Religious conservative elements in the Republican party have forced amendments to the United States Global HIV/AIDS bill that will require one-third of all prevention funds given to African countries to be used in promoting sexual abstinence. The bill was passed by the US House of Representatives on May 1, and will go to the Senate for consideration within the next month.
The bill will provide $3 billion a year for five years, 55% of which is to be spent on treatment. It aims to reach 2 million people with
anti-retroviral treatment, prevent 7 million new infections, and
provide assistance to 10 million HIV-infected individuals and children
orphaned by the disease. The initiative focuses on 12 African countries - Botswana, Ivory Coast, Ethiopia, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia - as well as Guyana and Haiti in the Caribbean.
The bill also earmarks $1 billion in 2004 for the Global Fund to Fight AIDS, TB and Malaria – providing that the US contributes no more than one-third of the Fund’s budget in that year. However, this sum will have to be approved by the House and Senate Appropriations Committees, which may decide that the allocation, more than President Bush asked for, is too generous.
The bill’s prevention component specifies that money should be spent on programmes modelled on Uganda’s HIV prevention campaign, which is argued to have reduced prevalence and incidence dramatically over the past ten years. The programme emphasises three forms of behaviour change: abstinence, sexual fidelity and use of condoms. However, Republicans have insisted that abstinence should be emphasised, with an amendment that requires such campaigns to be funded, regardless of the wishes of local people. Vice President Dick Cheney lobbied House members in support of the amendment, proposed by Republican Representative Joe Pitts of Pennsylvania. Organisations which oppose condom use on religious grounds will now be able to receive funding to run prevention activities that accord with their religious beliefs.
Whilst the bill does forbid HIV prevention money to be spent on abortion counselling and services, it does not prevent organisation that provide such services from receiving money – but they must be kept separate.