There has been more debate in Congress about the effectiveness of sexual abstinence versus use of condoms in the global fight against AIDS. The issue was discussed at length during a congressional hearing Wednesday which heard from U.S. global AIDS coordinator, Randall Tobias, and representatives of non-government organizations.
In approving President Bush's Emergency Plan for AIDS Relief in 2003, Congress directed that money designated for the $15 billion five-year initiative follow the ABC model, noted for its effectiveness in Uganda.
In public testimony, Mr. Tobias and other officials have reiterated that ABC, which stands for Abstinence, Be Faithful, Condoms, is the foundation of the U.S. program.
But ongoing debate in Congress over this approach to AIDS prevention continues to be marked by sharp ideological disputes between conservatives who favor abstinence and those who believe condom use is the best method to control the spread of AIDS.
Some lawmakers allege that money has been going to organizations known for emphasizing condom use, rather than to those favoring abstinence. Others insist that money should go only to groups promoting the A, B and C components equally.
Committee chairman Henry Hyde laid out his concerns at the hearing of the House International Relations Committee.
"Organizations best suited to promote A and B programs, such as faith-based and indigenous organizations, are often not the ones implementing these programs,” he said. “Instead, organizations long associated with the social marketing of condoms are given much of the funding for AB programs. This must not continue."
Mr. Hyde urges the Bush administration to direct more resources to pro-abstinence groups, which he says should be the key instruments to preventing the spread of HIV/AIDS.
More of the flavor of this debate played out as AIDS coordinator Tobias was questioned by Congressman Tom Lantos, a Democratic co-sponsor of the original AIDS funding legislation:
TOBIAS: "Organizations are expected not to provide or put out information that is simply not factually correct about A, or about B, or about C. That is our policy and we're doing our best to implement that.”
LANTOS: "With all due respect Mr. Tobias you did not answer my question. If an organization publicly announces that condoms do not protect young people from HIV/AIDS and demonstrably engages in the public burning of condoms, would such actions make them ineligible for U.S. taxpayer funds?
TOBIAS: "Well, based on the facts as you have represented them, I would think it would."
Among witnesses at Wednesday's hearing was Martin Ssempa, Director of Uganda's Makerere Youth Ministry and Representative to the AIDS Task Force headed by the wife of Uganda's president:
"I mince no words when I address my fellow Ugandans every day, and I mince no words with you. The reasons why other Africans and Ugandans are dying is because of sexual promiscuity - that is what is killing us," he said.
Mr. Ssempa faced some tough questions from one lawmaker who asked whether he had burned condoms. He said he was responding to a government directive to destroy inferior condoms that posed a hazard to the public.
Witnesses also addressed the growing impact AIDS is having on women around the world, particularly in Africa, urging that more money be directed at issues such as sexual abuse and violence against women.
Geeta Rao Gupta, President of the International Center for Research on Women, says the ABC approach alone is insufficient to deal with the widening scope of the AIDS pandemic, particularly in Africa where U.N. statistics show women and girls make up almost 57 percent of more than 25 million people living with AIDS:
"This inexorable rise in infections among women demands special attention and immediate action, action that must go beyond the ABC approach,” she said. “That approach, while necessary to contain the AIDS epidemic, is not sufficient to address the underlying vulnerabilities that contribute to women's risk of infection."
Further underscoring emotions over AIDS funding and prevention, protesters briefly interrupted the testimony of AIDS coordinator Tobias shouting, "Abstinence only is just a dream, marriage is not a vaccine."
As part of the U.S. initiative, which includes support for the Global Fund on AIDS, the United States is providing $2.8 billion in 2005.
But private groups warn although money has helped set up thousands of clinics and helped treat many with antiretroviral drugs, infection rates continue to rise and more needs to be done, especially in strengthening indigenous and local efforts to fight the disease.