Sound too good to be true?
With this money came a number of caveats.
1. "Emergency Plan funds will not support needle or syringe exchange".
Many people have objected to this because needle exchange programs have been proven to help reduce the spread of blood-borne HIV by providing injecting drug users with sterile syringes, without encouraging drug use. In some areas, this may be part of a wider harm reduction strategy, whereby users are given a safe, monitored place to inject and/or pure uncontaminated drugs to reduce the risk of overdose. However, the U.S. government is opposed to such measures as it believes they make drug use seem more acceptable, and facilitate continued drug use.
2. "No funds made available to carry out this Act, or any amendment made by this Act, may be used to provide assistance to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking."
This condition, also called the "Prostitution Loyalty Oath," led to Brazil refusing $40 million of PEPFAR funds in May 2005. The director of Brazil's HIV/AIDS program explained, "Brazil has taken this decision in order to preserve its autonomy on issues related to HIV/AIDS as well as ethical and human rights principles". The Brazilian government and many organizations believed that adopting the PEPFAR condition would be a serious barrier to helping sex workers protect themselves and their clients from HIV.
3. Congress required that 1/3 of prevention funds be spent on abstinence-until-marriage programs.
As a percentage of money spent specifically on prevention of sexual transmission, close to two-thirds is spent on abstinence-only education. This ideological requirement has been shown to divert funds away from other methods of HIV-transmission prevention, such as prevention of maternal-to-child transmission and prevention targeting injecting drug users.
Talking to people who work on HIV education, prevention and control in Africa have said that PEPFAR funding is virtually useless to them. Funding required them to sign an oath not to acknowledge the sex industry. In other words, they would not be able to distribute condoms or assist infected sex workers, unless those workers agreed on abstinence. Not only would PEPFAR funded projects have to follow this requirement, but the entire foundation would have had to adapt this oath. Fortunately, since the initiation of PEPFAR, a bill was introduced that would remove the 33 percent abstinence-until-marriage earmark from HIV prevention programs.
Elizabeth Pisani, an epidemiologist with years of experience working on HIV/AIDS, and author of the book, The Wisdom of Whores: bureaucrats, brothels, and the business of AIDS, has said she has mixed feelings about PEPFAR. On one hand, the money going into treatment has undoubtedly saved the lives of hundreds of thousands. On the other, without adequate prevention strategies, the spread of HIV will continue to grow exponentially. As the number of people living with HIV increases, so does the risk of spreading the disease.
With earmarks and other restrictions, PEPFAR really isn't doing everything it can to bring the spread of HIV/AIDS under control. It makes me kind of angry that our government would impose it's own ideological point of view when there are far greater issues at stake. I suppose I should be glad that the U.S. is at least doing something to improve the global problem of HIV/AIDS. I can only hope that in the coming years this trend will continue. Perhaps a new government will be better at listening to what needs to be done and allowing the funding to go where it needs to go.
One can hope.
Image lifted from www.avert.org