The Senate on Tuesday rejected 43-51 an amendment to the fiscal year 2004 $137.6 billion spending bill for labor, health and education services (HR 2660) that would have increased by $1 billion funding for the global AIDS initiative, the Washington Post reports (Dewar, Washington Post, 9/10). The amendment, sponsored by Sen. Richard Durbin (D-Ill.) would have added $1 billion to the roughly $2 billion appropriated by the Senate for the initiative (Associated Press, 9/9). The House has approved approximately $2 billion for the AIDS initiative in FY 2004. Although the measure (HR 1298) supporting President Bush's five-year, $15 billion initiative to fight AIDS in Africa and the Caribbean authorizes $3 billion for the first year of the program, the Bush administration has requested only $2 billion (Kaiser Daily HIV/AIDS Report, 9/9). Additions to appropriations bills that exceed budget limits must have 60 votes in order to pass (Washington Post, 9/10). The Senate in July passed a nonbinding resolution, called the Bingaman amendment, calling for $3 billion to be appropriated in FY 2004 to fight AIDS overseas, even if the amount exceeds the ceiling mandated in Congress' annual budget resolution (Kaiser Daily HIV/AIDS Report, 8/26).

Schumer Amendment
The Senate yesterday morning voted against an amendment, proposed by Sen. Charles Schumer (D-N.Y.), that would have provided additional funding for the Ryan White CARE Act, including an increase in funding for the AIDS Drug Assistance Program (SAVE ADAP release, 9/10). The federal-state ADAP program provides free or low-cost medication to low-income HIV-positive individuals who do not qualify for Medicaid or other drug assistance programs. Many state ADAPs are experiencing financial trouble due to high demand for the drugs, soaring prescription costs and state budget shortfalls. Fifteen states currently have waiting lists or access restrictions on their ADAPs, and four more states anticipate having to impose new or additional restrictions on their programs in fiscal year 2003. According to the ADAP Working Group, ADAP will require a total of $214 million in new federal funding during FY 2004 in order to restore stability and serve the people currently on waiting lists, and the amendment would have fully funded ADAPs. The Senate's labor and health spending bill would increase ADAP funding by $25 million; the House version of the bill, which was passed in July, includes about $39 million in new funding (Kaiser Daily HIV/AIDS Report, 9/5).

Reaction
"How could these Senators vote for the Bingaman amendment and yet vote down a measure that would have actually provided the funding?" Paul Zeitz, executive director of the Global AIDS Alliance, said, adding, "Their hypocrisy is simply breathtaking." Zeitz added, "[I]t's time to treat AIDS like a real emergency, as the president himself rightly termed it just nine months ago in his State of the Union address" (Global AIDS Alliance release, 9/10). Terje Anderson, executive director of the National Association of People with AIDS, expressed "extrem[e] disappointment" at the "twin failures" of the Senate to pass neither amendment. Anderson said, "Refusing to adequately fund AIDS will not make it go away; in fact, the Senate's action will do nothing except to make the work more difficult and costly and will result in more death and more suffering" (NAPWA release, 9/10). Jose Zuniga, president and CEO of the International Association of Physicians in AIDS Care, said, "Cuts or flat funding in both the House of Representatives and Senate for Ryan White CARE Act programs, with the exception of a negligible percentage increase for the AIDS Drug Assistance Program, means that an increasing, and increasingly poor, number of HIV patients will have reduced access to care and treatment." Zuniga added, "This course of action does not, I believe, relfect the values of the American people or constitute sound policy. I hope that members of Congress take steps to redress their mistake" (IAPAC release, 9/10).

The Kaiser Family Foundation yesterday released its annual update of "Federal HIV/AIDS Spending: Budget Chartbook," which provides a comprehensive overview of the most recent data on federal funding for domestic and international HIV/AIDS activities and spending trends since FY 1995. The document is available online.

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