On March 20, the House Energy and Commerce Committee held a hearing to discuss ways to combat HIV/AIDS, tuberculosis (TB), and malaria. The hearing focused primarily on the President’s “Emergency Plan for AIDS Relief in Africa,” which was outlined during his State of the Union Address (see The Source, 1/31/03). Under the initiative, Congress would provide $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.”
Claude Allen of the Department of Health and Human Services (HHS) explained that HHS has three operating divisions that are actively involved in fighting the global HIV/AIDS, TB, and malaria pandemics —the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA). He noted that the United States has “been the world’s leader in research and practical assistance to battle HIV/AIDS, and NIH’s budget confirms that commitment.” He added, “in FY2003, NIH will devote over $2.7 billion for HIV/AIDS research, with over $250 million to be spent on HIV/AIDS research and training efforts abroad.”
Mr. Allen also detailed the CDC’s role in the President’s initiative, saying the “CDC works directly with 25 countries in Africa, Asia, Latin America, and the Caribbean to prevent new infections, provide care and treatment to those already infected and develop the capacity and infrastructure needed to support these programs.” Additionally, Mr. Allen pointed out that the first stage of the President’s Mother-to-Child HIV Transmission (MTCT) Initiative has already begun in 14 countries and is jointly administered by HHS and the U.S. Agency for International Development (USAID). According to Mr. Allen, the initiative “will reduce MTCT by 40 percent among the women treated.”
Sophia Mukasa-Monico of the Global Health Council explained that Uganda is one of the target countries in the President’s MTCT Initiative. Noting that the program has “been a model in terms of providing care for pregnant women,” she added that one key aspect of the program is the “inclusion of voluntary counseling and testing.” Ms. Mukasa-Monico said that the collaboration between family planning and maternal health clinics is “critically important and will assure that those most in need continue to have access to services.”
Speaking on behalf of the Institute for Youth Development, Shepherd Smith said that while HIV/AIDS is an issue “that now impacts nearly all countries and has economic implications, it is primarily a health issue which needs incredible coordination” between the Department of State, HHS, and USAID. He added, “Substantial and expanded U.S. resources can probably be better utilized by a U.S. effort than through the Global Fund to Fight AIDS, Tuberculosis, and Malaria.” Mr. Smith stated that “when we’re talking about mobilizing such a large effort in such a short period of time, the United States alone is positioned to do this much better than any international entity with all its different perspectives and participants that come into play.”
Disagreeing with Mr. Smith, Donna Barry of Partners in Health said that more funding should be allocated to the global fund because “there are 300 million infections from malaria each year, 3.7 million persons newly infected with tuberculosis…and 42 million persons living with HIV,” and the global fund has implemented pilot projects that can “prevent and treat HIV and TB” in over 90 countries. She stated, “What is now needed is to take the projects to scale in these countries and the global fund is the only agency in the world with the resources and capability to fund and direct such expansion.”
