Congress Should ‘Eliminate’ Restrictions That ‘Hamper’ PEPFAR, Editorial Says

Although a recent report from the Institute of Medicine and the National Research Council found that the President's Emergency Plan for AIDS Relief is "off to a good start," it also "warns that restrictions imposed by Congress or by the administration are hampering efforts to slow the spread" of the HIV/AIDS pandemic, a New York Times editorial says (New York Times, 4/4). The report found that PEPFAR through September 2006 purchased antiretroviral drugs for 822,000 people in the program's focus countries. PEPFAR also pays for 165,000 people's antiretrovirals in other developing countries, according to the report. The report also highlighted PEPFAR regulations it said were hampering the program, including requiring separate FDA approval of antiretrovirals that already have received prequalification from the World Health Organization and PEPFAR's budget allocation requirements, including for abstinence-until-marriage programs. By law, at least one-third of HIV prevention funds that focus countries receive through PEPFAR must be used for abstinence-until-marriage programs. The panel added that the debate over the ABC prevention strategy -- which stands for abstinence, be faithful and use condoms -- has taken focus away from other risky behaviors, including alcohol use and violence against women (Kaiser Daily HIV/AIDS Report, 4/2). These "inflexible barriers are often imposed for ideological, not health, reasons," the editorial says, adding, "These restrictions needlessly hamper a program with great potential." It concludes, "Congress should eliminate them and let health professionals devise the most effective strategies" (New York Times, 4/4).