Washington Blade - February 6, 2009
Lou Chibbaro Jr.

The provision was packaged by supporters as a sexually transmitted disease prevention effort, with most of the funding allocated for STD and HIV testing and prevention programs carried out in states and cities. National AIDS advocacy groups said the proposal's HIV-related funding was especially needed in communities where the economic recession has resulted in severe cutbacks in HIV testing and prevention programs.

"We're still supporting the bill while expressing strong disappointment in the language change by the Senate," said Ronald Johnson, deputy executive director of AIDS Action, a national group that represents AIDS service providers throughout the country.

Johnson and officials with other AIDS groups noted that the House version of the president's $819 billion stimulus package includes $335 million in funding for STD and HIV prevention programs. The House passed its version of the bill last week.

The Senate Appropriations Committee added the $400 million funding provision for the STD and HIV prevention efforts to the bill, the American Recovery and Reinvestment Act, on Jan. 27.

Sources familiar with the committee said its chairperson, Sen. Daniel Inouye (D-Hawaii), removed the provision three days later, on Jan. 30, when the bill reached the Senate floor after conferring with Senate Democratic leaders and the White House.

House and Senate conferees must reconcile the two versions of the bill after the Senate passes the bill late this week or early next week.

Johnson and other officials with AIDS organizations note that the House version and the Senate committee version still include an additional $5.8 billion in funds for a Public Health and Social Services Emergency Fund.

According to the Senate committee version of the bill, the emergency fund would "carry out a program of grants, contracts and cooperative agreements to fund projects and activities to reduce the incidence or severity of preventable disabilities, diseases and conditions and to invest in health workforce training." The $400 million provision for HIV and STD testing and prevention was part of this fund before Senate leaders removed it last week.

"Many of the Republicans are griping about the STD and AIDS funds being in the bill but not about the rest of this public health fund," said Carl Schmid, director of federal affairs for the AIDS Institute, another national advocacy group.

"We support the fund, including the HIV part of it," Schmid said. "We feel prevention is cost effective and saves money in the long run."

He and Johnson said their respective groups also believe that including HIV and STD prevention funds in the president's economic stimulus package can be justified as a legitimate economic stimulus provision because the funding would result in more health care related jobs.

"Health care is the largest single component of the gross national product of the nation," Johnson said. "The economic impact of health-related activities, including HIV-related activity, is very substantial."

Republican and conservative critics of the president's stimulus plan have taken strong exception to that assessment. Some have said the plan was rapidly evolving into a "Christmas tree" bill, with liberal Democrats pressuring Obama to add many of their pet projects that the Bush administration had blocked over the past eight years.

A White House spokesperson could not be immediately reached for comment on the AIDS-related aspect of his stimulus package.

The White House and Senate Democratic leaders expressed concern last week when not a single Republican voted for the House version of the stimulus measure when it came up for a vote on the House floor.

The administration and Democratic leaders in Congress also took note over the weekend when a number of influential moderate Democrats raised strong objections to what they said were too many non-stimulus related provisions in the legislation.

Some Capitol Hill observers said that if moderate Democrats join Republicans in voting against the bill in the Senate, it could prevent Democratic leaders from stopping a GOP-led filibuster, leading to the defeat of the bill and a colossal loss for Obama in his first important presidential initiative.

Most observers believe the White House will ultimately work out an agreement with Republicans to enable the bill to clear Congress, in part, by agreeing to jettison more provisions that the Republicans don't like.

"There's an awful lot of spending in it that I think is questionable," said Sen. Ben Nelson (D-Neb.), one of the Senate's leading Democratic moderates. Nelson called the STD and HIV testing and prevention proposals important programs.

"But they ought to be part of something else, not part of a jobs stimulus bill," he said.

Michael Weinstein, president of the AIDS Healthcare Foundation, which provides AIDS-related medical care to people in the U.S. and developing countries, said critics are wrong in claiming HIV- or STD-related programs don't boost the economy.

"The funding of HIV and STD testing and prevention in the stimulus bill is actually a very prudent use of U.S. taxpayer dollars," he said.

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