1. PEPFAR is up for reauthorization. Now is the time to improve PEPFAR and remove these restrictions and save the lives of tens of thousands of individuals. I urge everyone to call their congressman to support the “Lantos Bill” (officially known as the Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, or PEPFAR 2.), which will be introduced to the House of Representatives tomorrow, February 27th (and a different version in the Senate in a few months).

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2. Continued... Restrictive PEPFAR rules ignore the reality on the ground. We advise married women to “be faithful”, ignoring the fact that in Uganda, 81% of the HIV positive women are infected by their husbands. (They need birth control and HIV prevention information, not preaching.) We prevent counselors from distributing any information about birth control and condoms to girls younger than 15, ignoring the fact that in Uganda, 51% of the girls are married before they reach the age to 18.

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3. continued Our refusal to use any of the high quality, low cost, generic 3-in-1 antiretroviral drugs for the first two years of the PEPFAR program and our continued insistence on using primarily brand name multi-drug cocktails costing twice as much as the generic drugs reduces the availability of the treatments to tens of thousands—who will die without them. (Of course, President Bush’s decision to appoint former drug giant Eli Lilly CEO Randall Tobias to run PEPFAR has no influence on our insistence on lining the pockets of US pharmaceutical companies at the expense of lives.)

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4. Regarding comment #3 Mr. Contreras, if you were one of my students I would admonish you for not doing your homework—writing a letter from a position of ignorance and attacking the author (me) benefit no one. The criticisms I wrote of concerning PEPFAR are well documented—they come from numerous complaints from the PEPFAR “host countries” and have been documented in two reviews by the US General Accounting Office (the non-partisan investigative arm of Congress). The concerns I raised are far from what you call “nitpicking”—they have resulted in the loss of tens of thousands of lives.

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5. Promoting the use of condoms promotes sexual behavior. Sexual behavior is risky behavior. On the other hand, promoting abstinence and fidelity promotes responsible behavior. which should we encourage in Pepfar? Which should we encourage in our own society? Let us stop taking the easy way out by condoning risky behavior; instead let us support the best way out, responsibility!

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6. And what's more, often AIDS treatment is in one place and reproductive health and family planing are in another place which makes no sense. The reason is that the Christian right in many instances does not approve of family planning and PEPFAR has played into this mindset.

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7. Is this guy kidding. President Bush is doing what no President has ever done, put on a full-court press against AIDS/HIV in the place where it is decimating entire populations. Nitpicking about who runs the programs or what drugs are used is just that, nitpicking by a non-doctor, non-scientist, partisan campaigner. Writing a newsletter hardly saves the lives President Bush's program saves.

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8. The comments regarding drug purchasing strategy trumps what I have to say. Unconscionable, despicable and in character describe this best. My faint comment is that abstinence is very much a personal descision and has no place in government policy. This is like saying 'be the people we want you to be, not the people you are.' Quite silly really.

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