On May 1, the House approved, 375-41, a bill (H.R. 1298) that would provide assistance for international HIV/AIDS, tuberculosis (TB), and malaria programs. The House International Relations Committee approved the bill last month (see The Source, 4/4/03).
Sponsored by Rep. Henry Hyde (R-IL), H.R. 1298 would authorize the request outlined in the President’s State of the Union Address for $15 billion over the next five years to “prevent 7 million new AIDS infections, treat at least 2 million people with life-extending drugs and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS” (see The Source, 1/31/03).
During debate, Rep. Hyde stressed that “today we have an opportunity, the opportunity to do something significant and of lasting importance.” He added, “This bill is a compromise, a delicately arrived at, painstakingly negotiated compromise between various factions interested in this legislation; but it hangs together, and it works and it will advance the cause that we so desperately need to support.”
Rep. Carolyn Maloney (D-NY) agreed, saying, “In Africa, the need and the will to combat the spread of AIDS is there. What is missing is the resources. That is what this bill brings in. No country should struggle to rise out of poverty while fighting a disease that can cut life expectancy by as much as 30 years.”
Rep. Joe Pitts (R-PA) offered an amendment that would require that one-third of all funds be set aside for abstinence programs. The amendment was approved, 220-197.
Speaking in favor of the Pitts amendment, Rep. Marilyn Musgrave (R-TN) said that “we look at women and the children and the men that are dying such horrible deaths, and it is hard to take it all in. But what we look for in Africa is a ray of hope, a ray of hope for these people; and we see this ray of hope in Uganda. And we see a ray of hope with abstinence education.”
Rep. Barbara Lee (D-CA) disagreed, saying “this pandemic is killing so many people…that we have to marshal each and every effective way to stop it.” She added, “we should not in any way constrain this bill to a 33 percent set-aside that places for the most part abstinence as a priority.”
The House approved a number of amendments by voice vote, including:
- An amendment by Rep. Billy Tauzin (R-LA) that would make those countries that most need assistance a priority;
- An amendment by Rep. Joseph Crowley (D-NY) that would require HIV/AIDS education programs to include a curriculum targeted to men and boys emphasizing gender equality and respect for women and girls;
- An amendment by Rep. Judy Biggert (R-IL) expressing the sense of Congress that the President should conduct an outreach campaign to inform the public about the Global Fund and to encourage private contributions to the Global Fund by establishing and operating an Internet website and making public service announcements;
- An amendment by Rep. Tom Lantos (D-CA) that would call for a pilot program of assistance for children and families affected by HIV/AIDS that ensures the inheritance rights of women, particularly women in African countries;
- An amendment by Rep. Betty McCollum (D-MN) that would ensure that orphans and vulnerable children affected by HIV/AIDS “receive not less than 10 percent of the amounts appropriated for HIV/AIDS assistance for FY2006 through FY2008, of which not less than 50 percent of the funding shall be channeled through non-profit, non-governmental organizations, including faith-based organizations, that implement programs at the community level;”
- An amendment by Rep. Sheila Jackson Lee (D-TX) expressing the sense of Congress that U.S. agencies should encourage U.S. businesses and private groups to provide assistance to sub-Saharan African countries to reduce the incidence of HIV/AIDS; and
- An amendment by Rep. Christopher Smith (R-NJ) that would allow faith-based organizations that oppose condom distribution to still receive federal funds even if they opted out of such programs.
Under the bill, $3 billion would be provided in each of FY2004 through FY2008 for HIV/AIDS, TB, and malaria programs. Of this amount, up to $1 billion could be used for the Global Fund to Combat AIDS, Tuberculosis, and Malaria in FY2004.
H.R. 1298 also would require the Department of State to establish a Coordinator of U.S. Government Activities to Combat HIV/AIDS Globally. The coordinator would be appointed by the President and would be responsible for oversight and coordination of all U.S. efforts to combat HIV/AIDS internationally.
Additionally, under the bill, prevention, treatment, and educational activities would include:
- Programs that teach ways to avoid contracting HIV/AIDS, including “delaying sexual debut, abstinence, fidelity and monogamy, reduction of casual sexual partnering, and where appropriate, use of condoms;”
- Confidential voluntary testing and counseling;
- Programs aimed at preventing and reducing mother-to-child transmission through medications and access to infant formula and other alternatives for infant feeding;
- Programs to strengthen indigenous health care delivery systems, including clinical training for indigenous organizations and health care providers;
- Assistance to strengthen and expand hospice and palliative care programs for patients with HIV/AIDS, their families, and their primary caregivers;
- Pharmaceutical assistance for individuals infected with HIV/AIDS, including “antiretrovirals and other pharmaceuticals and therapies for the treatment of opportunistic infections, nutritional support, and other treatment modalities;”
- Education of populations that are at high risk of contracting or spreading HIV/AIDS, including “those exploited through the sex trade, victims of rape and sexual assault, individuals already infected with HIV/AIDS, and in cases of occupational exposure of health care workers;” and
- Purchasing test kits, condoms and, when proven effective, microbicides.
