A guest-post by Kelly Castagnaro, Director of Communications at the International Women’s Health Coalition.
Despite evidence—and the efforts of Rep. Betty McCollum, experts and advocates around the world—the full House voted yesterday to reauthorize a $50 billion global HIV/AIDS relief initiative that threatens to further restrict, rather than support, expansion of HIV prevention through family planning services.
Several advocates and the mainstream media have overwhelmingly touted the President’s Plan for Emergency AIDS Relief (PEPFAR) as a legacy-building success, and in one case, the “AIDS relief miracle.” Today, nearly two million more people have access to anti-retroviral medication than five years ago due to U.S. government support. However, the number of people newly infected with HIV continues to outpace the number of people on treatment —hardly a miraculous approach to sustainable public health programming.
For women and girls, HIV/AIDS is fundamentally a sexual and reproductive health and rights issue. They are vulnerable because their rights are widely violated. More than four-fifths of new infections in women occur in marriage or long term relationships. They could be protected if their access to reproductive health services and education was expanded. They could be protected if bureaucrats in Washington didn’t insist on exporting faulty abstinence and faithfulness prevention programming to communities where women cannot abstain and are already faithful.
But the real tragedy is that lawmakers have missed the opportunity to take a step towards ending, rather than managing, the pandemic by refusing to talk about sex. Sexual transmission is a leading cause of new infections worldwide. However, hysteria surrounding abortion and premarital sex has prevented lawmakers from engaging in debate about what works and what doesn’t for people who are fighting this disease in their homes, in their communities and in their countries.
Public health experts on the ground must be able to determine the best mix of prevention programming. As it stands, their hands are tied by mandates from Washington politicos who can only talk about sex publicly when their extramarital affairs and indiscretions are exposed.
The Senate Foreign Relations Committee has approved a similar $50 billion bill, which the full Senate will soon consider. Let’s hope they recognize that there are no quick fixes to the global AIDS pandemic, and find a way to help women deal with their lives and their health in a humane way.