Kaiser Daily HIV/AIDS Report Sits Down with Rep. Nancy Pelosi
The Kaiser Daily HIV/AIDS Report sat down with Rep. Nancy Pelosi
(D-Calif.) to reflect on her contributions during the last Congress and to learn about her legislative plans for the 107th Congress. Pelosi is the ranking Democrat on the Appropriations Subcommittee on Foreign Operations, the only California representative on the Appropriations Subcommittee on Labor, Health and Human Services and Education and also serves on the Permanent Select Committee on Intelligence. Pelosi is also the co-chair of the AIDS Task Force of the House Democratic Caucus. She has been active in advocating increased HIV/AIDS funding and breast cancer prevention and research. Last year she
co-sponsored the Vaccines for a New Millennium Act and introduced the Microbicide Development Act of 2000, which would increase research and development on this new method of disease transmission prevention. This year she co-sponsored the Global Democracy Promotion Act of 2001, which aims to restore funding for international family planning programs, which was cut by President Bush's reinstatement of the Mexico City policy. Below is a transcript of the conversation.
Last year, Congress went through a controversial formula fight for this year's Ryan White CARE Act appropriation. Are you satisfied with the final funding formula for San Francisco?
I do consider the Ryan White CARE Act one of the greatest achievements of the Congress last year. ... It provides a foundation for care and treatment for low-income individuals, and ... I was so pleased that we were able to work out a compromise that protected San Francisco from drastic cuts. ... Certainly I had a couple of concerns about the context in which that discussion took place. The idea that [San Francisco] would be penalized for intervening early for people who are HIV-infected, rather than waiting until they are full-blown cases of AIDS, just didn't seem to make medical or fiscal sense. ... I certainly prefer the hold harmless provision [that limits HIV/AIDS funding cuts for San Francisco] in the Senate reauthorization bill, but I'm glad we were able to reach a fair compromise. ... Representative Anna Eshoo (D-Calif.) and Representative Henry Waxman (D-Calif.), two Californians on the committee, did a great job of controlling the damage.
How do you/would you like to see the Ryan White CARE Act evolve in the future?
I think the act will have to recognize that the formula should take into account HIV, and it does down the road. Hopefully we can accelerate that pace, or at least, in practice, fund according to HIV rather than just AIDS.
For years, you have worked to expand Medicaid coverage to those who are HIV-positive but not yet considered disabled. Do you plan to reintroduce the Early Treatment for HIV Act, which would give states the option to expand their Medicaid programs to provide treatment for low-income, HIV-positive individuals who have not yet developed symptoms of AIDS?
I look forward to introducing it soon, hopefully with Democratic Leader Dick Gephardt (D-Mo.) and Sen. Robert Torricelli (D-N.J.). [Leader Gephardt] has been very interested and has provided great leadership on this in the past, so I'm hoping that will be one of the first bills that I introduce. It will help [give] thousands of low-income people living with HIV access to the care and treatment they need to stay healthy. It contributes to the quality of their life, it keeps them healthier longer, and of course we're always optimistic that a cure is right around the corner, and we'll be ready for it. The Presidential Advisory Council on AIDS, NORA, RainbowPUSH, AIDSAction, the Human Rights Campaign, ADAP Working Group, Project Inform and the San Francisco AIDS Foundation will be among those groups urging the passage of the Early Treatment for HIV Act.
President Bush has reinstated the "Mexico City policy," which prevents USAID from allocating international family planning funds to overseas organizations that use their own money to promote or provide abortion services. What steps are international family planning advocates likely to take in response to this move?
The language in the [2001 Foreign Operations bill which repealed the "global gag" rule] was language that I wrote as a ranking Democrat on Foreign Operations at the time. Now I've moved up to [Intelligence], but I'm still on the relevant committee, and, anticipating that [President Bush] would do this, I called a meeting of many of the groups who had been supportive of eliminating the gag rule. I said [at the meeting] in December that there is a good chance that President-elect Bush will move to overturn the language we had in the bill. ... [W]e had one of the largest meetings that I've seen on this subject in the Congress. [T]hese restrictions on our international family planning assistance prevent foreign NGOs from using their own, non-U.S. money to lobby their own governments for changes in laws concerning legal abortion services. If the U.S. government tried to impose similar restrictions on U.S.-based organizations, they would, without a doubt, be unconstitutional. The global gag rule ... restrict[s] access to family planning services for poor women, which would result in more unintended pregnancies, more births, more maternal deaths and injuries, and more -- not fewer -- abortions. This isn't about abortion, this is about family planning. ... They know very well that no federal dollars internationally can be spent on performing abortions. ... If you hate abortion, you should love family planning, and this is an obstacle to that.
In addition to talking with Pelosi, the Kaiser Daily HIV/AIDS Report spoke with Pelosi Appropriations Associate Scott Boule about the Congresswoman's reflections on the previous congress and her priorities and plans for the future. Here's what he had to say:
What are some of the specific changes that happened regarding the Ryan White CARE Act?
Boule explained that, as a member of the Health, Human Services and Education appropriations subcommittee, Pelosi makes CARE Act appropriations a "top priority" in order to ensure the most widespread availability of funds possible. He explained that there is a $213 million increase in Ryan White funding and a $163 million increase for HIV prevention. Boule stated, "We're particularly proud of that because we had a long period in the mid-1990s where prevention funding was flat-funded." Boule stated that if the secretary of HHS certifies that HIV reporting systems are "reliable, accurate and available nationwide," HIV surveillance figures will play a part in the reauthorization formula established for 2005.
What work has been done on international AIDS issues?
Boule stated that Pelosi has also stepped up her commitment to international HIV/AIDS issues, and noted that she addresses global AIDS prevention research and treatment on both committees on which she serves. He noted that CDC funding for global AIDS issues has increased by $69.5 million this year, bringing the total CDC funding to $104.5 million. He further stated that USAID funding for global AIDS increased by approximately $125 million, bringing the new total up to $315 million.
How will Congresswoman Pelosi focus some of her efforts this session?
Boule stated that the following will be key issues:
- Microbicides: Pelosi will continue to make microbicide research and development a priority in the coming year. He noted, "Microbicides hold such tremendous potential ... for people in this country and abroad, particularly in the developing world," adding that "if this country were to make a sufficient investment in microbicide research and development, we could have an effective microbicide available within the next five years." Boule stated that microbicide efforts, including funding increases secured through the appropriations process, are "beginning to move in the right direction." He also indicated that the FY 2001 HHS appropriations bill included language that "urges" the NIH director and all institutes and offices involved in NIH research to "establish a program to support microbicide development.
- Human papillomavirus: Boule said, "Increasing awareness for HPV is [also] a very important issue and something that we need to do a better job of in this country." He stated that Pelosi does not support mandatory HPV reporting, however, because "surveillance based on sampling in much more cost effective." He stated that "we need to be doing more in this country to educate the public, particularly women, about HPV infections, the dangers associated with [such] infections and how people can protect themselves." He noted that Pelosi supports efforts to increase awareness and education, but stated that "we have to be mindful of making sure that our interventions are done in the most effective and efficient manner and the most cost-effective manner" (Ingrid Dries-Daffner, Kaiser Daily HIV/AIDS Report, 3/16).