Republican Senators Advocate Legislation That Would Specify Treatment Goals for PEPFAR

A group of Republican senators at a press conference on Tuesday advocated for legislation that would set specific treatment goals for the President's Emergency Plan for AIDS Relief, CQ HealthBeat reports.

The lawmakers said the Save Lives First Act (S 2749) would do more to address mortality and illness rates among people living with HIV/AIDS than the current PEPFAR reauthorization bills (HR 5501, S 2731).

At the press conference, Sen. Tom Coburn (R-Okla.), the bill's sponsor, presented a comparison of the number of people in need of antiretroviral treatment over the next five years under his bill with the number under the current PEPFAR reauthorization bills. Coburn's data showed that the number of people who need antiretroviral therapy or who have a life expectancy of less than three years would level off under his legislation, according to CQ HealthBeat.

In April, Coburn said that he might block attempts to pass the House and Senate bills that would reauthorize PEPFAR. He said that the current bills have "irresponsible spending levels," adding that he wanted to expand HIV testing and preserve a requirement in the existing law that 55% of PEPFAR funding be spent on treatment and prevention of mother-to-child transmission. The reauthorization bills do not contain treatment formulas, CQ HealthBeat reports.

However, Coburn noted at the press conference on Tuesday that he supports funding levels in the reauthorization measures and that his current goal is to restore a treatment target. "Any HIV/AIDS bill that moves through the Congress must prioritize saving lives," Coburn said in a release.

Michael Weinstein -- president of the AIDS Healthcare Foundation, which sponsored the press conference -- said the current reauthorization legislation would nearly triple funding but only raise treatment levels by 50%, from two million to three million, CQ HealthBeat reports.

"Critics of our proposal say you cannot treat your way out of AIDS, but their proposal is to die your way out," Weinstein said (Cooley, CQ HealthBeat, 5/13).

Related Editorial
It is the "nature of the Senate that the smallest of minorities can impede the work of the majority," Washington Post columnist Michael Gerson writes in an opinion piece, adding, "But it takes a conscious choice -- an act of tremendous will and pride -- for members to employ these powers against" PEPFAR reauthorization legislation, which has "overwhelming bipartisan support."

The seven Republicans -- Sens. Jim Bunning (Ky.), Richard Burr (N.C.), Saxby Chambliss (Ga.), Tom Coburn (Okla.), Jim DeMint (S.C.), Jeff Sessions (Ala.) and David Vitter (La.) -- who have signed a letter to delay action on PEPFAR reauthorization legislation "complain that the reauthorization is too costly," Gerson writes. He adds that for all of conservatism's "evident virtues, it can have one furtive, seedy vice: A justified suspicion of government can degenerate into an anti-government ideology -- rigid, stingy and indifferent to human suffering."

Concerns from some conservatives about "family planning and abstinence in the PEPFAR reauthorization are not imaginary, but they could be resolved through good-faith negotiations," Gerson writes, adding, "A generalized hostility toward AIDS prevention, however, is destructive." In addition, the 55% funding target for treatment "would force the program to waste money in pursuit of an arbitrary, nonsensical spending target," according to Gerson.

In addition, Sen. Majority Leader Harry Reid (D-Nev.) "supports the legislation but seems uninterested in scheduling floor time without assurances from Republicans that the debate will be short and the number of amendments limited," Gerson writes. He adds that if the legislation passes, President Bush "will get much of the credit." According to Gerson, the "political calculation must be tempting: Why not allow seven white Republicans to discredit their party by blocking a lifesaving bill for Africa?"

Gerson writes that each of the seven senators "counts himself pro-life," adding, "If a bill came to the Senate floor that would save millions of unborn children, one assumes that pro-life members would push to improve it." He concludes, "It is difficult to imagine why pro-life legislation involving millions of Africans should be viewed differently" (Gerson, Washington Post, 5/14).