The U.S. global
AIDS initiative has provided therapy and brought testing
and counseling to millions around the world. Now the
challenge is to move from emergency to sustained
efforts, the Institute of Medicine said Friday.
Launched three
years ago, the President's Emergency Plan for AIDS Relief
is active in 120 countries, with a concentrated focus on 15,
where it seeks to have an impact at the national
level, the institute said. In those focus countries,
800,000 people have received AIDS drugs through the
program, another 19 million got testing and counseling, and
therapy was able to block transmission of the disease
from mother to infant in an estimated 100,000 cases,
the report said.
A problem area,
however, has been spending rules imposed by Congress in
the law setting up the program. Because of these
restrictions ''the budget allocations have made
spending money in a particular way an end in itself
rather than a means to an end,'' the report warned. Congress
should remove these allocations and replace them with a
better way of ensuring accountability, the institute
said.
The continuing
challenge, the report went on, will be to maintain the
urgency and intensity of the startup years while placing a
greater emphasis on long-term planning and building
the ability to sustain the work. The AIDS initiative
was launched with five-year performance targets, and
the current report was requested by Congress to assess
progress so far. As the program looks to the longer term, a
particular need will be the vulnerability of women and
girls to AIDS.
Efforts to reduce
this vulnerability need to focus on such areas as
increasing the equality of men and women, reducing violence
and sexual coercion, and increasing income, education,
and legal protection for women and girls, the report
said. The focus countries for the program are
Botswana, Ethiopia, Guyana, Haiti, Ivory Coast, Kenya,
Mozambique, Namibia, Nigeria, Rwanda, South Africa,
Tanzania, Uganda, Vietnam, and Zambia.
The Institute of
Medicine is an arm of the National Academy of Sciences,
an independent organization chartered to advise the
government on scientific issues. (AP)
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