Two groups -- Pathfinder and the Alliance for Open Society International -- are exempt from the pledge following a federal court ruling, according to Pellegrom. He adds that although the lawsuit against the pledge "does not challenge the government's right to restrict the use of public funds," the pledge "forces groups to adopt an organizationwide policy, thereby restricting how organizations use their own private funds." Pathfinder and Open Society "believed this to be in violation of the Constitution," Pellegrom writes, adding that the judge in the federal case "agreed, placing the two organizations under protective order while the case is on appeal."

By requiring organizations to adopt the pledge, the government has "failed to explain exactly what is required," Pellegrom writes, adding that because "needed clarity" is missing, organizations do not "know how to comply with the rules and risk losing funding." Public health policies "based on ideology tie the hands of health workers and leave health care providers vulnerable to political posturing and congressional whim," Pellegrom writes (Pellegrom, Boston Globe, 3/4).

Source: Kaiser Daily HIV/AIDS Report, United States