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Divine Intervention Redux

New AIDS Bill Reduces Restrictions on Condom Promotion

By Peter Newbatt Smith | July 25, 2008, 8:00 am

Congress yesterday evening gave final approval to legislation that more than triples U.S. funding for care, treatment, and prevention of HIV/AIDS in developing countries.

The bill reauthorizes the program known as the President’s Emergency Plan for AIDS Relief, committing up to $48 billion for fiscal years 2009 through 2013, including funds to combat tuberculosis and malaria, in addition to AIDS. President Bush initially proposed the plan in his 2003 State of the Union address and Congress subsequently approved a $15 billion budget for the program’s first five years.

PEPFAR was at the center of Divine Intervention, a year-long investigation by the Center’s International Consortium of Investigative Journalists that was published in November 2006. ICIJ found PEPFAR was hampered by ideological restrictions, such as a greater emphasis on promoting sexual abstinence or fidelity than on the use of condoms. In 2003 Congress suggested that 20 percent of the funds go toward prevention and directed one-third of that amount to be spent on abstinence-until-marriage programs. As the program was implemented, discussion of condom use was routinely discouraged.

The current bill is more flexible in its funding allocations but will require the State Department to report to Congress if it plans to use less than half of prevention funds “for activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction” in any of the recipient countries.

Earlier this year, The New York Times wrote that PEPFAR “may be the most lasting bipartisan accomplishment of the Bush presidency.” The President is expected to sign the bill.

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  1. Posted by: capitol hill on August 01, 2008, 3:17 pm

    Thanks for the link to the 2006 article.  Is the increase in funding based on the increase in costs of ARV medicine?  Are they continuing to use brand name rather than generic?

  2. Posted by: Peter Newbatt Smith on August 02, 2008, 12:20 pm

    To capitol hill:
    As I understand it, the increase is primarily to expand the number of individuals counseled, tested, treated, cared for, etc.
    Since the Center first reported on this (http://projects.publicintegrity.org/aids/report.aspx?aid=836), PEPFAR has expanded its use of generic drugs—to 57% of the money spent on ARV drugs in fiscal 2007, according to an item in The Wall Street Journal this week (http://online.wsj.com/article/SB121746894789699503.html).
    Obviously, use of generic drugs allows PEPFAR’s budget to stretch farther. There have been concerns, however, in some quarters about whether the generic drugs are of reliable quality.
    Thanks for your interest.
    Peter Smith
    Research Editor
    Center for Public Integrity

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International Consortium of Investigative Journalists

The Center’s International Consortium of Investigative Journalists (ICIJ) is a collaboration of some of the world’s leading investigative reporters. ICIJ extends globally the Center’s style of watchdog journalism, working with 100 reporters in 50 countries to produce long-term, transnational projects.

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