Coalitions of AIDS activists and American business leaders lobbied hard to boost PEPFAR, the Bush administration’s signature AIDS relief effort, above the president’s 30-billion dollar reauthorization target. In his State of the Union address last month, President Bush had asked congress to double the initial 2003 infusion of 15-billion dollars over the first five years of the program. But in its first legislative test on Wednesday before the House Foreign Affairs Committee, PEPFAR funding won strong bipartisan support in the fight against HIV/AIDS to reauthorize the next five-year infusion for at least 50 billion dollars.
Communications director David Bryden of the Global AIDS Alliance says that funding to expand the President’s Emergency Plan for AIDS Relief (PEPFAR) with some strategically new initiatives was achieved through consummate bipartisan cooperation between congress and the White House.
“I think that we had members of congress from both sides of the aisle who realized it would be a mistake to flat-fund the program. And we heard from Republicans as well that they were uncomfortable with that. I mean (New Jersey Republican) Congressman Chris Smith, for instance, made it very clear that he felt that this level of 50-billion dollars was the right figure and that steps could be taken to make sure that the money could be appropriately used….Now we see that the White House has put out a statement praising this outcome and showing their support for this,” he said.
During his just-concluded trip to five African countries President Bush’s discussions with heads of state focused on efforts to combat HIV/AIDS and two other prevalent diseases, malaria and tuberculosis, that impede AIDS patients’ ability to survive their misfortune. David Bryden of the Global Alliance says he thinks Mr. Bush was successful in adding urgency and awareness of the challenges that lie ahead.
“There is still a significant amount of stigma and denial in a number of African countries and to have the President of the United States to be very forthright and direct about these issues helps break down that stigma. And I think he also worked to try to reassure leaders and the African people generally that the American commitment could be counted on. You know, he got some hard questions on his trip about certain aspects of his program, including from African journalists and others. I’d like to think that that made an impression on him in terms of the dialogue with congress that he needed to be flexible,” said Bryden.
The new appropriation adds 14 Caribbean countries to the 15 African countries already participating in PEPFAR. Bryden says it will be left to President Bush’s successor to determine how the additional AIDS funding will be applied.
“How the money would be divided up, I think, would be at the discretion of the next president. There are some African countries that we as advocates had hoped would receive more attention, like Malawi, for instance, which was not included the list of focus countries,” he noted.
Bryden adds that the most helpful benefits for Africa from the new PEPFAR infusions will be felt in the training of medical personnel and in fighting the AIDS-related companion diseases, malaria and tuberculosis.
“If the money is actually appropriated, then African countries can expect to receive a lot more help, particularly on TB and malaria, which are major killers on the continent, particularly malaria being a killer of children. The bill also specifies important goals in the areas of strengthening health systems, and that’s really something the African countries have struggled with when it comes to training and retention of health care professionals. So I think they’ll receive a lot more help in that area. And I also think we’ll see increases as appropriate for HIV/AIDS prevention, care, and treatment,” he said.
Bryden says he thinks the US Senate is likely to pass similar funding legislation to the measure just approved by the House Foreign Affairs Committee. But he suggests that the true test of whether the actual 50-billion dollar funding will hold up will be determined later in the year, when the measures are scrutinized by congressional appropriations committees.
“When the appropriations decisions come around,” he says, “that’s when we’re most worried because of the amount of money that is needed.”