WikiLeaks Document Release http://wikileaks.org/wiki/CRS-RS21114 February 2, 2009 Congressional Research Service Report RS21114 HIV/AIDS: Appropriations for Worldwide Programs in FY2001 and FY2002 Raymond W. Copson, Foreign Affairs, Defense, and Trade Division Updated March 19, 2002 Abstract. U.S. support for the struggle against the international HIV/AIDS epidemic is provided through several appropriations bills. This report identifies FY2002 appropriations for worldwide HIV/AIDS efforts and includes tables comparing these appropriations with appropriations for FY2001. Order Code RS21114 Updated March 19, 2002 CRS Report for Congress Received through the CRS Web HIV/AIDS: Appropriations for Worldwide Programs in FY2001 and FY2002 Raymond W. Copson Specialist in International Relations Foreign Affairs, Defense, and Trade Division Summary http://wikileaks.org/wiki/CRS-RS21114 This short report identifies FY2002 appropriations for worldwide HIV/AIDS efforts and includes tables comparing these appropriations with appropriations for FY2001. For additional information, see CRS Report RS21181, HIV/AIDS International Programs: Appropriations, FY2002 - FY2004. U.S. support for the struggle against the international HIV/AIDS epidemic is provided through several appropriations bills. A key component is the HIV/AIDS earmark in the Child Survival and Health Programs Fund1 of the Foreign Operations, Export Financing, and Related Programs Act. This earmark, which as indicated below in Table 2, reached $435 million in FY2002, primarily supports the bilateral HIV/AIDS activities of the U.S. Agency for International Development (USAID). These include programs aimed at preventing the spread of HIV, improving home-based care for AIDS patients, reducing mother to child transmission (MTCT) of HIV, and helping AIDS orphans. In addition, the U.S. contribution to the United Nations Joint Program on HIV/AIDS (UNAIDS) comes from this earmark.2 The FY2002 appropriations legislation sets aside $15 million of the Child Survival earmark for the development of microbicides to combat HIV infection, and these funds are to be managed by USAID.3 Additional funds for fighting AIDS are channeled through other bilateral economic assistance programs funded by this same legislation, such as the Economic Support Fund, International Disaster Assistance, and regional programs for Eastern Europe and the 1 The Child Survival Fund received this designation in the FY2002 appropriations legislation. Formerly, it was named the Child Survival and Disease Programs Fund. 2 The UNAIDS contribution was $17 million in FY2001 and $18 million in FY2002. 3 U.S. Congress. House. Making Appropriations for Foreign Operations, Export Financing, and Related Programs Appropriations for the Fiscal Year Ending September 30, 2002. Conference Report to Accompany H.R. 2506. H.Rept. 107-345. Ordered to be printed December 19, 2001. Congressional Research Service ~ The Library of Congress CRS-2 former Soviet Union.4 For FY2002, these funds are estimated at $40 million,5 bringing the total for international HIV/AIDS assistance under the Foreign Operations Appropriations to $475 million. The FY2002 Foreign Operations Appropriations also sets aside $10 million in Child Survival funds for a U.S. contribution to the International AIDS Vaccine Initiative.6 The appropriations does not specify that the contribution come from the HIV/AIDS earmark, but the Administration plans to take it from that portion of the Child Survival program. Like USAID, the Centers for Disease Control and Prevention (CDC) of the Department of Health and Human Services (HHS) also conducts HIV/AIDS programs overseas. Its Global AIDS Prevention (GAP) Program, which was active in 24 countries in FY2001, supports efforts to strengthen HIV prevention, as well as treatment and care, and to improve health infrastructure. The CDC is funded through the Departments of Labor, Health and Human Services, and Education, and Related Agencies Appropriations, and for FY2002, $143.763 million has been appropriated for its international HIV/AIDS activities (P.L. 107-116). The Labor, HHS Appropriations measure also sets aside $10 million for the Global http://wikileaks.org/wiki/CRS-RS21114 HIV/AIDS in the Workplace Initiative of the Department of Labor (DOL). According to the Department, this program's strategic plan has three components: prevention education in the workplace; workplace policy development addressing the issues of stigma and discrimination; and capacity building activities for governments, employers, and labor to strengthen national responses. The Department of Agriculture Appropriations for FY2002 (P.L. 107-76) sets aside $25 million in Section 416(b) food aid to mitigate the effects of AIDS on communities overseas (P.L. 107-76, Section 727). The Section 416(b) program was created by the Agricultural Act of 1949 and provides for the donation of surplus food commodities.7 In the Department of Defense (DOD) Appropriations for FY2002 (P.L. 107-117), $14 million has been earmarked for the DOD HIV/AIDS prevention education program for African armed forces. This program, which is being implemented by the Naval Health Research Center (NHRC) in San Diego, assists African militaries in establishing HIV/AIDS policies for their personnel, in adapting HIV/AIDS prevention programs for use by African armed forces, and in developing interventions to reduce high risk behaviors. Another source of funding for international HIV/AIDS efforts in FY2002 and beyond will be the multilateral Global Fund to Fight AIDS, Tuberculosis, and Malaria. The Fund is headquartered in Geneva, Switzerland, and starting in April 2002, it is expected to make its first grants to combat the epidemic. Grant applications have been received from "country partner" teams, including government, non-governmental organizations, 4 U.S. Congress. House. Committee on Appropriations. Foreign Operations, Export Financing, and Related Appropriations Bill, 2002. H.Rept. 107-142, July 17, 2001. 5 H.Rept. 107-345. 6 For more information, see the Initiative's website: [http://www.iavi.org]. 7 CRS Issue Brief IB98006, Agricultural Export and Food Aid Programs, continuously updated. CRS-3 and the private sector. It is expected that about 80% of the Fund's grants will be targeted toward combating the AIDS epidemic,8 although the Fund has not made a specific commitment in this regard. The United States has pledged $500 million to the Fund, including $100 million appropriated in the FY2001 Supplemental Appropriations Act (Table 1) and $200 million pledged for each of fiscal years 2002 and 2003. To date, Congress has made available $300 million, as indicated in Table 1. Table 1. Appropriations for U.S. Contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria ($millions) Supplemental Appropriations Act, Fiscal Year 2001 (P.L. 107-20) 100 Foreign Operations Appropriations Act, 2002 (P.L. 107-115) Child Survival and Health Programs Fund 50a Bilateral economic assistance, FY2002 and previous years 50a http://wikileaks.org/wiki/CRS-RS21114 Labor, Health and Human Services Appropriations, 2002 (P.L. 107-116) 100b Total 300 a. According to the legislation, "up to" this amount may be provided. b. According to the legislation, $25 million "may" be transferred from the National Institute of Allergy and Infectious Diseases of the National Institutes of Health (NIH) and $75 million from NIH buildings and facilities funds. In reporting the conference version of the FY2002 Foreign Operations Appropriations to the House floor, Rep. Jim Kolbe, Chairman of the House Appropriations Subcommittee on Foreign Operations, said he was assuming that $40 million of the contribution specified in the bill would come from the $435 million Child Survival HIV/AIDS earmark,9 and the conference report (H.Rept. 107-345) stated that $10 million would to be taken from the amount set aside for infectious diseases other than AIDS, primarily malaria and tuberculosis. Both of these earmarks are part of the Child Survival and Health Programs Fund. The Administration is currently planning to provide $50 million of the U.S. contribution to the Global Fund in this way. The Foreign Operations Appropriations also stated that another $50 million could be taken for the Global Fund contribution from bilateral economic assistance funds appropriated for FY2002 and previous fiscal years. However, the Administration has not taken up this option, and the source of the remaining $50 million of the FY2002 pledge to the Global Fund remains to be determined. Discussions involving USAID and HHS on this issue are reportedly underway. 8 H.Rept. 107-142. For more on the Fund, see its website at [http://www.globalfundatm.org]. 9 Congressional Record, December 19, 2002, p. H10443. CRS-4 Table 2. Appropriations for Worldwide HIV/AIDS Programs $ millions Program FY2001 FY2002 Child Survival HIV/AIDS earmark 300 (P.L. 106-429)a 435 (P.L. 107-115)b International AIDS Vaccine Initiative 10 (P.L. 106-429) 10 (P.L. 107-115) Other HIV/AIDS funds in the 15 (H.Rept.106-997)c 40 (H.Rept. 107-345)d Foreign Operations Appropriations CDC international HIV/AIDS earmark 104.527 (H.Rept. 106-1033)e 143.763 (P.L. 107-116) DOL AIDS in the Workplace 10 (H.Rept. 106-1033) 10 (H.Rept. 107-342)f Initiative Section 416(b) Food Aid 25 (H.Rept. 106-948)g 25 (P.L. 107-76)h DOD HIV/AIDS prevention education 10 (P.L. 106-259)i 14 (P.L. 107-117)j http://wikileaks.org/wiki/CRS-RS21114 with African armed forces Total 474.527 677.763 k a. Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2001. Note the possibility, mentioned in the text, that $40 million of this amount could be used as part of a contribution to the Global Fund to Fight AIDS, Tuberculosis, and Malaria. b. Foreign Operations, Export Financing, and Related Programs Appropriations Act, 2002. c. U.S. Congress. House. Making Appropriations for Foreign Operations, Export Financing, and Related Programs Appropriations for the Fiscal Year Ending September 30, 2001, and for Other Purposes. Conference Report to Accompany H.R. 4811. Ordered to be printed October 24, 2001. d. U.S. Congress. House. Making Appropriations for Foreign Operations, Export Financing, and Related Programs Appropriations for the Fiscal Year Ending September 30, 2002. Conference Report to Accompany H.R. 2506. Ordered to be printed December 19, 2001. e. U.S. Congress. House. Making Omnibus Consolidated and Emergency Supplemental Appropriations for Fiscal Year 2001. Conference Report to Accompany H.R. 4577. Ordered to be printed December 15, 2000. f. U.S. Congress. House. Making Appropriations for the Departments of Labor, Health and Human Services, and Education, and Related Agencies for the Fiscal Year Ending September 30, 2002, and for Other Purposes. Conference Report to Accompany H.R. 3061. Ordered to be reported December 19, 2001. g. U.S. Congress. House. Making Appropriations for Agriculture, Rural Development, Food and Drug Administration, and Related Agencies for the Fiscal Year Ending September 30, 2001, and for Other Purposes. Conference Report to Accompany H.R. 4461. Ordered to be printed October 6, 2000. h. Agriculture, Rural Development, Food and Drug Administration, and Related Agencies Appropriations Act, 2002. i. Department of Defense Appropriations Act, 2001. j. Department of Defense Appropriations Act, 2002. k. Again, note the possibility that $40 million of this amount may be put toward a contribution to the Global Fund for AIDS, Tuberculosis, and Malaria.