Trick or Treat?

Federal funding for domestic and international HIV/AIDS research by the National Institutes of Health (NIH) and the Center for Disease Control have also been afflicted by conservative ideology, some of it religious. Last year, the conservative Traditional Values Coalition released a "hit list" of researchers and projects, and the Republican leadership in the House of Representatives directed the NIH to subject grants to programs addressing sex outside of marriage to an additional layer of review. Fortunately, NIH director Elias Zerhouni defended the projects targeted by the Traditional Values Coalition, reaffirmed the scientific review process, and committed himself to continued investment in research on human sexuality. But the episode cast a chill among researchers and academics working on HIV/AIDS, particularly those committed to helping patients engaged in high risk activities such as prostitution and intravenous drug use.

Thus, after its first year, the Bush administration's global AIDS initiative looks like a glass both half full and half empty. On the one hand, President Bush's leadership in Congress has secured unprecedented commitment to and funding for AIDS treatment. On the other, the administration's decision to buy high-priced brand drugs and the international perception that ideology has trumped pragmatism have tarnished its record and diminished the international recognition that the United States otherwise deserves as the world's biggest donor on HIV/AIDS.