It seems churlish to criticise the US President’s new $1.2bn five-year malaria initiative (Bush renews efforts to cut malaria deaths, GW, Jan 5-11), nor the earlier $15bn President’s emergency plan for Aids relief (PEPFAR). Yet so much money given in aid by the US Government has had strings attached that one has to ask: what strings will be attached to the malaria program? PEPFAR money, for instance, cannot go to any program that favours condom promotion over abstinence despite empirical evidence that condoms are the best method of HIV prevention. Uganda once boasted a highly successful condom-based program for HIV prevention but, once US money was involved, condoms remained impounded in government warehouses.
Similarly, the US global ‘gag rule’ prevents any funds going to any non-government organisation that has anything to do with abortion. A number of NGOs that were working successfully in women’s reproductive health around the world suddenly found themselves bankrupt because of the imposition of the gag rule. As a consequence of these ideologically driven policies, the US has contributed to countless deaths relating to childbirth and unsafe abortion.
The concern is that, with so much money now going to HIV/AIDS, TB and malaria through both the Global Fund and now the President’s separate initiatives, sexual and reproductive rights for women are being marginalised. Programs that empower women to make sexual and reproductive choices of their own are crying out for money while HIV-abstinence programs (useless for married women and victims of sexual violence), TB and malaria are now awash with it.
Perhaps the President could divert a little money – not from HIV, TB or malaria but from Iraq perhaps – to funding social clubs in Mali and Mozambique for young girls that empower them through activities and discussions on sexual health, and then ensuring that such successful initiatives are repeated.