The Office of the US Global AIDS Coordinator (OGAC) has released new guidance for the massive US President’s Emergency Plan for AIDS Relief (PEPFAR), a US$48 billion dollar programme started by George Bush. The programme has come in for criticism for providing millions to church-run organisations promoting the unscientific prevention strategy of abstinence alongside providing no funding for programmes which address the needs of Men who have Sex with Men (MSM). The new guidance document shows strong leadership, said The Global Forum on MSM & HIV (MSMGF), in recognising that human rights, legal barriers and homophobia must be addressed as part of an effective HIV response.