Global AIDS Treatment Reauthorization
Cleared for President at $48 Billion
By Adam
Graham-Silverman
Congressional
Quarterly
July 24, 2008
The House cleared a
five-year, $48 billion bill to fight AIDS and other diseases overseas Thursday,
sending it to President Bush’s desk.
Bush is expected to
sign the legislation next week, but some advocates are already expressing
concerns that Congress won’t be able to provide the funding increase the bill
promises.
The House cleared the
bill (HR 5501) by agreeing, 303-115, to a motion to adopt the version the
Senate passed last week. The House vote marked the end of a seven-month
legislative journey that began when the late Tom Lantos , D-Calif. (1981-2008),
drafted legislation to reauthorize the 2003 global AIDS program (PL 108-25).
Bush had spearheaded the program, which earned bipartisan praise as a foreign
policy success.
The $48 billion
reauthorization would mark a significant increase over the 2003 law’s $15
billion. Some advocates, however, say the fiscal 2009 appropriations bills
working their way through both chambers suggest that Congress is not on track
to spend the full amount over the next five years.
Though Congress has
provided the program about $19 billion, including $6 billion in fiscal 2008,
the Senate’s fiscal 2009 State-Foreign Operations spending bill (S3288) would
provide $5.1 billion, while the House’s draft version would provide $5.5
billion.
“In terms of funding,
it appears there is more rhetoric than reality,” said David Bryden,
a spokesman for the Global AIDS Alliance.
Congress developed
its fiscal 2009 spending blueprint before the global AIDS bill had taken its
final shape, and with appropriations markups stalled in both chambers,
lawmakers may simply pass a continuing resolution to keep fiscal 2008 funding
levels. But Bryden and others say that each year the
Bush made note of
that in a speech Thursday.
“The challenge for
future presidents and future Congresses will be to continue this commitment, so
that we can lift the shadow of malaria and HIV/AIDS and other diseases once and
for all,” Bush said.
Berman’s Compromise
After Lantos’ death
in February, Howard L. Berman, D-Calif., took over as chairman of the Foreign
Affairs Committee and helped broker a bipartisan compromise on the bill that
headed off contentious debate on abortion and family planning issues. That
compromise, in which Republicans, including some fiscal conservatives and the
White House, signed on to a large funding boost, has largely held since.
The White House had
requested a $30 billion reauthorization.
“The fact that
compromise was achievable in this highly politicized era is a testament to the
bipartisan roots of this legislation,” Berman said.
The bill now bears
Lantos’ name, along with that of the House Foreign Affairs Committee chairman
who guided the 2003 law to enactment, Henry J. Hyde, R-Ill. (1975-2007), who
died late last year.
The House passed a
$50 billion bill on April 2. A group of Republicans led by Sen. Tom Coburn of
Oklahoma threatened to block the Senate version (S 2731) until late June, when
they added a requirement that more than half the program’s bilateral aid go
toward AIDS treatment and care.
Some conservatives
remained opposed to the bill’s cost, but after three days of floor debate and
consideration of 10 amendments, the Senate passed a $48 billion bill on July
16. It included an amendment that would channel $2 billion of the bill’s total
price tag to American Indian health care, law enforcement and drinking-water
programs, but the Senate turned back other challenges to its cost.
“The 2008
reauthorization seeks to consolidate and advance the success of the past five
years by providing the funding and the framework to transform this from an
emergency program to a sustainable program,” said Ileana Ros-Lehtinen of
Abortion Debate
Averted
The final bill makes
no mention of family planning or reproductive health programs. The bill would
overturn an existing law requiring that one-third of the money for HIV
prevention be spent on abstinence education. It would instead require a report
to Congress if abstinence and fidelity programs fall below half of prevention spending
in a given country.
The bill would
include new linkages between AIDS and nutrition programs and would set a target
of recruiting 140,000 new health care workers.
The measure would
also set aside $5 billion for malaria and $4 billion for tuberculosis and would
repeal a ban on HIV-positive visitors to the
It would authorize $2
billion in fiscal 2009 for the Global Fund to Fight AIDS, Tuberculosis and
Malaria. Congress provided $845 million for the fund in fiscal 2008.