Maintaining momentum in the fight against AIDS

Posted: May 19, 2006 12:06 AM

Three years have passed since President Bush committed America to the "massive and complicated undertaking" of fighting AIDS on a global scale. And the question that confronts the Congress is this: are we going to stay the course and prioritize funding the fight, or are we going to cut back?

Fighting global AIDS generally unites us rather than divide us; the stakes are too high not to confront a disease that has already claimed 25 million lives, a pandemic that claims 6,000 lives each day, a tsunami of death every week. And tragically, it has left 11 million children orphaned in Sub-Saharan African alone in its wake.

As Secretary of State Condoleezza Rice stated, "HIV/AIDS is not only a human tragedy of enormous magnitude; it is also a threat to the stability of entire countries and to entire regions of the world." Leaders in both parties have understood that it is not enough merely to express the right sentiments, or offer up words of empathy or exhortation. In appropriations made and budgets passed, we have made good on the promises our country has made to the world.

Recently, however, several conservative allies have expressed opposition to my efforts with Sen. Dick Durbin to increase funding for the global fight against HIV/AIDS.

Let me explain.

First, I commend the president and my colleagues for passing the historic bill in 2003 that authorized $15 billion over five years to combat international AIDS. Sen. Durbin and I have led the bipartisan efforts not only to keep this promise, but to set the international pace by appropriating more annually than the president has requested.

In part, this is because an estimated 40 million people are living with a disease that is both easily preventable and easily treatable, yet a chasm exists between those in need and the resources necessary for their health and security.

America has stood in the gap. We are making progress. We are restoring hope. Now is not the time to back off.

This year's budget is a particular challenge. The president's 2007 budget request for global AIDS is $4.83 billion, an increase of $900 million over last year. Since the authorization bill first passed, I have maintained a commitment to fully fund the president's "bilateral" budget requests (PEPFAR) as well as contributing $1 for every $2 from other countries to The Global Fund to Fight AIDS, Tuberculosis and Malaria.

These approaches are complementary, and both are necessary. PEPFAR focuses on 15 countries and applies largely to bilateral HIV/AIDS prevention, treatment, and care programs, in coordination with host governments' national strategies. The Global Fund reaches 130 countries around the world and provides one quarter of all donor HIV/AIDS spending, two-thirds of all donor TB spending, and half of all donor spending on malaria. As of December 2005, the Global Fund was providing voluntary counseling and testing to 3.9 million people; supporting community outreach efforts to 7 million people, and providing antiretroviral drugs for 384,000 people enrolled in programs reversing death sentences on a daily basis.

Additionally, the Fund has provided 7.7 million bed nets to prevent malaria and has treated 1 million cases of TB through Directly Observed Therapy.

Congress should fully fund the president's bilateral request, and it should not cut back on the support it has shown for the Global Fund. It will be a big lift, but this a crisis of global proportions.

I may disagree with some of my conservative friends regarding how much should be appropriated, but I do agree that Congress must be diligent spending taxpayer dollars in the most efficient way for the greatest good.

We agree that faith-based organizations should be included more fully and that an appropriate balance between abstinence, being faithful, and condom distribution be struck, just as it has been so effectively in the country of Uganda.

My support for the Fund is not unconditional. For example, I will insist on increased transparency from the Global Fund on information such as the percentage of dollars awarded to fund prevention, treatment and education-related activities. The Fund should prioritize increased accountability practices out of respect for the financial accounting needs of Congress, especially in our fiscally tight environment.

But I've learned along the way that few bills in Congress will ever quite meet the standard of 100 percent agreement. Sometimes less will do -- especially when "less" in the legislative process still means life and hope for so many people. If our own lives were at risk in the global AIDS pandemic, surely none of us would reject such a compromise. When the lives of others are in the balance, the scales tip in exactly the same direction.

So I will continue to lead the fight against AIDS and other infectious diseases. Some of my conservative friends may vote differently, and I respect that decision, knowing it was informed by conscience and good faith. From old and valued friends, I know they will extend the same courtesy in return.