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February 6, 2009

Adeline at the European Union

It’s been far too long since I updated this page, especially since I have happy news to report. Adeline, who is now working as a book keeper for the European Commission mission in Lesotho, gave a copy of No Place Left to her boss, the mission head. He asked her to talk about her experiences to local staff. The speech was so moving that they asked her to come to Brussels to speak on World AIDS Day (see the picture below). I was able to join her there for her speech, which left very few eyes in the audience dry.  Adeline at the European Union 

At home in Lesotho, she and her son Bongy are both responding well to ARV treatment. Bongy is growing fast and Adeline has nearly finished building a house. I also had the chance to visit South Africa for quick trip in November to do a little bit of reporting for Scientific American about the U.S. government’s global AIDS program, the President’s Emergency Fund for AIDS Relief (PEPFAR) which has been far more successful than anyone expected, especially in helping to expand treatment. You can read the article here. 

Despite a general overall positive feeling about the program, there were however still concerns about its emphasis on abstinence-only prevention and U.S. policy that bans organizations that “promote” prostitution from receiving American aid. One of President Obama’s first acts was to end this rule, to the delight of many AIDS and family planning organizations. 

Concern about PEPFAR’s prevention earmarks for abstinence wasn’t as pronounced as I had expected it to be, in large part because a major shift in thinking about prevention seemed to be underway. While there’s still little support among most AIDS professionals for abstinence-based programs, which have little evidence to support their efficacy, there is a growing consensus in South Africa more should be done to promote fidelity and partner-reduction. A whole host of innovative new programs, like South Africa’s One Love campaign, are trying to change attitudes about multiple partnerships. PEPFAR is funding many of these — and spending money earmarked for abstinence programming for these types of programs under a more liberal interpretation of the rule. See an article I wrote for The Christian Science Monitor on this issue. Most still hope, though, that the Obama administration will end the earmarks and allow policy on this to be dictated by research, not politics.  

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