HIV cash misspent on abstinence education

The critics can say "We told you so." Restrictions imposed by Congress are hampering the US government's global AIDS relief programme, a report by the US Institute of Medicine (IOM) concluded on 30 March.

Launched in 2003, the $15 billion President's Emergency Plan for AIDS Relief (PEPFAR) is the largest ever financial commitment by a nation to fight a single disease. In a move widely condemned at the time, Congress insisted that one-third of the $3 billion set aside for disease prevention be spent on abstinence-before-marriage sex education. This has limited money available for strategies such as condom distribution and needle exchanges for intravenous drug users, which are proven to slow the spread of HIV.
The report recommends that this restriction be removed. This would leave healthcare workers in PEPFAR's 15 target countries free to tailor their prevention programmes to local needs, says Jaime Sepulveda of the University of California, San Francisco, who chaired the IOM committee.

It also recommends that healthcare providers no longer be restricted to buying only those anti-retroviral drugs approved by the US Food and Drug Administration. If cheaper drugs approved by the World Health Organization could be purchased instead, three times as many drugs could be obtained for the same amount of money, according to committee member Charles Carpenter of Brown University in Rhode Island.