Washington, April 4 -- The US Government Accountability Office (GAO) issued a new report today which shows that the US approach to AIDS prevention is essentially unworkable.

The Report is posted online at:

www.globalaidsalliance.org/docs/GAO_Report_April_2006.pdf

The State Department requires that two-thirds of funding devoted to preventing sexual transmission of AIDS must be spent on programs that encourage abstinence and fidelity. The GAO report says that to comply with the requirement US country programs have had to reduce funding for programs that meet the needs of sexually active youth, truckers, sex workers, and couples in which one partner is negative and the other is positive.

The GAO conducted a full survey of the seventeen country teams in charge of implementing the US program in Africa and other regions. Ten of these teams found that satisfying the requirement would force cutting back on essential programs, including Prevention of Mother to Child Transmission (PMTCT). These teams requested, and received, exemptions.

The remaining seven country programs also cited potential cuts in PMTCT and other services, but they did not qualify for exemptions. As a result, the State Department effectively required these seven teams to spend more than 33% of their prevention funds on abstinence and fidelity programs, the report says. Spending on other kinds of programs declined.

A major concern has been to what extent information and skill building about condom use is being presented within programs that promote abstinence and fidelity. The report states that eight of the seventeen country programs have found that the policy "compromises the integration of their programs."

Most country teams found the policy "ambiguous and confusing," and the report recommends that Congress should "assess the extent to which the spending requirement supports both the Leadership Act's endorsement of the ABC model and strong abstinence-until-marriage programs."

"This report confirms what we have been saying all along," said Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance. "There has been deep concern with this policy, from the European Union, UN officials, African experts, religious organizations and others, and it has been fully justified. Lives are in the balance, and so we need Congress to step in quickly to fix this policy."

In October 2003, the Senate considered an amendment that would have made the requirement more flexible, by allowing programs that simply place a "priority emphasis" on refraining from sexual activity before marriage to receive funds. But, under pressure from Randall Tobias, then the US Global AIDS Coordinator and now the head of USAID, the amendment was narrowly rejected.

"Messages promoting abstinence and fidelity have a place in a comprehensive strategy, and condoms are not the only solution to AIDS," said Zeitz. "But, the US approach is far from the 'balanced, effective' policy we were promised by President Bush."

President Bush, spurred by Senator Jesse Helms, first launched an AIDS initiative in 2002, when he proposed new funding for programs to stop transmission of the virus from mother to child (PMTCT). Yet, ironically, the GAO report shows that progress in this area is being sacrificed to meet the US demand for spending on abstinence and fidelity.

The reduction in funding for the programs other than abstinence and fidelity programs took place even as overall funding for the US bilateral AIDS program was being massively increased. For the period the GAO studied, Congress approved 95% of the funding the President had requested for US bilateral AIDS programs.

In FY 2005 the increased spending on abstinence and fidelity was not a hard requirement. For FY 2006, however, a hard requirement is in force, and the problems documented by the study could well be worsening.

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