The Bush administration is fond of placing ideological restrictions on foreign organizations that receive U.S. money to do their work–especially when it comes to all things sexual and reproductive. Details such as whether our ideological purity tests undermine accepted public health practices are of little importance to an Administration that prefers to base U.S. foreign policy decisions on domestic culture wars. PEPFAR, Bush's much-touted 5-year, $15 billion global HIV/AIDS prevention, treatment, and care initiative, is a case in point. First, one-third of all PEPFAR prevention funds must be dedicated to "abstinence-only-until-marriage" programs–that is, programs that don't work. Second, so-called "conscience clauses" allow religious organizations receiving PEPFAR funding to refuse to provide information about condoms, even if the funds they receive are meant to be spent on comprehensive prevention strategies. And third, there's the prostitution provision, which requires all PEPFAR grantees to adopt a policy "explicitly opposing prostitution and sex trafficking," even if their organizations are run by or work closely with sex workers. All of these restrictions make it easy to understand why more than one potential partner in the fight against HIV/AIDS has politely declined U.S. support.

Then again, when organizations and individuals receiving U.S. funding violate people's human rights in ways that the Bush administration considers politically acceptable, their transgressions tend to get written off as cultural inevitabilities. Such is the case in Uganda, where Human Rights Watch recently revealed that officials in the government of President Yoweri Museveni (who, along with this wife, Janet, has long been a PEPFAR poster child) are currently cracking down on LGBT activists who have petitioned for their right to exist under the oh-so-controversial slogan, "Let Us Live in Peace." For the past few months, the tabloid press and the anti-gay, anti-condom Pastor Martin Ssempa (a former PEPFAR grantee who was invited to testify before the U.S. Congress as an HIV/AIDS expert in 2005) have been targeting LGBT people with impunity. Meanwhile, members of the media who have provided a platform for LGBT activists to defend themselves have been censored and fined by officials in the Museveni administration. The U.S. government's response? Oh, right, there hasn't been one.

Of course, the Bush administration is more than happy to intervene when recipients of U.S. funding do things like mention condoms or fail to condemn sex workers in their efforts to prevent HIV, or work in a country that has a coercive population control policy, or tell women where they can get a safe and legal abortion. The Bush administration and its right-wing allies in Congress talk a big game about not trampling on the toes of so-called faith-based organizations whose moral squeamishness prevents them from being able to share accurate information about condoms, but what about the toes (and lives) of LGBT people in Uganda? Are they to be trampled on with the support of U.S. dollars?

Human Rights Watch has already documented the pernicious effects of U.S.-funded abstinence programs in Uganda (after all, if they don't work here, why on earth would we export them to a country with high HIV prevalence?). A deadly combination of misguided U.S. funding priorities and irresponsible national leadership have already turned Uganda from an HIV/AIDS success story into a perfect storm (infection rates have doubled in the past few years). PEPFAR has provided liberal funding to organizations and individuals who spread misinformation about condom effectiveness and instead focus exclusively on the benefits of abstinence and fidelity. This approach not only ignores reality, it also links HIV infection (and any sex outside heterosexual marriage, for that matter) with moral failure, which has a devastating impact on the one million Ugandans who are already living with HIV/AIDS.

Obviously, stigmatizing HIV-positive people and denying the existence of homosexuality are not just moral wrongs: they're substantial obstacles in the struggle against HIV/AIDS. Just like giving support to organizations that crusade against contraception (whether it's by funding them or just making major policy decisions based on their unsubstantiated claims) is an obstacle to reducing abortions, which the Global Gag Rule is allegedly supposed to be doing. But politically driven funding restrictions do more than just undermine the goals they purport to fulfill. They redirect money away from groups that base their programs on scientific evidence and sound public health practices, and toward those that base their programs on the political persuasions of the Bush administration. Last I checked, that was hardly a recipe for success.