*EPF509 04/04/2003
HIV/AIDS Legislation Advances in U.S. House of Representatives
(Commits $15,000 million to fighting infectious diseases worldwide) (730)

By Charlene Porter
Washington File Staff Writer

Washington -- The House International Relations Committee April 2 approved a $15,000 million bill known as the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, acting on what Chairman Henry Hyde called "one of the great moral challenges of our era." The legislation now goes to the full House of Representatives, where it is still likely to generate significant debate and encounter further amendment.

The bill follows on the call made by President Bush in his State of the Union address for a $15,000 million, five-year commitment to fighting disease around the world. The legislation authorizes programs targeted for treatment, prevention and care of people living with HIV/AIDS. Hyde described it as "a bill that, for the first time, authorizes treatment for more than 2 million people; a bill that takes the necessary step of creating a single coordinator to ensure cohesion and unity of effort among the various agencies of the United States government that can contribute to our overall AIDS effort."

The $15,000 million price tag on the bill "is an enormous sum by any measure," said Representative Tom Lantos, a Democrat from California who is a co-sponsor of the bill along with the Republican Hyde. "It is five times -- I repeat, five times -- the amount we considered authorizing for this cause just last year," Lantos said.

The bipartisan sponsorship of the bill and the substantial increase in funding reflect the growing recognition of the HIV/AIDS pandemic as not only a public health and humanitarian concern, but also as a threat to U.S. and international security. That view was first put forth by a Clinton administration analysis released in 2000, and has become one of Hyde's chief arguments in sponsorship of the bill.

In seeking support for the measure before the International Relations Committee, Hyde explained that the human devastation of the disease threatens to destabilize some hard-hit nations, pushing fragile governments and economies to near collapse. The armed forces of key African countries, including Nigeria, South Africa and Kenya, have experienced HIV/AIDS infection rates of between 30 and 40 percent, Hyde told the committee. "HIV/AIDS is a national security issue for those countries hit by the pandemic, and for us."

One of the key differences between the legislation approved by Hyde's committee and the president's proposal is the amount of the U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. The president designated about $200 million a year over the next five years while the Hyde-Lantos bill now headed for the full House would direct $1,000 million to the Global Fund in 2004 alone.

That provision could become the subject of further controversy as the debate unfolds before the full House and in the Senate. The Global Fund has been in existence just over a single year, and some lawmakers have raised questions about its efficiency and accountability. Health and Human Services Secretary Tommy Thompson began a term as chairman of the global fund in January, and is likely to exert considerable influence over the direction of the institution.

Some conservative lawmakers have tried to insert amendments in the bill that would shape the direction of international disease prevention programs receiving U.S. grants and support. While U.S. funding currently supports international programs participating in condom distribution as a means of preventing disease transmission, conservatives offered amendments that would have promoted prevention programs that place a greater emphasis on sexual abstinence and monogamy than prophylactics. The committee adopted an approach that puts abstinence, monogamy and condoms on equal footing as disease prevention strategies meriting U.S. support, but the point could cause further debate later on.

Lantos said the legislation represents more than 20 years worth of lessons about the HIV/AIDS pandemic. It emphasizes that treatment and prevention are both critical to stopping the virus, he said. It recognizes that strong international cooperation is necessary to address the epidemic, and it commits the United States and the "private and nongovernmental sectors" to sustained attention and leadership.

"Should this legislation become law, the United States will not simply be continuing its episodic engagement, but it will be committing to a long-term campaign to defeat the disease," Lantos said.

(The Washington File is a product of the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

Return to Public File Main Page

Return to Public Table of Contents