The type of international funding being given to fight against the AIDS epidemic is likely to do more harm than good.
The United States which is the major donor in most cases, has tied fund provisioning to certain clauses, which deny funds to NGOs working with sex workers and do not require highlighting of various modes of prevention.
"The issue has not been handled well by either the Clinton or the Bush administrations", said Richard Holbrooke, President and CEO of the Global Business Coalition on HIV / AIDS.
Calling AIDS the next weapon of mass destruction, he said that there was a need to focus on prevention now, before the epidemic reached serious proportions in newer parts of the world.
Speaking to Business Standard, Adrienne Germaine, President, International Women's Health Coalition, said the $15 billion AIDS initiative announced by George Bush was detrimental to the cause of HIV/AIDS prevention and control.
The initiative seeks to provide funds to 14 countries in Africa and the Caribbean to tackle the AIDS problem. Asian countries are not covered under the initiative.
There is a clause specifying that funds can only go to organisations who have a written policy statement against prostitution, which straight away rules out NGOs working with sex workers. Provisions of this kind seek to push the issue underground and only worsen the situation, she said.
Sex workers are a high risk category and worldwide AIDS prevalence rates for them were 15 per cent in 1998 according to UNAIDS.
The other issue is that the terms do not require the implementing agencies to advocate prevention.
So, for instance, in South Africa, which has the largest number of HIV/AIDS cases in the world, where a lot of the medicine provision is done by prayer groups and religious groups which are opposed to contraception and condom use, the prevention message is not delivered.
Prevention is not only the better, but also the cheaper option. A Booz Allen Hamilton estimate puts the cost of a general awareness programme worldwide at $0.37 per capita per year and of condom distribution and awareness programme at $0.81 per condom distributed. In contrast, the cost of anti-retroviral therapy is estimated at $618.12 per person annually.
Other than this, the Bush administration seems to have made the announcement to gain brownie points with voters and shows no serious commitment to fund the fight against AIDS.
"They are unwilling to provide $3 million this year and no attempt has been made to push the funding issue through the Senate," she added.
The European Union, which is a possible counter to this kind of funding is unwilling to take on Washington politically.
In addition, the Global Fund, another big UN initiative to tackle AIDS is now headed by Tommy Thompson, who is also Secretary of Health and Human Services, US Department of Health and Human Services.
There seems to be no way to change the approach and this does not bode well for AIDS control programmes.
