Capital Commentary is the weekly current-affairs publication of CPJ, written to encourage the pursuit of public justice.

Accommodating Faith-Based Organizations in HIV/AIDS Services

By Stanley Carlson-Thies


September 28, 2012

By Stanley Carlson-Thies

An earlier version of this article was originally published in the Institutional Religious Freedom Alliance eNewsletter for Faith-Based Organizations on September 27, 2012. 

Amidst the furor over the so-called “contraception mandate,” the Obama administration's positive action to accommodate conscientious, religious objections to its HIV/AIDS policy was not much noted at the time, so, although very belatedly, here is the story. 

The President's Emergency Plan for AIDS Relief (PEPFAR) program, started by President George W. Bush (with the flashy endorsement of Bono, the lead singer of U2), invests tens of billions of dollars in the battle against HIV/AIDS, particularly in Africa. The program extensively and deliberately utilizes faith-based organizations, both US-based ones and indigenous ones. As noted in a 2005 report to Congress, "Faith-based groups are priority local partners. In many focus countries, more than 80 percent of citizens participate in religious institutions. In certain nations, upwards of 50 percent of health services are provided through faith-based institutions, making them crucial delivery points for HIV/AIDS information and services." 

But there's a problem: the federal government these days is convinced that condoms are a key element in an effective battle against HIV/AIDS, while many religious people and organizations, both in the US and in the countries where services are to be provided, are sure that condom distribution undermines the most effective way to overcome the epidemic—abstinence or faithfulness to a single partner. Insisting that organizations include condom distribution and education in their services is likely to exclude many of the most effective organizations, including those faith organizations located far from big cities and uniquely trusted because of their religious authority. 

Fortunately, after discussions with religious leaders, in February, the U.S. Agency for International Development (USAID), the agency that runs the PEPFAR program, modified its grant rules to resolve this dilemma. The amended rules say that an organization with a conscientious objection to certain activities cannot be required, as a condition of receiving PEPFAR funding, "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." The organization must notify USAID in a timely manner about which activities or elements it objects to, but cannot be rejected for that reason. Instead, grant applications must be evaluated based on what organizations will do and must not be treated less favorably because of what they will not do. The federal government must then devise a way to supply missing services that it regards as essential.  (The USAID revised policy is announced in AAPD 12-04, Feb. 15, 2012.) 

There continues to be disagreement about how best to prevent HIV/AIDS. It’s a hot button topic that can easily be seen as—and has typically been seen as—a “my way or the highway” choice:  stress abstinence and faithfulness or push condoms.  And this debate should continue.  In the meantime, the U.S. government as well as private organizations ought to be active in battling the epidemic and treating the afflicted as they best know how.

 USAID’s new policy is a wise alternative to a stand-off between the pro-abstinence and pro-condom forces.  The policy is a reasonable and laudable accommodation of religious exercise, enabling federally funded services to be delivered effectively by not excluding the government's best partners. 

—Stanley Carlson-Thies is president and founder of the Institutional Religious Freedom Alliance.   He served on the church-state task force of President Obama's Advisory Council on Faith-Based and Neighborhood Partnerships and on the founding staff of President George W. Bush's White House Office of Faith-Based and Community Initiatives. He also serves as a Fellow of the Center for Public Justice.

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