By Senator Bill Frist, MD
Nov. 13, 2015 | Forbes
This week, former Senate Majority Leader Tom Daschle and I released a report recommending a policy of strategic health diplomacy, inspired and informed by the success of the President’s Emergency Plan for AIDS Relief (PEPFAR). The report’s publication was announced at a conference in Washington, DC, where many of the architects of PEPFAR came together to advocate for a foreign policy approach that incorporates health care and humanitarian aid. The PEPFAR program has provided access to anti-retroviral treatments to more than 7.7 million men, women, and children worldwide. It has prevented transmission of the virus to 95% of infants with infected mothers, offered care and support to millions of orphans, and trained over 140,000 new health care workers. It is by all accounts a major success. Yet it took many years for us to get to this point.
When I first became acquainted with the AIDS virus, I was a surgical resident in Boston in 1981. At that time it was still an unexplained illness with only a few documented cases. I never would have predicted the scourge that HIV/AIDS would become. Back then, we thought we would have a cure within a few short years.
Instead, AIDS was responsible for the deaths of 3 million people in 2003 alone, and 40 million people lived with AIDS or HIV at that time. As a surgeon, the emergence of AIDS spurred radical changes in surgical practices. In the early years, when I operated on a patient with HIV or AIDS, I wouldn’t require my assistants to scrub in due to the risks.
By the time I was elected to the Senate, I had treated and operated on HIV patients in the U.S., and seen the ravages of the disease during my medical mission trips to Tanzania, Kenya, Sudan, and the Democratic Republic of Congo. This disease had provoked widespread fear, prejudices, and at times hysteria. With no cure in sight, myths and false claims spread, including the horrific virgin cleansing myth that took hold in Sub-Saharan Africa and led to the rape of young girls and event infants.
There are few illnesses in modern history that have caused the destruction to society, family, and socioeconomic stability as HIV and AIDS. But as we learned more about the disease and how to treat it, the U.S. suddenly had an opportunity to lead and promote health as a currency for peace. In 1995 when the first effective treatment cocktail came out, it was a light at the end of the tunnel.
With the advent of this new therapy, AIDS fell out of the top 10 causes of death in the United States for the first time since 1990. At that time our federal investment in global AIDS relief was just a drop in the bucket, amounting to approximately $170 million compared to the $8.6 billion our government was spending domestically. While Americans were seeing a turning point, African nations were still in the midst of an epidemic.
In 2000, I got a call from U2’s front man Bono, urging me to travel with him to Africa to survey the impact of our federal dollars. I already had a medical mission planned, so agreed to meet him in Uganda, where we visited the medical clinics, the HIV programs, and the new wells that had been dug. It was clear to me then we had a real opportunity to make a difference—and a moral obligation as well.
In the year following this trip, I offered a budget amendment to more than double AIDS spending to $1 billion. This amendment was the first step that would help lead to a $900 million increase in global AIDS spending for 2002. I also found a Democratic partner sympathetic to the cause in Senator John Kerry. Together we introduced the Kerry-Frist Global AIDS bill, which would authorize the first large-scale AIDS treatment programs in the developing world.