The House of Representatives has approved bipartisan legislation by a vote of 308 to 116 to provide $50 billion over the next five years for U.S. efforts to prevent and treat HIV/AIDS around the world, and fight tuberculosis and malaria. VOA's Dan Robinson reports from Capitol Hill, similar legislation is pending in the Senate.
The measure extends the program proposed by President Bush in 2003 called PEPFAR (President's Emergency Plan For AIDS Relief) for another five years, and goes significantly above the $30 billion initially proposed by the White House.
With broad bipartisan support, it is the outcome of a year of tough bargaining between Republicans, Democrats, and the White House over provisions governing how U.S. funds are used for HIV/AIDS prevention and treatment.
Among compromises, lawmakers removed a requirement that least one-third of funds be used for abstinence-until-marriage programs.
They require what they call "balanced funding" for abstinence, fidelity and condom programs in the 15 focus countries in Africa, the Caribbean and Asia, while keeping a requirement that recipients pledge opposition to the commercial sex trade.
U.S. funds could be used for HIV/AIDS testing and education in family planning clinics, but not for contraception or abortion services, and Congress would have to be informed through regular reports if programs advocating sexual abstinence and fidelity comprise less than half of spending.
California Democrat Barbara Lee, an original co-sponsor of the original HIV/AIDS program, was among those reflecting on successes since 2003, including treatment for seven million people and 2.7 million orphans and vulnerable children:
"I have witnesses first hand many times the dramatic and positive impact of our AIDS programs on individuals and communities throughout the world, especially in sub-Saharan Africa," said Congresswoman Lee.
"I believe the United States has a moral obligation to lead the world in confronting the pandemic of HIV/AIDS," said Mike Pence, a Republican from Indiana.
The reauthorization measure was a priority for two legislators for whom it is named, Democrat Tom Lantos and Republican Henry Hyde, both of whom died in the past year.
Lawmakers described it as an important step forward in transforming an emergency program into a sustained long-term effort, and praised the focus on the need to expand treatment and prevention for women especially vulnerable to HIV/AIDS.
However, bipartisan support has not quieted the debate over the role of family planning in HIV/AIDS efforts, involving the U.S. Mexico City policy.
Also called the Global Gag Rule by critics, this limits funding eligibility for non-government organizations that provide or promote contraception or abortion.
"If we are serious about preventing new infections, we need to put aside our political differences on the merits of the global gag rule and ensure that the very best in the field have the support of the U.S. to do what they need to do and that is prevent the spreading of HIV/AIDS," said Joseph Crowley, a New York Democrat.
While AIDS groups and other organizations welcome the sharp increase in U.S. funding, they also say more could be done.
The Boston-based Physicians for Human Rights faulted House and Senate versions for not doing more to integrate family planning and HIV/AIDS services.
While noting that the compromise legislation is not perfect, House Foreign Affairs Committee chairman Howard Berman said it does maintain a strong, bipartisan coalition behind the HIV/AIDS fight.
Before the House vote, a White House statement expressed support for the legislation, while voiced concern about certain provisions it says might limit presidential authority to conduct foreign policy.
The House version adds three African countries - Lesotho, Malawi and Swaziland - to the list of 15 focus countries under the original PEPFAR program.