International HIV/AIDS, Tuberculosis, and Malaria: Key Changes to U.S. Programs and Funding

International HIV/AIDS, Tuberculosis, and Malaria: Key Changes to U.S. Programs and Funding
Kellie Moss
Source: Congressional Research Service (Open CRS Network)
Summary:
The United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (P.L. 108-25) authorizes $15 billion for U.S. global efforts to combat HIV/AIDS, tuberculosis (TB), and malaria from FY2004 through FY2008. It also authorizes the Office of the Global AIDS Coordinator (OGAC) to oversee U.S. government efforts to combat HIV/AIDS internationally. These efforts to combat HIV/AIDS implement the President’s Emergency Plan for AIDS Relief (PEPFAR), a program proposed by President Bush in January 2003. President Bush has requested $30 billion for the reauthorization of PEPFAR from FY2009 through FY2013, estimating it would support HIV/AIDS treatments for 2.5 million people, the prevention of more than 12 million new HIV infections, and care for more than 12 million HIV-affected people, including 5 million orphans and vulnerable children. Congress is considering reauthorization of U.S. international HIV/AIDS, tuberculosis, and malaria programs through FY2013 for $50 billion. H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, and S. 2731, a similar bill with the same title, would increase funding for U.S. efforts to fight HIV/AIDS, U.S. contributions to the Global Fund to Combat AIDS, Tuberculosis, and Malaria (Global Fund), and U.S. global efforts to combat tuberculosis and malaria. H.R. 5501 and S. 2731 propose a number of changes to U.S. international HIV/AIDS, tuberculosis, and malaria programs. The bills would: add Vietnam to the list of Focus Countries; remove the 33% spending requirement on abstinence prevention efforts; establish a Global Malaria Coordinator within the U.S. Agency for International Development (USAID); set targets for coverage of pregnant women and the care of HIV-infected children; and support the sustainability of health care systems in affected countries. There are some differences between the two bills. H.R. 5501 inserts family planning program language, maintains prevention and care spending directives, and adds 14 countries in the Caribbean and three countries in sub-Saharan Africa to the list of Focus Countries. S. 2731 proposes the use of compacts or framework agreements between the United States and each country receiving HIV/AIDS funds under the reauthorization. It eliminates Immigration and Nationality Act language that bars foreign nationals with HIV/AIDS from entering the United States. This report will discuss changes in coordination and funding for HIV/AIDS, tuberculosis, and malaria programs proposed in H.R. 5501 and S. 2731. Some questions remain about whether programs to combat tuberculosis and malaria should be further defined and if additional reporting requirements, distinct leadership authorities, funding and program guidelines, project timetables, and coordination requirements with HIV/AIDS programs are needed. This report will be updated as events warrant.

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