Underneath the hullabaloo of the American presidential election, there are encouraging signs that a more pragmatic approach is emerging on the always vexed issue of America’s international and domestic HIV/AIDS policies.
In his State of the Union address, President Bush confirmed that he would seek US$30 billion from Congress to fund the President’s Emergency Fund for AIDS Relief (PEPFAR). This doubles the previous size of the program and seems likely to be supported by both Republicans and Democrats in Congress. PEPFAR funding is directed mainly to Africa, and more for the provision of care and treatment through subsidised AIDS drugs than to effective prevention strategies. Nevertheless, the sheer size of PEPFAR funding will make a significant and welcome contribution to the global fight against AIDS. A portion of PEPFAR funding will be directed to the support of key international agencies, including UNAIDS and the Global Fund.
Also, the two principal contenders for the Democratic presidential nomination, Senator Clinton and Senator Obama, have both publicly pledged their support for greatly expanded needle and syringe exchange programs in the US, an essential component of successful HIV prevention. Both Clinton and Obama have generally supported a greater emphasis on practical prevention programs with less emphasis on such things as abstinence promotion. Both supported President Bush’s expansion of PEPFAR. Many members of the recent US House of Representatives delegation that visited Australia were eager to discuss HIV/AIDS policies and programs, and to learn from Australia’s record of successfully containing AIDS.
Taken together, these developments shift American policies towards far more realistic HIV/AIDS policies, and away from the highly-politicised and ineffectual policy settings of the last two decades.
