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Blog - Amplify your voice

Wednesday, December 2, 2009 at 9:01:00 AM EST

This entry is a part of our World AIDS Day Blogathon.  During this week we share our experiences, stories, and ideas about how HIV affects young people around the world. Join the blogathon .

I just finished a first quick review of the long-anticipated PEFPAR Five-Year Strategy which was released today by OGAC (the Office of the U.S. Global AIDS Coordinator). (The full strategy can be found here:  http://www.pepfar.gov/documents/organization/133035.pdf.)  

 
I wanted to share some of the things that stood out to me, though on balance, I find the document encouraging--mostly because of these two bullets (though throughout the document a number of items are particularly positive):
 
PEPFAR’s Targets from Fiscal Year (FY) 2010-FY 2014: Prevention
In every partner country with a generalized epidemic, provide 100% of youth in PEPFAR prevention programs with comprehensive and correct knowledge of the ways HIV/AIDS is transmitted and ways to protect themselves, consistent with the Millennium Development Goal indicators in this area.

Programmatic Strategy for Linking HIV/AIDS to Women's and Children's Health (p. 7)
"Expanding integration of HIV prevention, care, support, and treatment services with family planing and reproductive health services, so that women living with HIV can access necessary care and so that all women know how to protect themselves from HIV infection."
 
 

Both of these bullets are extremely promising, yet some frustratingly infamous omissions remain causes of concern:
 


 
1.  No mention of young people/adolescents living with HIV (once again there is the gap between "children living with HIV/AIDS" and adults, but adolescents are conveyed almost exclusively through a prevention/orphan optic). 
 
2.  No mention of the term "comprehensive sex education"
 
3.  Only one mention of "rights"--though a good one one--on p. 16 "PEPFAR also utilizes its services as a mechanism through which to advance the rights of populations that face stigma, and expand equal access to care."  It's great to see this--but it wouldn't hurt to have a more explicit statement that PEPFAR is a rights-based response to the HIV pandemic. The focus on the access to information and integrated RH/FP services is inherently rights-based, as is the whole section titled "PEPFAR is responsive to people, not just to a virus" on p. 15, so the lack of explicit terminology may not be particularly problematic, but because documents like this set such standards for the semantic and conceptual framing of the pandemic and our response to it, more explicit rights-based language can be positive.
 
4. No mention of the need for data to be disaggregated by age/gender in the Programmatic Strategy for Metrics and Standardized Monitoring (though this will likely appear if there is an annex on research/metrics etc.
 
On the whole, despite these omissions, I am encouraged by the 5-year strategy from my first quick read, and I hope that the annexes, once released, will also be encouraging with more specifics and supplementary information (particularly regarding prevention for youth and metrics for monitoring and evaluation).    Perhaps most indicative of our frustration with Obama Administration policies, what is in the document is generally good, it's what's missing (and why it's missing) that is concerning. Thus these omissions and others are crucial for us to be aware of and to continue to press OGAC on as the second phase of PEPFAR moves forward.   
 
I'm really curious to hear others' thoughts on the bullets highlighted thus far and to keep a conversation going on what this means for our work moving forward. 
 

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Comments
Thanks so  much for this analysis of PEPFAR. I hope you are right and that the annexes will include more details about comprehensive sex education, adolescent focus, and a rights-based approach. I thought you point that: 
Perhaps most indicative of our frustration with Obama Administration policies, what is in the document is generally good, it's what's missing (and why it's missing) that is concerning.

I am wondering if you are referring here to the fact that Obama seems to be missing the delivery on some of the controversial (?) issues that he promised during the campaign like expanding/recognizing LGBTQ rights, more explicit funding and promotion of comprehensive sex education and ___? I kind of agree with you on this. Its though because I think the Obama administration is walking the tight rope of common ground and "bipartisanship" with this in order I guess to ensure more success in 2010. During the healthcare debate I have to admit that i became very frustrated with this approach. However now I am torn because I really do not know how the democrats can continue this search for common ground with such agressive and malicous conservative opposition regarding issues like this.
# Posted By  vanessaaishacoleman | 12/2/09 09:44 AM | Report | Reply