House Expected To Send PEPFAR Reauthorization Legislation To Bush Thursday

Main Category: HIV / AIDS
Article Date: 25 Jul 2008 - 11:00 PDT

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The House on Thursday is expected to approve a bill (HR 5501) to reauthorize the President's Emergency Plan for AIDS Relief that was passed by the Senate last week, CQ Today reports. President Bush likely will sign the bill, which would authorize $48 billion for the program. "The bill before you is truly a compromise in the best sense of the word," Rep. Barbara Lee (D-Calif.) said. Rep. Ileana Ros-Lehtinen (R-Fla.) said, "The challenges have been great ... but the urgency of the HIV/AIDS pandemic has moved us toward this bicameral, bipartisan consensus" (Graham-Silverman, CQ Today, 7/23).

The legislation allocates a total of $50 billion -- $48 billion of which would go to PEPFAR and $2 billion of which would go to American Indian issues. The bill also includes an amendment intended to increase oversight of the Global Fund To Fight AIDS, Tuberculosis and Malaria and encourage cost-sharing and transition strategies as part of agreements with countries that receive PEPFAR aid. The measure also includes a provision that would ease U.S. HIV/AIDS travel restrictions.

One primary difference between the original House version of the legislation and the version passed by the Senate last week is that the House version would have allowed groups to use PEPFAR funding for HIV testing and education in family planning clinics but not for contraception or abortion services. The Senate bill passed last week does not mention family planning programs.

The measure approved by the Senate last week also includes a provision that more than half of the program's aid go toward HIV/AIDS treatment and care. In addition, it would overturn an existing law that requires one-third of prevention funds be spent on abstinence and fidelity programs, instead requiring a report to Congress if countries do not spend half of prevention money on such programs. The bill also would direct 10% of funding to programs for orphans and vulnerable children, as well as allocate $2 billion for the Global Fund in fiscal year 2009. The legislation contains an existing requirement that organizations receiving PEPFAR aid have a policy that opposes commercial sex work. The bill would create links between HIV/AIDS and nutrition programs and set a target of recruiting 140,000 health care workers. In addition, the measure would allocate $5 billion for malaria programs and $4 billion for tuberculosis initiatives (Kaiser Daily HIV/AIDS Report, 7/18).

According to CQ Today, lawmakers "must now follow through on the funding boost" outlined in the legislation. Congress provided about $6 billion for HIV/AIDS in FY 2008, but the Senate's FY 2009 foreign operations spending bill would provide $5.1 billion. The House's draft version would allocate $5.5 billion (CQ Today, 7/23).

Related Opinions
Editorial
Washington Post: The PEPFAR legislation has "dodged multiple challenges from Republican lawmakers and is set to become one of the Bush administration's finest accomplishments," a Post editorial says, adding that "one of PEPFAR's most significant provisions" is the easing of HIV/AIDS-related travel restrictions. However, the provision to ease such restrictions might "not take effect even if the legislation passes" because the "bill leaves to [HHS] the decision as to whether HIV-positive visitors may enter the country," according to the editorial. It adds that "HHS officials have previously expressed a willingness to remove the ban but may delay a decision until the next administration takes office." Bush has "an impressive legacy of combating HIV/AIDS," the editorial says, adding that if the PEPFAR bill passes, Bush "could further burnish that legacy by urging [HHS] to end the ban on U.S. admission for would-be visitors and immigrants who are HIV-positive" (Washington Post, 7/24).

Opinion Piece
Mike King, Atlanta Journal-Constitution: Although "Democrats and Republicans disagree over the Bush administration's foreign policy, they do agree that under President Bush, the U.S. has taken a decisive role in saving hundreds of thousands of lives in the global battle against AIDS and other infectious diseases," columnist King writes in a Journal-Constitution opinion piece. He adds that the PEPFAR reauthorization legislation "marks a rare, bipartisan agreement between Congress and the administration and shows the world this country's compassion toward those threatened by poverty and disease" (King, Atlanta Journal-Constitution, 7/23).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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