Editorial: Struggling over aid for AIDS

Thursday, April 6, 2006 | 6:50 a.m.

President Bush's $15 billion global AIDS relief plan's emphasis on sexual abstinence and faithfulness to one partner is hobbling prevention efforts in Third World countries.

According to a report released Tuesday by the Government Accountability Office, which investigates federal programs for Congress, AIDS prevention teams in 17 of the 20 countries that receive U.S. financial aid say delivery of effective programs is difficult because a requirement to integrate such efforts with local cultural norms typically conflicts with the ideological requirements attached to the money.

The strategy for the president's Emergency Plan for AIDS Relief, established in 2003, is based largely on the so-called "ABC model," which the GAO says stands for "Abstain, Be faithful or use Condoms." A congressional directive requires that $1 of every $5 reserved for AIDS relief be spent on prevention efforts. And a third of the prevention money must promote sexual abstinence until marriage and fidelity to one partner - a practice that isn't always the cultural norm in some countries.

Some workers say they have been forced to cut prevention programs to avoid breaking one rule or the other, the GAO reports. The GAO recommended that the global AIDS office clarify the rules and investigate the effects of the spending requirements.

If the United States truly wants to help curb AIDS in developing countries, it must deliver aid in a manner that exhibits some level of respect and understanding of these nation's cultures.