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PEPFAR Reauthorization Advocates Corner | Print |
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Welcome to the PEPFAR Reauthorization Advocates Corner. Our goal is to give you the information you need about PEPFAR Reauthorization in one location. We hope you find it helpful.

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PEPFAR Signed Into Law, Another 5 Years of Flawed Prevention Policy?
On July 30, President Bush signed into law The Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008.  In response, the Center for Health and Gender Equity (CHANGE) issued the following press statement. CHANGE emphasized the bill's politicization of public health and failure to rectify serious flaws regarding PEPFAR’s prevention policies that will have harmful implications for the health and rights of women and girls worldwide.

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PEPFAR Passes Senate, Women and Girls Pay Price
On July 16, the Senate passed S. 2731, the Tom Lantos and Henry J. Hyde United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008—with a $48 billion authorization level (reduced via an amendment to divert $2 billion in these funds to Indian reservations)—by a margin of 80-16.  However, women and girls continue to be shortchanged by the flawed prevention policies that were retained in the bill.  Among these include funding directives for abstinence and be-faithful programs, the inclusion of the anti-prostitution loyalty oath, and the failure to integrate HIV prevention services with family planning services.  Please stay tuned for further updates about next steps in the PEPFAR reauthorization process. (top)
PEPFAR Senate Update
The Senate has faced an uphill battle to bring a PEPFAR reauthorization bill to the floor for a vote.  The bill (S. 2731) has been blocked by seven ultra-conservative Senators--led by Senator Tom Coburn (R-OK), since March.  The Senators have asserted that the proposed legislation’s price tag of $50 billion is too high and they have requested a 55% funding allocation for treatment efforts within countries hardest hit by AIDS. In addition, the group of seven objects to any efforts to integrate HIV/AIDS programs with other sectoral efforts claiming they “dilute” programs. They also claim that any effort to change gender norms is “morally questionable” and a “feckless or morally dubious” activity.

They recently worked out a compromise with Senate Majority Leader Reid and Senate Minority Leader McConnell which includes harsher restrictions on prevention activities, the requirement that “more than half” of PEPFAR funds be allocated for treatment and care, and the extension of a “conscience clause”—enabling organizations receiving funds through PEPFAR to pick and choose for whom to provide prevention, treatment, and now care services based on moral and religious grounds.  The “conscience clause” is seen by some advocates as a codification of discrimination in PEPFAR law.    

In the meantime, a small group of dedicated sexual and reproductive health and rights organizations, including CHANGE, have  been working to fix provisions in the bill that are likely to be harmful for women and girls. We are advocating for the following changes in the proposed legislation: allowing integration of HIV/AIDS services with family planning services; including a comprehensive prevention strategy for women and girls; striking the anti-prostitution pledge; and eliminating the onerous 50% so-called “balanced” funding requirement that replaces the 33% abstinence-until-marriage earmark included in original PEPFAR law.  The groups are still hopeful that changes can be made before a floor vote in the Senate--which is likely to occur during the week of July 14. 

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PEPFAR Passes the House
On Wednesday, April 2, the House of Representatives passed H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008.  To find out how your member of Congress voted, click here. 

While the House PEPFAR bill authorizes $50 billion over five years for HIV/AIDS, TB, and Malaria efforts, prevention continues to be compromised.  This includes funding directives around abstinence and be faithful programs, the incorporation of the anti-prostitution pledge, and problematic language around family planning.  

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PEPFAR Introduced in the House and Senate
The "Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008" was introduced in the House on February 27, 2008 by Congressman Howard Berman and Congresswoman Ileana Ros-Lehtinen (H.R. 5501) and in the Senate on March 7, 2008 by Senators Joe Biden, Richard Lugar, Edward Kennedy, and John Sununu (S. 2731).

Both PEPFAR reauthorization bills would authorize $50 billion over 5 years for HIV/AIDS, TB, and Malaria efforts and provide support for health workforce and systems strengthening.  Only the House reauthorization bill, however, includes a strategy to address the vulnerabilities of women, girls, and youth--drawn largely from the PATHWAY Act of 2007, H.R. 1713.  

Prevention Compromised 

Both bills in their current form contain problematic prevention provisions.  Please read the following documents for more information.  

PEPFAR Reauthorization Quick Find 

House Bill (H.R. 5501)

 Senate Bill (S. 2731)


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What is PEPFAR?
In a January 2003 State of the Union Address, President George W. Bush announced his intention to create a new U.S. initiative to address the global AIDS pandemic. Several months later, in response to the President's Initiative, the U.S. Congress passed the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (Global AIDS Act, 2003).

Also known as the President’s Emergency Plan for AIDS Relief (PEPFAR), the initiative’s original goal was to prevent 7 million new HIV infections, treat 2 million people living with AIDS related illnesses, and provide care and support for 10 million persons affected by AIDS. The Global AIDS Act authorized the President to spend up to $15 billion over 5 years (FY 2004—2008), including $10 billion in new money to expand global HIV/AIDS, Tuberculosis, and Malaria programs.

Resources on PEPFAR and HIV Prevention Policy 


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What is PEPFAR Reauthorization?
Reauthorization is the legislative process by which Congress reviews and/or amends an existing program. Congress originally authorized PEPFAR for 5 years (fiscal years 2004-2008). Fiscal year 2008 ends on September 30, 2008. Because the authorization of PEPFAR will expire in less than a year, Congress is planning to reauthorize the legislation early in 2008, most likely for another five years. During reauthorization, Congress will have an opportunity to make changes to the policy requirements laid out in the Global AIDS Act, including restrictions on prevention funding for abstinence and be faithful programs.  They will also have the opportunity to increase funding for the initiative.

The Senate Foreign Relations Committee is the committee in the Senate that has jurisdiction over this bill; in the House of Representatives, it is the the House Committee on Foreign Affairs.

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What are the problems with the abstinence-until-marriage earmark?

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How are the PATHWAY Act and the HIV Prevention Act related to PEPFAR reauthorization?

The Protection Against Transmission of HIV for Women and Youth Act (PATHWAY Act, H.R. 1713 and S. 2415 ) and the HIV Prevention Act (S. 1553)  are critical pieces of legislation that lay the foundation for removing funding restrictions around prevention programs during PEPFAR reauthorization.

Through building Congressional support for the two bills, we educate members of Congress and their staff about the problems with funding restrictions around abstinence and be faithful prevention programs, such as the abstinence-until-marriage earmark—with the goal that these advocacy efforts will translate into informed debate among lawmakers around removing these funding restrictions during PEPFAR reauthorization. 

In addition, advocacy around the PATHWAY Act and the HIV Prevention Act has generated significant media interest over the last year and a half. This media engagement with the abstinence-until-marriage set-aside will prove particularly valuable during the process of reauthorization when news sources will undoubtedly be covering the issue and writing editorials about what the bill should and should not include.

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Media Center

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How can I take action around PEPFAR Reauthorization?

Featured actions
  • On March 31, 2008, HIV/AIDS, women's rights and student activists took their demands for PEPFAR reform directly to Senator Lugar.  Activists gathered outside his Indianapolis office with giant keys inscribed with critical messages and then delivered them to Lugar's staff during a subsequent meeting.  The "key" demands included:
    • Elimination of  abstinence and be-faithful funding directives for prevention programs
    • Integration of HIV/AIDS services  with family planning services regardless of whether family planning programs already receive U.S. support
    • Removal of the requirement that PEPFAR grantees pledge their opposition to prostitution
    • Training and retention efforts for at least 140,000 new health care professionals
    • Support for treatment of one-third of those in clinical need in developing countries
  • The American Medical Student Association (AMSA) held a call-in day around PEPFAR reauthorization at their national convention in Houston.  Hundreds of calls were made to members of the U.S. Congress urging them to support a PEPFAR reauthorization bill that integrates HIV/AIDS services with family planning services, without restrictions on those family planning services.   

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Last Updated ( Thursday, 02 July 2009 )
 


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