The House of Representatives will take up two pivotal HIV/AIDS-related amendments today as it debates a massive spending bill for domestic labor, health and education programs. Although the policy decisions at stake today are part of a domestic funding bill, they have implications for global AIDS.
The first is a proposal by Rep. Darrell Issa, R-CA, to rescind funding for three peer-reviewed grants that focus on HIV/AIDS prevention. Issa says they are an example of wasteful spending. The three grants ar focus on : substance abuse and HIV risk among Thai women; HIV prevention for hospitalized Russian alcoholics; and venue-based HIV and alcohol use risk reduction among female sex workers in China. More information is included below in an action alert being circulated by health advocates.
The second amendment, from Rep. Mark Souder, R-Ind., would reinstate the ban on federal funding for needle exchange programs. As we’ve written in earlier posts on this subject, Rep. David Obey, D-Wis., moved to overturn the ban in subcommittee. He inserted a watered-down version in full committee but has pledged to work toward full repeal. Souder’s proposal would cut those efforts short and put back in place a ban that physicians and other AIDS advocates have long criticized as an unnecessary hurdle to effective HIV prevention efforts.
Although this does not technically apply to US global AIDS programs, PEPFAR officials have acted as though it does and have not funded any international needle exchange programs. Lifting the domestic restriction could lead to a similar move at PEPFAR. Read this post for more on that.
Both these votes are crucial if we are to have evidence-based HIV/AIDS policies in place. Please contact your lawmakers today to urge no votes on these amendments. We’ll update you on the outcome of these votes as soon as we can, so check back for the latest news.
Here’s the aforementioned action alert on the HIV research grants:
We wanted to alert you to the fact that Rep. Darrell Issa (R-CA) plans to offer an amendment to the House FY 2010 Labor, Health, and Human Services, and Education Appropriations bill which is scheduled to come to the House floor tomorrow. The House Rules Committee is scheduled to meet this afternoon at 3pm to decide which amendments will be considered. We understand that it will be one of the amendments that will be allowed for consideration when the House begins debating the bill tomorrow, Friday, July 24th. The amendment would rescind the funding for the following three currently funded, peer-reviewed grants that that focus on HIV/AIDS prevention, as an example of wasteful spending.
1) Substance Abuse Use and HIV Risk Among Thai Women
Grant Number: 1R21DA026324-01A1
The proposed collaboration study between Ms. Usaneya Perngparn, Chulalongkorn University, Thailand and Dr. Nemoto, Public Health Institute, California, will investigate the sociocultural contexts of HIV risk behaviors and drug use among Thai female and male-to-female transgender (kathoey) sex workers in Bangkok. Research is currently needed to develop and adapt HIV prevention models that take into account sociocultural factors so that the further transmission of HIV and sexually transmitted infections can be averted. Participation in these types of studies also can provide a way for persons suffering from the health consequences of illicit sexual activity to receive treatment while contributing to our knowledge of prevention and treatment outcomes in these populations.
2) HIV Prevention for Hospitalized Russian Alcoholics
Grant Number: 5R01AA016059-03
Investigators are adapting a prevention approach that has been demonstrated to be effective in decreasing high-risk HIV related behaviors in the U.S. for use in Russia, a country with a rapidly expanding incidence of HIV. The approach, called Health Relationships Intervention, involves the development of a plan of action for each client to increase social support and reduce high-risk behaviors. This includes the disclosure of information to family and friends on the client’s health, social needs and condition thereby assisting the client in maintaining low risk behaviors.
3) Venue-based HIV and Alcohol Use Risk Reduction Among Female Sex Workers in China
Grant Number: 1R01AA018090-01
Research has provided evidence linking alcohol-related, high risk sexual behavior with HIV and other sexually-transmitted infections. Research has also provided rich descriptions of social, cultural, and economic contexts in which people engage in alcohol-related sexual risk behaviors. More specifically, alcohol use characteristics (e.g., binge drinking) have been linked with sexual risk-taking that occurs in a range of high risk environments. The investigators have proposed a 5-year study to develop, implement, and evaluate a theory-guided, multiple components, and venue-based HIV and alcohol use risk reduction intervention among commercial sex workers (FSWs) in China.
Attached are talking points from the NIH regarding the public health relevance of the grants being targeted. Given that HIV/AIDS is a global epidemic that has already killed more than 25 million men, women, and children and 33 million are currently living with HIV, it is clear that prevention of HIV infection should be a priority area of research funding. The research is easy to ridicule if it is taken out of its public health context. The fact is, scientists need to explore a range of research avenues in vulnerable populations around the world to learn the best ways to control the transmission of HIV.
How Does NIH Decide to Fund These Grants?
The NIH uses a rigorous peer review process to determine which grant applications to fund. NIH’s scientific peer review process is the gold standard for determining the quality and relevance of grant proposals. Thousands of scientists each year submit applications to the NIH requesting funding for their scientific proposals. Applications are evaluated initially by the NIH’s Center for Scientific Review and peer review groups composed of scientific experts from around the U.S. and the world. These groups (also called “study sections”) assess and rate the scientific and technical merit of the proposed research or training projects. Projects reviewed in a particular session are scored and ranked in relation to each other. The applications are then assigned to one of the 27 institutes and centers at NIH. A second level of peer review is conducted by the NIH National Advisory Councils of the respective funding Institutes or Centers, which are composed of both scientists from the research community and public representatives. These councils ensure that the NIH receives advice from a cross-section of the U.S. population in its deliberation and decision-making.
This system ensures that research conducted and supported with taxpayer dollars is scientifically meritorious and serves to improve the lives of all people equally. Approximately 70 percent of meritorious, scientifically valid proposals do not receive funding through this process. The grants that receive funding, however, are the best in their fields.
In response to previous congressional concerns about whether sexual health research should be funded by the agency, NIH reviewed the entire NIH sexuality portfolio in 2004. That investigation found that all of the NIH grants in areas of sexual health met the rigorous standards of scientific and ethical quality, that they were not funded out of proportion to the public health burden of these diseases, and that the merit review system had been followed.