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4 

AGENCY FOR INT’L DEVELOPMENT v. ALLIANCE FOR 
OPEN SOCIETY INT’L, INC. 

Opinion of the Court 

AIDS Vaccine Initiative or to any United Nations agency.”
§7631(f).  It  is  this  second  condition—the  Policy  Require-
ment—that is at issue here. 

The  Department  of  Health  and  Human  Services  (HHS) 
and  the  United  States  Agency  for  International  Develop-
ment  (USAID)  are  the  federal  agencies  primarily  respon-
sible for overseeing implementation of the Leadership Act. 
To  enforce  the  Policy  Requirement,  the  agencies  have
directed  that  the  recipient  of  any  funding  under  the  Act
agree in the award document that it is opposed to “prosti-
tution and sex trafficking because of the psychological and
physical  risks  they  pose  for  women,  men,  and  children.” 
45 CFR §89.1(b) (2012); USAID, Acquisition & Assistance
Policy Directive 12–04, p. 6 (AAPD 12–04). 

II 
Respondents  are  a  group  of  domestic  organizations
engaged in combating HIV/AIDS overseas.  In addition to 
substantial private funding, they receive billions annually 
in  financial  assistance  from  the  United  States,  including 
under the Leadership Act.  Their work includes programs 
aimed at limiting injection drug use in Uzbekistan, Tajiki-
stan,  and  Kyrgyzstan,  preventing  mother-to-child  HIV
transmission in Kenya, and promoting safer sex practices
in India.  Respondents fear that adopting a policy explicitly
opposing  prostitution  may  alienate  certain  host  govern-
ments,  and  may  diminish  the  effectiveness  of  some  of 
their  programs  by  making  it  more  difficult  to  work  with
prostitutes  in  the  fight  against  HIV/AIDS.    They  are  also 
concerned that the Policy Requirement may require them
to  censor  their  privately  funded  discussions  in  publica-
tions, at conferences, and in other forums about how best 
to prevent the spread of HIV/AIDS among prostitutes. 

In 2005, respondents Alliance for Open Society Interna-
tional and Pathfinder International commenced this litiga-
tion, seeking a declaratory judgment that the Government’s