As Think Progress and CREDO pointed out, George Bush shouldn’t have been quite so smug in his State of the Union address. They list some of the ways that US money is undermining progress against HIV. But I’m afraid they’ve missed some other gems that the administration has thrown up in the way of effective HIV prevention.
One is the Loyalty Oath. Different from the gag rule, the Loyalty Oath prevents organisations that accept any funding from the US from working constructively with sex workers, because it prevents us from recognising sex work as a legitimate way of making a living. The restriction applies not just to US money, but to ANY money. i.e. if a government accepts US money to do abstinence programmes, it is not allowed to use its own taxpayers’ money to improve working conditions in the sex trade. Some governments have the balls to treat this violation of their sovereignty with the contempt it deserves. Brazil, for example, turned down US$ 40 million dollars of US “aid” money for HIV prevention because it wanted to continue to engage prostitutes in prevention programmes as grown-ups making independent economic choices, rather than as simple victims of trafficking.
The second is the prohibition on spending money on clean needles for injectors. In most of Asia and much of Latin America, drug injection is the major driver of HIV infection. It has recently surfaced as well in Nigeria, South Africa and Tanzania, which are already struggling to deal with sexual infections. Sterile needle programmes are one of the most effective, and cost-effective, HIV prevention strategies. But under current US policy we can’t use them. We’ll give expensive, US-made pharmaceuticals to people once they are infected, but we won’t stop them getting infected in the first place. Go figure.
It’s easy (and quite correct) to bash the Bush administration for this folly. But remember that the law that authorised this spending was passed by a congress that contained an awful lot of Democratic congressfolks.