Abortion Groups Welcomed Into Global HIV Response

By Stefano Gennarini, J.D. | June 9, 2016

NEW YORK, June 10 (C-Fam) What do abortion and family planning have to do with HIV?  A lot, according to a newly endorsed international HIV strategy.

Health ministers and global health honchos were in New York this week to hail a UN declaration to boost international efforts to stop the spread of the human immunodeficiency virus (HIV). The heightened security at UN headquarters underscored the importance of the agreement, reviewed every 5 years.

The novelty in the political declaration this time around is the intrusion of a broad “sexual and reproductive health” agenda that has more to do with social norms about sexuality than health outcomes into HIV treatment and prevention.

HIV is the single largest item on the global health aid balance sheet, and family planning and abortion groups have tried for years to get their hands on these funds.

In 2014 wealthy countries and multilateral agencies donated more than $11 billion to HIV policies and programming, according to OECD data. The United States provided almost $7 billion of the total in 2014.  HIV funding enjoys significant proportion of global health funding. The total for general and basic health funding was $14.5 billion during the same period.

In the political declaration, health ministers embraced an “integrated” sexual and reproductive health agenda that welcomed groups that do not deal with HIV treatment or prevention, such as family planning and abortion groups.

The declaration is a setback for efforts to limit the amount of money, flowing to abortion and population control groups from HIV aid. Since 2003 abortion and family planning groups have sought PEPFAR funding, the U.S. HIV aid mechanism, even though they do not directly or indirectly treat or prevent HIV transmission.

These groups argue for “unintended pregnancy prevention” as a strategy for “lowering the rate of new HIV infections”—that is, preventing births altogether as a strategy to end mother to child transmission of HIV. They began to have free access to PEPFAR under the Obama administration, precisely under the banner of “integrating” reproductive health and HIV policy.

While the political declaration does not oversee any funding directly, it gives political legitimacy to UNAIDS, the U.N. system-wide program to combat HIV. It also provides guidance to international efforts and backs strategies and priorities of donor countries.

This week’s agreement masks a great deal of differences of opinion.

In many ways, the substance of the declaration shows how much control LGBT activists continue to exert on HIV policies and programmes. The political declaration ignored once again calls to include behavior change and normal viral infection protocols to address the HIV epidemic. At the same time, there are signs that regardless of what is endorsed at UN headquarters countries will march to the beat of their own drums.

A bloc of UN member states, including Russia and Islamic countries, blocked LGBT groups from attending the adoption of the declaration. And, after its adoption, health ministers complained about the lack of recognition for “LGBT rights” in the political declaration. Moreover, the declaration stopped well short of wholesale endorsement of the strategy of the UN system on HIV, as UNAIDS hoped.