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Fighting AIDS One Dollar at a Time
For years, critics of various AIDS and HIV prevention programs have insisted officials can’t “simply throw money at a problem.” Yet two recent studies from the World Bank suggest that the conventional wisdom may have pegged deterrence all wrong.
According Alex Ogle of Yahoo! News, the studies followed two programs which offered financial incentives to girls and young women in Malawi and Tanzania, two countries rift with poverty and a high rate of infection. The Malawi program gave cash rewards to girls who kept up with regular school attendance, while the Tanzania program paid young people not to have unprotected sex.
“The studies show the potential for using cash payments to prevent people, especially women and girls, from engaging in unsafe sex while also ensuring that they stay in school and get the full benefit of an education,” David Wilson, who heads the Bank’s global HIV/AIDS program, tells Ogle.
It may seem incredible: paying girls and young women to be smart, and be safe. However, an emphasis on education and safety often take a back seat to the societal pressures of poverty. With few resources available to them, girls and young women will commonly engage in “transactional sex,” or the trade of sexual intercourse for assistance, gifts or money. But the studies findings suggest that financial incentives can be powerful motivators towards decreasing the risks with sexual activity. In Tanzania, the payment option found a 25 percent drop in curable sexually-transmitted infections. The World Bank also found that girls who received payments tended to be less sexually active, but when they did engage in sex, they did so with partners who were less likely to be infected.
The findings come at a critical time for AIDS research. Currently, the 18th International AIDS Conference is underway in Vienna, and the major concern for most participants is funding. With the Obama Administration shifting the focus to mother-and-child health, AIDS advocates are afraid that the necessary $20 billion in pledges won’t be reached over the course of the next three years.
AIDS IS STILL WITH US
“This is not the time to withdraw resources from AIDS,” Nicci Stein, director of the Canadian-based Interagency Coalition on AIDS and Development, tells the Associated Press on July 22. “We risk losing the investments made to date and we will be betraying those communities who for the first time have real hope for the future.”
Many of the attendees to the Vienna conference blame the lack of funding on recent efforts to revitalize the War on Drugs. In fact, attendees put together a document called the Vienna Declaration, which urges a policy of amnesty towards drug users if they have AIDS. It also makes provisions for those infected with AIDS to receive clean needles, methadone and treatment.
“The declaration argues that arresting drug users forces them into hiding, which spreads the epidemic,” Donald G. McNeil, Jr. writes for The New York Times on July 22. “It backs “science-based public health approaches” proven in clinical trials, which can include everything from clean needle swaps to 12-step recovery programs to methadone.”
Outside of Africa, nearly a third of HIV infections world wide stem from intravenous drug use. In America alone, it accounts for 16% of the infection among females. But many countries, including America, have taken a strict anti-drug policy; criminalizing users instead of treating them. The fear of prosecution keeps many drug users from seeking medical assistance, increasing the likelihood of infecting others. The criminalization of drug users is, according to experts at the Vienna conference, “fueling the HIV epidemic.”
“Many of us in AIDS research and care confront the devastating impacts of misguided drug policies every day,” Julio Montaner, president of the International AIDS Society and director of the BC Center for Excellence in HIV/AIDS, is quoted as saying by the Associated Press on June 28 . “As scientists, we are committed to raising our collective voice to promote evidence-based approaches to illicit drug policy that start by recognizing that addiction is a medical condition, not a crime.”
For many AIDS activists, prevention methods in the status quo are currently inadequate. Even the success of the cash payment programs in Malawi and Tanzania suggest several building blocks are missing.
A NEW MODEL FOR CHANGE
“Programs like these could become an important missing part of effective HIV-prevention strategies,” Berk Ozler, a senior economist with the World Bank’s Development Research Group, who conducted the study with researchers from George Washington University and the University of California, tells the Associated Free Press.
The World Bank’s creative response to the threat of HIV could be a model for the United States to follow, setting an impressive precedent that combines efficient prevention techniques with innovative strategies to curtail the global rate of infection. First, the United States needs to abandon the War on Drugs (even Gil Kerlikowske, the administration’s current drug czar, has referred to the 40-year, $1 trillion expenditure, called the war a failure in an interview with the Associated Press last month) and reallocate the funding elsewhere. Following the example of Malawi and Tanzania, states and localized agencies can offer financial incentives to HIV-positive, intravenous drug users to seek treatment, avoid sharing needles and refrain from unprotected sex.
While the Vienna conference also shared some positive breakthroughs for AIDS research–including the announcement of a vaginal gel with an antiretroviral drug that protected 40% of the women who used it during the South African clinical trials — it highlights how AIDS-appropriate financing is being allocated elsewhere. America currently accounts for 58 percent of the global funding towards AIDS prevention and research, while Austria, the host of the conference, has given barely $1 million dollars since 2002. Medicine for AIDS treatment has reached something of a golden age, more affordable than ever, yet largely unavailable to the populations that need it most, as HBO’s “The Lazarus Effect” illustrated when it aired two months ago.
“I certainly agree with the fact that a lot of the progress that we have made could indeed be lost,” Michel Kazatchkine, Global Fund’s executive director, tells The Associated Press. “I know there is an economic crisis but then I’m saying this is a political decision and politics is about choices and where you put your priorities.”
Until countries refocus to promote innovative ideas to promote actual prevention, it is unlikely that funding for the health crisis will increase.
Do you think the governments of the world should do more to finance AIDS prevention and awareness programs? Should drug use be decriminalized to help check back the AIDS epidemic? Weigh in!
Longest Zero-Carbon Trip Ever Attempted
Kevin Shannon, a long time cyclist is about to undertake a grueling 3 year trip around the world in what will become the longest, unintentional zero-carbon trip ever attempted. That’s right, the ambitious 23 year-old isn’t even crusading for a green cause. Shannon’s trip which will also include a sailing portion across two oceans was planned to raise money for a charity that assists combat veterans. Because he also noted that he intends to create absolutely no carbon emissions, Kevin Shannon is being championed as the newest Earth advocate.
Shannon’s expedition will take him through Europe by bike, then across much of Russia, through Mongolia and China’s Gobi Desert, and down through Southeast Asia. From there he will exchange biking with sailing for a brief period while he navigates through the Indonesian islands, Australia, and New Zealand. From New Zealand Shannon hopes to hitch a yacht to Chile, where he will continue his journey through South America.
