Brazil yesterday became the first country to take a public stand against the Bush administration's massive AIDS program which is seen by many as seeking increasingly to press its anti-abortion, pro-abstinence sexual agenda on poorer countries.

Campaigners applauded Brazil's rejection of $40m for its AIDS programs because it refuses to agree to a declaration condemning prostitution.

The government and many AIDS organizations believe such a declaration would be a serious barrier to helping sex workers protect themselves and their clients from infection.

The demand from the US administration, heavily influenced by the religious right, follows what is known as the "global gag" - a ban on US government funds to any foreign-based organization which has links to abortion. This has resulted in the removal of millions of dollars of funding from family planning clinics worldwide.

Yesterday Pedro Chequer, the director of Brazil's HIV/AIDS program, said the government had managed to resist US pressure during negotiations on the AIDS funding to focus on promoting abstinence and fidelity rather than condoms - another ideological battle being waged by the religious right. But the US negotiators insisted that the clause on prostitution had to stay.

"I would like to confirm that Brazil has taken this decision in order to preserve its autonomy on issues related to national policies on HIV/AIDS as well as ethical and human rights principles," he told the Guardian.

Campaigners congratulated the Brazilian government for its stance, and voiced concerns that the declaration on prostitution could damage efforts to tackle AIDS among sex workers in many countries.

Jodi Jacobson of the Center for Health and Gender Equity in the US said that, unlike the global gag, the declaration on prostitution looked likely to be imposed on US-based organizations as well as their subsidiaries abroad. The office of Randall Tobias, the global AIDS coordinator who is responsible for spending the $15bn President Bush promised for the fight against AIDS, was working on the language to be adopted, she said.

"Any organization receiving US global AIDS funding will have to agree to the policy," she said. That would include charities as large as Care, Save the Children and World Vision.

"It is a hugely problematic policy from the standpoint of public health alone. It goes against the entire grain of public health principles in not judging the people you are trying to reach."

But Sam Brownback, a leading Senate conservative, told the Wall Street Journal: "Obviously Brazil has the right to act however it chooses in this regard. We're talking about promotion of prostitution which the majority of both the house and the Senate believe is harmful to women."

Most US AIDS funding goes directly to organizations working in the field and much will be channeled through faith organizations that back the no-abortion, pro-abstinence and anti-prostitution stance of the US neo-conservatives.

But the Brazilian government has strong HIV/AIDS policies and insists that all negotiations go through its own committee. It also has a strong partnership between government and non-governmental organizations that encouraged a united response to Washington.

"This would be entirely in contradiction with Brazilian guidelines for a program that has been working very well for years. We are providing condoms, and doing a lot of prevention work with sex workers, and the rate of infection has stabilized and dropped since the 1980s," said Sonia Correa, an AIDS activist in Brazil and co-chair of the International Working Group on Sexuality and Social Policy.

"The US is doing the same in other countries - bullying, pushing and forcing - but not every country has the possibility to say no."

Adrienne Germain, president of the International Women's Health Coalition, said: "The importance of the Brazilian government decision can not be overstated."

© Guardian Newspapers Limited 2005

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