This morning, Secretary of State Hillary Clinton will release PEPFAR Blueprint: Creating an AIDS-free Generation, the Obama administration’s plan for combating HIV and AIDS. For the plan to be effective, both family planning and condoms for HIV prevention must be included. Unfortunately, when it comes to making sure taxpayer-funded AIDS programs are comprehensive and designed to deliver the most effective interventions for people in need, the Obama administration’s track record has not been good.
PEPFAR’s FY2013 Country Operational Plan (COP) Guidance recognizes “there continues to be significant unmet need for voluntary family planning and reproductive health services worldwide” and asserts that “voluntary family planning should be part of comprehensive quality care for persons living with HIV.” The World Health Organization and the Obama Administration’s Global Health Initiative both argue forcefully and consistently that access to family planning is central to women’s lives—arguments that are affirmed by the FY13 COP. Nevertheless, despite PEPFAR’s repeated acknowledgement of the importance of family planning for succeeding in the fight against HIV, and the assertion that “PEPFAR programs should be optimized as a platform on which to incorporate and integrate other health services,” the FY13 COP inexplicably introduces a new restriction: “PEPFAR funds may not be used to purchase family planning commodities.”
This is shameful. Excluding family planning from PEPFAR ignores the reality of people living longer and healthier lives after contracting HIV—people who often continue to be sexually active and deserve the right to choose whether and when to have children.
Too often, the Obama administration has allowed faith-based groups, especially those affiliated with the United States Conference of Catholic Bishops (USCCB), to provide second-rate services in the name of the American people and with our tax dollars. For example, the USCCB refuses to agree to requirements that HIV prevention programs provide condoms. The bishops’ position on this is not only far from the mainstream, it runs counter even to the beliefs of American Catholics, the majority of whom support condom use to prevent HIV.
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Other scandals include requirements that non-US organizations aren’t even eligible for PEPFAR funds unless they take an anti-prostitution pledge. This means that they simply cannot serve the needs of sex workers.
Any smart prevention strategy is tailored to meet the needs on the ground, not the distressingly common desire to placate one or another conservative group.
The real scandal is that HIV, a tiny, complicated, ever-shifting virus that has confounded researchers for decades, is proving easier to tackle than the ongoing stigma, moralizing and confusion in policies ostensibly designed to help. The needs of people living with HIV and AIDS can be seen without either a microscope or scientific training. Individuals in HIV-affected areas need the resources that will allow them to govern their lives with dignity—appropriate treatment, contraception allowing them to choose whether and when to have children, and protective measures like condoms so that they may keep themselves and their partners safe. We’re making progress on the science—but it’s up to policymakers to do their bit and get these advances to the people who need them.