Nature Medicine | Spoonful of Medicine

The ABCs of Bush’s agenda

By now, there’s mountains of depressing evidence that in the Bush administration, ideology always trumps science.

Nowhere does this seem more cruelly short-sighted than in the administration’s approach to AIDS. I’ve written here before about the government’s insistence that any groups that receive federal funds have to formally oppose prostitution.

Here’s one more disheartening report: after a year-long investigation, the Center for Public Integrity, a nonprofit based in Washington DC, has found that PEPFAR, the administration’s $15 billion AIDS initiative, “has not worked out the way it was envisioned.”

One of PEPFAR’s most criticized aspects is the ABC approach for prevention: abstinence, be faithful and condoms. Neither abstinence nor being faithful is much of an option for a married woman whose husband is unfaithful, but let’s not get bogged down by practical details.

The center’s Consortium of Investigative Journalists filed two dozen Freedom of Information Act requests, FOIA lawsuits against the State Department, the U.S. Agency for International Development and the Department of Health and Human Services. After more than 100 interviews, examination of thousands of pages of documents and reporting on the ground in affected countries, they say that:

In fact, the actual prevention practices stress the “AB” messages — abstinence until marriage and being faithful to one partner. The “C” has moved to a small c, and the use of condoms is lumped into the category of “other preventions” that includes prevention of mother-to-child transmission, blood safety, safe medical injections and control of intravenous drug use.

It’s nice to see that tomorrow, this ambitious project, dubbed “”https://www.publicintegrity.org/aids/“>Divine intervention”, is set to win the first prize in online and trade journals category from the Association of Health Care Journalists.

On another positive note, I mentioned before that Brazil had turned down money from the US rather than meet the ideological demands. Looks like even within this country, there’s some rebellion afoot.

On March 5, Wisconsin turned down about $600,000 in federal “abstinence-only-before-marriage” funds because the money would have prevented programs from teaching kids about contraception or sexually transmitted diseases. California, Maine, New Jersey and Pennsylvania have also turned down the funds and another dozen are set to do the same, according to Madison’s The Capital Times

Comments

  1. Report this comment

    John said:

    As one of the people that came to this country because of its scientific excellence I am amazed to see that after decades of studies of HIV, we are still discussing about abstinence and “being Faithful”!

    By the way, the administration forgot castration-that should work just fine! Here you got your big “C”!

  2. Report this comment

    Eva Chmielnicki said:

    I have a friend working on AIDS prevention at a US federal agency who (in order to receive federal support) is specifically not permitted to discuss condoms with patients. So the fact that it is called an “ABC” approach seems to be a total joke…

  3. Report this comment

    Alan Dove said:

    As I had hoped, the Democratic Congress is taking on this issue with new legislation. See this site for a rundown on the PATHWAY bill, which would address at least some of the biggest problems Bush’s policy has created.