Is the Bush Institute's Pink Ribbon Red Ribbon Program Too Little Too Late?

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At right you see former First Lady Laura Bush, cheerily painting a door at a health clinic in Zambia. The photo was taken earlier this month by a staffer at the Bush Institute, part of the press surrounding the former first couple's visit to Africa earlier this month. It's also included in today's Dallas Morning News, part of a glowing profile of Laura Bush.

"In an exclusive interview at her Preston Hollow home," the DMN's Tom Benning tells us, Bush "reflected on the progress in Africa and how those gains can be advanced by groups setting aside partisan differences."

The progress she's talking about is fighting breast and cervical cancer in sub-Saharan Africa, especially in HIV-positive women, who are particularly prone to cervical infection. Bush is the face of a new program called Pink Ribbon Red Ribbon, spearheaded by the Bush Institute in a partnership with the Komen Foundation, the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Joint United Nations Programme on HIV/AIDS (UNAIDS)

What the DMN's hyper-exclusive interview didn't quite manage to touch on, though, is the role Bush Administration policies played in spreading HIV and AIDS throughout Africa and the rest of the developing world. We have no idea how that one didn't come up.

We're talking about the global gag rule, also known as the "Mexico City policy," which Ronald Regan first instituted in 1984 and which every Republican president has enforced since then (and every Democratic president has repealed). The gag order worked like this: If you were a health clinic or organization in a foreign country receiving U.S. Agency for International Development (USAID) money, you couldn't provide abortions. Or counsel your patients about them. Or even mention the word "abortion." Ever. (Sound familiar?)

The problem with the gag rule is that USAID money had been the key source of funding for an awful lot of foreign family-planning clinics. If those clinics signed the gag, they lost their ability to provide the care and counseling they saw fit; if they didn't sign it, they couldn't receive any funding, even for non-abortion things like cervical cancer screenings, prenatal care and contraception.

Then President George W. Bush reimposed the gag rule in 2001, with provisions to make it even stricter and with a new emphasis on abstinence-only counseling. And then, very quickly, condoms started not making their way to Africa.

Investigators led by the nonprofit Population Action International found in 2003 that USAID "had to cut off shipments of contraceptives, already in short supply, to 16 countries in Sub-Saharan Africa, Asia and the Middle East," according to the Guttmacher institute. A Planned Parenthood Association in Lesotho, for example, had received nearly 500,000 condoms from USAID during the Clinton years. With the gag rule back in place, Lesotho couldn't partner with Planned Parenthood, and USAID ended the shipments to the country entirely.

At that time, one in four women in Lesotho were infected with HIV.

In Uganda, health clinics also suddenly faced a dire condom shortage. Stephen Lewis, a special envoy for AIDS in Africa, told another researcher: "There is no question in my mind that the condom crisis in Uganda is being driven and exacerbated... by the extreme policies that the administration in the United States is now pursuing in the emphasis on abstinence."

According to Guttmacher, the pattern repeated itself across the developing world, where many women lost access to family planning and reproductive health services "from trusted local providers, putting many of them at risk of unintended pregnancy and unsafe abortion." Not to mention an increased risk of HIV infection and cervical cancer, both of which are very preventable with the right tools (condoms, yearly screenings, education).

Now, the Bushes are back in Africa, painting doors in Zambia and Botswana, and Laura Bush is touting the life-saving effects of new HIV drugs (in what is obviously a giant coincidence, Pink Ribbon Red Ribbon is sponsored by both Merck and GlaxoSmithKline). At the health center they visited in Zambia, the DMN says: "... about 40 percent of those women were found to be HIV-positive and are receiving drugs. About 20 percent had cervical lesions, which can often be treated on-site with ingredients as cheap and basic as household vinegar and liquid nitrogen."

"Health should be nonpartisan," Bush told the paper. "We all want good health for people. I don't think it serves anyone very well to have it be political."

What an amazing realization. It's only about a decade too late.

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