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| | Bush-Cheney1 2 3 4 5 | Kerry-Edwards6 7 |
| | GLOBAL HIV/AIDS |
| Global HIV/AIDS Leadership & Funding | President's Emergency Plan for AIDS Relief (PEPFAR)1,3 provides $15 billion over 5 years (FY 2004-FY 2008) to global HIV/AIDS, TB, and malaria efforts: - Almost $10 billion in new funding, with $9 billion targeted to 15 countries, and up to $1 billion for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund).
- $5 billion directed to ongoing bilateral programs in more than 100 countries.
- Targets most funding to 15 priority countries among hardest hit (14 in Africa and Caribbean). “Next wave” countries of India, China, Russia, not primary focus for funding.
| Five-year strategy to combat global HIV/AIDS would double U.S. funding through FY 2008 to at least $30 billion for HIV/AIDS, TB, and malaria including "substantial increases" to the Global Fund. |
| Support for Global Fund to Fight AIDS, Tuberculosis, and Malaria | Made first government pledge to Global Fund; U.S. has pledged largest amount to date. President’s budget asks for $200 million per year for 5 years for Global Fund (channels most PEPFAR funds through bilateral aid, not Global Fund). | Supports substantial increases in U.S. support for the Global Fund, beyond $200 million per year |
| Availability of Low Cost/ Generic Drugs | U.S. funds can be used to purchase fixed-dose combination and co-packaged products, including generics, for global distribution, but only after expedited FDA approval process (will not rely on World Health Organization’s pre-qualification process).8 | Would provide rapid distribution of quality medicines, including generics, in support of World Trade Organization’s DOHA Declaration. Would work to develop international bulk purchasing mechanism for AIDS drugs. |
| Global HIV Prevention Approach | Supported legislative requirements for abstinence-only funding (at least 33% of PEPFAR’s bilateral prevention funds) and other requirements.9 Uses “ABC” approach (Abstinence, Be Faithful, Use Condoms) and emphasizes abstinence | Would urge Congress to eliminate all legislative requirements for abstinence-only funding and other restrictions on use of funds. Supports ABC approach “but only if all three elements of the approach are used.” |
| Mexico City Policy (Bars U.S. foreign assistance from organizations that perform or advocate abortion) | Restored 1984 Mexico City Policy as applies to USAID family planning funding; expanded to include all State Department family planning funding. Policy does not apply to foreign assistance for HIV/AIDS. 10 | Would rescind Mexico City Policy. |
| | HIV/AIDS IN THE U.S. |
| Ryan White Comprehensive AIDS Resources Emergency (CARE) Act | Ryan White budget requests have been for its AIDS Drug Assistance Program (ADAP), not other parts of CARE Act. In June 2004, announced availability of additional $20 million in funds for states with ADAP waiting lists.4,5 Supports Reauthorization of CARE Act. Wants more focus on life-extending care (medications, medical care); flexibility to target resources to areas of greatest need, with federal government setting more of the priorities; enhanced participation by faith-based organizations.4,5 | Supports increased funding for Ryan White and an end to ADAP waiting lists. |
| Medicaid | Position on Early Treatment for HIV Act (ETHA), which would provide states option to cover low-income people with HIV prior to disability, is unclear. | Supports ETHA. Supports development of federal guidelines for Medicaid providers on integration of HIV prevention services into primary care. |
| Domestic HIV Prevention Approach | Called for doubling funding for abstinence-only education.4 “Advancing HIV Prevention” Initiative focuses more of prevention on those who are HIV-positive; encourages testing as routine part of care; recommends routine testing of all pregnant women.11 Supports federal ban on funding of syringe exchange. | Supports “a comprehensive, science-based approach to prevention.” Would end federal ban on funding of syringe exchange. |
| HIV Research | Proposed small increase in FY 2005 funding over FY 2004, but not as high as FY 2003 funding level.12 | Supports increased research funding for HIV/AIDS at NIH, CDC and other agencies. Incentives for public and private development of AIDS vaccines and microbicides. Supports new research toward simplified regimens for AIDS and TB. |
| Minority AIDS Initiative | Proposed small increase in FY 2005 funding over FY 2004, but not as high as FY 2003 funding level.13 | Supports highest level of funding for Minority AIDS initiative. |
Prepared by Health Policy Alternatives, Inc.
1 White House, Office of Management and Budget, Budget of the United States Government, Fiscal Years 2004 and 2005.
2 White House, Fact Sheet: The President's Emergency Plan for AIDS Relief, January 29, 2003.
3 State Department, The President's Emergency Plan for AIDS Relief: U.S. Five Year Global HIV/AIDS Strategy, February 23, 2004.
4 White House, Fact Sheet: Extending and Improving the Lives of Those Living with HIV/AIDS, June 23, 2004.
5 White House, President's Remarks: President Bush Discusses HIV/AIDS Initiatives in Philadelphia, June 23, 2004.
6 Information drawn from candidate’s website, www.johnkerry.com: “The Kerry-Edwards Plan To Respond To The AIDS Crisis.”
7 Kerry-Edwards, Press Release: Statement of John Kerry on the Meeting of the XV International AIDS Conference in Bangkok, July 10, 2004.
8 DHHS, Press Release: HHS Proposes Rapid Process For Review of Fixed Dose Combination and Co-Packaged Products, May 16, 2004.
9 U.S. Congress, U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 (PL 108-25).
10 White House, Memorandum for the Administrator of the United States Agency for International Development, January 22, 2001.
11 CDC, MMWR, “Advancing HIV Prevention: New Strategies for a Changing Epidemic – United States, 2003”, Vol. 52, No. 47, November 2003.
12 White House, Fact Sheet: Global HIV Vaccine Enterprise, June 10, 2004.
13 Kaiser Family Foundation, Policy Brief: The Minority AIDS Initiative, June 2004.
