Bush HIV/AIDS Fund: Critics question why hard-hit India not chosen instead

[Guest guest]

Vietnam 15th nation getting U.S. AIDS relief

Critics question why hard-hit India not chosen instead

Sabin , Chronicle Medical Writer

June 24, 2004. the Sanfrancisco Chronicle

President Bush has added Vietnam to a list of 14 other nations that

will receive direct U.S. assistance under his emergency AIDS relief

program, and he cleared the release of a second round of grants

totally $500 million for such overseas assistance.

The announcement at a Philadelphia church nevertheless was brushed

aside by critics, who say the president has been too slow, and has

added too many conditions, in carrying out his pledge of $15 billion

over five years for AIDS programs abroad.

Bush also said he was adding $20 million to domestic AIDS spending

to spread among 10 states that have waiting lists for patients who

cannot afford antiviral drugs.

Vietnam was selected for the president's Emergency Program for AIDS

Relief, according to the White House, because of forecasts showing

the number of HIV infections there will increase eightfold, to 1

million cases, by 2010.

There also were powerful symbolic considerations. " We're putting a

history of bitterness behind us with Vietnam,'' Bush said. " ... And

Vietnam is cooperative and wants help.''

Eighteen months ago, when the president announced his intention to

triple overseas AIDS spending, only 14 countries -- two in the

Caribbean and a dozen in Africa -- were to be included. But Congress

required that one more nation be added, specifying that it be in a

different region.

Vietnam was chosen over several other countries thought to be in

contention, including Russia, India and China, all of which have

larger numbers of AIDS cases than Vietnam. Bush indicated that some

of the potential recipients may not have made their cases strongly

enough.

" People have got to say, 'I've got a problem, come and help us,' ''

the president said.

India was a contender because it now has an estimated 4.6 million

infections, more than any other nation except South Africa. The

Indian government estimates that infections could double to 9

million by 2010, while independent assessments warn of as many as 25

million.

" I was disappointed by the decision to go with Vietnam, " said

Colorado College President Celeste, who was ambassador to

India from 1997 to 2001. " I think India was ripe for the kind of

collaborative effort this designation would have enabled. "

Celeste, a former Democratic governor of Ohio, led a private

delegation to India in January for the Center for Strategic and

International Studies. Its report, India at the Crossroads, called

for the administration to pick India as the 15th country. " The

president's program aims to change the course of this epidemic. It

cannot do so by ignoring the big challenges.''

Bush spoke to an audience at the predominantly African American

Greater Exodus Baptist Church and stressed the value of faith-based

organizations as providers of AIDS care. " People shouldn't fear the

fact if there's a cross on the wall and an AIDS program in that

building,'' he said.

The president noted that he has asked Congress to double spending

for local groups that promote sexual abstinence as an AIDS

prevention tool. The Bush administration favors such programs, but

they have been attacked by critics, who say there is scant

scientific evidence that they work. Abstinence programs also tend to

disparage the use of condoms, which are deemed effective in

preventing the spread of the virus.

The $500 million released by the president Wednesday follows an

initial appropriation of $350 million. According to Tom Flavin, a

spokesman for the administration's global AIDS coordinator, Randall

Tobias, the latest round of funds will be distributed in a matter of

days to a variety of organizations that had applied for grants.

By year's end, the combined programs should bring antiretroviral

treatment to 200,000 AIDS patients in the recipient nations, he

said.

The announcement drew a bitter response from international AIDS

advocacy groups, which have been increasingly critical of the pace

of the president's program.

Laurie Wen of the Health Gap Coalition noted that Vietnam's epidemic

is driven primarily by the needle sharing behavior of intravenous

drug users, but the president's program prohibits the use of needle

exchange and other harm reduction techniques that work in that

population. " If we're going to choose countries, let's at least do

something that actually helps, " she said.

E-mail Sabin at srussell@....

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