WASHINGTON, Feb. 26 On Wednesday, February 27, 2008 the House Foreign Affairs Committee will convene for the first time since the death of Chairman Tom Lantos to take up what Lantos himself referred to as the most important piece of legislation before the committee this year -- reauthorization of the US Global AIDS Act of 2003 (otherwise known as the President's Emergency Plan for AIDS Relief or PEPFAR).
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The draft bill -- originally authored by Lantos -- would provide a minimum of $50 billion over 5 years for global AIDS, Tuberculosis and Malaria programs and would support building the long-term capacity of health care systems in Africa. The Chairman's bill reflects recommendations on best practices from the World Health Organization (WHO), the Institutes of Medicine (IOM), the Government Accountability Office (GAO), and the Office of the Global AIDS Coordinator (OGAC), as well as input from countless individual health experts and program implementers.
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The bill also lifts restrictions on prevention programs placed in the original PEPFAR legislation that have been proven by numerous studies to be undermining efforts to slow the spread of new HIV infections. Among other changes, the new bill strikes an earmark requiring that 33 percent of all funding for prevention activities be spent on abstinence-until-marriage programs and eliminates a requirement that organizations sign a "pledge" opposing prostitution.
"These changes are critical to preventing the greatest number of new infections possible," said Dr. Joia Mukherjee, a physician and the Medical Director of Partners in Health. "There are roughly 2.5 million new infections each year worldwide, and approximately 7 new infections for every new person put on treatment. A sustainable response to the HIV epidemic clearly requires that we use the most effective strategies possible to stopping the spread of HIV in the first place."
Mukherjee is one of a diverse group of advocates, implementers and researchers supporting removal of restrictions on prevention programs and calling on members of the Committee to honor the legacy of Mr. Lantos' commitment to public health and human rights by placing evidence over ideology.
A report by the Government Accountability Office based on evidence collected in 20 countries, stated that the earmark "limits some country teams' ability to shift program focus to meet changing prevention needs." Another study by the Institute of Medicine conducted across 15 PEPFAR countries found that, "The earmark has greatly limited the ability of Country Teams to develop and implement comprehensive prevention programs that are well integrated with each other and with counseling and testing, care, and treatment programs and that target those at greatest risk."
Despite these findings, a small but vocal minority of opponents in the House have threatened to kill the bill. "The opposition to this bill is bewildering," said Jodi Jacobson, Director of Advocacy for American Jewish World Service, an international humanitarian and development organization with partners in 36 countries. "The draft is based on the best available evidence from leading authorities in public health. We have a moral, ethical and fiscal responsibility to spend US funds on programs that give people the tools needed to avoid infection in the first place and a wealth of evidence and field experience that make clear the changes in strategy needed to dramatically strengthen our response to HIV and AIDS."
"This bill offers more choices for effective programs than the current strategy," asserts James Wagoner, President of Advocates for Youth. "Critics have misrepresented what the bill does support. This bill underscores the need for comprehensive efforts to encourage the delay of sexual debut, partner reduction
