Obama Likely To Reverse Some Bush Administration HIV/AIDS Prevention, Family Planning Policies, Adviser Says

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs
Article Date: 12 Nov 2008 - 10:00 PST

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President-elect Barack Obama likely will undo U.S. family planning and HIV/AIDS prevention efforts that long linked funding to antiabortion and abstinence-only policies, Susan Wood -- co-chair of Obama's advisory committee for women's health and a professor at George Washington University's School of Public Health and Health Services -- said recently, Bloomberg reports. Wood said that although President Bush's global health programs -- such as the President's Emergency Plan for AIDS Relief -- have brought more HIV/AIDS treatment to developing countries than under any other president, spending requirements for abstinence-only education have hampered family planning and the prevention of sexually transmitted infections worldwide.

"We have been going in the wrong direction, and we need to turn it around and be promoting prevention and family planning services and strengthening public health," Wood said. She added that Obama "is committed to looking at all this and changing the policies so that family planning services -- both in the U.S. and the developing world -- reflect what works, what helps prevent unintended pregnancy, reduce maternal and infant mortality, prevent the spread of disease."

According to Bloomberg, one of Bush's policies that has been cited for hindering STI and HIV/AIDS prevention efforts is restrictions on condom education. Gill Greer, director-general of the International Planned Pregnancy Federation, said CDC has pulled some condom information from its Web site. Greer said, "The U.S. administration has certainly succeeded in demonizing condoms rather than showing that they can be part of prevention of both unplanned pregnancy and sexually transmitted infections."

Valerie Huber, executive director of the National Abstinence Education Association, said the Bush administration's emphasis on abstinence and fidelity "been shown to have demonstrable success in Africa," adding, "It would be more than unfortunate if that policy was changed." According to Huber, both Republicans and Democrats have cited support for PEPFAR's focus on abstinence and education, which has reduced the spread of HIV in countries such as Uganda. "If the president-elect wants to be science-based in foreign sex education policies, it would be wisest to continue this way because it's shown to be effective," Huber added.

Wendy Turnbull, a senior policy analyst with Population Action International, said that because of the "Mexico City" policy -- which restricts U.S. international foreign aid to family planning programs abroad using their own funds to provide abortion services or lobby their governments regarding abortion rights -- many family planning associations that rejected the terms of the rule "lost funding ... lost technical assistance and ... lost contraceptives." Under the basis of the policy, Bush also halted support for the United Nations Population Fund in 2002, saying it supported "coercive" abortion programs in China, an allegation the agency has denied, Bloomberg reports (Gale/Lauerman, Bloomberg, 11/10). The Los Angeles Times "Top of the Ticket" blog reports that the Mexico City policy is likely to be "quickly rescinded" after Obama takes office (Hoffecker, "Top of the Ticket," Los Angeles Times, 11/10).

According to Wood, the U.S. government in recent years has influenced and "tightly vetted" international organizations to reflect its own policies. She added that Obama will bring "back a sense of balance and perspective and the use of good science and good medicine in these positions, and not just this narrow, political ideology"(Bloomberg, 11/10).

USA Today Examines Future of HIV/AIDS Efforts in Africa Under Obama
USA Today on Monday examined the future of efforts to address HIV/AIDS and other issues in Africa under Obama's administration. According to USA Today, Obama's commitment to fighting HIV/AIDS and addressing other issues might be hindered by the global economic crisis and large U.S. military commitment overseas.

Although expectations "have been high" in Africa since Obama traveled to the continent as a senator in 2006, some African leaders "have tried to tamp down their own peoples' hopes" because they are "[a]ware of the limitations now that Obama is president-elect," according to USA Today. Senegalese President Abdoulaye Wade said, "Africans must not ask extraordinary things from [Obama], must not expect ... that through the miracle of his election, America will drain money on Africa to change our continent." John Norris, executive director of the Enough Project, said that issues such as HIV/AIDS in Africa are "clearly issues that [Obama] is passionate about and serious about," adding, "There's a lot of goodwill and a sense of optimism. But that new approach is being tempered by a lot of realism about the magnitude of the problems that he has to deal with."

According to USA Today, HIV/AIDS is an "issue where the money crunch could be particularly acute." Laurie Garrett, a senior fellow at the Council on Foreign Relations, said that even though Congress passed legislation that increases PEPFAR's funding to $48 billion over five years, the economic crisis could force cuts in funding for other critical foreign aid programs. Garrett said, "If they cut the rest of foreign assistance by 50% or more, we're going to be funding a U.S. foreign assistance that is just basically three things: Iraq, Afghanistan and AIDS."

Peter Piot, executive director of UNAIDS, last month said that even if U.S. foreign aid remains at current levels, AIDS-related deaths worldwide could reach three million annually by 2011, an increase from two million in 2007. In addition, providing treatment to HIV-positive people under PEPFAR is becoming more expensive as many people develop resistance to first-line drugs and require more expensive second-line therapies. "The dollar has declined so much in value," Garrett said, adding, "There is the food crisis, the economic crisis and energy crisis, and when you put it together, the cost of doing anything is far greater today than it was a year ago" (Alsop, USA Today, 11/10).

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