PEPFAR Has ‘Too Many Strings Attached’ To Be Effective Against HIV/AIDS, Opinion Piece Says
The President's Emergency Plan for AIDS Relief comes with "too many strings attached" to be an effective plan to fight HIV/AIDS in developing countries, Douglas Feldman, a professor of anthropology at the State University of New York-Brockport, writes in a Rochester Democrat and Chronicle opinion piece. Although the United States has made an "enormous economic investment" in fighting HIV/AIDS in the countries covered under PEPFAR, the Bush administration's insistence that generic antiretroviral drugs are "unacceptable" for the plan will "significantly reduce the number of people who could be treated for the same price," Feldman says. The Bush administration "shifted" to allow generic antiretrovirals -- which are "cheaper, easier to take, tested, approved and effective" -- to undergo a fast-track FDA approval process, but "bureaucratic obstacles have slowed this testing," Feldman says. In addition, the Bush administration's support for "abstinence as the primary solution to HIV prevention" is a "misrepresentation" of the methods used by Uganda to reduce its HIV/AIDS prevalence, according to Feldman. Ugandan officials, beginning in 1986, helped to destigmatize HIV/AIDS by encouraging discussion of the disease in schools, mass media, workplaces and homes, Feldman says, adding that the country was able to reduce its prevalence because many people were "very fearful" of the disease and reduced their sexual partners or delayed the onset of sexual activity. However, "fear is only a short-term solution," and the "widespread growth" of condom use helped further reduce the country's HIV prevalence, Feldman says. For PEPFAR to be successful, the United States needs to develop strategies to destigmatize HIV/AIDS, expand condom promotion campaigns, target high-risk populations, expand HIV testing, promote the development of microbicides and offer low-cost generic antiretrovirals, Feldman says, concluding, "Millions of lives, and the future of much of Africa, is at stake" (Feldman, Rochester Democrat and Chronicle, 8/3).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.