Heart Hurt

(Editorial cartoon by Joel Pett / Lexington Herald-Leader (July 25, 2012) and featured at McClatchy DC. Click on image to enlarge and then kindly return.)

Journalist and documentary film-maker Lisa Biagiotti has a heart-breaking op-ed piece in the Los Angeles Times. There's an international AIDS/HIV conference being held in the US and most folks are busy congratulating each other on the fact that we finally seem to have a handle on this dread disease in terms of treatment, and some signs that we may have a vaccine in the pipes to prevent the infection to begin with.

Ms. Biagiotti reminds us that those congratulations just might be a little premature, especially in this country.

The South has the highest rate of AIDS deaths of any U.S. region. It also has the largest numbers of adolescents and adults living with HIV and the fewest resources to fight the epidemic.

The disease there is concentrated largely in poor minority communities. Diagnoses tend to be late and often only after the infection has progressed to AIDS. Treatment is less effective at that stage, and that's assuming it is even available. Thousands of those living with the human immunodeficiency virus are unable to get the medications they need, waiting in limbo for slots to open up in state AIDS drug assistance programs. President Obama recently pledged to eliminate these waiting lists, and I hope he does.

In Mississippi, the AIDS death rate is 60% higher than the national average, and about 50% of the people who know they are living with HIV are not receiving care, about the same percentage of nontreatment as in Ethiopia. [Emphasis added]

As if the racism and poverty aren't bad enough, those infected face the additional burden of homophobia from within their own family and culture.

I have spent time with and interviewed many black gay men living with HIV in the South, and they tend to tell similar stories. Their families have shamed and shunned them; their churches have condemned them. The schools they attended failed to provide even the most basic sex education.

The culture, they say, has forced them into hiding. Some marry; some have girlfriends. They try to be invisible in a culture that can accept black men as prisoners, drug dealers, gangsters, adulterers, absent fathers — but not as gay.

The underlying problems of stigma, discrimination and homophobia are palpable, and they exacerbate the crisis. One black pastor I filmed urged his flock to see HIV/AIDS as a punishment: "Some say that homosexuality is not a sin," he intoned. "It is. AIDS is God's curse to a homosexual life."

That's a rough road, one that needs to be addressed by all the smiling scientists and sociologists and politicians at that international meeting.


[Note: "deepsouth", Lisa Biagiotti's documentary on HIV in the South, premiered this week. More information on the film here]

Fact Free Promoting

The nature of the worst administration ever has been summed up rather aptly in its own words. Last night's Bill Moyers' Journal brought up a perfect example of the irrationality of all occupied White House operations from end of term musings.

President Bush is racing against the clock to polish his legacy for posterity. In an interview the other day on ABC News he claimed credit for trouncing Al Qaeda in Iraq. Journalist Martha Raddatz promptly reminded him there were no Al Qaeda in Iraq until he invaded the country. Where upon the President replied.

PRESIDENT BUSH: Yeah, that's right. So what?

BILL MOYERS: There you have it. Our own judges' choice of the defining quote of '08 and the mantra of the Bush years, the facts don't matter, so what.

It is a feature, not a bug, that rationality does not apply in the programs of the maladministration. The New York Times editorialized about the idiocy of abstinence education in what otherwise would be programs for the fight against AIDs.

Mr. Bush is pressing for a new five-year commitment of $30 billion. He will travel to Africa in February to make his case — and, the White House hopes, burnish the compassionate conservative side of his legacy.

Despite the effort, there are still 33 million people living with H.I.V., and the United Nations estimates that there were 1.7 million new infections in 2007 in sub-Saharan Africa alone. Critics, including Mr. Kerry, are particularly incensed by the requirement that one-third of the prevention funds be spent teaching abstinence, despite a lack of scientific consensus that such programs reduce the spread of H.I.V.

When a Ugandan AIDS activist, Beatrice Were, denounced the abstinence-only approach at an international AIDS conference last year, she received a standing ovation. Paul Zeitz, executive director of the Global AIDS Alliance, an advocacy group here in Washington, says the Bush program has been hamstrung by “ideologically driven policies.”

That assessment was echoed, in more diplomatic terms, by the independent Institute of Medicine, which evaluated the program in March. It called on Congress to abandon the abstinence requirement and to lift the ban on paying for clean needles for drug addicts, among other changes.
(snip)
Some AIDS experts say the money could be spent more efficiently. Yet the fight is not over whether to reauthorize the program, but how. Much of the money has been channeled through American religious-based organizations...

Of course, using taxpayer money to fund the right wing has often made him a love object for its members. That has led to ever greater domination of the rethuglican party by that wing. Its effects have been fatal in more than one way.

The irrational exuberance that has characterized the departing war criminals has made them dear to the weakminded, while it has destroyed so much of what made this country prosper. The result has been the wingers' embrace of the worst interests of the U.S., while insisting that this country has their gods' blessings.

As Moyers concluded yesterday, the fact free operation of the executive branch has been its dominant characteristic. He could have enlarged that conclusion to include the rest of the wingers. Facts have a liberal bias, when any regard for them would destroy your anti-liberal cause.

Peripheral Damage

A report that is being posted throughout media outlets this morning concerns what happens to youths who are given sex education slanted toward abstinence. The incidence of use of protection is quite naturally higher among those who are given information about prevention.

There were no statistics in the study for actual pregnancies and contraction of disease. As I recently reported, in Dallas, rising AIDs occurrence is leading the City Council to reconsider its prevention of public health workers' distributing condoms.

The sadly recidivist trend in winger circles is damaging children affected in more than just their homes. When community attitudes force schools to shutter down education, in many fields, the future of this country is damaged as well.

The study is the latest to raise questions about programs that focus on encouraging abstinence until marriage. The findings also reignite the debate about the effectiveness of abstinence-focused sexual education just as lawmakers are about to reconsider the more than $176 million in annual funding for such programs.

Rosenbaum analyzed data collected by the federal government's National Longitudinal Study of Adolescent Health, which gathered detailed information from a representative sample of about 11,000 students in grades seven through 12 in 1995, 1996 and 2001.

Rosenbaum focused on about 3,400 students who had not had sex or taken a virginity pledge in 1995. She compared 289 students who were 17 years old on average in 1996, when they took a virginity pledge, with 645 who did not take a pledge but were otherwise similar. She based that judgment on about 100 variables, including their attitudes and their parents' attitudes about sex and their perception of their friends' attitudes about sex and birth control.

By 2001, Rosenbaum found, 82 percent of those who had taken a pledge had retracted their promises, and there was no significant difference in the proportion of students in both groups who had engaged in any type of sexual activity, including giving or receiving oral sex, vaginal intercourse, the age at which they first had sex, or their number of sexual partners.

There is a tragic difference between the parenting that informs children of facts and that that seeks to indoctrinate children in a particular religious pattern. The adolescent stage for all children includes resistance to whatever background they are familiar with. When they have been given rational patterns to follow, they will find their way to facts that will help them make decisions they will benefit from. When all they have been given is prejudice, of any sort, they start from so far behind that they may have any amount of trouble finding out what works for them.

Caring for children demands intelligence, and hopefully studies of the sort reported here will help guide parents away from the doctrinaire approach that damages their own family.

My direct experience with parents who put their religion above their children in importance do deep and lasting damage - particularly to 'family values'.

World AIDS Day Monday

Tomorrow the world will mark a day set aside to raise awareness of the epidemic AIDS has been. It will be time again for responsible leadership to draw attention to the easily available ways that the killing illness can be avoided.

In this country, responsible adults will be silenced by the occupied White House in its campaign to enable right wing religious organizations that refuse to acknowledge prevention that does not set abstinence as its major tenet. A celebration last July made a point of showing the harm done.

NAIROBI, Kenya -- On July 5, Beatrice Were, the founder of Uganda's National Community of Women Living with HIV and AIDS, stood before hundreds of other HIV-positive women in Nairobi's vaulted city hall and denounced the Bush administration's AIDS policies.

Like many in attendance, Were contracted HIV from her husband, a common occurrence in a region where women make up the majority of new infections and marriage is a primary risk factor. For those like her, the White House's AIDS prevention mantra -- which prescribes abstinence and marital fidelity, with condoms only for "high risk" groups like prostitutes and truck drivers -- is a sick joke.

"We are now seeing a shift in recent years to abstinence only," she said. "We are expected to abstain when we are young girls and to be faithful when we are married to men who rape us, who are not necessarily faithful to us, who batter us." The women in the audience, several waiting to share their own stories of marital rape, applauded.

Were exhorted her audience to "denounce programs that are not evidence-based, that view AIDS as a moral issue, that undermine the issues that affect us, women's rights. I want to be very clear -- the abstinence-only business, women must say no!" Again, there were hollers and applause.

There were lots of voices like Were's in Nairobi last week, where the YWCA sponsored a massive international conference on women and HIV. Yet they rarely seem to break through in the United States, where the conventional wisdom holds that the President's Emergency Plan for AIDS Relief (PEPFAR) is a bright spot in an otherwise execrable presidency, one that only the ideologically blinkered refuse to credit. Nick Kristof seems to repeat this notion in The New York Times every other week, and Bono affirmed it when he insisted on putting Bush on one of the 20 different covers that graced Vanity Fair's special Africa issue. "USA TODAY's Susan Page just got off the telephone with Bono. She says President Bush can count the rock star as a fan today," the newspaper's blog reported in late May. "The Grammy winner was singing the praises of the American president for his announcement today that he would propose spending an additional $30 billion over five years to fight AIDS in Africa, doubling the U.S. commitment."

For many toiling in the trenches of the pandemic, though, opinions about PEPFAR are far more ambivalent. It's a moral conundrum: how do you weigh lives saved by treatment against lives lost through policies that sabotage prevention?

In less than two months the bizarre figures who have stamped out rationality in the U.S. executive branch will leave. The responsible adults will return. They will face a huge barrier in the personnel implanted in this government by the departing bottomfeeders.

We can celebrate a return to respect for intelligence while taking the lesson learned, that indulging the deficient to the point of giving them power can be fatal.

The Heartbreak of Denial

There was a heartbreaking story in today's NY Times today. A study has established that because of a government policy, hundreds of thousands of people died needlessly.

A new study by Harvard researchers estimates that the South African government would have prevented the premature deaths of 365,000 people earlier this decade if it had provided antiretroviral drugs to AIDS patients and widely administered drugs to help prevent pregnant women from infecting their babies.

The Harvard study concluded that the policies grew out of President Thabo Mbeki’s denial of the well-established scientific consensus about the viral cause of AIDS and the essential role of antiretroviral drugs in treating it.

How could this happen? And why did it? Thabo Mbeki is no fool. He was a well-respected leader at a time when South Africa needed him. What happened? Well, he succumbed to ideology over science, as the article makes clear.

Mr. Ramatlhodi [a senior ANC party member now running the party’s 2009 election campaign] himself acknowledged in a recent interview that in 2001 he sent a 22-page letter, drafted by Mr. Mbeki’s office, to another of Mr. Mbeki’s most credible critics, Prof. Malegapuru Makgoba, an immunologist who was one of South Africa’s leading scientists. The letter accused Professor Makgoba of defending Western science and its racist ideas about Africans at the expense of Mr. Mbeki. [Emphasis added]

Mr. Mbeki fell for the science deniers' allegations that it was all a nasty Western plot to portray black South Africans as sex-crazed like all primitive blacks are. HIV didn't cause AIDS, and besides, beet juice would take care of everything.

Generations of South Africans are dead as a result, including babies who were born with and then died of the virus when retroviral medication would have prevented the deadly outcome.

Sadly, this is only the latest tragedy of science denial. I did a search of just this blog and found that I had posted on some similar situations in which ideology trumped science with disastrous effects. I indicated in that post, it's not just 'underdeveloped' nations who fall prey to such easy thinking. As I noted three years ago, the link between HPV and cervical cancer is undeniable, and yet fundagelicals in this country are still fighting against the administration of the vaccine to pre-teen girls who aren't yet sexually active for fear that the kids will see this as a license to fuck:

In the US, for instance, religious groups are gearing up to oppose vaccination, despite a survey showing 80 per cent of parents favour vaccinating their daughters. "Abstinence is the best way to prevent HPV," says Bridget Maher of the Family Research Council, a leading Christian lobby group that has made much of the fact that, because it can spread by skin contact, condoms are not as effective against HPV as they are against other viruses such as HIV.

But there is something worse than ideology trumping science, as hard as that might be to imagine at first. Sometimes short-term economic considerations have the same effect. A recent vice presidential nominee suggested that she is still not convinced that there is a link between human activity and global warming. Now, this is a slight improvement: it's only been the last nine months or so that some people in this country have acknowledged the reality of global climate change.

However, in the last eight years the current administration and its financial owners have done everything possible to thwart any meaningful American involvement in the problem and, more importantly, in the solution. To so engage the country might result in shrinking bottome lines for oil companies and their lackeys. Alaska might not get its natural gas pipeline. Coal mine owners might not get their government dole for the next "clean coal" advertisement.

It will take more than a new president with a new vision to turn things around for this country and for this planet. It will take a commitment by the entire world, including those who are uncomfortable with the role science must play. If we cannot make that commitment, then we truly are doomed. Each day the problem is not addressed more species disappear, more complications arise, and more chances for reveral dissipate. The human world, at the very least, will end.

Not with a bang, but a whimper.

Negotiation Is In Order

The refusal of the occupied White House to negotiate with other nations has recently been winding down as the policy resulted in nothing but failure. With North Korea at last being allowed off the idiotic 'Axis of Evil' designation, some thawing is occurring in the U.S. relations with that country. Soon we may even be back to the state we were in when this worst administration ever came into office in 2000.

In returning to some degree of sanity in negotiating with Iran, this country may well be reacting to ongoing incidents of detention of those with good relationships with the U.S., as well as to the threat of nuclear capabilities.

A human rights group is calling on Iran to release immediately or charge two doctors renowned for their work on the prevention and treatment of HIV/Aids.

Human Rights Watch says the authorities have not disclosed why Arash Alaei and Kamyar Alaei were detained last month, or where they are being held.

The two brothers have travelled widely outside Iran, including to the US, to take part in conferences on HIV/Aids.

They were due to take part in a major meeting in Mexico next month.

Arash Alaei was scheduled to give a presentation on some of Iran's innovative HIV programmes, Human Rights Watch says.

The brothers are credited with getting the Iranian authorities to tackle the stigma of HIV infection and the disease Aids, in a country where sex, drug abuse and the disease itself are taboo subjects.
(snip)
In recent years Iran has arrested a number of academics who have ties with the US, its main global enemy.

It will take more than the feeble gestures toward reconciliation with the nations it has treated as disposable for the administration to regain our place in the world. The adolescent bravado it mistakes for machismo has done so much damage, it is doubtful that the rest of the world would ever see this country as capable of leading the world.

In the recent talks concerning nuclear development, things came to a standstill when the administration's sticking point of giving up in the beginning wasn't accepted by Iran.

The failure of the Geneva meeting resurrected fears that the U.S. or Israel – a country Ahmadinejad has threatened repeatedly – would seek a military solution.

"The Iranians are playing a colossal game of chicken with us," says Ilan Berman, vice-president of the American Foreign Policy Council. "Does the international community have the will to take the short-term pain and disarm these guys, or accept the long-term pain of a region completely dominated by this regime? I think the world community has essentially come to grips with the fact that Iran is going to go nuclear. The talks are an implicit endorsement of Iranian nuclearization."

Escalating unease is a lack of certainty about how far Iran may be from creating a nuclear bomb.

There is too much time between now and the return of levelheaded service in the executive branch. That will take regime change.

Damage control can begin in 182 days.

Abstinence from Rational Behavior

Joined at the hip with the right wing, this worst administration ever has made a big show of massive funding for AIDs prevention in Africa, with emphasis on promoting abstinence programs. As discussed with ql in comments this morning at Eschaton, the administrators of the actual program ignore this required ignorance because they are actually interested in prevention. Personal knowledge is not the only counterforce against the idiocy, though.

The President's Emergency Plan For Aids Relief (Pepfar), personally initiated by George W Bush, has been described in Washington as the most successful foreign aid programme since the Marshall Plan, and "the best thing that ever happened to the poor people I work with" by one HIV programme leader in Africa. On a recent visit to the continent, Bush was feted as the saviour who has put one and a half million Africans on life-saving drugs.

"We used to sit around fantasising about having unlimited resources," Pisani recalls. "Like winning the lottery." Today, the Aids industry - "or Aids mafia", in her words - effectively has won the lottery. But Pisani is not celebrating. Her book, The Wisdom of Whores, published this week, condemns the global strategy for Aids as an ill-conceived waste of money which is not saving but costing lives.

"HIV is mostly about people doing stupid things in the pursuit of pleasure or money," declares the cover on a proof copy of the book. "We're just not allowed to say so." She suspects she will never work in the Aids industry again for saying so. "But it's true."
(snip)
Even the 20 cents in every US dollar allowed to be spent on prevention is wasted, Pisani argues. A third of the prevention budget has to be allocated to faith-based organisations, which refuse to distribute condoms and will promote only abstinence before marriage. The failure rate of "virginity pledge" programmes among young Americans in the US is about 75%; condoms' failure rate is roughly 2%. Yet Pepfar, Pisani laughs, "claims its policy decisions are 'evidence based'".

This supposed secret has been known by practitioners and DFHs for some time. Pisani admits that she knows her putting out the truth is a career ender for the epidemiologist. The programs, though, are killing people, as Professor Wombat remarked this morning, also in comments. We were discussing the WaPo editorial on the PEPFAR funding that made my blood boil, ignoring all the tenets of AIDs treatment to promote a useless expenditure on the trophy program.

THE PRESIDENT'S Emergency Plan for AIDS Relief (PEPFAR) is American "soft power" at its life-saving best. Since 2003, PEPFAR has supported HIV testing and counseling for more than 33 million people and care for more than 6.6 million (including more than 2.7 million orphans and other children infected and affected by HIV). The program has funded medicine for about 1.5 million men, women and children worldwide, the vast majority of them in sub-Saharan Africa. Even President Bush's harshest critics concede that PEPFAR, which has cost $15 billion so far, is one of his best accomplishments. When Mr. Bush asked Congress to authorize a five-year, $30 billion extension, Democratic lawmakers in both houses raised the proposed funding level to $50 billion, and legislation sailed through with bipartisan support in both the House and the Senate Foreign Relations Committee.

Then it stopped: Sen. Tom Coburn of Oklahoma and six other Republicans have exercised their prerogative to keep it off the Senate floor.

In its effort to support a failed presidency that it promoted, WaPo's editorial poster children will blind themselves to any information, even though it is published in their own news sections.

Abstinence doesn't work. Teaching it instead of actually preventing the spread of AIDs is killing people.

The Texas Education Code, written by the state legislature, requires that classrooms give more attention to abstinence than any other approach and that they must present abstinence as the only method that is 100 percent effective at preventing pregnancy, sexually transmitted infections, HIV/AIDS, and the “emotional trauma associated with adolescent sexual activity.”
(snip)
This lack of sex education is certainly taking a toll:

* Texas ranks number one in teenage births, costing taxpayers there over $1 billion a year. And 24 percent of those births are not the girl’s first delivery.

My comment at WaPo on their editorial about our AIDs program for Africa:

jocabel wrote:
As noted, 33% goes to abstinence - which directs the funds to rightwing groups for the most part, spreading their particular virulence thru the program. This definitely indicates that the U.S. effort is a waste of funds, unless the purpose is proselyting, not a value that the funds are dedicated toward. Coburn has better sense than the worst administration ever.

*******************************************************

McCain Flip-Flop List , my favorite: McCain supported a major campaign-finance reform measure that bore his name. In June 2007, he abandoned his own legislation.

U.S. Policy is Just Plain Wrong

While Africa is gaining the name of the "orphan continent" since so many children are losing their parents to AIDs, the U.S. continues to promote abstinence programs with a large percentage of its funds. A study program just published has revealed that they do not work.

Mr. Smith is in Sydney to address the World Congress for Sexual Health. He spoke to PM's Sabra Lane.

WILLIAM SMITH: This was a major, very sound study, paid for actually by the Federal Government. So it was their own commissioned study that found that what was about half a billion dollars invested had no impact whatsoever.

A side effect of the kind of programs the U.S. has was brought out today in an article in the LAT which observed that; the "practice of formal or informal polygamy links sexually active people not only to one another but also to the partners of their partners ... creating a giant web that can extend across huge regions," Epstein writes. According to Epstein, the issue has been "absent" from school-based HIV/AIDS education curriculums and "until recently," from national strategic plans to address the virus and in media and billboard campaigns. Abstinence-based education programs and condom promotion programs, which are the main sources for information on HIV/AIDS in Southern Africa, might have "reinforced the idea that victims of the disease are those who are promiscuous rather than ordinary people in relatively ordinary relationships," Epstein writes. Promoting condom use is "important," but condoms alone won't stem the epidemic because they are "seldom used in long-term relationships," Epstein writes, adding that public health agencies in the region "must do more to inform Southern Africans about the dangers" of concurrent relationships (Epstein, Los Angeles Times, 4/15).

While actual research and actual pioneering efforts in the treatment of AIDs continues to give new hope to the continent that our recidivist executive department would avoid, the Gates Foundation is trying to work on new approaches to drug development in that and a lot of other areas.

A $287 million grants program announced last July -- creating an international network of 16 labs to try new approaches to making a vaccine against AIDS -- exemplifies the ground-breaking approach pioneered by the foundation.

It aims to transform the so-far unsuccessful AIDS vaccine effort by rewarding individual labs that come up with innovative ideas and helping them develop those ideas, while also ensuring they collaborate with rivals.

To get quick results, the new Collaboration for AIDS Vaccine Discovery may need to access and use patented compounds still under development at pharmaceutical and biotech firms, IMS said.

Pressure on Big Pharma is something badly needed in many areas other than research, of course, but this is a promising new 'partnership' of beneficent nonprofit pressure and the greedy, to my mind.

It isn't just the people of the U.S. alone suffering the long-term effects of blind ignorance in high office. We are inflicting it on the rest of the world as well. Meantime, however, the truly concerned are forging ahead without a backwards U.S. and making a real difference.

Managing HIV

Yesterday I posted on the disappointing strings attached to US assistance to international AIDS efforts. An article in the April 4, 2007 Los Angeles Times indicates that some state programs are also hamstrung by federal requirements. California is one of those states.

A widely touted law that was supposed to provide medical care for poor, uninsured Californians infected with HIV has yet to be put into practice by Gov. Arnold Schwarzenegger's administration, leaving thousands without the health coverage lawmakers promised more than four years ago.

The 2003 law was endorsed by newspapers across the state and championed by activists as the most significant piece of AIDS-related legislation in a decade. It was designed to allow low-income, uninsured people with HIV — but not full-blown AIDS — to get medical care through the state's Medi-Cal program, as they can now do after their illness fully develops. [Emphasis added]

The program sounded perfect. Treating HIV is less expensive than treating AIDS. Unfortunately, the legislation had a catch to it, and that catch is the reason the new law hasn't been implemented.

Healthcare for HIV patients was to be paid for by savings from AIDS patients voluntarily moving from expensive fee-for-service treatment to more cost-effective managed care. But the state Department of Health Services says that of the 18,000 Medi-Cal recipients with AIDS, only 200 have agreed to switch.

The stipulation that the program's costs be offset was required by the federal government, and the law said that the state could not launch the program until it had shown how it would do that. Lawmakers and advocates expected that the state would start enrolling people with HIV as the money became available. [Emphasis added]

Because Medi-Cal requires federal grants to sustain it, the state really had no choice but to include the stipulation. The problem is that patients with AIDS are reluctant to switch from doctors who have shown their expertise in treating this disease to the unknowns of managed care, and it's pretty hard to fault them for such a decision. However, that means that not enough "savings" have accumulated to institute the new program, and that means that the poor and uninsured with HIV are not getting the treatment they need to forestall the onset of the full-blown disease.

Unfortunately, Governor Schwartzenegger has shown little interest in promoting the program which urges AIDS patients to switch to managed care. Right now he's concentrating on ways to cut costs on the fees-for-service AIDS Medi-Cal program.

In other words, a pretty good idea which actually made it into legislation is dying on the vine.

And that's a shame.

And The Band Still Plays On

AIDS, contrary to conventional wisdom, is still plaguing the world, especially in Africa and parts of the East. The problems receive scant attention when compared to such looming pandemics as Bird Flu (even though far more people die of AIDS than die of Bird Flu). The US isn't helping as much as it could, primarily because of some weird and unsound decisions made by Congress and the Bush administration, as an editorial in today's NY Times.

Programs to prevent the spread of H.I.V., the virus that causes AIDS, are perhaps the most important tool in that long-term fight. Yet Congress specified that only 20 percent of the money could be spent on prevention, and one-third of that had to be used to promote abstinence until marriage. More money has been spent in that area than on other prevention activities, including distribution of condoms and blocking mother-to-child transmission.

We've seen how effective "abstinence until marriage" programs have worked out in the US, even though millions of tax dollars have been poured into such unrealistic nonsense, thanks to the efforts of the last Congress and such people as Wade Horn. Imposing that faux religious approach on countries where poverty is endemic has proven to be just as ineffective.

More than pharasaical moralism is involved, however.

Another restriction that existed even before the creation of Pepfar forbids the use of taxpayer money to give clean needles to injecting addicts, while a third requires that all antiretroviral medications be approved by the United States Food and Drug Administration, even those already approved by the World Health Organization. [Emphasis added]

No doubt PHARMA had its hand in the drafting of such legislation, apparently feeling that its refusal to waive its patent rights on retroviral medications so that poor countries can afford to provide the intensive care required in HIV and AIDS by the use of generic medications just wasn't enough.

The results of such sanctimonious hypocrisy have led to the deaths of hundreds of thousands men, women, and children, and there doesn't appear to be an end in sight.

Jesus wept.

As we all should.