On July 16, the Senate approved, 80-16, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 (H.R. 5501), after substituting the text of its own bill, S. 2731, as amended. The bill was approved by the Senate Foreign Relations Committee on March 13 (see The Source, 3/14/08). The House passed a similar bill, H.R. 5501, on April 2 (see The Source, 4/4/08). The House is expected to pass the Senate version of the bill next week.
The bill would authorize $48 billion through FY2013 for the Global Fund to Fight AIDS, Tuberculosis, and Malaria. This amount also includes $5 billion for malaria and $4 billion for tuberculosis (TB). The bill’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.
The Senate version would require that “more than half” of the bill’s bilateral assistance be used for treatment and care services, a provision added at the request of Sen. Tom Coburn (R-OK). Unlike the House-passed bill, the Senate version does not address family planning; the House measure would permit PEPFAR funds to be used for HIV testing and education in family planning clinics.
Like the House bill, the measure would continue the ten percent set-aside for orphans and vulnerable children included in the original authorization, strengthen mother-to-child transmission prevention and treatment, and authorize microbicide research and development at the National Institutes of Health, the Centers for Disease Control and Prevention, and the United States Agency for International Development, in recognition of the “need and urgency to expand the range of interventions for preventing the transmission of…(HIV), including nonvaccine prevention methods that can be controlled by women.” As in the House version, the Senate bill would remove the requirement that one-third of all funds spent on prevention go to abstinence-until-marriage programs. However, if a country’s HIV prevention plan dedicates less than 50 percent of funds for “activities promoting abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction,” the bill would require the U.S. Global AIDS Coordinator to report to Congress “on the justification for this decision.” Both versions also would maintain the requirement that no funds “may be used to provide assistance to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking.”
Among the amendments considered, the Senate adopted, by voice vote:
Sen. Richard Lugar (R-IN), who cosponsored the bill with Sen. Biden, stated, “PEPFAR has provided treatment to an estimated 1.4 million men, women, and children infected with HIV/AIDS in Africa and elsewhere. Before the program began, only 50,000 people in all of sub-Saharan Africa were receiving life-saving, anti-retroviral drugs. Reauthorization of PEPFAR enables us to build upon these successes, save lives on a massive scale, and preserve the fabric of numerous fragile societies. We should understand that our investments in disease prevention programs have yielded enormous foreign policy benefits during the last five years. PEPFAR has helped to prevent instability and societal collapse in a number of at-risk countries; it has stimulated contributions from other wealthy nations to fight AIDS; it has facilitated deep partnerships with a new generation of African leaders; and it has improved attitudes toward the United States in Africa and other regions.”
