Controversies at XV International Aids Conference

The US delegation has been reduced to almost
20% of former levels. The US has also reduced its contributed
funding by over seven times. In the weeks leading to the
conference, forty presentations and three satellite sessions scheduled
for presentation by Americans were cancelled.

Health and Human Services (HHS) blamed budget cuts, while noting that half of the
$500,000 contributed was solely for funding attendance by
80 African, Asian and Caribbean scientists. However, a leaked email
obtained by the journal Science in April shows that
William Steiger, Director of HSS’ Office of Global Health Affairs,
indicated the decision was retribution for the treatment of HHS chief
Tommy Thompson at the 2002 Barcelona meeting. In that meeting,
Thompson described the US program for fighting HIV/AIDS pandemic, a
plan called ABC: “Abstinence works, Being faithful works, Condoms
work.” He was so
forcefully booed his speech was inaudible.

In reaction, Reps. Henry Waxman (D-Calif.) and Louise Slaughter
(D-N.Y.) wrote
a letter to Thompson in which they very eloquently stated:

“By grounding these experts, you are keeping them from
learning from their peers across the world, and you are depriving the
world of the scientific leadership of the United States.”

As an aside, the issues which that quote implies were reiterated a
month later by the Union of Concerned Scientists of the USA.

The conference organizers and the IAS have also written
HHS in protest. Both statements can be read in full:

• Link to letter
  from conference organizers
• Link to statement by the XV International AIDS Conference

On July
14 U.S. Global AIDS Coordinator Randall Tobias gave his speech to
the delegates attending in Thailand. A group of forty protesters
interrupted the proceedings, complaining that the US has withdrawn from
the collegial effort to fight HIV/AIDS. He replied by saying:

We may not agree on every tactic employed by every donor,
and we may have passionate opinions about how things can be done
better, but we must work with each other to find the best solutions,
while knowing that every person in this fight simply wants to save
lives.

Tobias’s speech was in part to discuss PEPFAR, the President’s
Emergency Plan For AIDS Relief. PEPFAR is a five year US $15 billion
initiative. That’s a laudable donation to be sure, but it is very targeted:
The funds are donated mainly to a group of 14 nations. It has drawn
criticism,
which suggests the donation should be managed by the U.N. sponsored Global Fund to
Fight AIDS, Tuberculosis and Malaria. The money is available only
to countries that subscribe and implement the ABC approach, carelessly
called by some “Abstinence First.”
Uganda has had considerable success implementing ABC .

Critics are also bringing attention to the drug plan aspects of PEPFAR. The
Global Fund allows the use of generic drugs and can medicate
individuals for the cost of US $150 a year. Under the PEPFAR plan,
only name-brand drugs (mostly American) are used and cost typically
US $700 per individual. Tobias has stated that the only reason for denying generic drugs
is their lack of FDA approval, and that the World Health
Organization’s (WHO) drug approval, which most generic drugs are
approved under, is not “transparent enough.”

Last December, Thompson led the
largest-ever delegation of leaders to five AIDS-ravaged African
countries. Critics of the PEPFAR funding, and of the recent savaging of
the US Bangkok attendance, point to this trip. The trip was at a cost of
more than US $250,000, including US $11,000 in cell
phone charges, US $10,000 for a public relations firm and nearly
$US 400,000 for a chartered jet.

In an interview after his speech, Tobias rejected a July 13th
request by U.N. chief Kofi Annan for US $1 billion to the Global
Fund. The US is already donating nearly twice as much money to the
AIDS effort than the rest of the world combined, but there is only a
US $200 million contribution planned for the Global Fund.