An ICIJ Investigation Divine Intervention: U.S. AIDS Policy Abroad

Bush's AIDS initiative: Too little choice, too much ideology

Restrictive funding, emphasis on abstinence hinder $15 billion effort.

Key findings

  • A year-long investigation of President Bush’s initiative to fight AIDS abroad finds that conservative ideology hinders its real benefits by insisting on abstinence-only programs over promoting condom use.
  • In 2003, President George W. Bush asked Congress to appropriate $15 billion for an international AIDS initiative, the President’s Emergency Plan for AIDS Relief (PEPFAR) — a plan that, while seeking to treat those infected with HIV/AIDS and prevent the spread of the disease, is hindered by conservative ideologies.
  • ICIJ found that PEPFAR actually restricts the use of funds because of its ties to faith-based organizations that promote abstinence-only programs and overlook the importance of other courses of action such as condom use.

About this investigation

A year-long investigation into how rigid rules and restrictions of President Bush's initiative to fight HIV/AIDS have affected countries struggling with the pandemic.

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Divine Intervention

‘Holy water cures even HIV’

ETHIOPIA: Atnafu Betseha, 32, is an Ethiopian Orthodox priest at the holy water site of St. Mary’s Church. His job is to administer the water and pray for the healing of the more than 700 pilgrims that arrive here every day.

ETHIOPIA: Michot Sebresilassei, 20, an HIV-positive woman from Eritrea, drinks holy water every morning to wash down the antiretroviral drugs (ARVs) provided by the U.S. government through the local hospital.

ETHIOPIA: Tatiana Shoumilina is an adviser for UNAIDS, the Joint United Nations Program on HIV/AIDS, in Ethiopia. She says HIV programs won’t work unless they combine a sense of urgency with long-term planning.

ETHIOPIA: Mengistu Asnake is the deputy country representative in Ethiopia for Pathfinder International, a Boston-based charity that supports family planning and reproductive health services in the developing world.

SOUTH AFRICA: In South Africa, some AIDS funds go to faith-based groups with little expertise.

HAITI: Jean-Saurel Beajour is the founder of the Haitian-based Association of National Solidarity for People Living with HIV-AIDS (ASON), Haiti’s first AIDS community advocacy group.

NIGERIA: Nigeria has been slow to respond to the HIV threat, and may be understating the epidemic’s reach.

ETHIOPIA: Hotels along the Djibouti corridor, Ethiopia’s main trade route to the Red Sea, are lately undertaking an unexpected and disturbing role as hospices for commercial sex workers infected with HIV/AIDS.

INDIA: Insistence on condoms keeps HIV under control in India but clashes with U.S. funding restrictions.

Click on the above link (centralfunds.xls) to download a list of centrally awarded and managed funds by the U.S. Agency for International…

HAITI: The Cité de Dieu community is one of many that have fallen off the radar screens of governmental and nongovernmental organization programs. The one organization still helping to feed the community is a neighborhood church named Redemption.

Divine Intervention

Condoms’ Reliability Disputed

Four U.S. agencies rate effectiveness higher than PEPFAR.

KENYA: Complicated funding forms in Kenya beyond the reach of illiterate caregivers.

UGANDA: As Uganda lessens its promotion of condoms, early HIV achievements suffer a setback.

ETHIOPIA: “During the day I am a member of the association and at night I am a commercial sex worker in the streets. I am not sure how old I am, but I think I am around 27,” says Tigist Salomon.

ETHIOPIA: Sixteen-year-old Yeshiwork Gashaw lives with her mother in Ethiopia’s remote northeastern Amhara region. When interviewed she was taking an HIV prevention course taught by Food for the Hungry, an Arizona-based relief organization that received an $8.3 million President’s Emergency Plan for AIDS Relief (PEPFAR) grant to teach abstinence and fidelity to young people.

HAITI: Dieula sits in a circle of women on the tiled floor of a dimly lit room here, discussing the sexual violence that makes HIV infection an ever-present danger for Haitian women.

HAITI: Dr. Catherine Maternowska is an assistant professor at the University of California, San Francisco in the departments of Obstetrics, Gynecology and Reproductive Sciences and Anthropology, History and Social Medicine.

HAITI: Bresa Belizaire works out of a wood hut with a raked-dirt floor. Under a wooden chair in the corner are bottles of medicine and human bones. Belizaire is a voodoo priest, or “houngan” in Creole, in Thomonde, Haiti, an impoverished area in the center of the country.

ETHIOPIA: An estimated 130,000 adults and children died of AIDS in Ethiopia in 2005 alone. But others are surviving with the help of antiretroviral drugs — a therapy that fights the HIV virus — that they get through the President’s Emergency Plan for AIDS Relief.

HAITI: Project Medishare is one of many U.S. organizations working on improving the health of this community, where between 5 and 10 percent of the population is infected with HIV.

Divine Intervention

Once-Tamed Epidemic Reemerges

THAILAND: Condoms on the wane in Thailand, but not risky behavior.

The government program is funded entirely with public money. It has nothing to do with national security. And it appears to spotlight the Bush administration’s “compassionate conservative” profile. It would seem, in other words, to be just the kind of program officials would gladly share with journalists.

From Abstinence to the WHO: Here are some common acronyms and terms in the Divine Intervention project.

KENYA: Treatment’s cost and stigma force some Kenyans to take their chances.

THAILAND: Brothels in Thailand under pressure from police and faith-based groups.

Divine Intervention

About This Data: PEPFAR Grants

In the course of the investigative reporting for the Divine Intervention project, the Center for Public Integrity sued the U.S. State Department on behalf of the International Consortium of Investigative Journalists (ICIJ) to gain access to funding information for the President’s Emergency Plan for AIDS Relief (PEPFAR).

A year-long investigation into how rigid rules and restrictions of President Bush’s initiative to fight HIV/AIDS have affected countries struggling with the pandemic.

Divine Intervention

Key Findings

  A year-long investigation of President Bush’s initiative to fight AIDS abroad finds that conservative ideology hinders its real benefits by insisting…

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