Expensive or Priceless:  analytical perspectives regarding the costs of AIDS prevention and the application of global funds

by Mondale Patterson

This paper presents an exploratory analysis of critical viewpoints in regards to the large amounts of global funds geared towards the prevention of AIDS.  The three articles present three different positions.  Brink’s article “Dancing in the Dark” commends the deployment of funds into the fight against AIDS.  She illustrates how free treatment and medicine is changing the welfare of victims in Botswana.  In stark contrast, we have William F. Jasper’s article “Global AIDS con game” criticizing all government funding to foreign aid programs focused on AIDS prevention.  He believes that the programs harm the fight against this international pandemic more than they help.  One of Jasper’s sub claims is that African dictators are exploiting funds for more power and goods.  Caroline Halmshaw and Kate Hawkins offer their readers a realistic, ground-zero depiction of what is happening with the millions and billions of dollars circulating throughout the HIV positive communities in their article “Capitalizing on global HIV/AIDS funding: the challenge for civil society and government.”  Some of their worthy sub claims are that:  the moneys are reaching the communities but sometimes insufficiently because of concepts such as absorptive capacity (a nation’s ability to absorb large inflows of funds) and disbursement capacity (a nation’s ability to effectively apply large amounts of funds); actors lack morale because of morbidity and mortality therefore slowing processes; and actors lack professional knowledge and skill and the much needed compassion to deal with victims.  Their studies help us as outsiders understand the reasons behind Brink and Jasper’s focuses, which take different stances, but fail to address many of the fundamental tasks and actual groundwork involved in applying the funds and resources.
Susan Brink’s credibility comes from two main factors.  The first and most important factor is a proven track record of reporting on AIDS and other health related issues.  Brink has written at least four critical articles on the AIDS pandemic in the last three years ranging from cost expectations (The Price Tag for a Pandemic, December 15, 2003); to analyses of organizations and institutes (AIDS: darkening in America, July 12, 2003); to in depth assessments on the epidemic and projections of its possible effects in the future (In Death’s Shadow, July 21, 2003).  The second factor of credibility is the wide range of pertinent statistics she offers in her articles.  For example, Brink states in the article, “Dancing in the Dark”, that the nation of Botswana with “1.6 million has the highest rate of HIV infection in the world.”  Most importantly she states that “Almost 39 percent of its adult population, or about 300,000 people, are thought to be HIV positive, though few know it.”  Here we see she not only retrieved the statistics but also performed comparative analyses.  In addition, her sources consist of data from UNAIDS and World Health Organization (WHO), two key organizations in the world of HIV/AIDS prevention.
The claim of Brink’s article is that the emergence of free HIV/AIDS treatment and ARV medicine will increase momentum towards combating the AIDS pandemic by increasing the ability to reach and counsel the victims who would otherwise remain unknown.  The source of  “Dancing in the Dark” is the nation of Botswana’s choice to provide free treatment and ARV drugs to all its citizens; the first in the highly HIV/AIDS plagued region of Sub-Saharan Africa to take the crucial step.  The intended audience for this information is all the nations plagued by the disease, primarily those with high rates like Botswana.  Brink engages the issue through a vivid illustration of a mother and child finding success as a result of these turn of events.  Botswana’s choice to provide this otherwise unaffordable care was crucial for “Mompati and his mother, Obusitswe Nthusang” (who actively played with his truck in the yard in Brink’s introduction).  Mompati had been unable to walk or talk a half a year earlier because of a lack of treatment.

Fig 1.  Brink suggests hope for the future of AIDS prevention through knowledgeable victims, medical breakthroughs, and adequate financial assistance.

The author appeals to pathos by vividly illustrating the crucial circumstances victims are dealing with in these hard hit countries.  For example, Brink states, “…one of his sisters returned from the butcher with the head of a slaughtered cow.  It would be skinned and boiled for hours… the scant meat picked from the skull… cow’s head cost 13 pula… it would feed the family for two days.”  Her audience is forced to sympathize with not only the condition plaguing the country but the heart wrenching repercussions.  To maximize the effect, she comments on Ombusitswe’s intelligence regarding she and her child’s medicines as far as dosages, types, and effects.  Here she forces the audience, which is basically donors and supporting programs, to refute claims against funding that state that victim’s are ignorant to the use of the medicines.  Brink also focuses on the rape of school aged girls in Botswana.  A powerful use of pathos, Brink gives two examples of Sinah and Ogaune, 15 and 13 respectively, who were raped at school and became infected.  Another powerful example that appeals to pathos and logos is a quote by Ernest Darkoh, operations manager of the Botswana National ARV Program, “With a 38 percent infection rate, if each of them infects one additional individual, you are fighting a losing battle.  What will it be next year?  The theoretical worst it could be is 76 percent.  Then you end up turning the whole country into a hospital.  That’s scary.” 
She states in the next paragraph specifics regarding the application of funds.  “The money is being used to counsel, test, and treat people; to prevent the spread from pregnant women to their babies; to provide free condoms through 10,500 dispensers; to fund research; and—the program of last resort—to care for the orphans left behind.”  An example of how Brink gives the solid issues the moneys will address as well as specific statistics to add to an already stellar credibility. 
In Hawkins and Halmshaws’ article “Capitalizing on global HIV/AIDS funding the challenge for civil society and government,” initial credibility stems from the fact that they report for an academic journal.  This speaks volumes for their professionalism.  The authors present several hypotheses and loads of research and perspectives evaluating their reasons for arriving at those conclusions.  In addition, they utilize the language common in the world of HIV/AIDS prevention.  For instance, in the article key words such as non-governmental organizations (NGO), community-based organizations, and international donor funding are used which show that these authors have experience in the field of research.
The claim of this article is that the community sectors in areas plagued by AIDS must avoid certain pitfalls in order for spending to effectively tackle the disease and better victims’ lives.  The source of this article is to analyze NGOs, community-based organizations, and governments’ capacity to ensure the successful application of the HIV/AIDS funds.  The authors enter into the issue by covering some of the main issues at hand.  Some of the concerns discussed are: whether blockages are influenced by organizations inability to absorb or disburse funds; the question of what type of funding is necessary to respond effectively, and whether an emergency response can fund a long term battle; and lastly, “the different types of partnerships between government and civil society actors responding to HIV/AIDS; are these “marriages of convenience” or committed relationships?”
Blockages introduce the concept of absorptive capacity, defined earlier.  Hawkins and Halmshaw shed light on “facilitation of access to anti-retroviral therapy (ART) and related services” as the leading cause of this problem.  The authors’ not only present a solution but also present an example of success.  In Brazil, increased spending on commodities and access to treatment helped solve the issue of overstretched systems by enabling HIV-positive staff to continue work and encouraging capacity maintenance as whole.  Hawkins and Halmshaw comment on the connectivity of concepts, such as the way lack of capacity maintenance from lack of access causes the dying off of knowledge and diminishing of actor morale.  As well as maintenance, the authors’ suggest the key focus of directing funds towards non participants in the statement, “Another way of making the most of the increase in funding is by continuing to use our collective imagination to identify and catalyze non-traditional actors.  The authors summarily offer numerous options for global funding, primarily how to make it work against the spread of the disease. 

Fig 2.  HIV/AIDS funding accounts for the bulk of U.S. Government funds.

The claim of William F. Jasper’s article “Global AIDS con game” is that President Bush and the U.S. Government’s deployment of funding into foreign programs for HIV/AIDS combat is an outrageous action that may work further towards spreading the disease than preventing it; just as crucial, and disappointing for Bush, is the moral implications perceived by his “moralistic” supporters.  Particularly, those supporters who are against abortion, promiscuity, and other activity not accepted by social conservatives. 
The author William F. Jasper’s credibility in this article stems from his use of actual quotes from the related characters and his reference to actual laws and other governmental activities related to the topic.  Jasper includes key quotes from both supporters and non-supporters.  His article is written for and inclined towards social conservatives and the pro-life community.  One of Jasper’s main sub claims is that Bush’s actions places he and his supporters’ morality into question since the funds are awarded to programs supporting pro-abortion, condom use, and sexual education which is believed to promote promiscuity.  His credibility is furthered because he places faces with stances and offers statistics.  As far as non-supporters, he states, “Forty Republicans and one Democrat—Gene Taylor of Mississippi—stood on principle and voted against this unconstitutional, immoral measure.”
The author has significant knowledge regarding the activity in Congress.  For example, he mentions the location, time, and several occurrences of the enactment of H.R. 1298, the plan that will call for the disbursement of $15 billion over five years.  He uses pathos to sway his audience by stating that, “Sadly, this $15 billion expenditure comes even as Congress is cutting funding for veterans by roughly the same amount.”  To justify his audience and own personal stance, and add to his use of pathos, he states “This should anger every American who still believes in the true conservative tenets of limited government, fiscal restraint, and private charity instead of social welfare programs.”
Jasper’s sub claims are clearly stated.  He believes the Bush AIDS initiative is unworthy because it creates anti-life forces in Congress like Ted Kennedy and UN Secretary-General Kofi Annan.  Jasper believes proceeds of the initiative will be poured into the bank accounts of African dictators and terrorist groups, not successful prevention programs.  Further, he’s solid on the idea that WHO and UNAIDS diminish morality through their programs.

Fig 3. Social conservatives, political leaders, and the world are in hot debate about the best methods of HIV/AIDS prevention.

I support global funding of the HIV/AIDS pandemic.  In my commentary paper, I will use these three sources to piece together my reasoning and compare and contrast the evidence and claims to prove why I believe global funding works.  The most powerful and persuasive of the three articles is Susan Brink’s “Dancing in the Dark.”  The main reason is she seems to be the most experienced in the field of HIV/AIDS research prevention.  Although she uses pathos and appeals to sympathy, she backs her stances with statistics and utilizes effective rebuttals in response to the warrants of her adversaries.  I plan to explore particular instances more in depth in the position paper.  Her most convincing example of the connection between funding and improvement was her testimony about Mompati and the drastic, timely boost in health.  My position stems around the idea of utilizing the research and theoretical analyses of Hawkins and Halmshaw with Brink’s facts and truths to expose the reasons why global funding is good.  Most of my rebuttals will focus on Jasper’s warrants about ceasing global funding.  I understand what his worries and concerns are but he seems somewhat unethical at points; specifically when he speaks against family planning in hard hit countries as if to suggest HIV/AIDS victims do not have a right to life.   

Works Cited

Brink, Susan.  "The Price Tag for the Pandemic." U.S. News & World Report
         135.21(2003): 44.

Hawkins, Kate.  "Capitalizing on global HIV/AIDS funding: the challenge for 
         civil society & government." Reproductive Health Matters 12.24 (2004):

Jasper, William F.  "Global AIDS con game: President Bush’s new global AIDS
         initiative will provide a massive infusion of funds to UN affiliates that may
         be responsible for spreading the AIDS epidemic."    The New American
        19.11 (2003): 19.