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To the Editor: In their Commentary, Ms Denny and Dr Emanuel¹ are correct in saying that diarrhea and other illnesses exact a terrible toll on infants and children in resource-limited settings. However, their proposal to shift funds from the President's Emergency Plan for AIDS Relief (PEPFAR) to maternal and child health programs could result in unintended adverse consequences for the women and children they seek to protect.

The bill reauthorizing PEPFAR (PL 110-293) includes a large increase for tuberculosis and malaria programs ($4 billion and $5 billion, respectively), and it authorizes $10 billion for the US contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria over a 5-year period.² Children experience high rates of morbidity and mortality from both malaria and tuberculosis. In addition, the bill includes important targets for strengthening health care systems, which will benefit primary care generally.

Ten percent of US AIDS funding to poor . . . [Full Text of this Article]

Kenneth Hugh Mayer, MD
kenneth_mayer@brown.edu
Department of Medicine
Brown University
Providence, Rhode Island

Carol Dukes Hamilton, MD
Family Health International
Research Triangle Park, North Carolina

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