On April 2, the House passed, 308-116, H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, after defeating, 175-248, a motion to recommit that would have lowered the cost of the bill to $30 billion. The House Foreign Affairs Committee approved the bill on February 27 (see The Source, 2/27/08). The Senate Foreign Relations Committee approved its version of the bill (S. 2731) on March 13 (see The Source, 3/14/08).
The bill would authorize $50 billion through FY2013 for the President’s Emergency Plan for AIDS Relief (PEPFAR). Of that amount, the bill would authorize $2 billion annually for the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, $4 billion from FY2009-13 to combat tuberculosis, and $5 billion from FY2009-13 to combat malaria. PEPFAR’s current authorization (P.L. 108-25), which provided $15 billion over five years, expires at the end of FY2008. President Bush had called for $30 billion for the program during his State of the Union address.
During consideration of the bill, the House passed by voice vote:
During floor debate, the bill’s sponsor, Rep. Howard Berman (D-CA), said, “As a direct result of the extraordinarily successful law we passed five years ago, the United States has provided lifesaving drugs to nearly 1.5 million men, women, and children; supported care for nearly 7 million people, including 2.7 million orphans and vulnerable children; and prevented an estimated 150,000 infant infections around the world…The reauthorization bill increases the number of individuals receiving prevention, treatment, and care services. It also builds stronger linkages between the global HIV/AIDS initiative and existing programs designed to alleviate hunger, improve health care, and bolster HIV education in schools, an approach endorsed by the president’s global AIDS coordinator just a few short weeks ago.” He added, “The 2003 law gave inadequate attention to the needs of women and girls. The new legislation remedies this situation by strengthening prevention and treatment programs aimed at this especially vulnerable population. The reauthorization legislation also eliminates the one-third abstinence-only earmark, but requires a balanced approach to HIV/AIDS sexual transmission prevention programs and a report regarding this approach in countries where the epidemic has become generalized.” Speaking in support of the bill, Rep. Ileana Ros-Lehtinen (R-FL) said, “The agreement that we have is carefully crafted and designed in the area of reproductive health and family planning to ensure that HIV funding for prevention is not misused to promote programs beyond the scope of this bill…The bill ensures also that those working to fight these diseases are not required to choose between their conscience and receiving the assistance they need to carry out their work.” She added, “Also, we worked a lot on the prostitution and the sex trafficking pledge. The bipartisan agreement maintains the existing certification requirement that any group or organization receiving PEPFAR funds explicitly oppose prostitution and sex trafficking…Neither current law nor the pledge itself prevents organization from working with prostitutes or other high-risk groups, but it does mandate that that assistance to these individuals not be mistaken for approval or support of the activities that take their terrible toll on their bodies and that can only be described as destructive to human dignity.” Rep. James McGovern (D-MA) applauded the bill’s support for linkages to other needs besides HIV/AIDS treatment: “Teacher deaths and absenteeism due to HIV/AIDS compound problems of quality and access in education systems that already face teacher shortages. Children are often pulled out of school to care for a family member with HIV/AIDS or, when a parent dies, they’re forced to take care of younger siblings rather than attend school…Young people with little or no education are more than twice as likely to contract HIV as those who have completed primary education. But under this bill, and as we continue to better integrate our HIV/AIDS programs with our other development priorities, schools can become hubs of care and support for orphans and vulnerable children by providing psychological support, nutrition and basic health care and support to OVC caregivers.” He added, “In a 32-country demographic and health survey, women with post-primary education were four times more likely than illiterate women to know the basic facts about HIV/AIDS, and three times more likely to know that HIV can be transmitted from mother to child.” Rep. John Culberson (R-TX) opposed the bill, saying, “We have not adequately invested in our own scientific and medical infrastructure in the United States, first and foremost, before you even begin to talk about curing disease globally. We have not secured our border. The southern border is essentially wide open and unprotected in areas other than Del Rio and Laredo. What are we doing to make sure that we’ve done all that we can do here at home first and foremost for our own folks?…This bill creates a worldwide entitlement to anyone in the world that has AIDS or malaria or tuberculosis at U.S. taxpayer expense…It is utterly irresponsible at a time of record national debt, record deficits, record federal spending that we need to reign in.” Rep. Dana Rohrbacher (R-CA) said, “[W]hat we have to decided to is, are we going to deprive our own people, our seniors? I just came from a meeting with doctors from my district. We can’t afford to provide health care for our seniors, for our veterans. We can’t afford all the educational things we want to do. How can we possibly, then, take $50 billion and send it to Africa, even though it’s a worthy cause? We should not be doing this. It is not in the interests of the American people. And I would call on my colleagues to oppose this totally wasteful expenditure of money.” |
