WP Editorial; Spinning AIDS

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http://www.washingtonpost.com/wp-dyn/articles/A45354-2003Feb21.html

Spinning AIDS

THE ADMINISTRATION is sending out a confused message on its global AIDS

initiative announced in the State of the Union address. A recent internal

memo was portrayed as a deepening of the president's resolve. " Abortion

Providers May Get AIDS Money, " one headline read, implying that the

president had nobly set aside political pressure from antiabortion groups to

focus on the bottom line: " getting help to people with AIDS, " as an unnamed

official said. But the real news of the White House memo in question,

circulated last week, seems to be the opposite. It alludes to White House

plans to extend the " Mexico City policy " -- what abortion rights group call

the " gag rule " -- to AIDS funding, meaning many clinics that receive U.S.

money to combat AIDS could not discuss abortion as part of family planning.

Until now, AIDS money has been channeled mostly through the U.S. Agency

for International Development with no strings attached. If the

administration follows through on this plan, the AIDS treatment and

prevention work in poor countries the president so admirably promised to

boost would be greatly hampered. In many places AIDS treatment and family

planning happen in one clinic. Resources are scarce, and field workers say

people feel less stigma about going to a general health clinic than a

stand-alone HIV/AIDS clinic. Subjecting them to the scrutiny of the gag rule

would mean that clinics with few resources would have to find some way to

restructure or choose between Bush money and other family planning money. In

addition, experts say abortion is sometimes a choice of last resort for AIDS

patients: A pregnant woman comes into a remote clinic weak with AIDS. The

medicine to prevent mother-to-infant transmission is not available. The

pregnancy will weaken her immune system further. Her choices are bleak: her

other children orphaned, or an abortion.

The administration has done this before: In a negotiation with Asian

regions on HIV prevention in December, officials tried to delete a mention

of condom use and substitute abstinence-only education. In the domestic

context this stance is mistaken; in the context of AIDS in poor countries it

is myopic and dangerous.

When challenged, White House officials said they might give money to

integrated clinics that won't abide by the Mexico City policy and require or

ask them to refer their AIDS patients for family planning advice elsewhere.

This seems unrealistic, as there often is no " elsewhere, " but it would at

least give clinics some flexibility.

The president's emphasis in the State of the Union address on stemming the

AIDS epidemic was a breakthrough. He should not risk eroding that progress.

Already his budget offers a tentative start, pledging only $500 million in

the first year of Mr. Bush's promised $10 billion. And with his latest

proposal he risks letting domestic political considerations blur the focus

on the emergency work at hand, which, as the clever official said, is

" getting help to people with AIDS. "