KHN Morning Briefing

Summaries of health policy coverage from major news organizations

New York Times Examines How PEPFAR Could Be Bush’s ‘Most Lasting Bipartisan Accomplishment’

The New York Times on Saturday examined how the President's Emergency Plan for AIDS Relief could be President Bush's "most lasting bipartisan accomplishment." According to the Times, PEPFAR is a "rare exception" to several of Bush's other initiatives, which are "not fully embraced by Democrats." About 1.4 million HIV-positive people have received antiretroviral drugs through PEPFAR, an increase from 50,000 receiving U.S.-funded drugs before the initiative was launched. In addition, PEPFAR has provided care to about 6.7 million people affected by HIV/AIDS, including 2.7 million orphans and other children, according to government figures. Drugs to prevent mother-to-child HIV transmission provided through PEPFAR have prevented an estimated 152,000 pediatric HIV cases, according to the government.

PEPFAR, which was announced in Bush's 2003 State of the Union address, initially called for $15 billion for HIV/AIDS prevention, treatment and care and focused on 15 countries with high HIV prevalence. Bush now is calling on Congress to reauthorize the program at $30 billion for five years. Bush in February plans to visit Africa to "make his case" for PEPFAR's reauthorization and to "burnish the compassionate conservative side of his legacy," according to the Times.

Critics of the program have expressed concern about a requirement that at least one-third of HIV prevention funds focus countries receive through PEPFAR be used for abstinence-until-marriage programs. Paul Zeitz, executive director of the Global AIDS Alliance, said the program has been limited by "ideologically driven policies." Despite such reservations, many critics conclude that through PEPFAR, Bush has "spawned a philosophical revolution" and has "put to rest the notion that because patients were poor or uneducated they did not deserve, or could not be taught to use, medicine that could mean the difference between life and death," the Times reports.

According to Michael Gerson, a former speechwriter for Bush, PEPFAR "fit a broader conception of [Bush's] view of America's purpose in the world, which included not just the liberation of other people, but their treatment for disease." According to the Times, several Democrats, including Sen. John Kerry (Mass.), "find it difficult to argue" with the success of PEPFAR. "It's a good thing that [Bush] wanted" to start the program, Kerry said, adding that PEPFAR "represents a tremendous accomplishment for the country."

Some HIV/AIDS experts have said that PEPFAR funding could be spent more efficiently, and other advocates say that $50 billion -- not $30 billion as Bush has requested -- is needed. However, the "fight is not over whether to reauthorize the program, but how," according to the Times (Stolberg, New York Times, 1/5).

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