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HIV/AIDS in Africa: Bush’s Broken Promise
D uring his 2003 State of the Union address, President Bush proposed the AIDS Leadership Act, claiming that “this comprehensive plan will prevent seven million new AIDS infections, treat at least two million people with life-extending drugs, and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS.” He touted the success of this 5-year, $15 billion initiative in his 2007 State of the Union speech when he said that “the number of people receiving life-saving drugs has grown from 50,000 to more than 800,000 in three short years.”
Many are unaware that these efforts were largely spurred by Bush’s “Christian supporters [who] seldom get the credit they deserve for their role in the global fight against AIDS” ( LA Times , November 30, 2006). Also off the radar screen is one of the most controversial clauses in the AIDS Leadership Act that states that federal funding is unavailable “to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking.” Stipulations like this one, which is currently the subject of ongoing litigation, have served to undermine the potential of foreign aid to curb the epidemic of HIV/AIDS in Africa. (Note: this article is concerned with outreach to sex workers whose sexual activity is consensual.)
The manner in which wealthy countries like the United States contribute foreign aid has drawn disapproval from those saying that the amount is too little and is “primarily designed to serve the strategic and economic interests of the donor countries or to benefit powerful domestic interest groups.” To serve these interests, there are often strings attached, such as requiring governments to “open up to trade and foreign investors” and adhere to “enhanced patent protections” that prevent access to affordable medications. According to Nii Akuetteh, executive director of Africa Action, “There are conditions that are attached where the emphasis is more on countries that open up their markets so American companies can go in and privatize things like water and electrical service or have access to certain resources.” Some of the most damaging restrictions, though, are the ones reflecting moral dogma, like the sex worker clause in the AIDS Leadership Act. This clause, however, is not without precedent. Often, a designated percentage of U.S. foreign aid for HIV/AIDS prevention must be dedicated to abstinence programs, although even many mainstream experts assert that there are more effective methods.
The politicizing of foreign aid in areas of health has its roots in the Mexico City Policy initiated by Ronald Reagan in 1984. The policy prohibited recipients of U.S. international family planning funds from having anything to do with abortion, including mentioning the procedure in counseling. This “global gag rule,” retracted by Clinton but resurrected by Bush, is responsible for the closing of essential health clinics, including five in Kenya, some of which “were the only affordable reproductive health services in the area.” The AIDS Leadership Act follows this example, with devastating effects and questionable legality.
Many organizations have condemned the Act, resulting in two ongoing lawsuits brought by the Alliance for Open Society International, Inc. and DKT International, both of which have been heavily involved in preventing the spread of HIV/AIDS in Africa. Last year, over 200 charities and organizations signed a letter to Bush protesting the sex worker rule. Many of these organizations, with support from the American Civil Liberties Union, have attacked the Act for violating the First Amendment rights of U.S. organizations. According to DKT International, the Act constrains the organization’s “speech in other programs for which it does not receive federal funds and…forces [it] to convey a message with which it does not necessarily agree” ( DKT International, Inc v. USAID). Though two federal courts ruled that the Act’s policy was in violation of the First Amendment, the Court of Appeals of the District of Columbia Circuit reversed the decision in the DKT International case on February 27.
DKT International, which receives roughly 16 percent of its budget from the United States Agency for International Development (USAID), refused to sign the pledge because it would result in “stigmatizing and alienating many of the people most vulnerable to HIV/AIDS—sex workers.” This concern was echoed by the 25 organizations that signed the ACLU’s friend-of-the-court brief, including such varied voices as the American Foundation for AIDS Research, American Jewish World Service, Physicians for Human Rights, and Dr. Jim Young Kim, chair of the Harvard Medical School Department of Social Medicine. According to the ACLU, “Many organizations that work to prevent the spread of HIV/AIDS often reach out to commercial sex workers to distribute condoms and offer education on safer-sex measures.”
This point was emphasized by Chris Beyrer, the director and founder of the Center for Public Health and Human Rights at the Johns Hopkins Bloomberg School of Hygiene and Public Health, in a declaration to the court in Alliance for Open Society International, Inc. v. USAID . Beyrer cites USAID’s own research to support his claims: “Providing sex workers with access to education, condoms, and other prevention tools is very effective in curbing the spread of the disease within this community and the general population. It is essential to involve members of the target high-risk community, such as sex workers, in delivering the message of HIV/AIDS prevention.” It was USAID, in fact, that released valuable information on the ways in which stigma and discrimination “push people in high-risk groups (e.g., sex workers, injecting drug users) underground, making them difficult to reach through prevention programs and thus creating more opportunities for HIV/AIDS to spread to the general population.” Though the political aspects of this debate are highly contro- versial, there is a near consensus among health experts that the pledge in the AIDS Leadership Act is misguided and harmful.
Most experts agree with Paul Zeitz of the Global AIDS Alliance who says that the most rapidly growing HIV/AIDS epidemics “are happening among sex workers in developing countries, yet the Bush administration policy would create an even bigger crisis.” Organizations like DKT International do most of their work in these vulnerable nations, such as Sudan and Ethiopia, which have some of the highest rates of infection. According to Beyrer, groups including the World Health Organization, UN- AIDS, and the World Bank have promoted working with commercial sex workers as an effective strategy to fight the epidemic. Evidence of this effectiveness is clear in nations like Brazil (which has refused to accept $40 million in American aid because of the restrictions) and Thailand, the latter having seen rates of infection in soldiers peak at over 12 percent in 1991 and then fall to under 1 percent 10 years later, due to programs involving outreach to sex workers.
Not only have organizations seen success with these tactics, but sex workers have formed their own coalitions to battle the virus. Women in the Indian state of Maharashtra created the organization SAN- GRAM, “a collective of female sex workers that grew to include thousands of members.” SANGRAM has worked extensively against the spread of HIV, leading to a number of international awards for their positive results. Despite these proven strategies, no organization receiving funding from the AIDS Leadership Act could effectively work with a group like SAN- GRAM.
The deleterious effects of attaching politically motivated strings to foreign aid are evident. The sex worker pledge in the AIDS Leadership Act could hurt states that were previously on upwards paths, such as Uganda, one of the few African countries that was reducing infection rates, but that improvement has recently deteriorated, partly as a result of U.S. policy. Stephen Lewis, the UN Secretary General’s Special Envoy for HIV/AIDS in Africa, says that U.S. cuts in funding for condoms and a focus on abstinence has contributed to a critical shortage of condoms. According to Lewis, “There is no doubt in my mind that the condom crisis in Uganda is being driven by [U.S. policies]. To impose a dogma- driven policy that is fundamentally flawed is doing damage to Africa.”
The fact that this Administration, despite these harmful restrictions and opting for political moralizing over saving lives, has done more for victims of HIV/AIDS in Africa than any previous Administration is a testament to how poorly the United States, and other wealthy nations, have done in addressing the problem. That the AIDS Leadership Act rejects the advice of health experts in order to appease those who morally object to prostitution, though, is unconscionable, if not unconstitutional. For true progress to be made against HIV/AIDS and other diseases that plague impoverished populations in Africa and elsewhere, the United States and other nations must cooperate with local coalitions and health experts, even at the expense of political gain.
Activist “die-in” at international AIDS conference in 2004—photo by Paul Jeffrey/GlobalAware
Aaron Sussman is a freelance journalist, activist, and co-founder/editor of Incite- Magazine.org. He is also a radio host, stand-up comedian, and works for a legal advocacy and civil liberties organization in New York City.
Z Magazine Archive
AnnouncementsLABOR - May 1 is May Day. Workers of the world will celebrate the 124th anniversary of International Worker’s Day. Born out of a call for an 8-hour workday in the United States, this day is an opportunity for all workers to show their solidarity with one another, as well as to renew the call for labor rights.
FARM CONFERENCE - The Farm Conference on Community and Sustainability will be held May 24-26 in Summertown, TN, in partnership with the Fellowship of Intentional Communities. Tour green homes, see sustainable food production, learn about solar installations, alternative education, midwifery, and more.
Contact: Douglas@thefarmcommunity.com; http://www.thefarmcommunity.com/.
PALESTINE - The Conference of the Palestinian Shatat in North American will be held June 3-5 in Vancouver. The conference will examine the future of the Palestinian liberation movement.
Contact: firstname.lastname@example.org; http://www.palestinianconference.org/.
LABOR - The Pacific Northwest Labor History Association’s 45th annual conference will be held May 3-5, in Portland, OR. This year’s theme is Labor Under Attack: Learning from the Past and Preparing for the Future. A call for presentations, workshops and papers is currently underway.
Contact: PNLHA, 27920 68th Ave. East, Graham, WA 98338; 206-406-2604; PNLHA1@aol.com; http://www3.telus.net.
MARIJUANA - On the first Saturday of May marijuana legalization activists will hold informational and educational events, rallies and marches in over 300 cities around the world.
ECONOMICS - The Union For Radical Political Economics will hold its 39th annual conference May 9-11 in New York City.
RECLAIM THE DREAM - The 2013 Poor People’s Campaign & March from Baltimore to Washington D.C. will be May 11. Communities, schools and unions interested in participating are encouraged to contact the Baltimore People’s Assembly.
Contact: 410-500-2168; 410-218-4835; BaltimorePeoplesAssembly@gmail.com; Southern Christian Leadership Conference of Baltimore and the Baltimore Peoples Power Assembly, 2011 N. Charles St., Baltimore, MD 21218.
MOTHER’S DAY - The 17th Annual Mother’s Day Walk For Peace will be May 12th, in Dorchester, MA. The walk began in 1996 for families who had lost children to violence. The day has become a way for thousands of people to financially support the work of the Louis Brown Peace Institute.
Contact: http://www.ldbpeaceinstitute.org/; http://mothersdaywalk4peace.org/.
NATO 5 - An International Week of Solidarity with the NATO 5 has been called for May 16-21. Supports call on supporters to raise awareness of the NATO 5 and support funds for the defendants on the one-year anniversary of their preemptive arrests.
Contact: email@example.com; https://nato5support.wordpress.com.
MOUNTAINTOP - The 2013 Mountain Justice Summer Activist Training Camp will be held May 19-27 in Damascus, VA. It will be a week of workshops, field trips to view Mountain Top Removal coal mines, direct actions, and service project.
FEMINIST SCI-FI - The feminist science fiction convention WisCon 37 is scheduled for May 24-27 in Madison, WI.
Contact: WisCon, ? SF3, PO Box 1624, Madison, WI 53701; firstname.lastname@example.org; http://www.wiscon.info/.
ANARCHY FEST - A month-long Festival of Anarchy is scheduled for May in Montreal. The festival includes The Montreal Anarchist Bookfair (May 19-20).
Contact: http://www.anarchistbookfair.ca/; http://www.radicalmontreal.com/.
LABOR - The International Labor Rights Forum will present: Down the Supply Chain, Driving Corporate Accountability, on May 22 in Washington, DC. The Labor Rights Awards Ceremony and Reception will honor pioneers in supply chain worker organizing, working solidarity and international labor rights policy.
MULTICULTURE - The 26th annual National Conference on Race & Ethnicity in American Higher Education (NCORE) will take place May 28-June 1, in New Orleans.
Contact: SWCHRS, 3200 Marshall Avenue, Suite 290, Norman, OK 73072; 405-325-3694; email@example.com; www.ncore.ou.edu.
MEDIA - The 2013 Alliance for Community Media Annual Conference will be held May 29-31, in San Francisco, CA. Participants will include educators, community leaders, media professionals, journalists, nonprofit leaders, policymakers and students.
RADIO - The 38th Annual Community Radio Conference is schedule for May 29-June 1, in San Francisco, CA, with discussions and workshops.
Contact: 1101 Pennsylvania Ave. NW, Suite 600, Washington, DC 20004; 202-756-2268; firstname.lastname@example.org; http://www.nfcb.org/.
BRADLEY MANNING - On June 1, a rally will be held at Fort Meade in support of Bradley Manning.
BIKES - Bikes Not Bombs is holding its 24th annual Bike-A-Thon and Green Roots Festival in Boston, MA on June 3, with several bike rides scheduled, music, exhibitors and more.
Contact: Bikes Not Bombs, 284 Amory St., Jamaica Plain, MA 02130; 617-522-0222; email@example.com; www.bikesnotbombs.org.
LEFT FORUM - The 2013 Left Forum will be held June 7-9, at Pace University in New York City.
Contact: 365 Fifth Avenue, CUNY Graduated Center, ? Sociology Dept., New York, NY 10016; http://www.leftforum.org/.
VEGAN FEST - Mad City Vegan Fest will be held in Madison, WI, June 8. The annual event features food, speakers, and exhibitors.
Contact: 122 State Street, Suite 405 B, Madison, WI 53701; firstname.lastname@example.org; http://veganfest.org/.
ADC CONFERENCE - The American-Arab Anti-Discrimination Committee (ADC) holds its annual conference June 13-16, in Washington, DC, with panel discussions and workshops on civil rights, media and other topics.
Contact: 1990 M Street, Suite 610, Washington, DC, 20036; 202-244-2990; email@example.com http://convention.adc.org/.
CUBA/SOCIALISM - A Cuban-North American Dialog on Socialist Renewal and Global Capitalist Crisis will be held in Havana, Cuba, June 16-30. There will be a 5 day Seminar at University of Havana, plus visits to a cooperative, urban garden, community development project, social research centers, and educational & medical institutions.
Contact: firstname.lastname@example.org; http://www.globaljusticecenter.org/.
NETROOTS - The 8th Annual Netroots Nation conference will take place June 20-23 in San Jose, CA. The event features panels, trainings, networking, screenings, and keynotes.
Contact: 164 Robles Way, #276, Vallejo, CA 94591; email@example.com; http://www.netrootsnation.org/.
MEDIA - The 15th annual Allied Media Conference will be held June 20-23, in Detroit.
Contact: 4126 Third Street, Detroit, MI 48201; http://alliedmedia.org/.
GRASSROOTS - The United We Stand Festival will be hosted by Free & Equal, June 22 in Little Rock, Arkansas. The festival aims to reform the electoral process throughout the U.S.
SOCIALISM - The Socialism 2013 Conference is scheduled for June 27-30 in Chicago, featuring talks and panel discussions.
Contact: firstname.lastname@example.org; http://www.socialismconference.org.
LITERACY - The National Association for Media Literacy Education (NAMLE) will hold its conference July 12-13 in Los Angeles under the heading, Intersections: Teaching and Learning Across Media.
Contact: 10 Laurel Hill Drive, Cherry Hill, NJ 08003; http://namle.net/conference/.
IWW - The North American Work People’s College will take place July 12-16 at Mesaba Co-op Park in northern Minnesota. The event will bring together Wobblies from branches across the continent to learn new skills and build One Big Union.
PEACESTOCK - On July 13th, the 11th Annual Peacestock: A Gathering for Peace, will take place at Windbeam Farm in Hager City, WI. The event is a mixture of music, speakers and community for peace. Sponsored by Veterans for Peace.
Contact: Bill Habedank, 1913 Grandview Ave., Red Wing, MN 55066; 651-388-7733; email@example.com; http://www.peacestockvfp.org.
CHILDREN’S DEFENSE - July 15-19, join clergy, seminarians, Christian educators, young adult leaders and other faith-based advocates for children at CDF Haley Farm in Clinton, Tennessee, for five days of spiritual renewal, networking, movement building workshops, and continuing education about the urgent needs of children at the 19th annual Proctor Institute for Child Advocacy Ministry.
Contact: firstname.lastname@example.org; http://www.childrensdefense.org.
ACTIVIST CAMP - Youth Empowered Action (YEA) Camp will have sessions in July and August in Ben Lomond, CA; Portland, OR; Charlton, MA. YEA Camp is designed for activists 12-17 years old who want to make a difference in the world.
Contact: email@example.com; http://yeacamp.org/.
LA RAZA - The annual National Council of La Raza (NCLR) Conference is scheduled for July 18-19 in New Orleans, with workshops, presentations and panel discussions.
Contact: NCLR Headquarters Office, Raul Yzaguirre Building, 1126 16th Street, NW, Washington, DC 20036; 202-785-1670; www.nclr.org.
LABOR - The Eastern Conference For Workplace Democracy: Growing Our Cooperatives, Growing Our Communities, will be held at Drexel University in Philadelphia, PA, July 26-28.
Contact: firstname.lastname@example.org; http://east.usworker.coop/.
WOMEN/LYNNE STEWART- Radical Women is asking for support letters and cards to be sent to Lynne Stewart. Stewart is a civil rights attorney and political prisoner who is currently in jail. She has breast cancer and authorities have denied her request for transfer from her Texas prison to the New York City hospital where she received medical attention during a prior bout of breast cancer. Send messages and cards to: Lynne Stewart 53504-054, Federal Medical Center Carswell, P.O. Box 27137, Fort Worth, TX 76127.
Contact: 747 Polk Street, San Francisco, CA 94109; 415-864-1278; RadicalWomenUS@gmail.com; http://lynnestewart.org/; http://www.radicalwomen.org/.
HAITI/WOMEN - Haiti’s government is considering a legal reform measure that would prohibit and punish all sexual assault, including marital rape. MADRE and the International Campaign to Stop Rape & Gender Violence in Conflict are launching a petition to raise international support for this push to address violence against women in Haiti.
Contact: 121 West 27th Street, #301, New York, NY 10001; 212-627-0444; email@example.com; http://www.madre.org.
SYRIA/MIDDLE EAST - The Middle East Children’s Alliance (MECA) is currently seeking funds to assist more than 200,000 refugees fleeing violence in Syria.
FOLK FESTIVAL - The Falcon Ridge Folk Festival will be held August 2-4, in the Berkshires, NY.
Contact: http://www.falconridgefolk.com/; firstname.lastname@example.org.
WAR RESISTERS - The War Resisters League will hold its 90th anniversary conference, Revolutionary Nonviolence: Building Bridges Across Generations and Communities, August 1-4, at Georgetown University. The event will focus on the U.S.’ long history of antimilitarism.
Contact: 339 Lafayette Street, New York, NY 10012; 212-228-0450; email@example.com; http://www.warresisters.org.
POPULAR ECONOMICS - The Center for Popular Economics is holding its 2013 Summer Institute August 4-9 at Hampshire College in Amherst, MA. No background in economics is needed for this intensive training. This year’s theme is, The Care Economy: Building a Just Economy with a Heart.
Contact: Center for Popular Economics, PO Box 785 Amherst, MA 01004; 413-545-0743; firstname.lastname@example.org; www.populareconomics.org.
VETERANS - Veterans for Peace is holding the 28th annual convention August 6-11 in Madison, WI. This year’s theme is, Power To The Peaceful.
DEMOCRACY - The Democracy Convention will take place August 7-11 in Madison, WI. The convention brings together nine conferences including topics such as media, education, defense, race, environment and others.
MEN - The 38th National Conference on Men & Masculinity: Forging Justice: Creating Safe, Equal and Accountable Communities, presented in partnership with HAVEN, will be held in Detroit, MI, August 8-10.
Contact: email@example.com; http://www.nomas.org/.
OCCUPY - An Occupy National Gathering will be held in Kalamazoo, MI, August 21-25.
Contact: firstname.lastname@example.org; http://occupynationalgathering.net/.
COMMUNITIES - The Communities Conference is a networking and learning opportunity for co-operative or communal lifestyles, with workshops, events and entertainment; scheduled for August 30-September 2 at the Twin Oaks Community in Louisa, Virginia.
LABOR DAY - The 29th annual Bread and Roses Festival, a celebration of the ethnic diversity and labor history of Lawrence, MA, will be held September 2, in honor of the 1912 Bread and Roses Strike. There will be music, dance, poetry, drama, ethnic food, historical demonstrations, walking & trolley tours.
Contact: PO Box 1137, Lawrence, MA 01842; 978-794-1655; http://www.breadandrosesheritage.org/.
OCCUPY WALL STREET - September 17 is the two-year anniversary of the Occupy Wall Street movement. Events are planned in New York City and worldwide.
TEACHERS - The 13th Annual Conference, “Teaching for Social Justice: The Politics of Pedagogy,” will be held October 12 in San Francisco, CA. The free event features workshops, resources, and free childcare.
Contact: 415-676-7844; email@example.com; http://www.t4sj.org/.
HAITI - International Action, which brings clean water and chlorinators to Haiti, seeks office space capable of housing up to six people and their office equipment.
Contact: Zach Bremer, Zbrehmer@haitiwater.org; 202-488-0735; http://www.haitiwater.org/.
MEDIA - The Union for Democratic Communications and Project Censored are sponsoring a joint conference on media democracy, media activism and social justice to be held November 1-3 at the University of San Francisco. Proposals for presentations, workshops and panels from activists and critical scholars are invited.