House International Relations Committee Approves International AIDS Bill, Amendments
The House International Relations Committee yesterday approved 37-8 an amended bill (HR 1298) that would authorize $15 billion over five years to fight global AIDS, the Washington Times reports (Fagan, Washington Times, 4/3). The bill, sponsored by Rep. Henry Hyde (R-Ill.), would allocate $3 billion a year for five years for HIV/AIDS, with up to $1 billion in fiscal year 2004 going to the Global Fund to Fight AIDS, Tuberculosis and Malaria. President Bush in his State of the Union address on Jan. 28 proposed spending $15 billion over five years to fight HIV/AIDS in Africa and the Caribbean. Bush's plan includes $10 billion in new money. Under the initiative, new funds averaging an additional $2 billion per year would be phased in gradually to supplement the $1 billion per year the government now spends on AIDS; only $1 billion total would go to the Global Fund (Kaiser Daily HIV/AIDS Report, 4/2). Hyde's bill endorses the "ABC" approach of "abstinence, being faithful and, when appropriate, use condoms," which has had success in lowering AIDS prevalence rates in Uganda (Kaiser Daily HIV/AIDS Report, 4/1). But committee members rejected an amendment sponsored by Rep. Joseph Pitts (R-Pa.) that would have provided funding "priority" to programs promoting abstinence over those that focus on condom use. Members instead approved 24-20 an amendment from Rep. Barbara Lee (D-Calif.) that states that condom use is also a "priority item." A second Pitts amendment that would have "explicitly permitted" funding for faith-based groups -- even if they favor abstinence "at the expense of condom use" -- was defeated 21-23 (MacFarland, CongressDaily Markup Report, 4/2). The committee also approved an amendment by Rep. Dana Rohrabacher (R-Calif.) that recommends that 10% of the funding go to help orphans whose parents have died from AIDS-related causes (Abrams, AP/Houston Chronicle, 4/3). In addition, the committee approved 24-22 an amendment sponsored by Rep. Christopher Smith (R-N.J.) that would prohibit funds from going to any group or organization that does not have a policy "explicitly opposing prostitution and sex trafficking" (Abrams, AP/Fort Worth Star-Telegram, 4/3). Other amendments include:
- A measure sponsored by Rep. Nick Smith (R-Mich.) that would have authorized more funds for the later years of the five-year initiative instead of the first years was defeated 15-25.
- A measure sponsored by Rep. Sherrod Brown (D-Ohio) that would require the U.S. Agency for International Development to show more accountability for its TB programs passed by voice vote.
- An amendment by Rep. Grace Napolitano (D-Calif.) that would give priority to groups that already provide mother-to-child HIV transmission prevention programs was approved by voice vote.
- An amendment by Rep. Howard Berman (D-Calif.) that would "recognize[e] the importance" of the public-private partnership Medicines for Malaria in developing new anti-malaria medicines was approved by voice vote.
- A measure sponsored by Rep. Jeff Flake (R-Ariz.) that would reduce the amount of federal funding for the Global Fund by an amount equal to the amount provided by the fund to governments on the State Department's terrorism list was approved by voice vote. Money provided by the Global Fund to nongovernmental organizations in such countries would not be affected by the amendement.
- An amendment from Rep. Betty McCollum (D-Minn.) that would make physician's assistants eligible to participate in a pilot program for the placement of health care professionals in other countries "severely affected" by HIV/AIDS, TB and malaria passed by voice vote (CongressDaily Markup Report, 4/2).
- The committee also approved unanimously an amendment from Rep. JoAnn Davis (R-Va.) that would require an analysis of HPV in sub-Saharan Africa and the "impact that condom usage has upon the spread of HPV in sub-Saharan Africa," according to Roland Foster, a senior staff member of the House Government Reform criminal justice, drug policy and human resources subcommittee (Foster, E-mail correspondence, 4/2).
Hyde, who opposes abortion rights, has avoided the abortion issue by excluding language from the bill that prohibits federal funding from going to health and family planning groups that perform or counsel on abortion. The so-called "Mexico City" policy -- which was originally implemented by President Reagan at a population conference in Mexico City in 1984, removed by President Clinton and reinstated by Bush on the first day of his presidency -- "bars U.S. money from international groups that support abortion, even with their own money, through direct services, counseling or lobbying activities (Kaiser Daily HIV/AIDS Report, 4/1). The Bush administration had shown support for extending the policy to HIV/AIDS efforts (Kaiser Daily HIV/AIDS Report, 3/18). Hyde said, "I am doing everything humanly possible to separate abortion from this effort." Hyde added that abortion is not addressed in the measure because it would "kill the bill" (Sweet, Chicago Sun-Times, 4/3).
White House spokesperson Scott McClellan said, "We're pleased that they're moving forward with this important priority," adding that the administration will work with lawmakers to pass a bill "that is consistent with what the president proposed" (Abrams, AP/Boston Globe, 4/3). Some critics of the measure have said that they disagree with channeling funds through the Global Fund. A House aide said, "The Global Fund is ineffective and bureaucratic." But Dr. Paul Zeitz, executive director of the Global AIDS Alliance, defended the fund calling it "super-efficient" (Cusack, The Hill, 4/1). Zeitz also said, "This is something everyone ought to unite around. The bill approved [yesterday] takes the AIDS crisis seriously, and it shows that a broad range of members of Congress favor a pragmatic approach. Now it's up to Congress to see [that] this money is actually provided so effective programs can do their work" (Cobb, AllAfrica.com, 4/3). Michael Weinstein, president of the AIDS Healthcare Foundation, said that the "swift" passage of the bill will "help to save millions from the certainty of death by providing treatment and the money to purchase life-sustaining AIDS drugs for Africa and the developing world" (AHF release, 4/2). Jamie Drummond, executive director of Debt, AIDS, Trade in Africa, said, "House leadership should move swiftly to schedule a vote on the ... bill, to send a clear message to other rich countries that they must join America in stepping up the struggle against AIDS in Africa," adding, "Many more steps need to be taken for the U.S. initiative to save tens of millions of lives. AIDS supporters in the Senate ... will have to guide authorizing legislation through the Senate" (DATA release, 4/2). Mark Isaac, vice president of the Elizabeth Glaser Pediatric AIDS Foundation, said that the bill's passage "sends a strong signal that we can get a bipartisan global AIDS bill passed this year." He added that the group is "very pleased" that the measure "puts a high priority on programs to prevent [vertical HIV transmission] and includes provisions to provide care and treatment programs for families" (EGPAF release, 4/2). Dr. Nils Daulaire, president and CEO of the Global Health Council, said, "This is a very solid bill to address a very serious problem. The levels are right, the ramp-up is early, and we are especially heartened by the policy language that calls for an integrated strategy of prevention, care and treatment. ... We urge the full House and the full Senate to pass this legislation quickly" (GHC release, 4/2). The bill could see action on the House floor by next week (AllAfrica.com, 4/3). A Web cast of the markup session is available online.