The House voted Thursday to triple money to fight AIDS, malaria and tuberculosis around the world, giving new life and new punch to a program credited with saving or prolonging millions of lives in Africa alone.
The 303-115 vote sends the global AIDS bill to President Bush for his signature. Bush, who first floated the idea of a campaign against the scourge of AIDS in his 2003 State of the Union speech, supports the five-year, $48 billion plan.
Passage of the bill culminated a rare instance of cooperation between the White House and the Democratic-controlled Congress. It was "born out of a willingness to work together and put the United States on the right side of history when it comes to this global pandemic," said Rep. Barbara Lee, D-Calif., a leader on the issue.
The current $15 billion act, which expires at the end of September, has helped bring lifesaving anti-retroviral drugs to some 1.7 million people and supported care for nearly 7 million. The President's Emergency Plan for AIDS Relief, known as PEPFAR, has won plaudits from some of Bush's harshest critics both in Congress and around the world. Both Democrats and Republicans hailed it as one of the most significant accomplishments of the Bush presidency.
'Hope to millions'
The United States, said Rep. Howard Berman, D-Calif., chairman of the House Foreign Affairs Committee, "has given hope to millions infected with the HIV virus, which just a few years ago was tantamount to a death sentence."
According to a study by UNAIDS and the Kaiser Family Foundation, the United States provided one-fifth of AIDS funding from all sources — governments, international aid groups and the private sector — in 2007. About 40 percent of the $4.9 billion disbursed in 2007 from the G-8 countries, Europe and other donor governments came from the United States.
The legislation approves spending of $5 billion for malaria and $4 billion for tuberculosis, the leading cause of death for people with AIDS. It authorizes spending of up to $2 billion next year for the international Global Fund to Fight AIDS. The measure also provides $2 billion, on top of the $48 billion, for American Indian water, health and law enforcement programs.
While some GOP conservatives questioned the sharp spending increase, others said the U.S. aid had important security as well as moral implications and gave a needed boost to America's reputation abroad.
7,000 new HIV infections every day
The pandemic, said Rep. Ileana Ros-Lehtinen, R-Fla., top Republican on the Foreign Affairs Committee, "is leaving a trail of poverty, despondency and death which has destabilized societies and undermined the security of entire regions." The program has enhanced the U.S. image around the world, she said. "Even in the most remote areas of Kenya or Haiti, for example, people know about the PEPFAR program."
PEPFAR has focused on nations in sub-Saharan Africa that have been devastated by AIDS, but it has also provided assistance in the Caribbean and other areas hit by the pandemic now affecting some 33 million worldwide. Even with advances in treating the disease, there are still about 7,000 new HIV infections every day around the world.
The new bill, like the current law, states that 10 percent of funds should be allocated for orphans and vulnerable children. It sets as a goal preventing 12 million new HIV infections, treating more than 2 million with anti-retroviral drugs, supporting care for 12 million people infected with HIV/AIDS and training at least 140,000 new health care workers and paraprofessionals.
It increases attention on women and girls, including stressing the importance of preventing gender-based violence.
Pamela W. Barnes, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, applauded the bill's target of reaching 80 percent of HIV-positive pregnant women with services needed to prevent transmission to their children. "We are still only reaching 34 percent of pregnant, HIV-positive mothers with the medicine they need to keep their babies HIV-free," she said.
Months of compromise
The final product took months of compromise: Democrats took out a provision in the existing act requiring that one-third of prevention funds be spent on abstinence education but allowed for reports to Congress if abstinence and fidelity spending falls below certain levels. Conservatives won "conscience clause" assurances that religious groups would not be forced to participate in programs to which they morally object.
Bush, who originally proposed doubling the program to $30 billion, first balked at but later accepted the $50 billion bill that passed the House in April. The Senate diverted $2 billion of the $50 billion to Indian programs and inserted a provision that more than half of funds for AIDS programs go for treatment and care.
The Senate also attached a measure, welcomed by AIDS advocacy groups, that ends a two-decade-old U.S. policy that has made it nearly impossible for HIV-positive people to get visas to this country as immigrants, students or tourists.
The bill is named after former House Foreign Affairs Committee Chairmen Henry Hyde, R-Ill., and Tom Lantos, D-Calif., who wrote the 2003 bill. Hyde died last November, and Lantos died in February as he was working on the new bill.