Bush's AIDS plan criticised for emphasising abstinence and forbidding condoms
http://www.100md.com
《英国医生杂志》
A field study to be published later this year of George Bush's new AIDS plan known as the President's Emergency Plan for AIDS Relief will say that Africans are calling the plan "unethical" for its refusal to support condom distribution and for imposing other restrictions. The plan was announced in January 2003 and is allocating $15bn (￡8bn; 12bn) to fight AIDS over five years.
The field study, carried out by the Center for Health and Gender Equity, an international reproductive health and rights organisation based in Takoma Park, Maryland, will also claim that the operational strategies in most countries are being set "almost entirely" by US officers without involving those community groups most experienced in AIDS. Local groups are being recruited, but these are mostly faith based, rather than those related to public health.
Other claims made by the centre are that the plan, which now has schemes running in 12 African countries (plus Guyana, Haiti, and Vietnam), puts excessive weight on abstinence and discriminates against any group that provides information on safe abortion.
George Bush announced his emergency plan for AIDS in his state of the union address in January 2003
Credit: PABLO MARTINEZ MONSIVAIS/AP
All the claims are denied by the chief officers of the plan.
Jodi Jacobson, executive director of the centre, claimed that her staff had found "a huge focus on abstinence only."
"What the US is doing... is telling everyone to abstain from sex," Ms Jacobson told the BMJ. Moreover, she says, "it is prohibiting organisations from providing condoms or condom information."
Her evidence came from "ground work with colleagues in Africa" and from officials from aid agencies—including the US Agency for International Development, the UK Department for International Development, and Denmark's Danish International Development Agency—who had often had to speak in secret (for example, not on office phones) to staff from the centre.
According to Ms Jacobson, organisations that object to the plan's emphasis on abstinence see their money withdrawn. One organisation in Namibia, for example, that had had funding from the US government for well over 12 years to do reproductive and social health work with adolescents, and has been favourably reviewed all of that time, has recently been cut off from funding, because they contested the president's plan.
The same had applied to organisations that provided information on abortion. "In Tanzania, Ethiopia, and Namibia, organisations have been told that because they provide information on safe abortion services they won't be able to get money," she said.
Mark Dybul, the plan's deputy chief medical officer, told the BMJ last week that the programme was soundly based on evidence of successful interventions in countries such as Uganda and Zambia. The plan embraces the "ABC" message (abstain, be faithful, or use condoms), but "AIDS is very complex, and to reduce it to any one thing is against the evidence and against common sense," said Dr Dybul.
It was "utter nonsense" to say that the plan focused on abstinence. "They must be looking at the first, central announcements. Only $20m of $865m was on abstinence, in youth," he said. And $700m was for "what the field people say they want to support."
Furthermore, he added, "To say that condoms alone are going to solve this problem is crazy. You need the full ABC message, which was really initiated by President Museveni of Uganda."
Dr Dybul claimed that whether organisations provided information on abortion was not an issue. He also insisted that staff from the plan worked with local groups.
"We've been on the ground working shoulder to shoulder with folks for 20 years. Of the 1000 partners we have so far, 61% are local groups."(Robert Walgate)
The field study, carried out by the Center for Health and Gender Equity, an international reproductive health and rights organisation based in Takoma Park, Maryland, will also claim that the operational strategies in most countries are being set "almost entirely" by US officers without involving those community groups most experienced in AIDS. Local groups are being recruited, but these are mostly faith based, rather than those related to public health.
Other claims made by the centre are that the plan, which now has schemes running in 12 African countries (plus Guyana, Haiti, and Vietnam), puts excessive weight on abstinence and discriminates against any group that provides information on safe abortion.
George Bush announced his emergency plan for AIDS in his state of the union address in January 2003
Credit: PABLO MARTINEZ MONSIVAIS/AP
All the claims are denied by the chief officers of the plan.
Jodi Jacobson, executive director of the centre, claimed that her staff had found "a huge focus on abstinence only."
"What the US is doing... is telling everyone to abstain from sex," Ms Jacobson told the BMJ. Moreover, she says, "it is prohibiting organisations from providing condoms or condom information."
Her evidence came from "ground work with colleagues in Africa" and from officials from aid agencies—including the US Agency for International Development, the UK Department for International Development, and Denmark's Danish International Development Agency—who had often had to speak in secret (for example, not on office phones) to staff from the centre.
According to Ms Jacobson, organisations that object to the plan's emphasis on abstinence see their money withdrawn. One organisation in Namibia, for example, that had had funding from the US government for well over 12 years to do reproductive and social health work with adolescents, and has been favourably reviewed all of that time, has recently been cut off from funding, because they contested the president's plan.
The same had applied to organisations that provided information on abortion. "In Tanzania, Ethiopia, and Namibia, organisations have been told that because they provide information on safe abortion services they won't be able to get money," she said.
Mark Dybul, the plan's deputy chief medical officer, told the BMJ last week that the programme was soundly based on evidence of successful interventions in countries such as Uganda and Zambia. The plan embraces the "ABC" message (abstain, be faithful, or use condoms), but "AIDS is very complex, and to reduce it to any one thing is against the evidence and against common sense," said Dr Dybul.
It was "utter nonsense" to say that the plan focused on abstinence. "They must be looking at the first, central announcements. Only $20m of $865m was on abstinence, in youth," he said. And $700m was for "what the field people say they want to support."
Furthermore, he added, "To say that condoms alone are going to solve this problem is crazy. You need the full ABC message, which was really initiated by President Museveni of Uganda."
Dr Dybul claimed that whether organisations provided information on abortion was not an issue. He also insisted that staff from the plan worked with local groups.
"We've been on the ground working shoulder to shoulder with folks for 20 years. Of the 1000 partners we have so far, 61% are local groups."(Robert Walgate)