AIDS IN AFRICA: Mission Control

President Bush's new $15 billion AIDS-fighting initiative for Africa will triple U.S. spending on the crisis. It is a "work of mercy," says Bush-a mission-one undertaken by a "blessed country" that recognizes its moral responsibility to help the wretched of the earth. It's no surprise that Bush speaks of the plan in the language of religious mission. He himself is a believer, and his decision to commit massive resources to the African catastrophe reportedly was influenced by his meeting with evangelical Christian leaders.

We applaud the president's tender heart for suffering Africans, but we hope he keeps a hard, clear head as the program is implemented-and that he stays in close touch with those evangelicals. As our Rod Dreher reported in NR's last issue, experts have had solid evidence for at least a decade that the only effective way to arrest the HIV infection rate in Africa is with an education program emphasizing abstinence and fidelity, with condoms as a safety net should the first two strategies fail. Uganda, almost alone among African nations, tried this approach, working closely with religious groups preaching traditional morality. Most other African nations followed the condoms-only advice of Western experts. Result: HIV infection rates peaked in Uganda in the early 1990s, while the crisis in the rest of Africa raged out of control. Behavioral change is the only thing shown to have worked to bring down HIV infections in Africa.

Yet this is the strategy that the vast majority of the Western AIDS establishment-doctors, scientists, public-health bureaucrats, donor organizations, activists-resists with all its might, in large part because it sees this approach as "moralizing." If the president wishes to avoid throwing good money after bad, these experts must not be allowed to continue excluding proven behavior-change strategies from their AIDS-fighting arsenal. Fully half the budget of the new program will go to pay for anti-retroviral drug therapy for those already suffering from AIDS, which would reduce their infectiousness. This is needed, as are the monies set aside for other medical interventions. (We trust, however, that the administration will work to make sure that any legislation precludes the possibility that AIDS funding will be diverted to the promotion of abortion. The goal of the initiative is after all to save lives, not end them.) But what's most important is that funds be spent on behavior-change programs that stigmatize promiscuity and extramarital sex, and inculcate a sense of personal responsibility.

Bush surely knows this, but aside from general references to Uganda's example, he has not dwelled on it in public, probably for domestic political reasons. Nevertheless, this reality must be faced squarely and forthrightly, to prevent the $15 billion program from becoming a boondoggle for the international AIDS industry and corrupt African governments, and, above all, to save lives.