Daily HIV/AIDS Report: Politics and Policy

BRAZIL May 02, 2005: Brazilian officials last week said that the country has refused $40 million in U.S. AIDS grants because of a Bush administration requirement that HIV/AIDS organizations seeking funding to provide services in other countries must pledge to oppose commercial sex work, the Wall Street Journal reports (Phillips/Moffett, Wall Street Journal, 5/2). Under the Bush administration policy, even groups whose HIV/AIDS work in other countries has nothing to do with commercial sex workers have to make a written pledge opposing commercial sex work or risk losing federal funding.

In addition, the Bush administration might refuse to fund HIV/AIDS groups that do not accept Bush's social agenda on issues such as sexual abstinence and drug use. The new policy stems from two 2003 laws, one involving HIV/AIDS funding and another regarding sex trafficking (Kaiser Daily HIV/AIDS Report, 2/28). Brazilian officials last week wrote to USAID to explain its decision to refuse the remainder of a $48 million HIV/AIDS grant that began in 2003 and was scheduled to run through 2008. According to some HIV/AIDS advocates, Brazil has been a "model" for combating HIV/AIDS with its "accepting, open" policies toward commercial sex workers, injection drug users, men who have sex with men and other "high-risk" groups, the Journal reports. Brazilian authorities said that the Bush administration requirement that groups receiving funding must condemn commercial sex work would hinder the country's efforts to fight the disease, according to the Journal.

"We can't control (the disease) with principles that are Manichean, theological, fundamentalist and Shiite," Pedro Chequer, director of Brazil's AIDS program and chair of the national commission that decided to refuse the grants, said, adding that the commission, which includes cabinet ministers, scientists and AIDS advocates , viewed the Bush administration policy as "interference that harms the Brazilian policy regarding diversity, ethical principles and human rights."

Brazilian Strategy

Brazil's national AIDS program, which is considered to be one of the most progressive in the world, includes HIV/AIDS prevention, care and treatment services. The program manufactures and distributes generic versions of antiretroviral drugs, providing them at no cost to all HIV-positive people in the country (Kaiser Daily HIV/AIDS Report, 3/16).

Although Brazil's HIV/AIDS prevention strategy emphasizes abstinence and sexual fidelity, it focuses more on condom education and distribution, according to the Journal. Commercial sex work is not a crime in Brazil, and advocates for commercial sex workers have been "among the most active" in the country's fight against HIV/AIDS, according to the Journal.

The U.S. grants were to include $190,000 for eight groups that advocate for commercial sex workers in Brazil, according to Gabriela Leite, coordinator of the Brazilian Network of Sex Professionals. Leite said that she had "lengthy" discussions with USAID to assure U.S. officials that the grant money received only would be used for HIV/AIDS education and prevention and not for commercial sex worker rights issues, according to the Journal. However, despite a 50-page agreement between USAID and Leite's group, talks "broke down" when Leite's group refused to condemn commercial sex work, according to the Journal.

"Why should we adopt a different orientation if we have been successful for the more than 10 years?" Sonia Correa, a Brazilian AIDS advocate and co-chair of the International Working Group on Sexuality and Social Policy, asked. Although experts in 1992 estimated that 1.2 million HIV-positive people would live in Brazil by 2002, the country's epidemic has been "far less serious" because of its prevention efforts, and by 2002 there were only about 660,000 HIV-positive people in the country, according to the Journal. Reaction

"Obviously, Brazil has the right to act however it chooses in this regard," Sen. Sam Brownback (R-Kan.), who has been a leader for "conservative cause(s)" in Congress, said, adding that he hopes the grants can be redirected to other countries with policies that are in line with the Bush administration, according to the Journal. "We're talking about promotion of prostitution, which the majority of both the House and Senate believe is harmful to women," Brownback added. USAID spokesperson Roslyn Matthews on Sunday said that the agency is "still reviewing" Brazil's decision, adding, "We are in the process of determining next steps." The U.S. grants were only a "small part" of the amount Brazil spends on HIV/AIDS programs, and Chequer said the Brazilian government will increase spending on the programs to make up for the lost funding, according to the Journal (Wall Street Journal, 5/2).

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