Thanks to Pete Witzler, Health Action AIDS Student Organizer for Physicians for Human Rights, for an update on the US Presidents Emergency Plan for AIDS Relief (PEPFAR).

As you may know, the House of Representatives has already passed their version of the PEPFAR program. The next step in the process for the bill to become law (think schoolhouse rock) is for the Senate to pass their version of the bill. Any differences between the two bills will be sorted out in a conference committee, made up of key stakeholders from the House and Senate, which then sends the bill to the President to sign into law.

We still have a big fight ahead of us to get the best possible bill signed into law. Unfortunately, a group of fiscal conservatives in the Senate, led by Tom Coburn, are using a procedural hold to stop the bill from going to the floor of the Senate. Michael Gerson has written a great op-ed in the Washington Post, which explains:

The seven, led by Coburn, complain that the reauthorization is too costly. They object to “mission creep”—the funding of “food, water, treatment of other infectious diseases, gender empowerment programs, poverty alleviation programs”—as though people surviving on AIDS treatment do not need to eat, work or get their TB treated. And the senators are concerned that AIDS funds might be used for things such as abortion referrals and needle distribution, though the legislation doesn’t mention these possibilities. So they are pushing for the extension of a superfluous spending mandate requiring that at least 55 percent of PEPFAR resources be used for treatment, on the theory that this will starve “feckless or morally dubious” prevention programs.

Gerson emphasizes that there is no way to control the epidemic with treatment alone.

Given that there are about 2.5 new HIV infections for every person starting on AIDS drugs, there is no way to control the pandemic through treatment alone. And because treatment is less expensive than it used to be, PEPFAR is meeting its treatment goal for less money. The 55 percent treatment floor would force the program to waste money in pursuit of an arbitrary, nonsensical spending target— the worst kind of congressional earmark.

The implementation of PEPFAR has shattered the old conceptions that it is simply too expensive to treat people with AIDS. We’ve also learned over the last 5 years that ABC only prevention strategies tie the hands of implementers on the ground and do not work, especially not for women who now comprise 60% of those living with AIDS in sub-Saharan Africa.

As I’ve noted before, the current versions of the House and Senate bills are based on series of compromises—some of which are good and some of which are not so good. One area we are fighting for improvement on is the integration of family planning services with HIV/AIDS services as a crucial way to give women access to care. In partnership with other AIDS advocacy organizations, we are working on several fronts to ensure that PEPFAR incorporate evidence- and human rights-based prevention and treatment programs.

Watch your in boxes for some new opportunities to help PHR’s Health Action AIDS Campaign in these efforts by contacting your Senators.

Update 5/16:

Senator Coburn one of the leaders of the current opposition to the speedy passage of PEPFAR, has posted a response to Gerson’s article.

Further information:

pwitzler@phrusa.org

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