On the eve of World AIDS Day on Dec. 1, 2009, several White House officials, including Secretary of State Hillary Rodham Clinton, made public remarks to highlight the efforts of the Obama administration on HIV/AIDS issues. Clinton talked about the progress U.S. contributions have made toward global health, and others highlighted some of the initiatives the White House has undertaken on AIDS this year.

So it seemed like a good time to check in on the one HIV/AIDS campaign promise we have in our database, Obama's promise that he would provide at least $50 billion by 2013 for the global fight against HIV/AIDS.

That commitment, along with Obama's many public pronouncements and votes in support of the global campaign against AIDS, convinced many global AIDS activists that the country had elected the right man to take the global AIDS fight to a higher level.

In late 2008, with Bush still in office, then-Sen. Obama co-sponsored a reauthorization of the President's Emergency Plan for Aids Relief (PEPFAR) initiated by President Bush in 2004, which called for $48 billion for global AIDs relief over the next 5 years. So this one seemed like an easy layup if Obama simply stuck to that plan.

But Obama's proposed 2010 budget, unveiled early this year, was very disappointing to many in the global AIDS community. It called for only a small increase in global AIDS funding, including $6.7 billion for PEPFAR (just $165 million more than this year). Global AIDS advocates said the budget would have had to increase by $1 billion to stay on course with Obama's pledge.

In the spring, the administration changed the game a bit, announcing a new, wide-ranging initiative on global health. It would put the United States on a path to provide $63 billion over six years (2009 to 2014) for global health programs. The White House said 70 percent of that money would go toward HIV/AIDS, but the initiative would also include efforts to address such critical needs such as child health, family planning and neglected tropical diseases.

White House officials say Obama's plan keeps him on course, that 70 percent of that health funding by 2014 comes to $51 billion for global AIDS relief.

But that's a year later than promised, some AIDS activists say.

The Global AIDS Alliance put out a report saying the new timeline would have "devastating health consequences." As a result of the new plan, the alliance claimed, one million people around the world will not receive treatment for AIDS.

"Many people could die because of that change of the game," said the group's executive director, Dr. Paul Zeitz.

The Global AIDS Alliance gave Obama a D+ on his first World AIDS Day report card. Obama's budget essentially froze spending for global AIDS at 2009 levels, the group said, and as a result, "the global community could revert to little more than running in place in response to the global AIDS crisis, rather than making real progress in ending the pandemic and achieving a sustainable global response to the greatest public health challenge of our generation."

An August letter from Eric Goosby, the administration's global AIDS coordinator, to American ambassadors gave some global AIDS activists further pause.

"The landscape around us is changing, with the need to balance a broad portfolio of global challenges at a time of financial crisis," Goosby wrote. "As a result, we need to plan for the next stage of PEPFAR's development in this context and cannot assume the dramatic funding growth of PEPFAR's early years will be repeated."

In an interview with Global Health Magazine , published on Nov. 5, 2009, Goosby was asked how he was going to continue to add people on treatment and expand prevention efforts when some believe the Obama administration will flat-fund global AIDS for the next several years.

"We are in an economic crisis," Goosby said. "The reality is that a flat or slightly rising PEPFAR allocation is what we are looking at for at least two years, maybe longer."

The White House contends that its global health initiative meets the AIDS pledge Obama made during the campaign, and that while that plans stretches into the 2014 fiscal year, it still meets his pledge because the 2014 fiscal year begins in 2013. But we're not buying that.

An extra year has clearly been added, according to the reauthorization bill for PEPFAR.

And consider the president's remarks on World AIDS Day in 2007: "As part of my comprehensive national HIV/AIDS strategy, we'll provide $50 billion by 2013 to fight the pandemic, and contribute our fair share to the Global Fund. ... I"ll expand the President's Emergency Plan for AIDS Relief by $1 billion a year in new money over the next five years so we can reach more people in places like Southeast Asia, India, and Eastern Europe, where the pandemic is growing."

Let's review where he stands: Obama did not increase PEPFAR by $1 billion in the proposed 2010 budget (just $165 million), and all signs indicate that PEPFAR funding may remain fairly flat for the next couple of years. Some may argue that pushing the deadline from 2013 to 2014 isn't a big deal. But Obama promised to do it by 2013, so we believe he's moving the goalposts on this one to make his promise more achievable. The facts show that the administration is already falling behind in meeting the promise and will continue to do so in the next few years. If there's a surge in money in the future, we'll revisit this item, but for now we rate the promise Stalled.