Global Gag Rule

HIV spreads under Bush Africa policy

   By ROBYN E. BLUMNER,  St.Petersburg Times  Published October 12, 2003

Visiting a neighborhood bar or shebeen in Soweto, South Africa a few years back, I noticed a basket of condoms propped on the floor of the tiny restroom. The prophylactics were free, available for the taking - a tangible reminder of safety first.

I often wondered just how many lives that small public service had saved in a country where more than 20 percent of the population is HIV-positive. Hundreds? Thousands?

There is nothing magical about the way to stop a sexually transmitted killer. If a population is not going to abstain from sex - and even many Catholic priests can't seem to accomplish that feat - then protection against transmission is the best defense. But sub-Saharan Africa, home to 30-million of the world's 40-million HIV/AIDS sufferers, is suddenly facing a condom shortage. Family planning clinics from Ethiopia to Swaziland have had their American-donated supplies sharply reduced or cut off; and we can thank our president and his religious right politics for this.

President Bush reinstated the Mexico City Policy, also known as the global gag rule, as one of his first official acts. It was also one of his meanest. The policy bars organizations that receive U.S. international family planning funds from having anything to do with abortion; even uttering the word in counseling is verboten.

Ronald Reagan gets the credit for this political stroke, announced at the 1984 Mexico City Conference on Population. It was a way to spread an antiabortion agenda around the world - delighting the religious right - without doing much political damage at home. Americans notoriously have little interest in what our government does relative to the developing world.

Bill Clinton retracted the policy and Bush resurrected it. Think of it as our culture wars exported.

So how has Bush's Mexico City policy been impacting women in Africa? A new report titled "Access Denied," put out by Population Action International and a few other sponsoring organizations, lays out the harms.

In Kenya, five established clinics have closed; some were the only affordable reproductive health services in the area. One was located in Kisumu, a town with the highest HIV prevalance rates in the country. In Lesotho, where one in every four women suffers from HIV/AIDS, the Lesotho Planned Parenthood Association no longer receives any donated condoms from USAID, the U.S. government agency that doles out family planning money and supplies. During the years 1998 to 2000, the Lesotho group had received 426,000 donated condoms.

In short, thanks to the closure of medical clinics and reductions in supplies wrought by the policy, more Africans will contract HIV, more mothers will transmit it to their babies and more of the population will die. Those tend to be the calculations in places like Lesotho when a lifeline gets snatched back.

USAID is the single largest donor of condoms in the developing world, providing $75-million worth annually, or about a third of all donations. Yet, according to the PAI report, 16 poor countries in Africa, Asia and the Middle East have been cut off from USAID condom shipments because their family planning groups are associated with the International Planned Parenthood Federation, which refuses to sign the antiabortion pledge.

In another 13 countries, including Ethiopia and Zambia, the nations' leading providers of reproductive health services also no longer receive USAID condom supplies.

"This (gag rule) is an antiabortion policy - why is it affecting family planning supplies?" asks Wendy Turnbull, legislative policy analyst with Population Action International and an author of the report. "(Condoms) can't be used to promote abortion, they're trying to help women avoid abortion."

That is the sad twist in all this. Bush claims to care about stemming the AIDS pandemic in Africa. He was in Africa this summer, eyes welling as AIDS orphans sang America the Beautiful, pledging billions in assistance. And he is certainly antiabortion. This is the man who held back the most promising area of medical science with his nutty stem cell skittishness.

But stopping the supply of condoms to organizations that counsel clients on all legal reproductive health options is leading inexorably to HIV's spread and a rise in unwanted pregnancies and abortions.

Hillary Fyfe, chair of the Family Life Movement of Zambia, which counsels young people on abstinence, reproductive issues and HIV prevention in nine provinces, says the funding cuts have been devastating. There is not a donated condom to be had in the region,"completely nothing," she says, and "when the (young women) fall pregnant they have no place to go. They take a knitting needle and push it down or they go in the bush and dig up a poisonous root and push it down. Half the time they die."

These are the real-life consequences in Bush's war of ideology. The PAI report puts Bush on notice; if changes aren't made we must presume that he cares more about gaining a political edge than African lives.

 
Prostituting the Constitution

   written by Kathleen Peratis     Aug 26, 2005

Let’s say you run an agency administering governmental disaster relief funds and, after a big hurricane, you are told you no longer will be permitted to administer funds unless you publicly announce that you are opposed to gay marriage — whether or not you actually oppose it, whether or not you even have an opinion. Far fetched? Absurd? An outrageous infringement of your right to free speech and its corollary, silence?

Unfortunately, no.

The conservative right has relentlessly advocated its extreme agenda, rendering plausible what was once absurd. And it has successfully lobbied to transform the newly plausible into law. Case in point: The Global AIDS Act and its requirement that all recipients of funding for programs to combat HIV/AIDS in the developing world must become promoters of the administration’s anti-prostitution campaign, whether or not they actually endorse it.

When the Bush administration signed on to the global war on HIV/AIDS in 2003 and Congress provided funding for both domestic and foreign agencies involved in the “war,” the “faith-based community” went to work on two fronts: One, to ensure that the abstinence-only programs of religious groups got a share of the funding, though there is plenty of proof that such programs do no good in HIV/AIDS prevention and often do serious harm. Two, in an effort to limit funding to the “godless” progressive community, to insert a requirement into the Global AIDS Act that all recipients of funding declare that they have a policy “opposing prostitution and sex trafficking.”

Even if they have no such policy. Even if their work has nothing to do with sex workers. Even if, as many of them believe, such a declaration is counterproductive because it stigmatizes prostitutes and makes it more difficult to teach them how to protect themselves against infection.

Most of the NGOs that work with sex workers pursue what some call a “harm reduction” approach — condoms, health care, safe-sex negotiating skills — which they deem the best way to save lives. The Bush administration, on the other hand, agrees with those who argue that all prostitution is slavery and that the only thing to do is close down the brothels and rescue the victims.

Despite the administration’s official anti-prostitution stance, the Justice Department advised the president in 2003 that while the “loyalty oath” called for in the Global AIDS Act could be applied to foreign NGOs, it could not constitutionally apply to Americans — what with the First Amendment and all. Foreign NGOs protested. Brazil, where prostitution is not illegal and whose AIDS program is regarded as one of the most successful in the developing world, famously decided to forgo $40 million in American aid rather than cease distributing condoms and other health information and support to sex workers, as the law was deemed to require.

This did not cause the administration to back down. In fact, the opposite occurred. Last fall, the Justice Department withdrew its earlier advice regarding the unconstitutionality of applying the law to Americans: The administration promptly announced that henceforth, the requirement applied to all NGOs, both foreign and American, without distinction.

American NGOs complained that the requirement was unwieldy and counterproductive. A Catholic Relief Services spokesperson said: “If we had to require the archbishop of Ouagadougou to sign a pledge against prostitution, that’s hard to do. And we have 20,000 partners.” According to Ruth Messinger of American Jewish World Service, the pledge resulted in a Cambodian partner of an American NGO discontinuing its plans to provide English-language training classes for sex workers, even with funds provided by other sources, thereby depriving these women of a skill that could move them toward a better life.

Last month, many of the affected NGOs joined in a lawsuit challenging the law as an unconstitutional infringement of their free-speech rights.

A precursor of the Global AIDS Act loyalty oath is the “global gag rule,” developed in 1984 under the Reagan administration, revoked by President Clinton and then reinstated by President Bush on his first day in office. It forbids foreign recipients of American-backed family planning grants not only from providing abortion services abroad, even with nongovernmental funds, but also from even mentioning the word “abortion” in their discourse with clients or others. This draconian rule never applied to Americans. Such interference with our free-speech rights was unthinkable — or at least it was five years ago.

According to Washington lawyer Martina Vandenberg, who represents the plaintiffs in the court case challenging the law, no governmental attempt of this kind has ever succeeded. She cites the stirring condemnation, issued in the dark days of World War II, by Supreme Court Justice Robert Jackson: “If there is any fixed star in our constitutional constellation, it is that no official, high or petty, can prescribe what shall be orthodox in politics, nationalism, religion, or other matters of opinion or force citizens to confess by word or act their faith therein.”

If the loyalty oath called for in the Global AIDS Act is not declared unconstitutional as applied to Americans, what is the next “official orthodoxy” we may be required to endorse as a condition for receiving government funds? It would be wise to hedge your bets.

As this newspaper’s editorialist pointed out a few weeks ago, the days when we could count on the courts to rescue our agenda — and, for that matter, the Constitution — are over. This is the way the lights go out.

Kathleen Peratis, a partner in the New York law firm Outten & Golden, is a trustee of Human Rights Watch.

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