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Policy & Politics

Bush Faces Criticism for Domestic HIV/AIDS Policy; Lauded for Efforts to Fight Disease in Africa

August 5, 2003

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

Although President Bush has been "applauded" by some HIV/AIDS advocates for his efforts to fight the epidemic in Africa, he is also facing criticism for his domestic AIDS policies, the Houston Chronicle reports (Roth, Houston Chronicle, 8/3). Bush in May signed into law in a measure (HR 1298) that authorizes $15 billion over five years to fight AIDS in Africa and the Caribbean. The House so far has approved a total of $2 billion for the AIDS initiative in fiscal year 2004, an increase of about $500 million over FY 2003 AIDS spending (Kaiser Daily HIV/AIDS Report, 7/31). Although Bush has increased total federal spending on domestic HIV/AIDS programs -- the Office of Management and Budget says the government will spend $15.1 billion in the current fiscal year, compared with $13.4 billion during Bush's first year in office -- some advocates say that he is "shifting funding away from prevention and toward AIDS testing to avoid dealing with controversial programs," such as programs that teach comprehensive sex education including condom use, the Chronicle reports (Houston Chronicle, 8/3). In June, a group of 151 AIDS organizations and other advocacy groups sent a letter to Bush outlining their concerns about the administration's policies concerning domestic HIV funding levels and the potential "censorship" of prevention programs and federally funded research, as well as the CDC's new HIV prevention initiative. In the letter, the groups asked the administration to increase funding for domestic HIV/AIDS programs; ensure that new CDC HIV prevention guidelines allow "comprehensive prevention strategies" for people most at risk of contracting HIV; allow local groups to continue to operate "culturally relevant" prevention programs without the "relentless and intrusive" scrutiny of the CDC; allow comprehensive sex education programs that address the use and efficacy of condoms; and protect science from the "clear censorship of potentially life-saving information" (Kaiser Daily HIV/AIDS Report, 7/1).

"More Attention"
Dr. Jim Curran, dean of Emory University's Rollins School of Public Health, said, "There needs to be a lot more attention paid to the HIV epidemic in the United States. People need to realize there's still no cure and no vaccine. Our greatest enemy in HIV prevention is ... complacency about our epidemic here" (Yee, AP/Long Island Newsday, 8/3). Tamara Kreinin, president of the Sexuality Information and Education Council of the United States, said, "I'm concerned that this administration is legislating a particular view of morality rather than doing public health." Dr. Georges Benjamin, executive director of the American Public Health Association, said, "Public health always has a political element. But we're moving from science with a big 's' and politics with a small 'p' to science with a small 's' and politics with a big 'p'" (Wahlberg, Atlanta Journal-Constitution, 8/3). Terje Anderson, executive director of the National Association of People with AIDS, said, "You've got to recognize the social environment risk happens in. There's a shared responsibility for prevention and recognition that (HIV) positives and negatives need a whole range of services. We need an approach that adds to both, not takes away from one" (AP/Long Island Newsday, 8/3).

Administration Reaction
Dr. Robert Janssen, director of the CDC's Division of HIV/AIDS Prevention, said that with "essentially flat funding" for domestic HIV/AIDS prevention programs, the government cannot offer financial support for all education programs, according to the Chronicle. He said, "We don't have the resources to mount prevention programs for the general population," referring to the CDC's new HIV prevention strategy, which targets people who are at high risk for contracting HIV. An unidentified senior Bush administration official said that although the president has not publicly met with AIDS patients in the United States, he has "privately" visited people living with disease. The official added that Bush is "very, very aware of [domestic HIV/AIDS] problems" (Houston Chronicle, 8/3).

Newspapers continue to publish editorials related to the recently reported increase in the number of newly diagnosed HIV cases among men who have sex with men and an overall increase in the number of AIDS cases reported in the United States. Summaries of two editorials follow:

  • Oregonian: The increase in the number of HIV/AIDS cases shows that "we aren't anywhere close" to "freezing" the overall number of HIV/AIDS cases in the United States, an Oregonian editorial says. The editorial says that the general public has an "unrealistic expectation ... that education about AIDS can just be delivered once and the message should sink in." However, "AIDS remains a disease without a cure," the Oregonian says, concluding, "The new numbers show that the campaign against the disease -- our effort to outwit it via education -- has to be continually renewed and reinforced. The alternative to teaching is death" (Oregonian, 8/4).

  • Philadelphia Inquirer: There is "little excuse" for an increase of HIV and AIDS cases among people in the United States, where education and prevention "have been an accepted part of our daily lives for so many years," according to an Inquirer editorial. But "too many people, especially young gay men," have become "fatally complacent about their sexual behavior," the editorial says. They need to realize that "AIDS remains a killer disease without a cure," and the decision "not to practice safe sex ... or not to abstain, is as risky today as it was a decade ago," according to the Inquirer. The editorial concludes, "Safe sex and abstinence are not just good ideas. They are behaviors that save lives" (Philadelphia Inquirer, 8/4).

  • Salt Lake Tribune: The reported increase in newly diagnosed AIDS cases in the United States serves as "a reminder that the deadly disease is still very much with us and that failing to face up to the danger only increases it," according to a Tribune editorial. The editorial calls for more "practical" sex education to help curb the increasing AIDS cases, saying that "what is [taught in the schools] too often focuses only on abstinence" and is "out of step with reality." The editorial concludes that the "spread of AIDS among the younger population is first and foremost a health issue, in some cases a matter of life and death. Not educating young people -- either at home or in school -- about sexually transmitted diseases and their prevention is a moral failure we all must bear" (Salt Lake Tribune, 8/4).

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Reprinted with permission from You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at The Kaiser Daily HIV/AIDS Report is published for, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2003 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
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