Randall Tobias, head of the U.S. State Department's Office of the Global AIDS Coordinator, this week bowed to harsh reactions from AIDS activists and HIV experts, announcing that his office has dropped a recently created regulation requiring overseas recipients of U.S. AIDS grants through the Global Fund to Fight AIDS, Tuberculosis, and Malaria to sign a document opposing sex work, The Washington Post reports. The government had implemented a policy forcing all recipients of U.S. AIDS funds, including those given to and distributed by the United Nations-led Global Fund, to sign a document stating opposition to sex work, even if they did no direct HIV prevention outreach to sex workers. The Centers for Disease Control and Prevention had created a pledge document specifically for distribution to more than 3,000 groups in 128 countries that receive Global Fund money.
Overseas AIDS activists said signing the pledge would have severely hampered their HIV prevention and education work among sex workers, which typically have some of the highest HIV prevalence rates in developing nations. A group of health and AIDS organizations--CARE, the International Rescue Committee, Save the Children, and the International Center for Research on Women--wrote to Tobias in February to denounce the new policy. Global Fund officials also worried that the agency would lose U.S. funding--which makes up about one third of the agency's annual budget--if it did not enforce the policy among its grant recipients in more than 100 poor nations.
Health and Human Services spokesman Kevin Keane said the CDC document for Global Fund recipients "hadn't been fully reviewed and cleared" and has been rescinded. Tobias said the document that had been presented to overseas AIDS groups for their signatures "is not one I have seen and considered," and added that his office does not intend to invoke such a pledge in the future. It was unclear, however, whether other HHS or Bush administration officials would attempt to resurrect the sex-work pledge for Global AIDS Fund grant recipients.
Countries receiving U.S. AIDS funds directly through the President's Emergency Plan for AIDS Relief are still required to sign pledges opposing sex work.