Sen. Vitter Reinserting Ab-Only in PEPFAR


Who needs fiction when you've got politics? You really can't make this stuff up.

As Gov. Eliot Spitzer's (D-NY) political career comes to an end for his involvement with a prostitution ring, Sen. David Vitter, (R-LA) of "DC Madame" fame, plans to amend the President's Emergency Plan for AIDS Relief (PEPFAR) to reinsert the 33 percent abstinence-only earmark.

Sen. Vitter, not exactly a model for abstinence, or being faithful, has the audacity to put his hypocritical ideology ahead of evidence-based public health strategies that tell us abstinence-only should be removed from PEPFAR. He puts ideology ahead of his own reality in the ultimate paternalistic perversion of "do as I say, not as I do."

Yet Democrats and some advocates choose to compromise the lives of Africans by running from a fight with hypocritical social ideologues.

The Senate Foreign Relations Committee will mark-up its version of PEPFAR on Thursday. The House has delayed action on the floor until after Spring recess.

Sen. Barbra Boxer (D-CA) will offer an amendment allowing PEPFAR to refer clients with family planning needs to NGO's providing those services. Family planning will be added to services like nutrition, income assistance, primary health care, maternal and child health care, diagnosis and treatment of STI/STD's, substance abuse and legal services.

The goal of the Boxer amendment is to allow grant recipients to refer clients to these services provided by other NGO's so PEPFAR does not have to pay for them. Currently, family planning programs are often the first responders in the health care system for women and girls needing HIV prevention services, and should be supported by PEPFAR funds. But Congress has yet to indicate it will do that, so this basic referral is a step toward efficient delivery service that can save lives.

The Boxer Amendment improves on the House Bill in which Democrats compromised with the White House prior to committee action, complicating PEPFAR by adding the Global Gag Rule, and substituting behavior change language for ab-only earmarks instead of following the advice of public health experts from the Institutes of Medicine and many other organizations. Removing all complex ideologically-driven behavior change mandates, including the ab-only earmark, allows country level teams of public health experts to determine what works best in any community. Instead the current bills allow hypocritical Congressmen in the "Emperor's Club" that the American political elite occupy, to determine that impoverished people should not have access to essential prevention and health services.

So far there seems to be no legislator courageous enough to remove the anti-prostitution pledge, effectively tying the hands of public health organizations from delivery services to this most vulnerable population. If you've not read Bill Smith's post from Zambia on this issue, please do.

With all this talk about politicians and $3500 prostitutes, surely there is someone who will stand up for impoverished women and girls in Africa to allow PEPFAR to educate and treat them for HIV/AIDS in order to slow its spread.

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