Religious right wields clout
Secular groups losing funding amid pressure
For six decades, CARE has been a vital ally to the US government. It supplied the famed CARE packages to Europe's starving masses after World War II, and its work with the poor has been celebrated by US presidents. So the group was thrilled when it received a major contract from the Bush administration to fight AIDS in Africa and Asia.
But this time, instead of accolades came attacks. Religious conservatives contended that the $50 million contract, under which CARE was to distribute money to both secular and faith-based groups, was being guided by an organization out of touch with religious values.
Senator Rick Santorum , a Pennsylvania Republican, charged last year that CARE was ``anti-American" and ``promoted a pro-prostitution agenda." Focus on the Family, the religious group headed by James Dobson , said the agency that delivered the contract, the US Agency for International Development, was a ``liberal cancer."
The complaining paid off. CARE's $50 million contract is being phased out this year; it has been replaced with a $200 million program of grants that is targeted at faith-based providers, and overseen by USAID itself.
The pressure on CARE is emblematic of that facing many other secular groups. President Bush's faith-based initiative has not only increased funding for church groups, but also raised the expectations of the religious right, which has asserted a stronger role in setting policy.
The pattern of outcry by religious conservatives, followed by accommodation by the administration, has been replicated on numerous occasions at USAID, from personnel decisions to choices of who runs humanitarian programs overseas.
In the process, secular groups have seen an overall drop in funding. CARE's USAID dollars declined every year, from $138 million in fiscal 2001 to $96 million in fiscal 2005, the last year for which data is available, according to a Globe survey of prime contractors and grantees in the development arena.
Kristin Kalla , the CARE official overseeing its AIDS contract, said she found herself in the middle of a war over politics, religion, and money.
``There was a lot of resentment, a lot of pressure, from the religious right feeling that they supported Bush, especially for the second term, and they wanted to get paid their dues, they wanted a piece of the pie in terms of foreign assistance," Kalla said.
James Towey , the former head of the White House's faith-based office, acknowledged that he fought hard to shift international aid to faith-based groups, although he denied it was a political payback.
``The fact is [officials at USAID] tended to be left of center and they tended to be more of a secular perspective than a religious one," said Towey, who served as Bush's top faith-based official from 2002 until June 2006. ``There were pockets of extreme hostility to faith-based organizations. There were instances where people had agendas that were very clearly at odds with what President Bush had laid out as his foreign policy agenda. . . . We wanted to see the new groups have a chance."
Under pressure from Dobson, members of Congress, and Towey's office at the White House, USAID officials promoted groups favoring abstinence as the prime means of preventing AIDS. The officials gave funds to one such group despite a review panel's determination it was not suitable, and allegedly stripping money from a group that criticized the administration's emphasis on abstinence.
And USAID required groups to sign an anti-prostitution pledge despite concerns over its constitutionality. The pledge required all organizations receiving USAID money overseas to renounce prostitution, which some groups interpreted as abandoning efforts to prevent prostitutes from spreading AIDS.
The Brazilian government, which has had success in decreasing AIDS by working with prostitutes, refused to sign the pledge and lost a $40 million grant.
In an affidavit for a lawsuit over the matter, Pedro Chequer , director of Brazil's AIDS program, said his country strived to adhere to ``the established principles of the scientific method and not allow theological beliefs and dogma to interfere."
AIDS has been the Bush administration's top overseas health priority, and it consumes about half of the global health budget, much of which is overseen by USAID.
But disagreement has raged for years over how best to prevent AIDS. US policy has long supported condom use. But some religious conservatives say distributing condoms actually increases AIDS by promoting sexual activity. Others say the only sure way to stop AIDS is by teaching abstinence and faithfulness.
With faith-based groups seeking a major share of the anti-AIDS funds, the administration sought to resolve the controversy in 2003 by endorsing a three-pronged strategy of promoting abstinence, faithfulness, and, when appropriate, condoms.
Under a bill approved by Congress and signed by Bush, one third of the administration's $3 billion international AIDS prevention budget must be spent on programs promoting ``abstinence until marriage." Meanwhile, the administration was also buying hundreds of millions of condoms for distribution overseas.
But some leaders of the religious right felt that any program involving condoms is inappropriate, and they focused their anger on USAID.
The dispute erupted in public after a remark in 2002 by then-secretary of state Colin Powell, who had visited Africa and been appalled at the AIDS rate. In a television interview, Powell said that while he respected churches that are opposed to condoms, ``In my own judgment, condoms are a way to prevent infection and, therefore, I support their use."
Dobson blasted back, declaring ``Colin Powell is the secretary of state, not the secretary of health. He is talking about a subject he doesn't understand."
Raised by a Nazarene preacher, Dobson has emerged over the past three decades as one of the nation's top political leaders among religious conservatives. He is known for his strong views against gay marriage and abortion.
Dobson's organization, Focus on the Family, has played a major role in presidential politics, sending out 5 million letters, postcards, and e-mails just before the 2004 election. He is close to Bush and White House adviser Karl Rove .
The administration had hoped to avoid fights with religious conservatives by putting people in charge of USAID with strong faith-based ties: administrator Andrew Natsios and global health director Dr. Anne Peterson .
Natsios is a former Massachusetts legislator who once supervised the Big Dig and has served as vice president of World Vision, the largest evangelical recipient of USAID grants. Peterson, a physician, is an evangelical Christian and former Virginia state health commissioner who has also worked with Christian groups in Africa.
Peterson said in an interview that she assumed she would be embraced by religious conservatives.
She was wrong: Dobson's group singled her out for a series of attacks, since her global health division oversaw AIDS policy.
In September 2004, Peterson boarded a plane for Colorado on a secret and sensitive mission: to try to prevent an all-out assault by Dobson, who had vowed to use his clout with Congress to pressure USAID into giving more funds to faith-based groups.
Peterson spent the day at the Colorado Springs headquarters of Focus on the Family, culminating in a short, terse audience with Dobson himself.
``Where do you stand on condoms?" Dobson asked, according to Peterson.
Peterson replied that, as a physician, she was convinced condoms played an important role in preventing AIDS, along with abstinence and faithfulness. Dobson was displeased, she said.
``It was very clear that I did not budge him on the condom issue," Peterson said. Focus on the Family, meanwhile, prepared a briefing that was critical of Peterson, quoting her as saying that the Bush administration had doubled condom availability in developing nations.
Within months, Peterson had resigned for personal reasons, deeply bruised by the attacks.
``I had not expected to have that from the Christian community," she said. ``I had expected to find more resonance with a broader group of people to find a common ground. This is a core good thing to do, help people to stay healthy. It was disconcerting to find that when money is on the table everybody fights harder to get the piece of it."
A private briefing on Capitol Hill in January 2005 for 50 congressional staffers prompted more than two dozen members of Congress to sign a letter demanding that more money go to faith-based groups that favored abstinence.
They complained in the letter to Natsios that government funding for faith-based groups was being ``delivered by anti-American, anti-abstinence, pro-prostitution, and pro-drug use groups."
In its printed materials for the briefing, Focus on the Family targeted a USAID official who it claimed was gay and committed to a pro-homosexual agenda.
Natsios, who left his post as USAID administrator earlier this year, said of the attack: ``It was over the top, it was outrageous."
Dobson declined to comment. The briefing was overseen by the group's chief public policy officer, Peter Brandt . In an interview, Brandt acknowledged that ``that individual should not have been targeted." But he stood by the attacks on USAID and what he called the ``condom cartel."
Peterson was replaced as head of global health by a well-known conservative evangelical leader, Kent Hill . Unlike Peterson, he had no medical degree and no prior experience in public health.
Over his long career, Hill had worked to protect evangelicals in the former Soviet Union, wrote a book stressing the importance of evangelism in the world, and ran into controversy when he became president of Eastern Nazarene College in Quincy and sought to ban non-Christians from teaching positions.
While some liberal groups expressed concern about Hill's record, he has endorsed Peterson's position on condoms, and used his credibility with evangelicals to urge religious leaders to show more civility.
``I can tell you from personal experience that all too many Christians on both the right and the left display an arrogance and self-righteousness about their views," Hill told a conference on faith and international development in Michigan last February. ``Too many Christians are judgmental, black-and-white thinkers who don't do their homework, do not nuance their positions, and on top of that are nasty and mean-spirited to those that they have a disagreement with, and in the end they undermine what they are trying to do. But what is worse, they undermine their faith."
Despite the insistence of senior USAID officials that they were not influenced by Dobson in making grant awards, many secular groups contend that the attacks have had a major impact.
They cite a case in which Natsios overruled his own review panel to provide a grant to Children's AIDS Fund, a group that highlights abstinence.
The fund has ties to both Focus on the Family and the Bush administration. It was cofounded by Shepherd and Anita Smith . Shepherd Smith has worked closely with Dobson and attended the Focus on the Family briefing that attacked USAID. Anita Smith has been the chairwoman of the Presidential Advisory Council on HIV and AIDS.
The Smiths believed that their application was just the kind being sought by the Bush administration. But USAID's technical review panel determined that the grant proposal was ``not suitable for funding." The agency has refused to release the panel's report, leaving it unclear why the proposal was considered unsuitable.
In any case, Natsios wrote a memo on Oct. 21, 2004, urging that Randall Tobias, who was then in charge of the international AIDS program, approve the funding because the group favored abstinence.
``The selection of a `non-suitable' applicant such as [Children's AIDS Fund] . . . is not inconsistent with USAID's grant-making policies," Natsios wrote. Tobias agreed, and funding was granted on Nov. 1, 2004. The grant could reach $10 million over a five-year period.
The memo raises the question of how many other ``nonsuitable" applicants have received money from USAID. Representative Henry Waxman, a California Democrat, wrote to the Bush administration that the approval ``raises questions of political cronyism."
The Smiths said in separate interviews that no political pressure was applied. They said their group is not faith-based, although it distributes money to faith-based groups.
Natsios said his decision was meant to help shore up abstinence work in Uganda, and not ``for the religious right."
But Population Services International, a secular group that failed to get the grant, worries that it lost because of its history of condom distribution.
``If they are faced with giving us a grant and someone else a grant, I think they would rather give it to the other guys because they don't want their careers to be damaged because they would be seen as fellow travelers with us," said Sally Cowal , the group's senior vice president. USAID said in response that the group still receives major contracts.
``The money is so big this is not just about ideology, it is about money," Cowal said. ``Before, the amount of money available for HIV and AIDS internationally was very small so a lot of people weren't interested. Now it is very big. Suddenly people not interested in the million dollars are interested in the billion dollars."
The total PEPFAR budget is $15 billion over five years, including $3 billion for prevention. Of that amount, about $1 billion must go for ``abstinence-until-marriage" programs.
Some of those who have lost funding under the Bush administration, however, say the huge abstinence budget has been used as a political payout to faith-based supporters of administration policies.
For example, a nonprofit organization called Advocates for Youth, which focuses on AIDS and teen pregnancy, says it lost an $800,000 contract for AIDS prevention among youth in South Africa, Nigeria, and Botswana because it had been critical of the administration's emphasis on abstinence.
``At times it turns into a political slush fund for organizations that are ideologically aligned with the administration rather than public health organizations with a proven track record," said James Wagoner, president of Advocates for Youth. A PEPFAR spokesman said the group's grant expired.
Dr. Mark Dybul , who oversees PEPFAR, said funding decisions are all made on merit . But he added that he considers faith-based groups to be crucial partners: ``Our goal is not the recruitment of faith-based organizations . . . [but] to me, as the coordinator, you cannot achieve those goals without faith- and community-based organizations."
Dybul stressed that he supports Bush's strategy of using abstinence, faithfulness, and condoms to fight AIDS. But he also said that until recently there was too much reliance on condoms.
``Just go to an international meeting and mention the words `abstinence and fidelity,' " Dybul said. ``I've sat in rooms where people snicker."
Kalla, who administered the program of AIDS grants to faith-based and community-based groups for CARE, said the pressure to give money to religious groups was intense.
She cited an example in which she determined that a small faith-based group favored by senior administration officials was not qualified to manage hundreds of thousands of dollars. Kalla said that she was roundly criticized by the officials, and that the administration found another source of money for the group.
Kalla said CARE made special efforts to fund faith-based groups, but she said administration officials sometimes criticized the grants that went to Muslim and Jewish groups.
``We were told repeatedly by staff at USAID directly in meetings that these were not the `right types' of faith-based organizations that the White House faith-based office was looking for," Kalla said. In an effort to placate USAID, she said, CARE awarded a $100,000 grant to Samaritan's Purse, a group run by Bush's friend, Rev. Franklin Graham, for work in Mozambique. She said USAID informed her it was the right type of faith-based group.
The USAID official who oversaw the CARE program said he did not pressure Kalla to favor conservative groups. And Natsios and Hill said that all groups are treated equally in the funding process.
Nonetheless, the pressure on USAID from Christian groups has raised persistent questions about whether Jewish and Muslim organizations are being overshadowed.
The Globe survey of prime contractors and grantees indicated that 98.3 percent of funds to faith-based groups went to Christian-led organizations.
Eugene Lin , a former employee of the office of faith-based programs at USAID, said the office catered mostly to evangelical Christians. He calculated that of 167 organizations invited to discuss potential grants during a 15-month period ending in September 2004, only five were non-Christian.
``I was fairly outspoken in the office, saying it is really unfair we never invite Jewish or Muslim groups to our office, everyone is Christian," Lin said. ``There is no balance whatsoever."
Lin said that he was told by the acting director of the office, Linda Shovlain , that she wanted to have what she described as a ``Come to Jesus" meeting to discuss his work. Lin said he felt intimidated because Shovlain had a 2-foot high crucifix over a conference table in her office.
Lin eventually was fired, and filed a religious-discrimination complaint.
In a deposition, Shovlain said her ``Come to Jesus" remark was misunderstood.
``One day, after I had had to exercise tremendous oversight over [Lin], I told him jokingly that if things continued as they had been that we would have to have a `Come-to-Jesus' meeting, and jokingly added that if we could not come to resolution on his performance I would fire him," Shovlain said in the deposition. ``I very quickly saw he thought this phrase `Come to Jesus' meeting had a religious connotation, and I explained to him that this phrase was an expression for having a meeting where we discussed plainly what needs to change and find resolution."
Shovlain added: ``If I had known he was so sensitive about religion, I wouldn't have used the term. . . . I didn't know until recently he was Jewish or so sensitive about religion."
A USAID panel dismissed Lin's complaint in July. He has filed an appeal.
The panel endorsed Shovlain's right to display the crucifix, quoting from a 1997 federal regulation that a federal employee may display religious art as long as it does not create the impression that the government is ``favoring or disfavoring a particular religion."
The law says funding cannot be given to any group ``that does not have a policy explicitly opposing prostitution and sex trafficking." Supporters said they hoped the legislation would ``eradicate" prostitution and thus curtail the spread of AIDS.
While few, if any, aid groups support prostitution, many expressed concern that the US policy was so broad -- and applied even to their private funds -- that it would obstruct their outreach to sex workers who are at high risk of transmitting the AIDS virus.
In some countries, half of all prostitutes are infected with the AIDS virus, according to congressional testimony. As a result, USAID's leaders originally were sympathetic to groups that resisted the anti-prostitution pledge.
The issue seemed to be resolved when the Justice Department advised USAID that the law was unconstitutional on the grounds that it violated free speech.
But the decision set off a firestorm of protest from the religious right and its allies in Congress, after which Bush's Justice Department reversed itself.
When USAID then started requiring the pledge, some major grant recipients refused to take it -- and suffered.
The Brazilian government, which lost $40 million, said the pledge would undercut one of its most successful anti-AIDS strategies, persuading sex workers to use condoms or other measures to stop spreading the disease.
Chequer, the country's AIDS director, said its work with prostitutes is a major reason why Brazil's infection rate among young adults is only 1 percent.
``We view sex workers as essential partners in our HIV prevention efforts," Chequer said.
The US government disputed that the pledge would suspend the Brazilian AIDS program, but other funding recipients interpreted the pledge the same way as the Brazilians.
American Jewish World Service, one of a handful of non-Christian faith-based groups to get US funds, received a single subgrant of $60,000 for AIDS work in Kenya, provided through the CARE program. The organization reluctantly agreed to sign the anti-prostitution pledge but quickly had second thoughts. The organization tries to stop the spread of AIDS by providing education opportunities for children of prostitutes, which can help mothers leave the brothels.
Julia Greenberg , the group's international aid director, said she believes the anti-prostitution pledge was designed to make grants more accessible to conservative Christian groups. She said her organization has not sought more funds ``because of the politics involved."
Some organizations that refused to sign the pledge have fought back. A company called DKT International says it lost US funds for a $60,000 AIDS program in Vietnam. DKT filed suit against the federal government, saying the pledge violated its First Amendment rights.
A similar lawsuit was brought against USAID by several other groups, including Pathfinder International, a Boston-based humanitarian group, and an aid group founded by billionaire George Soros.
To some conservative faith-based leaders, however, the plaintiffs in both cases are symbolic of what's wrong with US policy. Soros financed groups opposing Bush's re election. DKT is run by Philip D. Harvey, who operates a large mail-order pornography business that is separate from his anti-AIDS organization.
But in both cases, judges sided with the plaintiffs, issuing restraining orders that prohibited USAID from enforcing the anti-prostitution pledge.
Moreover, a judge in the Soros case declared that the Bush administration had altered its stance on the pledge due to political pressure.
US District Judge Victor Marrero noted that Senator Tom Coburn , an Oklahoma Republican, had written a May 19, 2005, letter to Bush blasting USAID for funding programs for prostitutes to attend ``parties and games."
The sponsor of the program mentioned in the letter said that it was a bingo-style program designed to educate prostitutes about AIDS.
The judge found that the pressure had an immediate effect: By June 2005, the Justice Department had reversed its position on the constitutionality of the pledge, and USAID was requiring groups to sign it.
``This shift in position coincided with pressure exerted upon USAID and the President," Marrero wrote.
Enforcing the pledge would do ``irreparable harm" to the aid groups' rights to free speech, Marrero said.
The Bush administration appealed the decision in August.
Globe Correspondent Kevin Baron contributed to this report. 
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