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From: PlusNews <[email protected]>
Date: Mon, Nov 14, 2011 at 6:48 PM
Subject: HIV/AIDS: Clinton sets out new US focus
To: Elisabeth Janaina <[email protected]>


HIV/AIDS: Clinton sets out new US focus

NEW YORK, 14 November 2011 (PLUSNEWS) - US Secretary of State Hillary
Clinton's announcement that the American government now prioritizes
creating an AIDS-free generation could be more than just political
lip-service: it may also shape the next several years of US global
health programming and funding, analysts say.

 Clinton's 8 November speech at the National Institute of Health
reflects recent scientific breakthroughs. She said a three-pronged
approach - eliminating mother-to-child transmission of HIV, scaling up
male circumcision procedures and expanding early treatment for people
living with HIV and AIDS - offered a combination prevention strategy
that would help reach the goal of having virtually no child born with
HIV within three years.

 "It's the first time the US has outlined a policy goal on how to
reach an AIDS-free generation," explained Jennifer Kates, director of
HIV policy at the Washington DC-based Kaiser Family Foundation.

 "We're starting to think about this and talk about this and with some
of the recent studies, it is really changing the way we are
approaching the epidemic... this provides reorientation for how
programmes are approached and trying to figure out combination
prevention on the ground."

 Clinton also committed an additional US$60 million to rapidly scale
up combination prevention in four unspecified countries in sub-Saharan
Africa to measure the impact of this approach.

 About 53 percent of pregnant women living with HIV in the developing
world receive antiretroviral drugs to prevent transmission to their
infants, according to the UN Children's Fund (UNICEF). Last year, the
US President's Emergency Plan for AIDS Relief (PEPFAR) helped prevent
114,000 babies from being born with HIV, Clinton said.

 Recent studies have shown that male circumcision can help reduce a
man's risk of becoming infected with HIV by 60 percent during
heterosexual sex, according to the World Health Organization (WHO).
Earlier this year, the HIV Prevention Trial Networks 052 study found
that men and women living with HIV reduced their risk of transmitting
HIV to their partners by up to 96 percent if they received an early
initiation of combination antiretroviral therapy.

 Kates cautioned that it may be too soon to tell how much these three
new policy priorities - the first the US has put forth since the Bush
Administration's approach of abstinence, fidelity and condoms - will
guide US foreign programmes, and that interventions will have to be
tailored to different populations.

 Reproductive rights

 But some women's and girls' sexual and reproductive health advocates
are concerned that these new priorities sideline reproductive rights.
Clinton did not specifically discuss family planning or access to safe
abortions.

 That exclusion might be reflect the domestic agenda, where
reproductive rights continue to play a divisive role between liberal
and conservative politicians, says Serra Sippel, president of the NGO
Center for Health and Gender Equity (CHANGE).

 "There is a legitimate fear that Congress controls the purse strings,
so if the Secretary thinks this could give them an inclination to
think PEPFAR money would be supporting programmes addressing these
rights, Congress can at any time step back and decide to use that as a
way to pull that money back," said Sippel.

 Ann Starrs, co-founder and president of the NGO Family Care
International, says Clinton's prevention-as-treatment approach could
have been furthered by presenting contraception as an option to
HIV-positive women, instead of just prevention of transmission
interventions.

 "Studies done by a number of researchers show that 50 to 85 percent
of HIV-positive women don't want a baby," Starrs told IRIN/PlusNews.
"You provide them with contraception and you have a greater impact in
terms of reducing the number of HIV-positive infants born at a greater
cost."

 But programmes under the umbrella of USAID and the $63 billion Global
Health Initiative, which stresses country-led ownership and focuses on
women's and girls' health, may well continue to foster a holistic
approach on their own, said Sippel.

 Natasha Billmoria, president of the Friends of the Global Fight
Against AIDS, Tuberculosis and Malaria, which advocates for US
partnership with the Global Fund, says she hopes Clinton's "incredibly
strong message" will be backed by strong funding commitments for the
next financial year.

 America continues to be the largest donor to the Global Fund, but
between 2010 and 2011, kept its contribution flat at $1.05 billion.
Kates of the Kaiser Foundation says the financial crisis makes the
ability to back up strong words with even bigger money unclear.

 "There's an irony of having these new tools before us to combat HIV,
and at the same time there's a downward pressure on the budget, so it
isn't clear," she said.

 al/kn/mw

[END]

This report online: http://www.plusnews.org/report.aspx?reportID=94202



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