US govt policy at work

AIDS prevention efforts are being undermined by spending restrictions in US foreign aid the Washington Post reports today. Despite years of evidence showing that tied aid is less effective than untied aid (Sachs, 2005), Bush's PEPFAR plan requires that a significant proportion of US funding must be spent on abstinence only prevention efforts. This means that in many cases struggling health systems have had to cut spending to more necessary areas in order to fulfill US demands.

Of the 15 "focus countries" -- 12 African countries, plus Haiti, Guyana and Vietnam -- nine reduced the amount of money for programs to prevent mother-to-child transmission of HIV in their 2006 budgets to meet the spending target for abstinence promotion.

In one, mother-to-child funding was cut from $1.4 million to $1 million, and in another it was reduced by $300,000, said GAO's David Gootnick, who oversaw the report.

In perhaps the largest adjustment, one country cut from $8 million to $4 million its spending on prevention services for couples in which one person has HIV infection and the other does not -- an extremely high-risk group -- as well as on sexually active youths and sex workers.