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Staying the Course in the Fight Against AIDS


by Richard M. Doerflinger

April 4, 2008

Good news from Washington D.C. is rare enough that any victory for statesmanship and common sense should receive attention. The approval of a bill to reauthorize PEPFAR (the President's Emergency Plan for AIDS Relief) by the House of Representatives on April 2 is a good example.

In February I wrote a column expressing alarm about some features of a draft bill. Population control advocates had rewritten the program to promote family planning and "reproductive health" as a priority in fighting HIV/AIDS, malaria and tuberculosis in Africa and other developing nations. I wrote then: "A program for preventing the next generation of Africans from getting AIDS could become a program for preventing the next generation of Africans."

However, objections by Catholics and others raised awareness in Congress about this ideological takeover, and wiser heads prevailed. The final bill reported by the House Foreign Affairs Committee, the product of negotiations among the White House and Republicans and Democrats on the committee, preserves many life-saving and morally sound features that made this program so effective in its first five years. The bipartisan nature of this bill is reflected in the lopsided House vote to approve it, 308 to 116.

Abstinence and fidelity are recognized as important prevention methods in the House bill; protection for Catholic and other agencies with conscientious objections to some methods is retained and strengthened; and some new features, such as provisions for nutrition assistance and better training of health care workers, are most welcome. All references to the misleading code word "reproductive health" are gone.

The House bill now mentions family planning only to say that HIV services should be available to clients of "family planning programs supported by the U.S. government." This compromise language is very different from earlier language urging PEPFAR to promote family planning services to people who want HIV/AIDS assistance. And the phrase "supported by the U.S. government" means that the AIDS program will not link with programs that violate U.S. policies against abortion as family planning or the coercion of women. An amendment to delete this important phrase, supported by family planning groups, was not allowed a vote on the House floor. A parallel reauthorization bill pending in the Senate does not mention "family planning" at all.

Some problems and disagreements remain. For example, the original program's allocation of 33% of prevention funds for abstinence programs has been replaced by a much weaker and vaguer provision that cries out for clarification.

One sign of hope is a floor speech by Foreign Affairs committee chairman Howard Berman before the House vote. He praised members of both parties on his committee for their efforts, and said each had learned from the other: Republicans were persuaded of the need for a well-funded program to combat AIDS in the Third World, and Democrats were persuaded that abstinence programs and faith-based organizations are an important part of the solution. If those insights are fully reflected in the final legislation, we will have a renewed and expanded humanitarian program for the suffering people of Africa that President Bush and Congress can be proud of.


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