Senate Foreign Relations okays PEPFAR bill with TB, health worker provisions

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DoorWith the government facing shutdown today over a congressional standoff on domestic healthcare policy, the Senate Foreign Relations Committee moved quickly Monday night to approve a bill to extend the United States’ signature and largest global health effort.

The committee had been scheduled to vote today on the bill, which will extend the authority of, and add reporting requirements to, the President’s Emergency Plan For AIDS Relief.

An amended version of the PEPFAR Stewardship and Oversight Act, introduced by last week by committee Chair Sen. Robert Menendez, and ranking Republican Sen.Bob Corker, passed by voice vote in a meeting called shortly before 6:45 p.m. Monday. Additions to the bill introduced last week include requirements to specifically report on efforts to address HIV-TB coinfection by providing information by country on the number and percent of people in HIV care starting treatment for tuberculosis, and the number and percentage of patients with HIV who are eligible for isoniazid preventive therapy to keep them from becoming sick with tuberculosis, who actually receive it. Tuberculosis is the No. 1 killer of people with HIV. The bill also now includes a requirement for reporting that details efforts by  countries receiving PEPFAR support to train, hire and keep health workers and address health work force gaps. In addition, the bill adds the word “partner” before all references to countries receiving PEPFAR support and changes “community-based” institutions to “locally based” institutions.

Dr. Charles Holmes, who heads the Centre for Infectious Disease Research in Zambia, attended the committee’s hearing and said the bill was encouraging.

“It  is a critical step toward ensuring continued support for PEPFAR’s mission. The bill builds from PEPFAR’s history of accountability and sets an even higher standard for the next five years- importantly, it stresses higher level outcome metrics, indicator performance and expenditure analysis, impactful resource allocation and careful attention to transition and country ownership, ” he said. “”From my perspective in Zambia, I see daily examples of the beneficial societal effects of slowing down the ravages of the HIV pandemic. Continued investment in PEPFAR and the Global Fund will help to secure these gains, and the impacts we achieve today will save resources down the road.”

The committee’s action Monday night coincided with the official end date of the  Lantos Hyde Act, which reauthorized the President’s Emergency Plan For AIDS Relief for five years in 2008. Prior to the shutdown, the bill was then set to go to the Senate floor, and then the House, where House Foreign Affairs Committee leaders Reps. Ed Royce and Eliot Engel, joined by Rep. Barbara Lee, Rep. Ileana Ros Lehtinen last week introduced an identical bill to the one originally introduced in the Senate committee.



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