New five-year course for U.S. AIDS response

As a fitting tribute to the late Committee Chairman Tom Lantos, Republicans and Democrats have crafted a bipartisan compromise to support AIDS, TB and malaria policy.

The agreement will set US programs on a new five-year course. The bill was approved this morning at a House Foreign Relations Committee mark-up and likely be approved by the full House next week.

"This historic agreement will save millions of lives, if approved by the full Congress and then fully funded," said Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance. "With bi-partisan support, Congress is beginning to fix aspects of the AIDS program that were clearly not working.

“ At the same time, it is moving to increase funding for TB and malaria and set goals on the strengthening of health system capacity. These changes are crucial to development, especially in Africa, ” said Zeitz.

White House spokesperson Dana Perino stated today, “ We support this legislation and we want to express that today. We appreciate the effort to draft in a thoughtful, bipartisan way … .It retains the important policy principles that have made the program such a success and we applaud the committee's work in quickly moving this bill forward and we hope that the House and Senate will soon follow suit and send it on to the President for signature. ” In comments during today ' s mark-up, Rep. Ileana Ros-Lehtinen (R-FL) and Rep. Chris Smith (R-NJ) also praised the outcome.

The agreement essentially removes the requirement that one-third of all HIV prevention funding be spent on abstinence and fidelity. Instead, the bill supports promotion of these behaviors while not requiring a fixed funding proportion. Programs must report to Congress if, in countries that have generalized HIV epidemics, they spend less than 50% of funding for behavioral change interventions to prevent sexual transmission of HIV.

"Promotion of abstinence and fidelity has its place, but I have seen how the funding requirement has harmed AIDS programs," said Beatrice Were, Uganda-based Africa Program Director of the Global AIDS Alliance. "So, as a women's rights activist, I see this change as a major step forward, and I must congratulate all who made this bill possible.

"The biggest worry I have now, however, is that this bill will not be fully funded," Were stated. "By itself, this bill provides no actual money. So, I urge everyone involved, from advocates to policy makers, to work to ensure the entire $50 billion is actually appropriated so we can save lives here in Africa."

The agreement stops short of providing desperately needed funds for family planning for women who are HIV-positive, despite clear evidence that women must have easy access to this service to protect their health. Anti-abortion groups had falsely claimed this would lead to US funding for abortion.

"Much to our dismay, this agreement does not allow the use of US AIDS funding for family planning," said Dr. Zeitz. "It is also deeply wrong that President Bush has proposed cutting funding for family planning for 2009. We will have to re-double our efforts to increase funding for family planning generally as well as the overall amount of money available for poverty-focused aid.

"We are also troubled that this agreement does not remove the requirement that programs sign a statement signaling their opposition to prostitution, said Zeitz. "This requirement has led many important programs to turn down US funding."

At least $4 billion of the bill is reserved for a wide range of programs that benefit orphaned and vulnerable children in countries affected by AIDS. An additional $9 billion is specified for bilateral programs that address tuberculosis and malaria, and the bill would authorize $4 billion for Global Fund programs on these diseases.

"We're delighted to see $50 billion authorized in this bill," said Zeitz. "However, it is important to be clear that, at most, $37 billion of the total would be directed to AIDS-specific programs."