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On March 24, just a month after Ugandan President Museveni signed a bill making homosexuality a crime punishable by life in prison, Obama administration officials announced that they were increasing military aid to Uganda in its effort to quell rebel forces. Human rights groups criticized the move, arguing that the aid offered Museveni “legitimacy” after he supported a law that has been widely condemned for violating human rights. The same day, a State Department spokesperson quietly announced that the administration would also “demonstrate our support for the LGBT community in Uganda” by shifting $6.4 million in funding away from the Inter-Religious Council of Uganda, whose actions, State Department spokesperson Marie Harf said, “don’t reflect our values.” That may be the understatement of the year.

According to Ugandan AIDS activists, administration officials had been told a year and a half earlier that the Inter-Religious Council and other State Department grantees were actively promoting the antigay bill. In September 2012, several LGBT and AIDS advocates in Uganda were invited to a call with representatives from USAID, the Department of Health and Human Services (HHS) and the Office of the US Global AIDS Coordinator and other US officials to discuss HIV service delivery to vulnerable communities. According to minutes taken by one of the participants and conversations with others on the call, the US officials were warned that several grantees and subcontractors through the President’s Emergency Plan for AIDS Relief, commonly referred to as PEPFAR, were visibly supporting the bill, undermining service delivery to men who have sex with men, or otherwise fomenting anti-gay activities. US officials asked the Ugandan activists to provide information on these actions by the US government’s so-called “implementing partners,” and told them that such evidence might lead to an investigation by US officials.

Clare Byarugaba and other Ugandan activists on the call submitted a detailed spreadsheet to State Department officials with the names of US grantees they suspected were engaged in anti-gay advocacy, including the Inter-Religious Council; several of the advocates said they had been pushing US officials to defund the group as far back as 2009.

The Inter-Religious Council, the recipient, under Obama, of a $30 million grant through PEPFAR, had taken out newspaper ads in February urging Museveni to sign the bill and calling “homosexuality and Lesbianism” “sinfulness that must be addressed at personal level [sic] through repentance.” The ad goes on to express “support for any effort against the spread and promotion of homosexuality and Lesbianism in Uganda” and call upon “all Ugandans to take appropriate measures to protect themselves, their families and children from this vice.”

Kikonyogo Kivumbi, executive director of Uganda’s Health and Science Press Association, forwarded a press release announcing the ad campaign to the US Embassy in Kampala along with a note that read, “IRCU clearly continues to undermine US foreign policy values to non-discrimination…. I think what they are doing is not right.”

The Ministry of Health in Kampala. Despite PEPFAR guidelines that free condoms be made available, condoms are often scarce in the country.

Calls to US government officials listed in the minutes of that Uganda conference call were not returned, except by Patricia Davis of the State Department’s Office of Global Programs, who said that PEPFAR had never requested a “formal” investigation into US-funded NGOs in Uganda. And the State Department has announced that while funding for the Inter-Religious Council was reduced, it will continue to receive $2.3 million in US funds to provide HIV care.

The slow and partial action by Obama administration officials in this case—it’s taken nearly five years—appears to be part of a broader pattern of uninterrupted funding to faith-based groups and programs that lack oversight and accountability. Indeed, since taking office Obama has done little to end Bush-era funding to a whole range of conservative religious groups.

A Federally Funded Evangelical Economy

The late David Kuo, an evangelical Christian who played a key role in developing President Bush’s faith-based initiatives, wrote in his 2006 book Tempting Faith that the Bush administration openly wanted to enable religious groups to evangelize through federally subsidized programs. “We knew government couldn’t feed Jesus to people,” he wrote, “but if we could get money to private religious groups—virtually all of whom were Christian—we could show them to the dining room.” The broad contours of this effort have now become familiar: faith-based offices were set up in agencies as diverse as the Department of Health and Human Services, the State Department, the Department of Justice, the Department of Defense and the Department of Agriculture and given hundreds of millions of dollars a year to distribute to faith-based groups.

As a presidential candidate, Obama promised to make a sharp break from Bush administration policies by holding federally funded faith-based groups accountable. “If you get a federal grant, you can’t use that grant money to proselytize to the people you help and you can’t discriminate against them,” he said during a July 2008 stump speech. But a review of a database of federal grants, independent reports and numerous interviews with government officials and grantees reveals that little has changed since Obama took office.

Some Bush-era grants—multiyear contracts signed before Obama took office—had to be paid out well into Obama’s first term. But that’s not the extent of it. Conservative faith-based groups affiliated with the Family Research Council, anti-choice crisis pregnancy centers and an entire network of evangelical abstinence-only educators have raked in millions of dollars every year under new or renewed Obama-era grants through abstinence-only, fatherhood, “healthy marriage” and other initiatives. Under Obama, many states continue to use federal TANF or Medicaid dollars to funnel money to Christian organizations as well. And faith-based groups that proselytize their clients, oppose the use of condoms and believe homosexuals can be prayed out of the gay “lifestyle” are still handed millions every year through PEPFAR. Instead of seeking out new implementing partners that would follow best public health practices, many Bush-era grantees have seen their funding renewed again and again. An entire federally funded evangelical economy took root during the Bush years, and under Obama it continues to thrive.

There have been gestures at reform. In a 2012 report called “A Firm Foundation,” PEPFAR committed to holding accountable faith-based organizations that are either “ineffective” or “actively use religion to promote stigma and shame.” But almost two years later, the Inter-Religious Council of Uganda is the only group known to have had funding even partially withdrawn. By e-mail, a State Department official said it will continue to urge Uganda to “repeal this abhorrent law,” but didn’t indicate the United States would take any additional action.

“Love the Sinner, Hate the Sin”

It’s not as if advocates haven’t sounded the alarm to administration officials. On that September 2012 call, participants raised concerns about other US-funded groups besides the Inter-Religious Council, notably the Children’s AIDS Fund (CAF), an American organization, led by the husband-and-wife team Shepherd and Anita Smith, that operates in Uganda.

The Smiths got their start working with Watergate crook Chuck Colson and his evangelical prison ministry; later, Shepherd was a top strategist for* Pat Robertson’s 1988 presidential campaign. They took on AIDS as their mission in the 1980s, fashioning what they saw as a love-the-sinner, hate-the-sin approach that focused on ministering to the sick, particularly children. Over time, they would articulate a more fulsome conservative evangelical approach to AIDS centered around praying people out of homosexuality, abstinence-only education, virginity pledges and robust criticism of condoms, laid out in their 1990 book Christians in the Age of AIDS. Even in recent years, Shepherd has pounced on modest failure rates to denounce condom efficacy against HIV.

“The first evangelical ministries to see AIDS and respond were those already in place in the gay community, helping heal sexual brokenness and bring gays out of their lifestyles,” the book reads. The Smiths go on to caution Christians against buying into “society’s attempts to make homosexuality an acceptable alterative lifestyle.”

Despite lacking any medical background, Shepherd and Anita were embraced by Bush officials: Shepherd was appointed as an AIDS advisor to the CDC, Anita was the co-chair of the presidential advisory council on HIV and AIDS, and Shepherd’s nonprofit, the Institute for Youth Development, was one of the first groups ever to receive funding through Bush’s faith-based initiatives. In 2004, a review panel determined CAF unsuitable for funding due to “outstanding technical issues.” In a memo to USAID officials, Representative Henry Waxman, then ranking minority member of the Government Reform Committee, wrote that the funding of CAF was so out of bounds that it “raises serious concerns about the integrity of the PEPFAR grant review process.”

Yet CAF has received at least $45 million in since then through direct PEPFAR grants, and still more as a third-party grantee, subcontracting with Catholic Relief Services, for example. As recently as February of this year, CAF received $1 million for its New Hope clinic in Kampala.

On a hot but breezy day in August 2012, I visited New Hope. The clinic is located in Kampala’s Naguru district, on the northern shore of Lake Victoria, and is funded by PEPFAR to provide care and treatment for people with HIV and AIDS. The clinic is also tasked with implementing an HIV prevention program to include comprehensive sexual education and access to condoms.

There were very few patients the day I visited, and the clinic’s administrator ushered me into a counseling room with several posters on the wall. One depicted HIV as a gang of scowling green blobs being attacked by anti-retroviral drugs, represented by smiling cells in crisp white lab coats; another was an image of Jesus, his hand raised, light spilling from his opened chest and Jesus I trust you! written below. Below Jesus was a portrait of the Virgin Mary and on the opposite wall, an image of St. Jude, patron saint of lost causes.

A poster at the Children’s AIDS Fund clinic in New Hope reads “Jesus, I trust you!”

A few minutes into our chat, I asked the clinic administrator about condoms. She paused. Finally, she said, “We are very suspicious of those.” When I asked whether the clinic provided comprehensive sex education—including instruction on the correct and consistent use of condoms—she said she didn’t know for sure and left to find a more senior clinic employee.

That employee arrived, but was no more able to answer my questions. All she could do was show me was a spot in a three-ring binder where she swore sex-ed materials were supposed to be and a big empty cardboard box labeled “CONDOMS,” which was relegated to a back hallway of the clinic. PEPFAR guidelines stipulate that grantees make condoms available and distribute them as part of a comprehensive prevention strategy.

One of CAF’s sub-grantees in Uganda is He Intends Victory, which uses the acronym HIV. HIV bills itself as a Christian HIV/AIDS education and support group that spreads the “love and companionship of Jesus Christ” to those affected by the epidemic and has received praise from Rick Warren, who calls the group “a real pioneer” in AIDS ministry. The group receives funds from CAF to distribute goats and school uniforms to needy Ugandan families and children whose lives have been touched by HIV/AIDS.

He Intends Victory is also an ex-gay ministry. During the International AIDS Conference in Washington, DC, in 2012, HIV member and sometime spokesperson Dan Davis told me how “grateful” he was to the group and its president, Bruce Sonnenberg, for helping him out of the gay lifestyle. He told me the group had helped him see that his homosexuality was the result of childhood sexual abuse and that even though he still “gets those urges,” the group’s support sees him through. (Sonnenberg has also appeared as a guest on the anti-gay Mastering Life Ministries’ weekly program Pure Passion talking about how HIV’s co-founder, the late Herb Hall, came out of “ten years” in the “homosexual life”—and how He Intends Victory ministers to people who want to leave homosexuality.)

The Smiths, in an interview, claimed that they supported He Intends Victory with private funds, and that no PEPFAR dollars were used. Though it’s impossible to tell from public disclosures how CAF spends its government and private funds, federal funding makes up the majority of CAF’s annual budget, and the two groups have close ties—Sonnenberg sits on CAF’s board of directors. When I asked whether it was appropriate for the head of an ex-gay ministry to sit on the board of an AIDS organization, Anita shrugged it off, saying CAF doesn’t have “litmus test for whether someone is gay or not.”

Still, the Smiths have been foes of what they see as the undue influence of LGBT organizations in the field of AIDS relief and continue to align themselves with right-wing “pro-family” organizations. In 2011, for example, Anita Smith was listed as a featured speaker** at the Moscow Demographic Summit, sponsored by the anti-gay World Congress of Families, alongside representatives of Concerned Women for America; the Population Research Institute, which promotes the threat of a “demographic winter” if white Christians don’t reproduce in greater numbers; and the Family Research Council. In Uganda, the couple became close allies of Pastor Martin Ssempa, best known for his public condom burnings and anti-gay diatribes, who strongly pushed the anti-homosexuality bill. In 2004, Ssempa became a PEPFAR subgrantee. The Smiths’ support helped his work get noticed in Washington, and in 2005 he testified on Capitol Hill.

Other conservative evangelical groups continue to receive millions of dollars under Obama to provide critical services in sub-Saharan Africa. Samaritan’s Purse, whose president, Franklin Graham, is the son of famed televangelist Reverend Billy Graham, is just one example.

Roadside churches pepper the landscape between Kampala and Entebbe. This Catholic Church sits just blocks from Lake Victoria.

Samaritan’s Purse has a rocky record on the international stage. The group routinely delivers Bibles around the world as part of a so-called “hygiene kit” given to countries devastated by wars or natural disasters, a practice that has spurred diplomatic complications in predominantly Muslim nations like Iraq and Niger—only worsened by Graham’s tendency to use the language of “holy war.” The group was kicked out of a district in Uganda in 2012 because it had been ineffective in implementing a food safety program. Graham is also unabashedly anti-gay. When Chick-Fil-a was being boycotted after its CEO, Dan Cathy, came out against same-sex marriage, Graham jumped into the fray, “applaud[ing]” Cathy’s courage in taking a “bold stand” for biblical principles.

Nevertheless, according to the grant tracking website USA Spending.gov, Samaritan’s Purse has received 103 federal grants since 2004 totaling over $47 million—including more than $23.3 million awarded since Obama took office in 2009. For example, Samaritan’s Purse received $1.9 million from PEPFAR in 2009 to implement a “Families Matter” prevention program in Mozambique, a grant that continues to be paid out, most recently in December of last year.

By the middle of Bush’s second term, 23 percent of PEPFAR’s world partners were faith-based programs, the majority of them evangelical. One State Department staffer, who asked not to be named, said moving federal grant money away from groups like CAF and Samaritan’s Purse, hand-picked by Bush officials to run HIV/AIDS programs abroad, would be difficult. By the time Obama entered office, the staffer said, these groups were so entrenched in the service delivery infrastructure, right down to the village level, that it was easier for the administration leave the money in their hands.

Abstinence-Only Rules

The Obama administration has not only renewed contracts with groups actively engaged in the culture war but has created new funding streams for them to tap into. Rather than stripping faith-based groups of their funding or subjecting them to oversight, administration officials repackaged and refunded Bush-era programs through amendments to legislation. The Affordable Care Act set aside funds for abstinence-only through state block grants. Competitive abstinence grants to directly fund abstinence-only groups reappeared. And Obama expanded states’ ability to use leftover TANF funds, slotted for work programs, to be funneled instead to marriage promotion and abstinence-only programs.

The abstinence-only funding provision in the ACA was a compromise forged during the pitched battle to pass healthcare legislation, when Senator Orrin Hatch inserted an amendment to give $250 million to abstinence-only programs, funds that would be distributed as state block grants by HHS. But two years later, without such pressure, the Obama administration created another new $5 million pot of money for abstinence-only, so-called “competitive” abstinence grants also administered by HHS. And last year, Hatch inserted yet another $250 million pool of funding for abstinence-only programs into the so-called “Medicare fix” bill, designed to prevent a pay cut to doctors. The result is that since Obama took office his administration has awarded over $170 million in abstinence-only grants, $36.8 million last year alone.

Public health experts have long discounted abstinence-only programs as ineffective. While there is scattered evidence that the approach, used with very young adolescents, can delay adolescents’ first sexual experience, there’s no reliable evidence that it reduces either teen pregnancies or sexual transmitted diseases. A 2005 study published in the Journal of Adolescent Health found that virginity pledges, a staple of religious abstinence-only programming, did not decrease the occurrence of teen sexually transmitted infections (STIs) and resulted in pledge-takers not seeking medical attention once infected. And in 2011, a definitive nine-year study by the American Congress of Obstetricians and Gynecologists found that “these programs have no beneficial impact on young people’s sexual behavior.”

Adolescent health advocacy groups have pushed the Obama administration to stop funding these ineffective, ideological programs, asking that such funds be redirected toward comprehensive sex ed instead. In 2012, for example, when materials produced by the evangelical group Heritage Keepers were added to a list of federally approved abstinence-only curricula, Advocates for Youth (AFY), which promotes comprehensive sexuality education, issued a statement saying, “The Obama Administration’s endorsement of this abstinence-only-until marriage program runs in direct contradiction to its stated commitment to the health and well-being of young people and, quite possibly, its promise to uphold science and evidence.” The program, AFY found, uses virginity pledges, fear, sexual shaming and activities like “envisioning your wedding” as teaching tools, and eschews any discussion of condoms or contraception. Yet the funding for such programs has continued.

Monica Rodriguez, president of the Sexuality Information and Education Council of the United States (SIECUS), told The Nation that although they are pleased Obama’s proposed 2015 budget doesn’t currently include a line item for ab-only programs they are “extremely disappointed that $55 million is still being authorized each year for abstinence-only-until-marriage programs”—through the Department of Health and Human Services—“that are often inaccurate, incomplete, and degrading to young people.” In addition, she points out, Obama has ceded abstinence-only funding as a political carrot to Republicans in Congress before, and may again during the forthcoming budgeting process.

Last December I sat with a group of about fifty faith leaders gathered at the Salvation Army headquarters in Jackson, Mississippi, all waiting for Republican Governor Phil Bryant to kick off his abstinence-only teen pregnancy prevention program. As the lights dimmed, haunting music came up, and a dramatic fade-in flashed on the large screen at the front of the room. The video, produced by Truth in Action Ministries, showed a series of people urgently addressing the camera. “The time is now!” declares a young woman. “[It’s] the call of The Kingdom,” says a middle-aged man. “We are raising up an army of God to transform the culture for Christ,” says a montage of boys and girls.

Mississippi Governor Phil Bryant kicked off his abstinence-only teen pregnancy initiative at a Salvation Army headquarters in Jackson.

When the video ended, the crowd erupted in applause. Bryant rose to welcome everyone and thank Truth in Action for its work. He explained that the group would be spearheading Mississippi’s abstinence-only program within the faith community. While groups teaching abstinence-only have argued that their message is not religious in nature, the very idea of abstention from sexual activity until heterosexual marriage as the only acceptable outcome is, at its core, based in Christian belief. In this case, the religious link was explicit.

Truth in Action Ministries, formerly known as Coral Ridge Ministries, is led by popular televangelist D. James Kennedy and is dedicated to “proclaiming the Lordship of Christ and America’s Christian heritage, and lovingly applying principles to all cultures and spheres of life.” The group believes that homosexuality can be prayed away, warns that the “homosexual agenda” is the “iceberg” that will destroy America, and has been listed as an anti-gay hate group by the Southern Poverty Law Center.

Nycole Campbell Lewis, who oversees Mississippi’s program, claims that no public funding is being used to support Truth in Action’s faith-based work as part of the initiative. But according to HHS records, Mississippi received $739,000 in federal funds through a state block grant to implement its abstinence-only program in 2012 and 2013, with a requirement for state matching funds. And a FOIA request revealed that Campbell Lewis’s full $67,000 salary is funded by the block grant; her staff time, according to the Mississippi Department of Human Services, is entirely dedicated to implementing the federal abstinence-only grant—including, presumably, her time spent coordinating with Truth in Action Ministries event. Truth in Action’s Carmen Pate, who led the Mississippi gathering, confirmed only that the group was working closely with the governor’s office, not who paid the tab.

According to an audit of Mississippi’s TANF expenditures requested by State Rep. Cecil Brown, the state has tapped additional monies to expand abstinence-only programs in the state. The state had a TANF balance of $2.85 million at the end of fiscal year 2012, the review found. And thanks to that Obama executive order, those unspent funds were legally diverted from direct aid to needy families and used instead to fund abstinence-only programs.

Less than 4 percent of families in poverty in Mississippi receive TANF benefits, compared to 9.5 percent nationwide. In a state where more than a third of children live in poverty, that galls Jamie Bardwell, of the Women’s Foundation of Mississippi, a staunch advocate for comprehensive sex ed. “It seems immoral that the state would invest over $2 million in abstinence-only-until marriage programs that feature mock wedding ceremonies, inaccurate medical information, and fear-based tactics that a majority of Mississippi parents don’t support,” Bardwell says.

Crisis Pregnancy Centers Remain Flush

One of the Bush administration’s trademark gambits was to send millions of dollars in abstinence-only grants to so-called “crisis pregnancy centers,” or CPCs, the faux abortion clinics set up by anti-choice groups to dissuade women from terminating pregnancies. Many peddle misinformation about abortion, including its apocryphal link to breast cancer and infertility; many also engage in religious proselytizing. Before Bush took office, most were low-budget outfits run primarily by volunteers; shortly after he took charge, federal funds began to flow, which expanded their operations and bolstered the GOP’s Christian right base. The Obama administration continues to fund these CPCs, both directly through HHS’s competitive abstinence-only grants or as subgrantees of abstinence-only state block grants.

Some of this funding was grandfathered in, as was the case with the national chain of Alpha Centers, based in South Dakota. Founded by well-known anti-abortion activist and abstinence-only champion Leslee Unruh, Alpha Center has received over $2 million in federal support, receiving its most recent payment from HHS in 2010 in fulfillment of a Bush-era multi-year grant. But other CPCs have received new grants under Obama.

Take the Evansville Christian Life Center, located in Evansville, Indiana, which won a competitive federal abstinence-only grant for $244,110 in September 2012. The center’s mission is summed up in its tag line: “Restoring the Lives of Families and Individuals through Jesus Christ.” As CPCs typically do, it promises support for pregnant women, including a free pregnancy test and ultrasound, as long as the women sit through testimony from a counselor first. The center is also engaged in anti-abortion activism, and advertises “Choose Life” license plates, which provide funding to CPCs throughout Indiana.

Multi-million dollar grant recipient Care Net Pregnancy Services, based in Du Page, Illinois, says its ultimate aim is to “share the love and truth of Jesus Christ”; another federal grant recipient, the Pregnancy Center of Pinellas County, with multiple centers in southern Florida, is “dedicated to saving and preserving lives for the cause of Jesus Christ.” Yet another, Bethany Christian Services, which has several US locations, props up the bogus claim that abortion leaves emotional and psychological scars.

Obama officials have also sent taxpayer money to firms that design abstinence-only programs and curricula, including one of the largest, now known as the Center for Relationship Education, which produces the widely used WAIT (Why Am I Tempted?) Training. CRE first received federal grants and contracts under Bush; the group’s founder, Joneen Mackenzie, was a favorite, serving the Bush administration as a national abstinence program advisor. Under Obama, CRE has continued to be a major player, bringing in over $1 million in federal abstinence-only funds, as well as marriage-promotion grants of $6.7 million through HHS.

CRE has obtained this funding despite the fact that its presenters have lied about the link between female sterility and the HPV vaccine, likened vaginas to Hoover vacuums, and cautioned girls against dressing provocatively. In a recent CRE teacher’s guide, instructors are warned that doing condom demonstrations could make them vulnerable to claims of sexual harassment.

Marriage Promotion, Evangelical-Style

Federal marriage-promotion grants are another avenue through which conservative evangelical groups have received funding under Obama. The Family Research Council, an influential Christian right advocacy group, benefited greatly from Bush administration grants being awarded to its state level affiliates. These state affiliates accomplish locally what FRC does at the national level—shape public debate and formulate public policy. One of these, the Indiana Family Institute, or IFI, counts among its greatest accomplishments shepherding a same-sex marriage ban through the state legislature. Yet the State of Indiana chose IFI to be its official partner in implementing a $1.5 million federally funded “healthy marriage” program in 2012. The project, funded through a Medicaid waiver, allows states to tap Medicaid funds for so-called “demonstration” projects, including ones designed to promote heterosexual marriage. The Indiana program, called Hoosier Commitment, boils down to a series of marriage promotion workshops lead by the IFI’s Sue Swayze, who previously served as a paid lobbyist and board member for Indiana Right to Life.

Under Obama, federal marriage promotion grants have been awarded to a number of other FRC affiliates, including The Family Leader in Iowa, the Palmetto Family Council in South Carolina, and New Jersey Family Policy Council in New Jersey. Although the Bush administration initiated the grant funding, Obama has done nothing to curtail them.

Had HHS, which is responsible for awarding marriage grants, investigated any of these FRC state affiliates, it would have found cause to revoke funding. The Family Leader serves as case in point. The group simultaneously took federal money—to the tune of $3 million—to conduct “Healthy Marriage Workshops” while aggressively running the “LUV Iowa Campaign.” LUV stands for “Let Us Vote!”—a campaign to promote a constitutional amendment to ban same-sex marriage. After being outed in the press as an HHS grantee in 2010, the group denied using federal money inappropriately but requested to opt out of their last year of funding.

Iowa’s “LUV” (Let Us Vote) campaign, to amend the Iowa Constitution to ban same sex marriage, rallied on the steps of the Iowa Supreme Court in 2010. LUV was led by federally funded Family Research Council affiliate The Family Leader. The measure failed.

Marriage promotion grants have gone to several other important conservative players in the fight over LGBT and women’s rights, including Project SOS, The Center for Relationship Education, and the Northwest Marriage Institute, each of which received more than half a million dollars through 2012 from HHS “healthy marriage” competitive grants.

The Northwest Marriage Institute, for example, was awarded a $747,281 “healthy marriage” grant in 2013, seven years after Americans United for Separation of Church and State sued the organization on behalf of thirteen Washington state residents, alleging that the group had used a 2005 federal grant to lead “Bible based” marriage classes. A federal court dismissed the case on the grounds that faith-based groups are allowed to implement federal social welfare programs, but the defense attorney, the conservative Center for Law & Religious Freedom’s Steven H. Aden, interpreted the decision far more broadly, claiming that “faith-based organizations are not required to abandon their religious mission and viewpoint when they cooperate with the government to address pressing social problems.”

Both Project SOS and CRE, meanwhile, were found to have ties to Martin Ssempa, the anti-gay Ugandan pastor. CRE built Ssempa’s website, produced his business cards and other brochures, and served as a de facto agent for him, booking speaking engagements for Ssempa across the United States. CRE was awarded over $1.6 million in 2013 through a federal “healthy marriage” program. Pam Mullarkey, the founder and CEO of Project SOS, is quoted as a validator on Ssempa’s website, saying, “Martin Ssempa is the man to watch. He is the most powerful voice for abstinence in the world, and his passion, charisma and character make his vital message irresistible.” (Shepherd Smith, Ssempa’s most powerful friend in Washington, was on Project SOS’s board of directors; the Smiths say they have since dissociated themselves from Ssempa.***)

Project SOS walked away from federal funding in 2010 after a report funded by the Healthy Teens Campaign of Florida and SIECUS found some of its ab-only curriculum “medically inaccurate.” But both CRE and Project SOS are back at the federal trough; in 2013 SOS received $672,703 and CRE over $1.6 million to implement “healthy marriage” programs.

A Crisis of Accountability

The amount of money the federal government gives faith-based groups is staggering. But federal agencies make the matter worse by doing very little oversight of their grantees. Most funding programs require little more than a document outlining what a group purports to do, a signature on a list of assurances that the organization will abide by all laws, and a promise to self-police by submitting periodic progress reports to the awarding agency. Public scrutiny is limited as well: Obama made transparency a priority when he took office, but information on federally funded groups, including faith-based organizations, remains hard to come by.

A nonprofit organization’s tax returns are matters of public record; Form 990s, which all non-profits must file, can be found on a number of websites. But these documents don’t show how an organization’s various funding streams are apportioned. If a group gets $2 million in federal grants and $100,000 in private donations, all of it must be declared as income. However, groups are not required to itemize how each source of money was used. Vague explanations of programs they implement suffice; “implementation of “healthy marriage” program” or “fund activities directed at preserving the family” pass muster for IRS regulations. As a result, hundreds of millions of dollars continue to be awarded to anti-choice and anti-gay groups, groups that disregard scientific data or public health best practices and groups that use taxpayer dollars to proselytize, and the public is unable to learn much about it.

In 2003, PEPFAR earmarked $1 billion for HIV prevention programs, most modeled on US programs that strictly promote “abstinence only until marriage.” By then, hundreds of millions of dollars had already been spent on these programs inside the United States, where they had failed to reduce teen pregnancy or transmission of STIs.

Helen Epstein, noted public health researcher and author of The Invisible Cure: Africa, the West and the Fight Against AIDS, was in Uganda when PEPFAR money started flowing to faith-based groups. Epstein moved there in 1993 as a scientist with a biotech company searching for an AIDS cure. In her book, she notes that many experts feared that abstinence-only programs would have “similarly dismal results in Africa” as they did in the United States. Noting that evangelicals almost single-handedly delivered George W. Bush the presidency in 2000, Epstein wonders at the abrupt change in attitude by many Christian groups towards AIDS, many of whom would go on to benefit from the newly available PEPFAR dollars. “It is maybe no coincidence that some of the same people who once treated the issue of AIDS with indifference and scorn suddenly seemed so concerned about it,” she writes.

Epstein was writing in the early years of the AIDS response in sub-Saharan Africa, but her assessment of the on-the-ground partners fostered under President Bush could just as easily be applied to those now working with the Obama administration.

Faith-based groups like Children’s AIDS Fund and IRCU aren’t the only ones equipped to deliver life-saving care and prevention in sub-Saharan Africa. Smaller, home-based healthcare organizations with no religious agenda are operating in Uganda with little funding but huge potential. That’s true in the United States too. Proven programs that reduce the risk of teen pregnancy and STIs could be getting the millions of dollars in government funding now allocated to CPCs.

The evidence is in that federal tax dollars are being used to support conservative, faith-based organizations that stigmatize young women, foster anti-gay sentiment and harm public health. Whether this funding is an expression of Obama’s ideology or a cynical attempt at political pandering is ultimately immaterial.

This article was updated with some corrections and clarifications on 1/23/2015.

*An earlier version of this article incorrectly stated that Smith ran the campaign.

**An earlier version of this article stated that Anita Smith spoke at the event; she was listed in the program as a speaker but Shepherd Smith and the World Congress of Families now say she never actually appeared. An additional remark attributed to Anita Smith was found to have insufficient substantiation and was removed.

***An earlier version of this article failed to note the Smiths’ assertion that they dissociated themselves from Ssempa several years ago.