The United States is committing $15 billion over the next five years to the global fight against AIDS. President George W. Bush signed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 into law on May 27.
One of the key provisions of the bill is funding, for the U.N. Global Fund (G.F.) up to $1 billion per year, beginning in 2004, but not exceeding Global Fund contributions from other donor nations, which to date have only reached a few hundred million. The “up to” language in the law would permit the U.S. to contribute nothing. This is significant, since during debate on May 2, 2003 over the bill in the House of Representatives, Rep. Henry Hyde, the chief sponsor of the legislation, clarified that no funds would go to any program that uses abortion as a method of preventing HIV transmission.
Recent shipments of manual vacuum aspirators (MVAs) by USAID and Global Fund NGOs to developing nations, for use in integrated “reproductive health” and HIV/AIDS prevention programs, have raised concerns. The MVA is often used for abortion.
UNFPA and USAID
The G.F. is a fund of the World Bank. Funds from the account arc to be applied in-country through “country-coordinating mechanisms” or CCMs. It has been discovered that the U.N. Population Fund (UNFPA), which supports forced abortion, is part of the G.F. CCM, and that USAID and G.F. HIV/AIDS implementing organizations arc the same in many countries. In Haiti, for example, there appears to be little difference between G.F. and USAID HIV/AIDS programs.
Faith, Hope and Charity
Another key provision of the law is that a third of the non-Global Fund funds must go to abstinence-until-marriage programs. It includes conscience protections for genuine faith-based groups who wish to receive federal dollars but who will not promote condoms. These amendments would permit genuine faith-based abstinence groups to participate in abstinence-only programs.
At present, controversy is swirling at the Global Health Bureau of USAID around its promotion of the AB, then C (abstinence, being faithful, and condoms) method of HIV prevention. Scientific data shows that condoms actually help to spread HIV. Plus, abortion and population control groups are attempting, with USAID’s help, to position themselves as faith-based abstinence groups that promote condoms. Funding for such groups would at best preserve the status quo regarding failed HIV programs run from substandard reproductive health clinics overseas.
Abstinence-Only Programs
Yet abstinence-only funding for genuine faith-based groups would provide for new and effective programs, and break the decades old juggernaut held in U.S. foreign policy by population control ideologues. Needless to say, this battle depends largely on who the coordinator of the AIDS relief plan will be.
According to the law, this coordinator will be situated in the U.S. State Department, and will work with USAID. New faith-based offices at both USAID and in the White House provide hope that abstinence funding will go to genuine faith-based groups that are opposed in conscience to condoms.
Only then will the U.S. government be fulfilling its promise for genuine charitable foreign aid to HIV/AIDS stricken people abroad.
Integrated AIDS and Reproductive Health
Many influential AIDS experts believe that heterosexual transmission accounts for 90% of HIV infections in African adults. But several new meta-analyses reveal that the real culprit may be medical transmission. These studies posit that unsafe injections and other medical exposures to contaminated blood may account for two-thirds or more of the new cases of HIV/AIDS.
These findings have serious implications for current HIV/AIDS programs as practiced by USAID and the Global Fund. Their programs combine, or “integrate,” HIV/AIDS relief programs with “sexual and reproductive health” (SRH) programs. Such “integrated” programs raise the possibility of increased non-sexual transmission. They bring HIV positive and HIV negative patients together in the same ramshackle clinics, and subject both to invasive medical procedures.
This problem has been exacerbated by foreign aid programs that emphasize reproductive health procedures (contraception, sterilization, and abortion) to the near exclusion of primary health care. Clinics are well supplied with Depo-Provera, IUDs, and condoms, but lack health care essentials such as rubber gloves, needles, and disinfectant. Medical equipment, such as syringes and manual vacuum aspirators, cannot be properly disinfected before they are reused.
False Sense of Security
The over-reliance upon condoms that characterizes these programs is not without its drawbacks as well. The accompanying “safe sex” message creates a false sense of security that may encourage promiscuous behavior. New studies show that the condom does not provide absolute protection against HIV. President Bush has proposed a program based on abstinence before marriage, fidelity within marriage, and condoms for the intemperate. Abstinence stops heterosexual transmission absolutely and should be promoted without hesitation or equivocation.
But the safe sex message alone is insufficient. Millions of married and monogamous couples on the African continent have gotten HIV/AIDS from poor medical procedures. To stop the infection of additional innocents we need to stop funding existing “integrated” HIV/SRH programs. These resources can then be shifted back into primary health care where they belong. Hundreds of millions of lives are at stake.
Meanwhile, the call of all foreign aid workers interested in saving lives should be one thing: abstain, abstain, abstain.
