Bush cripples AIDS initiative with global 'gag rule'

Catholic New Times, May 4, 2003 by Frances Kissling

I WAS STUNNED and delighted when President George W. Bush announced in his State of the Union address that he planned a major commitment to fighting AIDS. A five-year, $15 billion program of treatment and care for those infected and even some modest support for condom education and distribution--it sounded like something that I, a fairly reliable critic of this administration, might have proposed myself. Could it be that I would be able to halt my barrage of letters to the president and to Secretary of State Colin Powell attacking their assault on family planning, their reneging on support for the UN Population Fund, and their "faith-based initiative," which would force-feed the poor with religious propaganda? Would I be able to stop worrying about all the women who could die from the administration's sellout to right-wing radicals who see abortions in any reference to women's health? Could I now write a letter praising my president for a well-intentioned humanitarian aid program?

I did write that letter, and now I'm sorry I did. As it turns out, the president's AIDS initiative is likely to attach antiabortion paranoia to every single dollar and to force-feed religion to the poor on a global scale. It also ignores this basic truth about AIDS: the pandemic has a woman's face, as UN Secretary General Kofi Annan has put it, and meeting women's needs is key to stopping it.

The State Department recently floated a proposal to apply the infamous "Mexico City policy" to all organizations that get the new AIDS initiative funding. That policy, a global gag rule imposed by President Reagan, lifted by President Clinton, and reinstated by President Bush on his first day in office, bars funding to family planning groups that provide abortion counseling, referrals, and services or that lobby on abortion rights, even if they do it with their own money.

The gag rule has never applied to HIV/AIDS assistance. Yet the administration tried to portray this move as somehow a "compromise" that merely requires family planning groups to separate their work fighting HIV/AIDS from everything else they do. But the two are inseparable, and every responsible international family planning program has been integrating them for years.

Family planning and fighting HIV/AIDS are not just about handing out contraceptives. Central elements in both are education on reproductive health care, safe sexual practices, and pre-and postnatal care for mothers and their babies. Effective programs in both promote a woman's right to decide the number and spacing of her children, because AIDS is spreading most rapidly where young girls have no power to negotiate the terms of sex with older men, or where women cannot insist on condoms or fidelity from their partners for fear of violence.

Women are also the chief caretakers of other AIDS victims and their orphans. Often they are forced out of work and school and into poverty. Bush's initiative promises medicines, condoms, and care for the sick, but it makes no reference to addressing women's needs.

On the contrary, the initiative would expect women to visit separate facilities for family planning and for HIV/AIDS education and services.

Where AIDS victims are stigmatized, many who are now treated quietly at family planning clinics would be forced either to go public or go without assistance. The initiative would force perennially short-funded, non-governmental groups with proven track records of success against AIDS to set up separate buildings and bookkeeping systems and perhaps double their staffs and equipment in order to continue. In many poor countries where U.S. funded family planning clinics are the only health care providers within miles, this simply will not happen.

Meanwhile, given the president's belief that religious groups are the best providers of social services, we can expect they will be favored recipients of the funds. Will evangelical Christian groups who still believe that homosexuality is a sin that can be cured by prayer proliferate? Will Catholic groups that abhor family planning offer anything that prevents AIDS other than abstinence?

The administration's agenda seems clear: to defund secular, tolerant providers of health care and family planning worldwide in favor of religious groups that will likely choose whom to treat and how to treat them based more on ideology than medicine. Dear President Bush: I write you yet again to urge you to reconsider this latest assault on women. You can and must do better.

Frances Kissling is president of Catholics for a Free Choice, Washington DC. This article first appeared in the Boston Globe, March 4, 2003. Reprinted with permission.