Pubdate: Mon, 28 Feb 2005 Source: Wall Street Journal (US) Section: Pg A3 Copyright: 2005 Dow Jones & Company, Inc. Contact: http://www.wsj.com/ Details: http://www.mapinc.org/media/487 Author: Michael M. Phillips Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization) Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction) Bookmark: http://www.mapinc.org/women.htm (Women) Bookmark: http://www.mapinc.org/find?137 (Needle Exchange) BUSH TIES MONEY FOR AIDS WORK TO A POLICY PLEDGE WASHINGTON -- The Bush administration is barring private American AIDS organizations from winning federal grants to provide health services overseas unless they pledge their opposition to prostitution, as part of a broader Republican effort in recent weeks to apply conservative values to foreign-assistance programs. The White House move comes as Republican lawmakers have been pressing the administration to cut off funds to private organizations that encourage clean-needle programs overseas for intravenous drug users -- a group at the center of the AIDS epidemic in Central Asia and other areas. Some also are pressing to ban federal funding of all AIDS organizations that fail to accept the president's social agenda on such issues as sexual abstinence and drug abuse. At stake are billions of dollars in U.S. funds that private health organizations working in the developing world spend on AIDS programs (See related article1.) Administration officials recently started requiring U.S. AIDS groups seeking federal grants as support for their overseas programs to sign a pledge publicly opposing prostitution. "There is conservative support" for AIDS programs, said Sen. Sam Brownback, a Kansas Republican. "But there are areas of concern...that risk the continued support from a number of conservative members and conservative groups." Many AIDS organizations are reluctant to issue a statement condemning prostitution because they work closely with prostitutes on health initiatives such as distributing condoms. The groups say such official stigmatization would increase the women's isolation, making it harder for them to receive AIDS prevention and treatment services. Many nongovernmental organizations in the AIDS field are critical of the administration moves. "This is another salvo in the campaign that the administration and its fellow conservatives are undertaking to create more and more litmus tests and blacklists of those they're willing to do business with," said Susan Cohen, director of government affairs for the Alan Guttmacher Institute, a private think tank that does research on sexual and reproductive health and favors abortion rights. The dispute marks an escalation in the decades-long debate over attaching moral strings to U.S. foreign assistance. Until now, that battle has centered largely on whether U.S. aid should go to groups providing abortion counseling and services overseas. The new policy shift regarding prostitution stems from two 2003 laws, one applying to AIDS grants and the other to sex trafficking, which involves luring or forcing individuals into prostitution. The Bush administration had previously applied the requirement only to overseas groups because the Justice Department initially advised that it would be an unconstitutional violation of free speech to demand that American grant applicants support Mr. Bush's policy. But the Justice Department reversed itself last fall. The charged debate over morality and AIDS programs has drawn new fuel recently from the practice known in the AIDS field as "harm reduction." Many AIDS groups -- some of them considered liberal on social issues -- say the best way to limit the disease is to acknowledge that some people inevitably engage in risky behavior -- intravenous drug use, prostitution or multipartner sex, for example -- and health workers should try to both discourage those activities and make them less dangerous. Some conservative groups, on the other hand, urge a just-say-no approach, arguing that making prostitution and intravenous drug use less risky encourages people to engage in them. At a recent congressional hearing, John Walters, the director of the Office of National Drug Control Policy, said, "We have been pretty aggressive with international bodies that have...drifted toward harm reduction, more aggressive than I believe others have been in the past." Mr. Bush, who has made AIDS prevention and treatment a centerpiece of his effort to convey a compassionate side to his conservatism, asked Congress for $3.2 billion for international HIV programs for fiscal 2006. Most such spending is channeled through the U.S. Agency for International Development and the Department of Health and Human Services to private organizations and other health groups working in developing nations. The new strictures from the White House and Congress match proposals of various conservative religious groups that claim credit for helping the president win re-election. Some are now for the first time applying for such grant money. Janice Crouse, a senior fellow at Concerned Women for America, an evangelical lobbying and advocacy group, says left-leaning groups have long dominated international AIDS programs, and the changes pursued by the administration and Congress aim to redress that imbalance. Ms. Crouse describes the dominant side as a "connected inside group of people who are mostly liberal," and says, "They have large staffs, they have experts in grant writing, and they've had almost exclusive access to government and foundation funding." Until last year, CWA had never applied for government funding or ventured across the line between advocacy and hands-on operations. In November, however, the group won a $113,000 State Department grant to teach Mexican church and community leaders to combat sex trafficking. The group hopes to apply for more money to help the Mexicans set up hotlines and shelters for victims of sex trafficking. Some health groups charge that the administration and Republicans are imposing their social agenda on a medical crisis. "Social conservatives inside and outside this administration are going way beyond trying to transform what the government funds to focusing on who the government funds," Ms. Cohen said. A major target of congressional Republicans is an institute founded by billionaire investor George Soros, who spent millions of dollars during last year's presidential campaign trying to defeat Mr. Bush. Mr. Soros's Open Society Institute supports programs that allow heroin addicts in the former Soviet bloc to swap dirty syringes for clean ones in order to limit the spread of HIV. The group receives some federal funds, though Mr. Soros's aides say that money isn't applied to needle-exchange programs. Marc Wheat, chief counsel to the Subcommittee on Criminal Justice, Drug Policy and Human Resources, says his boss, Indiana Republican Rep. Mark Souder, began investigating Mr. Soros's group before Mr. Soros became involved in the presidential campaign. "We've been concerned about what the Open Society Institute has been doing for a while," Mr. Wheat said. Under the new antiprostitution requirement, even organizations whose prevention and treatment programs for AIDS have nothing to do with prostitutes must now certify in writing their acceptance of the pledge or face a funding ban. "If you're trying to go after the spread of HIV, it is not inconsistent to be concerned about issues of prostitution," said Kent Hill, USAID's acting assistant administrator for global health. Some private organizations expressed dismay at the new policy. "I'm sure there are good intentions motivating the implementation of this policy, but...we feel very concerned that this will fuel stigma against sex workers," said Geeta Rao Gupta, president of the International Center for Research on Women. U.S. officials say some AIDS grant applicants have signed the pledge, but the administration won't identify them. While the administration has focused on prostitution, Republicans in Congress are working to yank federal funding from private groups that advocate or discuss clean-needle exchange programs. Leaders of that effort include Reps. Souder and Tom Davis, the Virginia Republican. Sen. Brownback laid out his goals in a strategy memo for allies this month that called for a ban on USAID grants to organizations that don't fully support the president's views on issues ranging from drug use to sexual abstinence. "How many lives have been saved from this totally preventable disease by the 'disease control' efforts of these longstanding and aggressive family planners, drug legalizers and pro-prostitution groups?" the memo asked rhetorically. The Brownback memo singled out Population Services International, a Washington-based nonprofit organization involved in family planning and AIDS work abroad, for sponsoring a sexually suggestive condom ad on Kenyan television, even though the ad itself wasn't funded by the U.S. government. PSI says that sexually provocative ads are the most effective in getting people's attention and persuading them to practice safer sex. The memo also accused groups associated with Mr. Soros of using USAID funds to hand out clean needles in Eastern Europe and Asia. USAID policy forbids using federal money to finance needle exchanges. Aryeh Neier, president of Mr. Soros's Open Society Institute, said it doesn't take a position on drug legalization or use federal money to finance its needle-exchange programs in Central Asia. The institute uses some USAID money to discourage drug use, but is largely funded by $400 million a year from Mr. Soros, Mr. Neier said. - --- MAP posted-by: Beth