Remember a few years ago, when Bush
promised billions of dollars to treat people with AIDS and fight the spread of AIDS in Africa, the Caribbean, and elsewhere through the President's Emergency Plan For AIDS Relief (PEPFAR)? How great was that news for countries like Botswana and South Africa and Haiti, where AIDS treatment and prevention programs would be helped by major funding. Health officials nationally and internationally were ecstatic. President Bush was addressing AIDS! What a compassionate conservative!
Well, maybe not.
According to a report from the bastion of oversight, the Government Accountability Office (GAO):
The requirement that a large fraction of President Bush's global AIDS plan go to promote abstinence and fidelity is causing confusion in many countries and in a few is eroding other prevention efforts, including ones to reduce mother-to-child transmission of the virus.
PEPFAR's main prevention message is:
"Avoiding AIDS as easy as... A bstain
B e faithful
C ondomise"
Commonly referred to as the ABC message. The argument for ABC is that abstinence 100% prevents the spread of AIDS, being faithful to one partner prevents the spread of AIDS, and as a last resort, using condoms will help, but not 100%, prevent the spread of AIDS. However, the A and B parts are the focus of the program, considering that 66% of the prevention funding must go to programs that promote abstinence and fidelity. The effectiveness of an abstinence based program has been studied, and in most studies, abstinence education has been proven not as effective as comprehensive programs. Yet, the focus is on abstinence. The message is enforced, and no one is allowed to suggest any other course of action. Opposition will be crushed, so to speak.
As an anecdote, I know someone involved in the media side of promoting PEPFAR. The individual programs within the countries are being run as best they can, and in many cases the ABC message is ignored. Condoms are purchased, either using discretionary funds or out of pocket, and proper sex education is taught. However, the danger is that funding would be cut off completely, so the workers on the ground are careful. Additionally, the filtering of messages is so bad that any footage of AIDS prevention education is screened to prevent "the wrong message". The people on the ground in these countries are forced to hide their actions from their own government, lest they lose funding or re-assigned or worst, fired and sent home. It is so bad, that at an international AIDS conference last year, the Peace Corps sent a person to talk to about their work in PEPFAR. That person was booed by the audience, because the focus of the talk was on the ABC message, which is considered a joke outside of the U.S.
This is a travesty. The Bush administration's adherence to the ABC message does not help, and probably harms. Deeper than just the prevention message, PEPFAR has many flaws that need to be addressed. The billions of dollars supposedly allocated for the program are spread out over so many years, and misdirected when they are received, that in the end, PEPFAR will do little to help treat AIDS patients as well as prevent the spread of AIDS. The world can not wait while the richest nation with some of the best research institutions wastes time and money in a program that helps in such a miniscule way.