Newspapers Publish Opinion Pieces On Provisions Of U.S. Global AIDS Program

Main Category: HIV / AIDS
Also Included In: Women's Health / Gynecology
Article Date: 14 Mar 2008 - 8:00 PDT

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Members of Congress can "participate in something extraordinary" by "resisting the ideological extremes" and reauthorizing the U.S. global HIV/AIDS program with the same compromises on HIV prevention programs reached five years ago, Michael Gerson -- columnist for the Washington Post, senior fellow at the Council on Foreign Relations and President Bush's chief speechwriter from 2001 until June 2006 -- writes in an opinion piece.

Calling the program the "most successful foreign assistance effort since the Marshall Plan," Gerson notes that in 2003 there were about 50,000 people taking HIV/AIDS drugs in sub-Saharan Africa and that now there about 1.4 million. He credits the original authors of the 2003 global HIV/AIDS bill, also known as the President's Emergency Plan for AIDS Relief, or PEPFAR, with separating "AIDS relief from the partisan debate over abortion" by requiring funding for HIV prevention to be focused on "a proven approach known as ABC -- practice abstinence, be faithful and use condoms." According to Gerson, this compromise "seemed to be unraveling" during this year's debate on the global HIV/AIDS reauthorization bill (HR 5501) because some congressional Democrats "pushed for more expansive family planning within HIV/AIDS programs, which a number of conservatives interpreted as a push for abortion rights." According to Gerson, Democrats achieved an increase in PEPFAR funding, as well as an "end" to the requirement that at least one-third of HIV prevention funds that countries receive through PEPFAR be used for abstinence-only education programs. Gerson notes that the bill still calls for "balanced funding" for prevention programs.

Gerson says that "a few liberal health advocates" wanted to "revisit the abortion issue" because of their belief that "aggressive family planning" is necessary for HIV prevention. According to Gerson, "It is true that abortion prevents the transmission of AIDS -- as it prevents the transmission of cleft lip and club foot and bedwetting." In what Gerson calls a "last-minute, late-night outbreak of sanity," legislators chose to "skirt" family planning and abortion issues, and Republicans kept a provision that requires grantees to pledge opposition to commercial sex work. The late Reps. Tom Lantos (D-Calif.) and Henry Hyde (R-Ill.), who helped pass the original PEPFAR bill, "knew how legislative compromise could serve an honorable cause," Gerson writes, concluding that the lives "saved" by PEPFAR is the "best reason" to pass the compromise bill (Gerson, Washington Post, 3/12).

Related Opinion Piece

The "impressive gains" in fighting HIV/AIDS made by PEPFAR in the last five years have been hindered because the program does not provide HIV prevention to women through expanded access to family planning and reproductive health programs, Janet Fleischman, senior associate at the Center for Strategic and International Studies' HIV/AIDS Task Force, writes in a Philadelphia Inquirer opinion piece.

According to Fleischman, providing family planning services allow women to reduce the number of "unintended pregnancies leading to children born with HIV, as well as the number of child deaths." Integration of family planning and HIV services also will "help strengthen the health sector overall," according to Fleischman. In addition, integrated programs represent the "kind of efficiency and long-term cost-effectiveness that should make" integrated programs a "priority," she adds.

Although it "won't be easy" to combine family planning services with HIV prevention programs because of a lack of funding for family planning, the U.S. has an "unprecedented opportunity" to do so as Congress debates PEPFAR reauthorization, Fleischman writes. She concludes that the U.S. "should heed the evidence and promote this integrated approach as a key component of its AIDS policy" (Fleischman, Philadelphia Inquirer, 3/11).

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