Monday, March 02, 2015

A stupid expenditure that saved lives


Worth noting: statistical analysis shows that the 1.3 billion taxpayer dollars in abstinence education insisted upon by conservatives as a condition for funding AIDS prevention programs in Africa under George W. Bush was "largely waste."

The study, done by a second-year student at Stanford Medical School for a professor with an expertise in cost-benefit analyses, caused a major stir in the room where it was presented [in Seattle last week].

The researcher, Nathan Lo, analyzed records showing the age of people having sex for the first time, teenage pregnancy and number of sexual partners in international health surveys that have been paid for by the State Department since the 1970s.

...Global health specialists came to the microphone to congratulate Mr. Lo. Advocates who had long opposed the American policy that sought to prevent AIDS by promoting abstinence and faithfulness applauded.

“That was fantastic,” said Dr. Gilles van Cutsem, medical coordinator for Doctors Without Borders in South Africa.

Staff members from the government program that Mr. Lo had accused of wasting money — Pepfar, the President’s Emergency Plan for AIDS Relief — came up afterward to quietly congratulate him. When they realized a reporter was present, they nervously asked that they not be named.

Guess this just goes to show that it takes an outsider to point out that the emperor wears no clothes. People who lived through the epidemic in this country could (and did) predict this, but it took somebody who didn't need the grant money to prove it.

This is not to say that U.S. AIDS programs in Africa under Bush II were all useless. In fact, they were probably the closest thing to a successful feature of that awful presidency. Here's Washington Post columnist Eugene Robinson, not usually a Bush fan:

When the Bush administration inaugurated the program in 2003, fewer than 50,000 HIV-infected people on the African continent were receiving the antire­troviral drugs that keep the virus in check and halt the progression toward full-blown AIDS. By the time Bush left office, the number had increased to nearly 2 million. Today, the United States is directly supporting antiretroviral treatment for more than 4 million men, women and children worldwide, primarily in Africa.

This is an amazing accomplishment, especially because it wasn’t supposed to be possible. ... the conventional wisdom was that the drug-treatment regimens that were saving lives in developed countries would not work in Africa. Poor, uneducated people in communities lacking even the most basic infrastructure could not be expected to take the right pill at the right time every day. When the drugs are taken haphazardly, the virus mutates and becomes resistant. Therefore, this reasoning went, trying to administer antiretroviral treatment in poor African countries might actually be worse than doing nothing at all.

The Bush administration rejected these arguments, which turned out to be categorically wrong. Africans are every bit as diligent about taking their HIV medications as are Americans or other Westerners. ...

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