Pledges and Punishment

By Esther Kaplan, AlterNet. Posted March 15, 2006.

Since George W. Bush's first day in office, Republicans in Washington have come up with creative ways to attach puritanical restrictions to U.S. foreign aid, often at a tremendous cost to public health.

First came Bush's revival of Reagan's Mexico City Policy, which canceled funds for any family planning organization that advocates for abortion rights, a measure that pulled tens of millions of dollars from International Planned Parenthood and others on the far right's enemies list. Then came a State Department missive to USAID missions that all funded programs, publications, even websites had to fall in line with Bush's social conservative worldview on everything from abortion to drug use. Then Congress used the President's Emergency Plan for AIDS Relief, or PEPFAR, to set aside $1 billion for abstinence-only education, which bars discussion of condoms and safer sex. Most recently, Republican congressmen introduced a series of anti-prostitution loyalty oaths, requiring any organization receiving U.S. funds to combat AIDS or human trafficking to condemn prostitution in word and in deed.

This injection of conservative social mores into U.S. foreign aid policy has been fueled by what Rep. Barbara Lee of California has called a "coordinated campaign of false innuendo," led by such groups as Focus on the Family, which held a Capitol Hill briefing last year demanding that USAID be purged of its "liberal cancer," and by Republican ideologues like Representatives Chris Smith of New Jersey and Mark Souder of Indiana, each of whom seek to forge reputations as Capitol Hill's holiest. The strictures have produced a wholesale restructuring of who receives U.S. funds around the world -- from experienced family planning, AIDS, and relief organizations to public health neophytes such as Rev. Franklin Graham and the National Association of Evangelicals.

But harder to trace than who's joined the gravy train is what's happened on the ground to those who got kicked off. A consortium of international family planning organizations released a report, "Access Denied," in 2003 (updated in 2004) examining the impact of the Mexico City Policy. They documented a hobbling of HIV prevention efforts in Ethiopia and Zambia and, ironically, a potential uptick in abortions in Romania, where it is now harder to encourage women choosing abortions to access birth control in the future.

A recent Washington Post story noted that Brazil's decision to forgo $48 million in U.S. funds rather than sign the anti-prostitution pledge has put financial pressure on the nation's successful effort to combat AIDS. AlterNet had the chance to speak with Meena Seshu, director of Sangram, a small but widely respected HIV prevention program in western India, about how this crusade by social conservatives in Washington has reached all the way into her rural town.

With 5.1 million infected, India has the second-largest AIDS epidemic in the world -- smaller only than South Africa's in sheer numbers -- and infection rates among certain high-risk populations, including sex workers, has reached a stunning 40 percent. For 14 years, Sangram has been doing HIV prevention work among several thousand rural sex workers, helping them to form a prostitutes' collective, known as Vamp, which has lobbied the national government for improved condoms, enforced a 100 percent condom usage campaign within local brothels, and branched out to educate truckers, migrant workers and rural youth about HIV risk.

Sangram and Vamp together have survived on less than $150,000 a year -- even less now, since Sangram returned a $12,000-a-year grant to USAID last summer after refusing to adopt "a policy explicitly opposing prostitution," as the law requires.

Months later, Sangram remains in the crosshairs of the morality brigades. Evangelical missionaries targeted their town for a "rescue" last May, raiding the local brothels with military force to recover underage girls (they found only two). Last September, John R. Miller, head of anti-trafficking initiatives at the State Department, openly accused Sangram of thwarting efforts to rescue minors from brothels. And in early February, Rep. Souder circulated a dossier about the organization at a State Department briefing on Capitol Hill, accusing Sangram of "retraffick[ing] women back into a brothel" and calling for heads to roll at USAID. "It was a little over the top," said one Democratic congressional aide who received the document. "But USAID and the Global AIDS coordinator are feeling intimidated."

Just politics as usual in Washington these days, perhaps. But the consequences are serious for those, like Meena Seshu, who are on the frontlines of the global AIDS fight.

Esther Kaplan: So explain why you need to organize sex workers in order to combat HIV. This idea is extremely foreign on Capitol Hill.

Esther Kaplan is a contributing editor at POZ, the national AIDS magazine, and author of "With God on Their Side: George W. Bush and the Christian Right" (New Press, 2005).

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