Senate Votes To Consider PEPFAR Reauthorization Legislation This Week

The Senate on Friday voted 65-3 to consider legislation (S 2731) that would reauthorize the President's Emergency Plan for AIDS Relief this week, the AP/Forbes reports. As the vote was taking place, the Bush administration issued a statement in support of the legislation that said PEPFAR is "creating strong partnerships and allies in countries where five years ago AIDS threatened to destroy entire generations" (Abrams, AP/Forbes, 7/11).

Senate Majority Leader Harry Reid (D-Nev.) last week filed a cloture motion that aimed to set up a vote on the bill on Friday. Supporters of the measure needed 60 votes to invoke cloture and move to the bill (Kaiser Daily HIV/AIDS Report, 7/10). However, supporters held negotiations into Thursday night with several Republican objectors, and did not reach a compromise for limiting debate time and deciding what amendments could be offered, according to the AP/Forbes (AP/Forbes, 7/11).

The Senate version of the PEPFAR reauthorization bill passed the Foreign Relations Committee in March, and the House version was approved in April. Both the Senate and House versions of the bill would reauthorize PEPFAR at $50 billion over five years. A Senate agreement reached last month with some of the bill's detractors would ensure that more than half of PEPFAR funding would go to treatment. The agreement also would require that antiretroviral drugs used in PEPFAR programs be approved by FDA or another approved regulatory agency. In addition, the agreement would prevent PEPFAR funding for wealthier developing nations, such as China and Russia. Some senators, including Jim DeMint (R-S.C.), have continued to express concern about the measure, including its price tag (Kaiser Daily HIV/AIDS Report, 7/10).

Reid on Friday said that 10 amendments offered by Republicans would be allowed during debate next week, including proposals to reduce the funding levels. He added that he is confident the legislation could be passed in the Senate to allow for negotiations with the House on a final compromise version. "Eight thousand people are dying every day on that continent (Africa) from AIDS," Reid said when calling on senators to support the bill. Sen. Richard Durbin (D-Ill.) said that many people worldwide have a negative view on the U.S., adding that PEPFAR is "part of the good news about the United States."

DeMint said that he is "very disappointed that Sen. Reid decided to ram this $50 billion in deficit spending for foreign aid through the Senate without a full and open debate." DeMint added that Reid "insisted on hand-picking and modifying amendments" (AP/Forbes, 7/11). DeMint will offer an amendment this week to reduce PEPFAR funding levels to $35 billion, which corresponds to a Congressional Budget Office ranking of how much could be spent in the legislation's five-year duration. However, supporters of the current legislation say that the smaller amount estimated by CBO is a reflection of a spending baseline of zero, rather than the $6 billion allocated by Congress in fiscal year 2006, according to CQ Today.

DeMint said that the $50 billion level could shift PEPFAR's focus away from HIV/AIDS to a wide range of development activities. "It's no longer an Africa bill," he said, adding, "It's no longer an HIV bill."

In addition, Sen. Jeff Sessions (R-Ala.) plans to offer an amendment that would strike a provision in the bill to loosen HIV/AIDS-related travel restrictions. Sens. Jon Kyl (R-Ariz.) and John Thune (R-S.D.) also plan to offer an amendment that would redirect money to improve American Indian drinking water and law enforcement. According to CQ Today, the amendment highlights the argument from some Republicans that Congress should focus on domestic issues and not foreign aid (Graham-Silverman, CQ Today, 7/11).

Global AIDS Alliance spokesperson David Bryden said that the group is pleased that the bill is moving forward, but he expressed disappointment that the bill wasn't passed before the Group of Eight industrialized nations summit in Japan last week. "It's sad and outrageous that we have to go to such lengths to maintain American leadership to fight these global health epidemics," he said (AP/Forbes, 7/11).