Charity challenges US “anti-prostitution” restriction

BMJ 2005; 331 doi: (Published 18 August 2005) Cite this as: BMJ 2005;331:420
  1. Bob Roehr
  1. Washington

    A US charity is to challenge the US government's requirement that international non-government organisations must explicitly oppose prostitution and sex trafficking if they are to receive government funds for family planning and HIV prevention activities.

    DKT International, which is based in Washington, DC, filed a lawsuit against the US Agency for International Development (USAID) on 11 August. It claims that the provision is a gag order restricting its right to free speech and is therefore unconstitutional.

    The law was enacted by Congress in 2003, with the strong support of the Bush administration, and is only now being enforced.

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    DKT claims that state opposition to prostitution restricts free speech


    DKT is a non-profit organisation that implements programmes to market family planning and HIV prevention services to nearly 10 million people in 11 countries around the world. It uses commercial marketing techniques and private sector networks to distribute family planning services at an affordable, subsidised price. About 16% of its total funds come from the US government, either directly or indirectly through grants and contracts. It also receives money from the governments of the United Kingdom, Australia, and Germany, as well as from the Bill & Melissa Gates Foundation.

    In July another charity specialising in work on HIV and AIDS and family planning, Family Health International, said it could not renew a USAID sub-contract with DKT for ongoing work making lubricants and condoms available in Vietnam unless DKT signed the anti-prostitution pledge.

    “DKT has no policy on prostitution and does not wish to adopt one,” DKT argued in its lawsuit. “It believes it has a first amendment right not to do so.” It said it strongly believes that it can best achieve its goals “by maintaining neutrality on the controversial question of how to handle the complex problems that arise at the intersection of the HIV/AIDS epidemic and prostitution.”

    “The government can tell us what to do with their money—that is not in question,” said DKT's president, Philip Harvey. “But it is reprehensible and, we believe, unconstitutional to tell us what to do with private money.”

    The issue has been building for some time. Many organisations involved in AIDS services believe that sex workers are a key group in AIDS prevention activities and that the anti-prostitution pledge undermines the organisations' trust and credibility among sex workers.

    “The extent of the consternation among non-governmental organisations doing this work in the field is enormous. Some have simply held their noses and signed it, while others have signed under protest or refused to do so,” said Mr Harvey.

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