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House rejects Africa AIDS/abstinence aid

WASHINGTON (BP)–The House of Representatives has struck down an amendment that would have reinstated funding for abstinence education programs to fight AIDS in Africa.

Rep. Joe Pitts, R.-Pa., introduced the amendment to the State, Foreign Operations and Related Programs Appropriations Act, which had arrived on the House floor without the provision for abstinence programs under the President’s Emergency Plan for AIDS Relief (PEPFAR) authorization.

The House vote, 226-200, would eliminate the requirement that 33 percent of funds be allocated toward abstinence and be faithful programs under the ABC model — abstinence, be faithful and condoms when necessary.

The White House has warned that President Bush would veto legislation repealing abstinence funding.

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Pitts said in his comments on the House floor that 33 percent of funding for the “A” and “B” sections of the model was only 7 percent of the total PEPFAR budget.

“Experts continue to testify to the fact that behavioral change continues to be the key indicator of HIV/AIDS prevention,” Pitts told fellow House members. “Yet, for some reason, some of my colleagues have decided to make a crucial provision of this strategy optional.”

The ABC model has accounted for falling HIV/AIDS rates in seven of the 15 PEPFAR focus countries, Pitts said in his speech.

Also, according to the Demographic and Health Survey, the number of males in Uganda age 15 to 25 reporting premarital sex decreased from 60 percent in 1989 to 23 percent in 1995. The decline for females was from 54 percent to 16 percent.

Pitts cited the work of Edward Green, a researcher at Harvard University who was initially opposed to the ABC model, particularly abstinence. Green changed his opinion on the matter after he saw the success of the model in Uganda.

“Many of us in the AIDS and public health communities did not believe that abstinence, or delay and faithfulness were realistic goals. It now seems we were wrong,” Green said in testimony before the House Energy and Commerce Committee.

The ABC model also was responsible for a decrease in HIV/AIDS in Kenya, Zimbabwe, Ethiopia, Namibia, Tanzania and Zambia, a fact Pitts asked the House to consider.

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“In countries that have relied predominantly on condom distribution, HIV/AIDS prevalence rates have not improved, while countries that promote behavioral change have seen significant improvement,” Pitts said.

The United States is the largest distributor of condoms in the world.

A June 19 statement from the Office of Management and Budget said the president would use his veto power if he were presented a similar bill and the administration believed the legislation would “undermine the evidence-based, balanced ‘ABC’ approach to prevention in the President’s Emergency Plan for AIDS Relief.”

PEPFAR was introduced in 2003 as a pledge of $15 billion over a five-year period (2003-2008) to fight the HIV/AIDS pandemic. It is the largest international health initiative ever instituted by a single country and set a goal to provide treatment to 2 million HIV-infected people, to prevent 7 million new infections and to support care for 10 million people.

As of September 2006, the program estimated it had provided treatment to nearly 900,000 people.

Critics of the abstinence-until-marriage funding praised the June 21 House vote. PEPFAR Watch, a website run by the Center for Health and Gender Equity (CHANGE), released a statement saying the removal of the abstinence and be faithful funding would eliminate the “ideologically driven policies implemented and defended by the Bush Administration.”

“This earmark denies people critical, life-saving information and skills,” Serra Sippel, acting executive director of CHANGE, said in the statement. “By allowing PEPFAR funds to be implemented without the abstinence-until-marriage earmark, Congress is granting countries the ability to provide comprehensive HIV prevention messages and services to those most vulnerable to infection, women and girls.”

The House approved the final version of the appropriations bill on a vote of 241-178. The Senate has yet to vote on its version of the legislation.
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