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
namer ed acted
Specialist in International Relations
Foreign Affairs, Defense, and Trade Division
Summary
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
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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
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.
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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
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.
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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
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.
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