If you ran a small public health or workers' rights organization with a shoestring budget, what on earth could make you refuse to take a lot of money from the government?
For some, being asked to take the so-called "anti-prostitution pledge" was enough. The pledge is a few lines in a big law. The law — the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act — pours billions of dollars into the global fight against AIDS and other diseases. The pledge says that to get some of this money, groups doing HIV prevention work have to mouth the government's position "opposing prostitution," and avoid doing anything an official might construe as promoting prostitution. In practice, that has meant that health services providers and advocates for the rights of vulnerable workers have to close their doors to women and men who need help but who are involved in sex work.
The anti-prostitution pledge has caused many organizations to bite the hand that had fed them. Some, in places like Thailand, India, and Brazil, rejected U.S. funding because the pledge is too far out of line with humanitarian and human rights principles, or because they simply couldn't do effective HIV prevention work while ignoring a group of people who are both vulnerable to infection and potentially key allies in the promotion of sexual health. Some U.S.-based organizations brought suit, challenging the pledge as a violation of the Constitution's guarantee of free speech.
Yesterday, the ACLU and the NYCLU filed a friend-of-the-court brief in that lawsuit on behalf of almost 25 public health and human rights organizations.
In terms of free speech, there's a lot at stake in this case. It's about the government doling out some money to private organizations, and then trying to dictate what those organizations can say — anywhere, anytime — about a controversial issue. According to the U.S. government, as long as an organization has taken a penny of government money to do HIV prevention work, it has to toe the party line, even when it is engaged in activity funded by money from sources other than the government. While it's true that in some situations the government can choose to promote one message over another when government funds are directly involved, that notion is now being stretched to dangerous lengths.
But the stakes in this case are highest in the real world. In a multitude of ways, the pledge has made it harder for organizations in the trenches of the fight against AIDS to do their job. Internationally-acclaimed HIV prevention programs have shut down or downsized, condom distribution programs have been slashed, and doctors and counselors have refused to provide sexual health information to people who need it. And women sex workers who, with the help of aid organizations, had united to oppose violence perpetrated against them by clients and police have found themselves isolated once again. All of this means needless infection, and needless suffering and death. It's hard to imagine a starker triumph of politics and ideology over human life.
A lower court has already suspended the pledge twice, and the government is now appealing. If the appeals court sides with the government, it will be a victory for state orthodoxy and a defeat for free speech, public health, and sensible public policy.