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[afro-nets] Global AIDS Funding Be Shifted To Groups Promoting Abstinence

  • From: Leela McCullough <leela@healthnet.org>
  • Date: Fri, 15 Apr 2005 14:25:27 -0400

Rep. Hyde Suggests More Global AIDS Funding Be Shifted To Groups
Promoting Abstinence

15 April 2005
The Kaiser Daily HIV/AIDS Report

Rep Henry Hyde (R-Ill) on Wednesday urged the Bush administra-
tion to direct more resources from the President's Emergency
Plan for AIDS Relief to groups promoting abstinence and away
from those promoting condom use as an HIV/AIDS prevention
method, VOA News reports (Robinson, VOA News, 4/13). Hyde made
the suggestion during a House International Relations Committee
hearing on PEPFAR -- a five-year, $15 billion program that di-
rects funding for HIV/AIDS, tuberculosis and malaria to 15 focus
countries (CQ HealthBeat, 4/13). The law (HR 1298) authorizing
PEPFAR endorses the "ABC" HIV prevention model, which stands for
abstinence, be faithful, use condoms. The measure also specifies
that one-third of the bill's HIV/AIDS prevention funding should
be used for abstinence programs (Kaiser Daily HIV/AIDS Report,
4/22/04). However, Hyde said during the hearing that groups
"best suited to promote A and B programs, such as faith-based
and indigenous organizations, are often not the ones implement-
ing these programs. Instead, organizations long-associated with
the social marketing of condoms are given much of the funding
for AB programs. This must not continue" (VOA News, 4/13). Mar-
tin Ssempa, director of Uganda's Makerere Youth Ministry and a
representative of the Ugandan First Lady's AIDS Task Force, at
the hearing said that the U.S. Agency for International Develop-
ment and CDC are undermining the country's ABC prevention pro-
gram through "what he calls a tilt toward condom distribution,"
according to CQ HealthBeat. Ssempa said that the social market-
ing of condoms "encourages sexual promiscuity," CQ HealthBeat
reports (CQ HealthBeat, 4/13). "I mince no words when I address
my fellow Ugandans every day, and I mince no words with you. The
reason why other Africans and Ugandans are dying is because of
sexual promiscuity," Ssempa said, adding, "That is what is kill-
ing us."

Sexual Coercion

Geeta Rao Gupta, president of the International Center for Re-
search on Women, said that the ABC model alone is inadequate to
address the HIV/AIDS pandemic, especially in Africa, where
nearly 57% of HIV cases are among women and girls, VOA News re-
ports. "This inexorable rise in infections among women demands
special attention and immediate action, action that must go be-
yond the ABC approach," Rao Gupta said, adding, "That approach,
while necessary to contain the AIDS epidemic, is not sufficient
to address the underlying vulnerabilities that contribute to
women's risk of infection" (VOA News, 4/13). Hyde suggested that
a fourth component be added to the ABC model to address sexual
coercion, which he said is a "vastly underreported" source of
HIV transmission. Funding policies "must include a D for defend-
ing the rights of the vulnerable," Hyde said, adding, "We must
expand programs to deter violence against women and children
that leads to HIV transmission." Although some women might be
"committed" to abstinence or monogamy, Hyde added that they are
still at risk of infection because of sexual coercion or the
"promiscuous sexual behavior of their husbands," according to CQ

Lack of Health Care Workers

U.S. policy also must address the shortage of health care work-
ers to administer antiretroviral therapy, Hyde said, adding that
the dearth of health workers is a "far greater impediment" to
treatment access than the cost of drugs, CQ HealthBeat reports
(CQ HealthBeat, 4/13). According to an analysis by the Joint
Learning Initiative -- a consortium of more than 100 health care
leaders -- that was published in the Nov. 27, 2004, issue of the
journal Lancet, approximately four million health care workers
are needed in order to effectively fight diseases such as ma-
laria, HIV/AIDS and TB in developing nations (Kaiser Daily
HIV/AIDS Report, 11/29/04). Holly Burkhalter, U.S. policy direc-
tor for Physicians for Human Rights, in written testimony said
that Congress and the Bush administration should implement a
"Global Health Workforce Initiative" to help highly affected
countries hire and retain African health care workers. Hyde
added that he supports shifting the PEPFAR goal of treat!
ing two million people with antiretroviral drugs by 2008 to
having two million people "treated by their own citizens in
their own country" by that date, according to CQ HealthBeat (CQ
HealthBeat, 4/13).


"Today women and girls represent more than half of those in-
fected with HIV worldwide," Jodi Jacobson, executive director of
the Center for Health and Gender Equity, said, adding, "Yet the
Bush administration is actively dismantling effective prevention
programs in the very places where women and girls are most at
risk. It is time we realize that marriage is not a protective
factor against HIV, a fact that PEPFAR ignores" (CHANGE release,
4/13). Anita Smith, president of the Children's AIDS Fund, said,
"Americans don't realize what an impact our dollars are having
on the ground thanks to the President's Emergency Plan. We are
so used to the grinding slowness of government action in this
country that we don't understand how immediate the impact can be
of a program like this. ... We applaud [U.S. Ambassador Randall]
Tobias and his staff in their efforts to jump start this massive
program in a way that has yielded significant and tangible re-
sults" (CAF release, 4/13).

Waxman Letter

In related news, Rep. Henry Waxman (D-Calif.) on Wednesday sent
a letter to the Department of Justice opposing a Bush admini-
stration policy requiring U.S. HIV/AIDS organizations seeking
funding to provide services in other countries to make a pledge
opposing commercial sex work (CQ HealthBeat, 4/13). Under the
policy, even groups whose HIV/AIDS work in other countries has
nothing to do with commercial sex workers will have to make a
written pledge opposing commercial sex work or risk losing fed-
eral funding. In addition, the Bush administration might refuse
to fund HIV/AIDS groups that do not accept Bush's agenda on is-
sues such as sexual abstinence (Kaiser Daily HIV/AIDS Report,
2/28). "It would be easy to demonize anyone who complains about
the administration's new policy as a 'supporter of prostitu-
tion,'" Waxman wrote, adding, "But the fact that prostitution is
a dangerous practice does not make the new policy right." He
added that the policy also limits constitutional free speech
rights, according to CQ HealthBeat. Although the federal govern-
ment has the right to limit how organizations use federal money,
"what is new is the decision by the administration to require
American organizations to adopt a policy explicitly opposing
prostitution as a condition of receiving a grant," the letter
said, adding, "Until now, the free-speech provisions of the U.S.
Constitution have been understood as prohibiting the government
from requiring American organizations to sign pledges to support
specific government policies. Once a precedent is established, a
variety of unconstitutional speech restrictions and policy re-
quirements on U.S. organizations may follow" (CQ HealthBeat,

"Reprinted with permission from kaisernetwork.org You can view
the entire Kaiser Daily HIV/AIDS Report, search the archives, or
sign up for email delivery at
http://www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily
HIV/AIDS Report is published for kaisernetwork.org, a free ser-
vice of The Henry J. Kaiser Family Foundation. © 2005 Advisory
Board Company and Kaiser Family Foundation. All rights reserved.


Leela McCullough, Ed.D.
Director of Information Services
30 California Street, Watertown, MA 02472, USA
Tel: +1-617-926-9400
Fax: +1-617-926-1212