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July 30, 2008 Update
President George W. Bush signed the new version of the President's Emergency Plan for AIDS Relief (PEPFAR) into law. Click here to read a letter IWHC and 55 other organizations sent to Senators urging them to fix the PEPFAR bill before it passed. Click here for a press release issued by IWHC and five other organizations.
The U.S. Global HIV/AIDS Prevention Plan—Ideology over Public Health
Thirty-three million people are living with HIV worldwide and young women and girls are particularly at risk. In response to this pandemic, President Bush launched in 2003 PEPFAR. This groundbreaking program allocated $15 billion over five years to combat HIV/AIDS in Africa and the Caribbean (Congress actually appropriated over $19 billion over the five years). The funding PEPFAR provides for HIV/AIDS is the largest international initiative ever dedicated to a single disease. As of September 2007, PEPFAR has provided lifesaving treatment to an estimated 1.45 million people.
As Congress considered a reauthorization of these programs, it provided an opportunity to correct some of the prevention failures enacted the first time around—based on what was learned during the first five years of implementation. In the summer of 2008, Congress reauthorized the PEPFAR programs for 2009 – 2013, but political expediency prevailed over sound public health programs and the new five year, $48 billion law does not fix the problems of the past, and actually creates some more for the future. More>>
2008: PEPFAR Reauthorization
As Congress worked on its revisions to the initial law, IWHC collaborated with other advocacy organization to make improvements to the bill. Our recommendations were guided by the input of our international colleagues based on the realities they see each day. Early in the legislative process, many of those recommendations were incorporated into the bill, but the sound public health practices were under fire from the Administration and a handful of Members of Congress. And those voices won out, halting the progress toward more effective means to prevent new HIV infections.
After making several changes that have a negative impact on prevention, the House passed its version of the bill April 2, and the bill then moved to the Senate for action. Weeks of behind the scenes negotiations led to an even more ineffective Senate bill that created more problems for HIV prevention programs rather than fixing them. The Senate passed that bill July 16 by a vote of 80-16. Because both the House and Senate need to pass the exact same version of legislation for the President to be able to sign it into law, the House then passed the Senate bill on July 24 by a vote of 303-115. It was signed into law on July 30, 2008. Click here to read a letter IWHC and 55 other organizations sent to Senators urging them to fix the PEPFAR bill before it passed. Click here for a press release issued by IWHC and five other organizations. More>>
Missed Opportunities: What lawmakers failed to do to make PEPFAR work for women and youth:
- Remove arbitrary prevention spending guidelines that stand in the way of providing every individual with the range of services and education they need to protect him or herself against HIV. More>>
- Strengthen linkages between reproductive health services and HIV prevention. Despite calls from the World Health Organization (WHO), U.S.-funded operational research, and even OGAC's own recognition of benefits, so far in the PEPFAR reauthorization process Congress has failed to recognize the benefits of strengthening and linking health services that provide multiple benefits - including reproductive health services and HIV prevention. More>>
- Implement WHO and USAID Recommendations on PMTCT: The World Health Organization recommends that women seeking treatment to prevent maternal-to-child transmission (PMTCT) of HIV have access to voluntary family planning information and commodities should they choose to prevent another pregnancy. More>>
- Eliminate the prostitution pledge that requires groups fighting HIV/AIDS overseas to pledge their opposition to prostitution and sex trafficking before receiving U.S. money. More>>
- Remove the unconscionable "conscience clause." The original PEPFAR legislation contains a provision that enables organizations receiving U.S. funding to pick and choose the prevention and treatment services they wish to provide. The 2008 version makes it worse. More>>
Why Congress Ignored the Evidence
A small yet vocal group of advocates and Members of Congress opposed these positive steps for women and youth, in many cases by promoting ideology over public health evidence—especially related to sound prevention policies. The small group of conservatives threw a red herring argument into the mix by saying that any of the changes we were calling for was simply an effort to expand abortion services in Africa. For those that don’t know better, this created nervousness and confusion. Those that know better were either stifled in the debate or folded to the arguments rather than standing up for better prevention practices. Read IWHC’s Beth Fredrick’s blog on this issue.
We need to build a stronger set of informed citizens who will let their elected officials know of their support for public health practices that meet the real life needs of women and youth. You can help.
Stay Informed.
Visit Bush's Other War for information about other Bush administration policies that are undermining women's and girls' health worldwide
Donate to IWHC. IWHC's partners worldwide are working to eradicate the gender inequalities that make women so vulnerable to HIV/AIDS. They are providing young people with the information, skills, and strategies they need to reach adulthood in good health. By supporting us, you will strengthen our support for these groups. Click here to make a contribution.
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This webpage last updated in July 2008. For more information, contact Whitney Welshimer at 212-979-8500 or wwelshimer@iwhc.org.
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