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HIV/AIDS: Comparison of the Candidates’ Proposals


HIV/AIDS: Comparison of Candidate’s Proposals

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Bush-Cheney1 2 3 4 5

Kerry-Edwards6 7


Global HIV/AIDS Leadership & Funding

President’s Emergency Plan for AIDS Relief (PEPFAR)1,3 provides $15 billion over 5 years (FY 2004-FY 2008) to global HIV/AIDS, TB, and malaria efforts:

  • Almost $10 billion in new funding, with $9 billion targeted to 15 countries, and up to $1 billion for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).
  • $5 billion directed to ongoing bilateral programs in more than 100 countries.
  • Targets most funding to 15 priority countries among hardest hit (14 in Africa and Caribbean). “Next wave” countries of India, China, Russia, not primary focus for funding.

Five-year strategy to combat global HIV/AIDS would double U.S. funding through FY 2008 to at least $30 billion for HIV/AIDS, TB, and malaria including “substantial increases” to the Global Fund.Support for Global Fund to Fight AIDS, Tuberculosis, and MalariaMade first government pledge to Global Fund; U.S. has pledged largest amount to date. President’s budget asks for $200 million per year for 5 years for Global Fund (channels most PEPFAR funds through bilateral aid, not Global Fund).Supports substantial increases in U.S. support for the Global Fund, beyond $200 million per yearAvailability of Low Cost/ Generic Drugs U.S. funds can be used to purchase fixed-dose combination and co-packaged products, including generics, for global distribution, but only after expedited FDA approval process (will not rely on World Health Organization’s pre-qualification process).8Would provide rapid distribution of quality medicines, including generics, in support of World Trade Organization’s DOHA Declaration. Would work to develop international bulk purchasing mechanism for AIDS drugs.Global HIV Prevention ApproachSupported legislative requirements for abstinence-only funding (at least 33% of PEPFAR’s bilateral prevention funds) and other requirements.9 Uses “ABC” approach (Abstinence, Be Faithful, Use Condoms) and emphasizes abstinenceWould urge Congress to eliminate all legislative requirements for abstinence-only funding and other restrictions on use of funds. Supports ABC approach “but only if all three elements of the approach are used.”Mexico City Policy (Bars U.S. foreign assistance from organizations that perform or advocate abortion)

Restored 1984 Mexico City Policy as applies to USAID family planning funding; expanded to include all State Department family planning funding. Policy does not apply to foreign assistance for HIV/AIDS. 10

Would rescind Mexico City Policy.


Ryan White Comprehensive AIDS Resources Emergency (CARE) Act

Ryan White budget requests have been for its AIDS Drug Assistance Program (ADAP), not other parts of CARE Act. In June 2004, announced availability of additional $20 million in funds for states with ADAP waiting lists.4,5

Supports Reauthorization of CARE Act. Wants more focus on life-extending care (medications, medical care); flexibility to target resources to areas of greatest need, with federal government setting more of the priorities; enhanced participation by faith-based organizations.4,5

Supports increased funding for Ryan White and an end to ADAP waiting lists.MedicaidPosition on Early Treatment for HIV Act (ETHA), which would provide states option to cover low-income people with HIV prior to disability, is unclear.Supports ETHA. Supports development of federal guidelines for Medicaid providers on integration of HIV prevention services into primary care.Domestic HIV Prevention Approach

Called for doubling funding for abstinence-only education.4

“Advancing HIV Prevention” Initiative focuses more of prevention on those who are HIV-positive; encourages testing as routine part of care; recommends routine testing of all pregnant women.11

Supports federal ban on funding of syringe exchange.

Supports “a comprehensive, science-based approach to prevention.”

Would end federal ban on funding of syringe exchange.

HIV Research Proposed small increase in FY 2005 funding over FY 2004, but not as high as FY 2003 funding level.12

Supports increased research funding for HIV/AIDS at NIH, CDC and other agencies. Incentives for public and private development of AIDS vaccines and microbicides. Supports new research toward simplified regimens for AIDS and TB.

Minority AIDS Initiative

Proposed small increase in FY 2005 funding over FY 2004, but not as high as FY 2003 funding level.13

Supports highest level of funding for Minority AIDS initiative.

Prepared by Health Policy Alternatives, Inc.

1 White House, Office of Management and Budget, Budget of the United States Government, Fiscal Years 2004 and 2005.
2 White House, Fact Sheet: The President’s Emergency Plan for AIDS Relief, January 29, 2003.
3 State Department, The President’s Emergency Plan for AIDS Relief: U.S. Five Year Global HIV/AIDS Strategy, February 23, 2004.
4 White House, Fact Sheet: Extending and Improving the Lives of Those Living with HIV/AIDS, June 23, 2004.
5 White House, President’s Remarks: President Bush Discusses HIV/AIDS Initiatives in Philadelphia, June 23, 2004.
6 Information drawn from candidate’s website, “The Kerry-Edwards Plan To Respond To The AIDS Crisis.”
7 Kerry-Edwards, Press Release: Statement of John Kerry on the Meeting of the XV International AIDS Conference in Bangkok, July 10, 2004.
8 DHHS, Press Release: HHS Proposes Rapid Process For Review of Fixed Dose Combination and Co-Packaged Products, May 16, 2004.
9 U.S. Congress, U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 (PL 108-25).
10 White House, Memorandum for the Administrator of the United States Agency for International Development, January 22, 2001.
11 CDC, MMWR, “Advancing HIV Prevention: New Strategies for a Changing Epidemic – United States, 2003”, Vol. 52, No. 47, November 2003.
12 White House, Fact Sheet: Global HIV Vaccine Enterprise, June 10, 2004.
13 Kaiser Family Foundation, Policy Brief: The Minority AIDS Initiative, June 2004.

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