U.S. International HIV/AIDS, Tuberculosis, and Malaria Spending: FY2004-FY2008

Publication Date: March 2007

Publisher: Library of Congress. Congressional Research Service

Author(s):

Research Area: Health; International relations

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Abstract:

On January 28, 2003, during his State of the Union Address, President George Bush proposed that the United States spend $15 billion over five years to combat HIV/AIDS, tuberculosis (TB), and malaria through the President's Emergency Plan for AIDS Relief (PEPFAR). The President proposed that most of the spending on PEPFAR programs be concentrated in 15 countries in Africa, Asia, Latin America, and the Caribbean. Of the $15 billion, the Plan proposed spending $9 billion on prevention, treatment, and care services in the 15 Focus Countries, where the Administration estimated 50% of all HIV-positive people lived. The President also proposed that $5 billion of the funds be spent on existing bilateral HIV/AIDS, TB, and malaria programs and research, and $1 billion of PEFPAR funds be reserved for U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund). Between FY2004 and FY2008, PEPFAR aims to have supported care for 10 million people affected by HIV/AIDS, including children orphaned by AIDS; prevented 7 million new HIV infections; and supported efforts to provide antiretroviral medication (ARV) to 2 million HIV-infected people.

Between FY2004 and FY2007 Congress provided almost $13.5 billion to fighting the global spread of HIV/AIDS, TB, and malaria. Through the FY2007 Continuing Appropriation Resolution, P.L. 109-289, as amended by P.L. 110-5, Members demonstrated strong support for global HIV/AIDS, TB, and malaria programs. Although most accounts were funded at the least of FY2006 enacted, FY2007 House-passed, or FY2007 Senate-passed levels, appropriators increased support for global HIV/AIDS programs by about $1.4 billion over FY2006 levels. The year-long continuing resolution appropriation provided nearly $4.8 billion to U.S. international HIV/AIDS, TB, and malaria initiatives, including $724.0 million for a U.S. contribution to the Global Fund -- the largest single U.S. contribution to date.

The President's FY2008 budget request includes about $5.8 billion for global HIV/AIDS, TB, and malaria efforts. The administration proposes that the bulk of the funds, about $5.0 billion, be provided through Foreign Operations appropriations. If Congress fully funds the President's FY2008 request, the United States will have exceeded the $15 billion originally sought for PEPFAR; some $19.2 billion would be spent on fighting the three diseases from FY2004 to FY2008. This report will review U.S. appropriations to the three diseases between FY2004 and FY2007, and will be updated to include further congressional actions in FY2008.