Hard to know why Harper would distance himself form this - possibly because the uneasy questions about abstinence vs. protection might have had his conservative popular base once again looking for reassurance that they had chosen the "right" man. Any idea where Ignatieff was during the conference?

Still, a joint study by (of all places) the Univ. of Toronto and a Medical Institute in Chandigarh recently demonstrated that increased condom usage drastically reduced the number of HIV infections in South India. It works - and innocent people (spouses, exploited women) need not suffer even more for actions they are not responsible for. I don't know how much longer some people are going to keep their heads in the sand.

I have a generally sunny disposition but I hope the sick geezers who fought to include this clause and its cousins “preach abstinence and being faithful for a third of the total prevention budget

while i agree that the principle of linking aid to abstinence is heinous - their is a subtle point here that i find that gets trodden under by some social activists.

abstinence has worked very well in uganda. the impact has been dramatic and President Bush's PEPFAR initiative has been an important driver in this. Stephanie Nolen in the Globe and Mail has covered the conference very well ovr the pat few weeks. Here's her article from this past Saturday.

Uganda is one of the few success stories in the African pandemic, a country that has indisputably succeeded in lowering its HIV-infection rate, from a high of about 17 per cent of adults in the early 1990s to just below 7 per cent now.

i am a huge fan of grassroots movement in driving social change. the reason the abstinence principle worked in uganda is because the people got behind it en masse - virginity is cool and accepted by the masses. i also liked the simplicity of the ABC principle (read the article ). such education is vastly more potent than all the magic bullets that are being chased after in the labs imo.

That being said, the article also goes on to say that the pharma lobby has such a stranglehold on PEPFAR that they've successfully kept generics out of the program. one of the lines was particularly poignant, that because the drugs are twice as costly as generics, the program can save only half as many people for the amount of funds they have.

i am totall behind the Gates Foundation because they seem to be stressing the same principles to go after the root causes - grassroots activism, education, drugs to infected mothers.

here's a relevant excerpt

Granted, part of that decline represents people who no longer show up on surveys because they have died. Uganda's epidemic began early, and hundreds of thousands of people died before AIDS treatment became available. But there is no question that part of the drop is the result of the Ugandan government's concerted efforts at public education -- persuading people to begin having sex later in life, to be faithful to one partner ("zero grazing," as it's known here) and to use condoms.

It's the strategy packaged as ABC (Abstinence/Be faithful/use a Condom), and in Uganda, it seemed to work. So when the United States got heavily involved in the African AIDS crisis, it seized on the model and took a major role in exporting it elsewhere on the continent and in the developing world.

In the heavily politicized world of global AIDS, there is no subject more incendiary than PEPFAR, the U.S. President's Emergency Plan For AIDS Relief -- a $15-billion (all figures U.S.), five-year program announced by George Bush in January of 2003. While originally intended to focus on 15 countries, most in sub-Saharan Africa, PEPFAR today has programming in almost every AIDS-ravaged African country. In its first three years, it has paid for or supported life-saving antiretroviral treatment for 561,000 people; HIV testing and counselling for 13.6 million people; care for three million AIDS orphans; and the prevention of an estimated 62,000 transmissions of HIV between pregnant women and their babies.

abstinence has worked very well in uganda. the impact has been dramatic and President Bush's PEPFAR initiative has been an important driver in this.

Hairy_D,

I actually disagree with that pretty strongly. ABC worked well in Uganda, but once they switch to abstinance only (when I was there a year ago the only condom billboard I found was an old one in a rural area) HIV infection rates have come back up quite strongly. Furthermore, it's not clear if it was actually ever that low - there have some contrary reports arguing that the figures may have been fudged. In any case, I spent a lot of time talking to doctors, nurses and pharmacists about this and I guess I disagree.

There's actually a ton I'd like to say about this topic, but I've got too little time right now.

There's actually a ton I'd like to say about this topic, but I've got too little time right now.

And I'll welcome your thoughts on this when you have the time - and I'm pretty sure I speak for a lot of us.

me got to work to. An RFP to kill tonite. :-)

I agree with you that in principle, without the "B" and the "C", this will not work. One of the highlights of the Toronto Aids conference was the paraphernalia linked to condoms - basically geared to bring it out into the public and purge the smutty associations from it - i forget the exhibits - but this is another one of those simple ideas that has had great impact either in S America or Africa - would love to hear from others.

Neha,
Nice to hear some news from North of the Border for a change.

And as for the case in Uganda: the New York Times reported on the Ugandan case over a year ago and there was more to their campaign than just the "ABC". There seemed to be a concensus that what really helped (even a little) was the change to publically addressing AIDS and sexual health. Apparently, Uganda used to be quite a closed society (much like India) where nobody talked about sex and people definitly didn't talk about contraception. Once the government and health societies started pushing the ABC approach, they brought the issue up in the public conscious and people talked about it more than they had previously. It's likely that a similar approach needs to be taken in India. How can people know what the risks are if nobody even talks about the issues? I don't know what sort of sex education they have now, but I know that my awareness of sexual health and sexual issues is much greater than that of my cousins who are the same age as me. They're taught almost nothing at school and the conversations they have with friends are simply not as informed. This in a culture that's getting more and more promiscuous in its attempt to imitate a western society (at least in larger cities like New Delhi). It's frustrating to see that there's a definite change in society but policies don't change! Perhaps one way to tackle this sort of problem would be a sexual health class in secondary schools though I suspect that parents would revolt and claim that schools were corrupting their innocent children. And this from a country that has not only the most people with AIDS in the world, but where the increase in AIDS cases is growing at an alarming rate.

Sorry for such a long comment, but it's an issue that really frustrates me. How can you let people DIE in the name of preserving archaic and close-minded beliefs?

i am a huge fan of grassroots movement in driving social change. the reason the abstinence principle worked in uganda is because the people got behind it en masse - virginity is cool and accepted by the masses.

I dunno about that last bit, hairy_d. The Ugandan government and people deserve all the credit for acting together in the 90s to save their society from an epidemic. However, their efforts were not limited to abstinence education as they seem to be now. I doubt virginity was as cool as getting infected was uncool.

When I read of things like condom shortages due to increased funding for abstinence-only programs in a country as rare an example in the fight as Uganda, it scares me witless. Preaching abstinence is not even close to being a surefire method of preventing infection.

For one, it doesn't take into consideration the large numbers of wives who have no choice but to have sex with husbands who may have visited a certain house of ill repute where no condoms were used (probably because PEPFAR wouldn't fund them!).

Two, abstinence linked with morality is causing more harm than good by making people who use condoms look like sinners where they should actually be praised.

However, all overseas groups wishing to receive U.S. Government funding, whether directly or indirectly, must still comply. Numerous non-governmental organisations and public health experts believe that the clause is harmful and should be removed.

This is absolutely ridiculous. But, what else can we expect from this administration and Congress? This is only increases the need for sane people to actually mobilize and actively participate in the upcoming elections.

I heard this second hand, so forgive me if I'm wrong, but I heard that the bill squared (Gates and Clinton) panel was pretty awesome. They kind of dodged the PEPFAR question, and instead choose to praise it somewhat for what it IS doing (I have my own opinions on that). The also talked about how, when faced with a situation like this, instead of crying over what was bad, it was up to outside forces (like their own organizations) to step in and fill the gaps.

I think it is available on the C-span website