U.S. Representative Chris Smith (R-NJ), Chairman of the House Subcommittee on Africa, Global Human Rights and International Operations, today called a Government Accountability Office (GAO) report on the President’s Emergency Plan for Aids Relief (PEPFAR) “biased and incomplete.” 

    “This GAO group did not even go to Uganda, the country that pioneered the ABC model which has helped to reduce the rate HIV/AIDS from 15 percent to 4 percent from 1991 to 2004.” said Smith, who visited Uganda in January. “With US assistance, countries including Zimbabwe, Kenya and Senegal are duplicating Uganda’s successful approach and HIV rates are beginning to decline there as well.”

    “One of the most underreported international stories is that the President’s Emergency Plan for AIDS Relief and the ABC approach are working,” Smith noted. “In Uganda and other parts of Africa, President Bush’s leadership is greatly appreciated and admired.” 

    The report – entitled “Spending Requirement Presents Challenges for Allocating Prevention Funding Under PEPFAR” – criticized a requirement in PEPFAR established by Congress that 20 percent of USG AIDS funding be spent on prevention programs and 33 percent of prevention funds be spent on abstinence-until-marriage programs. The report recommends that the U.S. Global AIDS Coordinator collect more information on the effect of the spending requirement and questions whether all USG AIDS programs should be subject to these spending requirements. 

    “The timing, methodology and substance of the GAO report all call into question GAO’s objectivity and the Comptroller General’s motivation for undertaking this project,” Smith said. “The most important question is whether the PEPFAR strategy that has proven to be successful in the past is continuing to provide effective results. GAO not only fails to answer that question, it doesn’t even bother to address it.”

    Smith pointed out numerous problems with the GAO report, including:

• Incomplete data: In the course of its investigation, GAO failed to visit the only countries in Africa which have successfully lowered their HIV/AIDS infection rates by focusing on promoting behavioral change. By not visiting these countries, GAO did not interview implementing partners to gain their perspective on the effectiveness of the USG programming, omitting crucial and relevant data.
  
• Premature conclusions: According to the report, GAO conducted its investigation from February 2005 to January 2006. The Office of the Global AIDS Coordinator established its policies implementing the spending requirement in August 2005. It is premature to evaluate the effectiveness of USG policies less than six months after their implementation.
  
• Missing Context: In criticizing the USG prevention spending requirements as forcing USG personnel in the field to cut other AIDS programs, GAO did not take into account funding available and expended through sources other than PEPFAR, which in many countries fills in alleged “gaps” in programming needs identified in the report’s examples.

    According to the US Office of the Global Aids Coordinator, the redirection of funds from the focus country programs to the Global Fund and other AIDS programs has forced PEPFAR teams in those countries to make difficult trade-offs between various prevention programs, treatment and care.

    “The report does remind us that we cannot repeat the same mistake of redirecting AIDS money to the Global Fund,” said Smith. It is not the spending requirements of the Leadership Act that force difficult trade-offs between prevention programs, but budget constraints imposed by Congress’ failure to meet these bilateral funding needs.”