By James Wagoner (Advocates for Youth) and William Smith (SIECUS)

President Obama's Fiscal Year 2010 budget is to be applauded.  The President has proposed an end to abstinence-only-until-marriage funding as we have known it for the better part of the last decade.  This marks a significant change in direction, one that finally brings science and evidence back into government policy. His leadership on this new direction will be essential in the coming negotiations with Congress.

He has also offered up a new initiative that has become the source of much discussion among advocates and between these same groups and the White House.  The President seeks to reallocate the funding previously spent on abstinence-only-until-marriage to teen pregnancy prevention in a "silo-ed" approach that will inhibit the comprehensive approaches needed to address the challenges facing teens today. 

Preventing teen pregnancy is incredibly important.  But unintended pregnancy among teens is not the only sexual and reproductive health issue facing our nation's youth.  We also have an epidemic of sexually transmitted diseases among youth and every hour, at least one young person acquires HIV in our country.  These and other adverse outcomes of unprotected sexual activity among youth--outcomes that may result simultaneously in one act of intercourse--are the consequences of a complex set of circumstances representing the failure of our nation to strategically and systemically provide the education and information young people need to make responsible decisions about their sexual health.

This is why our organizations, Advocates for Youth and the Sexuality Information and Education Council of the United States (SIECUS), have been staunch advocates for a much broader approach to these and other issues, through efforts that empower young people to make good and healthy decisions now and throughout their lifetimes. 

From a sexual and reproductive health perspective, vertical or silo-ed programs don't work.  In fact, if persistently high teen pregnancy and sexually transmitted disease rates, including HIV, prove anything, it is that addressing these outcomes separately has consistently failed.

SIECUS and Advocates for Youth, along with nearly 200 of our nation's leading health organizations, are seeking change that breaks from this mold. That is why, during the 2008 election and subsequent transition, for example, this large and informal coalition strongly advocated for deep investments by the new Administration in comprehensive sex education, rather than solely on one aspect of a broader problem.  Comprehensive sex ed provides teens with information and life-skills training that will reduce teen pregnancy and sexually transmitted infections while addressing other aspects of sex and sexuality, such as responsibility, respect, mutual consent, identification of abusive or controlling relationships, and other critical skills. 

Comprehensive sex ed is an approach that has been shown to be effective, for which Americans have consistently shown support in poll after poll, and which promotes prevention and good health across a range of outcomes rather than only one outcome.  So while the proposed new initiative is a step in the right direction, there is a great deal of consensus among the groups who have been working on these issues for decades that some changes are necessary to achieve maximum benefits in regard to improving reproductive and sexual health, which in turn will contribute to reduced health care and social costs. 

This week, more than 175 organizations reiterated the need to do better and sent letters to the White House and Congressional appropriators toward this end.  These letters underscored that just a few simple modifications to the President's proposed initiative can achieve what is needed.

First, expand the scope of the program.  The current teen pregnancy prevention language must be expanded to include other proven interventions that address sexually transmitted diseases and HIV/AIDS.   To do otherwise hamstrings this initiative before it even gets off the ground.  By supporting language that is inclusive of additional approaches, we can bring to scale comprehensive programs that meet the diverse needs of all young people in all communities, including lesbian, gay, bisexual, transgender, and questioning youth whose needs fall wholly outside of the narrow teen pregnancy prevention framework.  Admittedly, this step alone hardly gets us out of the "disaster aversion" silos, but we have to work with what has been so far advanced by the White House and these few additional words can at least ensure that broader interventions are supported.

Second, make schools a priority.  By prioritizing schools, the new initiative can help ensure smart and multi-faceted investments toward a sustainable legacy to improve the health of our nation.

Over the past several years, significant policy shifts and the adoption of evidence-based programming in schools have created a unique and unprecedented opportunity to support a systemic change.  The tired arguments that schools cannot do this are outdated.  Dozens and dozens of school districts are at the ready but need resources to make it happen.  By assisting schools in institutionalizing comprehensive programs aimed at helping improve adolescent sexual behaviors, we can provide the needed educational information to the widest range of teens. The current language excludes important public entities, such as schools, from accessing funds. 

Third, ensure effective implementation.  According to the Administration's current plan, all of the funding for these efforts rests within a single agency within the Department of Health and Human Services, one which currently oversees abstinence-only-until-marriage programs. While we believe this agency can and should play an important role in supporting community and faith-based organizations, the agency does not have the necessary experience or infrastructure to improve school-based programming.  Investments must be made through agencies that have a public health framework, existing structures and relationships with schools, and a proven record of the necessary support services to help ensure success.  For example, allocating some funding under the new initiative to the Centers for Disease Control and Prevention (CDC), which already has established working structures with our nation's state and local educational entities, will save the government from "recreating the wheel" - a process that all too often plagues good intentions.

This is not about semantics.  We need to create a bold new investment that can be sustained beyond electoral cycles, Administrations, and the occupant of the White House at any given time.  We need a lasting commitment with lasting effects. As currently written, the new teen pregnancy initiative does not represent that bold, new investment. 

But it can.

Congress and the White House must listen to the chorus of consensus within the majority of the advocacy community and support the changes requested by the broad community of advocates and experts engaged in this issue.  Given that the White House rejected the initial requests to specifically support sex education, these few modifications seem hardly too much to ask.

Without these changes, the much-sought after end of abstinence-only-until-marriage programs will not result in the ushering in of the first ever federal program supporting comprehensive sex education about which President Obama spoke so eloquently during his campaign.  Instead, it will be the same emphasis on teen pregnancy prevention, launched a dozen years ago by the Clinton Administration, which was easily highjacked by social conservatives after the mid-term election.  The result: more disjointed patchwork prevention programming that fails our youth and blows with the political winds. 

We have a chance to do something fundamentally different this time around but the first step is a critically important one and has to be placed on terra firma.  The job of advocacy groups is to push for a firm foundation that will withstand changing political winds and to differentiate that foundation from the thin layer of top soil that can easily be washed away.

The President's budget launched us in a new and important direction. Now we just need to make sure that we arrive at the right destination.

Originally published on RHReality Check.

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