EDITORIAL: Problems with PEPFAR

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The Senate agreed on Wednesday to spend $48 billion on the President's Emergency Plan for Aids Relief (PEPFAR), down slightly from the original $50 billion, but significant problems remain with the bill in its current form. The Bush administration, Senate Majority Leader Harry Reid and Sens. Barack Obama and John McCain are all supporting legislation to fund PEPFAR, which would more than triple spending on the program from the current $15 billion (five-year total) to $48 billion. This is too much when the Congressional Budget Office (CBO) reported that $35 billion would suffice in funding PEPFAR for the next five years, while the extra $13 billion would be spent by 2018.

The PEPFAR bill would also make it easier for HIV-positive aliens to obtain waivers to enter the United States; in general, we have public-health reservations about weakening U.S. law to facilitate the entry of persons with lethal, communicable diseases of any kind. In addition, we doubt that Congress has carefully examined the financial burden that such a change in the law could impose on the American taxpayer. To cite but one example, a July 11 report issued by the Congressional Research Service (CRS), titled "U.S. Immigration Policy on Foreign Nationals with HIV/AIDS" raises legitimate questions as to whether HIV-positive foreign nationals who visit the United States and become ill could have their medical bills paid by the American taxpayer. Pages six and seven of the CRS report suggest that such persons could become eligible to benefit from the Ryan White CARE Act, which lacks "restrictions on noncitizen eligibility."

For pro-life groups, one of the most troubling aspects of the bill is the $2 billion in annual funding for the United Nations Global Fund, where it would go to pay for coercive sterilizations and abortion. According to the report from the Gerard Health Foundation, the fund has paid for several HIV/AIDS grant requests from the agency empowered to enforce China's one-child policy, the National Population and Family Planning Commission (NPFPC). Similar grants have been awarded by the Global Fund to two organizations that "facilitate NPFPC's activities," the U.N. Population Fund (UNFPA) and Maria Stopes International. The United States has withheld contributions from the UNFPA since 2002 because of its participation in China's program of enforced abortion. Maria Stopes International, a major supplier of abortion around the world, acknowledges that several provinces in China are "major partners."

Separate from the abortion issue, the bill also leaves the door open for the use of U.S. tax dollars to finance programs in China, and Russia and India as well, which is by definition troubling. These are three of the fastest-growing countries in the world, and nations that are perfectly able to pay for their own HIV/AIDS programs. If Russia wants to set up such programs, perhaps it should consider using some of its oil-revenue windfall. As for China, it should slash its exploding military expenditures before getting HIV money from hard-pressed American taxpayers.

Overall, we support PEPFAR as a good human-rights program that attempts to protect innocent life. But the Senate-passed bill constitutes good intentions gone haywire, and it would be irresponsible for Congress to enact into law anything resembling this legislation.