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With these cuts, they may die

"With these cuts, they may die" Continued...

Issue: "Libyan exodus," March 26, 2011

Goosby recognizes that PEPFAR has done more than heal people. "We have no misconception of what this program has done in a spiritual sense," Goosby told me. "It's put hope back on the table."

Stephens agrees. At Karanda, he had the gospel to give patients as he watched them die, but no drugs. "If they continue the drugs, they still might die," Stephens told me. "They're facing death at any time. So they're open to the gospel, and we feel we need to share it with them." But there are drugs now, and more who are living as a result of U.S. spending: Since the early 2000s, the height of Zimbabwe's AIDS crisis, deaths at Karanda Mission Hospital have dropped by at least 60 percent.

Where to cut?

Conservative analysts argue budget deficits can be slashed without risking lives

Cuts to other less efficient State Department programs could allow the President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund to continue. Brian Riedl, a budget analyst at the Heritage Foundation, put out a 2012 budget that specifically does not cut the funding for those programs, but achieves $343 billion in cuts across the board. The Heritage budget analysts refused to cut PEPFAR, he said, because they understood that it was one program at State that used money effectively.

Riedl offered other options to provide the $783 million in cuts to global health that Republicans are proposing: "USAID in a lot of areas is a lot more poorly managed." Heritage analysts propose cutting USAID's Development Assistance Program, which would provide $1.5 billion in savings this fiscal year. Congress also could cut State's education and cultural exchange programs, which would provide $350 million in savings over the next months. Slashing the International Trade Administration's trade promotion activities, like sponsorship of events with foreign chambers of commerce, could save another $187 million through the end of this fiscal year. And zeroing out State's Trade and Development Agency, the Overseas Private Investment Corporation, the East-West Center, and the U.S. Institute of Peace would provide another $72 million in savings this year.

Sojourners, in a letter to Congress, proposed defense cuts instead of cuts to foreign aid, writing, "In Great Britain, Prime Minister Cameron made the choice to delay a costly nuclear submarine program, while also increasing life-saving funding for international aid. The U.S. Congress should follow this example." But the real drivers of the national debt are entitlements, healthcare cost inflation, and an aging population, said former Bush adviser Michael Gerson. Cuts to global health, he said, are "a distraction from the real issues we face." He agrees with Reidl that humanitarian aid programs are a tiny percent of the budget, "but they're saving millions of lives, making some of the largest health gains in history," he said. "It's something Americans should know about and be proud of."

Emily Belz
Emily Belz

Emily, who has covered everything from political infighting to pet salons for The Indianapolis Star, The Hill, and the New York Daily News, reports for WORLD from New York City. Follow Emily on Twitter @emzleb.

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