The Senate agreed Wednesday to spend $48 billion to fight AIDS globally during the next five years - a measure that included a provision to lift a 21-year-old ban on foreigners with HIV/AIDS entering the United States.
The overall AIDS package passed by a vote of 80-16 and now goes to the House, which easily passed a similar version of the bill in April.
Sens. John Kerry, Massachusetts Democrat, and Gordon H. Smith, Oregon Republican, drafted the proposal to kill the travel restriction, calling it an antiquated and punitively unfair reaction to people with HIV.
"For two shamefully sluggish decades the Senate and the Congress and the country really ignored this issue and were somewhat timid and even scared of it for very reasons," Mr. Kerry said on the Senate floor Wednesday. The proposal "is a good moment for the American people because it reflects our values."
Mr. Kerry said even people with avian flu or the Ebola virus have an easier time than those with HIV when it comes to applying for visas.
The United States is one of only about a dozen countries - including Sudan, Saudi Arabia, Libya and Russia - that bar travel and immigration for HIV-positive people.
The ban dates to a 1987 measure sponsored by North Carolina Republican Sen. Jesse Helms that directed the Public Health Service to add HIV to its list of "dangerous contagious diseases" that preclude people from entering the country.
Under current law, HIV is the only medical condition explicitly listed under immigration law. The Kerry-Smith provision would make HIV equivalent to other communicable diseases where medical and public health experts at the Health and Human Services Department - not consular officials at U.S. embassies - determine eligibility for admission.
Those with HIV seeking legal permanent residency would still have to demonstrate they have the resources to live in this country and would not become a "public charge."
Sen. Jeff Sessions, Alabama Republican, initially proposed an amendment to keep the travel restrictions intact but later withdrew the measure.
The larger AIDS relief package would continue funding the President's Emergency Plan for AIDS Relief (PEPFAR) for another five years. The program started in 2003, when President Bush dedicated $15 billion for five years to combat HIV/AIDS, malaria and tuberculosis in Africa and other afflicted parts of the world.
PEPFAR long has been criticized from both sides of the political spectrum. Liberals have complained the program is influenced too heavily by political and social groups with "moral" rather than public health agendas, while conservatives say some of the money is given to programs that support abortions.
But Capitol Hill lawmakers during the past few months reached several key compromises on the measure, including a provision that would kill a current program mandate that one-third of the prevention money be spent on abstinence education. In place, a report to Congress would be required if spending on abstinence program falls below 50 percent of the total spent on prevention spending in a particular country.
Another main sticking point had been a current mandate that requires 55 percent of the money go to treatment programs. But writers of the new bill dropped the provision, arguing that health care workers on the ground - not Washington politicians - can better determine which programs are most effective.
The bill had called for spending $50 billion over five years but senators diverted $2 billion to pay for expanded health care, law enforcement and water projects for Native Americans.
The Bush administration, which calls PEPFAR the largest commitment ever by a nation for an international health initiative dedicated to a single disease, says the program is on target of reaching its initial five-year goal of treating 2 million people, preventing 7 million new infections and providing care for 10 million people, including children.
PEPFAR also has been praised globally as an effective tool in combating AIDS.
cThis article is based in part on wire service reports.