The United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 passed the House with an overwhelming bipartisan vote of 375 to 41, on May 1.
The legislation carries out the pledge that President Bush made in his state of the union address in February. It authorizes spending $15 billion over the next five years, primarily in 14 heavily affected African and Caribbean nations.
One of the major provisions would require spending at least 55% of the funds on medical treatment. It will support the first major expansion of access to HIV treatment in many of those nations.
Social conservatives were successful in pushing an amendment that one-third of prevention money must be spent on abstinence programs. The amendment, proposed by Rep Joe Pitts, R-Penn., passed 220 to 197.
Rep. Henry Hyde, R-Ill., who as chair of the International Relations Committee did not allow the amendment to be added, said that it would not hinder other approaches to prevention. 'It simply says, as we move forward in this war, don't forget abstinence.'
A second amendment allows religious and other groups who oppose the distribution of condoms to not do so and still receive funding through these programs for other activities. It passed on a voice vote.
The two amendments 'make an otherwise distasteful bill palatable,' said Ken Conner, president of the reactionary Family Research Council.
'It is thrilling that a bill of this size and scope is moving forward and has the broad bipartisan support that it does,' said Terje Anderson, executive director of the National Association of People With AIDS (NAPWA).
'But, I think the amendments were gratuitous and political,' he said. 'It's a misinterpretation of what goes on in Uganda, where there is a balanced approach that lays out all of the options for people and doesn't just say, just be abstinent, be faithful, it talks about all of them,' including condoms.
'I'm not sure that all of the successful elements of Uganda could be funded under that one third of the bill,' said Anderson. 'I'm hoping that those provisions don't get in the way of the effective operation of programs.
'Funding abstinence programs as part of an integrated prevention strategy can be effective,' said Holly Burkhalter, policy director of Physicians for Human Rights. 'But funds for stand-alone programs deny best public health practices by failing to recognize the value of condoms. By diverting AIDS money to ineffective programs, money will be wasted, and more importantly, lives will be lost.'
'This is a very important bill that has the potential to go far in building infrastructure to fight AIDS in countries that have otherwise been ravished by the disease,' said Christine Lubinski, executive director of the HIV Medicine Association.
However, she criticized the amendments. 'It is not appropriate for the U.S. Congress to decide how Eritrea, Haiti, and other countries develop and implement prevention programs to meet the needs of their cultures.'
The Senate still must consider the legislation and there is some talk of trying to remove those amendments, or to offer compromise language that might be less restrictive. Majority Leader Bill Frist hopes to move the bill before the Memorial Day recess.
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