WASHINGTON-The U.S. House of Representatives was on the verge of passing a spending bill Thursday that covers the rest of the 2011 fiscal year, until September, and includes $61 billion in cuts. The House snipped $783 million from the State Department's budget for global health-about a 10 percent reduction from the 2010 budget. A large chunk of that budget includes the President's Emergency Plan for AIDS Relief (PEPFAR), President George W. Bush's 2003 initiative to fight the disease in Africa-it will lose $363 million.
Before PEPFAR, only 50,000 people were receiving antiretroviral treatment for HIV/AIDS-but over the last seven years the program has treated more than 2.5 million AIDS patients, mostly through partnerships with local hospitals, nonprofit organizations, and churches. The program has won wide acclaim, though some have criticized such use of taxpayer dollars. President Obama promised President Bush that he would continue the effort, and in his 2012 budget announced Monday, he increased funding for the project. It's the U.S. government's largest financial effort to combat a single disease.
Due to the House's cuts, PEPFAR estimates that 400,000 who were supposed to begin treatment this year will not, and 100,000 fewer mothers will receive services to prevent transmission to their babies, resulting in 20,000 more babies born with HIV. But the PEPFAR office said it would make sure not to drop anyone who is on antiretroviral treatment now, a disruption that would essentially be a death sentence for those already in the program.
The cuts will also dramatically reduce the United States' contribution to the Global Fund, an international collection plate for fighting HIV/AIDS. Through the Global Fund, the United States' essentially receives matching contributions from other countries for its investments in AIDS treatment and prevention. To date, the United States has provided about a third of the funds.
The U.S. Conference of Catholic Bishops and Catholic Relief Services, which is one of the top recipients of PEPFAR funds, sent a letter to the House, noting that while the House is cutting the overall budget by 2.6 percent, poverty-related international programs bear 26 percent of the cuts.
"Shared sacrifice is one thing; it is another to make disproportionate cuts in programs that serve the most vulnerable," they wrote, citing the cuts to HIV/AIDS programs, among others. "Cuts at the level being considered will result in the loss of innocent lives."
Another Christian leader who has championed PEPFAR, Kay Warren, who directs Saddleback Church's HIV/AIDS overseas work, told me, "It just breaks my heart to think that it's going to be cut. . . . I'll use whatever influence I have to keep PEPFAR alive." Warren plans to meet with members of Congress on the matter with the hope of avoiding even more cuts in the 2012 budget.
The spending bill does include a provision that reinstates the Mexico City policy, which bans U.S. funding for abortion overseas, a measure President Obama reversed when he took office. The U.S. Conference of Catholic Bishops applauded the House for that addition to the bill.
The Senate, still under Democratic control, is unlikely to swallow all of the House's proposed cuts-which the Senate will consider when it returns after a week-long President's Day recess. But House Republicans could play hardball and threaten a government shutdown March 4 if the Senate doesn't go along with the cuts. Senate Republicans seem to be on board with many of the House reductions.
Few of the members of Congress who originally sponsored President Bush's PEPFAR initiative are still in office, and the new Republican class is eager to cut spending wherever possible, so the program has few champions for now. Original sponsor Rep. Barbara Lee, D-Calif., remains in office, as well as Sens. John Kerry, D-Mass., Richard Lugar, R-Ind., and Patty Murray, D-Wash.
"Our global health programs represent some of our most successful and effective international policies," Kerry, the chair of the Senate Foreign Relations Committee, said in a statement. "The proposed cuts in the House spending package would have devastating implications for these policies and for our humanitarian agenda as a whole. Simply put, these cuts will cost lives."
Lugar's senior adviser Mark Helmke was more cautious and said the senator was "taking a hard look" at the cuts.
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