L. Neil Smith's
THE LIBERTARIAN ENTERPRISE
Number 282, August 1, 2004
Happy 50th Birthday Michael Badnarik!
AIDS Efforts Undermined by U.N. Politics
Special to TLE
During the 15th International Conference on AIDS held earlier this month, the Bush administration refused to pledge an additional $1 billion to the United Nations to fight AIDS.
The U.N. expressed outrage. Instead, it should have apologized for politicizing AIDS and explained where its figures are coming from.
No one diminishes the importance of fighting AIDS. The U.S. has already committed $15 billion to be disbursed over the next five years, making it the largest contributor to the AIDS fight by far. Even that $15 billion has drawn criticism from the U.N., however, because it is earmarked for specific nations.
Politics lies at the root of the U.N.'s constant bashing of American policies. The U.N. wishes to control where and how funds are directed. The U.S. demands to have a say in how its contributions are used.
(The Bush administration has similarly refused to release $34 million in congressionally-approved funds to the United Nations Population Fund (UNPFA), which supports "women's health." The reason: the UNPFA is widely perceived to be complicit in forced abortions under China's "one-child policy." The U.N. promises that the money would not be so used, but tracking the funds would be difficult once placed in a general fund. Similar questions of the U.N.'s politics and honesty surround the AIDS issue.)
Consider the political debate surrounding what should be an issue of AIDS prevention strategy: namely, how prominently should condom use be promoted as an AIDS preventative.
The Bush administration favors the ABC approach: Abstinence, Being faithful, and Condoms. ABC has made Uganda one of the few AIDS success stories in Africa; its HIV infection rate has been reduced from an estimated 18 percent to around 6 percent. Randall Tobias, who heads the U.S. State Department's Office of the Global AIDS Coordinator, explains that the three strategies are necessary.
"They all have a role but it's not a multiple-choice test where there's one right answer; all of the things have a place..."
Nevertheless, when Ugandan President Yoweri Museveni addressed the 15th International Conference, he was roundly attacked for being successful by using the "wrong" methods. Although condoms are distributed in Uganda, Museveni caused a furor when he made the politically incorrect statement, "I look at condoms as an improvisation, not a solution."
It is difficult to understand the furor his statement created unless you realize that the debate is not about strategy but over control and political correctness. Only then is it plausible that overwhelming hostility would be expressed toward including abstinence as an approach to AIDS.
It is a choice that has worked in some circumstances, just as condom use has failed in others. A 2003 report for UNAIDS by researchers Norman Hearst and Sanny Chen found that condom use was most effective where commercial sex was prevalent in transmitting HIV. In some areas, however, it appeared ineffective. For example, Botswana and Zimbabwe have high rates of both condom use and HIV, with condoms being (perhaps) badly or inconsistently used.
It is crucial to explore different strategies and to judge what is effective based on accurate data. What should be done is largely a matter of what has worked in differing circumstances. But serious questions have arisen about the accuracy and honesty of the U.N.'s data on AIDS and HIV.
Three weeks before the AIDS conference, the Boston Globe published a widely circulated report that announced, "Estimates of the number of people with the AIDS virus have been dramatically overstated in many countries because of errors in statistical models and a possible undetected decline in the pandemic."
Citing the CDC, the report quoted AIDS specialists as saying that "the current estimate of 40 million people living with the AIDS virus worldwide is inflated by 25 percent to 50 percent."
The U.N. was expected to revise its figures of global infection downward. But, according to its July 2004 report, the U.N. announced a record number of new AIDS cases in 2003. In short, the U.Nn is giving the clear impression that the AIDS epidemic is growing at an accelerating rate.
The U.N.'s direct response to the criticism of its data has been puzzling. The UNAIDS site admits, "There have been steady improvements in the modelling methodology used by UNAIDS/WHO and partners, along with better data from country surveillance. These have led to lower global HIV/AIDS estimates, not just for the current year but also for past years."
But the U.N. went on to say, "Current estimates therefore cannot be compared directly with estimates from previous years, nor with those that may be published subsequently."
Nevertheless, new and specific data emerged from the 15th International Conference. AIDS is now said to be a "woman's issue," that is, women are said to be infected at an unprecedented rate. (The difficulty of comparing women's data from year to year seems to have been overcome.)
"HIV Epidemic Could Help Women's Rights." The headline has been heralded by news sources across America from The Miami Herald to the Seattle Post-Intelligencer. Accordingly, a new political agenda is being attached to the global AIDS campaign. The agenda is embodied in a headline from the Toronto Star: "Empower Women to Conquer AIDS."
The solution to AIDS is being redefined as a matter of domestic violence and women's oppression. In the shifting vista of AIDS politics, where even the figures are blurring, the U.S. is correct and prudent to withhold its support.