Most public health advocates are probably already aware that U.S. funds for international AIDS relief come with counterproductive strings attached – specifically, requirements that one-third of HIV prevention money go to abstinence-only education and that entities receiving PEPFAR grants explicitly denounce prostitution. (Laurie Garrett’s recent LA Times op-ed provides a good summary of the policies and what’s wrong with them.)

The strings attached to food aid don’t get as much attention, but it’s another situation where U.S. policy overlooks a lifesaving solution while pleasing an influential constituency. In April, a New York Times article by Celia Dugger described the urgent situation in Zambia:

MULONDO, Zambia — Traveling to school in wobbly dugout canoes, Munalula Muhau and her three cousins, 7- and 8-year-olds whose parents had died from AIDS, held onto just one possession: battered tin bowls to receive their daily ration of gruel.

Within weeks, those rations, provided by the United Nations World Food Program, are at risk of running out for them and 500,000 other paupers, including thousands of people wasted by AIDS who are being treated with American-financed drugs that make them hungrier as they grow healthy.

“Not to put too fine a point on it,” said Jeffrey Stringer, an American doctor who runs a nonprofit group treating more than 50,000 Zambians with AIDS, “but it will result in the death of some patients.”

Hoping to forestall such a dire outcome, the World Food Program made an urgent appeal in February for cash donations so it could buy corn from Zambia’s own bountiful harvest, piled in towering stacks in the warehouses of the capital, Lusaka.

But the law in the United States requires that virtually all its donated food be grown in America and shipped at great expense across oceans, mostly on vessels that fly American flags and employ American crews — a process that typically takes four to six months.

While the Bush administration is behind the onerous abstinence-only aid requirements, they’re pushing to reduce the requirements on food aid – and Dugger quotes a Democratic lawmaker who opposes that move:

For a third year, the Bush administration, which has pushed to make foreign aid more efficient, is trying to change the law to allow the United States to use up to a quarter of the budget of its main food aid program to buy food in developing countries during emergencies. The proposal has run into stiff opposition from a potent alliance of agribusiness, shipping and charitable groups with deep financial stakes in the current food aid system.

Oxfam, the international aid group, and other proponents of the Bush proposal say it would enable the United States to feed more people more quickly, while helping to fight poverty by buying the crops of peasants in poor countries.

The United States Agency for International Development estimated that if Congress adopted the Bush proposal, the United States could annually feed at least a million more people for six months and save 50,000 more lives.

But Congress quickly killed the plan in each of the past two years, cautioning that untying food aid from domestic interest groups would weaken the commitment that has made the United States by far the largest food aid donor in a world where 850 million go hungry.

Representative Tom Lantos, Democrat of California and chairman of the House Foreign Relations Committee, warned last year at a food aid conference in Washington that decoupling food aid from American maritime and agribusiness interests was “beyond insane.”

“It is a mistake of gigantic proportions,” he said, “because support for such a program will vanish overnight, overnight.”

But James Kunder, acting deputy administrator of the development agency, said in an interview that the administration proposal, which would affect less than half of 1 percent of American agricultural exports, would not undercut American interests.

“The burden of proof is on producers and shippers to show this is going to significantly damage their interests,” he said, “because we can provide compelling evidence that allowing local procurement is going to save lives by speeding up delivery of supplies.”

Not only does local procurement speed up delivery; it also allows the World Food Program to get more food for the same amount of money, and sends more of that money to local farmers. As it stands now, here’s who gets the cash:

Over the past three years, the same four companies and their subsidiaries — Archer Daniels Midland, Cargill, Bunge and the Cal Western Packaging Corporation — have sold the American government more than half the $2.2. billion in food for Food for Peace, the largest food aid program, and two smaller programs, according to the Department of Agriculture.

Shipping companies were paid $1.3 billion over the same period to move the food aid overseas, the department’s figures show.

[…]

[Agribusiness and shipping groups] defend the idea that federal spending should benefit American business and farming interests, as well as the hungry. Without support from such interest groups, food aid budgets from Congress would wither, they say.

“It would be at extreme risk of being diminished,” said Paul B. Green, a consultant to the North American Millers’ Association, a trade group for the milling industry that counts Archer Daniels Midland, Bunge and Horizon Milling, a joint venture of Cargill and CHS Inc. among its members.

Gloria Tosi, a lobbyist and immediate past president of the American Maritime Congress, an association of United States-flag ship owners, agreed. “There’s no constituency for cash,” she said.

According to these trade associations, the only support for international food aid comes from the companies who profit from delivering it. The group Just Foreign Policy is out to prove them wrong – they’re collecting letters to Congress in support of food aid reform.