PEPFAR, a AIDS treatment bill passed five years ago is now up for debate as both the Senate and House consider reauthorizing the legislation. Five years ago there was a spending mandate. This bill said that 55% of the 15 million dollars allocated must be spent on treatment. In the process of re-authorization, this has spurred rigorous debate.
The Senate version of the bill has recently been approved by the Senate Foreign Relations Committee, but has been put on hold due to a threat of a filibuster. The current draft has cut out the treatment mandate in support of a more target oriented effort.
Sen. Joe Biden, the chairman of the committee and sponsor of the bill says that such a treatment enforcement has been voided so as to put the money where folks on the ground see best fit, so that countries in greater need receive greater funds, and money can be spent where it needs to be spent and not where it's told to be spent.
Opinions like this have raised deep concerns from many of Biden's colleagues. Sen. Tom Coburn, rising in support of the spending mandate has recently stated on the RealClear Politics website that:
This is a smart and well-designed policy. PEPFAR has been a Marshall Plan-like response, rather than a Katrina - like response to the AIDS crisis in Africa.
He says this legislation can only continue to be as efficient as it has if the mandate remains.
With a filibuster pending, non-congressional influences have voiced their opinions. Michael Gerson, an evangelical Christian op-ed columnist for the Washington Post has stridently supported cutting the mandate saying in a recent column that:
Given that there are about 2.5 new HIV infections for every person starting on AIDS drugs, there is no way to control the pandemic through treatment alone. And because treatment is less expensive than it used to be, PEPFAR is meeting its treatment goal for less money. The 55 percent treatment floor would force the program to waste money in pursuit of an arbitrary, nonsensical spending target - the worst kind of congressional earmark
He went on to assail Coburn and other fellow Republicans saying they are "indifferent to human suffering".
This proves to be a heated debate, with emotional pleas from both sides. What encourages me though is the passion of the debate. Folks here at home do care from time to time about the real issues in this world.