President Bush Calls for Congress To Approve Global HIV/AIDS Bill With ‘Speed and Seriousness’

President Bush yesterday called on Congress to pass an international HIV/AIDS bill (HR 1298) that would authorize $15 billion over five years to fight AIDS in Africa and the Caribbean, urging them to "move forward with the speed and seriousness that this crisis requires," Reuters Health reports (Zwillich, Reuters Health, 4/29). The bill, sponsored by Rep. Henry Hyde (R-Ill.), would authorize $3 billion a year for five years to international HIV/AIDS programs, with up to $1 billion in fiscal year 2004 going to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Hyde's bill endorses the "ABC" HIV prevention model -- abstinence, be faithful, use condoms -- which has had success in lowering AIDS prevalence rates in Uganda. The bill also allows international organizations that counsel about abortion to receive U.S. funding on the condition that family planning and abortion programs be financed and run separately (Kaiser Daily HIV/AIDS Report, 4/29). During a ceremony in the White House East Room, Bush said, "Time is not on our side," adding, "Fighting AIDS on a global scale is a massive and complicated undertaking, but this cause is rooted in the simplest of moral duties: When we see this kind of preventable suffering, when we see a plague leaving graves and orphans across a continent, we must act" (Epstein, San Francisco Chronicle, 4/30). Bush said, "There are only two possible responses to suffering on this scale -- we can turn our eyes away in resignation and despair, or we can take decisive, historic action to turn the tide against this disease and give the hope of life to millions," adding, "The United States of America chooses the path of action and the path of hope" (Curl, Washington Times, 4/30). Bush asked Congress to send him the measure by Memorial Day, the Los Angeles Times reports (Chen/Anderson, Los Angeles Times, 4/30). The White House and HIV/AIDS advocates are hoping that the legislation will pass before a G8 summit scheduled to begin June 1 in France so that they can urge other countries to contribute more money to the fight against the epidemic (Donnelly, Boston Globe, 4/30). In addition, Bush "is insistent" that he have the legislation "in hand" for a planned trip to Africa this year, and administration officials want to promote the humanitarian side of Bush foreign policy, which so far has focused on two wars in two years, according to the New York Times (Bumiller, New York Times, 4/30).

Possible Amendment
Rep. Joe Pitts (R-Pa.) this week is expected to introduce an amendment to the bill that would specifically allocate one-third of the bill's funding for abstinence programs (Kaiser Daily HIV/AIDS Report, 4/29). Pitts said in a statement after Bush's speech that he is concerned that nongovernmental organizations will "not always abide by the stipulation" that funds allocated for AIDS prevention not go toward abortion or family planning programs, the Los Angeles Times reports. He added, "What happens when President Bush leaves office -- when someone who may not share his commitment to what works takes office?" (Los Angeles Times, 4/30). After Bush's speech, officials said that the administration supports Pitts' amendments, the Washington Post reports (Goldstein/Eilperin, Washington Post, 4/30). White House spokesperson Ari Fleischer added, "There's a series of mechanisms in place, and that deals with the transparency of these organizations. They will not be able to do business with the government unless we were satisfied they had transparency in place to know about their use of funds" (Los Angeles Times, 4/30). But some Democrats said that they would pull their support for the measure if "conservatives go too far in deterring the use of condoms," the Post reports. Rep. Tom Lantos (D-Calif.) said, "There's always a danger of having the agreement unravel. ... People on our side have equally strong feelings on our preferred approach" (Washington Post, 4/30). In addition, some conservative Republicans -- who would be "ordinarily inclined to side with Pitts" -- are expected to reject the amendment because it could be a "poison pill" that kills the entire bill, the Los Angeles Times reports (Los Angeles Times, 4/30).

Reaction
Rep. Barbara Lee (D-Calif.) said that she is "cautiously optimistic the bill will be intact after it leaves the floor" (San Francisco Chronicle, 4/30). Edith Ssampala, Ugandan ambassador to the United States, said after Bush's speech that all three parts of the ABC program are "essential," including condom distribution, according to Long Island Newsday. She added, "It has to be comprehensive. If you start preferring one part ... you're not going to be successful" (Fireman, Long Island Newsday, 4/30). Tom Minnery, vice president of public policy at Focus on the Family, said, "As written, the bill guarantees failure because it does not emphasize abstinence" (Reuters Health, 4/29). Steven Mosher, president of Population Research Institute, said, "The president must not squander away $15 billion on a failed program. He must promote the only effective method of HIV/AIDS prevention. He must promote abstinence" (Politi, Financial Times, 4/30). Shepherd Smith, founder of the Children's AIDS Fund, said, "For the first time, I have hope. ... I've never felt that before." Kate Carr, president of the Elizabeth Glaser Pediatric AIDS Foundation, said, "There are ... disagreements about the approach, but there is unity in the sense of getting something done." Republican strategist Ed Goeas said, "This is another example of the president trying to do the right thing without getting bogged down in side arguments" (Stone, USA Today, 4/30).

More Reaction

• Africa Action: Executive Director Salih Booker said, "The Hyde bill represents the minimum that the U.S. should be doing to fight global AIDS next year and any attempts by conservatives to restrict this initiative will be seen for what they are -- anti-African in the extreme." Booker added that funding for the Global Fund, debt relief for African nations and U.S. support for generic drugs is "essential to waging a successful war against AIDS" (Africa Action release, 4/29).
  
• AIDS Healthcare Foundation: Bush's "further endorsement [of the Hyde bill] helps create momentum around HR 1298 that sends a strong message to Congress to act quickly and favorably on the bill by the president's Memorial Day deadline," Cesar Portillo, AHF's chief of public affairs, said. AHF President Michael Weinstein said, "It is disappointing that today, not one dollar of U.S. government funding pays for antiretroviral treatment globally," adding, "We look forward to working closely with this administration to make certain that the president's vision is made a reality and that his goal of two million people on treatment ... is a commitment we honor" (AHF release, 4/29).
  
• Concerned Women for America: CWA Vice President for Government Relations Michael Schwartz called for the addition of several amendments to the bill, saying, "Without a clear mandate, future administrations will be able to use AIDS prevention dollars for ineffective condom-based programs, rather than lifesaving ones based on abstinence and faithfulness." Schwartz urged Congress to add amendments that would "strengthen abstinence provisions," add a conscience clause for faith-based groups and limit funding to the Global Fund (CWA release, 4/28).
  
• Sen. Richard Durbin (D-Ill.): "I commend the president for renewing his support for the ABC approach to fight AIDS," Durbin said, adding, "It is imperative that we move beyond politics and act quickly to provide a comprehensive response to the AIDS epidemic, including funding the Global Fund" (Durbin release, 4/29).
  
• Family Research Council: FRC President Ken Connor urged Bush not to endorse the international AIDS bill, unless it contains "three essential pro-family amendments." Connor said, "By signaling that President Bush will sign the bill 'as is,' the White House probably has made it much more difficult to pass amendments which would focus U.S. efforts on abstinence and monogamy, or which would limit funding to the ... disastrous Global AIDS Fund and other anti-family organizations" (FRC release, 4/28).
  
• Global Health Council: President and CEO Dr. Nils Daulaire said that Bush "is making it clear that an integrated strategy of prevention, care and treatment is a top foreign policy priority," adding that the bill "aligns the moral imperative of addressing the global AIDS pandemic with good global public health policy bolstered by sound scientific advances." Daulaire urged Congress to quickly pass the legislation, adding, "We will see major differences in the next decade because of this level and form of international engagement" (Global Health Council release, 4/29).
  
• International Association of Physicians in AIDS Care: In a letter of support for the international AIDS bill that was sent to Congress yesterday, IAPAC said, "While [the bill] is but a first step in what must be a broader agenda of international aid, we applaud it for its open approach to funding a variety of methods for preventing the spread of HIV; for its handling of donations to the Global Fund; and for the fact that it would distribute money evenly over five years rather than starting smaller and increasing funding levels at the end of the five years." The letter urges passage of the legislation and rejection of amendments that would "overly restrict it" (IAPAC letter, 4/25).
  
• Pangaea Global AIDS Foundation: CEO and Chief Medical Officer Dr. Eric Goosby said that the bill "should be passed without any amendments or restrictions that would undermine our efforts to fight the global pandemic," adding, "The Senate must also act by moving a similar bill as quickly as possible." Goosby said that the "effort is critical to the health and well-being of the 42 million people worldwide living with HIV and the millions of others at risk for HIV infection" (PGAF release, 4/29).
  
• UNICEF: Commending Bush for his leadership in supporting the international AIDS bill, Executive Director Carol Bellamy said, "Investing in young people is the best strategy we have today for bringing the epidemic under control." She added, "Because the future of the epidemic will be driven largely by the decisions that successive waves of young people make throughout their lives, investments should focus first and foremost on providing young people with the wherewithal to make the healthy, informed decisions that prevent HIV infection" (UNICEF release, 4/29).
  

Media Coverage
A kaisernetwork.org HealthCast of Bush's speech is available online.

ABCNews' "World News Tonight" yesterday reported on opposition from conservatives and drug companies to Bush's HIV/AIDS proposals. The segment includes comments from Rep. Mike Pence (R-Ind.) (Moran, "World News Tonight," ABCNews, 4/29). The full segment is available online in RealPlayer.

PRI's "The World" yesterday interviewed Wall Street Journal reporter Greg Hitt about Bush's announcement (Bader, "The World," PRI, 4/29). The full segment is available online in Windows Media.