Congress Should Uphold Bipartisan Legacy on HIV/AIDS and Global Health
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Even as President George W. Bush used the 2003 State of the Union to outline his case for war in Iraq — an issue that thoroughly divided Democrats and Republicans — he also, in true bipartisan fashion, declared war on HIV/AIDS. Indeed, fighting HIV/AIDS, tuberculosis (TB), malaria, and other preventable, treatable killers is an issue that can, has, and always should unite our elected leaders.
As we approach this World AIDS Day on December 1, our country is politically divided. Economic crisis, disagreement on policies, electoral politics, and historic distrust have pitted the two major parties against one another. A survey of the post-election commentary shows each party paying lip service to bipartisanship, but few concrete proposals for cooperation have yet emerged. Recommitting the United States to a leadership role in global health is an issue that is ripe for such cooperation across the aisle.
This is not a hypothetical proposition. Democrats and Republicans have a stunningly successful history of working together to fight AIDS, TB, and malaria. The President’s Emergency Plan for AIDS Relief – or PEPFAR – that President Bush announced in 2003 to bipartisan applause is a case in point. Since it was launched in 2004, PEPFAR has spent $19 billion to help distribute life-saving antiretroviral treatments to about 2.5 million people infected with HIV.
These achievements would not have been possible without genuine bipartisan cooperation and leadership in Congress.
In the Senate, bipartisan cooperation has been a hallmark of the fight against HIV/AIDS, TB, and malaria. In 2002, Senate Minority Leader Bill Frist (R-TN) joined with Sen. John Kerry (D-MA) to introduce the U.S. Leadership Against HIV/AIDS, TB, and Malaria Act, which would lay the legislative groundwork for the ensuing PEPFAR program. In 2006, Sen. Rick Santorum (R-PA) partnered with Sen. Dick Durbin (D-IL) to author a critical spending amendment that more than doubled the proposed U.S. contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. And on World AIDS Day in 2006, then Sen. Barack Obama (D-IL) sat next to Sen. Sam Brownback (R-KS) as they both received an HIV test, bringing needed attention to the disease and the stigma that surrounds it.
In the House of Representatives, Republicans and Democrats came together in 2008 to pass a truly historic, bipartisan bill that laid out the boldest goals to date in the fight against AIDS, TB, and malaria. The Tom Lantos and Henry J. Hyde U.S. Global Leadership Against HIV/AIDS, Tuberculosis and Malaria Reauthorization Act authorized $48 billion over 5 years to prevent, detect, and treat these 3 diseases. The legislation was named for representatives Tom Lantos (D-CA) and Henry Hyde (R-IL), who spent a combined 60 years serving in the House and who had passed away within months of each other. As chairmen of the Foreign Affairs Committee for their respective parties, they were instrumental in U.S. leadership on global HIV/AIDS.
The Lantos-Hyde Act passed with overwhelming bipartisan support by votes of 303 to 115 in the House and 80 to 16 in the Senate. It serves as the legislative framework guiding our AIDS, TB, and malaria programs today and stands as a testament to bipartisan cooperation for the greater good.
One of the key components in the Lantos-Hyde Act was a measure to have the U.S. provide its fair share to the Global Fund to Fight AIDS, Tuberculosis and Malaria, an innovative partnership that has been instrumental in helping poor countries respond to the three diseases. Today, the Global Fund provides nearly one-quarter of the international financing for HIV/AIDS and two-thirds of funding for tuberculosis — the leading killer of people with HIV/AIDS. Global Fund-supported efforts in over 140 countries have saved nearly 6 million lives.
Support for the Global Fund has been — and must continue to be — bipartisan because it is a unique and transformative global institution. The Global Fund is transparent, impact-driven, inclusive, and accountable. Performance-based financing is at the heart of its operating model, which ensures that funding decisions are based on a transparent assessment of results against time-bound targets. The performance-based funding model rewards innovation and provides incentives for recipients to use funds efficiently to achieve results. And because the Global Fund requires broad community consultation in developing and implementing proposals, programs are best suited to local contexts.
In October of this year, President Obama made the United States’ first multi-year commitment to the Global Fund, pledging $4 billion over the next three years. While this funding promise is short of the amount needed to fully turn the tide against AIDS, TB, and malaria, it is an important step in the right direction. Now it is incumbent upon Congress to come together to follow through on this commitment.
Leading the fight against the world’s deadliest diseases is more than just the right thing to do. It is an opportunity for the two parties that so often tear one another apart to come together to do something truly great. This World AIDS Day, Republicans and Democrats should embrace our bipartisan legacy of global leadership on AIDS, TB and malaria. Millions of lives depend on it.