Political Cortex: Brain Food for the Body Politic

Indeed PEFPAR has brought relief and succour to many HIV infected persons in Africa. It has raised the number of Africans on anti-retroviral treatment from 50,000 to 1.2 million. But today this international AIDS program is mired in uncertainties that could mar its future and promises in Africa.

First of all, PEFPAR expires this year. And President Bush is using his visit to showcase the success of this initiative and to lobby the Congress to renew this global AIDS program. But that's not the main issue. The renewal process of PEFPAR is caught up in serious political and ideological debate and differences.

Some members of the congress want some of the conditions and criteria for the funding to be reviewed and removed. Some Democrats want to eliminate the provisions in PEFPAR that requires one-third of all prevention spending to go to abstinence-until-marriage programs and that some groups sign anti-prostitution pledges. But Bush and the Republican leaders want PEFPAR to be renewed as it is -without any alteration- preserving a requirement that steers more money into abstinence efforts. They continue to maintain that the program is balanced and effective.

According to President Bush, "PEFPAR is working. It is a balanced program. It is an ABC program- abstinence, be faithful and condoms. It is a program that's been proven effective" This is only partially true. And the American congress needs to know this before reauthorizing this program. PEFPAR may have been effective in terms of HIV treatment, but when it comes to its prevention programs, it has been largely a disaster. In fact PEFPAR may have contributed more to the spread of HIV/AIDS in Africa than to its prevention.

PEFPAR is not a balanced scheme at all. It is not an ABC program as Bush would make us to understand. Because most of the prevention spending goes into useless and unrealistic abstinence-only schemes, to groups that emphasize sexual abstinence and de-emphasize safe sex strategies including the use of condom.

PEFPAR is not comprehensive and evidence-based. A review of the abstinence-only schemes conducted in 2006 in developing countries found little evidence that they were effective in HIV prevention. That means the funding channeled into abstinence programs has been largely a waste. And Bush wants this wasteful initiative to continue.

Again PEFPAR is not steered towards addressing the needs of vulnerable groups like the commercial sex workers. So, where lies the comprehensive nature of this program? Where lies the evidence that its prevention programs are working?

President Bush has told us about millions of Africans who benefited from the HIV treatment funded by PEFPAR. Why didn't he tell us about `millions' of new infections that have been prevented by the fund's abstinence-until marriage programs? Unfortunately the American president continues to shy away from these facts. He has refused to acknowledge and address the gaps, flaws and inadequacies in PEFPAR.

In Tanzania he went to the extent of describing the attempts by some members of the congress to effect important changes on PEFPAR before renewing it as "squabbling". And I ask the members of the American congress not succumb to this cheap blackmail. They should not renew this global AIDS program as it is. American lawmakers should review the sections that steers more funding into abstinence schemes, and starve groups that promote safe sex strategies of funds. PEFPAR should be extended to NGOs working with vulnerable groups like the commercial sex workers. The American congress should not allow their politics to undermine this important AIDS program in Africa They should only renew and reauthorize a PEFPAR that is truly comprehensive, evidence based, balanced and effective.

Leo Igwe is the IHEU Director in West Africa