The President’s Emergency Plan for AIDS Relief (PEPFAR), a $15 billion commitment, is set to expire at the end of fiscal year 2008. This critical boost in U.S. AIDS funding has helped millions of individuals infected with HIV, and in so doing, has improved developing nations’ health and education systems and decreased violence against women. In an original podcast by the Environmental Change and Security Program and the Global Health Initiative, UNAIDS Executive Director Dr. Peter Piot discusses how reauthorizing PEPFAR at increased levels of funding, expanding AIDS prevention programs, and coordinating global efforts to combat HIV/AIDS under U.S. leadership could amplify the effectiveness and sustainability of the global AIDS response.

Click here for the Wilson Center, “PEPFAR Reauthorization and the Global AIDS Response” event summary.

Former Senate Majority Leader Bill Frist, who was a practicing surgeon before his political career, announced last week that he would return to medicine—in a big way. The New York Times reports that Frist will lead Save the Children’s new “Survive to Five” initiative. This program aims to reduce the number of children—estimated at nearly 10 million annually worldwide—who die before they turn five years old. Save’s website describes five solutions to the five biggest contributing factors to child mortality. By applying these solutions—all of them proven, and most of them very inexpensive—they hope to save as many as 6 million children every year.

The Times mentions that other American politicians, such as Jimmy Carter and Bill Clinton, have dedicated much of their post-political lives to global health, with excellent results. Perhaps even more encouraging is that some current world leaders are addressing these issues as well. Last month, British Prime Minister Gordon Brown and German Chancellor Angela Merkel vowed “urgent action” on health issues in developing countries. Their International Health Partnership, which began on September 5, will address child mortality, as well as maternal mortality and HIV/AIDS prevention and education.

The Times notes that Frist is playing a key role in a similar campaign with the Bill and Melinda Gates Foundation, along with former rival Senator Tom Daschle—although it doesn’t mention that while majority leader, Frist broke with political tradition by campaigning against his counterpart. It is encouraging that they have put political differences behind them and are working together on a new campaign that could save and improve the lives of millions of children around the world. Hopefully, they will be successful in persuading Americans and their elected officials that child mortality is not only unacceptable and preventable, but that reducing it is a worthy use of taxpayer dollars.

This effort may seem daunting, given that less than one-half of one percent of the U.S. budget goes to international assistance. Frist was successful in ushering through the President’s Emergency Plan for AIDS Relief (PEPFAR), which dedicated $15 billion over five years to fighting AIDS, principally in Africa. This was a major victory for global health, but there is room in the budget and the priorities of American leaders for more global health programs—especially if PEPFAR is doubled, as is now being considered, to $30 billion over the next 5 years. Campaigns to reduce childhood mortality do not face the political scrutiny of HIV/AIDS programs such as PEPFAR, but it will still be important that Frist and others involved allow science-based medicine to dictate funding priorities; one of PEPFAR’s main failings is that it has caved to ideology in placing an unadvisedly large emphasis on abstinence education.

Frist and his colleagues certainly have a difficult battle against child mortality ahead of them. But Frist—a surgeon, politician, and businessman—has an impressive range of skills and an equally enviable Rolodex of supporters to call upon.

A new study (login required) by the UN High Commission for Refugees and the University of Copenhagen, published in the June 30 issue of the Lancet, contradicts the prevailing belief that conflict fuels the spread of HIV. Data from the Democratic Republic of the Congo, Southern Sudan, Rwanda, Uganda, Sierra Leone, Somalia, and Burundi “did not show an increase in prevalence of HIV infection during periods of conflict, irrespective of prevalence when conflict began.” Additionally, the study finds “insufficient data to support the assertions that conflict, forced displacement, and wide-scale rape increase prevalence or that refugees spread HIV infection in host communities.”

Reporting on Population Action International’s latest report, The Shape of Things to Come, The New York Times’ Celia W. Dugger calls the link between young age structures and conflict “no simple coincidence,” observing that Iraq, Afghanistan, Sudan, and the Democratic Republic of the Congo all suffer from bad governance, violent conflict, and young populations. Retired Army Major General William L. Nash sets the scene with military efficiency:

You’ve got a lot of young men. You’ve got a lot of poverty. You’ve got a lot of bad governance, and often you’ve got greed with extractive industries. You put all that together, and you’ve got the makings of trouble.

K.Y. Amoako, distinguished diplomat, former Wilson Center African Scholar, and former executive secretary of the United Nations Economic Commission for Africa, will discuss regionalism as a major movement in world politics—particularly in Africa—on the Wilson Center’s radio show Dialogue this week.

Congressional Democrats agreed last week to spend $4.5 billion in 2007 to combat AIDS, malaria, and tuberculosis , signaling support of the Bush Administration’s earlier efforts to strengthen international programs aimed thwarting the diseases. New York Representative Nita M. Lowey said the joint support is a sign of the times:

“We’re in a different world now…. This is the first time since Sept. 11 we’ve had a power split in Washington, and there’s a growing recognition among the public and policy makers that foreign assistance is critical to stability around the world.”

Under Bush’s leadership, aid has quietly risen to more than twice the level of any previous administration. The upward trend reflects Washington’s renewed commitment to stemming the spread of AIDS, malaria, and tuberculosis, which continue to claim the lives of millions of people around the world each year.

Under an earmark in the President’s Emergency Plan for AIDS Relief (PEPFAR), free HIV/AIDS antiretroviral medication will be made available to military and civilians at a Vietnamese military hospital. The program, a collaboration of PEPFAR and the U.S. Department of Defense, will extend to other military hospitals in the future. Vietnam is one of 67 countries worldwide working to reduce the incidence of HIV/AIDS through involvement with militaries.

Violence against women was highlighted as a contributing factor to the spread of HIV/AIDS at the World Social Forum, taking place this week in Nairobi. Ludfine Anyango of Action Kenya-International argued that women still have little say in negotiating their sexual relationships, which increases their susceptibility to infection:

“Many women cannot even choose when to have sex or not. Many cannot ask their husbands to use a condom because in addition to being thought as unfaithful, they fear being beaten. The woman then has no choice but to continue having unprotected sex with her spouse.”

AIDS activists are calling for new and strictly enforced laws aimed at protecting women from all forms of violence, particularly sexual violence.