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.