Since its inception in 2003, the President's Emergency Plan for AIDS Relief - PEPFAR - has become the largest public health program in history. Created by President George W. Bush, it has distributed nearly $50 billion worldwide, mostly in Africa, to prevent the spread of HIV and to treat its victims. Over the last five years, the fund has provided care for 3 million people and prevented an estimated 12 million new infections. Even Bush's harshest critics do not deny that PEPFAR has been a huge success in combating the AIDS epidemic.
In spite of all that the program has accomplished, however, a persistent problem remains: the promotion of homophobia by African governments receiving American aid money. In no nation is this problem more acute than in Uganda, one of 15 PEPFAR "focus" countries that collectively account for half of the world's HIV infections. Homosexuality is considered a taboo in most of Africa, yet few governments have gone to the lengths of Uganda's in punishing it. The consequences are devastating not only for the people directly affected by these adverse policies but for the fight against AIDS in general.
Uganda's campaign against homosexuality took a disturbing turn last month when a member of parliament in the nation's governing majority introduced legislation that would stiffen penalties for actual or perceived homosexual activity, which is already illegal under Ugandan law. According to the proposed law, "repeat offenders" could be sentenced to death, as would anyone engaging in a same-sex relationship in which one of the members is under the age of 18 or HIV-positive. Gay-rights advocacy would be illegal, and citizens would be compelled to report suspected homosexuals or those "promoting" homosexuality to police; if they failed to do so within 24 hours, they could also be punished.
International human rights groups have protested the bill, but their complaints have only made the government more defiant. "It is with joy we see that everyone is interested in what Uganda is doing, and it is an opportunity for Uganda to provide leadership where it matters most," the country's ethics and integrity minister has said.
Aside from its evident inhumanity, such draconian legislation will only do massive harm to HIV-prevention efforts. Gay men are an at-risk community, and they already face severe repression in most African countries. Because of conservative social mores and government repression, many are hesitant to come forward to get information regarding safe sexual practices. This bill could make the very discussion of condom use and HIV prevention for gay men illegal. By driving gays even further underground, such governmental homophobia only ensures that HIV will continue to spread unabated.
When a government actively encourages homophobia, the effect reverberates throughout society. Uganda's president, Yoweri Museveni, has accused European gays of coming to his country to "recruit" people into homosexuality. Ugandan newspapers and bloggers have seized on the proposed law to launch their own broadsides against gays, posting the names and photographs of individuals in Wild West-style "wanted" posters in print and online. A major tabloid, the Red Pepper, trumpeted an expose headlined "Top Homos in Uganda Named" as "a killer dossier, a heat-pounding and sensational masterpiece that largely exposes Uganda's shameless men and unabashed women that have deliberately exported the Western evils to our dear and sacred society."
From 2004 through 2008, Uganda received a total of $1.2 billion in PEPFAR money, and this year it is receiving $285 million more. Clearly, the United States has a great deal of leverage over the Ugandan government, and the American taxpayer should not be expected to fund a regime that targets a vulnerable minority for attack - an attack that will only render the vast amount of money that we have donated moot.
Earlier this month, members of Congress led by the House Foreign Affairs Committee chairman, Howard L. Berman (D-Valley Village), and its ranking minority member, Ileana Ros-Lehtinen (R-Fla.), sent a letter to Secretary of State Hillary Rodham Clinton calling on the U.S. "to convey to Ugandan leaders that this bill is appalling, reckless and should be withdrawn immediately." And in an open letter to Dr. Eric Goosby, the new U.S. global AIDS coordinator, Charles Francis, a member of the Presidential Advisory Council on HIV/AIDS during the Bush administration, asked, "Will we stand by and let national governments scapegoat a sexual minority for HIV/AIDS while receiving major funding for AIDS relief?"
Irresponsible and reprehensible behavior on the part of Ugandan officials should lead to a serious re-evaluation of U.S. policy and an ultimatum for the Ugandan government: It must desist in its promotion of deadly homophobia or say goodbye to the hundreds of millions of dollars it has received due to the generosity and goodwill of the American people.