Bill Clinton: Hillary tripled her AIDS treatment without spending more

When Bill Clinton wasn’t talking about how he was courting his wife, he was giving his speech at the Democratic convention, published later on Medium, with a long list of Hillary Clinton’s accomplishments in public life.

When he took over as Secretary of State, he applauded his work on HIV / AIDS.

“It has tripled the number of people with AIDS in four countries whose lives are saved with your tax dollars,” Clinton said. “Most of them in Africa, going from 1.7 million lives to 5.1 million lives, and it didn’t cost you more money. She just bought available generic drugs approved by the FDA. “

We decided to take a closer look at these processing gains and the price tag that comes with them. Clinton’s statement is a bit fuzzy, first referring to a tripling in four countries and then giving the first treatment figures that cover many countries.

We contacted Clinton’s office for clarification. His staff told us that Clinton was talking about the overall HIV / AIDS treatment activities of the Presidential Emergency Plan for AIDS Relief, or PEPFAR.

We took his essential claim as being that thanks to his wife the treatment tripled and the costs remained stable. It’s not quite accurate, but it’s close.

PEPFAR started under President George W. Bush and President Barack Obama has maintained it. Hillary Clinton can take credit for the accomplishments of PEPFAR because it is a State Department program.

One of the main goals of PEPFAR is to bring treatment to as many people as possible, mainly in Africa, but also on other continents. There is no cure for AIDS, yet antiretroviral drugs can slow down the HIV virus in the body, sometimes for many years.

In 2013, the Government Accountability Office, the audit arm of Congress, looked at how well PEPFAR was getting these antiretrovirals to people in need. This report supported Clinton’s statement, but it only covered the years between 2005 and 2011.

Here’s why it’s important.

Hillary Clinton was Secretary of State from 2009 to January 2013. For a full view of what PEPFAR did under her watch, we got the numbers up to 2012.

Based on the GAO report, PEPFAR’s own reports, and the numbers we got from PEPFAR staff, we found these trends:

The graphs show us that the number of people in treatment rose from 2.1 million at the end of 2008 to 5.1 million at the end of 2012 (fiscal years). That number has more than doubled, but it hasn’t quite tripled like Clinton said.

However, this increase was done without additional taxes. In constant 2009 dollars, treatment spending fell dramatically for two years, then returned to 2009 levels.

When you put the two trends together, the big picture is that the United States used the same amount of money to provide about 250% more processing.

Eric Goosby, director of PEPFAR during those years and now professor of medicine at the University of California at San Francisco, said the administration of George W. Bush laid the foundation for these gains.

“It takes a long time to find the places to put the treatment in and put all the parts in place to deliver it,” Goosby told us. “We took advantage of it all.

But Goosby also points to the rapid switch to generics after 2009.

“We have gone from buying 90 percent of brand name antiretroviral drugs to less than 3 percent,” Goosby said. Generic drugs were much cheaper.

The program also reduced costs by eliminating air delivery and the transportation of goods by land and sea.

“This has saved millions of dollars and allowed for an uninterrupted increase in the number of patients on treatment,” he said.

The graph above shows that under Hillary Clinton’s watch, costs per patient fell by more than half, from $ 673 when she took control to $ 338 when she left.

The question is, does she deserve the credit?

Mead Over, a senior researcher at the Center for Global Development, a political center in Washington, calls for caution. Over told us that while much of the work is done by State Department agencies, not everything is. The Centers for Disease Control and Prevention and the National Institutes of Health and other agencies also play a role.

But in the end, Over told us that the Secretary of State sets the priorities and in this case the priority is to expand treatment at a lower cost per person.

There’s evidence Clinton wasn’t just calling him. AIDS activists saw her as an ally.

Mark Harrington, executive director of the Treatment Action Group, a New York-based rights organization, said he would give Clinton a lot of credit for what happened. Harrington said she had forged stronger reporting ties with PEPFAR than her predecessor and had a clear idea of ​​what was needed. Harrington gave an example of how this led to his direct involvement.

“It has helped pave the way for a shift from using expensive international NGOs to deliver services to working with national partners and ministries of health,” Harrington said. “There was a concern about corruption, and she made it clear to foreign leaders that it couldn’t happen. And it’s really surprising for a program of this magnitude that there wasn’t. . “

Harrington also noted that Clinton was involved in HIV / AIDS before becoming secretary. While in the Senate, she met with activists and advocated for the programs and funds they were seeking.

Our decision

Bill Clinton said when Hillary Clinton was Secretary of State, she tripled the number of people with AIDS whose “lives are saved,” and it didn’t cost taxpayers more money.

Clinton took some liberties with the numbers. Treatment increased rapidly by about 250 percent. It is not quite the triple. But Clinton was right that those gains came without additional spending on inflation-adjusted dollars.

And while Hillary Clinton cannot take all the credit for this, outsiders have said that she set the general direction for how the program should move forward and intervened specifically to help them do more for less.

We rate this statement to be quite true.

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