Bay Area Reporter - March 6, 2008
Bob Roehr

The measure passed on a voice vote, without any amendments, after a compromise was reached the night before in negotiations between committee leaders and the White House. Liberals gained some but not all of the changes they sought, while conservatives maintained several provisions they had fought for.

One primary change is a loosening of requirements on abstinence prevention programs. The new bill drops a mandate that a third of all prevention dollars be spent on abstinence and instead calls for "balanced funding" of prevention activities that include abstinence and "are implemented and funded in a meaningful and equitable way."

It also allows use of PEPFAR funds for HIV testing and prevention education at family planning clinics that offer counseling and services that include abortion. Some social conservatives had argued that supporting such activity was tantamount to supporting abortions.

The current law requires that organizations accepting PEPFAR funds pledge to oppose commercial sex work. Liberals had sought to ease that restriction as it impedes outreach to a high-risk population, but they dropped the effort as part of the compromise. The "pledge" requirement is under litigation.

The bill authorizes $9 billion to fight tuberculosis and malaria, two coinfections that are major causes of death in many of the countries that PEPFAR serves. It would allow use of funds for food supplements and for "microcredit" loans to women widowed by AIDS. It also expands the program to include 14 small nations in the Caribbean.

Acting committee Chairman Howard Berman (D-California) said, "This bill is not perfect, but no compromise ever is."

While there was broad bipartisan support within the committee, it was not unanimous. "I've been here 20 years and this is the most insane thing I have ever witnessed," said conservative Representative Dana Rohrabacher (R-California). Referring to the unmet needs of veterans and families that cannot afford health insurance he said, "We have people at home who need to be taken care of."

A major critic of PEPFAR regulations, Paul Zeitz, who leads the Global AIDS Alliance, said, "Congress is beginning to fix aspects of the AIDS program that were clearly not working ... This historic agreement will save millions of lives."

Speaking at a news conference the next day, Bush thanked the committee for its action. He said the reason that he and first lady Laura Bush made their recent trip to Africa "was to remind the American people about how important it is for our nation to remain generous and compassionate when it comes to helping people overseas."

The full House is likely to consider the bill before it leaves for Easter recess on March 14. There is some talk that the Senate may try to amend the legislation.

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