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