Cruising With Lazarus
President Bush's War on ... Prostitution?
Our president, Curious George, and his administration have already taken on terrorism. Last September, W vowed, "The United States is determined to stay on the offensive and to pursue the terrorists wherever they train or sleep or attempt to set down roots." That terrorism thing should be under control any day now, so W and all the neoconservative powers that be in Washington have time to take on the world's prostitutes -- wherever they train or sleep or solicit.
In Brazil -- South America's largest country and leading economic power -- prostitution is legal for consenting adults over the age of 18. Brazil has adopted open, accepting policies about commercial sex workers. Direct educational outreach to prostitutes and free condom distribution is believed to have curbed the spread of HIV and other sexually transmitted diseases. Simultaneously cutting-edge and practical, Brazil's approach to prostitution has been praised by many AIDS advocates and international health organizations. No one is saying prostitution is good for women -- degradation and exploitation remain commonplace. But Brazil was smart enough to acknowledge that punitive laws and public moralizing don't stop commercial sex work or HIV.
Back in 2003, the U.S. Congress passed legislation called The Leadership Against AIDS, Tuberculosis and Malaria Act of 2003 (also known as PEPFAR -- The President's Emergency Plan for AIDS Relief). The legislation contains references to "eradicating prostitution" and helping women who are victims of "sex trade." Not so much about malaria and tuberculosis. And an amendment to the legislation prohibits funds from going to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking. The legislation authorizes spending $15 billion over five years in African and Caribbean countries. Somehow -- and this remains unclear -- Vietnam and Brazil got thrown into the mix, too.
That $15 billion is doled out by an independent federal government operation known as the U.S. Agency for International Development -- USAID. Since 2003, USAID has awarded Brazil about $8 million of a promised $48 million grant. This past May, two years later, the Bush administration told Brazil it would get the remaining $40 million when the Brazilian government and any HIV/AIDS organization providing services in the country sign a written pledge condemning prostitution. Speaking on behalf of Brazil's National HIV/AIDS Commission, Dr. Pedro Chequer rejected both the money and the manipulation. "We can't control (HIV) with principles that are Manichean, theological, fundamentalist and Shiite," Chequer said, adding that the national commission -- which includes cabinet ministers, scientists and AIDS advocates -- viewed the Bush administration's demand as "interference that harms the Brazilian policy regarding diversity, ethical principles and human rights." Chequer said some other stuff, too, but no one in the Bush administration was listening after that Manichean reference.
Bravo, Dr. Chequer! Brazil's national AIDS policies are among the most progressive and successful in the world. The International Center for Equal Healthcare Access (ICEHA), a nonprofit organization that brings the infectious disease expertise of Western physicians and nurses to clinics in resource-poor settings, has said that more countries should follow Brazil's example. In 1992, experts predicted that there would be 1.2 million HIV-positive people living in Brazil by 2002. Brazil mounted an unprecedented HIV prevention campaign and built up its public healthcare system. The results? Brazil was able to halve its HIV prevalence rate from 1.2 % in 1997 to 0.6% by 2002. There are 660,000 people living with HIV in Brazil today -- not 1.2 million, as predicted.
And that's not all. Brazil's Ministry of Health distributes millions of free condoms each month -- fairly amazing when you consider that 80% of the population is Roman Catholic. Further, Brazil recognizes a constitutionally based right of each citizen to receive HIV medications regardless of ability to pay. Over the years, the Brazilian government has aggressively and successfully negotiated drug price cuts with major pharmaceutical companies -- something the U.S. government has never even attempted -- as well as funding domestic national laboratories that produce generic versions of other drugs. Earlier this year, Brazil even pledged to give antiretroviral drugs to nine eastern Caribbean nations.
In Brazil, sex workers play a part in HIV prevention and implementation of the nation's AIDS policies. The United States wanted Brazil -- and every other country that advocates for sex workers or treats them like human beings -- to condemn prostitution. While Brazil can afford to reject the Bush administration's ideological restrictions and money, many countries that need the U.S. grants cannot. The Leadership Against AIDS, Tuberculosis and Malaria Act of 2003 was well-intentioned legislation. Unfortunately, it's riddled with absurdly prohibitive language that ultimately undermines its original humanitarian goal by coercing developing countries into publicly condemning some of the very people who need HIV/AIDS services the most.
The Bush administration would have you believe they care about women. But you can't pretend to care about them while forcing governments and organizations all over the world to advocate official stigmatization of the ones who were forced into a life of prostitution or chose it as a means of survival. And apparently no one in the Bush administration can grasp the obvious, most problematic detail about this policy: it goes against the entire grain of sound public health principles to judge the people you are trying to reach.
Would it absolutely kill W and his disturbingly smug, misanthropic cabal of flying monkeys in Congress to admit, just occasionally, that some other country on the planet might be doing something worthwhile ... might have a better plan ... might even be more successful than us at addressing HIV? When developing nations have a sound plan, but no funds for implementation, doesn't it undermine the spirit of humanitarian aid when we wave millions of dollars at them -- money that will save lives -- but threaten to withhold it unless they condemn prostitution and reverse compassionate policies about commercial sex work?
Who says the United States ought to have the last word on prostitution, anyway? Prostitution is legal in counties throughout the state of Nevada. Why is the Bush administration picking on Brazil when legal brothels flourish in Nevada? You don't see Congress denying Nevada highway funds until the governor condemns prostitution. And what about that cornball Julia Roberts movie, Pretty Woman? She plays a prostitute who ends up with Richard Gere and an Academy Award nomination. People love that movie. Maybe Congress could come up with some kind of worldwide matching strategy for prostitutes that would place them all in traditional, monogamous heterosexual marriages with guys who look like movie stars.
David Salyer is an HIV-positive journalist, educator and activist living in Atlanta, Georgia. He leads safer-sex presentations for men and has facilitated workshops for people infected or affected by HIV since 1994. Reach him by e-mail at email@example.com.
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This article was provided by AIDS Survival Project. It is a part of the publication Survival News.