Politics & Policy

It Ain’t Broke

Hijacking the Africa AIDS fund.

The House Foreign Relations committee will convene on Wednesday to reauthorize funding for the President’s Emergency Plan for AIDS Relief (PEPFAR). But this successful program, which has treated and prevented millions of AIDS cases in Africa, could be radically changed if Democrats get their way.

The draft bill would ensure that most if not all of the money goes to groups that are involved in abortion and family planning. Its requirements that AIDS treatment and prevention be integrated with abortion referrals and family planning would chase many church organizations out of the program altogether — including the Catholic Church, which provides roughly a quarter of all health care in sub-Saharan Africa.

Five years and $18 billion after its inception, PEPFAR has helped get anti-retroviral drugs to 1.4 million AIDS sufferers in 15 focus countries. It has saved 10 million children in the wombs of infected mothers from being born with the death sentence of HIV. The program has brought dead villages back to life. As we saw during his recent Africa trip, many there are deeply grateful to President George W. Bush for the effort.

The president has asked Congress to double funding for this program — to spend about $30 billion over the next five years — and to do so without fundamentally altering the program as the current draft of the bill would do. “The time has come for Congress to act,” President Bush said in an appearance earlier this month at the Smithsonian African Art Museum. “Members of both parties should reauthorize the Emergency Plan, maintain the principles that have made it a success, and double our commitment to this noble cause.”

But House Democrats are trying to reshape the infrastructure of charitable AIDS treatment and prevention in Africa around the family-planning industry. Their bill, even though it spends more money, would not necessarily increase the number of AIDS patients treated over the president’s request. It would, however, increase the size of the pie for the family-planning groups, freeing billions in taxpayer funds for organizations currently barred from receiving U.S. government funding.

The so-called Mexico City Policy, adopted originally by President Reagan and re-adopted by President Bush in 2001, bars family-planning funds in the government’s foreign-operations budget from going to groups that perform or refer abortions. The family-planning lobby is trying to open up PEPFAR as a new source of money for such operations, which must currently be funded through private donations.

Family-planning activists feel that their funding has suffered as governments and world bodies have focused instead on AIDS. “There is something of a tension about the distribution of resources,” admitted one panelist at a London family-planning conference this fall. “The spotlight has gone away from reproductive health and onto HIV/AIDS.”

The Democrats’ bill to reauthorize PEPFAR is one way of changing this. It moves the program’s mission away from AIDS treatment and prevention and toward family planning and abortion. Recipient groups would have to report to Congress on how they are integrating themselves into the family-planning business and referring patients to family-planning groups. And even as groups that actually treat AIDS patients would lose their funding by failing to comply, family-planning groups would suddenly become eligible for a windfall in PEPFAR money by merely taking referrals of AIDS patients. This outcome is so desirable that some of the groups involved are even exploiting the recent death of respected Foreign Relations Chairman Tom Lantos (D., Calif.) in order to attain it.

“If you’re an organization that doesn’t want to integrate with family-planning groups, you’re going to lose your funds,” David Christensen of the Family Research Council tells National Review Online. This could chase many faith-based programs out of PEPFAR. As the U.S. Catholic bishops put it in a recent letter, the Democrats’ bill would “jeopardize Catholic participation in PEPFAR.”

Rep. Chris Smith (R., N.J.), the ranking Republican on the Foreign Affairs committee, is worried as he watches lawmakers inject America’s most controversial political issue into a non-controversial program that helps sick people. Even if the international family-planning lobby sees integration as being in its best interest, Americans support paying for treatment of sick Africans and oppose paying for abortion services.

The current bill “shatters the bipartisan cooperation and good will that is needed for this bill, by making billions available for pro-abortion groups,” Smith says. He adds that the Democrats’ bill, as currently drafted, would end a requirement that PEPFAR organizations pledge not to support practices that exploit women — prostitution and international sex-trafficking.

Before his recent death, Lantos, the chairman of the House Committee on Foreign Affairs, reportedly wanted to mark up a bipartisan bill that Smith and other Republicans could support. Smith prefers the larger $50 billion number proposed by the Democrats. The question is where the money goes — to treat AIDS patients, or to serve someone else’s agenda.

 – David Freddoso is an NRO staff reporter.

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