Posts Tagged ‘Senate’

The Senate Foreign Relations Committee today approved a resolution opposing Uganda’s Anti-Homosexuality Bill, a move intended to escalate pressure on that country as it considers legislation that would impose life imprisonment or a death sentence for same-gender consensual sex.

The Senate resolution notes that “such laws undermine our commitment to combating HIV/AIDS globally” by stigmatizing and criminalizing at-risk populations. It calls on Uganda’s Parliament to reject the bill and similarly urges other countries “to reject and repeal similar criminalization laws.” It was introduced by Sens. Russ Feingold, D-Wisc., Tom Coburn, R-Okla., Ben Cardin, D-Md., and Susan Collins, R-Maine.

The fate of Uganda’s legislation, which has sparked international outrage, remains murky.  But the problem of homophobia in Africa is alive and well. Read this griping story for more on the climate of fear that many homosexuals endure and the impact on HIV services. And click here for more on the Senate resolution.

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There seems to be a significant–and hopefully growing–degree of displeasure on Capitol Hill about the Administration’s commitment to combating the AIDS epidemic. The latest signal is a letter from eight U.S. senators, including the Senate’s No. 2 leader, urging the president fully fund PEPFAR at the congressionally-authorized levels.

“The success of our HIV/AIDS programs is potentially compromised by a proposed slow-down in the pace of funding,” reads the Senate letter, spearheaded by Sens. Barbara Boxer, D-Calif., and Johnny Isakson, R-Georgia, and also signed by Assistant Majority Leader Dick Durbin, D-Ill., among others. “We cannot afford to lose momentum in our fight against” HIV/AIDS, tuberculosis and malaria or to pull back from the expanded mandate set out in the Lantos-Hyde Act that reauthorized PEPFAR.

Here’s a link to the full letter: Boxer-Isakson letter on FY 11 

The Senate missive comes on the heels of a similar letter to Obama from five key House members, including the chair of the Congressional Black Caucus. Click here to read that letter and our blog post about it.

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Lawmakers have finalized the fiscal year 2010 budget for foreign assistance, setting funding for key programs to fight global HIV and TB and reaching a landmark deal to revise the needle-exchange ban.

The agreement—expected to pass the House before the end of this week and the Senate before the end of next week—includes some modest increases for bilateral HIV and TB, as well as for the Global Fund to Fight AIDS, Tuberculosis and Malaria. But the funding levels still fall far short of what’s needed to combat these twin epidemics and of what was authorized in the Lantos-Hyde Act passed by Congress last summer.

The deal, for example, would allocate $5.359 billion for global AIDS, $1.05 billion for the Global Fund, and $225 million for TB. It also includes a slight boost for NIH. The gloal AIDS figure does not include bilateral HIV/AIDS funds for USAID or the CDC’s Global AIDS Program; with those pots of money tallied, the total US bilateral AIDS funding for 2010 stands at $5.828 billion. (See chart below for more details on how this comparies to last year, etc.)

The real headline, though, is this: Key congressional negotiators agreed to ease the ban on federal funding for needle exchange programs. This is a long-overdue move that will remove an unnecessary and harmful barrier to effective HIV prevention efforts. It’s also a big surprise.

Earlier this year, the House approved lifting the ban, but included so many restrictions as to make federal funding for such programs essentially unfeasible (i.e., not near any schools, parks, arcades, etc.). The Senate voted to keep the ban in place.

The new agreement revises the ban so it would only prohibit the use of federal funds for needle exchange programs in a location “that local public health or law enforcement agencies determine to be inappropriate.”

Here’s the chart, which lays out the approved spending levels for FY2009, the funding levels authorized in the PEPFAR II, the President’s request for FY2010, and last night’s Congressional agreement.

Dollars in millions

  FY09 PEPFAR II Obama FY 10 Final
Global AIDS $5.159bil $6.5bil $5.259bil $5.359bil
Global Fund $600 $2bil $600 $1.05 bil
Tuberculosis $163 $650 $173 $225
NIH $30.566 N/A $30.758 $31.008


Notes:  The reauthorization bill did not contain specified year by year funding levels with the exception of the Global Fund which was authorized at $2 billion.   The amounts listed under PEPFAR II for bilateral Global AIDS and TB are extrapolated from the overall five-year funding levels authorized in the bill. In addition, as noted above, the global AIDS figure does not include money directed to USAID or CDC for their bilateral HIV programs.

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The search for new TB drugs and diagnostics is a long and windy road, paved with regulatory bumps and expensive R & D hurdles.

But the path could get a little smoother under an amendment recently added to the Senate’s fiscal year 2010 funding bill for the Food and Drug Administration and other related programs. The provision, offered by Sen. Sam Brownback, R-Kansas, would require the FDA commissioner to create two review groups to recommend new solutions for “the prevention, diagnosis and treatment of rare diseases and neglected diseases in the developing world.”

Brownback’s provision aims to streamline the regulatory process for new drugs and other tools to combat rare and neglected diseases that can take a huge toll on poor people in the developing world, where the potential to make big bucks off a new drug are slim to none. Click here for the amendment text and status of the bill.

In his floor speech urging support for the provision, Brownback specifically mentioned tuberculosis as a neglected disease that is “rampant” in the developing world but that has not gotten adequate R & D attention.

“You can have millions, even more than that, who are affected by a disease, but there is not a large marketplace to support the research that is necessary to develop a cure,” Brownback said. “It is my hope that what this will lead to is us developing systems and ways where we can reduce the cost and the time for drug delivery and development.”

Brownback’s provision passed the Senate but is not included in the House version of the bill. So a House-Senate conference committee will decide its fate. The Center for Global Health Policy, along with a coalition of other groups, is strongly supporting final passage.

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First, a quick update on needle exchange: The Senate Appropriations subcommittee on labor, health and education programs approved a spending bill this week that leaves in place the funding ban on needle exchange programs. This means a fight in conference over the fate of that provision, since the House approved language lifting the ban, albeit with lots of restrictions on where needle exchange programs can be located. As we’ve written here before, the ban technically only applies to domestic programs, but PEPFAR officials have extended it to international programs, so this has major implications for global HIV prevention efforts.

Now, for those who didn’t get enough HIV/AIDS science or policy news at the IAS conference in Cape Town (or those who didn’t get to go in the first place), Aidsmap.com has launched an online discussion forum to further delve into questions raised at the conference. Among the topics up for debate: the implications of calls for earlier initiation of antiretroviral treatment. Click here to check out the Aidsmap forums–and make sure to cross-post comments here, so the discussion can be wide-ranging.

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A key House subcommittee has called for lifting the ban on funding for needle-exchange programs, a significant step forward in the hard-fought battle for evidence-based treatment of HIV/AIDS.

Disease experts, particularly those who specialize in treating HIV/AIDS, have long argued that the ban on needle exchange unnecessarily impeded HIV/AIDS prevention efforts. Rep. David Obey, D-Wis., chairman of the House Appropriations Committee, noted as much in a statement today announcing the proposed change in policy.

“Scientific studies have documented that needle exchange programs, when implemented as part of a comprehensive prevention strategy, are an effective public health intervention for reducing HIV/AIDS infectious and do not promote drug use,” Obey said in this statement. (more…)

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From Capitol Hill to sub-Saharan Africa, the subject of spending on global health is likely to take center stage this week, or at least a more prominent place than usual. But the increased attention may not result in more robust resources for the deadly epidemics of HIV/AIDS and tuberculosis.

In Washington, the Senate Appropriations Committee is scheduled to take up its foreign affairs spending bill this week, determining crucial funding levels for global AIDS and TB programs. The House has already marked-up its version of the bill; click here to read our earlier blog post on the modest increases approved in that chamber for PEPFAR and bilateral TB.

Meanwhile, world leaders will gather in Italy on Wednesday for the G8 Summit; there’s deep concern that global health will get short-shrift at the session, as government officials seek to backtrack from earlier commitments amid the economic crisis. This Huffington Post piece provides a good sense of the landscape, and we’ll try to provide updates as the summit gets underway.

Finally, at the end of the week, President Barack Obama will travel to Ghana, his first trip to sub-Saharan Africa as president. It is a chance for global health advocates to highlight the immense needs in that region, but even that milestone visit isn’t likely to drum up much new support for global HIV funding. The White House choose Ghana because to showcase a stable democracy on the continent, as the New York Times reported in this story a while back. And Obama is set to talk about food aid there, not disease epidemics.

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