Important note: Information in this article was accurate in 2006. The state of the art may have changed since the publication date.
Washington Post (04.05.06) - Wednesday, April 05, 2006
David Brown
Of the 20 percent of PEPFAR funds that the Office of the Global AIDS Coordinator (OGAC) demands target prevention, half must be spent to prevent sexual transmission. Of that, two- thirds must be used to promote abstinence and monogamy - the result of Congressional mandate.
The survey found widespread support for PEPFAR's "ABC" strategy against AIDS, involving Abstinence, Being faithful to one sex partner, and proper Condom use. However, "Most of the 20 PEPFAR teams. reported that fulfilling [the spending target] presents challenges to their ability to respond to the local epidemiology and cultural and social norms," the report stated.
About half-a-dozen teams reported the quotas "can undermine the integrated nature of HIV/AIDS prevention programs." In nine PEPFAR countries, mandated abstinence targets led to reduced 2006 funding for programs preventing mother-to-child HIV transmission. One nation's MTC program was cut from $1.4 million to $1 million, while another was reduced by $300,000, said David Gootnick, who oversaw the report. One country halved spending, from $8 million to $4 million, to prevent HIV transmission among high-risk groups such as serodiscordant couples, sexually active youths, and sex workers.
In 2004, OGAC allowed fidelity programs to target those who are monogamous but unmarried. The office also applies the abstinence target to overall PEPFAR spending on prevention, rather than applying it to every country, allowing for 10 nations to be exempt. OGAC Director Dr. Mark Dybul said the trade-offs that GAO documented would not have been necessary had the administration's funding requests, $527 million over the last three budgets, been fulfilled.
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