Lewis, who has been UN Secretary General Kofi Annan’s Special Envoy for HIV/AIDS in Africa for the past five years, said the pursuit of an abstinence-only until marriage policy, at the expense of condoms, was not intelligent.
‘No government in the world has the right to dictate policy, it’s called conditionality,’ said Lewis. ‘It is saying to Africa ‘ this is how you will respond to the epidemic.’
The President’s Emergency Plan for AIDS Relief (PEPFAR) has been subjected to a great deal of criticism at the 16th International AIDS conference because of its ring-fencing of at least 33 percent of its prevention funding to abstinence and being faithful-only HIV prevention programmes.
PEPFAR, unveiled in 2003, is projected to spend U$15-billion over five years in 120 countries on prevention, care and treatment.
Jodi Jacobson, executive director of the Centre for Health and Gender Equity (CHANGE) said if you ‘compare apples with apples’ closer to 60 percent of PEPFAR’s prevention money was being spent on abstinence-only programmes.
‘In Nigeria it is 70 percent and in Tanzania PEPFAR’s newest grant aimed at a prevention programme for 15 to 24 year olds dictates that 90 percent of funding goes to abstinence-only,’ said Jacobson.
Statistics show that in South Africa 36 percent of PEPFAR’s prevention funding went to abstinence-only programmes in 2004, increasing to 57 percent in 2005.
At the same time studies by the health department has shown that over 60 percent of South Africans between the ages of 15 and 24 are sexually active.
Jacobson said there was no doubt that the platform of trying to prevent the spread of new infections was being eroded.
‘A survey among faith based leaders in Uganda found that 80 percent of them believed AIDS is God’s punishment and it shows that abstinence-only campaigns are increasing stigma,’ Jacobson pointed out.
She said although they had no hard evidence the up tick in prevalence in Uganda could be due to the massive PEPFAR driven abstinence-only rollout in the country.
US Congresswoman Barbara Lee, one of the principal co-authors of legislation establishing PEPFAR, said she was determined to unravel some of the ‘bad things’ in PEPFAR that have a negative impact on Africa.
An outspoken critic of Bush’s abstinence-only prevention agenda, Lee has introduced the PATHWAY Act to revise the US global HIV prevention policy for women and girls and eliminate the 33 percent abstinence-only prevention earmark.
Lee said PEPFAR had led to a cut in funding to support effective evidence based prevention programmes such as the prevention of mother to children transmission programmes and the distribution of condoms to vulnerable groups.
Lee said she already had the support of our 80 members of congress and almost 100 AIDS organizations in the US.
‘We must pass it and we must pass it quickly,’ she said.
PATHWAY will effect an increase in access to and effective use of both male and female condoms, clear programme guidance on restrictions in US law pertaining to organizations working with sex workers and strikes the funding earmark of 33 percent.