Washington, DC — By a 37-8 vote, Wednesday, the House International Relations Committee approved a five-year US$15 billion legislative proposal to prevent and treat HIV/Aids in Africa and the Caribbean.
The legislation - introduced by a bipartisan coalition of House members, including Committee chairman Henry Hyde (R-IL) and the committee's top Democrat, Tom Lantos (D-CA) - authorizes US$3bn a year for five years to combat Aids, malaria and tuberculosis.
The figure is roughly twice as much as President Bush has proposed for the Aids plan. In his budget, President Bush proposed a little over $500m in new money for 2004 and proposed drawing an additional $800m from other programmes.
Wednesday's Committee proposal also authorizes up to US$1bn in 2004 for the UN Global Aids Fund based in Switzerland although Bush had earlier proposed $200m in FY2004.
The legislation was drafted in response to the January State of the Union appeal by President George W. Bush for US$15bn, including US$10bn in new money, for the Aids fight. "Seldom has history offered a greater opportunity to do so much for so many," the president said then of the disease which has taken 28 million lives in Africa so far. HIV/Aids has imposed "a death sentence" on the continent, Bush said.
But despite bipartisan agreement that special effort and money is needed to begin to effectively combat the disease, the legislation has been held up by sharp disagreements over specific components. Two in particular stalled the effort:
Conservatives in the House Pro-Life Caucus wanted a stronger emphasis on abstinence and a reduced emphasis on condoms. Uganda's "ABC" approach - abstinence, being faithful and condoms - is the model the U.S. initiative should follow, they argued, although Uganda's aggressive campaign for condom use is widely regarded as a key factor in its success in slowing the progress of the disease.
Conservatives also objected to allocating money to the UN's Global Fund. The fund is not accountable to U.S. taxpayers , they asserted. This issue came into sharp relief during the final hours of the 2004 budget debate last month, when Senator John Kerry (D-MA) offered an amendment to allocate US$750m for the Fund.
A February 11 State Department memo recommending that the new Aids money be allowed to go to abortion providers as long as their Aids work was kept strictly separate from their abortion work, also alarmed the Caucus. This, they charged, violated the "Mexico City" policy - first declared by President Reagan at a 1984 UN conference there - which bars U.S. taxpayer money from going to groups that fund or promote abortion overseas.
As passed by the Committee, the legislation has no specific abstinence-only provisions. It authorizes money for what Hyde calls "responsive, coordinated and effective" initiatives that include provision of anti-retroviral therapy for people living with HIV and supports research and development for vaccines against HIV/Aids and malaria.
It just "endorses" wider application of the "ABC" approach, said one congressional aide. And, in a crucial compromise, while up to US$1bn is available for the Global Aids Fund, the U.S. contribution cannot be more than 33 percent of the total contribution of all nations, including the United States, to the Global Fund.
"This is something everyone ought to unite around," stated Dr. Paul Zeitz, Executive Director of the Global Aids Alliance. The organization has previously been critical of the Bush administration's Aids policy. "The bill approved today takes the Aids crisis seriously, and it shows that a broad range of members of Congress favor a pragmatic approach. Now it's up to Congress to see this money is actually provided so effective programs can do their work."
The bill could go before the full House of Representatives next week. Because it recommends a much higher level of Aids spending than President Bush proposed in his budget, it could still encounter difficulty getting passed into law.
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Similar legislation may come before the Senate Foreign Relations Committee that is led by Senator Richard Lugar (R-IN), next week. When that legislation comes out of the Senate committee, both legislative branches will try and produce a bill that the President will sign. There has been pressure from the White House and Senator Majority Leader William Frist (R-TN) to scale back the Senate measure. What the White House will support now is unclear.
The administration will work closely with lawmakers to pass a bill "that is consistent with what the president proposed," said a White House spokesman, Wednesday.
"We hope this [House] bill serves as inspiration to Senator Lugar and others. It's time to bring US policy in line with the sheer scale of this crisis," says Zeitz.
