In a way, the Bush administration set itself up for attacks from all quarters with its aggressive foreign policy, understandable in the case of Afghanistan but totally misguided and fundamentally wrong in the case of Iraq, as many of us stated clearly before the event. However, although it would be difficult to heap too much criticism on the Iraq disaster, PEPFAR is another story.
PEPFAR is The President’s Emergency Plan for AIDS Relief, which began in May 2003 with the US Leadership Against HIV/AIDS, TB and Malaria Act, a five-year programme allocating no less than fifteen billion USD to combat these infectious diseases in 120 countries around the world.
Stephen Lewis, the UN Special Envoy on AIDS, has been reported by several international media outlets as slamming the initiative, calling it “incipient neo-colonialism” in African nations due to its top-down approach and insistence on abstinence. While this official does a lot of good in his able handling and understanding of the problem and the people most affected by it, this type of criticism – and its reporting – is irresponsible because it creates a false image.
PEPFAR, for those who bother to do a little research, is crystal clear about how its funds are allocated: 55 per cent of the 15 bn. USD is for treatment programmes (75 per cent of this on ART); 15 per cent for palliative care on terminal patients; 10 per cent for care of orphans and 20 per cent on prevention. 33 per cent of this, i.e. a total of 6.6 per cent of the total, is for programmes to back up the ABC approach (Abstinence, Be faithful to one partner, Condom).
This is not a top-down approach imposed from alien cultural values, but rather an attempt to allocate a small fraction of the funding in areas where such approaches are popular – indeed PEPFAR has been criticised in some very conservative areas of Africa for not going far enough in this respect.
Any initiative which provides 15 billion USD for humanitarian causes is to be praised, and not slammed. With the Bush administration providing a string of issues on which it can rightly be challenged, by praising the positive actions, the international community can hope that in future more money and energies will be spent on saving lives rather than targeting civilian structures with military hardware and slaughtering people in their homes.
The other question which is fundamentally important to stress is that AIDS is also an African problem, but not only, indeed in many African countries incidence rates are falling whereas elsewhere they are rising. The reports linking Mr. Lewis’ comments to Africa underline once more that Africa is a lost continent of wars, locusts, disease and corruption and any media outlet providing and perpetuating this image deserves to be closed. It is not true.
In a democratic world, we should be free to criticise bad policies, given that we base our criticism on solid arguments but we must also follow the principle that good deeds deserve praise. PEPFAR is one of these.