Kaiser Daily HIV/AIDS Report Summarizes Opinion on House Passage of Global AIDS Bill

The House on Thursday approved 375-41 an international AIDS bill (HR 1298) that would authorize $15 billion over five years to fight AIDS in Africa and the Caribbean. 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. In addition, the bill would establish a new federal task force to act as a shadow for the Global Fund as part of an effort to allay fears among many Republicans that the fund is inefficient (Kaiser Daily HIV/AIDS Report, 5/2). A summary of opinion pieces responding to the bill's passage appear below:

Lawmakers

• Rep. Judy Biggert (R-Ill.): Biggert, who sponsored an approved amendment that calls for the president to establish an outreach and awareness campaign about the Global Fund, said, "Governments alone cannot conquer this enemy [HIV/AIDS] -- there is so much more that individual citizens and charitable foundations can and will do if we give them the avenue, the information and the opportunity" (Biggert release, 5/1).
  
• Rep. Joseph Crowley (D-N.Y.): Crowley, who sponsored an amendment to the bill that calls for educating men and boys about gender equality, said, "I sincerely hope that through [this] education, women and girls will be socially empowered. This is critical to reducing the spread of HIV worldwide." He added, "AIDS has no borders or boundaries. It affects a family in Uganda just as it affects a family in the Bronx" (Crowley release, 5/1).
  
• Rep. Tom DeLay (R-Texas): House Majority Leader DeLay said that the United States should support AIDS prevention methods that have been "proven effective" -- including abstinence -- adding that some people "still accuse abstinence proponents of being on a moral crusade. But this entire bill is a moral crusade, not to impose our values on anyone, but to save a continent from the Great Plague of our age" (DeLay release, 5/1).
  
• Rep. Dennis Hastert (R-Ill.): Speaker of the House Hastert said that the bill is a "common-sense investment in the future." He said, "By helping people of Africa deal with the AIDS crisis, we help them build a better world for their children," adding, "As we help them, we build better good will, which will lead to better relations between our nation and the nations of Africa in the future" (Hastert release, 5/1).
  
• Rep. Betty McCollum (D-Minn.): McCollum, who sponsored an amendment that would allocate a minimum of 10% of the bill's proposed funding for FY 2006 through FY 2008 to programs aimed at AIDS orphans and children affected by HIV/AIDS, said, "America possesses the wealth, the knowledge and the leadership to partner with the people of Africa to save lives" (McCollum release, 5/1).
  
• Rep. Jim Moran (D-Va.): Although the bill does include "some objectionable aspects," Moran said that it was a measure he "had to support because of the greater good it would do in providing billions of dollars to countries that are desperately trying to prevent the deaths of entire generations due to AIDS, but lack the financial resources to implement education and prevention programs." He added that the bill is a "good first step in helping Africans battle the scourge of HIV and AIDS" (Moran release, 5/1).
  
• Rep. Jim Nussle (R-Iowa): "The AIDS situation is truly an emergency," Nussle said, adding, "This legislation and appropriate funding will help [medical professionals] make a difference" in the fight against the disease (Nussle release, 5/1).
  
• Rep. Nancy Pelosi (D-Calif.): House Minority Leader Pelosi "strongly supported" the bill but opposed an amendment sponsored by Rep. Joseph Pitts (R-Pa.) that would specifically allocate one-third of the bill's HIV/AIDS prevention funding to abstinence programs. She said that the bill "gives equal weight to a full range of options and relies on the best scientific information." She added that the bill is not "anti-abstinence" and "supports a balanced approach to HIV/AIDS prevention" (Pelosi release, 5/1).
  
• Rep. Joseph Pitts (R-Pa.): Pitts said that the bill "protects faith-based groups, promotes abstinence, and demands accountability from the Global Fund," adding, "The bottom line is it gets money to the strategies that save lives" (Pitts release, 5/1).
  
• Rep. Bernie Sanders (I-Vt.): Sanders said that the bill is "an important step forward, but much more needs to be done," adding, "The world community must make it clear to the drug companies that in the midst of the [HIV/AIDS] epidemic, life-saving drugs must be made available to all those who need them." He said, "The issue here is not the profitability of the drug companies. The issue is saving human lives" (Sanders release, 5/1).
  

Press Releases

• Advocates for Youth: Pitts' amendment to the global AIDS bill represents an "unethical and dangerous" approach to HIV/AIDS prevention, Advocates for Youth President James Wagoner said. "While I applaud Congress for providing unprecedented funds for AIDS treatment and care to fight global HIV/AIDS, this vote represents the triumph of ideology over public health and the promotion of ignorance in the era of AIDS," Wagoner said, adding that the Senate should overturn the amendment (Advocates for Youth release, 5/1).
  
• AIDS Healthcare Foundation: "At the heart of this bill is a mission to bring two million people into antiretroviral treatment who would otherwise die," César Portillo, AHF chief of public affairs, said, adding that the bill will "ultimately save millions of lives." The foundation "echoes President Bush's call on the Senate to swiftly pass similar legislation by Memorial Day" (AHF release, 5/1).
  
• Center for Reproductive Rights: Some of the amendments approved as part of the House bill "ti[e] the hands of the organizations on the frontlines and should not be included in the Senate's version" of the bill, CRR President Nancy Northup said. The amendments do not represent a compromise but "an act that would undermine the work of the very groups most able to prevent and treat this terible disease," she added. The bill should demonstrate the United States' "understanding that this can only be done effectively if doctors are allowed to provide comprehensive counseling, preventive and treatment services" (CRR release, 5/2).
  
• Children's AIDS Fund: "With amendments to ensure the 'ABC' model is the priority intervention for preventing HIV/AIDS, and faith-based organizations able to fully participate without compromising the tenets of their faith, the House has passed a Global AIDS Bill that truly works," Children's AIDS Fund founder and board member Shepherd Smith said. Smith added that by "prioritizing prevention with a proven model of success emphasizing abstinence we finally see hope in ultimately curtailing the spread of this disease" (Children's AIDS Fund release, 5/1).
  
• Concerned Women for America: CWA "applauds" the passage of "lifesaving amendments" to the global AIDS bill. Members of Congress "had a choice between the Uganda model and the San Francisco model of AIDS prevention," Michael Schwartz, vice president for government relations for the group, said, adding, "The House chose to send life, not death, to Africa" (CWA release, 5/1).
  
• Elizabeth Glaser Pediatric AIDS Foundation: "Today was a critical next towards implementing the president's vision and bringing unprecedented new resources to this ever-growing pandemic," EGPAF CEO and President Kate Carr, said, adding, "However, we maintain that a comprehensive approach that includes condom distribution is the best way to help prevent the spread of HIV." She continued, "We hope that barriers are not erected to limit these proven methods" (EGPAF release, 5/1).
  
• Global Health Council: "This is a remarkable and historic day in the fight against AIDS," GHC President and CEO Nils Daulaire said. It is now the responsibility of the Senate to "act quickly and responsibly, and to ensure that the final bill is a workable, scientifically based approach to AIDS prevention, care and treatment," Daulaire said, adding, "[O]ur hope is that congressional appropriators act just as expeditiously, so we can start delivery of the vital services that we have been talking about" (GHC release, 5/1).
  
• HIV Medicine Association: While pleased by the passage of the bill, HIVMA is "concerned" with the passage of the Pitts amendment. Mandating that a third of prevention funds be used for abstinence-until-marriage programs is "not an appropriate public health strategy," Christine Lubinski, executive director of HIVMA, said, adding, "It is not appropriate for the U.S. Congress to decide how Eritrea, Haiti and other countries develop and implement prevention programs to meet the needs of their cultures." The group plans to work with advocacy organizations to ensure that the measure is removed from the Senate version of the bill (HIVMA release, 5/1).
  
• International Association of Physicians in AIDS Care: "It is encouraging that this past year has seen so many positive steps toward adequate funding of the global struggle against the AIDS epidemic," IAPAC Director of Global Health Policy Scott Wolfe said, adding, "However, it is a shame that the House was unable to succeed in passing this legislation without amendments that will reduce its potential impact, if it is ultimately signed into law, and if these funds are then actually appropriated" (IAPAC release, 5/2).
  
• NARAL Pro-Choice America: "Common sense and research show that a multi-pronged approach to preventing AIDS and HIV, that includes both abstinence and contraception, is necessary to combat the epidemic," Kate Michelman, president of NARAL Pro-Choice America, said. The focus of the Pitts amendment on abstinence "could adversely affect millions of the world's poorest citizens," she added. Michelman concluded, "By indicating a preference for abstinence, anti-choice politicians claim to know what is the best policy for countries around the world, when really they should not be micromanaging how other countries fight the HIV and AIDS epidemics" (NARAL Pro-Choice America release, 5/1).
  
• Pangaea Global AIDS Foundation: The House on Thursday approved amendments that will be "counterproductive to the global AIDS effort," according to a PGAF release. CEO and Chief Medical Officer Eric Goosby said that the Senate "must now respond swiftly by introducing and moving a similar measure, without the addition of these unnecessary and harmful amendments" (PGAF release, 5/1).
  
• Physicians for Human Rights: "Funds for stand-alone programs deny best public health practices by failing to recognize the value of condoms," PHR U.S. Policy Director Holly Burkhalter said in regard to the Pitts amendment, adding, "By diverting AIDS money to ineffective programs, money will be wasted, and more importantly, lives will be lost." According to PHR, it is "critical" that the Senate pass comprehensive AIDS legislation and that Bush request supplemental appropriations to pay for the programs contained within the bill (PHR release, 5/1).
  
• Planned Parenthood Federation of America: "While anti-choice members of Congress waste months playing deadly and unconscionable political games to appease their right-wing base, women's health and lives hang in the balance," PPFA President Gloria Feldt said. Stopping the spread of HIV is "too important" for Congress to succeed in "weaken[ing] the global AIDS bill with anti-condom, abstinence-only measures," she concluded (PPFA release, 5/1).
  
• Population Action International: "It's disheartening that a good bill with good intentions became burdened by ideology," Sally Ethelston, vice president of communications at PAI, said, adding, "What could have been a giant leap forward in the battle against HIV/AIDS was instead marred by amendments responding to political and not program needs." Congress should "focus on the best interests of the people these bills are intended to help" and pass legislation that "bring[s] down the barriers and build[s] access to a full-range of life-saving services," Ethelston said (PAI release, 5/1).
  
• Sexuality Information and Education Council of the U.S.: The Pitts amendment and an amendment offered by Rep. Christopher Smith (R-N.J.) that would strengthen "conscience" language already in the bill to ensure that religious groups will receive funding even if they object to certain aspects of prevention programs, including condom distribution, seek to export "policies born of conservative ideology not public health," Tamara Kreinin, president and CEO of SIECUS, said, adding, "In doing so, we are censoring critical reproductive health information from the world's most vulnerable populations." The amendments fail to recognize that "a broad comprehensive approach that addresses multiple factors, including the use of condoms" is the best mode of preventing the spread of HIV, Kreinin said (SIECUS release, 5/1).
  

Editorials

• Akron Beacon Journal: Bush should "push harder for what he has called America's moral duty" to fight the HIV/AIDS pandemic, because "[t]here is a moral obligation to provide people all available help before it is too late," an Akron Beacon Journal editorial says. The Journal continues that the "urgency of the situation imparts its own morality: to provide swift assistance to treat the suffering millions (which takes compassion) and to stop the death march of HIV/AIDS across continents (which demands stark realism)." The editorial concludes that the global AIDS bill "should not be held hostage to ideology in the abstinence-only versus condom debate" (Akron Beacon Journal, 5/5).
  
• Arizona Daily Star: Bush has shown "strong leadership" by supporting "generous contributions" to HIV/AIDS prevention and treatment programs throughout the world and by urging Congress to pass a bill that would provide an "unprecedented amount of foreign aid," while easing "outrageous obstacles his administration previously required of aid recipients," an Arizona Daily Star editorial says. Bush is showing he understands that "aid from the United States is vital in treating and preventing rampant diseases ravaging entire continents," the editorial concludes (Arizona Daily Star, 5/5).
  
• Baton Rouge Advocate: The House was "righ[t]" to pass the Hyde bill, but it was "probably unwis[e]" of lawmakers to approve Pitts' abstinence amendment, a Baton Rouge Advocate editorial says. The Advocate continues, "There is certainly an important place for abstinence programs, but U.S. aid agencies should not flinch from paying for condom distribution -- however controversial that is in some quarters -- if that is needed in nations fighting double-digit rates of infection." The editorial calls for senators to "look carefully at the Pitts amendment," adding that even if the amendment makes it through this year -- and "is later found to be unworkable in practice" -- it can be changed. The Advocate concludes that while the "richest nation on Earth simply cannot stand aside" in the fight against HIV/AIDS, the fight over the best way to address the epidemic is "not going to be won in a year" (Baton Rouge Advocate, 5/5).
  
• New York Daily News: Bush's support for the House-passed global AIDS bill shows that he is "willing to tick off his conservative base to do what's right to end" the AIDS epidemic, according to a New York Daily News editorial. The president's endorsement of the bill is significant because supporting the measure means "accepting the use of condoms in fighting AIDS" and "riling those conservatives who insist that abstinence is the only way to combat the disease," the editorial says. Although conservatives won a minor victory by approving an amendment that will allocate one-third of the bill's prevention funds to abstinence programs, that amount is "too much," the Daily News says. It would be "better to increase" the amount allocated for medical treatment, or to provide antiretroviral treatments, orphan care and funding for vaccine research, the editorial concludes (New York Daily News, 5/4).
  
• Philadelphia Inquirer: Some of the amendments added to the global AIDS bill demonstrate how "every government program that has anything to do with sex [could] get entangled in the social conservatives' domestic agenda," a Philadelphia Inquirer editorial states. In addition, when the bill heads to the Senate, lawmakers could make a "deadly choice" to "put ideology above effectiveness" by adding additional amendments restricting use of the funds. The editorial continues that abstinence and fidelity should be promoted, but "not at the expense of information" on safe sex, adding that "[r]ealism must apply." The editorial concludes, "If the aim is to tame this killer disease, domestic debates can't be allowed to undermine effectiveness" (Philadelphia Inquirer, 5/3).
  
• Sacramento Bee: Although the Pitts amendment directs one-third of the bill's prevention funds to abstinence programs, that amount is less than 7% of the "total package" and should "not be a major obstacle" to the bill's passage, a Sacramento Bee editorial states. Noting Bush's request that the Senate pass the measure before Memorial Day, the editorial concludes, "Given the ongoing devastation [of the HIV/AIDS epidemic], it can't be soon enough" (Sacramento Bee, 5/4).
  
• Tennessean: Bush "deserves credit for rising above the political fray and pushing for substantial funding" to fight global HIV/AIDS, according to a Tennessean editorial. Some have said that Bush's initiative on the disease has been a tactic aimed at procuring more votes for the 2004 election, but "even if it were a nod to political moderates, so be it," the editorial continues, adding, "The assistance [contained in the House-passed bill] will help countries that lack the resources to handle the job. It is a worthy proposal regardless of what sort of motivations people suspect." The Tennessean concludes, "The United States may not be able to offer a cure, but it can offer assistance where it is desperately needed" (Tennessean, 5/5).