Order Code RS21181
March 25, 2002
CRS Report for Congress
Received through the CRS Web
HIV/AIDS International Programs:
FY2003 Request and FY2002 Spending
Raymond W. Copson
Specialist in International Relations
Foreign Affairs, Defense, and Trade Division
Summary
The Administrationâ€™s FY2003 request for international HIV/AIDS spending would
increase funding for the bilateral programs of the U.S. Agency for International
Development but would hold constant spending by the Centers for Disease Control and
Prevention of the Department of Health and Human Services. Funds have not been
requested for some international programs funded in FY2002, although $200 million has
been requested for a contribution to the Global Fund to Fight HIV/AIDS, Tuberculosis,
and Malaria. This is the same amount provided by Congress for FY2002. For additional
information, see CRS Issue Brief IB10050, AIDS in Africa and CRS Report RS21114,
HIV/AIDS: Appropriations for Worldwide Programs in FY2001 and FY2002.
U.S. International HIV/AIDS Programs
During February and March 2002, the Bush Administration released information on
its FY2003 budget proposal for international HIV/AIDS programs. Table 1 summarizes
Administration requests for these programs and compares them with projected spending
in FY2002. The figures in Table 1 include U.S. contributions to the Global Fund to Fight
HIV/AIDS, Tuberculosis, and Malaria (Global Fund), which will not devote its resources
exclusively to combating HIV/AIDS. However, the preponderance of Fund grants are
expected to focus on the epidemic.
The first item in Table 1 is an â€œearmarkâ€ for HIV/AIDS programs in the Foreign
Operations Appropriations legislation. In FY2002, this earmark, which falls under the
Child Survival and Health Programs Fund of the Development Assistance program, is
$435 million.1 The Administration is requesting, as part of its overall FY2003
Development Assistance request, that $600 million be provided for HIV/AIDS programs.
The largest part of the HIV/AIDS earmark goes toward the bilateral HIV/AIDS programs
of the U.S. Agency for International Development (USAID). In FY2002, however, $40
1 H.R. 2506/P.L. 107-155, Title II.
Congressional Research Service Ëœ The Library of Congress

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million from the earmark is being put toward the U.S. contribution to the Global Fund, and
this amount would rise to $100 million in FY2003. Moreover, in FY2002 the earmark is
funding an $18 million contribution to the United Nations Joint Program on HIV/AIDS
(UNAIDS), $15 million for microbicide research, and $10 million for the U.S.
contribution to the International AIDS Vaccine Initiative (IAVI).2
Table 1. U.S. International HIV/AIDS Programs
$ millions
Program
FY2002
FY2003
Projected
Request
1. Child Survival/Development Assistance, including part of the
435.0
600.0
Global Fund contribution (Table 2)
2. Other economic assistance
40.0
40.0
3. Foreign Military Financing
0
2.0
7. DOD HIV/AIDS prevention education with African armed
14.0
0
forces
4. Centers for Disease Control
143.8
143.8
5. DOL AIDS in the Workplace Initiative
10.0
0
6. Section 416(b) Food Aid
7.3
0
8. Remaining Global Fund contribution (Table 2)
160.0
100.0
Total
810.1
885.8
The second line in Table 1 indicates that apart from the HIV/AIDS Foreign
Operations earmark, $40 million in other economic assistance is being allocated to
HIV/AIDS programs in FY2002 and that the same amount has been requested for
FY2003. This other economic assistance used to fight HIV/AIDS includes food aid,3
Economic Support Fund aid, assistance for the former Soviet Union under the Freedom
Support Act (FSA), and Assistance for Eastern Europe and the Baltics (AEEB).
Line 3 in Table 1 indicates that the Administration is requesting $2 million in Foreign
Military Financing (FMF) for fighting HIV/AIDS in FY2003. This funding, if approved,
would support a new Military Health Affairs program to complement the Department of
Defense (DOD) program offering HIV/AIDS prevention education to African armed
2 The FY2002 Foreign Operations Appropriations required that $15 million of the HIV/AIDS
earmark be used to support the development of microbicides. The contribution to IAVI was
appropriated under the general Child Survival program, not specifically under the HIV/AIDS
earmark. The contribution to UNAIDS was not earmarked.
3 Such aid is in addition to the Section 416(b) food aid listed in Table 1. For a description of food
assistance programs, see CRS Issue Brief IB98006, Agricultural Export and Food Aid Programs,
continuously updated.

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forces. New funding for the education program itself (line 4) has not been requested.4
Nor has funding been requested for the Department of Laborâ€™s AIDS in the Workplace
Initiative, or for Section 416(b) food aid.5 For FY2002, Congress had made available $25
million through the Section 416(b) program, which provides for the donation of surplus
food commodities, in order to mitigate the effects of AIDS on communities overseas.6
These funds were not used, but $7.3 million in FY2001 Section 416(b) assistance was
carried over to FY2002 and is being used to mitigate the effects of the epidemic.
U.S. Contributions to the Global Fund
Line 8 of Table 1 refers to U.S. contributions to the Global Fund to Fight HIV/AIDS,
Tuberculosis, and Malaria. On February 13, 2002, Secretary of Health and Human
Services Tommy Thompson testified before the Senate Foreign Relations Committee that
to date, the United States had pledged a total of $500 million to the Global Fund. Of this
amount, $100 million was appropriated under the FY2001 Supplemental Appropriations
Act (P.L. 107-20), $200 million has been made available in FY2002 funds, and another
$200 million has been pledged in requested FY2003 funds. Table 2, on the following
page, provides further information on how U.S. contributions to the Global Fund are
expected to be met.
4 Executive Office of the President, Office of Management and Budget, Budget of the United States
Government, Fiscal Year 2003. Appendix, 273. According to the Budget, â€œadditional authorizing
legislationâ€ is required for this program.
5 Budget of the United States Government, Fiscal Year 2003. Appendix, 197.
6 This food aid was earmarked by Congress in the FY2002 Department of Agriculture
Appropriations (P.L. 107-76).

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Table 2. U.S. Contributions to the Global Fund to Fight AIDS,
Tuberculosis, and Malaria
($ millions)
Source
FY2001
FY2002
FY2003
projected
request
1. Supplemental Appropriations, FY2001
100
2. HIV/AIDS earmark
40
100
3. Other infections diseases earmark
10
4. NIAID (NIH)
25
100
5. NIH buildings and facilities
75
6. To be determined
50
Total
100
200
200
Line 1 of Table 2 refers to the amount appropriated in the FY2001 supplemental,
while line 2 indicates the amounts, already noted, to be taken from the HIV/AIDS earmark
of the Foreign Operations Appropriations. Line 3 shows that in FY2002, $10 million will
also be taken from funds earmarked in the Child Survival appropriations for fighting â€œother
infectious diseases,â€ principally tuberculosis and malaria. As provided for in the FY2002
appropriations for the Department of Health and Human Services (P.L. 107-116), a total
of $100 million in FY2002 funds will be transferred to the Global Fund from the National
Institute of Allergy and Infectious Diseases (NIAID) of the National Institutes of Health
(NIH) and from the NIH buildings and facilities account, as indicated in lines 4 and 5 of
Table 2. Under the FY2003 request, $100 million would be appropriated within the
NIAID account.7
Line 6 of Table 2 indicates that the source of the remaining $50 million of the
FY2002 contribution to the Global Fund has yet to be determined. The Foreign
Operations Appropriations for FY2002 had provided that in addition to the $50 million for
the Global Fund under the Child Survival program, up to $50 million could be taken for
the Fund from bilateral economic assistance funds appropriated for FY2002 and for
previous years. However, the executive branch has not taken up this option. Instead,
discussions are underway involving USAID and HHS on the source for the remainder of
the FY2002 contribution.
7 Budget of the United States Government, Fiscal Year 2003. Appendix, 976.