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United States Claims Success in Clarifying AIDS Policy

By Charlene Porter
Washington File Staff Writer

Bangkok, Thailand -- U.S. officials say they have been successful at the XV International AIDS Conference in clarifying U.S. government policy on fighting the global epidemic.

"We have addressed some of the disconnects," said Dr. E. Anne Peterson, the assistant administrator for global health at the U.S. Agency for International Development. The ranking U.S. official on hand in Bangkok as the meeting closed July 16, Peterson said U.S. officials were challenged in the course of the week-long event to explain their AIDS policies, which she characterized as "extraordinarily unclear" in the minds of many of the almost 20,000 delegates who attended the meeting.

U.S. policies were criticized by delegates who did not understand an important prevention strategy of the President's Emergency Plan for AIDS Relief (PEPFAR), known as ABC, which stands for "abstinence, be faithful and use condoms." Global AIDS Ambassador Randall Tobias emphasized in a keynote speech July 15 that the United States is supporting all three strategies equally, rebutting critics who alleged that the PEPFAR strategy placed a lower priority on the use of condoms as a means of preventing the transmission of HIV.

That speech was met with protests and heckling, but Tobias was stoic about the response from about 50 demonstrators. "It goes with the territory," he said in a post-speech interview. Officials from other governments and executives from pharmaceutical companies faced similar heckling and protests waged by AIDS activists who believe that the global community is not responding to the epidemic with sufficient urgency.

Other important U.S. priorities have been to raise awareness and win greater commitments to combat the epidemic from other governments and private organizations. In a Washington File interview, Peterson said that pursuing those objectives is an ongoing priority, but the conference does "draw people together," creating greater solidarity in the anti-disease campaign.

"Good dialogue did take place," at the conference, according to Christopher H. Bates, the director of the Office of HIV/AIDS Policy in the Department of Health and Human Services. "Opportunities for people to do some sharing of best practices, opportunities for people to learn some new strategies for prevention, and getting people to adhere to their drug regimens and things of that sort were very aggressively played out here," Bates said in a Washington File interview.

The conference theme was "Access to All," advocating equal access to health care, treatment, education and prevention messages as they relate to the AIDS epidemic. Perhaps most urgent of those, however, is expanding access to the life-saving anti-retroviral drugs which have helped persons living with HIV in the developed world, but have been, because of their cost, largely out of reach for developing world patients.

Although the drugs have been available in wealthy nations for about a decade, they are just recently becoming available to HIV-positive people in poor nations through funding provided by PEPFAR and other initiatives sponsored by the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria.

"Now there are the dedication and the pledges to getting the treatment out," said Peterson. She said the conference was valuable for health care providers who engaged in technical discussions about the actual mechanics of delivering pharmaceuticals, which may sometimes require complex regimens. A major barrier to achieving that is establishing adequate health care infrastructure to deliver and monitor treatment, Peterson said. Strengthening those systems is a continuing U.S. priority, she said.

According to Peterson, faith-based caregivers are an untapped resource in helping to expand the cadres of people devoted to caring for people living with HIV/AIDS. Faith-based organizations participated in this conference in greater numbers than ever before, and Peterson said U.S. programs in the future will work more to link those caregivers to nongovernmental organizations and governments that are U.S. partners in working to cope with the epidemic.

Bates acknowledged that serious challenges remain ahead in the global effort to stop the AIDS epidemic. But he said he is leaving Bangkok optimistic about the opportunities ahead. "I think we're going to make some serious progress over the next few years," he said.