Annie Brown
WASHINGTON, Jul 30 2008 (IPS) – HIV/AIDS activists Wednesday hailed President George W. Bush s reauthorisation of the President s Emergency Plan for AIDS Relief (PEPFAR) to 48 billion dollars for fiscal years 2009 to 2013 as a major step in the global fight against AIDS, tuberculosis and malaria.
Paul Davis, director of Health GAP (Global Access Project), welcomed the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorisation Act of 2008 as a huge step forward for people with AIDS worldwide.
Health GAP and its allies were a leading voice in the yearlong negotiations that pushed the United States to pass legislation that they say goes beyond an increase in funding Bush s original proposal authorised only 30 billion dollars to address the critical lessons of the past five years of global AIDS programmes.
Health GAP activists in particular applauded the bill s new support for efforts to correct the shortage of health workers that has frustrated efforts to scale up access to care and treatment.
More than half the programme s bilateral aid would have to go towards AIDS treatment and care.
The bill sets a goal of putting two million people into AIDS drug treatment and includes a goal to recruit 140,000 new health care workers.
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The bill also calls for supporting poor countries efforts to achieve 2.3 doctors, nurses and midwives per thousand country residents, with direct support to train and retain 140,000 new health workers. In addition, the bill places an emphasis on training and retention of new doctors and nurses.
The reauthorisation also strengthens the focus on women and girls, a factor that groups highlighted as a welcome policy framework for the bill.
This important legislation boldly recognises that women and girls are at the centre of the global HIV epidemic, said Geeta Rao Gupta, president of the International Centre for Research on Women (ICRW). While far from perfect, PEPFAR will significantly bolster the reach and effectiveness of the U.S. global AIDS programme and will strengthen its priority to women and girls, laying out stronger measures to hold it accountable.
Gupta also commended the bill for addressing social factors that exacerbate womens and girls risk of HIV infection, such as gender-based violence and economic opportunities for women.
ICRW s research shows that when women and girls have access to education and economic resources such as the availability to earn a living or own their own homes or land remarkable changes occur in the lives as well as in their communities. They are less likely to marry as children, domestic violence diminishes, they are less economically dependent on men and as a result vulnerability to HIV decreases, she said.
Despite recognising the landmark status of the PEPFAR legislation in the global AIDS movement, activists have serious criticisms.
Following her praise of the bill s steps towards real solutions, Gupta stated, We are very disappointed that the final bill compromises women and girl s rights to full information and services related to sexual and reproductive health. This will ultimately undermine the effectiveness of the investments made to reduce women s vulnerability Without stronger links between HIV programmes and comprehensive reproductive health information and services, women will be short-changed.
Health GAP highlighted abstinence-only funding as a major area of concern in the bill. The Hyde/Lantos Bill does overturn a previous requirement that one-third of prevention funding be directed towards abstinence-only programmes.
However, to the dismay of grassroots organisations, this has been replaced by a reporting requirement which mandates that the Office of Global AIDS Coordinator submit a report to Congress if a country with a generalised epidemic spends less that 50 percent of sexual prevention funding on programmes promoting abstinence and faithfulness.
The Centre for Health and Gender Equality commented on the bill s educational provisions, stating that Congress is continuing to impose arbitrary funding directives to encourage abstinence-only programmes over effective, comprehensive prevention interventions.
Activist groups also cautioned that the bill only authorises spending the 48 billion dollars. During each of the next five years, Congress will actually have to appropriate the money in what is a separate process.
Although the bill was signed into law today, Congress is not providing the money to implement it until fiscal year 2009.
We deeply appreciate the hard work of everyone involved, in the Congress and the White House, which has led to this crucial legislation, yet, in terms of funding, it appears to more rhetoric than reality, said Dr. Paul Zeitz, executive director of the Global AIDS Alliance.
The Global AIDS Alliance also commented that, President Bush should also move to immediately implement the bill s provisions, such as by lifting immigration restrictions on people who are HIV-positive.
Many activist leaders look to an immediate lift of the ban as a priority when making the new law a reality.
Nils Daulaire, president of the Global Health Council said, Lifting the ban gives us hope that the U.S. government will move toward a comprehensive policy that responds to the realities of the epidemic and the science of prevention, treatment and care.
