International Day of
Brief Report on Activities in South Africa and Memo
24 June 2004
Today, in Johannesburg, Cape Town, Durban and East London, the
Treatment Action Campaign led marches calling on the US Government to
invest in health not war. Each march was attended by hundreds of
Seminars These activities were part of an international day of
aimed at the Bush Administration. In Johannesburg, COSATU President,
Willie Madisha, addressed the marchers. In Durban and Cape Town, a
delegate of the US Consulate accepted the following memorandum
President George W. Bush
C/O Ambassador Cameron R. Hume
United States Embassy
877 Pretorius St, Pretoria
24 June 2004
Delivered By Hand to US Consulates in South Africa
Dear President Bush
INVEST IN HEALTH NOT WAR!
Today, over eighty organisations around the world concerned with health
and human rights have joined together to express our concern with the
current policies and actions of the US government. In South
are marching in four cities to say that we are deeply disturbed by the
actions and policies of your Administration that undermine the
prevention and treatment of HIV/AIDS. The effect of the US
government's unlawful war in Iraq has been to divert international
attention and resources away from global health and poverty.
Hundreds of billions of dollars are being spent on the military instead
of investing resources in the biggest threats to human security today:
HIV/AIDS, tuberculosis (TB), malaria, malnutrition and poverty.
2003, the United Nations estimated that 2.5 to 3.5 million people died
of AIDS, one million of malaria and two million of TB. Yet these
diseases can be prevented and treated. Further, an estimated 800
million people endured malnutrition, which continues to play a major
role in half of the more than ten million annual child deaths in the
In many countries women undergo back-street abortions and risk death
because they are denied the right to make reproductive choices.
Inappropriate moral judgments stigmatise condom use and distribution,
thereby putting millions of people at risk of HIV and other sexually
transmitted infections. The spread of HIV is further fuelled by
oppression of sexual minorities and draconian legislation that targets
commercial sex workers and intravenous drug users.
Successfully reducing HIV infections and giving more people with AIDS
access to life-saving medicines requires the promotion of human rights
and investment in developing world health systems. The World
Organization (WHO) has called for three million people with AIDS to be
treated with life-saving antiretroviral medicines by 2005, but your
Administration has shown little political will for promoting this
objective or human rights.
We therefore say to your Administration:
Invest more money in the Global Fund to Fight AIDS, TB and Malaria!
The Global Fund to Fight AIDS, TB and Malaria (the Global Fund) is the
best opportunity for responsible funding of initiatives to prevent and
treat infectious diseases in poor countries. Yet this initiative
remains substantially underfunded. In January 2003, your
Administration promised $15 billion over the next five years to
alleviate the HIV epidemic. The Treatment Action Campaign (TAC)
other organisations cautiously welcomed your promise. Yet the
expenditure approved by the US Congress as part of this commitment for
2004 is only $2.4 billion, of which most funds are going to the
President's Emergency Plan for AIDS Relief (PEPFAR) and not the Global
The total amount of US aid money for 2004 is $17.55 billion. Yet the
military budget approved for 2004 is already $368.2 billion and your
Administration has requested a further $87 billion war supplemental for
Iraq. Much of this military budget is being used to fight the
so-called "War Against Terror" and to sustain the occupation of
We acknowledge the threat of terrorism. However, the most
and widespread threats to global security are the ones exacerbated by
poverty and lack of development: the HIV/AIDS, malaria and TB
epidemics, as well as malnutrition. Alleviating these problems,
together with promoting human rights and negotiating solutions to world
problems through international institutions, is the best way to ensure
long-term global security.
Your Administration must lead the world's countries in a drive to
ensure the Global Fund receives the finance it needs and the WHO
achieves its aim of treating 3 million people with antiretrovirals by
the end of next year.
Stop Undermining Public Confidence in Safe, Effective Anti-AIDS
In recent months your Administration has used pseudo-scientific
arguments actively to undermine access to generic antiretroviral
medicines, in particular fixed-dose combination (FDC) antiretrovirals
that reduce the number of pills people with AIDS have to take on a
daily basis. Reduced pill burdens result directly in increased
compliance with treatment and better health outcomes. In
FDCs generally cost less than standalone antiretroviral pills,
especially if generic and brand name suppliers compete with each other.
While cautiously welcoming recent announcements that indicate a
revision of this approach, we nevertheless believe that insisting on
FDA approval for FDCs and other generic antiretroviral medicines before
they can be purchased with PEPFAR money both disregards and undermines
the WHO's pre-qualification system and the independent regulatory
authorities of many developing countries. It will also further
the purchase of these medicines with PEPFAR funds.
Your Administration must commit to allowing recipient countries to
purchase medicines approved by their regulatory authorities or
pre-qualified by the WHO. At a minimum, the FDA must commit to a
maximum time-period for approval, with application fees for the
approval of FDCs and other generic antiretroviral medicines for
eligibility for purchase with PEPFAR funds being waived.
Stop Using Bilateral Pressure to Undermine the Doha Declaration on
TRIPS and Public Health!
Since the World Trade Organization (WTO) ministerial meeting in Doha in
2001, which clarified the opportunities that developing countries have
to access generic medicines, your Administration has vigorously pursued
bilateral free trade agreements that seek to impose considerably higher
standards of intellectual property protection that required by the
WTO. Imposing TRIPS-plus legislation on developing countries
significantly reduces their ability to protect and advance public
health, in particular, to take reasonable steps to mitigate the impact
of HIV/AIDS. We note with dismay that now there are signs that
might actually be used to the benefit of developing countries, your
Administration is threatening its viability.
We call on your Administration to recognise that countries can and
should exercise their rights under the Doha Declaration on TRIPS and
Stop Undermining Prevention Efforts by Marginalising Minorities and
Subverting Access to Condoms!
Prevention interventions aimed at gay men, commercial sex workers
and intravenous drug users are an essential part of reducing HIV
transmission. Yet your Administration, driven by religious
fundamentalism, opposes such efforts. For example a third of
prevention funds are earmarked for abstinence-until-marriage
programmes. While we support the promotion of delayed sexual
as an important aspect of life-skills education, we do not believe that
this should be framed in moral judgments concerning marriage or at the
expense of condom promotion and distribution, especially to youth.
Further, your Administration refuses to acknowledge the vital
importance of access to and information about condoms in the general
population. Most disturbing, it has been party to unscientific
and statements questioning the efficacy of condoms, for example
removing information on condoms from the website of the US Centers for
Disease Control. In addition, draconian legislation continues to
intravenous drug users and commercial sex workers at risk of HIV
infection. This has lead to the Lancet describing the current US
policy on HIV/AIDS as "perhaps one of the best examples of ideology
impeding sound public health policy."
We call on your Administration to encourage the promotion of
condoms, work towards the decriminalisation of commercial sex-work and
encourage needle-exchange programmes, both in the United States and
Recognise the Right to Reproductive Choice!
You have reinstated the Global Gag Rule, cutting US funding (as well as
donations of contraceptives) to family planning and other organisations
that provide comprehensive information on reproductive choice, which
includes the option of abortion. Around the world women undergo
life-threatening back-street abortions because they do not have access
to reproductive choice, particularly the right to choose to terminate
their pregnancies lawfully and safely. Your ideologically driven
religious fundamentalist policy fails to take into account how this
limits women's options, often threatening the completion of their
education, resulting in the loss of work or forcing dependency on
unwanted relationships and transactional sex.
We call on your Administration to drop the Global Gag Rule and
recognise women's rights to choose.
Your administration has a poor record of alleviating HIV/AIDS, TB,
malaria, malnutrition and poverty. We ask you today to rectify
Administration's negligence and to invest in health, not war.
(Signed by different representatives in different provinces.)
ON BEHALF OF THE TAC NATIONAL EXECUTIVE COMMITTEE