Laura and George's Bait and Switch Game

On September 15, Laura Bush spoke to the Organization of African First Ladies Against HIV/AIDS while her husband and theirs were attending the United Nations World Summit. Her speech underscored why this administration is always caught off-guard by reality: It was filled with admirable words used to deflect attention from the administration's short-sighted approach to critical global issues, and to obscure the ideological blinders used by the administration to screen out inconvenient facts about the way real people actually live their lives. It is a dangerous game of bait and switch that results in devastating consequences when reality strikes, as underscored by recent events in both Iraq and New Orleans.

For example, while Laura Bush was making repeated references to the beauties of global partnership, George Bush was presiding over unilateral U.S. opposition to effective multilateral efforts to combat poverty and global warming and increase international assistance.

And while Mrs. Bush talked in glowing terms about the President's Emergency Plan for AIDS Relief (PEPFAR), the realities of his HIV/AIDS initiative were being felt in capitals throughout sub-Saharan Africa.

PEPFAR has become one huge kickback to the fundamentalist religious groups that helped put Bush in office. Today, women and girls represent 60 percent of those infected in sub-Saharan Africa, and new infections are rising fastest among married women ages 18 to 35. Yet PEPFAR is pouring huge sums of money into questionable "faith-based" groups with no proven track record in public health, as long as they agree to promote the Administration's "abstinence-only" ideology.

At a meeting in Africa this weekend, one official from Nigeria told me that in his country, new "faith-based" groups are popping up all over, and have only to "hang out a cross and a shingle" to get PEPFAR money. Funding bogus groups will not reduce the social and individual burden presented by the 5 million infections contracted worldwide each year, the majority of them in sub-Saharan Africa.

In her speech, Mrs. Bush stated, "Education, especially for girls, is an important part of our campaign to increase understanding of how HIV can be prevented [reinforcing] the importance of taking responsibility for their own lives." In reality, this Administration seems bent on keeping women and adolescents ignorant of their choices.

In Uganda, where 66 percent of those ages 15 to 24 are sexually active, PEPFAR is spending 56 percent of funding for prevention of HIV on abstinence-only programs that prohibit the dissemination of condom information and supplies to this age group. The remaining funds can be used only to provide condoms to sex workers, truckers and people in bars, despite the rapid spread of HIV among women and older adolescents.

U.S. funding is filling the coffers of Uganda's First Lady Janet Museveni, whose idea of "increasing understanding of how HIV can be prevented" is to tell students that condoms spread disease and to parade "virgins" through the streets of Kampala. Colleagues in Nigeria, Kenya and Zambia tell me that restrictions in U.S. policy are crippling effective condom procurement and distribution programs that reach a broad audience with information on the importance of correct and consistent condom use.

Mrs. Bush also stated, "Women who have control over their own lives -- including economic power and social respect -- have a greater ability to protect themselves against HIV."

How true. But critical to exerting control over one's life is the ability to decide the number and spacing of children and the development of the skills and information necessary to practice safer sex. Yet on the very day Mrs. Bush spoke, her husband decided for the fourth consecutive year to withhold $34 million from UNFPA, the United Nations Population Fund, which provides reproductive health and HIV prevention services to poor women in 140 countries. And while family planning clinics are the "first responders" on HIV prevention for women and girls throughout sub-Saharan Africa, PEPFAR funding is being denied to family planning groups in Kenya and Uganda on the basis of ideological differences.