WASHINGTON (RNS) It took Dr. Hanna Klaus four years and $1.6 million in federal funding, but she and her team have preached abstinence to more than 23,000 African teenagers.
It's the only way to curb the AIDS epidemic that's sweeping that continent, said Klaus, executive director of Teen Star, based just outside Washington in Bethesda, Md.
"I don't know why people think they have to have a medical response to a behavioral problem," said Klaus, a gynecologist and a Roman Catholic nun. "Behavioral problems should be treated behaviorally. The easiest thing in the world is to wait (to have sex) until you get married, and marry a virgin."
Klaus and other abstinence advocates say their approach, favored by conservative policy makers, has fallen out of favor with the Obama administration. Now, Klaus said, her organization isn't eligible for the same grants she once received because she doesn't promote condom use, and because she'll never promote abortion.
Foreign aid officials say federal programs abroad continue to emphasize abstinence and fidelity along with contraception, but conservatives worry that the Obama administration is leaning toward abortion-friendly policies.
If the two sides can't find common ground, analysts say, poor Africans who benefit from the U.S. government's multi-billion-dollar AIDS relief strategy could lose out.
"The foreign development coalition is very fragile, and this is a debate that could break it beyond repair," said Michael Gerson, a former speechwriter for President George W. Bush and advocate of AIDS relief in Africa, at a recent foreign aid conference held at the evangelical Wheaton College outside Chicago.
Bush's five-year, $18 billion President's Plan for Emergency AIDS Relief (PEPFAR), introduced in 2003, provided HIV testing for 33 million people and anti-retroviral drugs to nearly 1.5 million Africans. The program saved an estimated 3.2 million years of adult life, according to federal documents.
The program earned a $48 billion, five-year extension in 2008, but not without a fight. A handful of conservative lawmakers complained the reauthorization was too expensive, and also worried that the money would be used to promote abortion.
The re-authorization was approved, but now conservatives worry that the consensus that emerged in 2003 and again in 2008 -- a combination of abstinence education and condom distribution -- is edging toward promoting abortion.
Secretary of State Hillary Clinton told Canadian reporters this spring that maternal health goes hand-in-hand with "reproductive health."
"And reproductive health includes contraception and family planning and access to legal, safe abortion," Clinton said March 30 during a news conference with G8 foreign ministers.
Clinton's "abortion grenade," as Gerson called it, threatens to upend support for the program from both Republicans and religious groups committed to overseas development but abhor abortion.
"It's a shame that the current administration and the majority party seem intent on using every opportunity they get to promote abortion,"
said Sen. Richard Burr, R-N.C., who was among those who opposed PEPFAR's reauthorization.
Burr said he'll oppose any legislation that includes an abortion provision, even within "life-saving programs such as PEPFAR."
Heated words and threats of pulled support are nothing new, said D.
Michael Lindsay, a Rice University professor and author of "Faith in the Halls of Power."
"What we're seeing is political posturing that's been going on for
25 years," ever since President Reagan decided that federal foreign aid would not be used to promote abortion, Lindsay said.
Reagan's announcement, known as the Mexico City Policy, became a political ping pong ball when President Clinton rescinded it in 1993, and when Bush re-instated it in 2001, and Obama removed it once again in 2009.
"It's become a symbolic move made by Republicans or Democrats as a way of signaling their allegiance in terms of their respective bases of support," Lindsay said.
It would take a lot more than a change in PEPFAR or another foreign health policy to realize conservative's worst fears. The 1973 Helms Amendment bars federal dollars sent overseas from being used to perform, pay for or promote abortion.
Conservatives are engaging in "phantom arguments," said Susan Cohen of the Guttmacher Institute, an abortion rights group. Too many anti-abortion activists think "abortion" when they hear the phrase "family planning," she said.
"Family planning is not abortion, and abortion is not a part of the U.S. Global Health Initiative," Cohen said. "Family planning is essential, and it makes a difference in saving people's lives, both in preventing HIV and making sure women are pregnant at intervals that are safe for them and safe for their newborns."
If family planning isn't a part of AIDS relief and other health programs, she said, poor Africans will lose their lives.
But Clinton's remarks, along with what they view as an increasingly pro-abortion administration, have so rattled conservatives that they're prepared to pull their support for global health programs, even if it means people will die from a lack of anti-retroviral drugs, condoms and other tools that have already saved countless lives.
"Things are on very shaky ground," said Tom McClusky of the Washington-based Family Research Council, a conservative advocacy group.
For many Americans, McClusky said, abortion is a deal-breaker, and Congress listens to their opinions.
"We've been pushing back on AIDS cases in Africa," he said. "But now, we'll probably see an increase in cases. Worst-case scenario? You'll see AIDS once again being the tyranny of Africa."
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