US promotes abstinence as global conference opens in Bangkok

Peter Gill
Sunday July 11, 2004
The Observer

The US faces condemnation this week from leaders of the worldwide struggle against Aids over the Bush administration's reliance on sexual abstinence as a response to the intensifying epidemic.

With a major international conference on Aids being opened by UN Secretary General Kofi Annan today in Bangkok, there are fears that lives are at risk in some of the world's poorest countries because of American objections to a 'safe sex' approach to combating Aids.

Hillary Benn, the UK's International Development Secretary, who spearheads Britain's fight against Aids overseas, told The Observer that an abstinence-only approach would not work. 'We need to have all the means at our disposal to fight the epidemic,' he said. 'People should have access to condoms.'

In Brussels, Poul Nielson, the EU's outspoken Commissioner for Development and Humanitarian Aid, criticised America for 'preaching one line only and denying people's rights by trying to push them into abstinence. It will weaken the battle against Aids, and the unfortunate reality is that it will directly endanger the lives of millions of women.'

Under the influence of the Christian right, Bush has adopted the so-called ABC approach to Aids prevention - A for abstinence, B for being faithful and C for condoms. But condoms are to be promoted only for use by 'high risk groups' such as prostitutes and drug abusers, with sexual abstinence the objective for all unmarried young people.

Unusually open criticism of US policy has also come from Unaids, the UN body responsible for co-ordinating the global response to Aids. Dr Peter Piot, executive director, said: 'We know condoms save lives. We are not in the business of morality. Condom promotion should be part of education about sexuality for young people.'

Bush's policy was laid down earlier this year in a 100-page document entitled 'The President's Emergency Plan for Aids Relief'. It is backed by a $15 billion commitment over five years and targets 15 countries, 12 in sub-Saharan Africa.

References to condoms - for decades heavily promoted in the US drive for population control in the developing world - make clear that they are to play a marginal role. They can be distributed 'near areas where high-risk behaviour takes place' such as brothels, but they are not to be promoted for the general population, which should receive 'a clear message that the best means of preventing HIV/Aids is to avoid risk altogether'.

In Bangkok this week almost 20,000 delegates will review the faltering progress made in stemming the Aids tide since the last conference in Barcelona two years ago. The US interpretation of the ABC approach is to be challenged in a debate tomorrow by Steven Sinding, director-general of the London-based International Planned Parenthood Federation, which had official funding withdrawn for refusing to accept the US administration's views on abortion.

Later in the week the American campaign group Population Action International is running a session entitled 'Abstinence is Coming Your Way', designed 'to challenge the substitution of science with ideology in the policy-making process'.

Britain's Department for International Development last week pointedly announced an additional £80m funding over four years to the UN Population Fund, which has also had US funding withdrawn over the abortion issue. 'We are unashamedly a strong supporter of the UNFPA and the work they undertake,' said Benn. But he would not make any direct criticism of US policy. 'We speak up, we make our position clear and we have a different view.'

The EU has been fighting a rearguard action against US efforts to overturn key international commitments on sexual and reproductive rights. Europe has stepped in to fill what Nielson called 'the decency gap' by funding both the UN Population Fund and the International Planned Parenthood Federation after America withdrew financing.

A realistic approach had to be adopted, Nielson said. 'I think it was Groucho Marx who was asked his opinion on sex and said, "I think it's here to stay.' "

The US delegation to Bangkok will be led by Randall Tobias, former chief executive of the pharmaceutical giant Eli Lilley, who was appointed global Aids co-ordinator by George Bush last autumn. The number of US delegates has been cut back and there are signs that Tobias is adopting a mollifying, low-profile role in the run-up to November's US presidential election. But the administration will stick to its controversial stand. At a recent meeting in Washington, Tobias told sexual health experts: 'Whatever historians of the future write about President Bush's plan, they can never say it was the "same old, same old".'

The same meeting heard from Janet Museveni, wife of Ugandan President Yoweri Museveni, who initiated the ABC strategy which led to dramatic reductions in Uganda's Aids prevalence. She said: 'Giving young people condoms is tantamount to giving them a licence to be promiscuous; it leads to certain death.'

As the US steps up funding for Africa, Christian organisations are responding to its emphasis on the role of 'faith-based organisations'. One US Catholic pressure group has sent circulars to bishops throughout Africa, advising them how to secure funds for abstinence-only Aids projects. Government officials are supposed to be professional and courteous, says the circular. 'If this is not the case - if, for example, anti-Catholic or anti-abstinence sentiments are expressed or implied - please report this to us.'

http://observer.guardian.co.uk/internation...1258589,00.html

AIDS Fight Too Slow, Too Many Heads in Sand-Annan
By Darren Schuettler

BANGKOK (Reuters) - The global fight against AIDS is falling short and leaders need to get their heads out of the sand as women increasingly bear the brunt of the killer disease, U.N. Secretary-General Kofi Annan said on Sunday.

Opening an international AIDS conference, Annan made a passionate plea for the education of girls as a vital means of protecting them from the epidemic in a world where more and more women are catching it from philandering husbands.

He also pleaded for more money to halt the spread of a disease that has killed 20 million people and to treat millions of sufferers.

Asian nations must intensify the fight against AIDS, which is spreading fast in a region home to 60 percent of the world's population and where one in four new infections occurs, he said.

"We need leaders everywhere to demonstrate that speaking up about AIDS is a point of pride, not a source of shame," he said.

"There must be no more sticking heads in the sand, no more embarrassment, no more hiding behind the veil of apathy."

Just before Annan spoke, 1,000 activists staged a sit-down protest outside the sprawling venue on the outskirts of Bangkok, waving placards saying "Access for All Denied" -- a play on the meeting's "Access for All" slogan.

Inside the teeming convention halls, students dressed in giant pink condom suits mingled with delegates. Outside, visitors were entertained by elephants playing soccer in a carpark.

One drug firm handed out press releases coiled in syringes.

NO CURE, NO VACCINE

Some 38 million people are living with AIDS and 14,000 more get infected every day -- more than 40 percent of them aged 15-24.

A cure and vaccines for the disease, which emerged in 1981, are still years away.
"We are not on track to begin reducing the scale and impact of the epidemic by 2005, as we had promised," Annan said, referring to the World Health Organization's plan to treat 3 million people by the end of 2005.

WHO officials say they failed to meet their initial six-month target, but are confident of catching up, although many barriers have to be overcome.
Annan said health systems and training of medical workers needed to be expanded to support both treatment and prevention.

He was concerned in particular about women, who account for nearly half of all adult infections in a world where many live in ignorance and usually controlled by men.

"Over the past few years, we have seen a terrifying pattern emerge: all over the world, women are increasingly bearing the brunt of the epidemic," Annan said.

"What is needed is real, positive change that will give more power and confidence to women and girls," he said. "In other words, what is needed is the education of girls."

Men had to change their attitudes, "such as the belief that men who don't show their wives 'who's the boss at home' are not real men; or that coming into manhood means having your sexual initiation with a sex worker when you are 13 years old."

The Bangkok meeting aims to boost access to lifesaving drug cocktails which can prolong the lives of AIDS sufferers.

Despite a dramatic fall in drug prices, mainly due to pressure on Western drug firms, only 440,000 of the six million AIDS patients in need in the poorer countries get treatment.

The issue of access to generic anti-retroviral drugs -- which can cost as little as $140 per patient a year in poor nations against $470 for branded products, according to charity ActionAid -- has overshadowed the runup to the biennial meeting.

So have accusations of complacency in countries, like host Thailand, which have had considerable success in curbing the spread of AIDS with vigorous action.

Thailand's success, particularly in its notorious sex industry in the 1990s, has made it a model.

But experts say infections are on the rise among youths and needle drug users, and they blame the government for cutting spending on AIDS awareness programs and waging a bloody "war on drugs" that has driven many away from treatment.

http://story.news.yahoo.com/news?tmpl=stor...1/ts_nm/aids_dc

"We cannot lose the war on AIDS and win our battles to reduce poverty, promote stability, advance democracy and increase peace and prosperity." - William J. Clinton, Barcelona, Spain 2002
clintonpresidentialcenter.com

Anger at US ban on Aids scientists
Bangkok conference forced to cancel meetings and retract papers after authors stopped from attending

Sarah Boseley in Bangkok
Monday July 12, 2004
The Guardian <http://www.guardian.co.uk>

The US government came under scathing attack from senior members of the medical establishment yesterday for blocking scientists from attending the International Aids conference which opened in Bangkok.
The biennial conference, with 17,000 delegates, is more political rally than scientific meeting and bears huge significance for those involved in the fight against HIV/Aids.
The US government has sent only a fraction of its usual contingent of scientists, pleading cost - 50 instead of the 236 who attended the last event in Barcelona in 2002.
The Department of Health and Human Services, headed by the health secretary, Tommy Thompson, was yesterday accused of actively preventing certain US scientists and doctors who had a contribution to make from travelling to Bangkok.
Many suspect that behind the action lies a rift between the US and Aids activists who oppose America's approach to the global pandemic.
Joep Lange, president of the Sweden-based International Aids Society, which organises the conference, said it had been forced to retract papers that had been accepted for conference sessions after the US scientist authors had been refused permission to come. Many meetings, some to train developing world researchers, have had to be cancelled.
"I really think it is shameful that they restricted the US government participation, particularly when you think they are putting so much money into the fight and people in the field who have to do the job are directly prevented from coming here," said Dr Lange.
Earlier, the editor of the Journal of the American Medical Association (Jama) had also unexpectedly spoken out. Catherine DeAngelis said that Marc Bulterys, the co-author of a Jama paper who worked for the government's Atlanta-based Centres for Disease Control (CDC), had not been allowed to accept an invitation to fly to Bangkok to talk about it.
"It stymies the ability of scientists to discuss and learn from each other," said Dr DeAngelis. "It is wrong."
She pointed out that the trip would have been paid for by the American Medical Association, not the US government. "It is an incredible example of political pettiness. It is anti-intellectual and it is interfering with scientists and the scientific process and means American government-employed scientists are not allowed to be here to share their knowledge," she said.
Behind the fracas lies the gulf between the US policies on tackling HIV/Aids in the developing world and those of Aids activists who tend to dominate the big international event. Two years ago, Mr Thompson tried to give a speech at the conference in Barcelona but was rendered inaudible by noisy protests. This year the organisers have asked activists to be more civil and allow those with whom they disagree to be heard.
Although the US has put more money into the fight against HIV/Aids than the rest of the world put together, including $15bn (£8.5bn) pledged by President Bush in January last year, activists are unhappy with the way the money is to be spent. Most of it will go to American-instigated programmes in 15 selected countries which stress the so-called ABC philosophy - abstinence, be faithful and condoms "where appropriate".
Peter Piot, executive director of UNAids, said last week that abstinence, particularly for women in southern Africa, was often not an option.
Randall Tobias, the former head of the pharmaceutical firm Eli Lilly, who runs the president's plan for Aids relief, heads the US team in Bangkok. Yesterday he said he had "a very large delegation" with him.
The CDC had offered another scientist instead of Dr Bulterys, he said. "It is true that the person who was the author was not part of the delegation but we offered another scientist and they declined," he said.
The significance of the conference was emphasised at the opening ceremony by Joep Lange, president of the International Aids Society. The Bangkok event is the first in the Aids-hit developing world since the conference in Durban, South Africa, in 2000.
"Durban was a watershed event that catalysed many developments," he said. Prices of Aids drugs came down, fundraising was stepped up and there are now plans to put millions on treatment.
"Like Durban, Bangkok could be a watershed event," he said. "The conference is strategically located in Asia, the most populous continent in the world and home to a quarter of all new HIV infections. Asia still has the opportunity to prevent the epidemic from getting completely out of hand."
Kofi Annan, UN secretary general, called for leadership from all parts of governments, all the way to the top, which has not been seen in all Asian countries, just as African leaders took years to recognise the crisis and speak out against stigma. "Aids is far more than a health crisis. It is a threat to development itself," he said.
Leadership was one of three priorities he defined. He also called for infrastructure to be scaled up in Aids-hit countries to allow more people to be treated and he called for a better deal for women who are unable to defend themselves against unsafe sex because of poverty, abuse, violence and coercion by older men. "What is needed is the education of girls," he said.

http://www.guardian.co.uk/aids/story/0,7369,1259156,00.html

Top Bush Administration Member on HIV-AIDS Policy
Also Heads Drug Industry Front Group Opposing Generics

With the 15th International AIDS Conference underway in Bangkok, American policy watchdogs charged today that the Bush administration is implicated in a conflict of interest with the drug industry...

http://www.accuracy.org/press_releases/PR071504.htm

How did the government prevent them from going? Did they deny them visas to travel there? Is the government telling people where they can and can't go now...besides to Cuba?
It says the AMA was paying for it so it wasn't like the admin just refused to pay...strange.