Letter to Congress on Funding for Abstinence-Before-Marriage Programs in PEPFAR, June 18, 2007

June 18, 2007

Dear Representative:

We are writing on behalf of the United States Conference of Catholic Bishops (USCCB) and Catholic Relief Services (CRS) to express deep concern regarding two provisions in the State/Foreign Operations appropriations bill, which the full House may soon debate. First, the bill would nullify the current 7% allocation (one-third of HIV and AIDS prevention funds) for abstinence-before-marriage programs in the President’s Emergency Plan for AIDS Relief (PEPFAR). These programs have proven to be very effective in Africa as part of a larger strategy that focuses on overall behavior change. We consider it unwise to abandon this strategy through the Appropriations process and urge you to support any effort to reverse this provision.

The other fundamental defect is language in Section 622 rescinding the Mexico City Policy, which prevents U.S. family planning assistance from being channeled through groups that perform and promote abortion as family planning. On this issue we urge you to follow the counsel by our Bishops’ Conference offered in a companion letter.

The Catholic Church is deeply committed to U.S. leadership on the issue of HIV and AIDS prevention and treatment. At home and around the world, and particularly through the experience of Catholic Relief Services in 12 of the 15 PEPFAR focus countries and many others, principally in Africa, the Church is deeply involved in offering life-saving help to people threatened by HIV and AIDS. This is not about ideology; it is about saving lives. In this common effort, we would urge the following steps to advance the US commitment to address the spread of HIV and AIDS:

Do not abandon the consensus that underpins U.S. leadership

PEPFAR, at its heart, is about coming to the aid of some of our most vulnerable sisters and brothers. PEPFAR legislation was carefully negotiated and reflects a consensus on how best to proceed and on what works in HIV and AIDS prevention. By setting aside the requirement that 33% of prevention funding focus on “abstinence-before-marriage,” Congress is summarily rejecting sound evidence and experience of what actually works in reducing HIV and AIDS.

Abandoning this approach through the Appropriations process, rather than through the process of reauthorizing PEPFAR, is also unwise, premature and counter-productive. This is an important issue that requires careful consideration of evidence and experience accumulated over a period of years. We and others on the front lines look forward to making our full case about the effectiveness of abstinence, behavior change, and partner reduction as ways to help save lives through the regular authorization process of hearings and deliberation. This is where decisions should be made in the interest of sound policy and on behalf of the lives and dignity of those who are most affected by HIV and AIDS.

USCCB and CRS were major supporters of the PEPFAR initiative when it was first announced in 2003. Since then, we have been actively engaged in education and advocacy to support major new investments in the U.S. commitment to fight the global pandemic. As we prepare for the reauthorization of PEPFAR legislation, attempts to abandon the current approach will seriously threaten consensus needed to expand U.S. leadership on this issue. It would be tragic if efforts to abandon this effective approach put at risk the consensus and momentum for increased U.S. commitment and investment in this life-saving initiative.

We strongly urge the Committee to retain designated funding for prevention of sexually transmitted HIV through abstinence and fidelity education

PEPFAR included a 7% allocation (one-third of HIV and AIDS prevention funds) for abstinence-before-marriage programs. The State/Foreign Operations appropriations bill abandons this commitment, even though there is a global shortage of funding available for this critical and effective method for preventing sexually-transmitted HIV.

Since 2003, CRS has been one of the largest and most successful partners in PEPFAR. In its extensive experience and in the documented experience of others, only an approach to sexually-transmitted HIV prevention that has sufficient funding for a behavior change strategy based on abstinence, partner reduction, and faithfulness education has yielded meaningful advances in stopping the spread of HIV. Educating youth on the risks they may face and providing them with good “life skills” so that they can make good, sound decisions, actually saves lives. Evidence shows that the HIV and AIDS prevalence rates in at least 7 of the 15 PEPFAR Focus Countries are declining – and in every such case, there is a significant decline in the reported numbers of sexual partners and in the number of unmarried youth aged 15–24 who are sexually active.

There is no evidence that an increase in the use of condoms alone, without abstinence and behavior change interventions, has reduced the rate of AIDS cases. Our experience leads us to strongly reaffirm the need for designated funding for abstinence-until-marriage, funding that was virtually non-existent before PEPFAR. Without funding for such programs, human lives, particularly in Africa, may be further threatened. A recent Washington Post article presents concrete evidence in this regard, affirming that in the case of Botswana, “soaring rates of condom use have not brought down high HIV rates. Instead, they rose together, until both were among the highest in Africa” (“Speeding HIV's Deadly Spread,” Washington Post, March 2, 2007; p. A1).

Congress has responded to the health needs of the poor around the world with generosity. We ask that you support any effort to restore the PEPFAR-mandated allocation for “abstinence-until-marriage” funding. In addition, we urge you to fully fund this important investment in preventing HIV infections and saving lives, and not let it be side-tracked into diversionary battles. Now is the time for new investment, not re-fighting old battles.

With appreciation for your continued support for addressing the critical health needs of the poor around the world, we remain,

Sincerely yours,

Most Reverend Thomas G. Wenski
Bishop of Orlando
Chairman, Committee on International Policy

Ken Hackett
President, CRS

letter-to-house-from-bishop-wenski-on-pepfar-funding-2007-06-18.pdf