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Committee Approves Global HIV/AIDS Prevention Bill

The House International Relations Committee on June 27 approved, 32-4, a bill (H.R. 2069) to authorize $1.36 billion to combat the international HIV/AIDS epidemic. The mark-up was postponed last week while Republicans and Democrats negotiated an agreement on the bill’s funding levels. Opening the mark-up, Committee Chair Henry Hyde (R-IL) said, “Mindful of the colossal threat posed by HIV/AIDS, this committee has chosen to embark upon a courageous and bipartisan course that constitutes a declaration of war on the pandemic.”

The mark-up comes at the close of a United Nations (U.N.) General Assembly Special Session on HIV/AIDS, where U.N. Secretary General Kofi Annan declared that $7-$10 billion would be needed annually to address the global HIV/AIDS pandemic. To date, roughly $500-600 million has been pledged to a newly established HIV/AIDS trust fund under the auspices of the U.N. Last month, the President announced that the United States would contribute $200 million to the fund.

Sponsored by Rep. Hyde, the original bill would have authorized roughly $1 billion for HIV/AIDS programs. Of that amount, $469 million would have been provided in each of FY2002 and FY2003 for HIV/AIDS prevention, education, and treatment programs operated by the U.S. Agency for International Development (USAID). Under the bill, funding would have been primarily earmarked for prevention and education. The President had requested $369 million for USAID programs.

The Global Access to HIV/AIDS Prevention, Awareness, Education, and Treatment Act also would have authorized a $50 million pilot project to provide anti-retroviral therapies to HIV-infected individuals. Additionally, the bill would have authorized “such sums as may be necessary” in each of FY2002 and FY2003 for U.S. contributions to multilateral HIV/AIDS prevention and treatment efforts.

Under the agreement reached between Reps. Hyde, Tom Lantos (D-CA), Jim Leach (R-IA), and Barbara Lee (D-CA), a substitute amendment to increase the authorized funding level to $1.36 billion was accepted by the committee. The substitute would authorize $560 million in FY2002 for USAID’s HIV/AIDS prevention, education, and treatment programs. The substitute also would authorize an additional $750 million U.S. contribution to the international HIV/AIDS trust fund, bringing the total contribution to $950 million. The substitute retains the $50 million pilot program for new drug therapies. The substitute would make funding for prevention and treatment equal priorities.

The substitute amendment also would establish a 12-member Global Health Advisory Board to advise the President, the Secretary of State, and the USAID Administrator on the implementation of international health programs.

After considerable debate, the substitute amendment was approved by voice vote. Many committee Republicans expressed their opposition to the bill because its funding levels were above the President’s request and because the bill did not include any offsets. “We are providing false hope,” argued Rep. Tom Tancredo (R-CO), saying that during a hearing on the subject several weeks ago, witnesses testified that the bill “would not prevent the spread of the virus” and that experts were still uncertain about which approach would best address the epidemic. Rep. Tancredo added, “I am loath to support increased funding until we find out what works.”

In responding to Rep. Tancredo’s comments, Rep. Hyde noted that HIV/AIDS was a global epidemic and required a significant response. “Now is the right time to do something.”

Rep. Donald Payne (D-NJ) argued that there was no “moral high ground” to take on this bill, adding that opposing the bill because of funding issues was “reprehensible” considering the recently enacted tax cut.

Rep. Lee called the bill “multi-faceted,” saying that it contained “many good provisions.” While commending the Chair for his willingness to work on the bill’s funding levels, Rep. Lee noted that she would “move forward on my efforts to increase amounts as we move through this process.” Saying that “it’s not just a matter of life and death, but it’s in our national interest,” Rep. Lee said a “massive response” was needed to a “massive plague.”

During the mark-up, Rep. Chris Smith (R-NJ) offered an amendment that would expand treatment services under the bill to include hospice and palliative care. The amendment was approved by voice vote. “Individuals who will die, deserve to die in dignity,” stated Rep. Lantos.

Several provisions of the bill fall under the jurisdiction of the House Financial Services Committee. Rep. Doug Bereuter (R-NE) noted that he wished to offer an amendment that would have allowed the bill to bypass another committee’s consideration. Rep. Hyde assured Rep. Bereuter that they would work together to move the bill to the floor as quickly as possible.

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