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https://studentshare.org/miscellaneous/1520015-antiviral-drugs.
PREPFAR allocates a third of the prevention budget to abstinence programs, even though the latter may not be relevant within the cultural and societal environments of some of the PEPFAR target countries. As may be inferred from the IOM’s report, PEPFAR ultimately conspires against its own ability to fulfill the promise and hope which is embodied within it, insofar as its budget allocation framework is, in essence, a mandate for the misallocation and wastage of scarce and precious resources – resources upon which the lives of the 8,000 people who die of AIDS every day are dependant upon. It is from within the parameters of the aforementioned concern that the IOM recommends both the expansion of the budgetary resources allocated to prevention and the allowance for greater autonomy in the determination of the prevention strategies which will be deployed in each of the target countries.
Antiviral drugs figure as another area of concern. At present, AIDS treatment is restricted to antiviral drugs which have received the approval of the Food and Drug Administration. More effective and less costly drugs approved by the World Health Organization cannot be used with their first receiving FDA approval, implying both waste of time and the associated waste of resources at the expense of health and lives. Although it couches its criticisms in diplomatic terms, the IOM report clearly outlines the nonsensicality of the stated and strongly urges the adoption into the use of WHO-approved antiviral treatments.
A third area of concern and one which further evidences PEPFAR’s undermining of its capacity to prevent the spread of AIDS, lies in the restrictions imposed on the provision of clean needles to drug addicts. Insofar as the spread of AIDS in the target countries are concerned, casual factors tend towards addicts’ use of infected needles, rather than sexual promiscuity. Yet, even as it allocates a third of its prevention budget to largely irrelevant abstinence-only programs, it disallows the use of any portion of the said budget for the provision of clean needles to addicts even though, as the IOM report notes, doing so would significantly stem the proliferation of the AIDS pandemic in the target countries.
The IOM report does not minimize PEPFAR’s contributions to date, nor does it undermine that which the program has achieved. It does, however, identify critical policy weaknesses which effectively undermine PEPFAR’s capacity to be all that it can be; to combat AIDS as much as it can, and, indeed, to live up to its potential and promise. Policymakers would be well-advised to implement the IOM’s three key recommendations as summarized above.
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