In April OMB Watch submitted comments on a proposed rule for international HIV/AIDS grantees. The rule requires such grantees to choose between adopting government policy for their entire organizations and setting up completely separate affiliated organizations. The recipients must submit certification of their policy opposing prostitution and sex trafficking, or have to under go the process of forming a separate entity. OMB Watch commented in April; "The issue is whether government can use its grants to control private speech of citizens associating together to carry out a public interest mission."

The Department of Health and Human Services released the controversial final rule on Dec. 24, 2008. The rule goes into effect Jan. 20, 2009.