PEPFAR Reauthorization and the Conscience Clause

Elisha Dunn-Georgiou

PEPFAR's "conscience clause" which allows organizations who have a moral or religious objection to opt-out of providing services to which they may object.

Within the next few weeks,
the President will sign the Tom Lantos and Henry J Hyde United States
Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization
Act of 2008
into law.  This reauthorization will extend the
President’s Emergency Plan for AIDS Relief for another five years
and provide unprecedented levels of funding to fight the global AIDS
pandemic.      

Unfortunately, the passage
of the Reauthorization Act is bittersweet as it not only fails to address
the ideological policies of the 2003 Global AIDS Leadership Act, but
in many cases has even expanded their impact.  One of these ideological
policies is the so-called "conscience clause," which allows organizations
who have a moral or religious objection to opt-out of providing services
to which they may object.  In the 2003 Act, the clause was limited
to objections over HIV prevention or treatment programs, thereby allowing
faith-based and other organizations to promote the A(abstinence) and
B (be-faithful) of ABC, without fear of retribution or loss of funds
for not providing the comprehensive information needed to prevent sexual
transmission of HIV. 

The 2008 bill expands this
provision to include "care" as an activity that an organization
may refuse to provide based on a moral or religious objection. This
will allow organizations who receive U.S. funds to deny services to
those whose behavior, identity, religion, or other attributes may be
deemed objectionable. In essence, it codifies discrimination and in
U.S. law and perpetuates stigma against people living with HIV/AIDS
as an acceptable norm.   

Money is sorely needed to fight
the pandemic- but our experiences with PEPFAR over the past five years
have shown us that money alone is not enough.  This is particularly
true when funding is restricted by ideological policies and by provisions
that have the potential to erase three decades of efforts to eliminate
the stigma and discrimination faced by people living with HIV/AIDS. 
Without addressing these problems, we have fallen short in our moral
and fiscal responsibility to use PEPFAR funding to prevent as many infections
as possible. The United States must use its leadership
to support effective (evidence-based) HIV/AIDS services and prevention
that will both save lives and, one day, end these pandemics.

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