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Policy & Politics
U.S. Global AIDS Ambassador Dybul Responds to Criticism of ABC Prevention Model

August 16, 2006

Mark Dybul, ambassador for the Office of the U.S. Global AIDS Coordinator, on Tuesday addressed criticism from some HIV/AIDS advocates that the HIV prevention strategy known as ABC -- which stands for abstinence, be faithful and use condoms and is promoted by the U.S. -- promotes abstinence significantly more than condom use, AFP/Yahoo! News reports (Collinson, AFP/Yahoo! News, 8/16). By law, at least one-third of HIV prevention funds that countries receive through the President's Emergency Plan for AIDS Relief -- a $15 billion, five-year program -- must be used for abstinence-until-marriage and faithfulness programs. Some HIV/AIDS advocates on Sunday at the XVI International AIDS Conference in Toronto said the U.S. focus on abstinence under ABC hinders efforts to curb the pandemic. In addition, U.N. Special Envoy for HIV/AIDS in Africa Stephen Lewis on Monday said, "No government in the Western world has the right to dictate policy to African governments around the way in which they respond to the pandemic," adding, "That kind of insipient neocolonialism is unacceptable. ... We're saying to Africa: 'This is how you will respond to the pandemic,' and that's not appropriate because African governments are eminently capable of deciding what their priorities are and what the response should be" (Kaiser Daily HIV/AIDS Report, 8/15). U.S. Rep. Barbara Lee (D-Calif.) in a recent news conference said, "What we see is a very ideologically driven administration, both domestically and internationally, trying to put their moral values ... on communities and countries" (Fox, Reuters U.K., 8/14). Dozens of protestors on Monday at the conference called on the U.S. to change its ABC policy, shouting, "Real prevention means talking sex and drugs," AFP/Yahoo! News reports.

Dybul Comments
In response to the criticism, Dybul said, "They ought to actually look at our numbers, look at our data, look at our guidance. There is no evidence in support of what they are saying." He added that the program is a part of a well-tuned, "evidence-based" approach to the HIV/AIDS pandemic. According to Dybul, abstinence funding in fiscal year 2005 made up 7% of the total U.S. AIDS package. Providing antiretroviral drugs made up 46% of the FY 2005 budget, "care activities" accounted for 26% and providing condoms made up 6% of the budget, AFP/Yahoo! News reports. In addition, Dybul said the abstinence strategy is effective in addressing young people but does not apply in situations where condom promotion might be more effective. "We know that when someone has gone to a prostitute, they have made a decision -- so the message you give to them is much different than (for) someone who is engaging in sexual activity in the general population," he said. Some HIV/AIDS advocates working in Africa have said the ABC approach is ineffective among youth and in cultures where girls are pressured to become sexually active at an early age, AFP/Yahoo! News reports. In addition, Dybul responded to Lewis' recent comments, saying, "It is colonialistic to not support ABC; ABC was developed by Africans for Africans -- we are supporting their strategies" (AFP/Yahoo! News, 8/16). Warren Buckingham, coordinator for PEPFAR in Kenya, said, "Very little of what PEPFAR is doing in prevention in any focus country is abstinence only" (Reuters U.K., 8/14). is serving as the official webcaster of the conference. View the guide to coverage and all webcasts, interviews and a daily video round up of conference highlights at A webcast of the interview with Dybul and a conference session featuring Lewis and former President Clinton are available online.

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