Summary of key provisions in the U.S. Global HIV/AIDS, TB, Malaria Reauthorization Act of 2008 (known as the “Global AIDS bill”)
Purpose:
- Establishes a comprehensive, integrated five-year global strategy to fight HIV/AIDS, tuberculosis, and malaria
- Supports treatment for three million people with HIV (PWHIV), prevents 12 million new infections, care for 12 million PWHIV
- NEW pieces on TB, malaria, health workforce and health systems, microbicide development, AIDS-related nutrition, protections for women and youth
Policy planning and coordination:
Develops a five-year comprehensive strategy to combat HIV/AIDS that includes:
- A comprehensive, evidence-based approach to prevention
- Specific linkages to food and nutrition, other basic health and development services
- Include prevention and treatment services for injection drug users
- Medical, social, and legal services for victims of violence
- Research, including incentives for HIV vaccine development and new protocols
- Greatly improves U.S. interagency coordination across a spectrum of U.S. government agencies for reviewing progress in host countries towards HIV/AIDS prevention, care and treatment objectives; identifying countries; reviewing policies that may be obstacles to reaching prevention, treatment and care goals; and coordinating with other U.S. foreign assistance particularly in the areas of health and development
- Improves coordination with other donors and development partners at the country level, improves transparency and accountability
Global Fund:
- Continues U.S. commitment to the Global Fund, including a contribution of $2 billion for 2009 and 2010, such sums as necessary thereafter.
- Retains 33 percent contribution
Prevention:
- Continues the ABC model aimed at prevention with strong emphasis on delay of sexual debut, abstinence, partner reduction, and life-skills programs, particularly for women and girls.
- Eliminates the abstinence earmark and enhances abstinence as a part of the ABC strategy. Conscience clause is retained, so that no PEPFAR contractor is required to deliver condoms.
- Eliminates the prostitution pledge and strengthens language on countering HIV/AIDS for victims of trafficking.
- Also includes counseling and testing including counseling to prevention sexual transmission of HIV; education and outreach including MSM
Treatment:
- Calls on addressing specific barriers to treatment services
- Supporting one-third of the people with HIV/AIDS in clinical need and three million people
- Access to psychosocial support systems
- Calls for purchasing drugs at the lowest price available
Referral systems/coordination
- Calls for integration and coordination within HIV/AIDS prevention, treatment and care and across global health and development programs
- Includes nutrition as a key component of treatment, including important new Body Mass Index target to ensure people with HIC are eating and able to adhere to medications.
Health systems/health care workers
- Supports country-led five year health workforce plans to train and retain new health workers
- Strengthens health systems in host countries including hospitals, clinics, medical equipment, laboratories, supply chain management systems, and capacity building.
- Provided technical and financial support, with countries and other development partners to achieve WHO-minimum health workforce densities of 2.3 doctors, nurses and midwives per thousand residents.
PMTCT:
- Substantial enhancement of programs to prevent mother-to-child transmission of HIV with new coverage targets to reach 80 percent of pregnant women in countries most affected by HIV/AIDS
HIV travel ban:
- Eliminates the HIV/AIDS travel ban that prohibits people with HIV from entering the United States.
Authorization of appropriations:
- Authorizes a total of $10 billion annually to combat AIDS, TB, malaria, support the GFATM, launch stronger PMTC and AIDS-related nutrition programs, health workforce training and retention measures and health systems strengthening, and support for orphans and vulnerable children under the Act for FY 2009 to 2013.
Tuberculosis:
- Incorporates HR 1567, the Stop Tuberculosis (TB) Now Act of 2007 sponsored by Rep Eliot. Engel (D-NY).
- Creates linkages and requires patient referrals between HIV/AIDS and TB programs.
- Creates new strategy to stop TB by enhancing testing and treatment in countries with high TB rates.
- Creates new strategies for attacking MDR and XDR forms of drug-resistant TB.
- Provides assistance for the World Health Organization Stop Tuberculosis Partnership to meet WHO goals to cut TB deaths and infections in half by 2016.
- Authorizes $4 billion in funding for stop TB programs for FY 2009-2013 out of the overall amounts authorized by the Act.
Malaria:
- Requires the president to develop a comprehensive five–year strategy to combat malaria globally and strengthen U.S. leadership against this disease.
- Creates a new coordinator of U.S. Government Activities to Combat Malaria Globally.
- Authorizes United States contributions to the WHO Roll Back Malaria Partnership to improve capacity of countries with high rates of malaria to address the disease.
- Supports Center for Disease Control and National Institutes of Health clinical research for new diagnostics, treatments and interventions to prevent, cure and control malaria.
- Authorizes $5 billion in funding for programs to combat malaria for FY 2009-2013 out of the overall amounts authorized by the Act.
Microbicides:
- Incorporates many parts of the Microbicides Development Act, which better coordinates U.S. research efforts towards microbicide development.
Gender:
- Calls for comprehensive U.S. strategy to address the vulnerabilities of women and girls