WASHINGTON – A House committee on Wednesday voted to more than triple spending for a global AIDS program that has proven to be one of the Bush administration's most successful and popular foreign policy initiatives.
The Foreign Affairs Committee's voice vote on the plan to approve spending of an average $10 billion annually over the next five years came hours after lawmakers and the White House reached a compromise on some of the policy issues, including spending on abstinence programs, that had held up action on the legislation.
The bill extends the President's Emergency Plan for AIDS Relief, which authorized spending of $15 billion total for five years for prevention and care programs in sub-Saharan Africa and other regions hit by the epidemic. That act, passed in 2003, expires in September.
Every day another 6,000 people are infected by HIV, said committee chairman Howard Berman, D-Calif. "We have a moral imperative to act decisively."
While the program has wide bipartisan support, the White House and many Republicans objected to the original Democratic-crafted draft because it removed a provision requiring that a certain amount be spent on abstinence programs and bolstered links between AIDS treatment and family planning. Some Republicans said that would open the way for family planning groups to spend money on abortions.
The compromise worked out in late-night negotiations Tuesday does eliminate the clause requiring that one-third of all HIV prevention funds be spent on abstinence, instead directing the administration to promote "balanced funding for prevention activities" in target countries. The administration must issue a report if programs focusing on abstinence and fidelity do not receive half of funds devoted to the prevention of sexual transmission of HIV, a smaller pot.
The agreement also allows the use of AIDS funds for HIV/AIDS testing and counseling services in those family planning programs supported by the U.S. government. Earlier drafts permitted use of funds for family planning programs including contraceptive services and commodities such as birth control pills. The final bill gives no authority beyond current law to fund family planning programs with AIDS money, although Democrats pointed out that it also does not prohibit such activities.
Rep. Ileana Ros-Lehtinen, R-Fla., top Republican on the committee, said the compromise maintained core values important to both sides. "Many of us in this room concluded that a collapse of the political consensus on this issue would do irreparable damage to what is arguably the most successful U.S. foreign assistance program of the last half century."
President Bush was hailed during his recent trip to Africa for a program that has resulted in 1.4 million people receiving drugs to fight the virus and has cared for nearly 6.7 million, including 2.7 million orphans.
The bill was named after two former chairmen of the committee, Reps. Henry Hyde, R-Ill., and Tom Lantos, D-Calif., Hyde, who died last November, and Lantos, who died earlier this month, sponsored the 2003 bill. Lantos was the sponsor of the new bill.
"This historic agreement will save millions of lives," said Dr. Paul Zeitz, executive director of the Global AIDS Alliance. He welcomed the increase in funds for tuberculosis and malaria while expressing concerns that the compromise retains limitations on AIDS funding for family planning.
The White House on Wednesday also repeated that the president's proposal to double spending to $30 billion, rather than the $50 billion in the House bill, was more appropriate. "We believe ... that $30 billion is the right amount of money that could be effectively used by these governments to tackle the HIV-AIDS problem," White House Press Secretary Dana Perino said. "We don't think it's smart to send additional American taxpayer dollars that will sit there and not be used, or be used ineffectively."
But Josh Ruxin, assistant clinical professor at Columbia University and a resident of Rwanda where he heads the Access Project, said that while the first five years of the program have been "extraordinary... simply continuing to implement the same policies and practices over the next five years will be inadequate to address this tidal wave" that is engulfing Africa.
He noted that investing more in such areas as running water and electricity for health centers and training medical personnel increases the capacity of programs to spend more to combat the disease.
The new bill adds 14 Caribbean countries to the 15 mostly African nations that have been the focus of the program. It also retains a provision in the 2003 act that requires organizations receiving funds to oppose prostitution and sex trafficking.