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

The Senate on Friday approved by voice vote an international AIDS bill (HR 1298) that would authorize $15 billion over five years to fight HIV/AIDS in Africa and the Caribbean, including an amendment that would increase funding for debt relief in countries hit hardest by the epidemic. The House earlier this month approved the measure, sponsored by Rep. Henry Hyde (R-Ill.), which 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. The bill endorses the "ABC" HIV prevention model -- abstinence, be faithful, use condoms -- which has had success in lowering AIDS prevalence rates in Uganda. 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. The measure also specifically allocates one-third of the bill's HIV/AIDS prevention funding for abstinence programs. The bill also would provide financial assistance "for the purpose of encouraging men to be responsible in their sexual behavior, child rearing and to respect women" (Kaiser Daily HIV/AIDS Report, 5/16). A summary of opinion pieces responding to the bill's passage appear below:

Lawmakers

• Sen. Sam Brownback (R-Kan.): Brownback said that he is "pleased" that the Senate passed this "important piece of legislation" to bring "much needed relief to those who are suffering from HIV." He added that he is "proud to stand with the president in confronting the global HIV crisis and look[s] forward to working with him to implement this legislation" (Brownback release, 5/16).
  
• Sen. Jon Corzine (D-N.J.): While the bill recognizes the potential use of microbicides as a "promising prevention tool, it does not go nearly far enough in supporting this area of research and development," Corzine said. Therefore, Congress should pass the separate Microbicides Development Act of 2003 (SB 859) to provide women with "HIV prevention tools that they can control to safeguard their health and that of their families and communities," Corzine said(Corzine release, 5/16).
  
• Rep. Henry Hyde (R-Ill.): Hyde said the legislation allows work to begin "in earnest to rescue millions of people suffering with HIV/AIDS," and he added that the bill "establishes a pattern of American leadership that other wealthy nations ... will follow." Hyde said that he expects the House to accept a Senate amendment to provide debt relief for poor nations and President Bush to sign the measure in "the next few weeks" (Hyde release, 5/16).
  
• Rep. Joe Pitts (R-Pa.): "The Senate's quick action [on this legislation] will get this money where it needs to go faster," Pitts said, adding that the Senate passed the measure "largely intact," including provisions "prioritizing abstinence and monogamy before other prevention strategies ... protecting faith-based groups and demanding accountability for the Global Fund." Pitts said that "Sen. Frist (R-Tenn.) and Sen. Daschle (D-S.D.) should be commended for making sure this bill did not get stuck in partisan politics" (Pitts release, 5/16).
  
• Sen. Rick Santorum (R-Pa.): The Senate's inclusion of a debt relief amendment, which says that a qualifying Heavily Indebted Poor Country should pay no more than 5% of its annual budget on debt service each year if that country is also suffering from a public health crisis such as HIV/AIDS, "represents a historic achievement in compassion and care for those nations struggling under debt burdens," Santorum, who sponsored the amendment with Senate Foreign Relations Committee Ranking Member Sen. Joseph Biden (D-Del.), said (Santorum release, 5/16).
  

Press Releases

• Africa Action: Although the bill represents a "forward movement to raise funding levels to near where they should be," it is a "backward movement on the question of how to fight this pandemic," Salih Booker, executive director of Africa Action, said. The organization advocates U.S. funding of at least $3.5 billion annually to the Global Fund and the immediate cancellation of Africa's external debt (Africa Action release, 5/16).
  
• AIDS Action: AIDS Action "looks forward to working ... to ensure that the initiative receives its due funding in the appropriations process and that its potential is fully realized" through proper implementation of the ABC model, continued support of effective local and faith-based organizations, significant commitment to the Global Fund and increased access to treatment for vulnerable populations, according to an AIDS Action release. "A fully integrated plan for comprehensive HIV and AIDS prevention, treatment and care has been a long time coming and although we are not there quite yet, it's clear that a change is going to come," Dr. Marsha Martin, executive director of AIDS Action, said (AIDS Action release, 5/16).
  
• AIDS Healthcare Foundation: Congressional passage of the AIDS bill is a "monumental achievement" that will enable millions to live "who would otherwise die," AHF President Michael Weinstein said. The wide margins with which the measure passed will "give the bill momentum" in the appropriations process, Cesar Portillo, AHF chief of public affairs, said, adding, "As a pioneer in antiretroviral treatment in Uganda, South Africa and Honduras, we look forward to treatment scale-up for children, mothers, fathers and all with HIV in need of medication" (AHF release, 5/16).
  
• Concerned Women for America: CWA "praised" the Senate for passing a bill that promotes "a new approach to fighting the AIDS epidemic" that is based on "abstinence and marital fidelity" and the "cultivation of character." CWA President Sandy Rios said, "Everyone who contributed to this result deserves the congratulations and the gratitude of the entire human race, for they have done something important for all of humanity" (CWA release, 5/16).
  
• Focus on the Family: Focus on the Family Vice President of Public Policy Tom Minnery commended the passage of the bill because it will focus on abstinence education, which is the "only successful approach" to combat the spread of HIV/AIDS, he added. "AIDS sufferers in Africa will no longer continue to be offered only condoms -- the same faulty approach that has increased sexually transmitted diseases in America," Minnery said (Focus on the Family release, 5/16).
  
• Global AIDS Alliance: While the bill promises an increase in AIDS program funding -- up to $3 billion -- for fiscal year 2004, the chances that Congress will appropriate "even close to the full amount authorized are quite remote," according to a GAA release. Bush on April 29 said that he was sticking to his original proposal of $2 billion for international AIDS funding, and while "House and Senate appropriators could improve on that," with the recently passed tax cuts, it will "likely have to cut other programs" to do so. In addition, the bill "asks European and other nations to assume such a large share of the burden [of contributing to the Global Fund] that it will prove to be unworkable," Paul Zeitz, GAA executive director, said (GAA release, 5/16).
  
• Global Health Council: Nils Daulaire, Global Health Council president and CEO, said that the bill's passage represents a "historic moment" as the measure turns "Washington's words into action on the front lines" of combating HIV/AIDS. The Global Health Council supports $3 billion in funding for the initiative in the coming year (Global Health Council release, 5/16).
  
• Physicians for Human Rights: PHR "welcomes" the Senate's passage of the bill but cautions that "ideologically motivated restrictions in the bill," including the designation of $130 million for abstinence education, "could subvert the president's goal" of preventing seven million HIV infections, according to a PHR release. "The president got the bill he sought. But his own budget is a billion dollars short of the authorization he supported. If this [bill] is to be something more than a public relations exercise on his part, President Bush must request budget authority for the full $3 billion for fiscal year 2004," Holly Burkhalter, U.S. policy director for PHR, said (PHR release, 5/16).
  
• Planned Parenthood Federation of America: Congressional Republicans "have shown once again that they are more interested in pandering to anti-family planning extremists than providing real solutions to a real crisis," PPFA Vice President for Public Policy Susanne Martinez said. The bill passed by both the House and Senate authorizes treatment for millions of HIV-positive women and children but "drastically falls short" in preventing HIV infection among women, Martinez said. "Congressional leaders have squandered the opportunity to pass legislation of lasting importance in the battle to end the AIDS pandemic and women will pay the price," Martinez said(PPFA release, 5/16).
  

Editorials

• Philadelphia Inquirer: The AIDS bill "won't mean a thing until Congress actually appropriates the money" to fund it, which makes the legislation "conditionally generous," an Inquirer editorial says, adding that it makes "little sense ... [that] ... Washington still wants the vast majority of the money to be distributed through a U.S. mechanism" instead of through the Global Fund. In addition, while an amendment earmarking one-third of prevention funds for abstinence programs "has a wonderful logic and morality to it," it fails to consider the fact that "women in these nations usually have no or little control over their menfolk's sexual activities," according to the editorial. The editorial concludes that Bush and Congress "need to follow through on their fine promises to tame a plague" (Philadelphia Inquirer, 5/19).
  
• Washington Post: While the passage of the bill "marks a historic commitment by U.S. policymakers to fight HIV and AIDS," the measure "contains restrictions that reflect U.S. domestic politics more than sound AIDS-fighting policies," including the allocation of one-third of the funding for abstinence programs, a Post editorial states. The editorial concludes that because the legislation authorizes but does not appropriate funds, the Bush administration and Congress must "make sure that the grand gesture this bill represents will not prove empty down the road," the editorial concludes (Washington Post, 5/17).
  

Opinion Pieces

• Michael Bennish, Philadelphia Inquirer: While it was "absolutely essential" that the AIDS bill be passed "without delay ... it is just as important that the legislation focus on strategies that work," Bennish, director of the Africa Center for Health and Population Studies and principal investigator for the Elizabeth Glaser Pediatric AIDS Foundation, writes in an Inquirer opinion piece. The prevention approach advocated in the bill is not "comprehensive" nor "flexible," and while "politically palatable," the measure will "leave a generation needlessly at risk in South Africa and other parts of the world," he concludes (Bennish, Philadelphia Inquirer, 5/16).
  
• Courtland Milloy, Washington Post: Instead of "launching some behavior-modification experiment in Africa," Congress should "find a way to deal with the AIDS disaster at home" among African Americans, Post columnist Milloy writes in an opinion piece. Efforts "through the usual lecturing, preaching, public service sound bites and bus stop posters" have failed to nationally change behavior, Milloy writes. He concludes that the United States is not "doing enough to empower our girls, to protect them from child abuse, prostitution and other forms of physical and spiritual violence," nor is the United States helping "gay, black men" stay HIV-negative (Milloy, Washington Post, 5/18).
  
• Richard Tren, San Francisco Chronicle: Although Africans are "pleased to see that the U.S. government is showing concern for the victims of AIDS on our continent ... no amount of money or free drugs ... will help [HIV-positive people in Africa] until our own governments commit to the fight against AIDS," Tren, director of Africa Fighting Malaria, writes in a Chronicle opinion piece. Tren says that African governments should end "widespread corruption" to ensure that drugs go to treat AIDS patients; change spending patterns to pay for more HIV/AIDS treatment; invest in health infrastructure and training to expand access to antiretroviral drug treatment; and take steps to "reduce the stigmatization of HIV-positive people" (Tren, San Francisco Chronicle, 5/18).