Furor Over Uganda's Extreme Anti-Gay Bill Grows

The international condemnation of Uganda's proposed extreme anti-homosexuality legislation is growing. There was a meeting of British Commonwealth leaders in Trinidad and Tobago this past weekend and the Prime Ministers of Canada and United Kingdom mentioned their disapproval in private meetings with Ugandan President Yoweri Museveni.

Gordon Brown expressed Britain's concerns about the parliamentary bill when he met Yoweri Museveni, the veteran Ugandan president, at the Commonwealth heads of government meeting in Trinidad and Tobago. The suggested legislation would apply to sex between gay men or lesbian women in which one person has HIV. The bill also proposes the introduction of a three-year prison sentence for anyone who knows of the existence of a gay man or lesbian woman and fails to inform authorities in Uganda within 24 hours. The British prime minister's anger was echoed by his Canadian counterpart, Stephen Harper. Harper's spokesman, Dimitri Soudas, said: "If adopted, a bill further criminalising homosexuality would constitute a significant step backwards for the protection of human rights in Uganda."

The proposed legislation includes the death penalty for "aggravated homosexuality." Secretary of State Hillary Clinton, U.S. Ambassador to the United Nations Susan Rice and President Barack Obama have made no public comments on the legislation.

Uganda receives an estimated $287 million in U.S. taxpayer funds annually under the President's Emergency Plan for AIDS Relief (PEPFAR).

Rod 2.0 and other bloggers are asking whether those funds will be withheld if the legislation becomes law. The short answer from Eric Goosby, chief administrator of PEPFAR, is no.

I'm very concerned about any decision that any country—including our own—would make to target a group that's in the population, and that's always been in the population, by excluding them from a service or passes legislation that criminalizes their behavior. Every time you do that, you push the behavior underground. It never works. Rather than minimizing the spread of the virus, it actually amplifies it.

The U.S. policy is trying to work with governments to say exactly that. I think I would do more harm than good by connecting our resources to respond to the epidemic to making them dependent on a behavior that they're not willing to engage in on their own. My role is to be supportive and helpful to the patients who need these services. It is not to tell a country how to put forward their legislation. But I will engage them in conversation around my concern and knowledge of what this is going to do to that population, and our ability to stop the movement of the virus into the general population.

This answer is unacceptable. To connect the anti-homosexuality legislation to the AIDS crisis in Uganda, which, like in the rest of Africa (and the world) is an overwhelmingly heterosexual phenomenon is shockingly ill-informed and borderline offensive.

Happy World AIDS Day!

Obama Names Goosby as Global AIDS Coordinator

President Obama announced Dr. Eric Goosby as his nominee for Global AIDS Coordinator at the Department of State on Monday April 27th, 2009.

Eric Goosby, Nominee for Ambassador at Large and Global AIDS Coordinator, Department of State

Eric Goosby, MD, has been CEO and Chief Medical Officer of Pangaea Global AIDS Foundation since 2001. He is also Professor of Clinical Medicine at the University of California, San Francisco. Dr. Goosby has played a key role in the development and/or implementation of HIV/AIDS national treatment scale-up plans in South Africa, Rwanda, China, and Ukraine. He focuses his expertise on the scale-up of sustainable HIV/AIDS treatment capacity, including the delivery of HIV antiretroviral drugs, within existing healthcare systems. Dr. Goosby has extensive international experience in the development of treatment guidelines for use of antiretroviral therapies, clinical mentoring and training of health professionals, and the design and implementation of local models of care for HIV/AIDS. He has worked closely with international partners on the development of successful HIV/AIDS treatment and treatment-based prevention strategies for high-risk populations. Dr. Goosby has over 25 years of experience with HIV/AIDS. His experience ranges from his early years treating patients at San Francisco General Hospital when AIDS first emerged to engagement at the highest level of policy leadership. In his role at HHS as the first director of the Ryan White Care Act, Dr. Goosby helped develop HIV/AIDS delivery systems in the United States. During the Clinton Administration he served as deputy director of the White House National AIDS Policy Office and director of the Office of HIV/AIDS Policy of the Department of Health and Human Services. Dr. Goosby has longstanding working relationships with leading multilateral organizations including UNAIDS, the Global Fund and the World Health Organization.

The reaction to the Goosby announcement has generally been positive. The Global AIDS Coordinator is the person in charge of the President's Emergency Plan for AIDS Relief (commonly known as PEPFAR), which is budgeted to spend at least $48 billion in the next five years.