Full support of global AIDS package expected from new U.S. president

WASHINGTON – An overseer of the President’s Emergency Program for AIDS Relief, known as PEPFAR, expects the incoming president to fully embrace the $48 billion package to provide treatment and prevention campaigns globally.

The worldwide AIDS program that was reauthorized last summer is also expected to be fully funded in the coming years, even if a predicted economic recession is drawn out, said Mark Dybul, U.S. global AIDS coordinator and an assistant surgeon general in the Bush administration.

Mr. Dybul told an audience at the Georgetown University Law Center in Washington Oct. 28 that PEPFAR is the largest global medical initiative in history, that it has been fully supported by the major-party presidential nominees, Democratic Sen. Barack Obama and Republican Sen. John McCain, and can be counted as one of President George W. Bush’s greatest accomplishments.

“This program has not come without its controversies, but it does have bipartisan support,” said Lawrence O. Gostin, law professor at Georgetown and moderator of the Oct. 28 discussion. “Love it or hate it, (PEPFAR has) transformed the lives of countless numbers of people.”

When both houses of Congress overwhelmingly passed the PEPFAR reauthorization bill earlier this year, officials from the U.S. Conference of Catholic Bishops, Catholic Relief Services and the Catholic Medical Mission Board applauded the measure.

Spearheaded by the Bush administration in 2003, PEPFAR has to date provided $19 billion to support the treatment of millions globally, to provide health care workers, and to carry out educational programs that focus on prevention, monogamy, fidelity and abstinence.

The five-year reauthorization bill – co-sponsored by Obama, McCain and the Democratic vice-presidential nominee, Sen. Joseph Biden, who made an impassioned plea for votes on the Senate floor – was signed by Bush July 30. The president predicted the $48 billion allocation would support treatment for at least 3 million people, prevent 12 million new HIV infections worldwide, and provide support and care for 12 million affected by HIV/AIDS, including 5 million orphans and vulnerable children.

Though Catholic leaders have backed key provisions of the reauthorization – namely funding for food aid, the retention of morally appropriate programs and 150,000 extra health care workers – they have expressed concerns about the funding for condoms. Although there is no official church ruling on the use of condoms and AIDS, some church officials have expressed concern because condoms do not offer 100 percent protection from AIDS and could encourage sexual promiscuity.

A conscience clause in the legislation prevents faith-based agencies such as CRS, the overseas relief and development agency of the U.S. Catholic Church, from being shut out of the program because they refuse to hand out condoms.

Vatican officials have objected to condom promotion in AIDS prevention campaigns, saying they believe it undermines the church’s call for sexual responsibility. Some theologians, however, including those who advise the Vatican, believe the use of condoms may be acceptable for disease control in certain situations.

“The promotion of condom use will continue to be a priority in the program,” Mr. Dybul said. “Donations of 2 billion condoms have been made so far. It’s a very important part of our prevention.”

PEPFAR also will focus on abstinence and fidelity education, especially among children as young as 7, he said.

“We want to promote this behavior at a young age,” Mr. Dybul said. “It’s difficult to get 25-year-olds to alter their sexual behavior.”

Leaders of the program want the second five years of PEPFAR to include more partners from the countries where they implement AIDS relief programs, including representatives of those nations’ governments and private sectors, community activists and members of faith-based organizations, he said.

When President Bush speaks about PEPFAR, he frequently references the biblical passage “to whom much is given, much is required,” from St. Luke’s Gospel, and believes this sentiment reflects the spirit of the American people, Mr. Dybul said.

“I have no doubt of the long-term commitment for this program,” he said. “We believe it will be continued as long as it’s needed.”

Catholic Review

Catholic Review

The Catholic Review is the official publication of the Archdiocese of Baltimore.