2008: PEPFAR Reauthorization
This year, Congress is acting to revise and reauthorize the PEPFAR program. On April 2, 2008, the House authorized $50 billion dollars to combat HIV/AIDS, tuberculosis, and malaria by a vote of 308 to 116. The Senate is expected to vote on its version of the bill this spring.

Lawmakers should 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. The “balanced funding” provision, which   continues to emphasize abstinence-until-marriage programs, should be removed because it contradicts sound public health evidence, which has shown abstinence-until-marriage programming is ineffective. 

This provision replaces the one-third earmark, which required one-third of funds to be spent on abstinence-until-marriage programs, but risks producing an outcome similar to the earmark at the field level. This provision will create pressure on programs to   meet arbitrary limits that are not driven by epidemiology or the reality of people’s lives. 

In reviewing PEPFAR programs, the Institutes of Medicine reported that "by requiring the Country Teams to isolate funding for these activities, this budget allocation has undermined the teams' ability to integrate prevention programming" and the Government Accountability Office review included similar recommendations.