PEPFAR: From Emergency to Sustainability (CRS Report for Congress)
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| Release Date |
Revised Nov. 26, 2007 |
| Report Number |
RL34192 |
| Report Type |
Report |
| Authors |
Tiaji Salaam-Blyther, Foreign Affairs, Defense, and Trade Division |
| Source Agency |
Congressional Research Service |
| Older Revisions |
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Summary:
The Joint United Nations Program on HIV/AIDS (UNAIDS) estimates that 33.2 million people are living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). The U.N. organization believes that in 2007, some 2.5 million people will contract HIV and it will kill about 2.1 million. Sub-Saharan Africa is the most affected region, with about 68% of the world's HIV-positive population, 90% of all HIV-infected children, and more than 11 million children who have lost one or both parents to the virus. UNAIDS anticipates that in 2007, about 420,000 children will contract HIV, due in large part to inadequate access to drugs that prevent mother-to-child HIV transmission; about 8% of pregnant women in low- and middle-income countries have access to PMTCT services.
In January 2003, President George Bush proposed that the United States spend $15 billion over five years to combat HIV/AIDS, tuberculosis (TB), and malaria through the President's Emergency Plan for AIDS Relief (PEPFAR). The President proposed concentrating most of the resources ($9 billion) in 15 countries, where the Administration estimated 50% of all HIV-positive people lived. The proposal allotted $5 billion of the funds to research and other bilateral HIV/AIDS, TB, and malaria programs, and $1 billion for contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund). The President estimated that from FY2004 to FY2008, PEPFAR funds would support the purchase of anti-retroviral treatments (ARV) for 2 million people; the prevention of 7 million HIV infections; and care for 10 million people affected by HIV/AIDS, including children orphaned by AIDS.
In May 2003, Congress passed the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003 (P.L. 108-25), which authorized funds for PEPFAR and created the Office of the Global AIDS Coordinator (OGAC) to manage U.S. funds aimed at addressing the three diseases in 15 Focus Countries. As of March 31, 2007, PEPFAR has supported the treatment of 1.1 million people; and as of September 30, 2006, supported PMTCT service provision during more than 6 million pregnancies and facilitated care for nearly 4.5 million people, including more than 2 million orphans and vulnerable children. From FY2004 to FY2007, Congress provided nearly $13.5 billion for U.S. global HIV/AIDS, TB, and malaria programs. In FY2008, the President requested $5.8 billion for global HIV/AIDS, TB, and malaria efforts; the House and Senate proposed spending almost $6.2 billion and nearly $6.1 billion, respectively.
On May 30, 2007, President Bush requested that Congress authorize $30 billion to fund PEPFAR an additional five years. The President asserts that from FY2009 to FY2013, the plan would support treatment for 2.5 million people, prevent more than 12 million new infections, and care for more than 12 million people, including 5 million orphans and vulnerable children. Supporters of the Administration's plan applauded the President and congratulated him for leading global efforts to address HIV/AIDS. Critics asserted that PEPFAR could treat more than 2.5 million HIV-infected people and that PEPFAR's spending requirements should be eliminated. This report focuses on some of the key issues that Congress might consider as it faces the issue of whether, and at what level, to reauthorize PEPFAR.
