A detailed independent assessment of President Bush's program to fight against AIDS worldwide effort gives high marks for its aggressive attempts to fight the epidemic in poor countries. But the report, released today, also criticized the initiative to allow politics to dictate how aid is distributed.
15Bush first announced the plan of its emergency Chairman for the fight against AIDS Relief (PEPFAR) in 03. The 5-year, $ billion initiative is to limit HIV infection in the world and to ensure the best care for those who have developed AIDS.
in many ways, the plan was a success, said the report, written by a committee of the Institute of Medicine (IOM). For example, the program has provided anti-HIV drugs to more than 800,000 people infected. It has also funded efforts to prevent transmission from infected mothers to their babies, training for health workers and community education. "PEPFAR has made a promising start," said the president of Jaime Sepulveda Committee, visiting professor in the Global Health Program at the University of California, San Francisco.
But there were problems with the how PEPFAR was implemented, Sepulveda said. When the US Congress authorized PEPFAR, he made several controversial provisions on how the money could be spent, including detailing the percentage of funding should go to abstinence-only education, limiting who can receive condoms and support ban on needle exchange programs. the IOM report recommends that Congress remove these provisions by stating that "allowances rigid budget "have" limited capacity to adapt its PEPFAR activities in each country to the local epidemic. " Sepulveda, for example, noted that Vietnam - one of 15 "focus countries" that PEPFAR funds the most strongly -. At an epidemic driven mainly by injecting drug use, which could benefit from the exchange needle efforts
The panel also recommended that PEPFAR "should work to support" a World Health Organization program (wHO), which tests and "pre-qualified" anti-HIV drugs at low cost. PEPFAR has angered the country by requiring them to use only drugs approved by the US Food and drug Administration, the report noted cost up to three times more than generic drugs wHO prequalified.
US Ambassador Mark Dybul, who oversees PEPFAR, welcomed the report. He said that recommendations for budget allocations start "a conversation important to have ", but insisted that PEPFAR is customized programs for each country. it also took exception to the idea that drugs approved by the FDA are more expensive. This question, he said, "evaporated" because the FDA today approved 41 generic versions of anti-HIV drugs. He said there is also a misunderstanding about the limits on the promotion of condoms and abstinence-only programs, which are largely limited to 10 to 14 years.
Chris Beyrer, an epidemiologist at Johns Hopkins University in Baltimore, Maryland, who works in many developing countries and has been critical of PEPFAR in the past, also welcomed the report. "This is an opportunity to really do things with this program and especially correct what has not worked," he said.
Related Sites
- More details on the report
- PEPFAR
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