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TRAVEL BAN LIFTED!!
Jul 19, 2008

Congratulations to us doc. I just sent an email to you last week about Obama and the travel ban. Apparently Dubya did the first right thing in his career.

<a href=http://andrewsullivan.theatlantic.com/the_daily_dish/2008/07/the-hiv-travel.html>http://andrewsullivan.theatlantic.com/the_daily_dish/2008/07/the-hiv-travel.html</a>

Congratulations to us all doctor!

Response from Dr. Frascino

Hi,

Well, not quite yet. The Democratic Congress has done the right thing and attached this provision (lifting the ban) to the PEPFAR bill. Dubya really wants to continue the PEPFAR program, but he's apparently not happy with some of the very logical changes mandated in this bill. We are all hopeful he'll sign it. See below for the latest information.

Dr. Bob

House Will Approve Senate's Version of PEPFAR Reauthorization Legislation Next Week, Leaders Say

July 18, 2008

The House next week will approve the Senate's version of a bill to reauthorize the President's Emergency Plan for AIDS Relief, sending the measure to President Bush to sign into law, leaders said on Thursday, CQ Today reports. The Senate on Wednesday voted 80-16 to approve the bill (HR 5501) after substituting language from its version (S 2731). The House Foreign Affairs Committee said that it will accept the Senate version, and Bush is expected to sign the bill (Graham-Silverman, CQ Today, 7/17).

The Senate version of the legislation allocates a total of $50 billion -- $48 billion of which would go to PEPFAR and $2 billion of which would go to 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. The Senate version also includes a provision that would ease U.S. HIV/AIDS travel restrictions.

The House version of the legislation, which would allocate $50 billion for PEPFAR, passed in April. One primary difference between the House and Senate versions is that 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, 7/17). The Senate bill does not mention family planning programs, according to CQ Today (CQ Today, 7/17).

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 (Kaiser Daily HIV/AIDS Report, 7/17). Both measures also would direct 10% of funding to programs for orphans and vulnerable children, as well as allocate $2 billion for the Global Fund in fiscal year 2009. Both bills contain an existing requirement that organizations receiving PEPFAR aid have a policy that opposes commercial sex work. The Senate version would create links between HIV/AIDS and nutrition programs and set a target of recruiting 140,000 health care workers. In addition, both measures would allocate $5 billion for malaria programs and $4 billion for tuberculosis initiatives (CQ Today, 7/17).

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/Google.com, 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/Google.com, 7/17).



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