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When Washington lawmakers approved $2.4 billion for the president's 14-country emergency AIDS relief plan, they demanded that the administration pick a 15th country beyond the African and Caribbean regions already covered. AIDS officials promised a pick within weeks. But that was January. By six months later, when officials announced Vietnam a winner last month, the selection had taken on the suspense and melodrama of an American Idol talent search. In the end, AIDS groups across the political spectrum were incredulous.
Most on the left - who lobbied for a non-African country outside Africa's faith-based, pro-abstinence orbit - couldn't understand why the Global AIDS Coordinator's office chose Vietnam. AIDS cases in Vietnam are largely confined to prostitutes, homosexuals, and drug users. Other Asian countries, such as India, have full-blown epidemics.
Conservatives have even deeper concerns. They fear communist Vietnam will misuse U.S. taxpayer dollars for its top-down population-control policies. Vietnam encourages abortion to limit family size and the government pays for the procedures. AIDS treatment and testing will take place in the same clinics that perform abortions. It's not hard to imagine that Vietnamese authorities will pressure women with HIV to abort their unborn babies to "prevent" transmitting the virus to them - and could use U.S. taxpayer dollars to do it.
"It doesn't make sense all the way around," said Connie Mackey, vice president for government relations at the Family Research Council. "Investment in a country like Vietnam should be more toward developing democracy rather than the way this money has been appended."
Officials in the Global AIDS Coordinator's office never wanted a 15th country added to the list. Conservatives in Washington say the idea was a Democratic initiative to deflect money away from pro-abstinence, faith-friendly groups. The official explanation: Vietnam rose through a short-list of 39 countries because it is on the cusp of an epidemic: It has 220,000 HIV infections projected to swell to 1 million by 2010. Intervening now could prevent the disease from breaking into mainstream society. They also say Vietnam has admitted it has a growing AIDS problem, unlike the more widely expected contestant, India.
"They'll have the same accounting responsibilities that everybody else does," Global AIDS Coordinator spokesman Tom Flavin said. "It's not like they can run a scam for any length of time and take the money and run."
Requiring the Vietnamese government to report how it uses U.S. money, however, will mean trusting Vietnamese government accountants. Washington also must trust Vietnam to play fair with nongovernmental organizations - meant to be the warhorses of the Bush AIDS initiative - yet when it comes to AIDS treatment and prevention, many groups are faith-based and will find it nearly impossible to operate there. The country is one of the world's worst religious persecutors, presenting conservatives with another irony: The newest recipient of U.S. AIDS funding could also this year become the latest to receive U.S. persecution sanctions.
"The government is going to insist on controlling all the aid," said Steve Mosher, president of the Population Research Institute. "They may set up front groups, but in the end they will decide who gets the medicines. You're not working at all with a government who is concerned with the loss of human life."
If the Bush White House didn't expect a conservative blowback from its choice, it may be because U.S.-Vietnam relations have improved over the last decade. Diplomatic relations resumed in 1995, and an agreement normalizing trade relations in 2001 has helped boost Vietnam's exports to half its gross domestic product. Last year, U.S.-Vietnam trade totaled almost $6 billion.
But while Vietnam's economy has accelerated, its human-rights record has tanked. The State Department reports that arbitrary arrests and beatings are widespread, with no freedom of assembly or speech. The government continues to arrest and harass minority Protestants and Buddhists who don't register with the state. One example is the Southern Evangelical Church of Vietnam: While recognized in 2001, it has seen 400 congregations associated with its underground predecessor shut down.
Vietnam fits in poorly with one $15 billion Bush plan objective, which is to target relatively well-governed countries burdened with AIDS epidemics. Other countries don't share its black marks: 1.5 percent of adults in Thailand have AIDS, compared to Vietnam's 0.4 percent, and Thailand is more democratic. Ms. Mackey suggested funding Taiwan, but not mainland China - a backhanded criticism of Beijing leaders for their human-rights abuses.
But the administration has made its choice, and now conservatives are looking for ways to control the damage. One way is to cap the funding that can go to Vietnam, or prohibit money going directly to the government. Another option is to fund only "dual use" programs, which would help with AIDS and advance human rights at the same time.
Persecuted churches could receive money to fight AIDS, for example, giving them stronger standing. Or treatment programs for drug users in prisons could also help identify political prisoners. For lawmakers who insisted the money go to a non-African country, now they must babysit how it will be spent.