Support Comprehensive Global Health Aid

We the undersigned present a petition re: H.R. 5501, The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

 
This bill--now approved by the Senate Foreign Relations Committee with versions currently introduced to both the House and Senate floors--authorizes $50 billion to be appropriated in FY2009-2013 for programming to fight HIV/AIDS, Tuberculosis and Malaria in some of the world's poorest populations.  While this funding is desperately needed, current versions of the bill:

·         Ban the use of monies by organizations or programs that work with prostitutes

·         Retain ambiguity regarding the use of monies for abstinence-only programming 

The prohibition on working with prostitutes is imbued with a moral judgment that serves to endanger, blame and further stigmatize women who, as many have shown[1], are already marginalized and pushed into vulnerable roles.  Further, it indisputably harms efforts to address HIV/AIDS, ignoring an abundance of evidence[2] and neglecting a primary population at high risk for HIV, and through which HIV is spread.   

The ambiguity regarding abstinence-only programming is an artifact of limitations on funds appropriated under the original bill in FY2003-2008, which required 33% of monies allocated for prevention--equaling over 66% of funding for prevention of sexual transmission--be spent on abstinence-only programming, which severely limited education about and provision of condoms.  This requirement imposed ideology in place of evidence, and the evidence overwhelmingly suggests abstinence-only programming does not work, and often reduces condom use, thus actually endangering the "educated" population further.[3]    The current reauthorization bill has removed the 33% requirement, but requires that 50% of prevention monies be spent on "behavior change," without specifying that these funds may be used for comprehensive prevention of sexual transmission, including education about and provision of condoms.  Without an explicit change in policy, many programs on the ground may be hesitant to initiate comprehensive programming for fear of losing funds granted by the United States. 

Therefore, we respectfully demand that United States foreign aid appropriated by this bill should:

·         Support programming and organizations that work with prostitutes, some of the world's most vulnerable women and likely sources of HIV transmission

·         Make explicit its commitment to comprehensive efforts to prevent sexual transmission of HIV, including the education about and provision of condoms amongst entire populations

[1] See, e.g., HIV and AIDS in Africa: Beyond Epidemiology (2003), edited by Ezekiel Kalipeni, Susan Craddock, Joseph Oppong, and Jayati Ghosh; and Women, Poverty and AIDS: Sex, Drugs and Structural Violence (1997), edited by Paul Farmer, Margaret Connors and Janie Simmons.

[2] See, e.g., Public Health Aspects of HIV/AIDS in Low and Middle Income Countries: Epidemiology, Prevention and Care (2008), edited by David Celentano and Chris Beyrer.

[3] See, e.g., "Abstinence-only education policies and programs: a position paper of the Society for Adolescent Medicine," Journal of Adolescent Health 38 (2006), 83-87.