AIDS Advocates, Lawmakers Work to End Budget Impasse That Could Jeopardize PEPFAR Programs, Including Delivery of Antiretroviral Drugs to Developing Countries

AIDS advocates and lawmakers are working to end an "impasse" in the U.S. Congress over government financing for fiscal year 2007 that could jeopardize President's Emergency Plan for AIDS Relief funding, including the delivery of antiretroviral drugs to people in developing countries, the San Francisco Chronicle reports. According to the Chronicle, a disagreement over the budget at the conclusion of the 109th Congress last month froze funding for nearly all federal programs, including PEPFAR, at 2006 levels (Russell, San Francisco Chronicle, 1/12). PEPFAR is a five-year, $15 billion program that directs funding for HIV/AIDS, tuberculosis and malaria primarily to 15 focus countries and provides funding to the Global Fund to Fight AIDS, Tuberculosis and Malaria (Kaiser Daily HIV/AIDS Report, 12/2/05). President Bush had requested an overall PEPFAR funding increase from $3.2 billion in 2006 to about $4 billion for 2007. Before adjourning last year, Congress approved continuing resolutions to keep spending at 2006 levels, and Democratic leaders recently decided to pass another continuing resolution to keep the spending levels the same until October 2007, the Chronicle reports. Rep. Barbara Lee (D-Calif.) earlier this week obtained 87 signatures from House members supporting a $930 million additional allocation for AIDS, tuberculosis and malaria programs, which was the funding level supported by the Senate Appropriations Committee last year. Drew Hammil, spokesperson for House Speaker Nancy Pelosi (D-Calif.), said Pelosi "staunchly supports these programs, but we are also trying to achieve fiscal responsibility," adding, "The Republican Congress created this fiscal mess and then punted the problem to us."

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Ambassador Mark Dybul, who serves as the U.S. global AIDS coordinator, last week said that if the additional funding is not approved, enrollment of new patients to receive antiretroviral drugs with PEPFAR funding -- which currently is enrolling 50,000 new patients per month -- would have to be halted by the end of next month. In addition, he said programs to prevent mother-to-child HIV transmission "will pretty much have to halt." If PEPFAR funding is kept at the 2006 level, about 350,000 HIV-positive people, mostly in Africa, who are scheduled to receive antiretroviral treatment will not get it, according to the Chronicle. Dybul said that he estimates between 110,000 and 175,000 of those people will die and that 23,000 infants will contract HIV at birth unless more funding is approved, the Chronicle reports. Some AIDS advocates say that because congressional spending has been limited to 2006 levels, federal spending has been reduced by $12 billion since October 2006, the beginning of the 2007 fiscal year. According to the Chronicle, advocates are campaigning to have $1 billion of that money allocated for President Bush's HIV/AIDS and malaria programs and to have $90 million go toward the Ryan White CARE Act. "If we don't get a correction, the whole upward trajectory goes down," Paul Zeitz, executive director of the Global AIDS Alliance, said, adding, "Momentum will be lost, and that's the hardest thing to gain again" (San Francisco Chronicle, 1/12).

A webcast of Dybul's comments on PEPFAR funding is available online at kaisernetwork.org.

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