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house Bill H.R. 6651

Should a Program to Fight HIV/AIDS, Tuberculosis, and Malaria Be Extended by 5 Years?

Argument in favor

The PEPFAR program has a major impact and has changed the trajectory of the HIV/AIDS epidemic by giving millions of people access to life-saving antiretrovirals. Extending the program is necessary for global public health.

BadHombre's Opinion
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11/12/2018
This program should be extended to help the world control HIV. Not all the provisions of this bill are acceptable, eg, gag rule. But the program overall has tremendous value.
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Sam's Opinion
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11/12/2018
Scratch out that gag rule and then we’re golden
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Douglas's Opinion
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11/12/2018
Helping the world be rid of these illnesses helps us too!!!
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Argument opposed

The PEPFAR program is very expensive and doesn’t directly benefit people in the U.S. It’s also flawed, as the global gag rule prohibits organizations involved in providing abortions from receiving PEPFAR money.

PhilAlban's Opinion
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11/12/2018
Part of this program includes expanding the global gag rule. Look it up. It fundamentally works against public health and it's shameful that Rep Lee intentionally ignores this. While there are some benefits to the PEPFAR program, a better program that is not based on policy over a decade old should be created. Focusing on prevention is of primary importance, as is public health. And, as we saw in the '80s public health isn't limited to just one country. Complaints that is of benefit to foreign countries is short-sighted, since epidemics don't follow man-made borders.
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Abbi's Opinion
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11/12/2018
Remove the gag rule and make it a criminal act to divert funds to child prisons.
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JayJib's Opinion
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11/12/2018
The root idea is good but the gag rule and other flaws mean that it’s better to just start over with a new and better plan.
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bill Progress


  • Not enacted
    The President has not signed this bill
  • The senate has not voted
  • The house has not voted
      house Committees
      Committee on Foreign Affairs
    IntroducedAugust 3rd, 2018

What is House Bill H.R. 6651?

This bill would extend the President’s Emergency Plan for AIDS Relief (PEPFAR) program’s end date from 2018 to 2023. PEPFAR, first proposed by President George W. Bush in 2003, is the U.S. government’s global effort to combat HIV. It’s the largest global program devoted to a single disease. It was originally authorized as a five-year, $15 billion initiative to combat global HIV/AIDS, tuberculosis (TB), and malaria primarily for 15 hard hit “focus countries,” and fund multilateral contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund), and UNAIDS.

Impact

PEPFAR; U.S. foreign aid; State Department; and HIV/AIDS, malaria, and tuberculosis.

Cost of House Bill H.R. 6651

The CBO estimates that this bill would cost $15 million over the 2019-2023 period.

More Information

In-DepthRep. Christopher H. Smith (R-NJ) introduced this bill to fund PEPFAR beyond its 2018 expiration. Rep. Barbara Lee (D-CA), a cosponsor of this bill, calls PEPFAR a successful bipartisan collaboration on U.S. leadership in global public health:

“For the last 15 years, PEPFAR has been a testament to the bipartisan cooperation on U.S. leadership in global public health. Thanks to PEPFAR, millions of lives have been saved through HIV/AIDS treatment, care, and education. But our work is far from over – we are at a tipping point and Congress must recommit to this fight. Many still do not have the resources and care they need, and stigma stands in the way of eradicating this disease for good. At this pivotal time, Congress must do the important work to protect and fund programs like PEPFAR and the Global Fund. As an early champion of these initiatives, I am so proud of our work across the aisle, ensuring that PEPFAR can continue to save lives for decades to come.”

Charles Lyons, president and CEO of the Elizabeth Glaser Pediatric AIDS Foundation, which supports this bill, calls this bill’s support for PEPFAR essential to the program’s continuation:

“Over the past 15 years, PEPFAR has driven stunning progress in the global fight against AIDS, including enabling more than 2.2 million babies to be born HIV-free to HIV-positive mothers. As a long-term PEPFAR implementer, we see the program’s remarkable success up close, but we are also very aware how much work remains. Sustained support and leadership on the part of the U.S. is instrumental, and EGPAF welcomes this step toward renewing commitments to ending the epidemic.”

Loyce Pace, President and Executive Director of Global Health Council (GHC), adds that PEPFAR is a prime example of investing in global health:

“We know that investments in global health work, and PEPFAR is a prime example of that. Over the past 15 years, PEPFAR has had an impact on the lives of those living with HIV/AIDS, as well as building health systems to address malaria, TB, and maternal and child health. By renewing our commitment to this groundbreaking initiative, we emphasize its value and pave the way for even more global health progress worldwide.”

The Center for American Progress’ Scott H. Evertz argues that PEPFAR, while admirable in its intentions, is a critically flawed program:

“PEPFAR has meant nothing less than another chance at life for millions of people around the world. And it provided a positive image of the United States at a time of controversial foreign policy entanglements. Yet the reality is that the Bush administration’s PEPFAR legacy is far more complicated and problematic. The program has proved deficient in many respects, most notably in prevention and reaching out to populations most in need of services. Some of these limitations are rooted in the statute or implementing regulations; others have played out on the ground through different interpretations of U.S. government policies; but most are due to a framework that placed ideology above science.”

Health GAP’s executive director, Asia Russell, adds that PEPFAR is “the kind of global AIDS response policymakers craft when they have one hand tied behind their backs,” and argues that the current PEPFAR plan fails to highlight the “dangerous impact” of expanding the Global Gag Rule, which blocks U.S. funds to any organization involved in abortion advice and care overseas. Ms. Russell adds that a truly ambitious HIV/AIDS strategy would be more global than PEPFAR’s current direction:

“An ambitious strategy wouldn't limit efforts toward epidemic control in just 13 of PEPFAR's more than 50 countries, but would aggressively map out a plan for ending AIDS as an epidemic in all countries, including those with the highest burden and greatest need such as Mozambique, South Sudan, the Democratic Republic of Congo and other parts of West Africa… PEPFAR leadership should sound the alarm about the risks of committing too few resources to the global AIDS response and the dangers of using scarce resources for anything other than evidence-based strategies."

The Trump administration has been hostile to PEPFAR, suggesting that it views it as a “massive, international entitlement program.”

This bill passed the House Foreign Affairs Committee on a unanimous vote with the support of 12 cosponsors, including six Republicans and six Democrats. It has the support of the United States Conference of Catholic Bishops (USCCB)Catholic Relief Services (CRS)Elizabeth Glaser Pediatric AIDS Foundation (EGPAF)Friends of the Global Fight Against AIDS, Tuberculosis and Malaria (Friends)World Vision,  Global Health Council, and the ONE Campaign.


Of Note: Since its original authorization, PEPFAR has been reauthorized twice, in 2008 and 2013. To date, PEPFAR funding has totaled over $70 billion. PEPFAR is widely credited with changing the trajectory of the global HIV/AIDs epidemic. Since its inception, PEPFAR has supported HIV treatments for over 13.3 million people globally, putting an AIDS-free generation in reach. Thanks to PEPFAR, 2.2 million babies have been born HIV-free to mothers receiving antiretroviral drugs. 


Media:

Summary by Lorelei Yang

(Photo Credit: iStockphoto.com / spukkato)

AKA

PEPFAR Extension Act of 2018

Official Title

To extend certain authorities relating to United Sates efforts to combat HIV/AIDS, tuberculosis, and malaria globally, and for other purposes.

    This program should be extended to help the world control HIV. Not all the provisions of this bill are acceptable, eg, gag rule. But the program overall has tremendous value.
    Like (53)
    Follow
    Share
    Part of this program includes expanding the global gag rule. Look it up. It fundamentally works against public health and it's shameful that Rep Lee intentionally ignores this. While there are some benefits to the PEPFAR program, a better program that is not based on policy over a decade old should be created. Focusing on prevention is of primary importance, as is public health. And, as we saw in the '80s public health isn't limited to just one country. Complaints that is of benefit to foreign countries is short-sighted, since epidemics don't follow man-made borders.
    Like (69)
    Follow
    Share
    Scratch out that gag rule and then we’re golden
    Like (42)
    Follow
    Share
    Remove the gag rule and make it a criminal act to divert funds to child prisons.
    Like (31)
    Follow
    Share
    The root idea is good but the gag rule and other flaws mean that it’s better to just start over with a new and better plan.
    Like (26)
    Follow
    Share
    Helping the world be rid of these illnesses helps us too!!!
    Like (26)
    Follow
    Share
    Needs to remove gag rule.
    Like (18)
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    Fix the flaws then pass.
    Like (15)
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    But remove the gag rule.
    Like (12)
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    Yes, but remove the gag rule.
    Like (9)
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    Another short term “feel good”program that refuses to end. Shut it down. No reauthorization of funds.
    Like (7)
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    Obviously. The gag rule is terribly stupid, but the program overall is very important.
    Like (4)
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    No more propagandistic programs. Yet again, America, we need comprehensive healthcare. Trump’s calling the program “global entitlement” is incorrect. The world is shrinking as superbugs grow in our own country and others. Along with our incoming issues with antibiotic-resistant bacteria, the transmission of these diseases and viruses could affect American lives as well. The worlds problem is our own problem as we become increasingly interconnected. We will all suffer if we do not help the weakest and least disadvantaged in this country and others. I reject this bill because we need a better one with optimized strategies ASAP—especially if it’s anything like our mismanaged healthcare.
    Like (4)
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    Why is there an end to this research. The end should only be when they find a cure or a vaccine and more importantly fix the problems in the bill such as the gag rule. only then!!! Pass the bill
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    Helping fight pandemics protects everyone.
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    The global gag rule should not be a part of this issue
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    I was all for this bill until it hindered physicians from speaking frankly about medical advice. Politicians, I'm going to need you to BACK UP. Once you go to medical school and either conduct research or practice medicine, then you can give me medical advice. As one put it, "Stay in your lane!"
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    Poorly written legislation. FIX IT! Stop with gag orders and religious dogma.
    Like (3)
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    Remove this archaic global gag rule and then pass the bill. It is critical to the safety and security of the U.S. that not just Americans are healthy, but people across the world as well. However, we can’t do that effectively if we can’t send funding to organizations that provide abortion services. This is the 21st century and we shouldn’t be maintaining absurd restrictions like this.
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    Why stop it?
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