Tracking Progress on PEPFAR Reauthorization

Congress is due to reauthorize the President's Emergency Plan for AIDS Relief (PEPFAR) this year, and the House of Representatives has approved bipartisan legislation that would authorize $50 billion for the US global AIDS initiative over the next five years—significantly more than the $30 billion requested by President Bush.

The Senate is now considering a similar bill, and key Senators are pushing to pass the legislation before the G8 Summit in Japan, where it could be used to leverage additional commitments from other wealthy nations.

Click here for a Health GAP comparison of the House and Senate bills and recommended changes.

Click here to email your Senators and Representatives urging them to extend and strengthen PEPFAR.

Both the House and Senate versions of the bill seek to prevent 12 million new HIV infections, provide treatment for at least 3 million people, and provide care for 12 million people living with HIV/AIDS, including 5 million orphans and vulnerable children. They also include $9 billion in funding to fight tuberculosis and malaria, two infections that are a major cause of death among people living with AIDS. 

In addition to authorizing significantly increased funding, both the House and Senate PEPFAR reauthorization legislation incorporate key provisions advanced by the Global AIDS Alliance and other groups, including the following:

  • Links AIDS, TB, and malaria programs to broader health and development programs
  • Requires 10% of PEPFAR funding support programs for orphans and vulnerable children
  • Requires a plan to strengthen health systems and build health workforce capacity
  • Includes provisions for preventing HIV infections among women and girls
  • Provides increased emphasis on prevention of mother-to-child transmission of HIV
  • Includes assistance to provide free medications to treat HIV-related opportunistic infections
  • Provides support for food supplements and microcredit loans to women widowed by AIDS

Both the Senate and House bills would remove a requirement that at least one-third of PEPFAR's HIV prevention spending be used for abstinence-until-marriage programs, and would require a report to Congress if abstinence and fidelity programs account for less than half of prevention spending in each PEPFAR focus country. The House and Senate legislation also would retain the requirement that PEPFAR grant recipients pledge opposition to prostitution, despite growing evidence that this requirement inhibits attempts to engage commercial sex workers who are at high risk of HIV infection.

The House version of the bill would allow groups to use PEPFAR funding for HIV testing and education in family planning clinics but not for contraception or abortion services. The Senate version does not mention family planning.

Click here for GAA's press releases on the House and Senate legislation.

The 2003 launch of PEPFAR was instrumental in catalyzing new political and financial commitments from governments and other stakeholders worldwide, and AIDS and global health advocates are working hard to strengthen the second phase of the US global AIDS initiative. Click here to learn more about specific recommendations from GAA and other civil-society groups.