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The Amendment Was the Pitts

Ellen Marshall

Rep. Pitts tried to remove a provision in the Foreign Operations Bill that would enable the President to waive the abstinence-until-marriage earmark in global HIV prevention.

The circular arguments used to defend why the United States needs to dedicate at least 33 percent for abstinence-until-marriage programs, rather than enabling those who are implementing the programs to determine the best mix of prevention funding needed makes you scrunch up your face and say, "what?"

A provision in the Foreign Operations Bill enables the President the flexibility to determine the most effective mix of HIV prevention programming in any particular country. It allows the President to waive the Congressional requirement (enacted in 2003) to spend at least 33 percent of HIV prevention funds on abstinence-until-marriage programs, so that programs on the ground can be the most responsive to local needs. Promoting abstinence-until-marriage will continue to be part of the prevention efforts, but, if enacted, the Administration will no longer need to segregate abstinence programs from the continuum of prevention efforts to be able to prove to Congress it is spending what is required. More importantly, individuals would have a better chance of getting all the information and services they need.

But Representative Joe Pitts (R-PA) doesn't trust the Administration to make good decisions about prevention strategies. He tried today to remove that flexibility from the bill—and used falsehoods to make his point. But that didn't work.

Pitts' supporters had no response to Representative Donald Payne's comment that there is no empirical evidence indicating that 33 percent of the funding needs to be spent on A (of Abstinence, Be Faithful and if all else fails use a Condom). The only reason for the 33 percent that is given is that A is one third of three letters. Hardly a public health approach.

Sex. Abortion. Parenthood. Power.

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In supporting Pitts, Representative Frank Wolf (R-VA) noted that the head of government's global HIV/AIDS efforts, Ambassador Mark Dybul, has "forgotten more about HIV than this Congress knows." Then what's the problem with giving Ambassador Dybul the flexibility to determine the best mix of prevention opportunities in each of the countries where the United States works?

Representatives Wolf and Pitts kept going back to the argument that any country wanting a waiver from meeting the 33 percent for abstinence-until-marriage programs received it. Well, isn't the fact that country teams are asking for waivers from the requirement evidence in itself that in some places there needs to be a different mix of programming than the required 33 percent on abstinence-until-marriage? They failed to mention that for those countries that get a waiver, the other countries need to "make up" the difference in abstinence-only-until marriage programming so that overall the prevention funding can meet the 33 percent earmark.

While Representative Jeff Fortenberry (R-NE) cited statistics about the effectiveness of abstinence efforts in Uganda, he used data from 1991-2000 (before the U.S. PEPFAR program even began). Perhaps he would be interested in knowing that Uganda now reports that HIV is spreading fastest among married couples—which may indicate that more needs to be done in other areas of prevention.

Getting so wound up in their own rhetoric, Representatives Pitts and Wolf went on to misuse and selectively choose elements of a statement on finding common ground on preventing sexual transmission of HIV, published in the Lancet. Pitts cited Bishop Desmond Tutu as a signer, and hand picked portions of the statement to make his case; then boldly (and falsely), Wolf exclaimed, "That's amazing—Bishop Tutu supports the Pitts Amendment."

The majority of Congress didn't fall for the circular and misguided arguments, defeating Pitts by a vote of 200-226—one step in sound public health approaches to preventing HIV. On to the Senate….

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