Bill Clinton on HIV/AIDS: Much More Needs to be Done

Former US president Bill Clinton speaks during a session at the International AIDS Conference Austria, 19 Jul 2010

Former President Bill Clinton addressed the 18th International AIDS Conference in Vienna Monday. He said while much progress has been made in the fight against the epidemic, much more remains to be done, including on human rights.

Mr. Clinton was the keynote speaker at Monday’s plenary session at AIDS 2010.

“This year’s conference theme – Rights Here, Right Now – reminds us that health care should be a right for everyone, but isn’t,” he said.

While progress has been made, he said, it is not the time to become complacent.

“Notwithstanding the current economic difficulties, the evidence of the progress that has been made in the last few years is not an excuse to walk away from that right.  It’s an excuse to run toward it for all of us.”

The former president expects the AIDS conference to produce – what he calls – encouraging scientific news.

 
Aids 2010
President Clinton speaking at the 18th International AIDS Conference in Vienna

That may include Tuesday’s announcement about whether a microbicide called CAPRISA 004 works. Microbicide trials in the past have all failed to show any protection against HIV. But CAPRISA 004, a gel, is the first to contain antiretroviral drugs.

Don’t rest on laurels

Mr. Clinton said successes against the epidemic need to translate into a long-term strategy.

“To paraphrase what Winston Churchill said when the British finally started winning a battle or two in World War II, this is not the end. It’s not even the beginning of the end.  It is only the end of the beginning.  In other words, we ramped up.  You’ve done a great job.  But we have to transition now from what has essentially been a make-it-up-as-you-go-along emergency response to one that we can sustain,” he said.

While praising efforts that have gotten five million people worldwide on treatment, he warned millions more still need life-saving drugs.

“We cannot get to the end of this epidemic without both more money and real changes in the way we spend it.  I think it is profoundly important that we think about both,” Clinton said.

Raised a lot of boats

Mr. Clinton also addressed the debate over spending more on global health programs, as opposed to more specific targets like treatment or maternal and child health.  He says it’s not a coincidence that fewer women and children are dying annually at the same time PEPFAR and the Global Fund to Fight AIDS, TB and Malaria have increased spending for global health.

“The fight against AIDS has raised a lot of boats – to fight tuberculosis and malaria, to improve health systems, to challenge and motivate governments and NGOs alike, to deliver more and better health care.  Fighting AIDS in the right way clearly improves maternal and child health,” he said.

For example, the Clinton Foundation takes a holistic approach to preventing mother-to-child transmission OF HIV.

“Our first measure is not an AIDS indicator.  It’s whether or not we’re increasing attendance of pregnant women in prenatal care and rates of women delivering with a skilled birth attendant. Seeing those numbers rise, will lower the number of children born with HIV and advance maternal health,” he said.

“And it works the other way around," he added. "If you invest in maternal health, you’re going to lower HIV transmission by educating girls on reproductive health, getting them into care when their pregnant, helping them to deliver at a clinic, or with an attendant.”

Unfair criticism?

The former president also addressed the criticism by activists and many NGOs that donors are not increasing spending for HIV/AIDS as fast as they have in the past.

“The world is awash in troubles," he said. "It is easy to rail at a government and say why doesn’t the government give us more money when they’re giving somebody else money.  But the government gets its money in most of these countries from taxpayers who have lower income today than they did two years ago.  So, if we’re going to make this case, they have to believe that we’re doing our job faster, better and cheaper.  And then we have the moral standing to go ask people to give us more money.”

President Obama has been the target of harsh criticism by those who say he reneged on his campaign promises to greatly boost spending for HIV/AIDS.  Mr. Clinton said he understands their concerns, but defended Mr. Obama.

“I do not think it is either fair or accurate to say the president has gone back on his promises, as if this was a callous walking away.  When he signed that petition saying he would support greater AIDS funding, it was before the American economy led the world into the worst financial crisis since the Depression.  Since then, he has tried to keep his commitments,” he said.

Bill Clinton advised participants at the AIDS conference to lobby the U.S. Congress to increase AIDS spending.  He says President Obama would never veto an increase in AIDS funding.