Policy & Politics

Senate Passes PEPFAR Reauthorization Legislation

July 17, 2008

The Senate on Wednesday voted 80-16 to approve legislation that would reauthorize the President's Emergency Plan for AIDS Relief at almost $50 billion over the next five years, "rejecting efforts to pare down the bill's" spending levels, the Washington Post reports (Kane, Washington Post, 7/17). The measure would replace and expand the current program, which was passed by Congress in 2003 at $15 billion and will expire at the end of September (Abrams, AP/, 7/17).

According to the Los Angeles Times, although passage of the measure had stalled in recent weeks over objections from some Republicans concerning its cost, how the money would be spent and the role of abstinence education, most Senate Republicans joined Democrats in backing the measure, which the Bush administration also supports. Sen. Richard Lugar (R-Ind.) said, "It's one of the strongest ways the U.S. has made an impact on a number of countries where our diplomacy hasn't been effective in the past," adding that one of the bill's goals is "the alleviation of extraordinary suffering on Earth" (Patel, Los Angeles Times, 7/17). Sen. Joseph Biden (D-Del.), chair of the Senate Foreign Relations Committee, praised Bush's "bold" support for AIDS funding, calling it his greatest achievement as president. "We've made tremendous strides, but our work is not nearly finished," Biden said, adding, "Two million people died last year of HIV/AIDS. Over two and a half million people died of malaria" and tuberculosis. According to the Post, Sen. Tom Coburn (R-Okla.), who is a "staunch opponent of most government spending," said PEPFAR "is by far the only true foreign policy program that's working. The dollars are actually making a difference" (Washington Post, 7/17). In a statement, Bush said, "With passage of today's bill, we are one step closer to ensuring that this excellent program continues to help those in need. I encourage the full Congress to move quickly to send me final legislation that I can sign" (Cowan, Reuters, 7/16).

Leading opponents of the measure earlier on Wednesday continued to express concern about the bill's price tag. Sen. Jim DeMint (R-S.C.), whose amendment to reduce the program's funding to $35 billion was rejected by a 32-63 vote, said, "Why, at a time when our country is in debt as far as we can see, why would we as a country create the biggest foreign aid bill in history and borrow more money, $50 billion, and send it all around the world?" (Graham-Silverman, CQ Today, 7/16). Sen. John Cornyn (R-Texas) said the funding should have been reduced to $35 billion over five years. "There should be a limit," he said, adding, "It's one thing to say you'll support it at $15 billion; it's another thing to say you'll support it at $35 billion. To me, it's entirely another thing to support it at $50 billion" (Washington Post, 7/17).

According to CQ Today, the only "sizeable change" adopted by the Senate was to trim the original $50 billion authorization to $48 billion and to include $2 billion for American Indian issues. The chamber also adopted an amendment intended to increase oversight of the Global Fund To Fight AIDS, Tuberculosis and Malaria and encourage cost-sharing and transition strategies as part of agreements with countries that receive PEPFAR aid (CQ Today, 7/16). Although some Republicans objected to a provision in the bill that would ease U.S. HIV/AIDS travel restrictions, Sen. Jeff Sessions (R-Ala.) dropped his amendment to challenge the provision (Reuters, 7/16). The Senate also defeated an amendment by Cornyn to establish a "sunset" commission to propose legislation that would abolish any global HIV/AIDS program Congress did not explicitly reauthorize. In addition, an amendment by Sen. Judd Gregg (R-N.H.) to set up an inspector general for the program, and another by Sen. Jon Kyl (R-Ariz.) that would have limited spending in the program's final year to $10 billion, also were rejected (CQ Today, 7/16).

The House version of the legislation, which would allocate $50 billion for PEPFAR, passed in April (Kaiser Daily HIV/AIDS Report, 7/16). According to Biden, there are small differences between the two versions of the legislation. The Post reports that one "key" difference between the House and Senate versions is that the House bill would permit funding for family planning programs in developing countries (Washington Post, 7/17). The House version would allow groups to use PEPFAR funding for HIV testing and education in family planning clinics but not for contraception or abortion services (Kaiser Daily HIV/AIDS Report, 4/3). In addition, the House version includes some spending mandates that are not in the Senate bill, including a requirement that 20% of PEPFAR funding be allocated to prevention. The Senate version includes a provision that more than half of the program's aid go toward HIV/AIDS treatment and care. Both versions would overturn an existing law that requires one-third of prevention funds be spent on abstinence and fidelity programs, instead requiring a report to Congress if countries do not spend half of prevention money on such programs (CQ Today, 7/16). Biden said that he has been working with House leaders and that he is confident they can come up with a final version "within a matter of days" (AP/, 7/17).

Back to other news for July 2008

Reprinted with permission from You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at The Kaiser Daily HIV/AIDS Report is published for, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2008 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.

This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.


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