Washington, D.C. — Representative Tom Lantos (Democrat – California) has called on the United States Congress to support President George W. Bush's efforts to renew the President's Emergency Plan for Aids Relief (Pepfar) for another five years and to double its funding.
Lantos also said that some of the ideological aspects of the program – such as abstinence-only education – should be re-examined in order to ensure the program is as effective as possible.
He was speaking at a July 16 briefing of the bi-monthly journal Health Affairs, in which panelists discussed health aid programs in low-and middle-income countries.
Lantos, who chairs the House Foreign Affairs Committee, is the co-author of the 2003 legislation that established Pepfar, a five-year, $15 billion aid package designed to combat HIV/Aids globally through prevention, care and treatment programs.
The program is due to expire in September 2008, but Bush announced on May 30 that he would seek to increase Pepfar's funding from $15 billion to $30 billion, and extend its mandate.
"I commit to you today…I will do my utmost to guarantee that Congress will reauthorize this crucial program at twice its present level," Lantos said. "There is a great deal for us Americans to be proud of."
Lantos said that the second version of Pepfar will need to include funds to ensure that countries maintain the momentum already generated by the program; instead of being entirely an emergency response effort, Pepar will need to shift to sustainable support.
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To date, Pepfar has supported antiretroviral treatment for over 1.1 million people, and counseling and testing for nearly 19 million, according to the program's fact sheet. In addition, it has supported training of health care workers and establishment of voluntary counseling and testing service sites.
"These numbers represent solid progress towards the program's [goals], but there is still a long way to go," Lantos said. One critical issue to resolve is a long-standing and heated debate about abstinence-only education and behavior and norms.
According to Lantos, when the first legislation was written, some members of Congress insisted that one third of Pepfar's funding for prevention initiatives be allocated to abstinence-only education. In order to get bipartisan support for the program, this requirement was entrenched in the law, despite his "strong reservations."
Lantos said that these "ideological barriers" – funding allocations and the emphasis on abstinence-only education – need to be addressed. "Education on condoms and proper protection get precious little funding," he said. "It seems that the famed ABC prevention mantra – abstinence, be faithful, use condoms – is distorted toward the beginning of the alphabet. Clearly we need to, and we shall, revisit this 33 percent provision as the law comes up for reauthorization."
Lantos said the issues of gender inequality, and the disproportionate burden of HIV/Aids on women, would also feature in coming debate: "The Aids epidemic has exposed the extreme vulnerability of women and girls to HIV infection because of cultural traditions, poverty and economic inequality," he said.
