Wednesday evening, the U.S. Senate voted to reauthorize the President's Emergency Plan for AIDS Relief (PEPFAR) with an overwhelming 80-16 majority. Africa Action commends the tireless work of the global health activists and leaders in the Senate who overcame a series of last-minute objections to get the bill passed, but notes that more still needs to be done to address the AIDS crisis in Africa.

"This bill is a tremendous improvement over the previous U.S. global HIV/AIDS initiative," said Michael Swigert, Africa Action's Associate Director for Policy and Communications. "It authorizes a more sustainable and holistic approach to the crisis by expanding efforts to train health care workers and address malaria and tuberculosis, the biggest infectious killer of people living with HIV. It increases the program's emphasis on women, who bear the brunt of the AIDS burden in Africa. It also repeals the disgraceful law that restricts the entrance of people living with HIV to the United States. More work is needed, however, to improve U.S. global HIV prevention policies. This legislation fails to integrate family planning with HIV programs, which public health experts agree is most effective. The bill also reduces, but does not fully remove, ideologically driven restrictions on comprehensive, evidence-driven prevention programs."

While the most recent UNAIDS statistics indicated that worldwide, HIV prevalence appears to be leveling off, sub-Saharan Africa remains the pandemic's epicenter. There were 1.7 million new infections in the region in 2007. AIDS is still the single greatest cause of death in Africa, where more than two-thirds of all people living with HIV live and over three-quarters of global AIDS-related deaths took place in 2007. This is due both to a lack of accessible treatment and to the weak overall health care infrastructure of African countries. Statements by leaders of the richest countries at the G8 Summit earlier this month are a far cry from the bold and decisive response needed to stop this global pandemic. Leaders said only that they will "work toward" increasing health workforce capacities in African countries to meet World Health Organization minimum standards.

"We can all celebrate a hard won victory with the passage of this bill; our determined advocacy paid off," said Briggs Bomba, Africa Action's Associate Director for Campaigns. "However, we cannot lose sight of the broader global context of the HIV/AIDS crisis in Africa. The growth of African health care systems continues to be held back by the chains of an illegitimate external debt burden and harmful economic conditions attached to development loans. Complete cancellation of the external debts owed by African countries is vital to long-term progress in the fight against HIV/AIDS. To maximize the impact of this reauthorized and improved program, the U.S. Senate should follow this bill by passing the Jubilee Act for Responsible Lending and Expanded Debt Cancellation (S2166)."

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