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USAID’s conscience directive praised

A pediatric client shows the two medications he takes each day to prevent opportunistic infections of the AIDS virus at Sekou-Toure Regional Hospital in Mwanza, Tanzania, in a collaborative effort with Catholic Relief Services. The U.S. Agency for International Development has issued a directive that includes a broad conscience protection for organizations seeking funding for AIDS treatment and prevention programs around the world.

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WASHINGTON – A little-publicized policy directive from the U.S. Agency for International Development (USAID) is getting a closer look from religious freedom advocates and promoters of conscience protections in federal law.

Months in development, the directive offers one of the broadest and most inclusive conscience protections to faith-based organizations funded by USAID to operate AIDS treatment and prevention programs and other health care programs around the world, Catholic observers said.

Specifically, the directive bans discrimination against faith-based and other organizations that decide not to engage in activities that violate religious or moral principles, such as condom distribution and education in their use.

Advocates of religious freedom see the language in the agency’s acquisition and assistance policy directive as a model that could be implemented in all government programs, contracts and grants with minor changes depending on the programs individual agencies oversee. Such language could pertain to federal programs ranging from health care reform to assistance to human trafficking victims.

The directive implements the conscience protection mandate that was included in the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act of 2008. The law authorized up to $48 billion over five years to combat malaria, tuberculosis and AIDS. It includes funding for the widely lauded President’s Emergency Plan for AIDS Relief program, known as PEPFAR.

The law, which expires at the end of fiscal year 2013, passed handily in both houses of Congress, both then under the control of Democrats: 308-116 in the House and 80-16 in the Senate. President George W. Bush signed the bill July 30, 2008. For the record, President Barack Obama, then a U.S. senator from Illinois, did not vote on the measure.

“(The directive) we feel expresses quite well what we would have wanted to see, and we are pleased with the constructive process we went through with them and they went through with us,” said Bill O’Keefe, vice president for government relations and advocacy at Catholic Relief Services (CRS).

“It’s very important obviously because the Church’s global health network is critical to addressing the problem of AIDS in many countries. That was recognized in the legislation and now is recognized explicitly in this guidance so we can at least compete fairly. We’re not asking for any preferential treatment. But as the law specified we wanted to be able to complete fairly without discrimination because of our teaching,” O’Keefe said.

He acknowledged that CRS played the leading role in the directive’s development. The agency has received hundreds of millions of dollars in federal funding for AIDS services around the world since 2004.

While CRS was unable to provide details on how much funding it received from USAID under PEPFAR, it has received $740 million for its AIDSRelief program from the federal government since 2004. The program has provided care and treatment to nearly 700,000 people in Ethiopia, Guyana, Haiti, Kenya, Nigeria, Rwanda, South Africa, Tanzania, Uganda and Zambia.

The directive affects not just CRS but all faith-based agencies that receive funding under PEPFAR. That includes the Catholic Medical Mission Board and its large AIDS-related programming in Kenya and Haiti.

The directive was welcomed by the U.S. Conference of Catholic Bishops, which is embroiled in its own dispute with the Obama’s administration over religious freedom issues and conscience protections on a number of fronts, particularly health care reform.

“This (directive) incorporates the purpose of the statute into implementation,” said Richard Doerflinger, associate director of the U.S. bishops’ Secretariat for Pro-Life Activities.

Doerflinger remained cautious, however, telling CNS the directive is limited to specific programs funded by one government agency. He said only the fact that the law reauthorizing PEPFAR and other health services included specific conscience protections was the directive as broad as it was.

When the programs are up for reauthorization in 2013, faith-based groups will have to renew their push to preserve the nondiscrimination wording they support, he said.

O’Keefe told Catholic News Service that CRS representatives expressed their desire that a strong protection for religious and moral rights be included in the directive in meetings with USAID officials that began in early 2011.

Officials at USAID did not return calls seeking comment on the drafting of the directive.

As the reauthorization law was being debated in Congress in 2008, the U.S. bishops took a particularly active role in ensuring that the final wording included the language protecting religious freedom, explained Stephen Colecchi, director of the bishops’ Office of International Justice and Peace.

“They understood the Catholic Church and the ties with Catholic institutions, which are very significant in many countries that suffer from the epidemic,” he explained.

The language in the directive to USAID staff around the world is explicit in explaining that any organization – faith-based or otherwise, both domestic and international – that is eligible to receive funding for AIDS prevention and treatment shall not be required to adhere to all aspects of what the agency calls a comprehensive approach to combating the disease. Such an approach includes the distribution of condoms and instruction on their use.

Specifically, the directive says an organization “shall not be required, as a condition of receiving such assistance … 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.”

In return, an organization must notify the appropriate USAID official no later than 15 days before the deadline for an application for funding if it cannot participate in all of the requirements of the program being funded because of a religious or moral objection. Then, on its application, the organization must indicate the activities it has omitted from its proposal based on those objections.

The directive specifies that any proposal “will be evaluated based on activities for which a proposal is submitted and will not be evaluated favorably or unfavorably due to the absence of a proposal addressing the activity(ies) to which it objected and which it thus omitted.”

The directive includes a prohibition on promoting or advocating for the legalization or practice of prostitution and sex trafficking and provisions for providing medically accurate condom information.

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