The Washington Post quotes CGD senior fellow Mead Over on the recently passed PEPFAR legislation and his concern regarding the potential implications of its open-ended commitment.
From the article:
One person with that view is Mead Over, a former World Bank economist who is now at the Center for Global Development, a Washington think tank. He fears that if PEPFAR's commitments grow, as they are likely to, they will squeeze out funding for other, equally important, foreign aid.
He also worries that with such lopsided and personal relationships between countries, providing life-sustaining care may become a "strategic resource that will be used, or will be an implicit bargaining chip, in negotiations." He added that "sovereign countries are likely to feel quite vulnerable if they perceive that the lives of a substantial number of their citizens are dependent on the continued largess of a donor."
Over's solution is to spend much more AIDS assistance on prevention efforts, and to channel money for treatment through international organizations to spread future obligations among as many donors as possible.