Senate Passes Global HIV/AIDS Measure

On May 15, the Senate approved, by voice vote, a House-passed bill (H.R. 1298) that would provide assistance for international HIV/AIDS, tuberculosis (TB), and malaria programs. The House approved the bill on May 1 (see The Source, 5/2/03).

During debate, Sen. John Kerry (D-MA) said that “Congress should send to the President legislation that substantially increases funding for our global AIDS programs, and indeed this bill will do that.” He added, “we need to leave no doubt in the world’s mind that we are going to be at the forefront of that fight in the years to come.”

Sen. Bill Frist (R-TN) also stated that H.R. 1298 “is not going to cure the virus. We have no cure. We have no vaccine.” However, he noted, “we can reverse that trend…this is the first major step.”

The Senate approved, by voice vote, an amendment offered by Sen. Joseph Biden (D-DE) that would allow for debt relief for those countries most affected by HIV/AIDS. The House is expected to approve the amendment next week.

Republicans defeated a number of Democratic amendments, arguing that the bill needed to be passed expeditiously. Sen. Richard Durbin (D-IL) offered an amendment that would have provided a minimum of $500 million a year to the Global Fund. The amendment was rejected, 48-52.

Sen. Dianne Feinstein (D-CA) offered an amendment that would have eliminated the House provision that one-third of all funds be set aside for abstinence programs. The amendment failed, 45-52.

The Senate also rejected, by voice vote, an amendment offered by Sen. Hillary Rodham Clinton (D-NY) aimed at improving women’s health and empowerment and reducing women’s vulnerability to HIV/AIDS.

H.R. 1298 would provide $3 billion 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. The measure 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.

H.R. 1298 also would include a provision 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.