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Senate Passes AIDS Relief Bill

July 16, 2008 09:00 PM

by Denis Cummings

After weeks of delay, the Senate voted Wednesday to approve the PEPFAR bill, sending $48 billion of AIDS relief to Africa over the next five years.

In 2003, President George W. Bush introduced the President’s Emergency Plan for AIDS Relief (PEPFAR), committing $15 billion over five years to fight AIDS in Africa. It was very effective in providing treatment to AIDS victims and now the Senate has tripled funding over the next five years.

The $50 billion PEPFAR bill passed through the House in April and had bipartisan support in the Senate, but a group of seven Republican senators blocked a vote on the bill. Though they supported PEPFAR, they objected to the cost and to what the initiatives it would cover.

The main stumbling block was whether the bill should require that 55 percent of the funding go to treatment; the 2003 bill had this clause, but it was not included this time around. There was also controversy about whether the bill committed enough to abstinence-based education and whether it should give funding to an organization that promotes abortion.

The Senate's bill included two significant changes that will still have to be approved by the House. One is that $2 billion of the original $50 billion is to be spent within the U.S. on water and health programs for American Indians. The second lifts a two-decade ban on HIV-positive foreigners entering the country as travelers or immigrants.

“With passage of today's bill we are one step closer to ensuring that this excellent program continues to help those in need,” said Bush. “I encourage the full Congress to move quickly to send me final legislation that I can sign.”

Headline Link: Senate approves PEPFAR bill

The Senate voted 80-16 to approve the bill, which also includes funding for malaria and tuberculosis relief. The House is likely to approve the changes to bill—funding for American Indians and a lift on the ban of HIV-positive foreigners—in the next several days.

Source: Associated Press

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Reactions: Bush thanks Senate

President Bush praised the Senate’s decision to pass the bill. “Traveling in Africa earlier this year, Laura and I had our most recent opportunity to witness the effectiveness of this program,” he said. “We were honored to see the doctors, nurses and caregivers of all faiths working to save the lives of their fellow citizens. And we met the patients, including many children, who understand and appreciate America's generosity.”

Source: MarketWatch

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Background: The PEPFAR initiatives

At his 2003 State of the Union address, Bush called for Congress to commit $15 billion dollars to treat and prevent HIV and AIDS in Africa. Five years later, the program is considered an overwhelming success in providing treatment and saving the lives hundreds of thousands of HIV and AIDS sufferers. However, it was less effective in preventing the spread of the HIV, and some experts criticized the provision that one-third of prevention spending be used on abstinence-only education. With the first PEPFAR initiative ending this year, many called for increasing funds dedicated to prevention.

Source: International Herald Tribune

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The proposed second PEPFAR initiative features a large increase in scope and funding. Bush originally proposed that $30 billion be spent, but that number rose to $50 billion and includes funding for malaria and tuberculosis. The House approved the bill 308-116 in April, controversially choosing not to require that 55 percent of the funds be spent on treatment.

Source: Los Angeles Times

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The bill had widespread support in the Senate, but a group of Republican senators lobbied against several provisions in the bill. Sen. Tom Coburn, R-Okla., called for more specific regulations on how the money should be spent, asking, “Will we turn PEPFAR into just another bloated, unmeasured and unmeasurable foreign aid program with no accountability and no real impact?”

Source: Dallas Voice (AP)

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On Tuesday, the Senate voted down several Republican amendments that would have decreased funding, limited the scope of the program, and diverted funds away from an organization that supports abortion in China.

Source: Kaiser Network

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Opinion & Analysis: How should PEPFAR money be spent?

Should there be a minimum requirement for treatment funds?

The Wall Street Journal believes the requirement is essential to PEPFAR’s effectiveness: “Pepfar has succeeded precisely because it is one foreign-aid program that channels money toward specific targets.” The Journal is concerned that, without the clause, money would be spent on less important issues. “Only the naïve would insist that money freed from treatment won’t float away in the direction of condom street festivals or endless conferencing.”

Source: The Wall Street Journal (subscription may be required)

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The New York Times contends that AIDS relief programs should be able to spend the money as they choose. “But earmarking a specific percentage of funds to be spent on particular activities hampers the flexibility and effectiveness of the program,” it writes. “One of the most promising prevention measures, circumcision of males, is apt to be very expensive, and it would be a shame if it got insufficient support simply because an arbitrary percentage of the program’s budget had to be spent on treatments.”

Source: The New York Times (free registration may be required)

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Should abstinence education be used?

The International Women’s Health Coalition argues for the end of abstinence education, calling for money to be spent on family planning and on treatment for prostitutes. It also believes that the “conscience clause,” which allows organizations to refuse certain treatment and prevention services, should be removed because it “paves the way for taxpayer-funded discrimination based on ‘moral’ and religious grounds.”

Source: AllAfrica.com

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Rev. Sam L. Ruteikara, co-chair of Uganda’s National AIDS-Prevention Committee, believes that abstinence-based education is the only way to effectively prevent the spread of HIV and AIDS. He writes that Uganda had success preventing the spread of disease in the ’90s by teaching abstinence, but the effort was undermined by foreign workers handing out condoms. “Most HIV infections in Africa are spread by sex outside of marriage: casual sex and infidelity,” he says. “The solution is faithful love.”

Source: The Washington Post

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Reference: PEPFAR

The official government Web site of PEPFAR provides data on treatment results, reports to Congress and information about the agencies affiliated with PEPFAR.

Source: PEPFAR.gov

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The full text of the bill is available from the Library of Congress Web site.

Source: Library of Congress

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PEPFAR Watch is a Web site maintained by the Center for Health and Gender Equity (CHANGE), a U.S.-based NGO. It explains the key issues of the initiative and includes analysis and reports of the past five years. It also links to news stories about the bill.