Today the U.S. Senate passed a crucial bill, backed by President Bush, that reauthorizes the U.S. program on global HIV/AIDS while also authorizing much greater funding for programs to address tuberculosis and malaria.

"The bill is a tremendous achievement, and I commend Senators Biden and Lugar, who authored the bill, and Senator Reid whose fierce determination to bring the bill forward was indispensable," said Dr. Paul Zeitz, Executive Director of the Global AIDS Alliance.

"The amount per year, about $10 billion, is less than 1 percent of this year's federal budget, and thus is a small price to pay for a program that will save millions of lives and foster good will around the world," said Zeitz.

The bill, S. 2731, was approved by the Foreign Relations Committee in March and was endorsed by both Senators Obama and McCain, but it was then stalled by several Republican legislators. Today several hostile amendments were defeated, and the bill was approved 80 to 16. The House appears ready to approve the Senate version.

"Myths and disinformation were used by Senators Kyl, Bunning, DeMint and others to try to undermine this bill, but in the end the truth won out," noted Zeitz. "This bill will expand American leadership on global health and foster hope around the world. Once fully funded, it will not only help poor countries but serve America's interests as well."

The bill lays out a five-year strategy for confronting AIDS, TB and malaria, while authorizing, though not actually providing, a total funding level of $48 billion for global health programs. The bill also lays out a policy framework on such closely related issues as gender, care for orphaned children, nutrition, and health care worker shortages.

Senator Kyl and others said the bill would triple the authorized funding for the AIDS program, known as PEPFAR, which is not accurate. He also said a level of $30 billion over five years would already have been "a big change in the amount of money available." In fact, because the Congress is now providing $6 billion a year for these programs, a level of $30 billion would have kept funding at the current level for the next five years.

Flat-funding would have made impossible significant new funding to stop tuberculosis, which is a global threat, including to Americans. In fact, much of the increased funding in the bill is not for the AIDS program, but rather for TB and malaria, which together kill about 7,000 people each day.

Kyl also decried the bill's effort to address nutrition, the inheritance rights of women and orphaned children and women's lack of economic opportunities. However, these issues are central to an effective and realistic approach to HIV/AIDS.

"Stopping AIDS is more complicated that handing out medication and telling people to abstain," said Rev. Mpho Tutu, Chair of the Board of the Global AIDS Alliance. "With this bill, the U.S. is starting to address the complexity of these related diseases, and that will make U.S. efforts much more cost-effective and sustainable," said Tutu.

"We have a window of opportunity, now, to get this bill passed, and it would have been a mistake to wait until next year," said Zeitz. "However, Congress will need to do still more to ensure full success in the fight against HIV/AIDS."

There are several problem areas which Congress will have to address, including:

-- The bill requires a report from programs in countries with HIV prevalence over 1% if spending on abstinence and fidelity goes below 50%. That is a step forward from current law, but Congress will have to ensure this does not have a chilling effect on the range of sexual prevention programs likely to be offered, especially for young people.

-- At the urging of Senator Coburn, the bill states at least 2 million people should receive AIDS treatment, but that figure will be obsolete by 2009. The U.S. must ensure it provides treatment to at least 3 million people through U.S. bilateral programs.

-- The bill does not explicitly authorize bringing together HIV programs and family planning programs under one roof, even though from a practical standpoint this integration is crucial to protect women's health, including safe pregnancy.

Global AIDS Alliance
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