U.S. versus HIV/AIDS
Last week, the US senate committee on Foreign Relations voted to contribute another $50 billion against HIV/AIDS. PEPFAR, the President’s Emergency Plan for AIDS Relief, has channeled funds to treat and care for people infected and affected by HIV/AIDS around the world since its inception five years ago. This renewal of commitment has more than tripled the funds available, but whether this increase in funds will quite those who would like to see less restrictions on how the money can be spent remains to be seen.
More might not be better if the grant-making PEPFAR continues to emphasize abstinence only programs and restrict funding to organizations that condemn commericial sex work. This presents two issues. First, evidence indicates that abstinence only campaigns do not provide the tools needed for youth and others to resist HIV/AIDS. As I’ve learned from my thesis research, knowledge alone doesn’t prevent HIV infection. Self-esteem, social networks (not in the facebook sense!), access to income — among other factors — all play an important role in preventing HIV. Second, commercial sex workers (CSWs) are especially vulnerable to contracting HIV/AIDS but can be left out of programming that is forced to condemn their livelihood. PEPFAR policy influences organizations who seek US HIV/AIDS money to either change their policy away from targeting CSWs and towards abstinence only campaigns, or risk not being eligible.
I think this is a poignant example of how funding priorities of donors can influence the approach of those working on the ground to combat poverty and HIV/AIDS in Africa and Asia. The power to dictate policy that comes with a sum of $50 billion is huge, but I think that as individual donors, we also hold some of that power when we choose which programs we will support and which we will not.
Bush has obviously tailored the guidelines for receipt of PEPFAR grants to fit the values of his conservative constituency, rather than the most effective interventions against HIV/AIDS. Despite this skewed accountability, $50 billion makes PEPFAR a significant player in the field
I try to think about these power dynamics in my development involvement: what power over project policy do I have when I give to charity? Am I working to empower the approaches that have come from experience, or to spread my values?
