Congress Must Resist ‘Ideological Extremes’ When Reauthorizing PEPFAR, Opinion Piece Says
The late Reps. Tom Lantos (D-Calif.) and Henry Hyde (R-Ill.), who created draft legislation to reauthorize the President's Emergency Plan for AIDS Relief, both knew how "legislative compromise could serve an honorable cause," Michael Gerson, senior fellow at the Council on Foreign Relations and a columnist for the Washington Post, writes in a Post opinion piece. Lantos and Hyde, "while shepherding the first" PEPFAR bill through the House five years ago, created a compromise that "separated AIDS relief from the partisan debate over abortion," Gerson writes. He adds that under the original PEPFAR bill, funding focused on the ABC approach -- which stands for practice abstinence, be faithful and use condoms -- and that the program "also helped provide AIDS treatment on a large scale for the first time."
Earlier this year, the compromise "seemed to be unraveling" as some congressional Democrats called for more family planning within HIV/AIDS programs, which a "number of conservatives interpreted as a push for abortion rights," Gerson writes. He adds that instead, lawmakers had a "last-minute, late-night outbreak of sanity." According to Gerson, "Negotiators chose ... to skirt the abortion issue; Republicans kept a provision" that requires PEPFAR recipients to pledge opposition to commercial sex work, and Democrats "achieved an $11 billion increase in AIDS funding," as well as an "end" to the requirement that at least one-third of HIV prevention funds that focus countries receive through PEPFAR be used for abstinence-until-marriage programs. The "substitute language" on HIV prevention programs still requires "balanced funding" among all elements of the ABC approach, Gerson writes, adding that it was a "concession to Democrats, not a surrender."
The "most effective" efforts to reduce the spread of HIV "combine broad condom use with behavior change," Gerson writes. PEPFAR has allocated about 7% of its budget to abstinence and faithfulness programs and about 6% to condom distribution -- "an even-handed approach," he adds. He notes that some conservatives oppose the increase in PEPFAR funding and that some liberal advocates want to address the abortion issue on the "theory that aggressive" family planning is necessary to prevent the spread of HIV.
By "resisting these ideological extremes," lawmakers "can participate in something extraordinary -- a true miracle of science and conscience, and politics at its noblest," Gerson writes. "A president proposes action, good men and women in the tradition of Lantos and Hyde pass a law, and ... many more are saved," he adds, concluding, "In the end, they are the best reasons for Congress" to reauthorize PEPFAR (Gerson, Washington Post, 3/12).