Sunday, March 23, 2008

Bush Abstinence-Only Crusade Exported=Death

Previously on ASIAF...

I outlined how Bush's Abstinence-Only Crusade=1/4 Of Teenage Girls Get STDs and how Bush's Abstinence-Only Crusade=Big Money For Religious Right.

Still, even with the explosion of abstinence-only programs (and the directly related decline of comprehensive sex ed programs), our teenagers are better off than the people of HIV/AIDS-ravaged Africa where George Bush and his evangelical/religious right pals have exported tax payer-financed abstinence-only AIDS programs via Bush's PEPFAR. The President's Emergency Plan For Aids Relief would be almost laughable in an Orwellian way if its results weren't so tragic. In 2005, Rolling Stone called PEPFAR An Epidemic Failure observing that:

Bush has shifted the bulk of U.S. money away from the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international organization that has funded projects in 128 countries and is widely recognized as the best way to distribute AIDS funds.
Instead of offering an "emergency plan for AIDS relief," George Bush created an AIDS relief plan emergency. PEPFAR's stated goal of AIDS-prevention is seriously compromised by its current requirement that 33% of the funds go to abstinence-only (read: religious right) groups:
Two highly-regarded studies, one by the Institutes of Medicine and another by the Government Accountability Office (GAO), found that the one-third earmark for abstinence programs undermines successful prevention efforts, in part by limiting flexibility on the ground. Both organizations called on Congress to strike the earmark. The House did so in theory, but replaced it with a new requirement that a minimum of 50 percent of funds for prevention of sexual transmission be allocated to "behavior change" as defined by Congress. Observers have called this a breakthrough.
Those "observers" aren't "observing" nearly hard enough. As Congress defines it, this "behavior change" means "abstinence, delay of sexual debut, monogamy and fidelity." So instead of only abstinence-only, Congress adds "wait" and "don't cheat." Congrats to the US Congress for inching their way towards treating Africans as adults.

This new language is unlikely to save any more lives. Feedback from our PEPFAR partners "suggests it is exactly these seemingly innocuous provisions now found in the House bill that cause the most trouble on the ground." Always impervious to anyone's concerns other than his own, Bush was found wandering Tanzania last month intently spinning the "new & improved" PEPFAR's as:
"a balanced program. It is an ABC program abstinence, be faithful and condoms. It is a program that's been proven effective."
Balanced and effective my ass. It's no accident that Bush listed condoms last. The 50% "behavior change" component is tailor-made for evangelical exploitation. It will ensure condoms continue to be a minor part of this effort. As for PEPFAR's overall efficacy, a Feb. 21 LA Times editorial (by a high school science teacher!), Popping The PEPFAR Bubble, has the skinny:
For the first two years of the program, Bush blocked the procurement of most low-cost, generic fixed-dose combinations of antiretrovirals in favor of brand-name, multi-drug regimens that cost twice as muchthus lining the pockets of U.S. pharmaceutical companies instead of saving lives. Even though a generic antiretroviral was approved by the FDA in 2005 and made available for purchase through Pepfar, only 27% of the antiretrovirals purchased by Pepfar in the 2006 fiscal year were generic. In addition, the U.S. has attempted to block access to quality generics on the global market.

Pepfar requires that 33% of all prevention monies (including prevention of nonsexual transmission) and two-thirds of sexual-transmission funds be spent on abstinence and fidelity programs. Many of these programs are administered by "faith-based" organizations, typically evangelical Christian groups that promote "abstinence before marriage" and "being faithful" and downplay the use of condoms. This, combined with the Bush administration's go-it-alone approach and refusal to integrate with national AIDS prevention programs already in place, has essentially destroyed years of AIDS prevention work in several countries. Nowhere is this more apparent than in Uganda, where a highly successful AIDS prevention program that stressed the used of condoms had been in place since 1990. After Uganda accepted Pepfar funding in 2003, faith-based organizations undermined the country's condom program. As a result, millions of condoms sat in warehouses because they were not wanted. According to Dr. Kihumuro Apuuli, the director general of the Uganda AIDS Commission, since it adopted the program, the rate of new HIV infections almost doubled, from 70,000 in 2003 to 130,000 in 2005.

This is only a taste of the many criticisms of Pepfar. Not to mention any of them in the article is negligent. Pepfar has done much good, but it has accomplished only a fraction of its potential. Pepfar should not be used as platform for Christian groups to proselytize and attempt to impose their own view of morality on different cultures. It should not be used to transfer taxpayers' dollars to the pockets of pharmaceutical companies. We must cut the many strings attached to the program that hobble its effectiveness and bring the focus back to saving lives, not playing politics.
(emphasis added)
Yep. George Bush's "go-it-alone" and "refusal to cooperate" approach strikes again. The difference is that PEPFAR profits evangelical, conservative and other big time Republican campaign contributors (i.e. Big Pharma) while killing the very people it purports to help. Among the many ironies (including the all-too-familiar "Christians "acting in a decidedly un-Christian manner theme) is that through his PEPFAR policy, our self-styled "promoter-in-chief of Democracy aboard" has unwittingly contributed to political instability in South Africa's democracies.

Due to its lack of geographical proximity to us and our overwhelming eight years worth of Bush fatigue, it's all too easy to chalk up Bush's abstinence-only African adventure as just another in a long line of colossal GWB fuck-ups. But in countries like Uganda, Malawi, Tanzania, Zambia and Zimbabwe the stakes are so much higher than everywhere else. For hundreds of thousands of Africans, Bush's and his evangelical pals' abstinence-only posture is a death sentence.


Some Africa HIV/AIDS resources:
Global HIV/AIDS pandemic:
Global Health Reporting.
The Elizabeth Glaser Pedriatric Foundation does great work in Africa and elsewhere. Donate here.