A Misguided Prescription for Women and Girls

Beth Fredrick

A group standing in the way of passing a bill on U.S. global HIV/AIDS prevention is fixated on abstinence-only measures as a remedy, ignoring the "crushing weight of the evidence" to the contrary.

A group of people held a press conference today on Capitol Hill to explain why they couldn't possibly support a U.S. Global HIV/AIDS strategy (PEPFAR) unless the bill reauthorizing funding for the strategy requires that at least 33% of prevention funds go to support abstinence-until-marriage programs.

The trouble with their position is that this earmark for abstinence-only prevention programs puts more lives at risk…so how can we, who are committed to confronting the epidemic, not fix this misguided law?

Protestors stand behind Pastor Rick Warren, one of the speakers at today’s press conference.

The group at the press conference today – which included Reps. Chris Smith (R-NJ) and Steve Chabot (R-OH), Pastor Rick Warren of Saddleback Church, and Chuck Colson, Founder of Prison Fellowship – were so focused on ensuring a dedicated amount remain in the re-authorization bill to abstinence-only-until-marriage programs, they failed to see the whole picture:

The number of new HIV infections continues to grow around the world, especially among women and girls, precisely because we haven't invested in prevention resources that address their real-life circumstances.

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The fixation on abstinence-only-until-marriage programs is out of step with the crushing weight of the evidence.

It's not just a bunch of uppity women wanting this abstinence-only earmark gone. An Institute of Medicine report calls for removing the earmark, as does the Government Accountability Office.

As the Elizabeth Glaser Pediatric AIDS Foundation's President, Pamela Barnes, said today,

"Proposals to maintain partisan, ideologically-driven mandates that constrain countries' abilities to respond to their own epidemics threaten the continued success of the President's Emergency Plan for AIDS Relief (PEPFAR)."

Furthermore, the 33% of funds set aside is a completely arbitrary number. It could have easily been 99% if Congress would have gone along with it in 2003.

At the time, when amendment author Rep. Joe Pitts (R-PA) called for the earmark, he couldn't really explain why it should be 33% – just that it should be there. My guess is that he thought it was one part of the A-B-C prevention message, and since it's one letter of the first three in the alphabet, it should get one third of the funds. But, really, who knows?

None of these reports – or the bill that Congress will soon take up – call for ending work that encourages abstinence and delaying sexual debut. The new legislation simply allows for the U.S. staff in-country to look at what is specifically needed there to prevent and reduce HIV transmission and decide what prevention efforts should be undertaken.

The bottom line is that not providing people with what they need to protect themselves is a sin. The abstinence earmark skews the programs and gives short shrift to all the other prevention efforts that need to be undertaken as well.

Next week, the House Committee on Foreign Affairs will mark up the U.S. Global HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008.

Among the improvements to the existing law are increased flexibility for developing country programs, and for addressing the vulnerability of specific populations, including women, youth, and men who have sex with men. The bill also provides increased technical and financial support to countries that would support the training of health workers and fund scientific research for new vaccines and prevention technologies.

Simply put, there is another way forward.

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