Appropriations Bill Marks Victory for Sexual Health, But Vigilance by Advocates Is Needed

James Wagoner

Important gains for sexual health realized in this week's appropriations bill can only be sustained through the constant vigilance of the advocacy community.

After a decade of denial and ideological assault on science-based
public health, the passage of the omnibus appropriations bill this past weekend
represents a major win for youth advocates who support rights-based,
evidence-based sexual and reproductive health programs.  Not only did the
legislation "flip the switch" on $114 million in federal spending
from abstinence-only-until-marriage programs to comprehensive teen pregnancy
prevention and sex education programs, it also established an office on
adolescent health within the office of the Secretary at HHS.

While these victories are significant, advocates will need
to maintain their vigilance given the timidity many Democrats and Administration
officials have exhibited when it comes to sexual health issues.

On Sunday, December 13th, the Senate passed the Omnibus Appropriations
Bill by a vote of 57 to 35. The House passed the bill late last week by a vote
of 221 to 202.  This appropriations "catch-all" bill contains
all of the remaining FY 2010 spending bills with the exception of Defense. The
omnibus bill will now go to the President for his signature.

The Omnibus Appropriations Bill marked two significant
victories impacting the sexual health of young people. 

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First, Congress and the Obama Administration removed all
direct funding ($99.5 M) for the ideological-based and harmful Community-Based
Abstinence Education program and in its place provided $114.5 million for more
comprehensive, evidence-based teenage pregnancy prevention.  This is a
great first step and a sea change from the Bush Administration.  However,
we know that young people are not just facing problems related to unintended
pregnancy, but also HIV and other sexually transmitted infections (STIs), and
that’s why it is important that these funds also be used for comprehensive sex
education programs that can address a number of sexual health needs.

Second, Congress placed this sexual health initiative in the
newly established Office of Adolescent Health (OAH) under the Secretary of
Health and Human Services. This is a major step forward in ensuring that the
sexual and reproductive health of young people will be monitored by public
health professionals rather than ideologues as in the past. According to the
conference summary, “the conferees intend that the Office of Adolescent Health
shall coordinate its efforts with the Administration for Children and Families,
Centers for Disease Control and Prevention, and other appropriate HHS offices
and operating divisions.”  We also know that this new Office of Adolescent
Health will integrate and coordinate a broad array of adolescent health issues,
including wellness, substance abuse, mental health, obesity, etc. This holistic
approach is welcomed since it treats young people as human beings rather than
as a set of independent, isolated “risk factors.”

As the Administration begins to structure the Office of
Adolescent Health, there are a few key principles that we would encourage them
to adopt from its inception:

  1. Youth
    – Young
    people should be engaged as partners from the very beginning. Too often,
    governments develop programs and policies that impact young people without
    ever hearing from young people themselves. Establishing a youth
    advisory committee should be a priority for OAH
    . Youth should not be seen and
    treated just as part of the problem; they must also be seen and treated as
    part of the solution. .
  2. Diversity
    – When it comes to sexual and reproductive health, one program is not
    enough. What works in urban areas, may not work in rural areas. What works
    for African American youth may not work for Latino youth. What works for
    heterosexual youth may not work for lesbian, gay, bisexual and transgender
    (LGBT) youth.  The Office of
    Adolescent Health needs to ensure that funding and program development
    encompasses the needs and concerns of all
    young people, especially those living in communities with the greatest
    health care disparities.
  3. Evidence-Based
    AND Rights-Based
    – Science and evidence must be the foundations of
    all decisions related to funding and programs. We have just emerged from
    ten years of pseudo-science and ideological politics. We must ensure that
    any program that addresses the sexual and reproductive health of America’s
    youth be grounded in fact, including those that may qualify for the
    “innovative strategies” grants.  We must also ensure that policies are based on the
    fundamental rights of young people to complete information about their
    sexual health and access to confidential services.
  4. Transparency – There should be clear
    documentation about how funding decisions are made and what programs are
    being funded. The OAH should conduct regular update meetings with public
    health and youth advocates to ensure that communication is open and policy
    guidelines are clear.

There can be no doubt that the appropriations bill
represents a major victory. But, only time will tell how the Obama
Administration fulfills the ultimate vision of creating a sexually healthy America.
Young people are the cornerstones of that pursuit.  We must remain vigilant and continue to provide feedback to
an Administration and Democratic Hill leadership that at times appears to be
listening with only one ear.



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