Randall L. Tobias

As President Bush's AIDS Coordinator, Tobias was responsible for setting policy detailing which countries would receive monies from various US agencies, how much, and what the rules governing assignment of those funds would be. As AIDS Coordinator, he discussed the rules in an interview with PBS' Frontline where he detailed a legal requirement that recipients of U.S. aid denounce prostitution:

The Congress I think very appropriately has put into the legislation that created this program that organizations, in order to receive money, need to have a policy opposed to prostitution and sex trafficking. I don't think it's too difficult for people to be opposed to prostitution and sex trafficking, which are in fact two contributing causes to the spread of HIV/AIDS. I think when organizations initially became aware of that requirement, some organizations were concerned about what the implications of that might be, but we implemented that in the first year with non-U.S. organizations. We're now implementing that requirement with U.S. organizations. And so far, I really know of no problems that we've had on the ground.[10]

"I think it is somewhat ironic and hypocritical that he would patronize an escort service while he was denying funding to organizations who want to help prostitutes, and supporting a policy that obviously forbids fraternizing with prostitutes," said Jodi Jacobson, executive director for the Center for Health and Gender Equity, Washington, D.C. The Bush administration's policy, said Jacobson and others, has led to the closure of numerous programs that had been teaching job skills to sex workers, forcing many prostitutes out of brothels and into the street.[11]

In his capacity as Director of Foreign Assistance, Tobias encouraged sexual abstinence, and discounted the use of condoms, in preventing HIV/AIDS. "Statistics show that condoms really have not been very effective," Tobias told a news conference in Berlin on April 21, 2004.[12]

Later, in March 2005, Tobias told PBS' Frontline:

Well, the heart of our prevention programs is what's known as ABC: Abstinence, Be faithful, and the correct and consistent use of Condoms, when appropriate. And it's not "ABC: Take your pick." It's abstinence really focused heavily on young people and getting them to understand that the best way to keep from getting infected is to be abstinent and not engage in sexual activity until they are old enough and mature enough and get into a committed relationship, such as a marriage. B is being faithful within that committed relationship. And A and B, those two things together clearly had a huge impact in bringing the infection rates down in Uganda.

C recognizes the fact that there are individuals in high-risk circumstances who either by choice or by coercion are going to find themselves unable to follow A and B, and therefore they need to have access to condoms, and they need to understand the correct and consistent use of condoms. I think more and more of the experts, the people who really understand the prevention requirements with HIV/AIDS, have come to endorse ABC in a very balanced way as the appropriate prevention centerpiece.

But I would also add that as important as ABC is, the fact is that this is a disease where 50 percent of the people infected in the world are women. When I cite those numbers to people here in the United States, I find most people are astonished. They just have no idea about that. In some countries in Africa, it's well above 50 percent that are women and girls. In many cases this is driven by cultural factors, where young girls are having sex with older men and [are] coerced to do that, where women aren't regarded as equal citizens with men. So there are lots of things that need to be done addressing those kinds of cultural issues also.[10]