[e-drug] E-DRUG: Brazil refuses US AIDS Funds, rejects conditions

["'Essential Drugs in English'" <e-drug@healthnet.org>]

E-DRUG: Brazil refuses US AIDS Funds, rejects conditions.
Publication: Wall Street Journal
Date: 2005 May 02

[copied as fair use]
Author: Michael Phillips and Matt Moffett

Brazil refused $40 million in American AIDS 
grants to protest the U.S. requirement that 
recipients first sign a pledge condemning 
prostitution.

Brazil's decision escalates a global fight over 
the moral strings President Bush and his 
conservative allies in Congress attach to foreign 
assistance, especially when it comes to sex, 
drugs and AIDS prevention in developing nations.

Brazil is seen by some as a model in the battle 
against the spread of AIDS, and Brazilian 
officials say that is in part because they deal 
in an accepting, open way with prostitutes, 
homosexual men, intravenous-drug users and other 
high-risk groups. The Brazilians say it would 
hobble their work if they complied with U.S. 
demands and forced groups that implement AIDS 
programs -- including prostitutes' associations 
-- to condemn prostitution.

"We can't control [the disease] with principles 
that are Manichean, theological, fundamentalist 
and Shiite," said Pedro Chequer, director of 
Brazil's AIDS program and chairman of the 
national commission that made the decision to 
turn down further U.S. money as long as the 
antiprostitution pledge requirement remains in 
place. He said the commission members, including 
cabinet ministers, scientists, church 
representatives and outside activists, viewed 
U.S. demands as "interference that harms the 
Brazilian policy regarding diversity, ethical 
principles and human rights."

Brazil appears to be the first major recipient 
nation to take such a definitive stand against 
U.S. efforts to link billions of dollars in 
foreign aid to conservative responses to social 
ills. Some Republican lawmakers in Washington are 
pressing to cut off federal grants to those who 
don't support the president's views promoting 
sexual abstinence, condemning prostitution and 
opposing clean-needle exchanges for drug-users. 
Meanwhile, the White House has steered more 
federal money to groups that bring a religious 
orientation to overseas health programs.

"Obviously, Brazil has the right to act however 
it chooses in this regard," said Sen. Sam 
Brownback (R., Kan.), one of the leaders of the 
conservative cause on Capitol Hill. He said he 
hoped the money would be redirected to countries 
whose AIDS policies are more in line with those 
of the Bush administration and the 
Republican-controlled Congress. "We're talking 
about promotion of prostitution, which the 
majority of both the House and the Senate believe 
is harmful to women," he said.

Last week, Brazilian authorities wrote the U.S. 
Agency for International Development, one of the 
main distributors of official American aid, 
explaining the decision to reject the remainder 
of the grant, which began in 2003 and was to run 
through 2008 for a total of $48 million.

The American money was a small part of Brazil's 
overall anti-AIDS push. About 90% of Brazil's 
total funding for AIDS programs comes from its 
own revenue, with 7% or 8% coming from the World 
Bank and the rest from the U.S. and other 
governments. Dr. Chequer said the Brazilian 
government would increase its funding to make up 
for the lost U.S. funds.

USAID spokeswoman Roslyn Matthews said yesterday 
the agency is still reviewing the Brazilian 
decision. "This is an evolving situation," she 
said. "We are in the process of determining next 
steps."

Prostitution isn't a crime in Brazil, and 
prostitutes' associations are among the most 
active groups engaged in anti-AIDS work. The U.S. 
money was to have included $190,000 for eight 
prostitutes' groups around Brazil, according to 
Gabriela Leite, coordinator of the Brazilian 
Network of Sex Professionals and a former 
prostitute. Ms. Leite said she participated in 
lengthy discussions with USAID to ensure that 
American money went only to AIDS education and 
prevention, and not to other prostitutes' rights 
issues. The result was a 50-page agreement, she 
said, but it broke down because her group was 
unwilling to condemn prostitution.

Brazil's approach to the AIDS epidemic is 
considered a model by some scientists and 
public-health specialists. The government 
encourages abstinence and sexual fidelity, but 
its prevention efforts focus more on condom 
education and distribution. In addition, since 
1996 the country has provided free, 
life-extending antiretroviral drug cocktails to 
anyone infected with HIV.

The result is a spread of HIV far less serious 
than had been feared. In 1992, experts forecast 
1.2 million Brazilians would carry the AIDS virus 
by 2002. Instead, there were an estimated 660,000 
cases. World-wide almost 40 million people are 
thought to be infected with HIV.

"Why should we adopt a different orientation if 
we have been successful for the more than 10 
years?" asked Sonia Corrja, a Brazilian AIDS 
activist and co-chair of the International 
Working Group on Sexuality and Social Policy, a 
global forum of researchers and activists.

The antiprostitution pledge requirement came out 
of two 2003 U.S. laws, one dealing with AIDS and 
the other with forced prostitution or sex 
trafficking.
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