Letter from the Yale AIDS Network to President Bush


May 19, 2001

The Honorable George W. Bush
President of the United States
1600 Pennsylvania Avenue, NW
Washington, DC 20500

Re: United States leadership in the fight against the global AIDS pandemic

Dear President Bush,

We, faculty and students of Yale University, are deeply concerned about the global HIV/AIDS crisis. We write to express our conviction that the United States must exhibit leadership at this critical juncture by coming forward as the lead contributor to the Global Fund for HIV/AIDS, and by signing a strengthened version of the Declaration of Commitment on HIV/AIDS at the June 25-27 United Nations General Assembly Special Session.

We have worked internationally in the prevention and treatment of HIV/AIDS, and in the formulation of laws, policies and ethics associated with HIV/AIDS. Our response to the growing pandemic includes providing comprehensive care to large numbers of adults and children with HIV/AIDS; discovering antiretroviral drugs; leading the World Health Organization Global Program on AIDS; initiating needle exchange programs; establishing community-based prevention and treatment programs around the world; addressing the human rights and legal implications of HIV/AIDS; serving on the editorial boards of leading medical journals focused on HIV/AIDS; and serving as consultants to the National Institutes of Health, Centers for Disease Control and Prevention, National Academy of Sciences, President's Commission on AIDS, and World Bank, among others. Most recently, Yale University has taken strong action to address the issue of access to treatment by negotiating with Bristol-Myers Squibb to relax the patent on the antiretroviral drug d4T in South Africa.

The world is now poised to take dramatic steps to combat the HIV/AIDS pandemic. United Nations Secretary General Kofi Annan has called for $7-10 billion annually for a Global Fund for HIV/AIDS. Two important conditions for the effective use of such a fund have crystallized in the last year: strong international and national leadership on HIV/AIDS, and a dynamic spirit of public/private partnership. As countries around the world join forces toward productive measures to combat the pandemic, the United States appears to be moving in a disappointing direction, unworthy of our role as a global leader. Even as the Administration has recognized AIDS as a threat to our national security, we have not provided a commensurate response. The United States has chosen to emphasize intellectual property rights over human rights, and to pit prevention against treatment.

At this formative moment, the United States should support an approach to combating the pandemic based upon two basic principles. First, treatment and prevention are inextricably linked, and the United States should fully support both. A false dichotomy between treatment and prevention will prevent progress on both fronts. As the "Harvard Consensus Statement on Antiretroviral Treatment for AIDS in Poor Countries" shows, treatment is necessary to optimize prevention efforts, to sustain the fabric of societies, and to continue global economic development. Second, increased respect for human rights is a necessary part of the response to the HIV/AIDS pandemic. Failure to protect the rights of people living with AIDS and other members of societies affected by the pandemic undermines prevention and treatment efforts, as well as prospects for healthy economic and social development. We should use the United Nations General Assembly Special Session to affirm respect for human rights as central to fighting the pandemic.

Following these principles, the Administration should approach the United Nations General Assembly Special Session with the following goals:

The United States should take the lead and support the Global Fund for HIV/AIDS fully and immediately. Costs associated with HIV/AIDS have risen exponentially, and every year it costs more to contain the crisis. An international consensus is emerging that a global fund of $7-10 billion per year is needed to fight AIDS, starting now. Recently, the Administration announced that the United States will initially contribute only $200 million to the Fund, just two percent of the total needed. A reasonable contribution, reflecting our share of the world's GNP and our firm commitment to halting the pandemic, would be twenty-five percent of the total, or $2.5 billion. This figure should be considered a sensible investment, since the costs of confronting the epidemic will only increase if we fail to act decisively now. The United States should also significantly increase official development assistance to combat inadequate education, poor nutrition, weak health care systems, and other aspects of poverty that contribute to the devastation of HIV/AIDS.

The United Nations General Assembly Special Session on HIV/AIDS Draft Declaration must be strengthened if it is to have any real impact. It must reflect the urgent need for collective action to bring about substantial and immediate change, and include explicit goals and timelines for prevention and treatment that correspond at a minimum with those set in the UNAIDS five-year plan.

The United Nations General Assembly Special Session gives you a unique opportunity to demonstrate world leadership and to turn the tide of the twenty-year HIV/AIDS pandemic. The sudden availability of low cost anti-retroviral drugs in low-income countries has focused the world's attention and provided an opportunity to raise the resources and achieve the political commitment needed to stop HIV/AIDS. We will not have this opportunity again. The United States must therefore take the lead in building the Global Fund for HIV/AIDS and galvanizing a collaborative international response to HIV/AIDS.

Sincerely,

Nadia Abdala, DVM, PhD
Associate Research Scientist, Department of Epidemiology and Public Health
Yale School of Medicine

Susan S. Addiss, MPH, MurS
Lecturer in Health Policy and Administration
Department of Epidemiology and Public Health, Yale School of Medicine
Former Connecticut Commissioner of Health

Frederick L. Altice, MD, MPH
Director, HIV in Prisons Program
Yale AIDS Program, Yale School of Medicine

Warren Andiman, MD
Director of Pediatric AIDS Program
Professor of Pediatrics (Infectious Disease)
Professor of Epidemiology and Public Health
Yale School of Medicine

Nancy R. Angoff, MD, MPH, MEd
Associate Dean for Student Affairs
Yale School of Medicine

S. Kelly Avants, PhD
Associate Professor of Psychiatry, Division of Substance Abuse
Yale School of Medicine

David Bartlett, PhD
Dean of Academic Affairs
Lantz Professor of Preaching and Christian Communication
Yale Divinity School

Frank J. Bia, MD, MPH
Professor of Medicine and Laboratory Medicine, Department of Internal Medicine
Co-Director, International Health Program
Yale School of Medicine

Ann J. Biersteker, PhD
Associate Professor, Adjunct
Linguistics and African Studies, Yale University

Kim Blankenship, PhD
Associate Research Scientist, The Institution for Social and Policy Studies
Associate Director, Center for Interdisciplinary Research on AIDS
Yale University

John Booss, MD
Professor of Neurology and Laboratory Medicine, Department of Laboratory Medicine
Yale School of Medicine

Elizabeth Bradley, PhD
Assistant Professor, Division of Health Policy and Administration
Yale School of Medicine

Martha Buitrago, MD
Director of HIV Services, Fair Haven Community Health Center
Clinical Instructor, Yale AIDS Program
Yale School of Medicine

Kent Buse, PhD
Assistant Professor, Division of Global Health
Yale School of Medicine

Dom Cicchetti, PhD
Senior Research Scientist, Child Study Center
Yale School of Medicine

Scott Clair, PhD
Associate Research Scientist, Department of Biostatists
Yale School of Medicine

Kamari Maxine Clarke, PhD
Assistant Professor, Department of Anthropology
Yale University

Elizabeth L. Cooney, MD
Assistant Professor of Medicine, Department of Internal Medicine
Medical Director, AIDS Program Clinical Trials Unit
Yale School of Medicine

Harlon L. Dalton, JD
Professor of Law, Yale Law School
Co-Director of CIRA Law, Policy & Ethics Core, Yale University

Robert M. Donaldson, Jr., MD
David Paige Smith Professor of Medicine Emeritus, Department of Internal Medicine Yale School of Medicine

Gail D'Onofrio, MD
Associate Professor, Section of Emergency Medicine
Yale School of Medicine

Michael R. Dove, PhD
Professor of Social Ecology, Yale School of Forestry and Environmental Studies

Ravi Durvasala, MD
Department of Internal Medicine, Yale School of Medicine

Margaret A. Farley, PhD
Gilbert L. Stark Professor of Christian Ethics, Yale Divinity School
Co-chair, Yale Interdisciplinary Bioethics Committee

William J. Foltz, PhD
H.J. Heinz Professor of African Studies and Political Science
Chair, International Affairs Council
Yale University

Brian Forsyth, MB, ChB
Director of Pediatric AIDS Family Support Program, Yale-New Haven Hospital
Associate Professor of Pediatrics, Yale School of Medicine

Jonathan M. Freiman, JD
Orville Schell Fellow, Yale Law School

Gerald Friedland, MD
Director of Yale AIDS Progam
Professor of Medicine and Epidemiology and Public Health
Yale School of Medicine

Catherine L. Gilliss, DNSc, RN, FAAN
Dean and Professor
Yale School of Nursing

Judith Bograd Gordon, PhD
Lecturer, Department of Psychiatry
Yale School of Medicine

Lauretta E. Grau, PhD
Associate Research Scientist, CIRA
Yale University

Robert Heimer, PhD
Associate Professor, Division of Epidemiology of Microbial Diseases
Yale School of Medicine

Michele E. Horne, MD
Fellow, Yale School of Medicine

Deena Hurwitz, JD
Robert M. Cover/ Allard K. Lowenstein Fellow in International Human Rights
Yale Law School

Keith A. Joiner, MD
Professor of Medicine, Cell Biology and Epidemiology
Chief, Section of Infectious Disease, Department of Internal Medicine
Yale School of Medicine

L. Serene Jones, MDiv, PhD
Associate Professor of Theology, Yale Divinity School

Gilbert M. Joseph, PhD
Farnam Professor of History, Yale University

Paul W. Kahn, PhD, JD
Robert W. Winner Professor of Law and the Humanities
Director, Orville H. Schell Jr., Center for International Human Rights
Yale Law School

David A. Kessler, MD, JD
Dean of the Yale School of Medicine
Former Commissioner of the United States Food and Drug Administration

Kaveh Khoshnood, PhD
Assistant Professor, Division of Epidemiology of Microbial Diseases
Yale School of Medicine

Ilona S. Kickbusch, PhD
Professor of Epidemiology & Public Health
Division Head for Global Health, Yale School of Medicine

Harold Hongju Koh, JD, MA
Gerard C. and Bernice Latrobe Smith Professor of International Law, Yale Law School
Former Assistant Secretary of State for Democracy, Human Rights and Labor

Michael Kozal, MD
Assistant Professor of Medicine, Department of Internal Medicine
Yale AIDS Program, Yale School of Medicine

Jean E. Krasno, PhD
Executive Director, Academic Council on the United Nations System
Yale University

Anthony Townsend Kronman, PhD, JD
Dean and Edward J. Phelps Professor of Law
Yale Law School

Forrester A. Lee, MD
Associate Professor of Medicine
Assistant Dean for Multicultural Affairs
Yale School of Medicine

Andres Martin MD
Assistant Professor of Child Psychiatry and Psychiatry
Child Study Center
Yale School of Medicine

Peter McPhedren, MD
Faculty, Yale School of Medicine

Michael Merson, MD
Professor and Chairman, Department of Epidemiology and Public Health
Dean of Public Health, Yale School of Medicine
Director of CIRA, Yale University
Former Director, WHO Global Program on AIDS

Christopher L. Miller, PhD
Frederick Clifford Miller Ford Professor of African American Studies and French
Yale University

Alexander Ortega, PhD
Assistant Professor, Division of Health Policy Administration
Yale School of Medicine

A. David Paltiel, PhD
Associate Professor, Division of Health Policy and Administration
Yale School of Medicine
Yale School of Management

Kim-Thu C. Pham, MD
Assistant Professor, Division of Global Health
Yale School of Medicine

William H. Prusoff, MS, PhD
Professor Emeritus, Department of Pharmacology
Yale School of Medicine

Gustav Ranis, PhD
Frank Altschul Professor of International Economics
Henry R. Luce Director, Yale Center for International and Area Studies
Yale University

John K. Rose, PhD
Professor of Pathology, Cell Biology, and Biology, Department of Pathology
Yale School of Medicine

Letty M. Russell, PhD
Professor of Theology, Yale Divinity School

Mark Russi, MD, MPH
Director, Occupational Health, Yale-New Haven Hospital
Associate Professor of Medicine, Yale School of Medicine

Nancy L. Ruther, PhD, MA, MIA
Director of the Yale Center for International and Area Studies
Lecturer in Political Science, Yale University

Peter Salovey, PhD
Professor and Chair, Department of Psychology
Deputy Director, CIRA
Yale University

James C Scott, PhD
Eugene Meyer Professor of Political Science and Anthropology
Director of the Program in Agrarian Studies
Yale University

Kathleen J. Sikkema, PhD
Associate Professor of Psychiatry
Division of Prevention and Community Research
Yale School of Medicine

James J. Silk, MA, JD
Executive Director, Orville H. Schell, Jr. Center for International Human Rights
Yale Law School

John G. Simon, LLB, LLD
Augustus E. Lines Professor of Law
Yale Law School

James Gustave Speth, MLitt, JD
Dean and Professor in the Practice of Environmental Policy and Sustainable Development
Yale School of Forestry and Environmental Studies
Former Administrator of the United Nations Development Program

Lynn E. Sullivan, MD
Assistant Clinical Professor of Medicine, Department of Internal Medicine
Yale AIDS Program, Yale School of Medicine

Diana Swancutt, PhD
Assistant Professor of New Testament, Yale Divinity School

David P. Watts, PhD
Professor of Anthropology, Yale University

Margaret R. Weeks, PhD
Research Associate, Department of Psychology
Yale University

Madeline Wilson, MD
Director of Yale Internal Medicine Associates, Yale-New Haven Hospital
Faculty, Yale School of Medicine

Brian Wong, MD
Associate Professor of Medicine, Department of Internal Medicine
Yale School of Medicine

Eric Worby, PhD
Assistant Professor of Anthropology, Yale University

STUDENTS
Glenn Adamson (School of Arts and Sciences)
Shaheena Ahmad (Law)
Teeb Al-Samarrai (Medicine)
Jason Andrews (College)
Eric D. Ashton (Public Health)
Sara Aviel (College)
Shirin Badrtalei (Public Health) Fran Balamuth (Medicine)
Rachael Barron-Duncan (School of Arts and Sciences)
Robert Bruce, MD (Divinity School)
Alison Bruey, MA (History)
Mairin Burke (College)
Brandee Butler (Law)
John M. Carney (Public Health)
Rachel Chrastil (History)
E. Tyler Crone, MPH (Law)
Hugo Cyr, LLM (Law)
Fabian Drixler (School of Arts and Sciences)
Elizabeth Emens (Law)
Rebecca C. Falik (College)
Cheryl Finley (School of Arts and Science)
Christina E. Fitch (Public Health)
Douglas Fordham (School of Arts and Sciences)
Matthew C. Franklin, PhD (Molecular Biophysics and Biochemistry)
Eric A. Friedman (Law)
Shur-Fen Susan Gau, MD (Public Health)
Matthew N. Goldenberg (Medicine)
Jessica Gottlieb (College)
Joshua Guild (School of Arts and Sciences)
Meghan Gutekunst (College)
Janet Hardy, MPH, MSc (Public Health)
Katrina Harpe (College)
Tessa Hayes (College)
Richard Heffernan, MPH (Public Health)
Michael Herce (Medicine)
Rhonda T. Heschel, MS (Nursing)
Mette Bastholm Jensen (Sociology)
Kohar Jones (Medicine)
Amy Kapczynski, MA, M.Phil (Law)
Kevin M. Keenan (Law)
Bonnie Kerker (Public Health)
Rebecca Kolsky (College)
Shafali Lal (American Studies)
Adrian Lingaya (Law)
Jessica Luck (College)
Kathleen Ramos Mangunay (Public Health)
Grace Meng (Law)
Kyeen Mesesan (Medicine)
Susan M. Nappi (Public Health)
Joanna Norland (Law)
Ann Kim Novakowski (Public Health)
Tavia Nyong'o (American Studies)
Rachel Oberter (School of Arts and Sciences)
Miriam F. Parsa (Public Health)
Paul Pascual (Public Health)
Nikkita Patel (Public Health)
Lea A. Payne (Public Health)
Emily Suzanne Pierce (Law)
Lisabeth Pimentel (History)
Eric Poolman (Medicine)
Nicole C. Quon (Public Health)
Rahul Rajkumar (Medicine)
Erika Samoff (Public Health)
David Sanders (History)
Kafi N. Sanders (Public Health)
Naomi Seiler (Law)
Amelia Shaw (African Studies/Public Health)
Brooke Sprague (College)
Katherine Stern, PhD (Law)
Shayna Strom (College)
Eric M. Stryker (School of Arts and Sciences)
Joann R. Sy (Divinity)
Jessica Thorpe (International Relations)
Mark Allan Totten (Religious Studies)
Virginia A. Triant (Medicine)
Elizabeth Tung (Yale College)
Minh Vo (Law School)
Sarah Vogel (Public Health/Forestry and Environmental Studies)
Jennifer B. Wang (College)
John T. Way (History)
Elizabeth Wiley (Public Health)
Angela Williams (Public Health)
Christianna Williams (Public Health)
Mark C. Williams (School of Arts and Sciences)
Ilene Wong (Medicine)
Megann Young (College)

On behalf of the Yale AIDS Network.

cc:
Secretary of State Colin L. Powell
Secretary of the Treasury Paul O'Neill
Secretary of Health and Human Services Tommy Thompson
National Security Adviser Condoleezza Rice
Director of the Office of National AIDS Policy Scott H. Evertz


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