The SPW team is shocked with the disaster that devastated Haiti on January 12, 2010, the thousands of deaths and the many risks may ensue the disaster that has been catastrophic for every sector of society, including Haiti’s feminist and LGBTI communities.

We call upon all governments and relief organizations to act as quickly as possible as to avoid further tragedies. In the links below you will find information on how to contribute financially to Haiti relief and re-construction efforts.

Haiti is here! Our hearts are in Port au Prince.

> Check here how to donate

> Read the article Earthquake in Haiti: Time for Seismic and Systemic Change (with more information on how to donate)

> Argentina
http://app.gbcorreo.com:80/pub/ViewOnline.aspx?idc=2188514&ide=5468&e=775&b=4309

> Brazil
http://www.comunidadesegura.com.br/pt-br/MATERIA-viva-rio-abre-conta-para-receber-doações-para-as-vitimas-de-terremoto-no-haiti

> Mexico

Embajada de Haití en México
Presa Don Martín 53, Col. Irrigación. Miguel Hidalgo. 11500
Tel. 5557-2065 5580-2487/2259. Ayuda en especie.
http://www.cinu.org.mx/haiti/

Naciones Unidas México
Presidente Masaryk no. 29, piso 2, Colonia Chapultepec Morales (Polanco).
Contacto: Ernesto Treviño
ernesto.trevino@undp.org.mx
Tel.: 52639762 en la Ciudad de México.
En Línea: http://www.undp.org.mx y
> US and Global

> Read the article Earthquake in Haiti: Time for Seismic and Systemic Change (with more information on how to donate)

IGLHRC
https://salsa.democracyinaction.org/o/1870/t/10454/shop/custom.jsp?donate_page_KEY=5868

Abandoned Children’s Fund
Donate directly above or call 1-888-884-0567.

American Red Cross
You can text “Haiti” to 90999 to make a $10 donation to the American Red Cross, call 1-800-REDCROSS or donate directly at the link above.

CARE
Donate online above or call 1-800-521-CARE from the U.S. or +1-404-681-2552 from outside the U.S.

Catholic Relief Services
Donate online by clicking the link above, text RELIEF to 30644, or call 1-800-736-3467.

Central Emergency Response Fund (CERF)
The UN’s Central Emergency Response Fund. Donate directly above.

Children’s Hunger Relief Fund
Donate directly above or call 1-888-781-1585 from the U.S. or +1-707-528-8000 from outside the U.S.

Doctors Without Borders / Medecins Sans Frontieres / Médicos sem fronteiras
Visit this link to donate from outside the U.S.

International Rescue Committee
Donate directly above or call  1-877-REFUGEE

Mercy Corps
Donate directly above or call 1-888-256-1900

Oxfam
If you are outside of the U.S., you can find the direct link to donate through your Oxfam affiliate here.

Partners in Health
Donate online through the link above, or donate by mail by sending a check with “Haiti Earthquake Relief” in the memo line to:
Partners In Health
P.O. Box 845578
Boston, MA 02284-5578

Save the Children
Donate directly above or make checks out to “Save the Children” and send to:
Save the Children Income Processing Department
54 Wilton Road
Westport, CT 06880

UNICEF USA
Donate directly above or call 1-800-4UNICEF. Canadians can donate directly to

World Emergency Relief
Donate directly above or call 1-888-484-4543 from the U.S. or +1-760-930-8001 from outside the U.S.

Yele Haiti
You can text “Yele” to 501501 to make a $5 donation to Wyclef Jean’s organization in Haiti, or donate directly here.

Redcross: Cruz Roja Norteamericana
http://www.redcross.org/

Cruz Roja Chilena
http://www.cruzroja.cl/

Cruz Roja Española
http://www.cruzroja.es

Wyclef Jean: Cantante Haitiano, Embajador de Buena Voluntad de las Naciones Unidas
http://www.wyclef.com

Organización Internacional Un Techo Para Mi País Institución de cooperación Internacional de viviendas
http://www.untechoparamipais.org/

Artist For Peace And Justice - Asociación de Artistas Unidos Para la Paz y Justicia
Encabezada por Paul Haggis
http://www.artistsforpeaceandjustice.com/

Operation Helping Hands
http://www.iwant2help.org
305-646-7129  305-646-7129         305-646-7129
Operation Helping Hands c/o United Way of Miami-Dade, P.O. Box # 459007Miami, Florida 33245-9007

Mercy Corps Institución
http://www.mercycorps.org
Dirección: PO Box 2669,Portland, OR 97208
1-888-256-1900  1-888-256-1900    1-888-256-1900

Arquidiócesis de Miami
Catholic Charities 1505 NE 26th St. Wilton Manors, FL 33305, Attention Earthquake Victims.

The Pan American Development Foundation, PADF: Fundación Panamericana de Desarrollo
http://www.PanAmericanRelief.org

Project Medishare, Miami: Projecto de Socorro Médico
http://www.projectmedishare.org
305-762-6448  305-762-6448      305-762-6448

Hope for Haiti, Naples
http://www.hopeforhaiti.com
239-434-7183  239-434-7183         239-434-7183

Agape Flights, Venice
http://www.agapeflights.com
941-584-8078  941-584-8078         941-584-8078

American Jewish World Service
http://www.ajws.org
212-792-2900  212-792-2900         212-792-2900

World Vision
http://www.worldvision.org
866-280-6587  866-280-6587         866-280-6587
P.O. Box 9716, Federal Way, WA 98063-9716.

The Salvation Armyorganización
http://salvationarmyusa.org
1-800-SAL-ARMY  1-800-SAL-ARMY         1-800-SAL-ARMY

Cruz Roja Internacional
http://www.icrc.org/spa
> Dominican Republic

Banco de Reservas
C/ Isabel La Catolica No. 201
Zona Colonial
Santo Domingo, Rep. Dom.
Swift code o ABA No. BRRDDOSD
Cta Corriente No. 010-251497-6

Camara Dominico-Haitiana
Necesitan: productos enlatados, agua, leche, medicamentos, colchones y frazadas.
Contacto: Rosa Maria Garcia (Presidenta)
809-440-1127 y 809-563-9382

Centro Bonó
Calle Josefa Brea NO.65 Mejoramiento Social
809-682-4448 y 809-688-1646

CDN, Cadena de Noticias
C/Dr. Defilló, Esq. Jhon F. Kennedy, al lado de Teleantillas.
Contacto: Yahaira Brea
809-683-8100

Centro Alberto Hurtado SERVIR-D
Av. Jimenez MOya No.37 ( al aldo de Inazucar)
809-535-2977

Centro Bellarmino
Km. 1.5 Autopista Duarte, Santiago
809-582-6998

Solidaridad Fronteriza
Calle Manuel Roca, no. 13, Dajabon.
809-579-8993

Save The Children Dominicana
Calle Jacinto Mañón No..32, Ensanche Paraíso, D.N.
809-567-3351
info@savethechildrendominicana.org

Central Institucional de Trabajadores Autónomos, CITA
Av. México #40, Suite 206, San Carlos. D.N..
809-221-0381
http://www.citasindical.com

Pontificia Universidad Católica Madre y Maestra
Grupo D.O.N.A.
Recinto Santo Tomás de Aquíno
Edificio B1, 7ma. Planta
Av. Sarasota, Esq. Winstonr Churchill, Plaza Universitaria, La Julia. D.N.
809-535-0111

Gremio de Estudiantes de Derecho de UNIBE
Universidad Iberoamericana
Escuela de Derecho. 6to. Nivel
Av. Francia casi Esq. Leopoldo Navarro, Gazcue.D.N.
Amelia Macarrulla 809-627-8411
Melissa Silié Ruíz 809-607-6154
Lenny Cabrera 829-901-0120
Boni Guerrero anto (809-729-8910
Boris De León 809-902-1466

Asociación Dominicana de las Naciones Unidas, ANU-RD
Edificio Fundación Global Democracia y Desarrollo, FUNGLODE
C/Capitán Eugenio de Marchena #26, La Esperilla. D.N.
809-685-9966 Ext. 2504, 2507, 2201
809-715-1737, 1738, 1739, 1742 y 1746

Universidad Autónoma de Santo Domingo, UASD.
Comedor y Polideportivo, Sede Principal. D.N.
C/Alma Matter, Zona Universitaria.
Contacto: Mercedes Feliciano
829-919-5066

Universidad del Caribe, UNICARIBE
Autopista 30 de Mayo, Km 7½, Urbanización Tropical, D.N.
Contacto: Miriam Molina y Marisol Valenzuela
809-616-1616 Ext. 392 y 397
829-715-5414

Centro Dr. Victor Atallah
Santo Domingo: Abraham Lincoln No. 1009, Torre EFA. Procurar a Dr. Atallah
Jimaní: Arzobispo Merino, # 7, Jimaní. Rep Dominicana
809-248-3167

Nearly a year ago, Obama lifted the “global gag rule,” which prohibited the US from funding any organizations that provide or “promote” abortions.  This move, combined with Obama’s appointment of Eric Goosby to the position of Global AIDS Coordinator and Ambassador-at-Large, signaled that the US government was becoming less conservative in its approach to fighting the AIDS pandemic.  These changes gave many hope that the government might soon eliminate its “ABC Policy” and “anti-prostitution pledge” funding requirement.  Unfortunately, neither has been eliminated.

The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (which was approved in March 2008, long before Obama’s election, and which provides funding through the 2013 Fiscal Year) amended the original 2003 PEPFAR law, which required that at least 33% of all funds being put towards prevention efforts be spent on abstinence-until-marriage programs.[i]  The 2008 law instead required that the Global AIDS Coordinator send an explanatory report to Congress within 30 days should less than 50% of US prevention funds be spent on “activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction.”[ii]

Though Goosby, in his executive summary of Obama’s five-year PEPFAR strategy, indicated that only evidence-based programs would be implemented going forward, the ABC approach to prevention is still considered the standard.  According to the PEPFAR website: “PEPFAR supports the most comprehensive, evidence-based prevention program in the world, targeting interventions based on the epidemiology of HIV infection in each country.  These include reducing sexual transmission with the ABC Strategy (Abstain, Be Faithful, correct and consistent use of Condoms), the prevention of mother-to-child transmission, the transmission of HIV through unsafe blood and medial injections, and male circumcision.”[iii]

As of December 8, 2009, Goosby had not given any definitive answers about the extent to which abstinence would be emphasized in practice or how condoms would be distributed to patients in religious hospitals that refuse to distribute them [iv].  The 2008 PEPFAR law states that “an organization, including a faith-based organization, that is otherwise eligible to receive assistance…shall not be required, as a condition of receiving such assistance—(A) to endorse or utilize a multisectoral or comprehensive approach to combating HIV/AIDS; or (B) to endorse, utilize, make a referral to, become integrated with, or otherwise participate in any program or activity to which the organization has a religious or moral objection.” [iii]

Goosby has, however, suggested that the ABC model may eventually be reworked and that the Obama Administration may be more flexible than the Bush Administration when it comes to funding non-abstinence-only/abstinence-first programs.  At a December 4, 2009 town hall discussion with the Kaiser Family Foundation, Goosby was asked about how abstinence-first/abstinence-only policies would be better communicated to people working in the field.  He responded: “We’re about to go into a dialogue with the field around the entire framework and through that very quickly, we will identify the need for specific guidance. Clearly this will be an area that we’ll need specific guidance, yeah.’” [v]

To summarize, the Obama administration has signaled its intention to move towards a more evidence-based approach to fighting HIV/AIDS, and this is certainly a positive change. However, both the ABC approach to prevention and the anti-prostitution pledge funding limitation remain on the books.  To truly emphasize condom distribution, Goosby will be required to submit a report justifying any decisions to spend less than 50% of prevention funds on “AB” programs (which it is not clear he will).  To eliminate the anti-prostitution pledge requirement, the law itself will need to be changed.  There is no indication that this will happen any time soon.

[i] http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=108_cong_public_laws&docid=f:publ025.108.pdf

[ii] http://www.pepfar.gov/documents/organization/108294.pdf

[iii] http://www.pepfar.gov/about/c19387.htm

[iv] http://www.nytimes.com/2009/12/09/health/policy/09aids.html

[v] http://globalhealth.kff.org/~/media/Images/KGH%20Home/120409_TownHall_Transcript.pdf

The content of the article contradicted SPW’s analysis of PEPFAR.  The ‘announcement’ of a major shift in US policy has mobilized Brazilian actors involved with HIV/AIDS debates and has revived the tensions and debates of 2005, when the Brazil-USAID agreement for HIV Prevention was suspended because the government and civil society organizations of Brazil refused to sign the prostitution pledge.   The potential agreement with Brazil to expand cooperation with poorer countries has also received international attention, as illustrated by a note posted on the USAID.

SPW therefore decided to verify the accuracy of the O Estado article. We have searched for updated information to determine whether the policy has been changed since Wittlin’s article was posted.  We have concluded that her analysis remains valid.  To ensure further precision, we now recapture the trajectory of the US HIV/AIDS policy since 2008, examining not just those aspects related to the prostitution pledge, but also those related to the A(Abstain) B(Be faithful) C (Condoms) model of prevention.

> Read the article “The trajectory of the US HIV/AIDS policy since 2008″

> Read the article “US Funding for HIV/AIDS” (published by SPW in December 2009)

Read more on PEPFAR:

> The Center for Health and Gender Equity (CHANGE) and Human Rights Watch wrote a letter to the US Department of Health and Human Services Office of Global Health Affairs in December 2009, with commments about the “anti-prostitution pledge” policy requirements.

> The Council for Global Equality released a study on the impact of PEPFAR on LGBT communities. In this report, Washington insider Scott Evertz, the former director of President George W. Bush’s Office of National AIDS Policy and an openly gay Republican, takes a serious look at the PEPFAR.

By Natalie Wittlin*

On Monday, November 23, the U.S. Department of Health and Human Services (HHS) released a notice proposing new regulations for the federal funding of U.S.-based organizations that do HIV/AIDS-related work [1].  The new, proposed guidelines, though slightly different from those issued under the Bush Administration, place the same fundamental restrictions on U.S.-based organizations receiving federal funds [1].  To be eligible to receive any federal funds, U.S.-based organizations that conduct privately-funded activities that do not “explicitly oppose prostitution” are still required to establish an “affiliate organization” to conduct these activities.

The release of these proposed guidelines came eight days before World AIDS Day 2009 (Tuesday, December 1), when Obama announced his five year strategy (2010-2014) for PEPFAR, the President’s Emergency Plan for AIDS Relief, a program initiated by former President George W. Bush in 2003 [2].  The strategy is focused on transitioning from an emergency response to a sustainable response in which other countries lead their respective programs in partnership with the United States and in which HIV/AIDS prevention, treatment, and care are integrated into other health and development-related programs that focus on, for example, reproductive health, family planning, and the eradication gender-based violence.

The executive summary of the strategy specifically notes that certain groups of people, such as sex workers, are stigmatized and particularly vulnerable to infection.  As the Washington D.C.-based organization CHANGE (Center for Health and Gender Equity) notes, however, the “anti-prostitution pledge,” instated by the original, 2003 legislation (the United States Leadership Against Global HIV/AIDS, Tuberculosis, and Malaria Act of 2003)[3], remains in effect, as the bill was reauthorized in 2008 (as the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008) [4] and provides funding through the 2013 Fiscal Year (FY).  The original law stated: “No funds made available to carry out this Act, or any amendment made by this Act, may be used to provide assistance to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking” [3].  Non-U.S. organizations that do not “explicitly oppose prostitution” are completely prohibited from received PEPFAR funds.

The 2003 “Leadership Act” is the law that implements section 7631(f) of the 2003 PEPFAR bill, which prohibits the funding of any organization “that does not have a policy explicitly opposing prostitution” [3].  The guidelines proposed on November 23 amend this “Leadership Act” [1].

In 2006, three U.S. organizations, represented by the Brennan Center for Justice at New York University School of Law, filed a lawsuit against HHS and the United States Agency for International Development (USAID).  A U.S. District Court ruled in favor of the plaintiffs and issued a preliminary injunction, stating that to withhold federal funding from U.S. organizations because they conduct privately-funded activities that do not “explicitly oppose prostitution” is a violation of the U.S. Constitution’s First Amendment [5].  However, a set of HHS guidelines was issued stating that that for a U.S. organization to receive federal funding, any activities that do not “explicitly oppose prostitution” must operate under a separate, “affiliate organization.”

In January 2009, the U.S. Department of Justice, on behalf of HHS, appealed the District Court’s preliminary injunction [6], but it dropped this appeal in July 2009 and committed to issuing final regulations (on the funding of U.S. organizations that “engage in activities that are not consistent with a policy opposing prostitution and sex trafficking” [1]) by January 8, 2010.  At that point, it will let the court know whether it wants to resubmit the appeal [7].

The November 23 proposed guidelines only slightly modify those that came before them.  The notice of proposed rulemaking says: “The proposed rule relaxes the criteria for recipient-affiliate separation, and simplifies the process for compliance…This proposal eliminates the requirement that recipients prepare and file additional documentation specifically to demonstrate adherence to this policy” [1].  However, the Brennan Center for Justice, in a memorandum issued on November 30, noted that decisions on funding restrictions will still be made on a case-by-case basis and that the vagueness of the proposed regulations makes it extremely difficult for organizations to ensure that they are in compliance [8].

No changes have been made to the original, 2003 regulations as they pertain to non-U.S. organizations.  Non-U.S. organizations must still take an “anti-prostitution pledge” to receive U.S. HIV/AIDS funding.  They do not have the option of establishing an “affiliate organization.”

Obama’s new PEPFAR strategy notes: “Most-at-risk populations – including men who have sex with men (MSM), sex workers, and injecting drug users – continue to face stigma that limit their ability to obtain services, contributing to the wider transmission of HIV” [2].  It later states: “[High-quality, low-cost care and treatment] services are responsive to the public health needs of marginalized communities, including injecting drug users, persons in prostitution, and men who have sex with men” [2].  It appears to use the terms “sex workers” and “persons in prostitution” interchangeably, which, to some, might signal a problematic conflation of sex work and coerced prostitution/sex trafficking.

Additionally, the extent to which organizations can work to decrease the stigmatization, marginalization, and vulnerability of sex workers while “explicitly opposing prostitution” is questionable.  As Nicole Franck Masenoir and Chris Beyrer from the Center for Public Health and Human Rights at the Johns Hopkins University School of Public Health have noted, “A substantial body of peer-reviewed published studies suggests that the empowerment, organization, and unionization of sex workers can be an effective HIV prevention strategy and can reduce the other harms associated with sex work, including violence, police harassment, unwanted pregnancy, and the number of underage sex workers” [6].  A 2008 policy brief issued by CHANGE also noted that PEPFAR’s funding restrictions “run contrary to best practices in public health and undermine efforts to stem the spread of HIV” [9].

Obama’s new strategy emphasizes the importance of using evidence-based, best practices and notes that it is “expanding its current partnerships with implementers, researchers, and academic organizations to improve the science that guides this work” [2].  Whether such partnerships could result in the elimination of the “anti-prostitution pledge” remains to be seen.

If your agency would like to submit comments on HHS’s notice of proposed rulemaking, visit http://www.regulations.gov, search for “RIN 0991-AB60,” and submit comments on “Organizational Integrity of Entities Implementing Leadership Act Programs and Activities” by December 23, 2009.

Sources:

[1] U.S. Department of Health and Human Services. (Nov. 23, 2009). 45 CFR Part 89, RIN 0991-AB60, 61097 Action: Notice of proposed rulemaking. Organizational Integrity of Entities Implementing Leadership Act Programs and Activities.
http://regulations.justia.com/view/159362/

[2] The U.S. President’s Emergency Plan for AIDS Relief Five-Year Strategy – Executive Summary of PEPFAR’s Strategy
http://www.pepfar.gov/documents/organization/133035.pdf

[3] P.L. 108-25, the United States Leadership Against Global HIV/AIDS, Tuberculosis, and Malaria Act of 2003
http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=108_cong_public_laws&docid=f:publ025.108.pdf

[4] H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008
http://www.pepfar.gov/documents/organization/108294.pdf

[5] Open Society Institute. (2006, May 9). Judge Rules in Favor of AOSI, Says USAID Pledge Rule Is Unconstitutional. Retrieved from http://www.soros.org/initiatives/health/focus/sharp/news/pledge_20060509

[6] Masenior, N. F., & Beyrer, C. (2007). The US Anti-Prostitution Pledge: First Amendment Challenges and Public Health Priorities. PLoS Med, 4(7), e207.

[7] Jacobson, J. (2009, July 22). DOJ Drops Appeal of ‘Prostitution Pledge’ Injunction. RHRealityCheck.org. Retrieved from:
http://www.rhrealitycheck.org/blog/2009/07/21/department-justice-withdraws-appeal-injunction-against-prostitution-pledge
Also available at HuffingtonPost.com:
http://www.huffingtonpost.com/jodi-jacobson/doj-drops-appeal-of-injun_b_242676.html

[8] Abel, L., & Diller, R. (Nov. 30, 2009). Memorandum re: HHS’ proposed regulation. Brennan Center for Justice at NYU School of Law.

[9] Center for Health and Gender Equity. (August 2008). Implications of U.S. Policy Restrictions for HIV Programs Aimed at Commercial Sex Workers. Retrieved from: http://genderhealth.org/pubs/APLO.pdf

——————————————————————-
* Natalie Wittlin is from the SPW secretariat at Columbia University Center for Gender, Sexuality and Health