Kaisernetwork.org (Washington, DC)
4 April 2008
Politics and Policy
Sen. Coburn Says He Might Block PEPFAR Reauthorization Bills
[Apr 04, 2008]
Sen. Tom Coburn (R-Okla.) has said in a letter that is circulating among senators that he might block attempts to pass both House and Senate bills (HR 5501, S 2731) that would reauthorize the President's Emergency Plan for AIDS Relief, CQ Today reports. Coburn plans to send the letter, which asks for support from other senators, to Senate Minority Leader Mitch McConnell (R-Ky.).
Coburn in the letter wrote that the PEPFAR reauthorization bills "contain dramatic policy reversals coupled with irresponsible spending levels," adding that the "combination prevents our support for reauthorization of the program that, until now, has been a rare model of foreign aid success." Coburn added that he wants to preserve a requirement in the existing law that 55% of PEPFAR funding be spent on treatment for HIV/AIDS and prevention of mother-to-child transmission. He has introduced a bill (S 2749) that would maintain the requirement and expand HIV testing.
Sen. Jim DeMint (R-S.C.), who signed the letter, said he believes the PEPFAR reauthorization measures represent the "height of irresponsibility in the middle of a war and surging debts" because they "dramatically increas[e] the cost and scope of the program." Coburn's spokesperson John Hart emphasized that Coburn is committed to reauthorizing the program but "wants to ensure that they money is directed to people that need the assistance." Hart added that the new versions would "take the focus off of widows and orphans and put it on consultants and program officers."
An unnamed congressional aide added that the senators who are supporting Coburn's letter are more concerned about a lack of accountability and "mission creep" in the new versions than the spending levels. The aide said the letter's support is not driven by a "knee-jerk opposition to foreign aid" (Graham-Silverman, CQ Today, 4/3).
House, Senate Bills
The Senate version of the bill passed the Foreign Relations Committee last month and is awaiting floor consideration. The House version was approved 308 to 116 earlier this week (Kaiser Daily HIV/AIDS Report, 4/3). Both the Senate and House versions of the bill would reauthorize PEPFAR at $50 billion over five years. President Bush had called on Congress to reauthorize the program at $30 billion over five years.
Both bills would remove a requirement that at least one-third of HIV prevention funds that focus countries receive through PEPFAR be used for abstinence-until-marriage programs. They also would retain the requirement that PEPFAR recipients pledge opposition to commercial sex work. Both versions would require a report to Congress if abstinence and fidelity programs account for less than 50% of prevention spending in each PEPFAR focus country.
In addition, the Senate version includes a requirement that 10% of funds be allocated for services aimed at AIDS orphans and other vulnerable children. It also includes a provision that would lift some U.S. HIV/AIDS-related travel restrictions. Included in the $50 billion allocated by the Senate version are $4 billion for tuberculosis programs and $5 billion for malaria efforts worldwide. The House bill would allow groups to use PEPFAR funding for HIV testing and education in family planning clinics but not for contraception or abortion services. The Senate version does not mention family planning (Kaiser Daily HIV/AIDS Report, 3/14). The House version would add Lesotho, Malawi and Swaziland as PEPFAR focus countries; include clean water programs; encourage countries to work with historically black colleges to improve their health infrastructures; and expand inspector general authority. In addition, the bill would add 14 Caribbean countries to the program and include $9 billion for TB and malaria efforts. That amount also would underwrite food supplements for people living with HIV/AIDS. The bill would provide loans to women widowed by the disease or ostracized because of their HIV-positive status. Of the $41 billion specifically allocated for HIV/AIDS under the House measure, up to $2 billion would be included annually for the Global Fund To Fight AIDS, Tuberculosis and Malaria. The bill limits U.S. contributions to the Global Fund to one-third of total contributions (Kaiser Daily HIV/AIDS Report, 4/3).
Related Editorial
Bush's "leadership in fighting disease and poverty" in Africa "culminated" Wednesday when the House passed its version of the PEPFAR reauthorization bill, a Los Angeles Times editorial says. The House's approval "marks a dramatic shift in the United States' attitude toward foreign aid," the editorial says.
According to the Times, the U.S. has "supported big international disease-eradication in the past," but "never with such an enormous financial commitment." Although there are a "few flaws" in the bill, it "gives Americans a good reason to be deeply proud of their country, a feeling" many U.S. citizens have not "experienced in a while," the editorial concludes (Los Angeles Times, 4/4).
Link to this story.
Rep. Farr Requests That Policy Barring MSM From Donating Blood Be Re-Evaluated
[Apr 04, 2008]
Rep. Sam Farr (D-Calif.) on Wednesday requested that the fiscal year 2009 agriculture spending bill include language to require FDA to re-evaluate its policy preventing men who have sex with men from donating blood, Farr spokesperson Tom Mentzer said, CQ Today reports (Sternstein, CQ Today, 4/2). According to the FDA policy, which has been in effect since the early 1980s, MSM are barred from donating blood regardless of sexual activity, safer-sex practices or HIV status. Potential blood donors are asked to fill out a questionnaire before donating, and MSM, injection drug users, people who received a tattoo within the previous 12 months and pregnant women are prohibited from donating (Kaiser Daily HIV/AIDS Report, 2/28).
Farr on Wednesday during a House Appropriations Committee Subcommittee on Agriculture hearing said the policy is "discriminatory" and outdated. "The science doesn't seem to support" the policy, Farr said. He added that testing for donated blood has improved since the policy was implemented and that women who have sex with women or heterosexuals who have had sexually transmitted infections are not banned from donating.
Jesse Goodman, director of FDA's Center for Biologics Evaluation and Research, at the hearing said the policy is supported by science and that allowing MSM to donate blood would result in a "real risk" of increased HIV and hepatitis cases. Goodman added that the policy is a "safety issue" and is "not discriminatory." According to Goodman, several other groups are banned from donating blood. The blood donation policy is not a "perfect system, but it's built on risk rates in those groups," Goodman said (CQ Today, 4/2).
Link to this story.
Across The Nation
AIDS Project New Haven Launches Program To Educate Older Women About HIV
[Apr 04, 2008]
AIDS Project New Haven in Connecticut has launched an initiative aimed at educating postmenopausal women about HIV/AIDS in an effort to prevent the spread of the virus among older women, the New Haven Register reports. The Center for Interdisciplinary Studies on AIDS at Yale University is partnering with APNH on the initiative, called Wise Women Win.
Six women older than age 50 recently received training to participate in the program as mentors and educators to other women ages 50 and older, APNH program coordinator Nick Boshnack said. These women then recruit other women to join a group in which they provide education about HIV/AIDS and safer-sex practices and help spread the messages among seniors. Senior centers, residential developments and retail stores have participated in the program.
According to the Register, many older women have little knowledge about HIV/AIDS but engage in unprotected sex because they are not concerned about pregnancy. Although some people consider seniors to be at low risk of HIV, many are still sexually active and at risk of contracting the virus. "There are women who are sexually active after divorce or after they are widowed," Boshnack said, adding that older women are not familiar with HIV prevention because the virus "wasn't around" when they first began having sex.
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