To US Congress
Re: PEPFAR
January 31, 2008
Dear Member of the US Congress:
We are members of non-governmental and community-based organizations from throughout the developing world. We are writing out of concern about the so-called anti-prostitution pledge within the President’s Emergency Plan for AIDS Relief (PEPFAR) and the ways it affects our work. The pledge requires organizations receiving U.S. funding to sign a pledge “opposing prostitution.” This policy has undermined the work of many of our organizations and we must protest it.
PEPFAR demonstrates the US’s commitment to address one of the world’s most urgent health problems, the need to prevent, treat, and care for people infected with or affected by HIV and AIDS. The United States Congress has generously appropriated nearly $23 billion for this program, yet the conditions attached to PEPFAR limit the success of this program and in fact even prevent the people most in need from accessing both the prevention services and anti-retroviral drugs the program was established to provide. In addition, this and other restrictions have seriously diminished the effectiveness of the plan by denying funding purely on ideological grounds to organizations and programs seeking to prevent the greatest number of new infections possible among some of the most vulnerable populations, specifically sex workers.
Many of us have turned down US funding because of these restrictions, which if adopted would prevent us from reaching some of the people most vulnerable to HIV/AIDS. Those of us who in fact still receive USAID funding are forced to restrict our activities and sometimes end our support for programs that have proven successful in meeting the needs of the most vulnerable. The vagueness of both the law and policy implementing the pledge fosters self-censorship and stymies programs aimed at building skills within vulnerable populations and saving the lives of those daily at risk of infection, violence, discrimination and even death.
We cannot effectively do our work of HIV prevention with the pledge. This restriction leads to violence against sex workers and other human rights violations by further isolating sex workers from mainstream society. Furthermore, this makes them prey to corrupt police and officials.
Our work gives us critical perspective on the gaps between U.S. funding through PEPFAR and the reality on the ground. For example:
* Sex workers in Bangladesh include women who have no other income-generating opportunities but whose programs have been cut due to the anti-prostitution pledge. HIV/AIDS has reached epidemic proportions among sex workers in some places. This pledge has been used as justification to deprive sex workers and suspected sex workers of clinical and humanitarian services. Sixteen drop-in centers for sex workers in Bangladesh were closed after their parent organization signed the pledge. For most of these women, the drop-in centers were the only places they had to bathe, to use the toilet, and to sleep.
* In Thailand, male sex workers were prevented from accessing care at a clinic because offering services to sex workers was seen as violating the anti-prostitution pledge.
* In Cambodia and Thailand, sex worker organizations have lost long-term partnerships with other service providers who feared losing their funding if they accepted sex workers at their facilities.
We strongly advocate striking the prostitution pledge from the President’s Emergency Plan for AIDS Relief. This well-intentioned clause has had extremely detrimental effects upon thousands of women, their families, and men throughout the developing world. It has undermined the effectiveness of US aid efforts. And it has undermined our trust in US support for the basic human rights of all persons, no matter their place in society.
Yours sincerely,
Manohar Elavarthi
Bangalore, India