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An AIDS "recovery boom"???

June 14, 2005
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I’ve been stewing over David Brooks’ column from last week, trying to decide what bothered me most about it, and how to combat it.

Let’s start with his ending, in which he spins out his bizarre “Silicon Valley in the early 1990’s” analogy (implying that regional clinics are awash in President Bush’s AIDS Initiative money) to declare “We could be on the verge of a recovery boom.” Yessirree! Would we expect a compassionate conservative to view a monumental human tragedy as anything but a metaphorical business opportunity?

But more damaging is an overall rose-tinted impression he leaves that diminishes the scale of suffering. Repeatedly, he sites precisely one illustration of scenes he then implies are commonplace —

Here in Windhoek, Namibia’s capital, you run into people like a 6-year-old who was born to parents who were both H.I.V.-positive. They gave her the name Haunapawa, which reflected their mood at the time. It means, “There is no good in the world.” But the parents are both still alive, and the girl, once racked by pneumonia, is thriving on the medicine.

You run into scenes like the one I saw at Oshakati Hospital in northern Namibia, by the Angolan border, where a young Zimbabwean doctor, Gram Mutandi, works at his clinic. Patients can wait for eight hours to receive treatment and counseling.

The whole misleading piece, save for one throwaway paragraph —

Obviously there’s a long way to go. You can still go out and visit children in mud huts who are raising themselves because their parents, aunts and uncles are all dead. Only a small fraction of those who need treatment are getting it. At the Lutheran Hospital in Onandjokwe, Namibia, the staff tested 858 women in the first quarter of this year, but could get only five of their male partners to even come in for testing.

— has the aura of having been written over cocktails in the air-conditioned lounge of an upscale safari lodge while flipping through a glossy brochure or glancing at a promotional video from some pharmaceutical company.

But I merely stewed over it because I didn’t have the stats and specs to counter it with, nor the time to find them. Well, here’s a good start, a necessary counterpoint to Brooks’ dewy and ultimately dangerous paean to the President’s Emergency Plan for AIDS Relief:

The president’s AIDS initiative, like his invasion of Iraq, is a go-it-alone affair that ignores the clear global consensus on how to fight AIDS. In launching his own initiative, Bush has shifted the bulk of U.S. money away from the Global Fund to Fight AIDS, Tuberculosis and Malaria, an international organization that has funded projects in 128 countries and is widely recognized as the best way to distribute AIDS funds. “Bush is starving the fund,” says Dr. Paul Zeitz, executive director of the Global AIDS Alliance. “It’s despicable, frankly.”

In addition to shortchanging international relief efforts, Bush is using AIDS funds to place religion over science, promoting abstinence and monogamy over more effective measures such as condoms and sex education. Before overseas groups can receive U.S. funding, for example, the Bush administration requires them to take a “loyalty oath” to condemn prostitution — a provision that AIDS workers say further stigmatizes a population in need of HIV education and treatment. Brazil recently became the first country to rebel against the oath, announcing in May that it was rejecting $40 million in AIDS grants from the administration. “What we’re doing is imposing a really misguided and ill-informed ideology on top of a public-health crisis,” says Jodi Jacobson, executive director of the Center for Health and Gender Equity in Takoma Park, Maryland.

Bush’s plan calls for an “ABC” approach to HIV prevention — which stands for abstinence, “be faithful” and condom use — but the administration is stressing the “A.” In its first year, PEPFAR spent more than half of the $92 million earmarked to prevent sexual transmission on promoting abstinence programs. Studies show that such programs actually increase risk by discouraging contraceptive use. What’s more, focusing on abstinence and monogamy ignores the reality facing young women and girls in Africa and other impoverished regions, who are often infected by wandering husbands or forced to have sex in exchange for food or shelter. Among fifteen- to twenty-four-year-olds in sub-Saharan Africa, studies show, more than three times as many young women are infected with HIV as young men.

“It’s only a matter of time before the impact of abstinence-only programs can be measured in needless new HIV infections,” says Jonathan Cohen, an HIV/AIDS researcher with Human Rights Watch.

Please read Geraldine Sealey’s whole piece before you let Brooks convince you of a “recovery boom.”

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