United Press International - March 5, 2004
David J. Kent, United Press International

Faith-based aid organizations, meanwhile, defend their use of federal funds and their broader interpretations of the administration's prescribed ABC prevention policy -- for abstinence, be faithful and use condoms -- to combat HIV infections.

The Bush administration said Feb. 23 that $350 million had been allocated -- of a total $15 billion the president had promised -- for a five-year emergency plan to prevent and treat acquired immunodeficiency syndrome and human immunodeficiency virus in select foreign countries.

The initial seed money was approved for grants to agencies, companies and universities that have programs in place in 15 target countries, 14 of which have been selected in Africa and the Caribbean.

Funding will be allocated on the basis of each country's adherence to guidelines outlined in the plan over the five-year period.

The U.S. government also has "substantial programs" in place for HIV/AIDS assistance in about 101 countries through the USAID and the Department of Health and Human Services, including the 14 focus countries, administration officials said.

Although organizations and companies contacted by United Press International generally said they were grateful for the funding, some officials representing major grant recipients characterized U.S. aid to countries stricken with the pandemic as minute, compared to the grants of other industrialized nations.

Christine Tucker, director of HIV/AIDS Global Response for Catholic Relief Services in Baltimore, said the administration's five-year plan is a step in the right direction.

The $24.7 million Tucker's agency received for the first year -- out of a five-year request of $335 million -- will be used to fund anti-retroviral drug deliveries and provide medical staffing in eight African countries and Haiti. The organism that causes AIDS is a retrovirus.

Tucker noted countries not among the initial 14 focus countries could lose out, however.

"If you are not one of those countries, you are not eligible," she told UPI, and added many countries not among the 100-plus slated to receive U.S. assistance for established programs still have problems with AIDS/HIV.

"They will have to continue their programs with an even smaller pot," Tucker said. "The problem has to be handled holistically."

Ambassador John Lange, the State Department's deputy global AIDS coordinator, told UPI the selection of countries is justified. Many developed countries, such as France and the United Kingdom, already have the wherewithal to help themselves, while other countries do not have diplomatic relations with the United States, he said.

Lange, former U.S. ambassador to Botswana, said $5 billion of the promised $15 billion is earmarked for continuing funding in the 100 so-called second-tier countries.

World Relief, also of Baltimore, will receive over $2.75 million in first-year USAID funding -- matched by an additional $1.9 million in federal grants -- to fund treatment and prevention in Kenya, Mozambique, Rwanda and Haiti, USAID spokeswoman Portia Palmer told UPI.

The faith-based group's Web page criticized Congress for falling $600 million short for fiscal year 2004 from what it said is $3 billion Bush had promised in annual HIV/AIDS relief. To make up the difference, World Relief said, the White House should have recommended $3.6 billion for the FY 2005 budget -- not the $2.8 billion proposed in the current, Feb. 2 version.

Rebecca Heidkampf, HIV-AIDS desk officer for World Relief, told UPI her organization felt encouraged by the progress made by their programs, which specialize in mobilizing communities using church resources.

"Just because we've received money doesn't mean there's not more that could be done," Heidkampf noted.

Paul Zeitz, executive director of Global AIDS Alliance in Washington, a watchdog group, told UPI he agrees the United States should pay $3.6 billion in AIDS/HIV assistance to offset what he concurs was this year's $600 million shortfall.

"We've never given our fair share to the global fund," he added.

Lange said the charges of underfunding are based on the assumption the administration was falling short of a promised $3 billion-per-year quota, which he told UPI is "really a charge that has no merit."

The White House issued a statement shortly after Bush's 2003 State of the Union address explaining that the annual amount would be ramped up over the five years for a total of $15 billion, Lange said. Such a large amount of money cannot be easily spread around the world, he noted, so advocacy groups should keep realistic expectations.

Bill Pierce, spokesman for the Department of Health and Human Services, told UPI he did not recall the administration promising $3 billion per year in HIV/AIDS funding. Instead, he said, funding would be built up over time as programs are developed, but the administration cannot spend anything more than Congress has allotted.

"The last thing we want is for there to be money not spent well, or for it to not be used to truly fight that disease," Pierce said.

Ambassador Randall Tobias, the State Department's coordinator of global AIDS affairs, said at a Feb. 23 news conference the U.S. government has provided more international HIV/AIDS funding than the rest of the world combined.

Zeitz said the administration's current approach is a "go-it-alone" strategy that allows the administration to channel more funding to faith-based groups, which he said do good work and should not be discounted.

Tucker said 30 percent to 50 percent of healthcare in sub-Saharan Africa now comes from faith-based groups, and the organizations provide key resources to help build communities.

Heidkampf said separating faith-based and government-based spending is "an ideal that's obviously never achieved." She said U.S. taxpayers want to maximize their money and USAID has a long history of funding faith-based groups. When Bush's emergency assistance plan was first proposed in early 2003, social conservative groups, including the Family Research Council, and some congressional Republicans criticized the bill for not including more pro-family amendments that would promote programs that teach abstinence and fidelity rather than condom use. Bush earmarked $268 million of the FY 2005 budget for domestic abstinence-only sex education programs -- almost double the amount requested for FY 2003, according to Adrienne Verrilli, spokeswoman for the Sexuality Information and Education Council of the United States in New York City.

A recent study from the Kaiser Family Foundation indicated American adults surveyed were split on what type of sex education works best, with 46 percent advocating "abstinence-plus" education -- which encourages abstinence but also teaches about condoms and contraception -- and 36 percent saying sex education should focus on teens making responsible decisions about sex.

At the Feb. 23 news conference, Tobias cited Uganda as a country where programs focused primarily on abstinence had succeeded. He added criticism of sex education programs for focusing more on abstinence programs than on condom use was "something we are mainly hearing from Americans."

How much each element of the ABC prevention initiative is emphasized in AIDS/HIV assistance varies by organization and the role faith plays.

"'Abstinence' and 'be faithful' are by far the front lines" of World Relief's programs, Heidkampf told UPI, but they are not the extent of the education programs.

"We don't want youths to think condoms are evil," she added.

World Relief ultimately leaves the choice up to the churches that reach out to area youth groups.

"We wouldn't ask or push churches to become distributors of condoms," Heidkampf said.

The American Red Cross -- approved to receive $2.25 million from USAID for the coming year to scale up its youth peer education rogram in Haiti, Guyana and Tanzania -- also focuses on abstinence and fidelity to one's partner, Matthew Chico, director of the Americas Region, told UPI.

"But we make it known what kind of service is available," when asked about condoms, he said, and added abstinence is not guaranteed.

Although Chico would not disclose the size of the first-year grant, he called the overall amount "historic" and said there still is a pressing need for more aid abroad.

"We'd like to see continued funding because the needs are enormous," Chico said.

David Kent is a UPI Science News intern. E-mail sciencemail@upi.com
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