Letter from Ambassador Randall L. Tobias, U.S. Global AIDS CoordinatorFebruary 23, 2004 Dear Senator/Representative: On behalf of the President of the United States, it is my pleasure to submit to you a comprehensive five-year global strategy for President Bush’s Emergency Plan for AIDS Relief, as required by Section 101 of P.L. 108-25, The United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. I am encouraged by the progress achieved in the four and a half months since I assumed the position of U.S. Global AIDS Coordinator – by those working with me to create and launch the new Office of the U.S. Global AIDS Coordinator, by my colleagues across the government, many of whom will play key roles in implementing this plan, and by those across a wide spectrum outside the U.S. Government who have already provided valuable input and advice, including those in countries in which we are working. This global strategy is an important part of that progress. It is intended to address key questions raised by the legislation, as well as to define the strategic direction of our activities – in the focus countries and around the world. The foundation for this effort is President Bush’s commitment to provide $15 billion over five years to fund the Emergency Plan for AIDS Relief. Our strategy takes into account the pragmatic necessity that annual funding requests within that commitment will ramp up as effective implementation capabilities are put in place and expanded. It outlines our work through bilateral programs as well as the significant role that will be played by multilateral partners such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria. And finally, it recognizes that national leadership is one of the critical factors in achieving success in the battle against HIV/AIDS. Our priorities in carrying out this extraordinary humanitarian effort ultimately draw on that leadership and will follow closely the strategies and priorities of the host countries we seek to assist. After all, their needs are what this effort is all about. This strategy has been carefully, thoughtfully, yet urgently developed with the knowledge that each day, 8,000 lives are lost to AIDS. Clearly, we do not have answers to every question we have identified. Working closely with host governments, U.S. Government teams in the field, our various partners, and those living with AIDS, we will continue to learn and to develop new or more comprehensive approaches. Our intent is to move ahead without delay. At the same time, our strategy will evolve as we engage new partners and respond to innovation, input, experience, and outcomes. It must be a living document – always a work in progress. We must maintain flexibility and remain responsive to the ever-changing nature of the HIV/AIDS pandemic. This plan reflects our current best thinking about what needs to be done and what we believe it is possible to do. We have not tempered our aspirations with our knowledge of the magnitude of the challenges ahead. Yet we do not underestimate the implementation difficulties the Emergency Plan will face. Addressing HIV/AIDS in the developing world requires confronting overstressed and struggling health care systems with limited capacity to provide treatment and care; social inequalities such as those involving the status of women, girls, and the poor; and the varied economic and political circumstances (as well as diverse and deeply ingrained cultural patterns) of each country. In addition, the sheer magnitude of the crisis, and its effect on present and future populations, brings about consequences that reverberate from the individual to the international community, many of which we are only beginning to understand. The challenges inherent in combating HIV/AIDS are very real, but if the battle is not won – if instead citizens, many in their most productive years, die in greater and greater numbers – opportunities for broad-based economic and social development will be set back for decades. In carrying out President Bush’s intent, our strategy is built on four cornerstones: (1) rapidly expanding services by building on existing successful programs that are consistent with the principles of the Emergency Plan; (2) identifying new partners and building capacity for sustainable, effective, and widespread HIV/AIDS respons-es; (3) encouraging bold leadership and fostering a sound enabling policy environment for combating HIV/AIDS and mitigating its consequences; and (4) implementing strong strategic information systems that will contribute to continued learning and identification of best practices. We will pursue these strategies through collaborative and coordinated processes that ensure programming that is responsive to local needs, is supportive of and integrated with national strategies, and enlists the strengths and expertise of the many U.S. agencies and departments, nongovernmental organizations including faith-based organizations, the private sector, and multilateral institutions that have made vital contributions to combating HIV/AIDS. This strategy will ensure that the President’s unprecedented commitment is a success. The Emergency Plan is the single largest up-front commitment in history for an international public health initiative involving a specific disease. In the short time I have held this position, I have been privileged to see firsthand the success that can be achieved in fighting HIV/AIDS, even in some of the most under-resourced communities in the world. This success is measured in lives saved, families held intact, and nations moving forward with development. I look forward to working with you as we embark on transforming despair into hope worldwide.
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