South Africa's national youth HIV/AIDS programme faces a funding crunch following a move by the global AIDS funding organisation to stop financing it, which the programme head blamed in part on US interference.
The Global Fund to Fight AIDS, Tuberculosis and Malaria announced last month it was scrapping a planned $56 million grant to South Africa's loveLife, citing concerns over governance and implementation.
David Harrison, loveLife's chief executive, said the move would strip the government-supported programme of 30 percent of its funding and would hit hard at the 500 "teen-friendly" clinics it uses to spread the anti-AIDS message in the country worst affected by the global HIV/AIDS pandemic.
"You can quibble over some of the content of HIV prevention aimed at young people, but the point is that you have to reach enough young people in a sustained manner," he said.
Echoing charges by some officials and activists of US interference in AIDS financing decisions, Harrison said he believed the move was tied to Washington's emphasis on "abstinence-only" programmes and reluctance to support efforts to supply condoms.
"Obviously the strength of conservative ideologies are spilling over into the field of HIV and HIV prevention and it has direct impact on programmes like loveLife," Harrison said in an interview on Wednesday.
"The US has been consistently against the continuation of funding to loveLife through that process, and made its position very clear to other (fund) board members," he said.
A spokesman for the Global Fund rejected Harrison's charges, saying politics played no part in ending loveLife's grants.
"The US played a very passive role in this whole issue ... this was a programme that was not sufficiently, despite being given more chances than any other programme so far, able to follow the directions and conditions that the Global Fund board gave," spokesman Jon Liden said.
Launched in 1999, loveLife has proved controversial in South Africa, where some critics have accused it of being overly provocative and failing to connect with rural youth.
The programme's roadside posters, suggestively showing naked bodies, shocked many parents.
But the programme has consistently been one of the highest profile HIV/AIDS interventions in South Africa, which with more than 5 million people estimated to be HIV-positive has the world's single biggest HIV/AIDS caseload.
Harrison's charges echo statements by the UN's AIDS envoy for Africa, Stephen Lewis, who in August said that fundamentalist Christian ideology was driving Washington's AIDS assistance programmes and was influencing broader funding decisions, particularly in Africa.
The office of the US Global AIDS Co-ordinator has said it maintains a balanced approach.
But Harrison said he believed loveLife had fallen victim to an ideological debate pitting "abstinence only" programmes against interventions which include condoms and sex education.
"In essence the dilemma is between largely school-based, education-based abstinence-only programmes on the one hand and programmes that recognise a far broader range of determinants of HIV infection ... we challenge the abstinence-only approach."
Liden said the funding decision was not a comment on the effectiveness of loveLife's efforts on sexual reproductive health - merely that these programmes were not part of the Fund's brief to slow the spread of HIV/AIDS.
"We are trying to prioritise among 130 countries. The concerns raised were that it was hard to say that the (loveLife) activities that were funded specifically contributed to reduction in HIV prevalence," he said.
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