Obama and Clinton wrong about Uganda

Hillary Clinton and Barrack Obama have both praised Bush's abstinence-based approach to the spread of HIV/AIDS in Africa because of the success story of Uganda. Watch this economist speak and see if you still believe the traditional wisdom.

So the traditional wisdom, even on the Democratic side, is that the President’s Emergency Plan For AIDS Relief (PEPFAR) is good.  Last weekend, both the Democratic contenders weighed in on it and essentially endorsed the plan:

Clinton:

I commend President Bush for his PEPFAR initiative. It was a very bold and important commitment.

Obama:

And, by the way, this is an area where — this doesn’t happen very often, so everybody should take note — where I compliment George Bush.  I actually think that the PEPFAR program is one of the success stories of this administration.

The left is reluctant to critique PEPFAR, even though it mandates that one-third of prevention spending be directed towards abstinence-only programs, because of the success story of Uganda.  The history is, Uganda implemented this kind of educational program, beloved by religious leaders, and the incidents of HIV/AIDS went down from 15% to 7% (or, to use the phraseology endorsed by religious leaders, "from 30 percent to 6 percent").  Anyway, there was an improvement, and that’s good, and it means abstinence education works!  Hurray Bush!

Thing is, the picture is not so simple.  If you have the time, check out the below eighteen-minute speech by University of Chicago economist, Emily Oster.  It’s a bit long, but she’s brilliant.  To ruin the punchline, she argues that the success story of Uganda could be caused by something other than abstinence education programs: the price of coffee beans.  Yes, really.  The price of beans.  It may sound crazy, but she’s convincing and not just because she’s hot.

Even worse, there’s this implied conclusion that our stated economic policies for Africa may inadvertently spread the virus.  Oops!  On the bright-side, Bush’s record as worst president is going to be tough to beat.

[This diary was cross-posted at Overbreadth.]

Update: I don't actually fault Obama or Clinton for giving the answers they gave.  Clinton went on to say it doesn't go far enough, and Obama pointed out that he's a believer in whatever works to fight the spread of the disease.  Also, I can't begin to imagine the backlash if either of them attempted to explain the economics that Oster addresses.

•  PEPFAR is in general good news

  It really is the one thing (apart from immigration, which Bush is surprisingly good on) which Bush has made a positive difference on.  Ditching the abstinence-education part (which is not what Clinton and Obama were praising specifically - I bet you're smart enough to know that you were being disingenuous about that) would be a good idea, but PEPFAR has been a huge boon to AIDS workers on the ground as far as I've seen..

  by salsa0000 on Wed Apr 16, 2008 at 02:37:39 PM PDT

•  Lots of disagreement exists

  about the effectiveness of the abstinence approach in Uganda, and some research a couple of years ago pretty much discredited it, iirc.  PEPFAR provided a lot of necessary funding but the gag rule and other restrictions have had really negative consequences.

  I hope both candidates will implement a more realistic, scientifically based program that focuses on public health rather than ideology.

  Thanks for bringing this up.  

  by maryru on Wed Apr 16, 2008 at 09:10:58 PM PDT

  •  Thanks Maryru...

    AIDS/HIV has been one of those important issues that's been suspiciously absent from the campaigns (except for a few, confused remarks by McCain).  I was hoping for a little more discussion here on Kos on the issue, but we're overshadowed by the "gotcha" debate tonight.  Ah well.

    by Cameron Fredman on Wed Apr 16, 2008 at 10:03:16 PM PDT