House Passes Global HIV/AIDS Bill

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs;  Women's Health / Gynecology
Article Date: 04 Apr 2008 - 5:00 PDT

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The House on Wednesday voted 308-116 to pass the President's Emergency Plan for AIDS Relief (HR 5501), which authorizes $50 billion for the U.S. global HIV/AIDS program over the next five years, the Washington Post reports. About $9 billion would go to fight tuberculosis and malaria (Brown, Washington Post, 4/3). Unlike the original global AIDS bill, the new legislation does not stipulate the percentage of spending that must be used to promote abstinence, the Los Angeles Times reports (Hohmann, Los Angeles Times, 4/3).

The measure reflects a compromise reached between House leaders from both parties and the White House. "For all its strengths, the bill before the House today is not perfect," Rep. Howard Berman (D-Calif.), chair of the House Foreign Affairs Committee, said, adding, "No compromise ever is" (Los Angeles Times, 4/3). Although it removes a provision included in the PEPFAR's original mandate that requires one-third of HIV prevention funding to be spent on abstinence-only programs, the bill includes new language requiring "balanced funding" for prevention programs to ensure that programs focus on abstinence and monogamy and are “implemented and funded in a meaningful way." Under the measure, countries that spend less than 50% of funding for the prevention of the sexual transmission of HIV on abstinence and fidelity programs will be required to explain the decision to Congress.

The bill retains the so-called "anti-prostitution" pledge. In addition, the compromise bill would allow funding for HIV-related services in some family planning clinics, although efforts by Rep. Betty McCollum (D-Minn.) to offer an amendment to ensure that a broad range of family planning providers remained eligible for program funding were rejected by the House Rules Committee on Tuesday. PEPFAR money cannot be used for contraception or abortion (Daily Women's Health Policy Report, 4/2).

The House adopted several amendments to the measure, including adding clean water programs to PEPFAR; expanding inspector general authority; encouraging countries to work with historically black colleges to strengthen health systems; and adding Malawi, Swaziland and Lesotho as PEPFAR focus countries (Graham-Silverman, CQ Today, 4/2). The measure already had added 14 more focus countries from the Caribbean region to the 15 countries in Africa and Asia included in the original global AIDS bill (Dunham, Reuters, 4/2). A motion by opponents of the bill's spending level to send the bill back to committee failed on a 248-175 vote. According to the Post, the Senate version of the bill (S 2731) is out of committee and awaiting a floor vote (Washington Post, 4/3).

Reaction

Despite a White House Office of Management and Budget memo released Tuesday that showed concern about the $50 billion authorization level, the White House issued a statement strongly supporting the measure after it passed Wednesday, the Times reports (Los Angeles Times, 4/3). Berman said, "It's a very big bill and an expensive one, but it does a lot of important things," adding, "I was pretty happy we maintained the essence of the bipartisan coalition on final passage" (Washington Post, 4/3).

Rep. Ileana Ros-Lehtinen (R-Fla.), the ranking member on the Foreign Affairs Committee, said the bill would save millions of lives worldwide and help maintain stability. She added, "The program that we are authorizing today ... is now recognized as perhaps the most successful foreign assistance program of the United States of America since the Marshall Plan" (Dunham, Reuters, 4/2).

Rep. Dana Rohrabacher (R-Calif.) said, "It is terrible that millions of Africans are suffering AIDS. But we cannot afford such totally irrational generosity. This is benevolence gone wild" (Reuters, 4/2). However, Rep. Mike Pence (R-Ind.), a fiscal conservative who supported the bill, said, "I believe it's possible to be responsible to our fiscal constraints while being obedient to our moral calling" (CQ Today, 4/2).

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