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FOR IMMEDIATE RELEASE
July 11, 2008
CONTACT: Kelly Castagnaro, International Women's Health Coalition,
212.979.8500 x. 266
Putting Health before Politics:
How the United States Senate can fix global HIV/AIDS funding
July 11, 2008, New York, NY
—In a letter to the Senate ,
forty-five leading human rights and global health organizations urge
policymakers to address critical shortfalls in legislation that would
reauthorize the President's Plan for AIDS Relief (PEPFAR). With Senate
poised to vote on a five-year, $50 billion HIV/AIDS relief package, the
organizations call on policymakers to "both set and correct policies
based on evidence gathered and lessons learned after five years and
nearly $20 billion of U.S. funding" for global AIDS programs since
PEPFAR was enacted in 2003.
Many have publicly touted PEPFAR as the Bush Administration's
legacy-building success and called for speedy passage through the
Senate following the House vote in April. Today, the Administration
estimates that nearly two million more people have access to
anti-retroviral medication than five years ago due to U.S. government
support. However, for every two people put on treatment five are newly
infected with HIV -hardly a far-sighted approach to public health
programming.
The failure to stem the tide of new infections is due in part to
restrictions contained in the original PEPFAR legislation. Much has
been learned since PEPFAR was enacted. Yet rather than heeding the
evidence collected by our own government agencies, the bill now before
the Senate continues to compromise sound public health practice for
ideology and political expediency.
Under pressure to act quickly to reauthorize PEPFAR, Congress is poised
to pass a bill that will lock these restrictions into law for five more
years. Doing so threatens scarce public resources, leaves more lives
at risk, and impedes the development of a comprehensive approach that
would make a difference in the lives of millions. The following
changes must be made to the bill before final passage:
Abolish arbitrary funding guidelines. In a 2007
report, The Institute of Medicine (IOM) recommended removing the
current PEPFAR requirement that one-third of prevention funds be spent
on abstinence-until-marriage programs. The Senate bill ignores the
findings of this congressionally-mandated study and findings from the
government's own Accountability Office (GAO) about the ineffectiveness
of this approach. The current bill calls for spending at least fifty
percent of prevention funds designed to halt the sexual transmission of
HIV, in countries with generalized epidemics, only on abstinence and
faithfulness programs. PEPFAR recipients that do not meet this
requirement must justify their programmatic decisions through an
onerous reporting requirement to Congress, potentially facing
defunding.
Every individual needs a range of information and services to protect
him or herself against HIV, and public health experts on the ground
must be able to determine the best mix of prevention programming for
their own communities. As it stands, their hands are tied by policies
from Washington.
Support prevention strategies that reach the largest number of people.
In most regions, the number of new infections is growing most rapidly
among women and adolescents, primarily through sexual transmission.
These two groups are more likely to use family planning and other
reproductive health services than any other segment of the population,
and would be better equipped to protect themselves from HIV if their
access to reproductive health services and education was expanded.
The U.S. government concluded that integrating family planning with HIV
prevention and treatment services could double the effectiveness of
programs to prevent transmission of HIV from mother to infants by
expanding women's choices about pregnancy and childbearing. Recent
studies suggest that upwards of 90 percent of HIV-positive pregnant
women in countries such as Uganda and South Africa have unmet need for
integrated family planning and HIV services. However, the current
bill before the Senate fails to call for or even acknowledge the need
to strengthen critical linkages between family planning and
reproductive health services and HIV prevention efforts.
Remove the unconscionable "conscience clause." The
2003 PEPFAR legislation contains a provision that enables organizations
receiving U.S. funding to pick and choose the prevention and treatment
services they wish to provide. Millions of dollars go to organizations
to provide prevention services, even though they refuse to discuss the
potential of condoms or other contraceptives in preventing the spread
of HIV. As abstinence and partner reduction programs have outpaced
programs that enable individuals to have all the information they need
to prevent HIV, the law stands in the way of effective use of
resources. The Senate bill takes this bad policy and makes it worse by
extending the so-called "conscience clause" to organizations that
provide care and support to people living with HIV/AIDS, their families
and their communities.
This provision paves the way for taxpayer-funded discrimination based
on "moral" and religious grounds leaving it wide open to refuse care to
someone based on their religion, how they got infected or any other
basis. The refusal clause is another damaging provision that flies in
the face of good public health practice.
Eliminate the prostitution pledge.
Current law
requires groups fighting HIV/AIDS overseas to pledge their opposition
to prostitution and sex trafficking before receiving U.S. money. Sex
workers are among the most marginalized people in every country and
often lack access to social and health support systems. Prevention
programs that have reached sex workers through first building trust
have yielded dramatic reductions in HIV infections among these
populations. Some continue to believe that having organizations sign
such a pledge will help end prostitution, but in reality, the opposite
may be true. According to numerous reports, the pledge has led to
further alienation of already-stigmatized groups and given free rein to
police and resulted in further discrimination against women in sex
work. Instead of reducing dependence on sex work, the policy is
driving sex workers under ground and away from the non-governmental
organizations and health workers best poised to help them and to
prevent HIV.
It is our moral obligation and fiscal responsibility to use PEPFAR
funding to prevent as many infections as possible. However, large sums
of money, spent unwisely, will not save lives and will require an ever
growing need for increased resources in the future. The bills fall
short exactly where more was needed: full and flexible funding of
prevention programs that will enable us to end the pandemic and
eliminate the stigma and discrimination that fuel its spread.
To read the letter, click here or visit www.iwhc.org/global/uspolicy/hivaids/senateletterjuly08.cfm
To arrange an interview or for more information, contact:
Advocates for Youth (http://www.advocatesforyouth.org/)
Contact: Marcela Howell, 202-419-3420/ marcela@advocatesforyouth.org
American Jewish World Service (www.ajws.org)
Contact: Jodi Jacobson, 301 257-7897/202 408-1380 office/ jjacobson@ajws.org
Center for Heath and Gender Equity (www.genderhealth.org)
Contact: Serra Sippel, 301.270.1182/ 301.768.7162/ ssippel@genderhealth.org
International Women's Health Coalition (www.iwhc.org)
Contact: Kelly Castagnaro, 212.979.8500 x.266 /646.707.1004/ kcastagnaro@iwhc.org
National Council of Jewish Women (www.ncjw.org)
Contact: Emily Alfano, 202. 296. 2588 x. 5; emily@ncjwdc.org
SIECUS (www.siecus.org)
Contact: Patrick Malone, 212.819.9770 x. 316/ pmalone@siecus.org
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