Katie Porter is a Legislative Policy Analyst at Population Action International.

As new discoveries in HIV prevention are made, including the use of circumcision and microbicides, the U.S. must have maximum flexibility to spend limited resources in the areas of HIV prevention that are most relevant to country demands. Maximum flexibility? You can almost feel the collective shudder on Capitol Hill. Congress cannot afford to let recipients do as they wish with tax payer dollars; can you blame them? But the alternative—dedicated funding for specific activities—can be dangerous, especially when funding is limited and lives literally lie in the balance.

The President's Emergency Plan for AIDS Relief (PEPFAR) states that 20% of PEPFAR's funding is spent on prevention activities, and the majority of the remainder for treatment. Of the prevention funding, one-third must be spent on abstinence-until-marriage programs. The message is clear: Regardless of how the epidemic is spreading or the number of people that need treatment, countries must address the disease by spending along arbitrary funding quotas as determined by U.S. law.

Promising new research in the area of male circumcision for HIV prevention has demonstrated again how dangerous this rationale is for the millions at risk of HIV infection. As reported late last year, male circumcision has been shown to reduce HIV infection rates in males by roughly 50%. If it is determined that male circumcision should be included in HIV prevention programs—to be used in addition to other evidence-based prevention efforts—it has the potential to make a huge impact in places like sub-Saharan Africa where there is both high HIV prevalence and low male circumcision rates. However, PEPFAR support for this new prevention method would compete with limited prevention funding due to required spending for abstinence-until-marriage programs. Again, countries must spend their U.S. funds according to the needs of the U.S. Congress, not the epidemic.

New discoveries are made in vain—and at considerable cost—if they cannot be funded and utilized in the countries where they can make the greatest impact. Congress can take full advantage of scientific discoveries that offer the most potential to save lives by stripping unnecessary and arbitrary earmarks from PEPFAR and exercising appropriate oversight of its programs instead. Let's see some flexibility.