of Law
Health GAP Coalition

Secrets and Liza

Your “POZcar” mock-award for “AIDS in a post-9/11 world” is a disappointing addition to a media response helping to foster hatred and misunderstanding in the U.S. [“The 2002 POZcars,” January 2003]. Your take on HIV in the Middle East refers to Palestinian “suicide bombers” using a flip photo caption and a loaded image of Arabs—nestled conveniently near a reference to Osama bin Laden. Your award misses the complexity of HIV in the region, one with porous cultural borders and lasting war. HIV rates in the Palestinian Authority are unclear: neither Planned Parenthood, USAID nor the World Health Organization documents them. Yet your article uses fear of HIV to demonize a  population. Israeli-Palestinian relations are complex and explosive. Instead of increasing understanding, the award simplifies and stereotypes—as hate crimes against Arab Americans and Muslims have increased exponentially since 9/11.

-- Mary Salome, Ramzi Ramey
Southwest Asian and North African (SWANA)
Health Working Group
San Francisco

Regarding “The Liza Minelli [sic] ‘I’m still here, dammit!’ POZcar”: It’s M-i-double-n. I thought I wanted to live, and then I saw that you misspelled Liza Minnelli’s name (is that still possible?) and have decided, “Oh, what the hell!”

-- Michael Aldridge
Laguna Beach, California

Ants at the Picnic 

Walter Armstrong says the “HIV is no picnic” campaign by San Francisco’s Stop AIDS Project has, for the first time in a decade, registered AIDS as a “dreadful reality” [“Editor’s Letter,” January 2003]. If he had HIV, he’d know that every morning as one plops a handful of meds down one’s throat, one is reminded of its oh-so-ever-present reality. For twentysomethings, [prevention] work needs to be done, but from a psychodynamic—not a short-term, divisive—approach.

Armstrong calls gays “self-hating.” I say, “Speak for yourself.” He says it’s hard to “imagine a more effective action [than ‘HIV is no picnic’] in a desperate but do-nothing time.” I say, “Try harder.” We need people who believe in themselves and never give up hope or imagination.

Dialogue doesn’t equal success. Coming together as a community does.

-- Robert S. Levine
Clinical Case Manager
The Derek Silva Community
San Francisco

Strub Light

One constant in my years reading POZ is  Sean O’Brien Strub [“How’s Sean’s Health?” January 2003]. Any article concerning him seems like a personal message of hope. Please thank him for being my hero, my inspiration and my light. My heartfelt thanks to everyone at POZ—your work gives me life! Be it our losses in this struggle or the joy of human experience, POZ sharing is the way to go on.

-- Charles Czuba

Fear Factor

I’m afraid to tell anyone I have HIV. There have been times I was on edge while waiting to see the doctor, and I’d pick up POZ. Before you knew it, I’d be crying, feeling for those I was reading about, no longer sulking in my own condition. Now I’m not as afraid. I know hard work and long hours go into POZ, especially since the layout is exceptional, the color coordination pleasing to the eye  and the subjects thought-provoking. POZ is on the cutting edge of educating and encouraging positive America!

-- J. Austin

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