Bush's AIDS Speech Rhetoric

Philadelphia   June 23, 2004

yada yada yada    Bush gave a Speech on AIDS                                      -- analyses below --

Bush Speech Talks of 'Immediate Release' of $500M to 15 PEPFAR Countries, $20M to ADAP Program

President Bush in Philadelphia on Wednesday said he would seek the "immediate release" of $500 million as part of the President's Emergency Plan for AIDS Relief, amid criticism that the program is "moving too slowly," USA Today reports (Benedetto, USA Today, 6/24). Bush, speaking about HIV/AIDS and "compassion" at Greater Exodus Baptist Church in Philadelphia, said that $500 million is "on its way" and called on Congress to release the funding. He said the grants will provide more antiretroviral treatment, promote prevention efforts and provide care for AIDS orphans. The president also said that some of the money will go toward building countries' infrastructures because "part of the challenge we face is to help poor countries have the capacity to absorb the drugs and compassion of America." He added, "[W]e really don't care here in America if it takes a bicycle or a moped to get antiretrovirals out of these big cities, but that's what we're going to do." Bush said he wants to "make sure the resources [for PEPFAR] keep coming on a timely basis" (White House transcript, 6/23). PEPFAR this year has allocated $350 million to combat HIV/AIDS for the 15 eligible "focus countries," the Philadelphia Inquirer reports (Fitzgerald, Philadelphia Inquirer, 6/24). Tom Flavin, spokesperson for Ambassador Randall Tobias, head of the State Department Office of the Global AIDS Coordinator, said that the $500 million in grants will be distributed to focus countries "in a matter of days to a variety of organizations," the San Francisco Chronicle reports. Flavin added that the combined programs under PEPFAR should provide antiretroviral treatment to 200,000 HIV-positive people by the end of the year, according to the Chronicle.


As expected, Bush also announced that Vietnam will be the 15th country to receive funding under PEPFAR, the Chronicle reports (Russell, San Francisco Chronicle, 6/24). PEPFAR originally included 12 African nations -- Botswana, Ethiopia, Cote d'Ivoire, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia -- and Haiti and Guyana in the Caribbean. Although currently there are about 130,000 HIV-positive people in Vietnam, some analysts predict that number could increase eight-fold to one million people by 2010. If the projections are correct, the increase would be greater than predicted increases in India, Russia or China, which are three of the countries considered to be in the next wave of the pandemicc. The country could be considered a controversial choice because some lawmakers had called for the president to select India as the next focus country (Kaiser Daily HIV/AIDS Report, 6/23). State Department spokesperson Richard Boucher said, "Swift, focused American action can radically change Vietnam's disease" (State Department release, 6/23).

ADAP Funding

The president also announced that the administration would make available $20 million for AIDS Drug Assistance Programs in states with waiting lists for HIV-positive people to receive antiretroviral drugs, the AP/Las Vegas Sun reports (Lindlaw, AP/Las Vegas Sun, 6/23). ADAPs -- which are supported with both state and federal Ryan White CARE Act funds -- provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 6/23). Bush said that the administration would "divert" the money from an "unrelated health program" to provide assistance to 10 states that have ADAP waiting lists and "chronically overstretched" programs, the Washington Post reports (Goldstein, Washington Post, 6/24). Bush said that several state ADAPs have "long lines" for antiretroviral drugs, which "seems like a problem that [the administration] can deal with, [a]nd we're prepared to help deal with it." The president added, "It's one thing to spend money, it's another thing to spend it wisely" (White House transcript, 6/23).

Ryan White CARE Act

During his speech, the president also pointed to his support for the reauthorization of the Ryan White CARE Act, the federal law that authorizes spending for HIV/AIDS treatment and prevention programs in the United States (Kaiser Daily HIV/AIDS Report, 6/23). Bush said that the measure "takes too little account of the most urgent needs" of people living with HIV/AIDS, according to the Post. He added that the administration should have increased authority to determine how funding is distributed, with more focus on subsidies for medicine and doctor visits, the Post reports (Washington Post, 6/24). Bush proposed making the measure "stronger and more effective by focusing resources on life-extending care, such as antiretroviral drugs and doctor visits and lab tests." He said that this "kind of care was just a dream 20 years ago" but "is a reality today," adding that the administration will "work with Congress to make sure that as many patients as possible are receiving the modern care they deserve." Bush also said that the "rigid geographical formula" that is used to make decisions for Ryan White funding should be changed to allow the administration to "set priorities" for funding because some areas of the country face "more severe" HIV/AIDS case loads. Bush said that HHS Secretary Tommy Thompson should have the "flexibility to cut through the red tape and get the money quickly to where it is needed," adding that the government also should "hold accountable" groups that receive federal funding for HIV/AIDS projects by monitoring their progress (White House transcript, 6/23).

Faith-Based Programs

Bush also focused on the "value" of faith-based groups as providers of HIV/AIDS care, according to the Chronicle (San Francisco Chronicle, 6/24). Bush said that for many people living with HIV/AIDS -- particularly those in low-income or rural communities -- local church programs are "their only source for treatment and support." He added that faith-based programs "deserve the support of our government when they're effective, not to be discriminated against" because they are associated with a religion. "People shouldn't fear the fact if there's a cross on the wall and an AIDS program in that building. We ought to welcome that. We ought not to fear the Star of David on a wall and an AIDS program ensconced in the building ... because the motivation by the people of faith is a motivation to help heal the hurt," Bush said, adding, "The faith-based groups are making a huge difference on the continent of Africa; they need to be making a huge difference here at home, as well" (White House transcript, 6/23).


According to the New York Times, Bush for the first time said that the United States should "learn from the experience" of countries like Uganda and support condom use as part of an HIV/AIDS prevention program. Speaking about domestic prevention programs, Bush said, "We can learn from the experiences of other countries when it comes to a good program to prevent the spread of AIDS, like the nation of Uganda. They've started what they call the 'ABC' approach to prevention of this deadly disease. That stands for: Abstain, Be faithful in marriage, and, when appropriate, use Condoms." Bush added that Uganda's program is a "practical, balanced and moral message," according to the Times. His comments "appeared to be offering something to both sides of the debate: his base of social conservatives as well as moderates ... who have argued that [he] has been too slow to embrace effective methods of preventing" HIV transmission, the Times reports (Sanger/McNeil, New York Times, 6/24). The law (HR 1298) authorizing the President's Emergency Plan for AIDS Relief endorses the ABC HIV prevention model and specifies that one-third of the bill's HIV/AIDS prevention funding should be used for abstinence and monogamy programs (Kaiser Daily HIV/AIDS Report, 4/22). A Population Action International study in 2002 found that developing nations need 10 billion condoms a year but only receive 2.5 billion, the Times reports. However, the United States is the largest provider of condoms -- USAID donated 458 million condoms to developing countries in 2003 and is on track to distribute 550 million in 2004, according to USAID Assistant Administrator for Global Health Dr. Anne Peterson. The ABC prevention approach is "a science-based approach and for that reason is to be applauded," Mark Isaac , Elizabeth Glaser Pediatric AIDS Foundation policy director, said. However, PAI President Amy Coen said, "[I]t's one thing to use the word and another thing to actually fund it" (New York Times, 6/24).

Protests, Reaction

About 150 people from several HIV/AIDS, labor and religious groups -- including ACT UP/Philadelphia -- protested outside the venue where Bush spoke, the Inquirer reports. Approximately 40 members of ACT UP/Philadelphia stood in front of a banner that said "Bush: Thou Shalt Not Lie About AIDS Funding" and tore up a fake $15 billion check addressed to "Big Pharma and Right Wing Extremists," according to the Inquirer (Philadelphia Inquirer, 6/24). Some HIV/AIDS advocates said that the president "shortchanged" prevention and treatment programs associated with the Global Fund to Fight AIDS, Tuberculosis and Malaria to focus on faith-based programs that stress abstinence, according to the Los Angeles Times. Health GAP Director of International Policy Asia Russell said that Bush's "stubborn and cruel unilateralis[t]" policy is "unfortunately ... costing the lives of people with AIDS" (Kemper/Wallsten, Los Angeles Times, 6/24). Terje Anderson, executive director of the National Association of People Living With AIDS, said that Bush is treating social services for HIV-positive people as "somehow icing on the cake" (Washington Post, 6/24).

'More Than Talk'

Presumptive Democratic presidential nominee Sen. John Kerry (Mass.) said in a statement that Bush "needs to do more than talk," according to USA Today (USA Today, 6/24). He added, "It is long past time for empty rhetoric on this issue. It is time for real resources and a real commitment that is based on science -- not politics -- to fight this epidemic" (Entous, Reuters, 6/24). AIDS Healthcare Foundation President Michael Weinstein said, "If the president's program is to be judged on the basis of lives saved, then it cannot possibly be considered a success at this point," adding that more than one year after PEPFAR was announced, the United States is providing treatment for only 2,000 people in developing countries (AHF release, 6/23). "It's critical to have AIDS leadership at the highest levels of government if our efforts are to be effective," The AIDS Institute Director of Federal Affairs Carl Schmid said, adding that although TAI does not "support all of the administration's policies on domestic and global AIDS, we commend the administration for their continued efforts to address a pandemic affecting some 46 million people worldwide" (TAI release, 6/23).

PBS' "NewsHour with Jim Lehrer" on Wednesday reported on Bush's speech on HIV/AIDS. The segment includes comments from Bush and Kerry (Holman, "NewsHour with Jim Lehrer," PBS, 6/23). The complete segment is available online in RealPlayer.

 -- analyses --

Bush panders to his Conservative Base.

(Bush SPEECHES always seem to differ from his ACTIONS.)

Compare the outrageous NYTimes story today on Bush's Philadelphia AIDS speech -- the Times article completely exaggerates the importance of Bush's tiny mention of the condom, doesn't even mention the demonstration outside the speech by ACT UP et. al, and contains not a word from critics of Bush's years-long war on the condom -- with the Philadelphia Inquirer infinitely more "fair and balanced" coverage:

Philadelphia Inquirer Editorial
Bush and AIDS Funding: Match deeds with words

President Bush will be in North Philadelphia today paying his second visit to the Rev. Herb Lusk 2d and his Greater Exodus Baptist Church.

The church and its Stand for Africa Crusade help African AIDS orphans. The President is expected to talk about compassion for the millions afflicted with the disease worldwide. He may also announce that Vietnam will be added to the list of 14 nations in line to receive money from his $15 billion global AIDS initiative.

It's good that Bush has declared HIV/AIDS to be one of his administration's top international priorities. Not only good but necessary - the fight against AIDS around the globe would suffer if the richest and strongest nation in the world turned its back on a disease that kills 8,000 people a day.

Mr. Bush needs to make a monetary commitment that's equal to his moral commitment.

There remains too many gaps between the President's fine intentions to combat AIDS and his administration's actual deeds.

The White House's follow-through on international HIV/AIDS funding has always fallen short of its rhetoric. Bush's promise to spend $15 billion over five years started out last year with his administration asking Congress for only $2 billion instead of the $3 billion that works out to the yearly funding. Congress, thankfully, raised the figure to $2.4 billion. This year, Bush is getting closer - but not achieving - that

$3 billion per year with a $2.8 billion request.

The White House explanation is that more money should be delivered toward the initiative's end because 14 African and Caribbean nations can't handle too much money too soon.

Considering Bush says he understands the urgency of this health crisis, it's reasonable to think the White House would send more money to the established, public-private partnership known as the Global Fund to Fight AIDS, Tuberculosis and Malaria. Programs already are up and running through it; an infrastructure exists for channeling money and supplies.

Yet the White House is scaling back that commitment, too. Congress approved $550 million this year for the Global Fund, which serves more than 120 AIDS-afflicted nations. Bush seeks only $200 million. The United States is sidelining this innovative cooperative program while pushing its own, underfunded AIDS effort.

The administration has also slowed the delivery of generic combination drugs to HIV/AIDS victims overseas.

It's worth cheering that the United States will pay for the drugs. But it has now mandated another layer of FDA approval even though the World Health Organization has endorsed the medications. Even a day's delay in delivery
means many more deaths.

Mr. President, the AIDS victims you want to help need more than your heartfelt words. They need your actions, in deeds and in dollars.

The election-year hypocrisy of Bush's Philly speech is, of course, underscored by the CDC's move last week to gut safe-sex education and require that kids be taught that condoms don't work, as well as by the long history of handing AIDS funding over to anti-condom "faith-based groups" both domestically and globally.

JUNE 25 - JULY 1, 2004   LA Weekly  by Doug Ireland

Condom Wars
New guidelines gut HIV prevention — and endanger young people’s lives
by Doug Ireland

Lethal new regulations from President Bush’s Centers for Disease Control and Prevention (CDC) in Atlanta, quietly issued with no fanfare last week, complete the right-wing Republicans’ goal of gutting HIV-prevention education in the United States. In place of effective, disease-preventing safe-sex education, little will soon remain except failed programs that denounce condom use, while teaching abstinence as the only way to prevent the spread of AIDS. And those abstinence-only programs, researchers say, actually increase the risk of contracting AIDS and other sexually transmitted diseases (STDs).

Published on June 16 in the Federal Register, the censorious new CDC guidelines will be mandatory for any organization that does HIV-prevention work and also receives federal funds — whether or not any federal money is directly spent on their programs designed to fight the spread of the epidemic. (The CDC is the principal federal funder of prevention education about HIV and AIDS, and its head a Bush appointee). It’s all couched in arcane bureaucratese, but this is the Bush administration’s Big Stick — do exactly as we say, or lose your federal funding. And nearly all of the some 3,800 AIDS service organizations (ASOs) that do the bulk of HIV-prevention education receive at least part of their budget from federal dollars. Without that money, they’d have to slash programs or even close their doors.

These new regs require the censoring of any “content” — including “pamphlets, brochures, fliers, curricula,” “audiovisual materials” and “pictorials (for example, posters and similar educational materials using photographs, slides, drawings or paintings),” as well as “advertising” and Web-based info. They require all such “content” to eliminate anything even vaguely “sexually suggestive” or “obscene” — like teaching how to use a condom correctly by putting it on a dildo, or even a cucumber. And they demand that all such materials include information on the “lack of effectiveness of condom use” in preventing the spread of HIV and other STDs — in other words, the Bush administration wants AIDS fighters to tell people: Condoms don’t work. This demented exigency flies in the face of every competent medical body’s judgment that, in the absence of an HIV-preventing vaccine, the condom is the single most effective tool available to protect someone from getting or spreading the AIDS virus.

Moreover, the CDC will now take the decisions on which AIDS-fighting educational materials actually work away from those on the frontlines of the combat against the epidemic, and hand them over to political appointees.

This is done by requiring that Policy Review Panels, which each group engaged in HIV prevention must have, can no longer be appointed by that group but must instead be named by state and local health departments. And those panels must then take a vote on every single flier or brochure or other “content” before it is issued.

This means that, under the new regs, political appointees will have a veto and be able to ban anything in those educational materials they deem “obscene” or lacking in anti-condom propaganda. With Republicans controlling a majority of statehouses, and having handed over control of the health departments to folks deemed acceptable to the Christian right and cultural conservatives in many Southern and Midwestern states — and the rest of public-health departments notoriously subservient to political pressure from the state and local legislatures that control their appropriations — anti-condom junk science that plays politics with people’s lives will rule the day.

Under the new regs, it will be impossible even to track the spread of unsafe sexual practices — because the CDC’s politically inspired censorship includes “questionnaires and survey materials” and thus would forbid asking people if they engage in specific sexual acts without protection against HIV. For that too would be “obscene.” (Questions about gay kids have already disappeared from the CDC’s national Youth Risk Survey after Christian-right pressure).

So what will be left?  Why, the abstinence-only ed programs dear to Bush’s heart and to the Christian right. A third of all federal HIV-education money — some $270 million more in Bush’s latest budget — now goes to abstinence-only programs, almost universally to Christian groups as part of Bush’s “faith-based initiatives” (no Jewish or Muslim groups receive any funds). This is a brilliant maneuver — Bush has turned money earmarked for fighting AIDS into political pork for his Christer base. Much of this money goes to anti-abortion groups masquerading as “women’s health” or “crisis-pregnancy” centers. Others receiving such funds engage in religious propaganda — a federal judge found that Louisiana’s federally funded Governor’s Program on Abstinence illegally handed out Bibles, staged anti-abortion prayer rallies outside women’s clinics, and had students perform Bible-based skits.

Yet Bush’s Health and Human Services Department refused demands to audit the Louisiana program, while at the same time conducting repeated harassing audits of effective AIDS-fighting groups that have vigorously protested Bush policies on AIDS, like New York’s Gay Men’s Health Crisis and San Francisco’s Stop AIDS Project. (The latter lost its federal funding earlier this year for sex-ed thought crimes similar to those banned in the new CDC regs — a pre-emptive warning to all other ASOs to toe the Bush-Christer line — and subsequently got a $100 contribution from former Bush AIDS czar Scott Evertz, ousted by Bush’s theocrats, to help continue what he called Stop AIDS’s “good work”).

Teaching about condoms doesn’t increase sexual activity and certainly doesn’t increase unprotected sex, but abstinence-only ed does both. For example, a Minnesota Department of Health study of the state’s five-year, abstinence-only program found last year that sexual activity by students taking the program actually doubled, from 5.8 percent to 12.4 percent.

Even more alarming, a study by Columbia University Department of Sociology chairman Peter Bearman of the sex lives of 12,000 adolescents from 12 to 18 years old over a five-year period found unsafe sex much greater among youth who’d signed pledges to abstain from sex until (heterosexual) marriage (a key component of most abstinence only–based education programs, which leave gay kids, who can’t get married in 49 states, to face a lifetime of chastity).

The Columbia study, released last March and financed in part by the National Institute of Child Health and Human Development, showed that while 59 percent of teenage males who did not pledge abstinence used a condom during sex, only 40 percent of abstinence-pledging boys used a condom. As Bearman told The New York Times, telling teens “to ‘just say no,’ without understanding risk or how to protect oneself from risk, turns out to create greater risk” of HIV and other STDs. In his study, 88 percent of those who’d pledged chastity reported having sex before marriage. The large Bearman study confirms one published in the American Journal of Sociology in 2001, which showed that pent-up sexual desire and failure to realize risk exposure among students in abstinence-only programs made them a third less likely to use condoms than others, even if, on average, they began having sex a year and half later.

All those numbers help explain why the new CDC regs are causing outrage and anguish among leaders in the AIDS community. “Kids are being taught that condoms don’t work, while real life-saving HIV education is being eviscerated across the board,” fumes Sean Strub, founder of POZ, the magazine for the HIV-positive community. And, Strub points out, the Bush administration has hamstrung AIDS organizations, “which are faced with the terrible choice of prioritizing care for existing HIV-positive clients over speaking out against the new CDC rules and risking losing their federal funding.”

There’s only a tiny window of opportunity to try to get the new CDC censorship rules changed before they go into effect (the deadline for public comments is August 16 — they may be e-mailed to HIVComments@cdc.gov or faxed to 404-639-3125.) But when the regs begin to be felt, just watch already-rising AIDS infection rates really soar.


Bush's AIDS Hypocrisy Cons the NY Times   by Doug Ireland   The Nation
June 30, 2004

When President Bush gave a speech on AIDS in Philadelphia on June 23, the New York Times got all moist because he mentioned the word "condoms" just once in his speech. "Bush Backs Condom Use to Prevent Spread of AIDS," blared the Times headline on the story, signed by David Sanger and Donald McNeil Jr.

Here's what Bush actually said: "We can learn from the experiences of other countries when it comes to a good program to prevent the spread of AIDS, like the nation of Uganda. They've started what they call the ABC approach to prevention of this deadly disease. That stands for Abstain, Be faithful in marriage, and, when appropriate, use Condoms."

Well, if Messrs. Sanger, McNeil, and their editors knew anything about Administration AIDS policy--or had bothered to find out--they might have mentioned the censorious new anti-condom guidelines issued only the week before the speech, on June 16, by Bush's Centers for Disease Control, which reveal as a sham the election-year rhetoric mouthed by Bush in Philadelphia.

The new CDC regulations, published in the Federal Register, are mandatory for any AIDS-fighting organization that receives federal money for HIV prevention, and they finish the job of gutting effective, disease-preventing safe-sex education that has been a goal of the Bush Administration since it took office. Far from trying to "learn" from the Ugandans, the regs demand that any sex-ed "content" include information on the "lack of effectiveness of condom use." In other words, the Bush Administration wants AIDS-fighting organizations to tell people: Condoms don't work. At the same time, the regs mandate the teaching of the failed policy of abstinence from sex until (heterosexual) marriage.

The Times article didn't even mention these new CDC censorship guidelines, or include any comment on Bush's speech in light of them from Administration critics.They even failed to notice the large and noisy ACT-UP demonstration outside the speech. Dissent wouldn't have been hard to find: When asked about the CDC regs, Representative Barney Frank told The Nation that "one has to reach back to Stalin and Lysenko to find an ideological distortion of science this complete." And Representative Henry Waxman called the CDC guidelines "shameful," and only the latest anti-condom move by an Administration whose policies have been "overwhelmingly suppressing and distorting science" for political purposes (as a sop to the Christian right). (One example: the US coalition with Iraq and Iran to stop the UN from teaching young people about condoms--see Doug Ireland, "U.S. and Evil Axis: Allies for Abstinence," The Nation, May 16, 2002.)

The CDC is the federal government's single funder of HIV-prevention work; its current head, Julie Gerberding, is a Bush appointee, named by Health and Human Services Secretary Tommy Thompson. The new CDC regulations meticulously define the "content" they censor as including "pamphlets, brochures, fliers, curricula," "audiovisual materials" and "pictorials (for example, posters and similar educational materials using photographs, slides, drawings or paintings)," as well as "advertising" and web-based info. They not only mandate teaching about condoms' purported "lack of effectiveness," they require all such "content" to eliminate anything even vaguely "sexually suggestive" or that might be interpreted as "obscene." That would, for example, forbid teaching how to use a condom correctly by putting it on a dildo--or even on a cucumber.

And who gets to decide what sex-ed materials are "suggestive" or "obscene"? Under the new CDC regulations, decisions on which AIDS-prevention educational materials actually work will be taken away from those on the frontlines of combat against the epidemic and handed over to political appointees. This is done by requiring that Policy Review Panels, which each group engaged in HIV prevention must have, can no longer be appointed by the group--but must instead be named by state and local health departments. And those panels must then take a vote on every single flier or brochure or other "content" before they are issued. This creates a new layer of heavy-handed bureaucracy to hamstring HIV prevention ed--one that will be felt most harshly in the majority of states in which Republicans control the statehouses. Most of them have handed over control of health departments to appointees acceptable to cultural conservatives and the Christian right.

In the absence of an AIDS-preventing vaccine, condoms are recognized by every competent scientific body as the single most important way in which people can prevent getting or spreading HIV. Condom effectiveness in doing so, according to a raft of studies, is rated at 98 percent or better

"It's very clear that the mistaken impression the President supports public health science which recommends condom use was dispelled totally by the new CDC regs," says James Wagoner, executive director of Advocates for Youth, a Washington-based coalition of youth service groups and the country's leading exponent and provider of safe-sex education, calling the regulations "another installment of this Administration's anti-condom campaign over the last three years--which says that if the science doesn't fit our ideology, we'll change the science."

Wagoner contrasts the Bush war on the condom with its attitude toward seatbelts. "The National Highway Traffic Safety Administration is constantly telling Americans, 'Use Seatbelts!' It's all over their website. But the American College of Emergency Physicians concluded in a study that seatbelts fail to protect lives 55 percent of the time, and fail to protect health 45 percent of the time. For the Administration to engage in its constant drumbeat that condoms--which are not 100 percent effective for all sexually transmitted diseases but are nearly so for preventing AIDS--are 'ineffective' in HIV prevention, while promoting seatbelts as 'effective,' shows that the CDC's anti-condom requirements are all about politics, not science." And, says Mark McLaurin, HIV-prevention director for New York's Gay Men's Health Crisis, "The President's faint nod to condoms in his speech is particularly galling in light of his CDC's proposal to tie the hands of prevention providers."

Little will be left of sex ed after the CDC regs' effects are felt except the failed policy of abstinence-only--which actually increases unsafe sex. A study by Columbia University department of sociology chairman Peter Bearman followed the lives of 12,000 adolescents from 12 to 18 years old over a five-year period. Released in March, and partially funded by the National Institute of Child Health and Human Development, the study found that while 59 percent of teenage males who did not pledge abstinence used a condom during sex, only 40 percent of abstinence-pledging boys used a condom. Bearman told the New York Times that telling teens "to 'just say no' without understanding risk or how to protect oneself from risk turns out to create greater risk" of HIV and other STDs.

There's only one word to describe the effect of the new CDC guidelines: lethal. And Bush's campaign boilerplate on AIDS in Philadelphia was "Pay no attention to that man behind the curtain" bilge. Too bad the Times didn't notice.

For a complete dissection of Bush's policies in this area since he took office, see the new report on "Global Implications of US Domestic and International Policies on Sexuality.

EXCUSION of Compassionate Conservatism:  GAY MEN

Over five thousand words spoken by Bush on HIV/AIDS and not once does he mention gay men, or men who have sex with men.  Bush's HIV/AIDS advisors should be aware that in the U.S., gay and bisexual men comprise the largest category of newly HIV infected individuals, and the same goes for full-blown AIDS cases.

The president managed to give an entire speech and -- again -- never mentioned one of the biggest groups in the country affected by it. Amazing. How do his speech-writers do it? To a black audience, he had a chance to help them confront the homophobia that has crippled the black community's ability to confront the epidemic. But, of course, Bush didn't. Imagine what James Dobson would say. [Bush] also said the following: 'The second part of a domestic strategy to fight AIDS is prevention. I think it's really important for us to focus on prevention. We can learn from the experiences of other countries when it comes to a good program to prevent the spread of AIDS, like Uganda. They've started what they call the A-B-C approach to prevention of this deadly disease. That stands for: Abstain, be faithful in marriage, and, when appropriate, use condoms. That's what A-B-C stands for. And it's working. It's been called a practical, balanced and moral message.'  And yet, in one of the populations most at risk from this disease, Bush opposes any measures that would encourage marriage. In fact, he is waging a war to ban such marriages, and erase any incentives for gay men to stick together. Is Bush aware of this lacuna? If marriage cannot be a strategy for prevention among gays, then what is his prevention policy? He has none, because in order to have one, he would have to acknowledge that gay people exist - and that he is their president too. That he cannot and will not do. It's too depressing for words."       -- Andrew Sullivan

Health GAP Press Release

AIDS Activists Reject President Bush's Global AIDS Victory Claims:
Lies on Speed of Spending, Lies on Prevention, and Lies on Access to
Cheap Medicines

For Immediate Release: June 23, 2004
Contact: Sharonann Lynch: 646 645-5225, Asia Russell: 267-475-2645

(Philadelphia) President Bush claimed dramatic victories and programmatic enhancements in the battle against HIV/AIDS in a speech at a Philadelphia church. According to Health GAP, these claims are dangerously misleading - rather than responding proportionately to the worldwide AIDS pandemic, the Bush Administration continues to under-fund global need, to impose failed prevention policies, and to place road-blocks on access to the cheapest AIDS medicines.

"President Bush claims that he has mounted an emergency response, but 4.5 million people have died of AIDS since his State of the Union Address in Jan. 2001," said Sharonann Lynch of Health GAP. "Rather than investing heavily in immediate treatment and prevention services and in expanding health care capacity in poor countries, Bush has adopted a go slow approach which thus far has only disbursed a fraction of promised resources, less than $350 million of the paltry $2.4 billion appropriated for FY2004," Lynch continued. "Although he's promising to release another $500 million 'shortly,' in the meantime real people are dying," Lynch concluded.

Activists claim that the $15 billion promised by Bush over a five year period represents only half of the U.S. fair share of $30 billion needed to meet global need. They also claim that he is bypassing the multilateral Global Fund to Fight AIDS, TB, and Malaria, which will be functionally bankrupt as of 2005 because of dramatic reductions in U.S. donations (down to $200 million/year). "Bush is not investing in medical infrastructure in Africa or elsewhere," said Paul Davis of Health GAP. "Moreover, his five year plan to treat only 2 million people means that 13-15 million people with AIDS while die during that same time period. How is that a compassionate and emergent response?" Davis asked.

In addition to criticizing Bush's delayed spending, Health GAP challenged the efficacy of Bush's emphasis on abstinence only prevention messages. "Each and every scientific discovery conducted thus far has found that abstinence-only messages are less effective in preventing HIV and STDs than more balanced messages that also promote proper use of condoms," said Asia Russell of Health GAP. "Couples in Africa have access to 4.6 condoms a year - how can we argue that condoms aren't effective, when we refuse to supply them in meaningful quantities?"

The U.S. choice of Vietnam as a 15th focus country is also controversial according to Health GAP. "The U.S. focuses most of its resources on just handful of countries rather than the hundred worldwide that tottering toward disaster," said Laurie Wen of Health GAP. "There's nothing wrong with addressing the escalating HIV epidemic in Vietnam, but what about India which has 50 times as many people living with HIV or what about China or Thailand? It makes no sense for the U.S. to bypass multilateral institutions like the Global Fund that countries like Vietnam rely and then to superimpose its own unilateral programs with all their conditionalities and restrictions," Wen said. "The pandemic in Vietnam, like that in Thailand is largely driven by intravenous drug use and infection among sex workers. Yet, the U.S. program, unlike the Global Fund, prohibits harm reduction programs like needle exchange and restricts condom use. If we're going to choose countries, let's at least do something that actually helps."

Also, the activist group disputes the claims made by the White House fact sheet released today, concerning U.S. plans to allow expedited access to low-cost, easy to use AIDS medicines. "The WHO Prequalification Process has already approved nearly 90 AIDS drugs nearly half of which are manufactured by Indian generics. Rather than authorize purchase of these pre-qualified drugs, the U.S. has set up a redundant process and took 18 months to do even that," said Brook Baker of Health GAP. "Moreover, the FDA process will not be open to the newest AIDS medicines because of data protections rules that prevent even tentative approval during the first five years of a new proprietary medicine," continued Baker, a law professor at Northeastern University School of Law. "Finally, the U.S. is negotiating intellectual property protections in its free trade agreements with developing countries in Africa, Asia, and Latin America which prevent countries from using cheaper generic medicines -- expanded patent rights and enhanced protection of proprietary companies' clinical data will deal a death knell to treatment access," according to Baker.

Bush's AIDS speech comes three weeks before the XV International AIDS Conference in Bangkok and just one day before a Global Day of Action against U.S. AIDS Policies called by the Treatment Action Campaign of South Africa. Tomorrow, activists in a dozen countries and a dozen U.S. cities will be protesting U.S. policy and challenging Bush's claim to leadership on the AIDS issue.

GLOBAL AIDS ALLIANCE     David Bryden <dbryden@globalaidsalliance.org>

Bush Hurts Vietnam by Cutting Global Fund

WASHINGTON, June 22 -- Today the White House is expected to add Vietnam to the list of focus countries within the Bush Emergency Plan for AIDS Relief.

The President will also make a speech at a church in Philadelphia touting his approach to AIDS both in the US and abroad, though religious activists and others plan to picket the speech. One of the world's leading voices on AIDS, Zackie Achmat, has called the Bush Administration's approach a danger to public health and called for worldwide protests this week.

Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance, commented:

"President Bush gives with one hand while taking away with the other. Vietnam is hoping to receive $44.7 million from the Global Fund, yet the President has proposed cutting the US contribution by 64%.

"The world is looking to the US to re-prioritize global cooperation over unilateralism. Yet, how will the Global Fund continue to provide resources to Vietnam if the President succeeds with his unilateralist cuts?"

"The Congress may reject the President's proposed cut, as it did last year. But, even so, Congress is unlikely to provide much more than what the US is providing this year. France, Canada and others are already supporting the Fund, and will not make up for the resulting shortfall. As a consequence, the Fund may not be able to finance new rounds of grants next year. If this happens, the original vision of the Fund as a quantum leap forward in AIDS funding will be dead."

"While Vietnam could certainly benefit from greater US assistance, once again the US Government is setting up a parallel delivery program. The Global Fund to Fight AIDS, TB, and Malaria is already supporting large scale programs. In Vietnam, women's organizations, religious groups, universities and others took part in requesting the funds, and that collaborative model deserves US support."

"Vietnam should carefully assess the strings attached to this funding. For the foreseeable future, it will not be allowed to purchase generic fixed-dose combination AIDS medications with these funds, even though these are cheap and effective. It may have had to make other policy concessions to please the United States."

"While Vietnam needs and deserves assistance, the question must be asked, 'Why not India or China, which are facing explosive epidemics'? These countries were identified as the Next Wave crisis countries by the National Intelligence Council in an October 2002 report, and addressing the epidemic there is matter of global security."

"Secretary of State Colin Powell has called AIDS 'the greatest threat to mankind today,' yet expenditures on the war in Iraq are thirty times what the US has spent to fight AIDS over the past two years. We can agree or disagree with US policy on Iraq, but, if Powell is truly serious, how can this proportion be so far out of whack?"

most ironically, regarding the Vietnam choice:

Laurie Wen, from ACT UP and the Health Gap Coalition, noted that Vietnam's epidemic is driven primarily by the needle sharing behavior of intravenous drug users, but the president's program prohibits the use of needle exchange and other harm reduction techniques that work in that population.

President's call for $20 million for ADAP

$20 Million to the States for ADAP is a great help, but this message shows that it is more complicated than it seems, and not a real solution to the growing ADAP problem.

June 29, 2004
TO: State AIDS Directors
FR: Julie Scofield, Laura Hanen and Murray Penner
RE: President's Announcement Regarding ADAP

As you are aware, last Wednesday the President announced the bulk purchase of $20 million in drug therapies for the ten states who currently have ADAP waiting lists. These ten states are Alabama, Alaska, Colorado, Idaho,Iowa, Kentucky, Montana, North Carolina, South Dakota, and West Virginia. The Administration claims that HRSA does not have the authority to send monies to states outside of the current CARE Act distribution formulas, and therefore HHS will purchase the medications and distribute them to states. HRSA held conference calls last week with the eligible states to outline the initiative, but many questions remain.

While appreciative that the Administration publicly acknowledged the national ADAP crisis and the importance of providing life-saving therapies to low-income Americans, NASTAD is extremely concerned about the time and effort it will take to operationalize this effort. The eligible ADAPs are expected to determine, without any additional funding, the treatment regimens of over 1,600 individuals and administer the delivery of HHS-purchased therapies. These regimens will be based on the drugs currently on the state's ADAP formulary. States will be required to work with case managers and treatment providers to determine the current treatment regimens for every person on their waiting lists. While this may not be too burdensome for states with less than 10 individuals on their waiting lists, it could easily overwhelm the states which must determine the treatment needs of hundreds of clients.

Some of the questions that have already arisen are the following:
* Why were states not consulted when the Administration was developing this initiative?
* How long will these individuals receive treatment and what will happen if their treatment regimen changes over time?
* What happens when a state has a waiting list for access to Fuzeon, will HHS make Fuzeon available?
* How will this impact rebates states?
* How will states without a central pharmacy distribute the medications?
* Is it rational for HHS to purchase therapies at the federal supply schedule price, when ADAPs may already receive better prices?
* Who will pay for shipping of the medications?

States will require technical assistance to implement this unique and complex effort. NASTAD is convening a conference call on Friday with the 10 eligible states to discuss this initiative and to flesh out implementation concerns and strategies. NASTAD is committed to working with HRSA and state AIDS programs to ensure this process goes as smoothly as possible.

NASTAD is also extremely concerned that there are a number of states that are on the verge of announcing the implementation of waiting lists or who have implemented other access restrictions whose citizens will not receive this relief. There are currently ten states that have reported to NASTAD that they anticipate new or additional access restrictions before the ADAP funding year ends on March 31, 2005. NASTAD will also be convening a conference call of the states in severe need to discuss action steps in responding to the President's announcement. If you are interested in participating in this call, please contact Murray Penner or Laura Hanen if you have any questions or need additional information.

Julie M. Scofield, Executive Director, National Alliance of State and Territorial AIDS Directors
444 N. Capitol Street, NW, Suite 339   Washington, DC 20001
202.434.8090 phone    202.434.8092 fax   jscofield@nastad.org   www.nastad.org

see additional links to ADAP

What Bush SAYS is greatly different from the realities of his ACTIONS!

see Bush index :  List of AIDS Policy Bushwacks       


use back button on browser to return