The news that health facilities in Uganda have received notification to stop enrolling new patients in PEPFAR programs confirms what we have suspected and reported on since mid 2009—that the Obama administration is curtailing its commitment to PEPFAR.Ambassador Goosby’s optimism regarding increased funding in the coming years and the Obama Administration’s commitment to nearly doubling the number of patients receiving drugs, to at least 4 million by 2014, is somewhat reassuring. Unfortunately this is likely to be too late for the patients who need treatment now and yet are being turned away. A Lancet study on maternal mortality found AIDS to be a leading cause of death for mothers in Africa—and a leading driver of the terrible maternal mortality rates there. With access to ARVs, these mothers’ lives could be saved.We realize that the program may appear expensive and that national governments also have a responsibility. However, seeking to control the costs of the program by capping the number enrolled is a short term strategy that will lead to greater human and financial costs in the longer term. It is essential that the US fulfill its promise to scale up global AIDS programs and do what is right for those in greatest need.
