New York Times Features Opinion Pieces on Domestic, Global HIV/AIDS Funding, Other Issues

The New York Times on Saturday featured a series of opinion pieces, titled "The New AIDS Fight," on funding for anti-HIV/AIDS efforts both domestically and internationally. The following summarizes those pieces:

• "A Plan as Simple as ABC" by Edward Green, a medical anthropologist at the Harvard School of Public Health and author of the forthcoming book "Rethinking AIDS Prevention": The United States must go "beyond the fruitless battle between the abstinence and condom camps" and develop a "balanced approach" to fighting HIV/AIDS, Green says. Green explores how the abstinence-based approach of "ABC" -- abstain, be faithful and use condoms if those options fail -- was successful in preventing the spread of the epidemic in Uganda. However, because the approach has been "embraced" by U.S. conservatives, many AIDS groups are "reluctant" to believe it works, Green says. He cites a 2002 United Nations study, which found that the "majority of Africans" cite behavior change and "becoming monogamous" as their first-line response to the epidemic, as opposed to condom use. Green concludes that AIDS advocates should "recogniz[e] that Africa and the West have different types of epidemics" and support programs that utilize the ABC technique (Green, New York Times, 2/1).
  
• "Protect Women, Stop a Disease" by Kati Marton, a member of the board of the International Women's Health Coalition and author of "Hidden Power: Presidential Marriages That Shaped Our Recent History": An effective AIDS program must empower women to "defend themselves against men who are infecting and abandoning them," and the Bush administration's policy in these areas has been "worse than disappointing," Marton says. "[S]exual coercion, violence against women, child marriage, polygamy and the widespread belief that having sex with a virgin will cure AIDS" have combined to make girls in sub-Saharan Africa four to seven times more likely than boys to be become infected, she adds. Marton states that administration policies, such as prohibiting any group that receives funds from performing or discussing abortions and opposition to condom distribution, have prevented organizations that are "already well positioned to provide women with [a] full range of [health] services" from taking action. Congress should authorize the president's proposed funds for international AIDS initiatives "only if girls' and women's needs are central," Marton concludes (Marton, New York Times, 2/1).
  
• "Don't Forget This Infectious Killer" by Ponsiano Ocama, a specialist medical officer at Makerere University Teaching Hospital in Kampala, Uganda, and William Lee, professor of internal medicine at the University of Texas Southwestern Medical Center-Dallas: It is "foolish" to treat HIV "without at the same time" diagnosing and treating hepatitis B and C, Ocama and Lee say. Four hundred million people worldwide have hepatitis B, 10 times the number of people with AIDS, they add. Inexpensive and reliable tests must be made widely available in Africa to stop the spread of the disease, they conclude (Ocama/Lee, New York Times, 2/1).
  
• "Generic Drugs Can Make the Money Last" by Mamphela Ramphele, a managing director at the World Bank, and Nicholas Stern, the chief economist of the World Bank: American leadership in helping developing nations get better access to drugs to fight public health epidemics such as HIV/AIDS "would be a fitting complement to President Bush's generous pledge" of increased HIV/AIDS funding, Ramphele and Stern write. Because developing nations represent only 1% of the global pharmaceuticals market, "allowing [the countries] to import generics would hardly erode incentives for Western conglomerates" to conduct new research. The authors conclude that while an agreement on generics "would not solve these countries' health problems ... continued legal access to generics for the poorest countries is vital to improving their health care systems" (Ramphele/Stern, New York Times, 2/1).
  
• "Race, Sex and Stigmas" by Tricia Rose, author of the forthcoming book "Longing to Tell: Black Women Talk about Sexuality and Intimacy" and a professor of American studies at the University of California-Santa Cruz: Although black women make up less than 15% of the U.S. female population, they represented 64% of all new AIDS cases among U.S. women in 2001, Rose says. Despite these statistics, "it is difficult to find any public [AIDS education] campaign that focuses specifically on ... black women," she adds. Rose states that a social and cultural legacy of "distorted notions" about black women's sexuality has led many black women to "retrea[t] into silence" and "neglect to adopt" safe sex practices. Any program that seeks to lower AIDS rates among this population must also address "the racial legacies of sexual stigma and the silences they have produced" to "make room for a new cultural language on sexuality that will help us navigate this crisis," she concludes (Rose, New York Times, 2/1).
  
• "Waging a Global Battle More Efficiently" by Paul Zeitz, executive director of the Global AIDS Alliance: While the president's pledge to increase HIV/AIDS funding is "encouraging [and] even historic," the plan "fails to make use of the most efficient way to distribute the money," which is through the Global Fund to Fight AIDS, Tuberculosis and Malaria, Zeitz says. Even if Congress quickly approves the president's initiative, the bureaucracy through which the funds must pass will prevent African nations from experiencing the effect of the money "for almost two years," he writes. He states that in contrast, the Global Fund "can deliver assistance in a matter of months [and] has strong safeguards to ensure the proper use of funds and spends only 3% on administrative overhead." In addition to directing money towards the fund, the United States should augment the AIDS initiative with programs that would provide "better access to clean water and good nutrition" and "mandat[e] debt cancellation," Zeitz concludes (Zeitz, New York Times, 2/1).