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Over the last few years, G8 and other national leaders have lamented that health care systems in poor countries are inadequate to keep pregnant women, mothers, babies, and children healthy and that universal access to HIV/AIDS prevention, treatment, and care services cannot be attained. Yet, at the same time they continue to make promises that they fail to fully fund. Despite public statements by world leaders that they remain committed to the United Nations’ Millennium Development Goals (MDGs), they fail time and time again to put the necessary financial resources on the table to realize them.

At the recent MDG Summit held in New York, September 20-22, global health leaders gathered to take stock of progress. With five years left to the target date of 2015, the three goals related to health — MDG 4, to reduce child mortality; MDG 5, to improve maternal health; MDG 6, to combat HIV/AIDS, malaria, and other diseases — remain seriously off track in a number of developing countries. Addressing summit participants, President Barack Obama called on donor nations,”let’s honor our respective commitments. Let’s resolve to put an end to hollow promises that are not kept.” But we have yet to see the president’s rhetoric match the U.S. share of what is needed.

Some progress has been made over the last decade, but the United States lacks a clear, consistent strategy for realizing the MDGs. Just this September, the U.S. government released Celebrate, Innovate & Sustain Toward 2015 and Beyond: The United States’ Strategy for Meeting the Millennium Development Goals. The document broadly describes the U.S. government’s approach to the MDGs but disappoints by filling up pages with vague statements about what will, should, and must be done to achieve them — while leaving out any substantive details.

The global economic crisis and its aftermath have made advocacy to regain the global political will, drive, and ambition to realize the MDGs much more difficult. G8 country governments are slashing overall development aid — aid to civil society organizations and contributions to important global health funders. Advocacy has been chilled by threats of austerity, and as a result advocates are fighting much harder for smaller increases in funding. With elections coming up in November and a possible takeover of the U.S. Congress by Republicans, we could soon be fighting just to maintain the status quo and to avoid deep cuts in global health and HIV/AIDS funding. This leaves the question of how flatlined and reduced spending in the short term will affect progress toward the fight against HIV/AIDS in the long term.

The Global Fund to Fight AIDS, Tuberculosis and Malaria, a vital source of health financing for affected countries, needs G8 countries to pony up $20 billion over the next three years if it is to continue helping countries to move closer to reaching MDG targets. Currently, there are over ten million people living with HIV who need life saving ARVs but do not have access; 7,400 more people become infected every day. Treatment as prevention, along with exciting development of new microbicides, may bend the cost and epidemiological curve in the very near future. With the upcoming donor pledging meeting for the Global Fund to take place in early October in New York, activists are staging actions, protests, and letter-writing campaigns, calling for bold pledges to reach the $20 billion mark in hopes that their demands will result in serious cash.

Please show your support by signing the Global Day of Health Action petition to G8 leaders calling for them to commit $20 billion over the next three years to support the Global Fund and to fulfill promises of universal access to essential HIV medicines. You can sign on at ARASA.

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