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Engel Floor Remarks on S. 1545 – The PEPFAR Stewardship and Oversight Act of 2013

Washington D.C.– U.S. Rep. Eliot L. Engel, the senior Democrat on the House Foreign Affairs Committee, delivered the below remarks, as prepared for delivery on the House Floor, for debate on The PEPFAR Stewardship and Oversight Act of 2013.

The statement follows:

“Mr. Speaker, I rise in strong support of S. 1545, the PEPFAR Stewardship and Oversight Act, and yield myself as much time as I may consume.

This important legislation, which passed the Senate by unanimous consent, reauthorizes key authorities that have helped the President’s Emergency Plan for AIDS Relief (PEPFAR) change the trajectory of the HIV/AIDS epidemic around the world. 

Before President Bush announced PEPFAR in his 2003 State of the Union address and Congress passed authorizing legislation in May of that year, HIV and AIDS were ravaging the continent of Africa. 

By then, more than 25 million people had died from HIV/AIDS and 14 million children had been left as orphans.

Another 42 million people were infected, and though life-saving treatments had been developed, far too many people had no access to the medications necessary to save their lives.

PEPFAR became – and remains - the largest commitment by any nation to combat a single disease internationally.

Today, nearly 6 million people are receiving life-sustaining antiretroviral treatment.

Last year, more than 46 million people received HIV testing and counseling.  Of these, more than 11 million were pregnant women, and as a result of treatment, the one-millionth baby was born HIV-free this year.

HIV/AIDS is no longer threatening to wipe out an entire generation on the continent of Africa.  In fact, a sustained commitment by the United States to fighting this epidemic has made it possible for experts and researchers to talk about achieving an AIDS-Free generation. 

PEPFAR is in the midst of an important transition as countries take on greater ownership of their HIV/AIDS programs. 

At this critical juncture, the PEPFAR Stewardship and Oversight Act is an important demonstration of our ongoing, bipartisan support for the fight against HIV/AIDS.

This legislation also contains critical provisions that will enable Congress to provide the oversight necessary to ensure PEPFAR continues to save millions of lives while protecting our taxpayers’ hard-earned money. 

The bill calls for continued coordination by the Inspectors General for the State Department, Department of Health and Human Services and the U.S. Agency for International Development in conducting audits and oversight of the PEPFAR program.

It also requires a more robust annual report from the Office of the Global AIDS Coordinator, which will ensure better accountability. 

This legislation also extends key funding requirements for the treatment and care portion of the program, as well as funding for orphans and vulnerable children.

Historically, the United States contribution to the Global Fund has been capped at 33% of total contributions.  This cap has been an effective tool to leverage contributions from other countries, as well as push for reforms as necessary within the Global Fund. 

However, when PEPFAR’s authorization ended at the end of September, the 33% cap lapsed as well.

It is critical this 33% cap be reinstated going into the Global Fund replenishment conference, which will be held the first week of December here in Washington, and this legislation would accomplish this important policy objective.  

Mr. Speaker, by all accounts, PEPFAR has been an incredible success and a program we should all be proud to be a part of.

I’d like to thank Ambassador Eric Goosby, the recently departed United States Global AIDS Coordinator, for his hard work on behalf of PEPFAR and his lifelong dedication to those living with HIV/AIDS.

I commend Chairman Royce, Representative Lee and Representative Ros-Lehtinen, as well as Senator Menendez and Senator Corker for their hard work on this legislation.  It has been a pleasure working with all of them in such a bipartisan and bicameral manner.

I would also like to thank the House Leadership for allowing this to come to the floor in a timely manner. 

I urge my colleagues to support this legislation.”

Background

The PEPFAR Stewardship and Oversight Act (S. 1545 and H.R. 3177) will extend certain critical authorities and strengthen program oversight to ensure access to essential prevention and treatment services continues. This streamlined bill requires:

Coordination by the Inspectors General: Extends the requirement for the State, USAID, and HHS Inspectors General to develop annual, joint oversight/audit plans. This has enhanced Congressional oversight and improved coordination between State, USAID, and CDC.

Cost Studies: Extends a reporting requirement intended to capture per-patient costs for PEPFAR-supported treatment and care. This is a key element of oversight and a useful tool for monitoring treatment costs.

Caps U.S. Participation in the Global Fund: Extends the current 33 percent limitation on U.S. contributions to the Global Fund, continues proportional withholding requirements related to State Sponsors of Terrorism, and a 20 percent withholding requirement related to Global Fund management reforms. The 33 percent cap serves as an effective tool for leveraging other donor funding, and the withholding requirement has leveraged substantial reforms at the Global Fund.

An Effective Annual Report. Updates the existing annual report on PEPFAR to better reflect the program’s shift from strictly U.S. supported and toward greater partner country ownership. As PEPFAR has transitioned from an emergency plan to a program focused on building country ownership and ensuring sustainable results, the information needed to conduct effective oversight has changed significantly.

Protected Funding for HIV Treatment and Programs for Orphans and Vulnerable Children. Extends existing funding requirements for treatment (at least 50 percent) and orphans and vulnerable children (10 percent).

Bill text can be found here.

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