House Appropriations Subcommittee Approves $1.3B in AIDS Funding for FY 2004; Senate Passes Resolution Calling for $3B

The House Appropriations subcommittee on foreign operations yesterday approved $17.1 billion in fiscal year 2004 foreign assistance, including almost $1.3 billion in funding to combat HIV/AIDS overseas, a 40% increase over the amount approved for this year, the Washington Post reports. In a separate action, the Senate approved 78-18 a nonbinding "sense of Congress" resolution calling for $3 billion in 2004 to fight AIDS overseas, even if the amount exceeded the ceiling mandated in Congress's annual budget resolution (Morgan, Washington Post, 7/11). The House subcommittee approved $1.27 billion to fight AIDS internationally, which is $86 million more than Bush requested. In addition, the full House yesterday approved a bill (HB 6470) to provide funding for labor, education and health programs, including $644 million for foreign AIDS research and prevention and $155 million for combating other infectious diseases, such as tuberculosis. As a result, total funding for global AIDS is now a little more than $2 billion for FY 2004 (Allen, Reuters/Newark Star Ledger, 7/11).

Global AIDS Initiative
The money will go to fund the five-year, $15 billion AIDS initiative (HR 1298), which Bush signed into law in May. The initiative seeks to prevent seven million new HIV infections, provide care for 10 million people living with the disease and provide treatment to two million HIV-positive people (Kaiser Daily HIV/AIDS Report, 7/9). The subcommittee "substantially restructured" the AIDS plan, reducing funds controlled by a newly appointed AIDS coordinator and increasing the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Washington Post, 7/11). The U.S.-based arm of the initiative still needs to be staffed and criteria for distributing money and oversight criteria must be developed. In addition, the Senate must approve Randall Tobias, former CEO of Eli Lilly, who Bush nominated to head the initiative. By shifting money to the already established Global Fund, the subcommittee is trying to "jump-start" the initiative, according to the Wall Street Journal (Cummings, Wall Street Journal, 7/11).

Funding Levels
The $2 billion represents two-thirds of the $3 billion authorized in HR 1298 but fulfills Bush's budget request of $2 billion. Subcommittee Chair Rep. Jim Kolbe (R-Ariz.) said that spending the full $3 billion was "unrealistic" in the initiative's first year since the program is "just getting off the ground," according to the Associated Press (Abrams, Associated Press, 7/10). White House Press Secretary Ari Fleischer confirmed Bush's commitment to the $15 billion program, saying, "The authorization is a full $15 billion over five years. There is a ramp up in the first year. So (while) the funding will hit the $3 billion level, it may not hit it in the first year for the appropriations." Rep. Mark Kirk (R-Ill.) said that because the Senate has yet to confirm Tobias, the global AIDS program's procedures for grant application, approval and oversight are not yet in place and appropriating the full $3 billion to the program could lead to "spending money so quickly that one of our contractors embarrasses the program," turning the public against the initiative, the San Francisco Chronicle (Epstein, San Francisco Chronicle, 7/11). Rep. Nita Lowey (D-N.Y.) next week at a meeting of the full appropriations committee plans to offer a $1 billion "emergency appropriation" amendment, which is not covered in congressional budget spending limits (Washington Post, 7/11). Final funding levels depend on the full appropriations committee meeting and on negotiations between the House and Senate (Beattie, Financial Times, 7/11). The full House is expected to vote on the foreign aid appropriations bill by the end of this month (Anderson/Chen, Los Angeles Times, 7/11).

Reaction
Democrats and AIDS advocates said that U.S. credibility would be damaged if Congress failed to appropriate the full $3 billion for the first year of the AIDS initiative, according to the Associated Press (Associated Press, 7/10). Dozens of House members have signed a letter to Bush, written by Rep. Barbara Lee (D-Calif.), urging him to lobby for the full $3 billion (San Francisco Chronicle, 7/11). Sen. Jeff Bingaman (D-N.M.) yesterday sponsored the Senate resolution calling for the full $3 billion to be appropriated, but Senate appropriators have not yet written their spending bills and are not expected to include a full $3 billion, according to the Chicago Tribune (Zuckman, Chicago Tribune, 7/11). Secretary of State Colin Powell said that he "would have preferred full funding" for the AIDS initiative but that the State Department would "make the best use of the money" Congress provides (Wall Street Journal, 7/11). "A plane doesn't take off at 500 miles and it doesn't take off at 30,000 feet," Kolbe said, adding, "It takes off slower and it climbs. And we do the same thing with programs, which is how you ramp them up" (Stevenson, New York Times, 7/11). Kolbe added that Bush has "compound[ed] the problem by continuing to talk about $3 billion while he's in Africa" (Washington Post, 7/11). "When you have a fire, you don't ramp up a response," Tom Hart of DATA, an AIDS advocacy group founded by Irish rock star Bono, said, adding, "With $3 billion a year, instead of $2 billion, we could prevent 1.5 million [people] a year from getting AIDS" (San Francisco Chronicle, 7/11).