(continued)

As a member of this fact finding mission, I participated in all discussions, paying particular attention to those meetings which focused on the central government’s role, private sector involvement, and the roles and responsibilities of non-governmental organizations in general and AIDS service and advocacy organizations in particular. Many questions were raised during the numerous site visits and meetings with governmental and community stakeholders about the development and implementation of comprehensive country-level HIV/AIDS plans; mechanisms and methodologies to involve all of the relevant partners; and vehicles to ensure that the in-country responses reflect the latest public health science appropriate to the local circumstances. Some of the responses are contained in this report.

Many U.S.-based HIV/AIDS and public health organizations raised questions and concerns about President Bush’s initiative (and the companion authorizing legislation) in the areas of prevention, antiretroviral treatment (ARV) challenges, and infrastructure demands. This trip provided the delegation the opportunity to get a better understanding about capacity from the countries themselves. Governmental and non-governmental representatives were asked repeatedly by members of the delegation repeatedly about their prevention programs, messages and strategies, and their capacity to deliver care and treatment in a consistent, medically appropriate manner, with clinical documentation and program monitoring and evaluation.

In each country, in every meeting, the following answers (or variations thereof) were articulated: We use the “ABC” model (i.e., Abstinence until marriage, Be faithful, and use a Condom), all of its components; We are currently administering ARVs (antiretroviral medications) and have established protocols for their use within our infrastructural context; and We have partnered with our national research, academic, and governmental institutions to develop a comprehensive strategy with clear goals and objectives consistent with our current capacities.