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On the Issue: International HIV/AIDS Funding
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Prepared by the Episcopal Church Office of Government Relations
Last Updated: 01/2006
Click here to download a PDF version
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ISSUE
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There are more than 40 million people living with HIV/AIDS today. It is the number-one cause of death in Africa, where over half the Anglican Communion lives. In sub-Saharan Africa, home to more than 35 million Anglicans, 25.4 million people currently live with the disease. There, the AIDS pandemic has decimated the workforce, led to a collapse in educational systems, deepened poverty, increased the risk of starvation by undermining agricultural production, and created millions of orphans and vulnerable children. Infection rates are also rising alarmingly in Eastern Europe, Central Asia, and China. The religious community has been a leading force in caring for victims, educating potential sufferers, and advocating for government aid in this crisis situation.
While the last five years have provided significant advances forward in the fight against HIV/AIDS, the crisis demands significantly increased funding from industrialized nations particularly for multi-national programs such as the Global Fund to Fight AIDS, Tuberculosis, and Malaria.
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U.S. RESPONSE
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In 2003, the United States established the President’s Emergency Plan for AIDS Relief (“PEPFAR”) to fight AIDS internationally. The United States, however, has decreased its funding to The Global Fund to Fight AIDS, Tuberculosis, and Malaria, an established international and independent agency which supports local programs that have proven successful in their fight against the pandemic. FY’06 funding for the nation’s international HIV/AIDS accounts saw modest steps in the right direction. Congress overrode President Bush’s request to slash funding for the Global Fund to Fight AIDS, Tuberculosis, and Malaria but ultimately fell short of levels sought by the HIV/AIDS advocacy community. Overall funding for the HIV-AIDS crisis in the Foreign Operations appropriations bill was set by Congress at $2.8 billion - $258 million more than President Bush sought but $200 million less than the level initially passed by the Senate bill. Another smaller pot of money for the crisis was provided by Congress through the Labor/Health and Human Service Appropriations bill.
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DIFFERENCES BETWEEN PEPFAR & THE GLOBAL FUND
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How they’re structured:
- The Global Fund is an independent partnership between the public and private sector, with the input of representatives from most of the world’s countries. The Global Fund provides a coordinated international response that maximizes and leverages resources while complementing ongoing local, bilateral and multilateral initiatives. http://www.theglobalfund.org/en/
- PEPFAR is a U.S. program operated by the U.S. Agency for International Development. http://www.usaid.gov/our_work/global_health/aids/pepfarfact.html
Where they’re active:
- The Global Fund is operating programs against AIDS, tuberculosis, and malaria in 128 countries across all regions of the world.
- PEPAR’s activities are concentrated in 15 “focus countries” representing many of the world’s hardest-hit areas. All but two of the 15 focus countries are in sub-Saharan Africa, and many regions of the world where AIDS is dramatically increasing – like south Asia – are not included.
How treatment drugs are approved:
- The Global Fund authorizes the delivery of drugs approved for their safety and efficacy by the World Health Organization (WHO). There are no restrictions on the use of generic drugs that provide benefits equivalent to brand-name drugs but at a significantly reduced cost.
- PEPFAR requires the U.S. of brand-name drugs manufactured by U.S. pharmaceutical companies, significantly increasing the drain on program resources for treatment regimens.
Ideological Restrictions
- The Global Fund has no restrictions on its prevention and treatment strategies, which are tailored to meet the needs of the local communities in which they are implemented.
- Congress and the Bush Administration have placed ideological restrictions on PEPFAR and other U.S. bilateral programs. These include: (1) A requirement that at least one-third of the prevention programs funded by PEPFAR promote a harmful “abstinence-only” approach while banning entirely the discussion or provision of condoms; (2) A requirement that programs cannot in any way provide or discuss abortion in their non-HIV activities (a condition that excludes many respected international-family planning providers); and (3) A requirement that programs receiving U.S. funds publicly condemn the legality of prostitution rather than working with the prostitute community to reduce risky sexual behavior (a key prevention step in many at-risk regions).
PEPFAR has also been hampered by communications problems in several countries, slowness in mobilizing resources and strategies.
None of these shortcomings in PEPFAR argue for not funding the program. PEPFAR will grow in effectiveness as it gains experience. Funding for PEPFAR should not come, however, at the exclusion or reduction of funding for the Global Fund, which is working at full steam now.
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109th CONGRESS
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FY’06 funding for the nation’s international HIV/AIDS accounts saw modest steps in the right direction. Congress overrode President Bush’s request to slash funding for the Global Fund to Fight AIDS, Tuberculosis, and Malaria but ultimately fell short of levels sought by the HIV/AIDS advocacy community. Overall funding for the HIV-AIDS crisis in the Foreign Operations appropriations bill was set by Congress at $2.8 billion - $258 million more than President Bush sought but $200 million less than the level initially passed by the Senate bill. Another smaller pot of money for the crisis was provided by Congress through the Labor/Health and Human Service Appropriations bill.
In FY’07, most global experts believe that more than $24 billion is needed to provide prevention, care and treatment for these global pandemics. The U.S. share of this effort should be approximately $7.4 billion, including $6 billion for global AIDS, $440 million for tuberculosis, and $970 million for malaria efforts. The Episcopal Church is joining most other anti-HIV/AIDS advocates in urging Congress to provide this level of funding, with at least $1.2 billion directed through the Global Fund.
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GENERAL CONVENTION RESOLUTIONS RELATED TO INTERNATIONAL AIDS FUNDING
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• 2003-D054 – Keep America’s “Promise to Africa.”
• 2003-D006 – Endorse UN Millennium Development Goals.
• 2003-A035 – Call on the Church to Implement U.N. Millennium Development Goals in Africa.
• 2000-A051 – Support Initiatives to Make Available AIDS-related Medications.
• 1997-A048 – Reaffirm Commitment to a Christian Response to HIV/AIDS.
• 1985-D062 – Recognize and Respond to the Tragedy of the AIDS Crisis.
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WHAT YOU CAN DO
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Visit the Episcopal Public Policy Network (EPPN) at www.episcopalchurch.org/eppn for action updates on how you can help fight the AIDS pandemic.
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OTHER RESOUCES
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