The 7 percent of U.S. AIDS funding planned for sexual abstinence programs might seem small ["AIDS Activists Misfiring," op-ed, July 19], but it is one component of a Bush administration policy based more on politics than on science and public health.

That seemingly small percentage is one-third of all funding for HIV infection and will amount to more than $100 million annually, no small change in any field. These valuable dollars will support an ideologically driven approach that ignores the importance of condom use and the vast at-risk population for whom abstinence is not an option, such as married women and girls who cannot "just say no" to sex.

No research gives credence to the belief that promoting abstinence in isolation will reduce HIV prevalence rates. Nor is there serious doubt that using condoms has prevented countless HIV infections.

Moreover, the Bush administration's emphasis on abstinence programs amounts to a U.S. imposition at odds with local "ownership" of HIV/AIDS prevention programs. Comprehensive programs, attuned to their own populations and working well, feel the pressure to shift to an abstinence-only strategy to gain U.S. funding that ultimately threatens their effectiveness. This is what AIDS activists were protesting when U.S. global AIDS coordinator Randall Tobias spoke in Bangkok, not the obvious fact that encouraging higher rates of abstinence can indeed make an important contribution to prevention.


Vice President for Research Population

Action International



In his July 19 column Sebastian Mallaby seems to be more concerned with manipulating the facts than telling the real story of the struggle against global AIDS. He seems to think that $2.6 billion is the answer to the biggest crisis our generation has ever faced. The United States ranks dead last among nations that donate to the Global Fund to Fight AIDS, Tuberculosis and Malaria in terms of money given as a proportion of gross domestic product. The Global Fund is our best shot at fighting the pandemic.

He also neglects to mention the debt factor. An amount of $2.6 billion is nothing compared with the $14 billion that flows from Africa to rich countries in often odious debt payments. It is nothing compared with the $15 billion per year experts say is necessary to stop the spread of AIDS.

So far, President Bush has only slowly increased funding of AIDS programs, excusing this with his unsupported claim of lack of capacity in the Third World. But while Bush takes his time, millions more die. If he were serious about combating AIDS, he would have trusted the World Health Organization's endorsement of generic drugs instead of dooming them to the U.S. Food and Drug Administration's lengthy approval process.

Mr. Mallaby had the right idea when he said that this administration has been obstructive in the fight against AIDS in the past. But he is wrong to think that things have changed.


Libertyville, Ill.