Diary Prequel Package — page 13

Providing drugs at or below cost is only part of the solution. Only a portion of the total HIVinfected population will meet criteria for beginning antiretroviral therapy. Far more need community support and basic care for opportunistic infections, such as tuberculosis, and for prevention, care and treatment of sexually transmitted diseases. Yet even if enough drugs to treat every single infected person were sent, free of charge, to the African continent, an adequate infrastructure to deliver them does not exist. There is no existing surveillance capability to ensure that patients follow extremely complicated drug regimens accurately, or to monitor what effect the treatment has on the spread of the disease. We should begin to help create the basic system to provide needed medications for opportunistic infections and symptomatic care, while also building the more complex systems needed to provide antiretrovirals and other medicines safely and effectively to avoid creating resistant strains, a lesson we have learned from efforts to control tuberculosis. At the same time, we must continue to focus our efforts on prevention - a proven strategy that is cost-effective. Individual and government accountability, behavior change and abstinence-based approaches that are culturally appropriate must be part of prevention efforts. We have found that working with local organizations, such as missionary hospitals and clinics, is an effective way to lessen the impact of the epidemic on individuals, families and communities. We should also encourage countries to adopt comprehensive, evidence-based national strategies to ensure the resources we devote to this challenge are well-managed to produce the results we seek. This is not, however, an issue that the U.S. Government can -- or should -- solve single handedly. We must reach out to a number of partners: our allies, the international community, pharmaceutical manufacturers, non-profits like the Gates Foundation, and the faith-based community that has infrastructure on the ground in the developing world. A successful strategy to reduce the impact of infectious disease requires close donor cooperation to achieve maximum efficiency and avoid competition and duplication of efforts. The Bush Administration stands ready to contribute to a comprehensive plan to begin building a public health delivery system in Africa and other parts of the world where HIV is rapidly expanding, an effort that should include prevention of new infections, care for the sick, provision of drugs, and training of medical professionals. To this end, we appeal to the world to join us in establishing a new, multi-lateral Global Fund to Fight Infectious Diseases, an international public-private partnership to provide grants for prevention and health infrastructure development focused on fighting HIV/AIDS, malaria, and tuberculosis. We believe the fund should operate under the following series of core principles: • Our goals are to prevent new infections and treat those already afflicted, to build the infrastructure for health care and disease control, and to develop and train human resources. • We seek to support a community-driven process that identifies the needs of affected areas and allows communities themselves to develop an appropriate, comprehensive set of medical, social and support services.