PEPFAR periodically makes the news not because of program accomplishments, but because of program restrictions. Last week the Administration reversed policy requiring grant recipients of the Global Fund, World Bank, and other multilaterals to sign a number of declarations required by the US Congress. Earlier this month Brazil rescinded a $40 million grant because of similar PEPFAR requirements.

Because PEPFAR's web site is so limited, it is difficult to find the actual language relating to prostitution, condoms, abstinence policies, and other declarations. Since the prostitution declaration has been the most contentious topic recently, we tracked down the relevant language and include its text with this posting (from PDI Project RFP / M-OQQ-GH-POP-05-527).

Brazil last week cancelled the remaining $40 million of a five year $48 million dollar USAID grant because of a refusal to pledge to oppose commercial sex work. Brazil has also cited concerns about agreeing to US government principles concerning sexual abstinence and drug use. The policies stem from two 2003 US laws, one involving HIV/AIDS funding and another regarding sex trafficking. Pedro Chequer, Director of Brazil's AIDS program, explains:

We can't control (the disease) with principles that are Manichean, theological, fundamentalist and Shiite.

He goes on to describe US policies as:

Interference that harms the Brazilian policy regarding diversity, ethical principles and human rights.

Further coverage in today's Wall Street Journal and also on the Kaiser Network.