Something extraordinary happened in February when President Bush visited Africa: He was cheered by locals and showered with kisses. That is in no small part a result of the $15 billion President's Emergency Plan for AIDS Relief, or PEPFAR, which has helped millions suffering from HIV/AIDS find treatment and may be the one arena in which the White House has shown positive leadership abroad.
Yet despite strong bipartisan support in both houses of Congress and the spirited backing of the White House, this lifesaving program might not get reauthorized. That is because three conservative Republican senators are still working to prevent the bill from being passed in its current form. One of the remaining sticking points is the overall price tag of the bill: $50 billion. Some would like to see this amount cut considerably. Not only is this politics at its worst, but opposing the bill will also hamstring President Bush's efforts to persuade the Group of Eight industrialized democracies, which holds its annual powwow next week, to fork over more funds for HIV prevention and other key global health interventions.
Over the past five years, PEPFAR has saved countless lives, especially in those countries hardest hit in sub-Saharan Africa. Since the program's inception, PEPFAR has supported 2.7 million orphans and the prevention of mother-to-child transmission for women during more than 12.7 million pregnancies. For pregnant women found to be HIV-positive, it has provided antiretroviral prophylaxis in more than 1 million pregnancies, preventing transmission of HIV to an estimated 194,000 infants. Thanks to PEPFAR, AIDS is no longer a death sentence in Africa.
But there is still much to be done. Some 143 million children in the developing world have lost one or both parents, many to AIDS. With the loss of a parent goes a child's first line of defense against disease, and it triggers an escalation of deprivation for the child.
Because of AIDS, more than half of the children toiling in Tanzania's mines are orphans. The same goes for children engaged in commercial sex work in Zambia. All of which makes the fact that just 15 percent of Africa's orphans and vulnerable children receive any kind of international assistance that much more appalling.
Interestingly, the United States, not Europe, has taken the lead on this issue. Washington devotes 10 percent of PEPFAR funding to orphans and vulnerable children. Slowly, other countries, inspired by our leadership, have stepped up to the plate. Ireland promised 20 percent of its HIV/AIDS funding to orphans and vulnerable children after watching the U.S. do so.
The G-8 summit in Japan is the perfect opportunity for President Bush to push other donors to fully fund their previous commitments to the world's children. But with PEPFAR's renewal in the Senate in jeopardy, the president will lack the leverage necessary to call on his counterparts to meet their obligations. If he can't even persuade senators of his own party to support him, how can he convince seven heads of state?
The time has come to put politics aside and reauthorize PEPFAR, which expires this fall. Republican leaders must rein in the conservative flank of their party and put lives before votes. Otherwise, the president's biggest achievement abroad may come undone, and millions of children will suffer the dire consequences.
Leila Nimatallah is policy director of Global Action for Children. Her e-mail is firstname.lastname@example.org.