The Bush administration and some members of Congress appear to be playing a nasty game of political football with AIDS and global health issues. In recent days, the administration has radically reduced the number of government scientists who will be permitted to attend the biennial International AIDS Conference, slashed its support for the event and its funding for an annual meeting of the Global Health Council. The reason? Aid and comfort for the policies of the religious right.
Last month Health and Human Services Secretary Tommy G. Thompson announced that the Centers for Disease Control and Prevention and the National Institutes of Health would send just 50 delegates to the 2004 International AIDS Conference in Bangkok, the preeminent scientific gathering on HIV research and treatment. The last gathering, in Barcelona in 2002, included 236 American government scientists.
In addition, Health and Human Services hacked its general funding for the AIDS conference from $3.6 million to less than half a million. The big losers will be scientists and physicians from Africa and other regions hit hard by AIDS, who typically attend the conference on fellowships largely underwritten by the U.S. government.
As U.S. cancellations pour in, many of the satellite sessions -- separate meetings in Bangkok on specific research topics -- have been forced to cancel or reorganize because key participants will be unable to attend.
What is lost? Consider one small example: Scientists from desperately poor countries, such as Zimbabwe, Nambia and Kenya, where more than 20% of the populations are HIV-infected, need critical skills in grant-writing, data collection and health-cost monitoring. Typically, American government scientists and officials teach those skills in satellite sessions at the conference. But not this year.
Similarly, the Global Health Council will hold its annual convention, in Washington on Thursday, without funding from the U.S. government, a first in the council's 31-year history. The conference lost a third of its budget when the Bush administration pulled the plug in April.
A Washington Times editorial on April 23 sparked the cuts, calling the Global Health convention a "reproductive rights" gathering that "expressly opposed the Bush administration's agenda on sexual-health issues."
The convention's theme, "Youth and Health: Generation on the Edge," prompted the organizers to include sessions on sex education, birth control and drugs -- issues that the council's President Dr. Nils Daulaire acknowledges are "sensitive, controversial and emotionally charged."
Among the scheduled speakers targeted by conservative opponents of the conference are representatives of Planned Parenthood, the U.N. International Family Planning Fund, MTV and MoveOn.org -- groups that the Traditional Values Coalition, the Eagle Forum and other right-to-life groups see as promoting birth control and abortion.
Programs like the council's may "not reflect the administration's policies" (to use the words of the Traditional Values Coalition's Angela Lafferty), but targeting the AIDS conference seems to fly directly in the face of Bush's own pronouncements.
"God has called us into action" in a war against AIDS, Bush has said in justifying his $15-billion AIDS initiative. So why radically reduce the effectiveness of the international scientific meeting that focuses on that war?
Perhaps part of the reason is that Thompson didn't like the heat generated at the conference in Barcelona by AIDS activists. Many think that the U.S. doesn't do enough, and loud jeers drowned out Thompson's speech in 2002. But there is also evidence that, as with the Global Health Council, the AIDS-meeting cuts reflect the agenda of the religious right.
A team of Republican members of Congress, led by Indiana's Rep. Mark E. Souder, charged in a recent letter to conference organizers that the 2002 AIDS gathering in Barcelona had 777 presentations that mentioned condoms, "compared to 16 for 'faithfulness' or 'fidelity' and 74 for 'abstinence.' " The Republican letter also brought up the "fact" that it was sexual abstinence and marital faithfulness that had led to a dramatic reduction in AIDS cases in Uganda. These critics also expressed shock that no representative of the Vatican was invited to give a keynote address to the Barcelona meeting.
Souder and his colleagues used their calculations to push for changes in the Bangkok agenda. They wanted faith-based approaches to get more-equal billing. They didn't seem to know that there were already five sessions scheduled to address the roles that religious organizations play in the war on AIDS.
And as for how the science from Uganda should be understood, even members of President Bush's Advisory Council on HIV and AIDS have agreed that the reduction in HIV infections there is actually the result of a complex education program. Promotion of sexual abstinence and faithfulness were among its elements, but so was condom use -- and relentless public promotion of safe sex by Ugandan President Yoweri Museveni.
It is intolerable to undermine American support of international health meetings for the purpose of promoting a narrow American agenda. With more than 70 million people living with HIV today, and with every new generation of adolescents in particular peril, the United States has an obligation to address teen health education, to make common cause with the world's scientists and to fund and fight the war for treatment, prevention and a cure for AIDS.
Laurie Garrett, a Pulitzer Prize-winning health reporter, is now a senior fellow at the Council on Foreign Relations.