Federal relief program does poor job at fighting disease

Another voice / AIDS treatment

Buffalo News Opinion

By Douglas A. Feldman
Updated: 12/18/07 6:38 AM

Thirty billion dollars to treat, prevent and care for HIV/AIDS over the next five-year period: This is double the initial commitment of $15 billion allocated in America’s global fight against AIDS. The White House is boasting 1.1 million people, mostly in Africa, are being treated for AIDS with funds from the President’s Emergency Plan for AIDS Relief.

Congress is currently discussing the reauthorization of the relief program, which would increase the number of people treated to 2.5 million, prevent at least 12 million new HIV infections and care for more than 12 million others. Who could oppose that?

The problem, however, is that when we look at the program’s track record, it is clear that it is extraordinarily flawed. It took two years before the program used any generic anti-retroviral drugs, and even though 34 generic medications have now finally been approved, 73 percent of all treatment dollars last year were still being spent on American brand-name pharmaceuticals at about four times the price.

Of even greater concern is that the claim of 1.1 million people treated for AIDS is a gross exaggeration. The most recent data show that only 64 percent of those treated actually received direct, site-specific support from the program.

In the area of HIV prevention, Congress in 2003 required that one-third of prevention funds be used for abstinence- only programs. Last year, the Bush administration quietly raised the requirement so that two-thirds of all funds must be used for abstinence-only or marital-fidelity programs. The problem with abstinence-only programs is that they are the only category of HIV prevention programs scientifically proven not to work. These programs falsely assert that condoms are ineffective, and they fail to prepare young people to practice other forms of safer sex when they do become sexually active.

The program has also been systematically shifting some funds away from more experienced AIDS service organizations with good track records. Inexperienced faith-based organizations that often preach religious morality — frequently worsening AIDS-related social stigma against people with AIDS — are now receiving an increasing share of the funds. Today, these faith-based organizations comprise 30 percent of all of the program’s funded organizations.

The program is mired in restrictions. To receive funds, for example, organizations and governments must sign a statement condemning sex work, even in places where sex work is legal and where organizations are working with sex workers to prevent HIV.

Before moving ahead and blindly accepting the $30 billion with the same restrictions, Congress should look at the program more closely. We need to ensure that the funds are used against AIDS, rather than to bolster a political and ideological agenda.

Douglas A. Feldman is a professor of anthropologyat Brockport State College. Hehas been conducting HIV/AIDS researchin the United States and Africa since 1982,and has edited several books on AIDS.


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