Treatment Report Takes PEPFAR to Task


A new report comes from the International Treatment Preparedness Coalition as covered in the Washington Post, “UN Releases Report on AIDS Treatment.” The report, Missing the Target: Off Target for 2010 – details how the global community is behind in reaching its goals for treatment distribution and research.

The report cites evidence of progress as well as impediments in various countries, and it takes each major program involved in the fight to task. Specifically, the report states that The President's Emergency Plan for AIDS Relief (PEPFAR), “has expanded the reach of its treatment delivery and has initiated a variety of activities to build health systems. While continuing these efforts it must, however, end counterproductive policy prescriptions that undermine service delivery and do more to build human resources capacity in countries.”

Translation from Diplomatic-ese: Mr. President, your Administration’s adherence to narrow ideology and attention to base-politics is killing people – at home and abroad.

Peter Piot, the head of UNAIDS, stressed that (link needed), "We need to move from crisis management. Running after the epidemic to prevent it, to a long-term commitment. You can't deal with AIDS on the basis of one fiscal year at a time. We need predictable long-term funding." (sic?) Conservative ideologues in Congress instead use every possible vote on funding to moralize and hamstring federal grant recipients whose primary interests are public health and preventing disease or saving lives, rather than politics.

The Global AIDS Act, which authorizes PEPFAR, contains several restrictions including those on funding for prevention activities and on organizations working with commercial sex workers. Some NGO’s have literally had to take the Bush Administration to court to provide proper prevention outreach to this high-risk group. Where is the compassion in policies that put money in the pockets of lawyers fighting in courtrooms as opposed to funding proven prevention methods targeted to high-risk groups?

Other policies promulgated under PEPFAR, though not written into the law, also restrict the kinds of programs that may be funded. The United States, for example, will not fund safe needle exchange programs for intravenous drug users, despite the proven efficacy of such programs.

The moral thing to do would be to lead by example, demonstrate common sense and make compromises on the world stage to regain some of America’s squandered good will. Let’s hope Mrs. Bush, who is leading the US delegation to the UNGASS (link) next week, has the courage to be more than just a kinder, gentler face on the Administration’s otherwise draconian policies. Let’s hope she makes decisions that will benefit the fight against HIV.

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