Over the past two years, U.S. law has required foreign non-governmental organizations receiving direct U.S. global HIV/AIDS and anti-trafficking funds to adopt specific organization-wide positions opposing prostitution. Now, the U.S. seeks to impose the restrictions on both U.S. NGOs receiving funding for overseas programs and also, recipients of U.S. funds from entities such as the Global Fund to Fight AIDS, TB, and Malaria (GFATM), the World Health Organization and the International AIDS Vaccine Initiative.

Brazil created waves this month over the controversial directive applied to NGOs when the country's national AIDS commissioner Pedro Chequer, on behalf of the NGOs on the AIDS Commission, refused the requirement in order to receive $40 million in US assistance from USAID for programs against the spread of HIV/AIDS. "For us it was an ethical issue," Chequer told a reporter last week. "We have to reach every segment of society, with no discrimination. Besides, no country is supposed to decide what another country must do."

Outside of Brazil, during the past two years the policy has been in place, many NGOs have signed the USAID pledge stating they are opposed to prostitution rather than lose critical funding for their programs. The U.S. policy restriction states:

"Any entity that receives, directly or indirectly, U.S. Government funds in connection with this document ("recipient")" cannot use such U.S. Government funds to promote or advocate the legalization or practice of prostitution or sex trafficking." *

The new directive, from the CDC and is expected to be posted by USAID this week, extends the restrictions to GFATM recipients and others, in compelling the organizations to adopt anti-prostitution policies:

"In addition, any recipient must have a policy explicitly opposing prostitution and sex trafficking. The preceding sentence shall not apply to any "exempt organizations" (defined as the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Health Organization, the International AIDS Vaccine Initiative or to any United Nations agency), but does apply to any non-governmental, non-exempt organization entity receiving U.S. government funds from an exempt organization in connection with this document." *

Activists point out the restrictions curtail the ability of organizations that work with women and men in prostitution to effectively fight the spread of HIV through outreach efforts and condom distribution programs. Many organizations, whether associations of sex workers or those engaging sex workers as peer HIV prevention educators, will be denied funding by otherwise independent international organizations like GFATM, as well as funding through U.S. Presidential Emergency Program for AIDS Relief (PEPFAR), CDC, and USAID under the new restriction.

"The U.S. is trying to impose its ideology over best practices, and attempting to compel community groups to become mouthpieces for its harmful stance on AIDS," said Sharonann Lynch of Health GAP. "The policy thwarts effective HIV prevention programs for some populations among the most vulnerable to the spread of HIV and those can be among the most effect first-line of prevention."

"The US is taking its ideologically motivated policy to new levels. This will undermine the independence and effectiveness of multilateral institutions like the Global Fund," said Asia Russell of Health GAP.

Such policies are creating new concerns about the appropriateness of the nomination of Ambassador Randall Tobias, the U.S. Global AIDS Coordinator, for the chair of the Global Fundâs new Policy and Steering Committee. The Policy and Steering Committee will be the most powerful Global Fund Committee, functioning as the Global Fundâs ăShadow Board.ä The Policy and Strategy Committee would be the same Committee to discuss the ramifications of the new U.S. policy, potentially inhibiting constructive discussion if Tobias is the Chair.

Activists also point out the expansion of the restrictions to U.S.-based groups contradicts the fundamental right to freedom of speech guaranteed in the U.S. Constitution, by compelling speech through the requirement that such groups adopt anti-prostitution policies.

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