After a yearlong investigation, on April 4 the Government Accountability Office (GAO) released its analysis of spending on HIV prevention programs funded by the President’s Emergency Fund for AIDS Relief (PEPFAR). The report recommends that Congress reevaluate the stringent requirements for how this money should be spent. Specifically, it exposes the challenges created by the requirement that at least one-third of global HIV prevention funds be reserved for “abstinence until marriage” programming. The GAO found that the spending requirement is squeezing out available funding for other key prevention interventions. In addition, the majority of PEPFAR country teams on the ground reported that meeting the spending requirement “challenges their ability to develop interventions that are responsive to local epidemiology and social norms.”
Notably, the spending requirement is forcing some country teams to cut funding for other prevention programs aimed at meeting the needs of sexually active youth, who could benefit from more comprehensive ABC (abstain, be faithful and use condoms) messages. It is also limiting support for programs to prevent the transmission of HIV from pregnant women to their children.
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