Progress on PEPFAR Agreement
According to this article from the Kaiser Network, negotiators in the U.S. Senate reached a tentative agreement on legislation to reauthorize PEPFAR. (I’ve been tracking developments in this area for a couple weeks; for background see posts from June 12, June 20, later on June 20, and June 21, and/or this article from yesterday.)
The report I just linked to is well worth reading, so I’ll just comment on a few points it mentions.
- I can’t help but wonder about the wisdom of earmarking more than half of PEPFAR funds for treatment (as opposed to prevention efforts, care for orphans, etc.). This article from Politico.com discusses some of the objections AIDS advocates have raised to this requirement. The criticisms are summarized in a chart at the end of the article as follows: “A mandate that most money goes to treatment undermines PEPFAR because treatment is not a substitute for prevention. The needs in each country vary depending on whether the AIDS epidemic is full-blown or just emerging. Cultural differences and different pub;ic health capacities mean that a one-size-fits-all approach is impractical. Local implementers need the flexibility to target their prevention programs toward the people they are serving.”
Treatment is obviously important, but so are efforts to stop the spread of HIV/AIDS and mitigate its more long-term consequences. If nothing else, this debate highlights the complex and heartbreaking calculus faced by everyone trying to address HIV/AIDS with limited resources.
- The prospect of amendments to the existing legislation is worrying, given that it is opponents of the bill who want to propose changes.
- Let’s hope this legislation can get passed before July 4. If the U.S. can cite the success of new PEPFAR legislation, that will put a lot of weight behind calls for further action on AIDS and other humanitarian issues from the G8 nations when they meet in Japan beginning on July 7.
- According to the article, “Sen. Jim DeMint (R-S.C.), who was one of the seven Republicans blocking the legislation, continued to object to the cost of the measure, saying it is ‘completely irresponsible’ for the U.S. ‘to attempt to buy friendship around the world by spending $50 billion’ (Rosen, Columbia State, 6/26).”
This comment just breaks my heart. Regardless of the wisdom of spending this much to “buy friendship” (especially given the amount the U.S. has spent doing things that – whether you agree with them or not – have drawn anything but international friendship), DeMint is completely missing the main point of the legislation. There are countless lives at stake here. PEPFAR isn’t, or at least shouldn’t be, about what it can do for the U.S. It’s about what it can do for the millions of people whose lives and communities are being devastated by AIDS, people who through no fault of their own lack the financial resources to deal with their situation alone. It’s stunning that some people can’t see this.
All that being said, I’m incredibly glad that it looks like PEPFAR is finally on the move again. I’ll be keeping this situation in my prayers as we see how it unfolds.