News: OSI Sues
USAID over Dangerous Public Health Policy
Open Society Institute
23 September 2005
The Open Society Institute (OSI), along with its affiliate the Alliance
for Open Society International (AOSI), filed a lawsuit today against
USAID to challenge its unconstitutional and dangerous policy of
requiring grantees to sign a pledge opposing prostitution. Failure to
endorse this loyalty oath means health workers across the world striving
to stop the spread of HIV/AIDS could lose funding and be forced to
abandon life-saving programs.
The United States has made a historic and laudable commitment to combat
HIV/AIDS. But these funding restrictions threaten to render these
achievements ineffective. More than 40 million people are living with
HIV/AIDS and five million became infected in 2004.
The USAID pledge requirement undermines efforts to provide life-saving
services and information to sex workers, who are at significant risk of
infection and can also transmit HIV to others. In many countries, the
epidemic is concentrated among sex workers and reaching them with
prevention services will help avert a wider epidemic.
Sex workers face harassment, violence, and discrimination. Severe
stigmatization and threat of fines or incarceration make sex workers
less able to access needed health and social services. Requiring health
workers to condemn the people they are trying to help will intensify the
stigma and fears among this vulnerable population and make it harder to
engage them effectively.
The AOSI and OSI lawsuit charges that the pledge requirement is
unconstitutional, under well established Supreme Court case law, because
it requires private organizations to adopt the government's point of
view in order to receive funding. The Justice Department under the Bush
Administration originally reached this same conclusion, only recently
reversing its view. Although the pledge requirement was passed by
Congress in 2003, it was not until this year that USAID sought to
implement it with US-based organizations.
The suit also alleges that the pledge requirement is unconstitutionally
vague and therefore allows the law to be applied arbitrarily. It is
unclear how organizations are supposed to "oppose prostitution," and the
uncertainty created by this provision creates a chilling effect on
efforts to stop the spread of HIV/AIDS. Despite repeated requests from
OSI and other groups, USAID has declined to give any guidance as to what
constitutes compliance with the pledge. In an attempt to keep its USAID-funded
HIV prevention programs alive in Central Asia, AOSI this summer signed
the anti prostitution pledge, while noting its objections.
On two previous occasions, USAID refused to indicate whether AOSI's
policy met the pledge requirement. AOSI has stated that it believes that
trafficking and sex work do harm both to the individuals directly
involved and to others in various ways.
AOSI is administering a government grant awarded in 2002 to implement
USAID's Drug Demand Reduction Program in Central Asia, where HIV/AIDS is
spread overwhelmingly through injection drug use and left unchecked will
have a devastating social and economic impact. Since sex workers are at
increased risk of using drugs, they are a prime target for this
program's interventions. The programs provide testing for HIV and other
infectious diseases, drug treatment and other services to help people
stop using drugs, and education and counseling to sex workers. Outreach
work is crucial to curbing the HIV epidemic and is consistent with
evidence-based public health best practices.
The Open Society Institute, which helps fund AOSI, is a leader among
groups working to stem the spread of HIV/AIDS in the former Soviet Union
where the epidemic is one of the fastest growing in the world. OSI also
implements a range of initiatives to support the rule of law, education,
public health, and independent media. OSI works to build alliances
across borders and continents on issues such as combating corruption and
AOSI and OSI are urging that the pledge requirement be lifted so that
aid groups and the government can continue to work together to save
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