Experts attack damaging approach to AIDS pandemic

Posted: 22 November 2005

All too often, AIDS campaigners and those who promote family planning pursue their goals in isolation of each other. This has slowed progress in reproductive health care in Asia, and enabled the AIDS pandemic to continue spreading, leading experts in the field said this week.

"Many in the family planning field (view) AIDS as a disreputable disease among disreputable people," Steven W. Sinding, director-general of the London-based International Planned Parenthood Federation, said at the third Asia-Pacific Conference on Reproductive and Sexual Health.

He recalled that in the 1980s, an official with the US Agency for International Development tried to separate condoms for family planning from those for HIV prevention, as if the contraceptive worked in different ways.

Sinding said the gulf between HIV/AIDS groups and those in areas of reproductive health was deepened by the 2002 creation of the Global Fund to Fight AIDS, Tuberculosis and Malaria. This sent a signal that donors wanted to see HIV/AIDS dealt with as a communicable disease rather than a sexually transmitted one. "In that sense, the donor community is (also) to blame," he noted.

In addition, the rise of conservative forces in the United States was accused of preventing greater integration between HIV/AIDS initiatives and family planning.

Focus on abstinence

US officials have focused on abstinence rather than safe sex in the battle to contain the pandemic. "This role of Uncle Sam in international AIDS funding has made it extraordinarily difficult for reproductive and sexual health institutions to get involved (in fighting AIDS," Sinding said.

Experts say bridging the artificial divisions between HIV/AIDS and family planning promises benefits on several fronts.

Enabling a family planning or counselling clinic to do AIDS tests might encourage more people to ascertain their status, as there is currently a stigma attached to going for a test in a stand-alone AIDS centre.

These words were echoed by Thoraya Ahmed Obaid, executive director of the United Nations Population Fund.

"It's time to integrate reproductive health and rights in all national AIDS plans," she told the conference, Wednesday. "And, it is time to include HIV prevention in reproductive health programmes, including family planning and antenatal services. This will save money and most importantly, it will save lives."

Sexual transmission

For integration in Asia, said Sinding, governments should "resist the tendency to separate both the delivery systems and the budget lines for HIV/AIDS on the one hand, and sexual and reproductive health on the other" -- as sex tended to become the dominant means of transmission as the AIDS pandemic expanded.

In Africa, more than 75 percent of new infections are from sexual transmission. Unless Asian countries guarded against the "artificial and self-defeating separation of AIDS from the rest of reproductive and sexual health, the same thing could happen here," Sinding observed.

There are already more than eight million people living with HIV/AIDS in the region.

On a more positive note, both Obaid and Sinding took heart in the inclusion of reproductive health in the outcome document of the September summit in New York that reviewed the Millennium Development Goals, a set of targets for which the deadline is 2015.

"Now we need to use this opportunity to accelerate action," Obaid said.

Source: Inter Press Service, 18 November, 2005

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