Expanding on a program that has saved and prolonged the lives of millions in Africa alone, the House prepared Thursday to pass and send to President Bush (web|news|bio) legislation that triples money to fight AIDS, malaria and tuberculosis around the world. Bush, who first floated the idea of a campaign against the scourge of global AIDs in his 2003 State of the Union speech, supports the five-year, $48 billion plan. The current $15 billion act, which expires at the end of September, has helped bring lifesaving anti-retroviral drugs to some 1.7 million and supported care for nearly 7 million. It has won plaudits from some of Bush's harshest critics both in Congress and around the world. Democrats in the Senate, which passed the bill last week, hailed it as one of the most significant accomplishments of the Bush presidency.

The President's Emergency Plan for AIDS Relief, known as PEPFAR, is "the largest commitment ever by any nation for an international health initiative," said Rep. Lincoln Diaz-Balart, R-Fla.

According to a study by UNAIDS and the Kaiser Family Foundation, the United States provided one-fifth of AIDS funding from all sources - governments, multilaterals, the private sector and domestic sources - in 2007. About 40 percent of the $4.9 billion disbursed in 2007 from the G-8 countries, Europe and other donor governments came from the United States.

The legislation approves spending of $5 billion for malaria and $4 billion for tuberculosis, the leading cause of death for people with AIDS. It authorizes spending of up to $2 billion next year for the international Global Fund to Fight AIDS. The measure also provides $2 billion, on top of the $48 billion, for American Indian water, health and law enforcement programs.

PEPFAR has focused on nations in sub-Saharan Africa that have been devastated by AIDS, but it has also provided assistance in the Caribbean and other areas hit by the pandemic now affecting some 33 million worldwide.

The new bill, like the current law, states that 10 percent of funds should be allocated for orphans and vulnerable children. It sets as a goal preventing 12 million new HIV infections, treating more than 2 million with anti-retroviral drugs, supporting care for 12 million people infected with HIV/AIDS and training at least 140,000 new health care workers and paraprofessionals.

It increases attention on women and girls, including stressing the importance of preventing gender-based violence.

Pamela W. Barnes, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, applauded the bill's target of reaching 80 percent of HIV-positive pregnant women with services needed to prevent transmission to their children. "We are still only reaching 34 percent of pregnant, HIV-positive mothers with the medicine they need to keep their babies HIV-free," she said.

The final product took months of compromise: Democrats took out a provision in the existing act requiring that one-third of prevention funds be spent on abstinence education, but allowed for reports to Congress if abstinence and fidelity spending falls below certain levels. Conservatives won "conscience clause" assurances that religious groups would not be forced to participate in programs to which they morally object.

Bush, who originally proposed doubling the program to $30 billion originally balked at but later accepted the $50 billion bill that passed the House last April. The Senate diverted $2 billion of the $50 billion to Indian programs and inserted a provision that more than half of funds for AIDS programs go for treatment and care.

The Senate also attached a measure, welcomed by AIDS advocacy groups, that ends a two-decade-old U.S. policy that has made it nearly impossible for HIV-positive people to get visas to this country as immigrants, students or tourists.

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The bill is H.R. 5501.

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Congress: http://thomas.loc.gov

Written By JIM ABRAMS

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