Women, HIV, and the Global Gag Rule: The Dis-Integration of U.S. Global AIDS Funding

Excerpt

"In his proposed "Emergency Plan for AIDS Relief" announced during last month's State of the Union Address, President Bush promised, among other things, "a comprehensive plan [to] prevent seven million new HIV infections." International organizations working to prevent the spread of HIV and improve women's health worldwide met the announcement with a mixture of hope and skepticism...

"Unprotected heterosexual sex is the leading factor in HIV transmission throughout the world today. Women now represent half of those infected with HIV worldwide, and 58 percent of those infected in sub-Saharan Africa, the region most severely affected by the AIDS epidemic to date...

"...[W]omen are uniquely at risk of HIV infection and pregnancy in every single act of unprotected intercourse, illustrating the urgent need to simultaneously address the realities of sex, power, and reproduction...

"Given this reality, the President's new AIDS plan immediately raised an obvious question. Could an Administration reflexively opposed to any kind of reproductive health services embrace a sound public health strategy in response to the inextricably linked problems of unprotected sex, unintended pregnancy, and infection? The answer: Apparently not.

"For the past two years, President Bush has been waging what can only be called a religious war on sexual and reproductive health programs both at home and abroad, undercutting the very foundations on which prevention strategies are built...

"In listening to the President's new religion on HIV, a healthy dose of skepticism therefore seemed warranted...The promised $15 billion ($10 billion in new money) for international HIV/AIDS programs evaporated in a cloud of double- and triple-counting of funds already appropriated, and of contributions deferred far into the future...

"Now comes the announcement last week by the Administration that U.S. funding for global HIV programs will be saddled by ideologically driven restrictions aimed at separating "family planning" from "HIV prevention" in developing countries. The so-called Mexico City policy or "global gag rule" will now be applied to all integrated family planning and HIV prevention programs. This policy denies funding to any international organization that, in addition to routine contraceptive and other essential reproductive health services, performs abortions in countries where they are legal (like, say, the United States), collects data on, provides referrals for abortion services or advocates for changes in laws regulating abortion (which, thanks to the First Amendment, still includes the United States)...

"...[T]he policy "would apply to foreign NGOs implementing US funded family planning within HIV/AIDS programs."...

"This policy is the clearest evidence yet that the Administration is against family planning and contraception, period...

"The most immediate victims of this new assault will be women and children for whom integrated services often make the difference between life and death. Hundreds of millions of women in every region of the world rely heavily on family planning programs for a range of services for which there are no alternatives...

"Now, service providers will have to refrain from counseling family planning clients on how to practice safe sex to avoid infection. They won't be able to help infected women prevent an unintended pregnancy. The President appears unable or unwilling to grasp the fact that women seeking contraceptive information and supplies are sexually active and therefore by definition at risk of infection from unprotected sex, and that HIV-infected women may remain sexually active and at risk of unintended pregnancy. What is more, he clearly has no idea of the realities of women's lives in settings in which violence, discrimination, and lack of access to the most basic forms of information and care are the norm.

"These restrictions are morally and ethically indefensible and contradict basic principles of public health, human rights, and economic efficiency..."

Please direct correspondence about this paper to Jodi Jacobson at jjacobson@genderhealth.org

Click here to access the PDF file of the full article on the Center for Health and Gender Equity site.