T H E   W H I T E   H O U S E

The Initiative

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Plan of Action

The Initiative

I. Increasing the US Government investment in the global battle against AIDS to begin to reflect the magnitude of this rapidly escalating pandemic.

Making a difference in Africa and in other highly impacted areas requires broader political commitment, enhanced community mobilization, and, most urgently, increased resources.  In 1998, spending on AIDS in Africa totaled only $165 million.  Compared to the ever-escalating need and other health programs, this amount is woefully inadequate.  For example, in 1998, over $500 million was spent for basic childhood immunization programs in Africa.   Based on our experience in those countries that are starting to demonstrate success, such as Uganda and Senegal, UNAIDS and donors now agree that a minimum of $600 million is needed in sub-Saharan Africa per year for HIV prevention alone ($2 per adult per year). 

While we acknowledge the leadership role that the US plays globally and the urgent need to act, clearly an effort to combat AIDS must be driven by many actors including host countries, multi-lateral organizations, and bi-lateral donors, to be successful.  In FY1999, the US Government spent $74 million in USAID prevention and care in Africa and $38 million in HHS research and surveillance/prevention.  But more remains to be done in sub-Saharan Africa and in other seriously affected parts of the world. 

The Administration proposes to commit an additional $100 million in FY2000 to the global battle against AIDS.  This initiative will enable us to move forward on four critically important and interconnected fronts including:

• Containing the AIDS Pandemic ($48 million) Implement a variety of prevention and stigma reduction strategies, especially for women and youth, including: HIV education, engagement of political, religious, and other leaders; voluntary counseling and testing; interventions to reduce mother-to-child transmission (MTCT); and enhance training and technical assistance efforts, including Department of Defense efforts with African militaries.
  
  
• Providing Home and Community-Based Care ($23 million) Deliver counseling, support, palliative and basic medical care including treatment for sexually transmitted diseases, opportunistic infections (OIs), and tuberculosis (TB) through community-based clinics and home-based care workers.  Enhance training and technical assistance efforts.
  
  
• Caring for Children Orphaned by AIDS ($10 million) Assist families, extended families, and communities in caring for their children through nutritional assistance,  education, training, health, and counseling support, in coordination with micro-finance programs.
  
  
• Strengthening Prevention and Treatment by Augmenting Planning, Infrastructure, and Capacity Development ($19 million) Strengthen host country ability to plan and implement effective interventions.  Strengthen the capacity for effective partnerships and the ability of community based organizations to deliver essential services. Strengthen surveillance systems to track the epidemic and target HIV/AIDS programs. 

This US Government assistance would be provided through AID ($55 million), HHS ($35 million), and DoD ($10 million).  The focus of this funding is HIV prevention, and AIDS care and treatment.  In those areas, this initiative represents nearly a doubling of funding in Africa from current levels ($81 million in FY99, which excludes research).  The Administration recognizes the fight against AIDS must be sustained to keep pace with this burgeoning epidemic, and is committed to a multi-year effort in this critical area.

 

II.         Building partnerships with other key stakeholders to maximize our impact on the rapidly expanding pandemic.

Increasing US investment in the global battle against AIDS is critical, but is not sufficient to achieve the outcomes needed. The commitment of in-country political leaders and of various segments of civil society are key to success.  Moreover, resources provided by the US Government need to help leverage, and to be coordinated with, those of other donors, the private sector, and national governments to ensure synergy and to maximize impact.  Building partnerships with key stakeholders in support of effective action at the community level is our greatest hope for progress.

This initiative will pursue a variety of strategic opportunities for challenging other partners to join in an enhanced effort, including:

• Leadership Meeting On September 7, 1999, First Lady Hillary Rodham Clinton will convene a meeting of key US officials, The World Bank, UNAIDS, as well as heads of foundations, corporate CEOs, and others to discuss how best to enhance AIDS prevention and treatment efforts in Africa and around the world.  The meeting will focus not only on leveraging additional resources, but also on establishing priorities, identifying effective public/private partnerships, and identifying targets for action to combat the crisis of HIV/AIDS.
  
  
• African Leaders Summit  We propose hosting a high-level meeting with Africa government and community leaders within the next ten months.  This meeting will highlight the critical role of leadership in arresting the epidemic and will work to encourage increased leadership efforts. Topics will include the economic impact of HIV/AIDS, examination of models of success in reducing the transmission of HIV, and addressing the need for increased investment in health programs. Additional topics will include AIDS care and treatment and support for children orphaned by AIDS.
  
  
• UN Conference on Children Orphaned by AIDS On December 1, 1999 (World AIDS Day), the United Nations in conjunction with the National Black Leadership Commission on AIDS, The White House Office of National AIDS Policy, The Magic Johnson Foundation and a variety of NGOs, will organize a conference to focus attention on the growing number of children orphaned by AIDS worldwide.  Special emphasis will be placed on assessing the needs of orphaned children in sub-Saharan Africa and the Americas.  Participants will include noted experts on the priority issues identified by UNAIDS, UNICEF, and other UN agencies.
  
  
• Business The Department of Commerce will facilitate a meeting of business leaders active in Africa to encourage them to increase their efforts to rise to the AIDS challenge. Given the impact that AIDS is having on businesses as well as the overall economic-impact on African countries, such a meeting will seek enhanced business commitment and involvement in AIDS programs.
  
  The Commerce Department will work with American Chambers of Commerce abroad and other business organizations to publicize the successful AIDS efforts of US firms in Africa and to support others taking similar action.  In addition, the Department will direct work to promote closer coordination in Africa between Commercial Service Offices, other USG agencies, the business community, and African NGOs in a united effort to promote corporate partnership in AIDS programs.
  
  
• Labor The Secretary of Labor will facilitate a meeting of US and African labor leaders, and will be co-chaired by the AFL-CIO.  The success of the AFL-CIO and its Solidarity Center in South Africa (supported by USAID) in working with the South African Trade Union Federations to include AIDS as a key labor outreach and policy issue provides a model for similar action elsewhere.  Outcomes include assisting labor organizations in educating their members and securing commitments to develop workplace-based AIDS education and prevention programs, including outreach to youth. 
  
  
• Religious Leaders Summit  The US government will facilitate a meeting of African, American, and other religious leaders to discuss the important role of communities of faith in the fight against AIDS. In Uganda and Senegal, the involvement of religious communities and leaders had a dramatic impact on the ability of these two countries to reduce HIV incidence and to maintain it at low levels over time. The outcome of such a meeting would be to increase attention to the need for involving religious communities, to mobilize these organizations and leaders in the fight against AIDS, and to identify ways to support their efforts.
  
  
• Diplomatic Initiatives The Department of State, NSC, and ONAP will work with US and African ambassadors to increase attention to AIDS within the diplomatic community.  The NSC, the Department of State, and USAID will work with G-8 and other donors, and challenge them to match the increased investment put forward in this initiative.

Africa Table of Contents

Findings; The Response

The Initiative

Government Agencies

Trip Manifest

Background

Plan of Action Background

Findings; The Challenge

Findings; The Problem

Key Reference Documents

The Goals

Groups Visited

Conclusion