My Turn: Hillary Clinton Targets the Presidency by Doug Henwood

Author:Doug Henwood
Language: eng
Format: epub, mobi
Tags: Bisac Code 1: POL052000; POL040010; POL000000
ISBN: e9781682190333
Publisher: OR Books
Published: 2014-10-22T16:00:00+00:00

PHILANTHROPIC WORK

Clinton fans counter all this smelly stuff by arguing that the Foundation does good work, pointing with special pride to its initiatives on AIDS in Africa. It’s indisputable that some good has come about as result of the Foundation’s projects, but overall, its impact points to profound structural limitations of the philanthropic approach to social problems—a strategy promoted by the neoliberal stripping of the state of its better functions and passing off the business of melioration to foundation program officers.

According to the audited financial statements of the Clinton Health Access Initiative (CHAI)—the part of the many-armed enterprise that carries out AIDS work—total program expenses in 2013 (the most recent year available) were $99 million, up from $69 million the previous year.194 Of the total 2013 program spending, almost $31 million went to salaries, and just $2 million for procurement (less than for office expenses). CHAI’s net assets increased by 42% between 2012 and 2013, to $36 million; it’s not clear why an entity focused on improving the health of the very poor needs such a large stash of assets relative to expenses.

The financial statements don’t break out spending by disease; programs to address tuberculosis, malaria, and other maladies are included in the total. According to CHAI’s tax return, the enterprise spent just short of $30 million on AIDS.195 If the AIDS “procurement” expenditures are similar to their overall share of the Initiative’s overall spending, something like $600,000 was devoted to purchasing supplies.

The small sums spent on procurement reflect the Initiative’s emphasis on negotiating lower drug prices rather than providing the drugs themselves. In a note included in the financial statements, it claims to have “helped more than 8.2 million people in 70 countries” since its founding in 2002, generating $1 billion in savings between 2011 and 2015 alone. Just how these people were “helped” and how they were counted is not disclosed.

CHAI also engages in classically Clintonesque micro-­initiatives, like improving supply chains, facilitating bulk purchases, and identifying “high-impact interventions.”196 It’s all reminiscent of Bill’s budget documents, where the prose was full of grand statements about investing in people, but the sums were barely visible when you scrutinized the numbers: $100 million overall, and $30 million on AIDS, is not a lot of money.

Contrast this with Clinton’s successor, the deservedly maligned George W. Bush, who nonetheless made a large U.S. government commitment to fighting AIDS in poor countries, mainly in Africa. The President’s Emergency Plan for AIDS Relief (PEPFAR) was begun in 2003 with $15 billion in funding for the next three years (which Congress subsequently raised to $18.8 billion). It brought antiretroviral therapy to 2 million with HIV and provided care to 10 million. Between 2004 and 2008, it supported prevention of mother-to-child HIV transmission in nearly 16 million pregnancies.197 In 2008, the program was granted another $39 billion, with a goal of treating at least 3 million, caring for 12 million, and preventing 12 million new infections.198 Surprisingly, perhaps, Barack Obama has cut PEPFAR funding significantly—even though his

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