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A decade ago, as I was beginning my time as Senate majority leader, bipartisan consensus in Washington helped launch a new era of progress in global health just when it was sorely needed. Twenty years had passed since I first saw AIDS patients in Boston, though at the time we didn’t even have a name for this savage disease. Advances in treatment and technology were helping control HIV in the United States, but AIDS was decimating communities worldwide. There were tens of millions of infections, yet only 400,000 people in low- and middle-income countries had access to lifesaving antiretroviral therapy, meaning only a tiny fraction were able to escape death.
World leaders united to tackle AIDS and other scourges through an innovative financing tool — the Global Fund to Fight AIDS, Tuberculosis and Malaria. President George W. Bush and Congress made a founding pledge of $300 million to the international initiative. Bush, with bipartisan support from both chambers of Congress, also established the President’s Emergency Plan for AIDS Relief, the largest program ever to combat a single disease. President Barack Obama has similarly embraced this program and America’s role in eradicating this disease.
U.S. leadership at the Global Fund, and bilateral health programs such as PEPFAR and the President’s Malaria Initiative, signaled a renewed commitment to a core facet of our country’s greatness: compassion for those most in need. Understanding that improving global health is good for national security, economically prudent and — most importantly — the right thing to do, the U.S. taxpayers made an unprecedented investment in the world’s future.
That investment is paying off.
As we mark the 10th anniversary of PEPFAR this year, the number of people on lifesaving treatment has increased more than twentyfold. HIV infection rates are down. The number of malaria cases has plummeted by more than 50 percent. Tuberculosis mortality rates are falling steadily. The Global Fund alone saves an estimated 100,000 lives each and every month, working in more than 150 countries. These health gains were once unimaginable.
A new chapter in global health begins this month as visionary leader Dr. Mark Dybul takes the helm as executive director of the Global Fund. With so much gridlock in Washington, Dybul’s appointment is a reminder of what we can accomplish by reaching across party lines.
Dybul, who began as a physician treating AIDS patients in the early years of the pandemic, helped transform the fight against the disease as the architect and leader of PEPFAR. Now at the Global Fund, he will lead the charge to defeat AIDS, malaria and tuberculosis. Armed with scientific expertise and dedicated to a mission that goes beyond political ideology, there may be no one better suited for the job.
Today there is real hope in this fight — but it’s far from over. We have the science to help people with HIV live healthy lives, but millions still lack access to the treatment they need. We can detect and treat TB, but drug-resistant strains represent a growing threat, and disease respects no borders. And malaria still takes countless lives each year, though it can be stopped with basic, incredibly cheap prevention.
Now is no time to shy away from our health investments. Scientific innovation continues to produce miracles at an accelerating pace. International donors are stepping up to the plate. Many traditional aid recipients are putting more resources into their own domestic health. The U.S. investment — less than 1 percent of our federal budget — saves and transforms hundreds of thousands of lives every year. It’s hard to imagine a better return on investment.
U.S. leadership has helped deliver a major blow to these three diseases, and backing down now would jeopardize that momentum. We’ve come too far to risk letting these diseases spread, mutate or reclaim the lives of people whom medicines have made healthy. We must finish this fight.
There are also real problems here at home, not the least of which is a challenging economic environment. And there is frequent division in Washington. But while sweeping agreement on Capitol Hill may be rare, the same bipartisan, compassionate commitment to global health remains strong. Obama called PEPFAR one of his predecessor’s “greatest legacies.” As Dybul and the Global Fund chart the path forward, we see new U.S. leaders from both parties taking up the mantle of global health, united in putting an end to these diseases.
Determined leadership today will help secure a stronger America and a brighter, healthier future for millions in the years to come. We have a long way to go, but together we can finally put AIDS, tuberculosis and malaria where they belong — in the history books.
Bill Frist, a physician, is a former Republican senator and majority leader from Tennessee.