Bush's AIDS Initiative: Too Little Choice, Too Much Ideology
By Wendell Rawls Jr.
WASHINGTON — Just two months before ordering the invasion of Iraq, President Bush in his 2003 State of the Union address asked Congress to appropriate $15 billion for care, treatment and prevention of HIV/AIDS in developing countries. The subsequent President's Emergency Plan for AIDS Relief (PEPFAR) served to burnish his "compassionate conservative" credentials even as he took the nation into war.
 This pro-abstinence billboard in Kampala is sponsored by the Office of the First Lady. Uganda's first lady Janet Museveni, a fervent Christian who embraces PEPFAR's policies, said in 2003 that condoms are unnecessary for young people. (Associated Press Photo by Morgan Mbabazi) |
And it has enabled his administration to funnel tens of millions of dollars to Christian faith-based organizations that support his ideology and form his political base.
Congress authorized the money to be spent over five years primarily in 15 "focus countries," although more than 100 other countries receive smaller amounts. The major goals were to treat those infected with HIV/AIDS, care for those dying of or orphaned by AIDS and prevent the spread of the disease.
"This was an unprecedented moment in history," said Dr. Paul Zeitz, executive director of the Global AIDS Alliance, a Washington-based AIDS advocacy group, and a former official with the U.S. Agency for International Development (USAID). "We've never had this opportunity before. We are the first generation in 100,000 years to have such an opportunity to face a global scourge and defeat it.
"We have the information technology, the communication technology, the transportation technology, the developmental and health systems technology, the biological technology, the global wealth and the moral compass to face this pandemic and change the course, change the reality faster than ever before. There's never been a time when we had all these technologies" to work with.
Dr. Mark Dybul, ambassador for the Office of the Global AIDS Coordinator, refused repeated requests for an interview about the PEPFAR program and its restrictions. But Zeitz was not so reluctant to make an assessment.Despite some successes, PEPFAR has not worked out the way it was envisioned.
"In fact," Zeitz said, PEPFAR "is failing to stop the global spread of AIDS and failing to help lead the world to stop this deadly disease." Instead of "empowering local people," he said, "we are restricting them. We have a flawed framework with flawed policies that have kept us from being where we should be by now."
Information accumulated by reporters in the International Consortium of Investigative Journalists (ICIJ) through more than 100 interviews, examination of thousands of pages of documents and reporting on the ground in affected countries indicates that this historic opportunity may be slipping away, because PEPFAR's "flawed framework" has stressed a restrictive use of the funds earmarked to combat HIV/AIDS.
Experts and activists say that attacking one of the most deadly pandemics in history is an extraordinarily complex venture, dealing with abject poverty and starvation; civil wars and rebellions; devastating violence against women; centuries of such cultural mores as male domination and polygamy, political and corporate corruption, and religions.
In the face of all of that, critics say, PEPFAR has proved at times to be too simplistic and narrow to deal with the complexities of the epidemic.
Initially, the program relied heavily on the use of brand-name antiretroviral drugs instead of more affordable generic drugs. Its prevention theories are mostly limited to what is known as ABC — for Abstinence, Be Faithful, and correct and consistent Condoms use — an approach that some experts say is not responsive to situations of violence and gender inequality.
And while the president set a goal of preventing 7 million new AIDS infections, the proportion of money in focus countries going for prevention has fallen by more than a third over the first three years of the program, from 34 percent of the total PEPFAR budget in 2004 to 22 percent this year.
 The U.S. government supports the "ABC" strategy for HIV/AIDS prevention as illustrated on this DKT Ethiopia poster in Shashemenē General Hospital, south of Addis Ababa. (Photo by Marina Walker Guevara) |
In fact, the actual prevention practices stress the "AB" messages — abstinence until marriage and being faithful to one partner. The "C" has moved to a small c, and the use of condoms is lumped into the category of "other preventions" that includes prevention of mother-to-child transmission, blood safety, safe medical injections and control of intravenous drug use.
While Dybul would not be interviewed for this article, in testimony at a House subcommittee hearing, he defended the ABC approach in all of its manifestations.
"To the extent any controversy remains around ABC," he swore, "I believe it stems from misunderstanding. ABC is not a narrow, one-size-fits-all recipe. It encompasses a wide variety of approaches to the myriad of [sic] factors that lead to sexual transmission. The interventions that help people choose to avoid the risk of HIV infection entirely, to reduce their risk, vary according to the circumstances of their lives."
In a speech delivered Nov. 27 at Georgetown University, he acknowledged that, concerning the AB and C programs, "It is all very complicated and we don't have it right everywhere and need to improve still."
A major source of HIV infection is sexual transmission through commercial sex work. But the administration requires organizations receiving PEPFAR funding to take an "anti-prostitution loyalty oath," a signed statement saying they oppose prostitution. As a result, many organizations that have worked on health, safety and rights issues of sex workers can't sign the oath and don't qualify for U.S. funding.
Many of the faith-based groups, nongovernmental organizations, American universities and private companies whose HIV/AIDS programs PEPFAR is funding have accepted the strings attached. But many others interviewed by ICIJ said they devise ways to get around the rules to spread their prevention messages. Some American evangelical groups are revising their own procedures and including condoms information in their abstinence-centered programs.
While some organizations receiving PEPFAR funds have extensive experience running public health programs in developing countries, others, such as Food for the Hungry and the International Orthodox Christian Charities (IOCC) started their first stand-alone HIV programs only when PEPFAR funds became available.
Critics say that some PEPFAR-funded groups lack the know-how to run HIV programs. In one instance, a politically well-connected U.S. faith-based group, Children's AIDS Fund (CAF), was found by an expert panel of reviewers to be "not suitable" for PEPFAR funds, according to published reports. But this finding was overruled by the then head of USAID, and the group was awarded a $10 million grant anyway to run abstinence-centered programs in Uganda, Zambia and South Africa. The president of CAF, Anita Smith, a longtime vigorous promoter of abstinence programs, has been the co-chairwoman of President Bush's Advisory Council on HIV/AIDS.
The president was an early subscriber to Smith's abstinence education views and he pushed them when he was Governor of Texas. But abstinence-only sex education programs in Texas were found to have had no impact in teenagers' sexual behavior, according to a Reuters news service report of a study by researchers at Texas A&M University.
In fact, reflecting statewide trends, teenagers in 29 high schools became increasingly sexually active despite taking courses emphasizing abstinence-only themes, according to the study commissioned by the Texas Department of State Health Services.
The President's and his supporters' focus on abstinence programs provides some perspective on their approach to the global epidemic. Here are some salient facts regarding the U.S. response and the president's global plan and actions:
 Many medicines used to treat HIV/AIDS patients, such as these stored in a Partners in Health facility in Cange, Haiti, require constant refrigeration. Despite receiving PEPFAR funding, Partners in Health chooses not to use it to buy drugs; the organization prefers to purchase less expensive generics from other sources. (Photo by Guy-Claude Jean-Baptiste Jr.) |
- About 40 million people in the world are living with HIV/AIDS, two-thirds of them in sub-Saharan Africa.
- More than 20 million people died from AIDS in the quarter-century before PEPFAR was established.
- Of the $15 billion appropriated for PEPFAR, only 60 percent was new federal funding. The remainder includes other, previous international commitments. And $1 billion of the $15 billion went to the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.
- About half of the treatment money is going for antiretroviral drugs, which at the beginning were required to be highly expensive name-brand drugs approved by the Food and Drug Administration and provided largely by major American pharmaceutical companies. More recently, some two dozen generic formulations have been approved for PEPFAR use by the FDA.
- Congress mandated that one-third of the prevention money (about 20 percent of the total appropriated) be earmarked to go to abstinence and fidelity programs. A 2006 Government Accountability Office report concluded that this spending requirement was hurting other programs in the field, such as prevention of mother-to-child transmission.
- The discussion of condoms is routinely discouraged as a primary prevention approach among youth and cannot even be mentioned to those under age 15 in school programs, even if they are already involved in sexual conduct. Condoms can be addressed in out-of-school settings among youth who engage in high-risk behavior.
- In general, at least two-thirds of all foreign aid funds never leaves the United States, according to a Congressional Research Service report. The money buys U.S. products, pays for U.S salaries, overhead, benefits packages, travel, American-made vehicles, office expenses, computers and other equipment. USAID awards 87 percent of its consultant dollars to U.S.-based firms.
How well has PEPFAR worked?
A yearlong investigation by ICIJ, a division of the Center for Public Integrity, including in-country reporting from Ethiopia, Kenya, Nigeria, Uganda, South Africa, Haiti, India and Thailand, disclosed that ideology has at times trumped science in the Bush administration's rules, regulations and support of the organizations that have received taxpayer money.
The precise amounts are difficult to discover. While the State Department, through its Office of the Global AIDS Coordinator, claims pride in its "transparency," the agency routinely takes a year or more to provide public documents requested under the Freedom of Information Act. Facing long delays with not even an estimated delivery date, the Center for Public Integrity filed lawsuits to gain access to PEPFAR records. By comparison, USAID was relatively prompt, but the State Department held the bulk of the requested documents.
When the State Department did provide the documents, under a schedule arbitrated by a federal court, it blacked out the significant financial information. Almost none of the public documents were made available except in response to the litigation.
Finally, to settle the Center's lawsuit, the State Department released data that included PEPFAR money flows for 2004 and 2005, but the numbers didn't always add up correctly, and officials admitted that their database contains flaws and errors.
Interviews with scores of activists, people living with HIV/AIDS, physicians, health care workers, government officials and academics, along with examination of thousands of pages of incomplete documents, also show a pattern of contradictory, conflicting and confusing policies. The picture presented is one of an extraordinarily disorganized operation.
More than 3½ years after President Bush's State of the Union address that led to PEPFAR's creation, about $8.3 billion has been spent for PEPFAR activities, according to the State Department. That is the about same amount spent in three weeks of war in Iraq.
Less than $1 billion has actually been spent preventing people from contracting AIDS in the 15 focus countries — about the same amount of money that is spent in three days of war in Iraq.
Meanwhile, the number of people who become infected with HIV continues to rise in some countries, and three-quarters of them are infected through sexual intercourse. More than 450 people contracted HIV each hour last year, constituting more than 4 million new cases.
While the spread of HIV/AIDS has continued and sub-Saharan Africa remains the global center of the pandemic, the people in some countries are faring worse than others.
An exceedingly high percentage of the population is infected in some of those countries, such as Swaziland, Lesotho and Zimbabwe. In Swaziland, infections among pregnant women rose from 4 percent in 1992 to 43 percent in 2004. In Lesotho and Zimbabwe, more than a fifth of the population is infected, although a new UNAIDS report released last week said the national adult HIV rate in Zimbabwe is declining.
But none of the three is included among the 15 PEPFAR focus countries, and no one in the administration could offer an explanation of how the focus countries were selected.
Still, the problems facing those included on the list are extensive.
 Ethiopian women participate in a Family Health International-funded literacy program in Addis Ababa, learning to read and write with the hope of making a better life for themselves. Women are at the bottom of society in Ethiopia and HIV infection rate of women is higher than that of men.(Photo by Marina Walker Guevara) |
In South Africa, for example, almost one of every three pregnant women attending prenatal clinics in 2004 was infected with AIDS. The 2006 United Nations Report on the Global AIDS Epidemic reported no clear signs of declining HIV/AIDS prevalence throughout southern Africa.
In Botswana, more than 24 percent of adults are infected.
A dynamic epidemic is under way in Mozambique, and infections are spreading particularly fast in areas linked by major transportation corridors to Malawi, South Africa and Zimbabwe, the U.N. reports.
In Uganda, whose programs President Bush touted and used to pattern PEPFAR's ABC prevention approach, success seems to be reversing. In the two years since the new U.S. emphasis on youth abstinence began, the rate of new HIV infections has almost doubled, from 70,000 in 2003 to 130,000 in 2005, according to the director general of the Uganda AIDS Commission.
Since the arrival of PEPFAR money, the student and teacher materials in schools now stress abstinence. One student handbook advises: "Young people do not need condoms; they need skills for abstaining from premarital sex."
According to documents, PEPFAR requires its partners to emphasize condoms' failure rates, which is exaggerated to approach 20 percent, when studies have shown that latex condoms are vigorously tested and, when used properly, have a success rate in excess of 98 percent.
Ethiopia is a nation staggering under the weight of poverty and famine, and rural women and girls move into cities in search of jobs. Many of them are not able to find steady employment and some become commercial sex workers along the main transportation routes. Even university students engage in sex in exchange for money to buy food and books.
A government survey found that 70 percent of the sex workers in the capital city, Addis Ababa, were HIV-positive in 1998. Only $110,000 of PEPFAR funds was allocated in 2006-2007 for condom promotion among sex workers, truck drivers and other high-risk groups along the Djibouti corridor, Ethiopia's main route to the seaports and an area where sex work is widespread. But almost five times that amount was allocated for abstinence and fidelity activities.
Over the entire country, PEPFAR's budget for prevention increased between 2005 and 2006. The funding for abstinence and fidelity activities increased by 63 percent, while condom funding increased 28 percent.
After Thailand went to a "100 percent condom" program in 1991, the rate of HIV infection among female sex workers declined from 30 percent in the mid-1990s to less than 10 percent in 2004. By 1995, the number of men coming to government clinics for treatment of sexually transmitted diseases declined by more than 90 percent.
 Samples of the different brands of condoms distributed in Thailand are posted on the wall at the Bangkok headquarters of the Rainbow Sky Association, a nongovernmental organization that works with MSM (men who have sex with men) groups.(Photo by Sheetal Doshi) |
When condom use was enforced on sex workers and in the brothels, the number of annual new HIV infections fell from 143,000 in 1991 to about 20,000 by 2003. The condom promotion program was so successful that public health experts urged that it be copied in other developing countries where prostitution was common.
Thailand has a long history with AIDS and a large HIV-infected population, but it was not selected to be a focus country.
Now the HIV/AIDS epidemic is feared to be resurging. A 2005 World Health Organization report said that new infections are no longer declining as rapidly as they did in the 1990s.
In Thailand between one-third and one-half of newly infected Thais are women in stable relationships, indicating that their male partners are engaging in risky sexual activity with others.
India, also not a PEPFAR focus country, has a relatively low HIV prevalence rate, but because of the country's population, it translates into almost 6 million HIV-infected people — the largest group in the world. About 85 percent of HIV/AIDS cases in India are attributed to heterosexual sexual activity, and commercial sex work is the major contributing factor.
Bharati Dey, a former sex worker who is a program director of a successful HIV/AIDS prevention project, sees commercial sex work not only surviving, but also expanding. "Traditional occupations of women are diminishing, and so the amount of female sex workers has increased over the past decade," she said.
That condition exists for women all over the globe, and the poorer the country, the worse their plight. There are limited opportunities for women in India as well as in Haiti, where fewer jobs, widespread starvation and more desperation to care for themselves and their children have put women at greater risk of contracting such sexually transmitted diseases as HIV/AIDS.
According to U.N. data, women and girls in the Caribbean, 15 to 24 years old, are up to six times as likely as men to contract HIV, often as the result of sexual violence. In rural areas of Haiti, economic dependence on men is one of the primary risk factors for infection.
Haitian women have the highest rate of new AIDS cases in the Americas. But while the World Health Organization says that violence against women is often a cause and a consequence of HIV, the money being spent by the U.S. government on HIV prevention in Haiti has not yet seriously addressed the issue of violence against women.
And the violence feeds on the poverty. In some communities in Haiti, people eat just one meal a day. Along with Afghanistan and Somalia, Haiti has one of worst caloric deficits per inhabitant in the world.
While PEPFAR orchestrates programs for abstinence and fidelity, reality in the developing world moves to different music. In many places, poverty and hunger are constant companions of women and playmates for their children. For some, survival sex is the only way of life.
The bottom line is that, for most women, abstinence is rarely an option. In fact, as Anne Sosin, the head of a rape crisis center in Haiti, says, "Abstinence, Be Faithful and Condom use works in a context where women are able to exercise their sexual rights." That is not the norm in many communities around the world.
More than 80 percent of new HIV infections in women results from sex with their husbands or primary partner. The men usually became infected from extramarital sexual partners.
Beatrice Were is a small, delicate Ugandan woman, mother of three, devoted HIV/AIDS activist and care volunteer.
In Uganda, she says, polygamy and promiscuity among men are both significant and socially acceptable. "This [PEPFAR] approach places a huge burden on a woman to abstain and, when she's married, to be faithful," she said in an interview with ICIJ reporters. "Personally, I did all of that, but I still got infected."
ICIJ members and Sheetal Doshi, Sarah Fort, Victoria Kreha and Marina Walker Guevara contributed to this story.
This article was published on the website for the Center for Public Integrity
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Your assignment is to respond to this prompt in an 11 sentence paragraph format. Publish your response as a comment to this post. When stating your opinion, consider US foreign policy, Republican and Democrat partisan politics, the current economic crisis and the recent elections.
“Should newly elected President Obama continue or change the US policy advanced by President Bush known as the President's Emergency Plan for AIDS Relief (PEPFAR)?
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Questions? Ask in class or email me at doug@dougabshire.com. This assignment is due by Monday 1.18. Thanks, Mr.A
13 comments:
Should newly elected President Obama continue or change the US policy advanced by President Bush known as the President's Emergency Plan for AIDS Relief (PEPFAR)? I think the President Obama should continue President Bush's PEPFAR because we could potentially find a cure or prevent millions of people from recieving or passing on this deadly virus. If we keep people informed then we can prevent this from spreading and educate them about using protection when having sex. "This was an unprecedented moment in history," said Dr. Paul Zeitz, executive director of the Global AIDS Alliance, a Washington-based AIDS advocacy group, and a former official with the U.S. Agency for International Development (USAID). "We've never had this opportunity before. We are the first generation in 100,000 years to have such an opportunity to face a global scourge and defeat it. This is the chance to change the world and prevent the world's most common and deadly virus from spreading.
I believe that soon to be President Obama should continue the (PEPFAR)and it's goals. My problem though, is that it seems like the program is focused solely on abstinence and not on actual prevention. Yes, abstinence will prevent spread among young people who aren't sexually active. However most teens even in America aren't abstinate and it is near impossible to convince them to be. So even in a culture where sex is still slightly taboo for young people it's hard to keep young people from having sex. Therefore how can we expect other countries with different customs and beliefs than us to adhere to our beliefs? The answer is we simply can't. People in other countries are suffering because of HIV/AIDS and our government can't stand by and offer aid only to those suffering who will change their entire culture about sex in order to qualify for aid. So i believe that we should not make abstinence the first line of defence against HIV/AIDS because it, in most cases just isn't practical. Also i believe that the money we put towards helping these other countries would be much better spent distributing condoms to those who are sexually active rather than just telling them "If you have sex you'll get a STD and if you get a STD we're not gonna help you, your gonna die." This is a copout. Instead of using this line i believe we should educate in condom use and then in abstinence in order to prepare people, because even if you get married it doesn't mean your spouse won't have an STD. This is to say that the spread of HIV/AIDS is interspousal and can't be prevented solely by abstinence and other methods must be given greater emphasis. This is how i see the current situation of if President elect Obama should continue (PEPFAR)funding.
In my personal opinion, President Obama should change the current policy of PEPFAR. The program itself is definitely a good idea. It builds awareness of this deadly disease that is quickly becoming a lead killer in millions worldwide. Given the fact that there is no cure at the given moment, awareness is the biggest weapon against such viral agents. The information that is necessary to prevent the spread of HIV/AIDS should continue to be dispensed to all available countries in the world. I do not believe, however, that the current strategy for prevention that is proposed by PEPFAR is effective. PEPFAR propagates abstinence. That's all fine and dandy, but in all seriousness, rather ineffective in the conditions of most countries around the world, especially those particularly stricken by the effects of poverty. As both Anne Sosin and Beatrice Were stated, Abstinence, Be Faithful, and Condom use is only effective in situations where women can stress their sexual rights. Many sex workers have been infected with HIV/AIDS, but are without the knowledge and required protection to prevent the spread of HIV/AIDS through their line of work. The Abstinence Only approach of PEPFAR, while completely undercutting the use and provision of condoms, actually hurts the program's efforts because they are preaching to the proverbial choir. Abstinence is a rare option for many of those in poverty stricken countries, but the provision of condoms is not beyond use. If that particular aspect of the PEPFAR program was more highly stressed and funded and condoms were provided and encouraged in these places where professions such as these sex workers is prevalent, the program would work better, in my opinion.
I think that President elect Obama should continue the emergency releif plan for AIDS. First of all, if a cure for AIDS is found now or even in the far future millions of peoples' lives can be saved. Also, other people can be spared from going through the agony of having AIDS. We all know that not everyone is going to follow abstinence or be smart enough to use a condom, and because they want to stop educating teenagers and shelter them their whole lives. So continueing to find a cure or way of prevention for HIV/AIDS is the only logical solution. Until then, they will need to teach condom use to young people in order to prevent AIDS and other STDs from being transmitted because abstinence isn't absolute and never will be. Also people should be checked for STDs, most all transmissions of STDs come from people who do not yet know they are carrying one. On the subject of continued (PEPFAR) funding i believe funding should be continued but methods should be changed
JORGE APODACA
My belief is that (PEPFAR) is a good plan, but we need to really consider on investing money on more efficient and enhanced preservatives that resemble an almost natural sexual experience. By doing so you will not only prevent STDS but you will encourage people to use it since it will fell natural. It is a great issue that people have when it comes to the condom, people that don't use it feel that it interferes with the whole experience making it feel almost artificial. People (especially these days) tend to seek for more sensation when performing sex, so it will be great if we spent more money and time on trying to create a third generation condom, instead of wasting time and money trying to change people's minds on not having sex. Therefore i conclude that the Barack Obama should make a wise decision and invest on new preservatives and drugs , as well as investing on researching for possible cures of HIV (AIDS).
This is just my opinion, but I believe that there are more important things to be involved in in this world other than protecting people that have sex from diseases. There can be 15 million dollars going elsewhere, sure people in Africa are well aware of the affects of AIDS on their country, but honestly, I think we have enough problems in the U.S already. So why should we worry about other countries problems when we cant even solve ours? MATT HAGEN
In my opinion President Obama should still continue with the PEPFAR program. The article states that we have all the resources requiered to really prevent the spred of HIV/AIDS. This is a great program but it does have one big flaw, it's a little one-sided. PEPFAR focuses on mainly abstinence and being faithful to one partner. Those are effective prevention methods but they don't apply for every country. For example countries that have sex occupations can't recieve funds from the program. Which is why there should be more focus on the use of condoms. Abstinence is great and all but the truth is not everyone will practice it. So President Obama should keep the PEPFAR program but tweak it to include all forms of prevention.
In my opinion, I believe that the newly elected President Obama should continue and make better changes to the US policy advanced by President Bush known as the President's Emergency Plan for AIDS Relief (PEPFAR). To begin with, the PEPFAR should be modified by the newly elected President Obama in order for it not to just only focus on promoting abstinence. Instead, also provide the global population with sufficient information about HIV/AIDS and ways to prevent it from spreading. This could be by letting people that yes abstinence is something that could prevent the spread of the disease but also, giving them other methods that will adapt to their form of life, like giving them condoms and stuff of that sort. Second, the PEPFAR should also have the ability to provide aid to the most affected countries. This could be by giving them medicines that will help make the process of AIDS longer, so that they have an opportunity to a longer life. Also, by providing funds to further some more research on AIDS/HIV. Last, the PEPFAR would be most helpful by having support programs in the most affected areas. In other words, having centers in which people that are suffering from the illness can go to in order to receive more information about AIDS/HIV or just plain moral support. Usually the countries that are highly affected by AIDS and HIV tend to be lacking of funds from their own government, so I would think that if they have a support program that will help them take tests to see if they have the illness that will help them know and become aware that they have the disease and will prevent the spreading of it, or at least they will keep track of who else might be possibly infected by the illness. All in all, it would be really beneficial to our entire world, that the newly elected President Obama continue or change the US policy advanced by President Bush known as the PEPFAR.
I think that newly elected President Barack Obama should continue and change the President’s Emergency Plan for AIDS Relief (PEPFAR). First, we should help spread other methods of prevention other than abstinence. This could include condoms and all that other fun stuff. Abstinence is fine, but can't be forever. People should know about their options and it is the governments' responsibility to provide the nation with information on prevention. Since there is no cure for AIDS yet, more money should be placed into AIDS research. This could include creating possible cures and testing them on people to see if they work. Money should also be invested in creating new forms of prevention and providing more information about spreading AIDS. We are not the only place where AIDS is spreading. We should learn more information from other countries. They could help us learn more information about AIDS and help us with creating cures. Barack Obama should continue and help to improve the President’s emergency plan for AIDS Relief.
This is just my opinion, but i believe that there are many more things that we should spend our money on, rather than wasting 15 million dollars on protecting people that are having sex. Sure many peole are dying due to AIDS/HIV, but giving money to foreing countries for the support of aids when we cant take care of our own country. I might seem rude, but there are much more important things for obama to do than protect third world countries from AIDS. So in my opinion, I dont believe that president elect Barrack Obama should not continue the foreing policy on AIDS. This is MATTTHEW HAGEN
Maryann Martel
I think that newley elected President Barack Obama should not continue the President's Emergency Plan for AIDS Relief also known as PEPFAR.However i do feel he should try to come up with a different plan to help reduce the risks of AIDS. In my opiniopn PEPFAR is not doing what it was set out to do which is to reduce the risks of AIDS.So far all it has done is waste 15 million dollars which could have been used to work on other world wide problems like world hunger or global warming. PEPFAR does have a good purpose but it is mainly foucusing on abstanence rather than the prevention of AIDS. Its also not up to the U.S on how other countries should handle sexual relationships in other countries. The U.S has an AIDS rate on its own that it needs to control before it tries to help other countries with their rates. All in all i truely belive PEPFAR is something that newly elected President Barack Obama should not continue.
In my opinion I think President-elect Obama should change the Emergency plan for AIDS because unfortunately as conservative as we may be we are still human beings and I am not saying abstinence is imposible but that's not the only option to safe sex and preventing the spread of STD's. Promoting abstinece is like trying to feed a child candy, you tell them they cant have it because its bad and it just raises the curiosity and makes it a bigger tempation. So rather than enforcing abstinece schools should promote safe sex and provide condom's and anti-contraceptives. They should be distributed for free because poverty and lack education are the main causes of the spread of AIDS so why not educate people and provide them with the right information and materials.
I agree with Devin, it seems this "PEPFAR" has only one approach to "curing" people from HIV/AIDS. This is abstinence. This will surely be a tough challenge. Abstinence is really hard to participate in especially during the teen years. There are plenty of people in the world who haven't got the slightest idea on what AIDS is and how to prevent it. So if we just go around telling people to stop having sex, because you can contract HIV, most of them wont realize what we are actually trying to do. Maybe if we took the time out to explain more deeply into how important sexual awarness is, and how the lack of it, can lead fatal diseases, we might get somewhere. Its alot easier to promote safe sex, then no sex at all.
Joe Kimbrough
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