The United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, which became law in May, calls for a major increase in U.S. funding for global HIV/AIDS, but attaches potentially dangerous constraints on those expenditures, according to "U.S. AIDS Policy: Priority on Treatment, Conservatives' Approach to Prevention," by Heather Boonstra.
In a departure from previous policies, the new law focuses the majority of new funding on care and treatment of people living with HIV/AIDS, rather than on prevention of new infections. Of the $15 billion pledged over five years by the new law, only about 20%, or $600 million per year, will be eligible for HIV prevention activities. Furthermore, at least one-third of prevention funds must be reserved for "abstinence-until-marriage" programs. And, no organization funded under the act may be required to promote or provide condoms or, indeed, to "utilize or participate in a prevention or treatment program" to which they claim a moral or religious objection.
In light of the recent availability of more effective and affordable HIV treatment options, investing greater resources in treating those living with AIDS makes sense. Yet on the prevention front, the limitations on funding for condom distribution and other prevention efforts illustrate how the relatively modest funds available have been caught up in the politics and ideology of religious and social conservatives. The health and lives of millions of people around the world at risk of or living with HIV/AIDS are at stake.
Boonstra's analysis appears in the August issue of The Guttmacher Report on Public Policy. Other analyses in this issue include: