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US Global AIDS Tsar Defends Focus on Abstinence

Posted - Apr. 22, 2004 at 8:20 a.m.



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BERLIN, April 22 (AFP) - US anti-AIDS coordinator Randall Tobias hit back Thursday at criticism that President George W. Bush's 15-billion-dollar program to fight AIDS abroad has an unrealistic focus on abstinence.

On the eve of a trip to sub-Saharan Africa, the region that has borne the brunt of the pandemic, Tobias said encouraging teenagers in poor countries to delay being sexually active and promoting monogamy were far more productive than distributing condoms.

"Statistics show that condoms really have not been very effective," Tobias told a news conference at the US embassy in Berlin, referring to a strategy in Africa of widespread distribution of condoms.

"It's been the principal prevention device for the last 20 years, and I think one needs only to look at what's happening with the infection rates in the world to recognize that has not been working."

The US anti-AIDS program, a five-year plan to dramatically cut the number of HIV infections focused mainly on African and Caribbean states, kicked off in February.

But the initiative has been criticized by US and international AIDS help groups for banking on what they call a false hope of convincing teenagers not to have sex before marriage as a means of fighting the spread of HIV.

Tobias said the US scheme was based on Uganda's successful AIDS education program that took the three-pronged approach of encouraging abstinence among young people, monogamy among married couples and condom use among those, including prostitutes, who have several sexual partners.

"What the Ugandans have proven is that if you can get young people -- and the results show that you can -- to understand how AIDS is spread and to delay the age at which they become sexually active, and then if you can get people who are sexually active to reduce hopefully to one the number of partners, they have proven to be the two most effective approaches to prevention," he said.

"The message to young people in the schools is not either 'Be abstinent or here are condoms, take your pick'. It is a message of 'Be abstinent'. Delaying sexual activity is a means of eliminating the risk of infection."

Tobias, a retired chairman and chief executive officer of US drugs giant Eli Lilly Company, was tapped by Bush last summer to spearhead the country's global anti-AIDS campaign.

Opponents seized on the appointment as proof that the president was more concerned with protecting US drug companies than mounting a genuine attempt to help poverty-stricken states fight AIDS.

Tobias rejected that criticism, saying that only six of his 40 years in business had been spent at Lilly and that his experience running international corporations had prepared him for the complexity of his brief.

He was in the German capital to attend a Global Business Coalition on HIV/AIDS, an international private-sector project to fight the disease, and was to embark Thursday on a tour of Ethiopia, South Africa and Mozambique to review US anti-AIDS efforts there.

AIDS has hit southern Africa harder than any other region in the world, with HIV infection rates ranging from 20 percent to nearly 40 percent of adults in the most affected countries, according to the UN agency UNAIDS.

Nine billion dollars of the 15 billion Washington has earmarked for the program are destined for 14 countries: Botswana, Ivory Coast, Ethiopia, Guyana, Haiti, Kenya, Mozambique, Namibia, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia.

Five billion dollars are earmarked for ongoing bilateral programs in more than 100 countries and one billion was set aside for UN anti-AIDS campaigns.

dlc/km/rh

Health-AIDS-US

COPYRIGHT 2004 Agence France-Presse. All rights reserved.

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