19 May 2008

Africa: U.S. Aids Funding Methods Questioned

Kigali — From Genocide survivors and campaigners, now US senators are also calling for a review of how American taxpayers' money is spent to focus more on prevention than treatment, RNA reports.

UK-based organization Survivors Fund or SURF - has launched a campaign aimed at ensuring that the Office of the US Global AIDS Coordinator recognizes HIV infected survivors in Rwanda as an at-risk population eligible for priority to anti-retroviral treatment.

The campaign was launched on April 06 at a function during which students from across several universities and high schools in New York held a vigil at Washington Square Park to read the testimonies of survivors to commemorate the 14th anniversary of the Rwandan Genocide.

Years after the mass slaughter, several women and girls were found to have contracted HIV/Aids from rape by the marauding militias. However, The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) currently recognizes prisoners but not survivors as an at-risk population for priority for anti-retroviral (ARV) treatment.

Several hundred prisoners, most of who were the militias hunting for the survivors for dead are getting free regular ARVs from the multi-billion dollar program initiated by President George Bush. Up to 40.000 people in Rwanda are getting ARVs from several programs including PEPFAR.

Despite the fact that many survivors are HIV+ today due to a systematic program of rape and deliberate infection during the genocide, many are denied access to the treatment available to the men that raped them, the organization says on its website.

The campaign by the Survivors Fund intends to demand that the Office of the Coordinator, which sets the policy of PEPFAR, recognize the plight of survivors and to ensure that they are given equal access to HIV and AIDS counseling, testing and treatment.

"There is no simple way of enacting justice, but by securing access to AIDS Relief then at least women survivors can look forward again to a future", said Mary Kayitesi Blewitt OBE, Founder of SURF, who lead the event.

Senators want more

Seven Republican Senators are also planning to block a bill that would help HIV/Aids patients in target countries benefiting from PEPFAR, and could postpone the bill's passage until next year.

The bill reauthorizes and expands on previous legislation to fight HIV/Aids, under which PEPFAR was established. The new bill, which authorizes $50 Billion in spending over the next five years, passed the House of Representatives on April 2 by a vote of 308-116. In order to become law, it must now pass the Senate and be signed by President Bush.

However, the seven senators object to the removal of a requirement that a minimum of 55 percent of spending should be directed to the treatment of HIV/Aids patients, AllAfrica reported on Sunday.

They have apparently signed a hold letter, which will postpone a vote on the bill indefinitely.

The formal title of the bill is the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008. It is named for two prominent U.S. congressmen, Lantos a Democrat and Hyde a Republican, who died recently.

Senator Richard Burr (Republican-North Carolina), one of the seven senators blocking the legislation, told a press briefing on Capitol Hill in Washington DC Tuesday: "The focus is not on delivering medicine, it is not on treatment, it is not on addressing the population of individuals with HIV/Aids in Pepfar countries. It is focused on what was politically accommodating. There are no hard targets."

"What we know is treatment is prevention," added Senator Tom Coburn (Republican-Oklahoma), another senator blocking the bill.

The move has several critics, including John Bradshaw, director of the Washington office of Physicians for Human Rights, who said in a statement to AllAfrica that the Pepfar program must be "flexible and respond to what is needed in each country - and people on the ground are in the best position to make those decisions, not senators in Washington dictating artificial, numerical targets."

The senators blocking the bill even have critics within the Republican Party. Michael Gerson, a former member of the Bush administration who played a key role in the first Pepfar bill, wrote in an op-ed published today in the Washington Post that the actions of the seven Republican senators are "destructive."

"The 55 percent treatment floor would force the program to waste money in pursuit of an arbitrary, nonsensical spending target - the worst kind of congressional earmark," Gerson wrote. He accused the senators of insisting on a minimum figure for treatment as a means of discouraging what they saw as "feckless or morally dubious" spending which might promote abortion or the purchase of needles for drug addicts.

The supporters of the seven senators claim that the delay is necessary for millions of people with HIV/Aids. Michael Weinstein, the president of Aids Healthcare Foundation, the organization that put together the press briefing, said "the removal of the language that requires Pepfar to direct a specific amount of its funds toward lifesaving Aids care and treatment will cost millions of lives."

Coburn added: "We are deadly serious about making sure [Pepfar] stays an effective program."

Gerson, however, accused Coburn of "undermining the bill." He reported that Senate Majority Leader Harry Reid (Democrat-Nevada), who schedules floor time in the Senate, supports the bill but will not introduce it if it leads to a long, drawn-out quarrel. Gerson added that President George W. Bush is not making the bill his top legislative priority.

"Given these obstacles, supporters of Pepfar reauthorization now estimate a 50 percent chance it will shelve until next year," Gerson wrote.

Coburn seemed to agree with this prediction, telling reporters that the bill was still in an early stage of Senate processes.

More voices for prevention

The World Bank said last week that African countries must continue to champion HIV prevention efforts to slow and reverse the rate of new HIV infections.

HIV/AIDS will remain for the foreseeable future an unprecedented economic, social, and human challenge to sub-Saharan Africa, the Bank said in a report. The region remains the global epicenter of the disease.

The UN also reported last week that the number of people living with HIV/AIDS in Rwanda dropped from 191,437 in 2006 to 184,859 in 2007.

Among age group 15-19, prevalence rate stands at 3.7 percent and about 2.5 percent for those between ages 20-24. However, women aged 30-34 are more greatly affected, with a prevalence of between 4.9 percent and 6.8 percent.

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