U.S. Retreats From AIDS Meet

By Katherine Stapp
July 9, 2004

New York - When the world's top experts on HIV/AIDS gather to swap strategies and experiences in Bangkok, Thailand this weekend, only a tiny handful of the estimated 15,000 attendees will be representing the United States.

Two years ago, Washington sent 236 employees from Health and Human Services (HHS) and other federal agencies to the International AIDS Conference, considered the leading scientific gathering on HIV research and treatment.

But this time around, the U.S. delegation has dwindled to 50, and its funding for the meeting slashed from 3.6 million dollars to about 500,000 dollars.

As a result of eleventh hour reshuffling in Washington, 40 scheduled presentations had to be withdrawn and at least three satellite sessions cancelled entirely because key U.S. scientists would no longer be attending.

Conference organisers say they are ”saddened” at the decision, which many critics believe stems from long-running ideological clashes between the conservative administration of President George W Bush and international health bodies over issues like condom use, abortion and homosexuality.

”It likely has both symbolic and substantive impact,” said Dr Neal Nathanson, a former director of the Office of AIDS Research at the National Institutes of Health (NIH), a sub-agency of HHS.

”Many of the talks won't be given, particularly those focused on control of the epidemic, and the opportunity for informal consultations with international collaborators -- these are substantial -- will be diminished,” he told IPS.

”It's (also) a slap in the face for those living with HIV/AIDS and their advocates, and it suggests that the U.S. has once again withdrawn from a collegial relationship with the international community.”

HHS blames the small delegation on budget cuts, and notes that one-half of the 500,000 dollars it is spending on the conference will underwrite the travel costs of 80 African, Asian and Caribbean scientists.

Critics of the move point out that money was apparently no object when HHS chief Tommy Thompson toured four African countries last December at a cost of more than a quarter million dollars, including 11,000 dollars in cell phone charges, 10,000 dollars for a public relations firm and nearly 400,000 dollars for a chartered jet.

Leaked correspondence from within HHS suggests that its snubbing of the Bangkok assembly is at least partly in retribution for criticism of the Bush administration's policies at the last conference in Spain, where AIDS activists booed Thompson so loudly his speech was essentially inaudible.

'Science' magazine obtained an e-mail in April by Jack Whitescarver, director of the Office of AIDS Research, relating that the director of the HHS office of global health affairs, William Steiger, said the decision ”was as a result of the treatment the secretary received in Barcelona and HHS opinion that this meeting is of questionable scientific value.”

The agency has refused to comment on the memo, but insists the decision to cut its Bangkok contingent is not politically motivated.

But in a related policy change denounced by public health experts and current and former employees, HHS also announced that from now on, all invitations for U.S. government experts to attend World Health Organisation (WHO) gatherings will be vetted for approval by a single official -- William Steiger.

Previously, U.S. government researchers were free to attend such scientific meetings at their own discretion.

Some members of Congress who have long been critical of the administration's HIV/AIDS policies are strenuously protesting the moves.

”By grounding these experts, you are keeping them from learning from their peers across the world, and you are depriving the world of scientific leadership of the United States,” complained Representatives Henry Waxman and Louise Slaughter, both members of the opposition Democratic Party, in a Jun. 14 letter to Thompson.

The cancelled presentations in Bangkok include strategies to counter AIDS stigma, the use of rapid HIV testing, racial and ethnic disparities in HIV care, and systems to track drug resistance.

In a recent editorial, Laurie Garrett, a Pulitzer prize-winning health reporter and member of the Council on Foreign Relations, called Washington's retreat ”a nasty game of political football with AIDS and global health issues” calculated to provide ”aid and comfort for the policies of the religious right”.

For example, in June, the CDC announced that any AIDS-fighting group that accepts federal money must include information on the ”lack of effectiveness of condom use” in the content it produces.

The new regulations will have a profound impact, since the vast majority of the 3,800 organisations in the United States working on HIV education receive at least some federal funding.

The rules also ban any content that is ”sexually suggestive” or that might be interpreted as ”obscene” by Policy Review Panels named by state and local health departments. Those panels must then vote on every single flier, brochure or other ”content” before it is issued.

Immediately after taking office in 2001 Bush reinstated the so-called ”global gag rule”, which bans non-governmental organisations (NGOs) working abroad that receive federal money from participating in any abortion-related activity, including lobbying local governments to ease anti-abortion laws -- even if they use their own funds.

At the same time, Washington is pouring one-third of all federal HIV education money -- some 270 million dollars -- into abstinence-only programmes, which teach children and teenagers that chastity is the only way to avoid pregnancy or HIV/AIDS.

This stance infuriates many HIV outreach workers, who note that condoms are 98 percent effective in preventing STD infections, and argue that while abstinence is a good idea, telling young people to ”just say no” to sex is unrealistic and dangerous.

Washington's ideological approach to public health is detailed in a new report by the International Working Group on Sexuality and Social Policy, which cites numerous instances of U.S. delegates exerting pressure to accentuate abstinence and heterosexual marriage at scientific meetings on HIV/AIDS and reproductive issues.

Just this April, Washington cut all funding for the Global Health Council's annual conference -- the first time in 31 years that it had no U.S. support -- because of planned sessions on sex education, birth control and drugs.

And before the U.S. delegation to Bangkok was dramatically reduced, some Republican Congressmen complained that the 2002 Barcelona meeting had featured 777 presentations that mentioned condoms, ”compared to 16 for 'faithfulness' or 'fidelity' and 74 for 'abstinence'.”

”Given the far-reaching nature of the Bush agenda on sexuality, non-U.S. NGOs and other governments have to pay particular attention to the terms under which they accept U.S. foreign aid,” says Francoise Girard, the author of the IWGSSP report, titled 'Global Implications of U.S. Domestic and International Policies on Sexuality'.

”Are they being asked to condemn sex workers in order to obtain HIV funds? Will they be asked to betray colleague organisations to secure their grant? Are they forgoing their right to speak out?”

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