HIV/AIDS: Appropriations for Worldwide Programs in FY2001 and FY2002

CRS Report for Congress
Received through the CRS W eb
HIV/AIDS: Appropriations for Worldw ide
Programs i n F Y2001 and F Y2002
RaymondW.Copson
Specialist i n International Relations
Foreign Affairs, Defense, and T r ade Division
Summary
This short report i dentifies FY2002 a p p r o p r iations for worldwide HIV/AIDS
efforts and includes t ables comparing thes e a p propriations with appropriations for
FY2001. For additional i nformation, see C R S Report R S21181, HIV/AIDS
International Programs: Appropriations, FY 2002 - FY 2004.
U.S. support for the s truggl e a ga inst the i nternational HIV/AIDS epidemic is
provided t hrough s everal appropriations bills. A key c o m ponent is the HIV/AIDS
ear m a rk in the C hild Survival and Health Programs Fund¹ of the Foreign Operations,
Ex port Fi n anci ng, and R el at ed P rogram s A ct . T hi s earm ark, w h i c h a s i ndi cat ed bel o w
in Table 2 , reached $435 million i n FY2002, primarily supports the b ilateral HIV/AIDS
activities of t he U.S. Agency for Int ernational Devel opment (USAID). These incl ude
programs aimed at p reventing t he spread of HIV, improving home-based care for AIDS
patients, reduci n g m o t h e r t o child transmission (MTCT) of HIV, and h elping AIDS
orphans. In addition, the U.S. contribution t o t he United Nations J oint P rogram on
HIV/AIDS (UNAIDS ) comes from t his earmark.² The FY2002 appropriations legi slation
sets as ide $15 million of t he Child Survival earmark for t he development of microbici des
to combat HIV i nfection, and t hese funds are t o b e m anaged by USAID.³
Additional funds for fighting AIDS are channeled t hrough o ther bilateral economic
assistance programs funded b y t his s ame l egislation, such as the Economic Support Fund,
In t e r n a t i onal Di s ast er Assi st ance, and regi onal p rogram s for East ern E urope and t he

¹ T he Child Survival Fund received t his designation i n t he FY2002 a p p r opriations legi slation.
Formerly, i t was named t he Child Survival and Disease Progr ams Fund.
² T he UNAIDS contributio n was $17 million i n FY2001 and $18 million i n FY2002.
³ U.S. Congress. House. Making Appropriations for Foreign Operations, Export Financing, and
Related Programs Appropriations for t he Fiscal Y e ar Ending September 30, 2002. Conference
Report t o Accompany H.R. 2506. H.Rept. 107-345. Or dered t o be printed December 19, 2001.
Congressional Research Service ˜ The Library of Congress

former Soviet Union.⁴ For FY2002, these funds are estimated at $40 million,⁵ bringi ng
the t otal for i nternational HIV/AIDS a ssistance under t he Fo reign Operations
Appropri a t i o n s to $475 million. The FY2002 Foreign Operations Appropriations also
sets aside $10 million i n C hild Survival funds fo r a U.S. contribution t o t he In ternational
AIDS Vaccine In itiative.⁶ The appropriations does not specify that the contribution come
from t he HIV/AIDS earmark, but the Administration plans to take it from t hat portion of
the C hild Survival program.
Li ke USAID, the C enters for Disease C ontrol and Pre v e n t i o n (CDC) of the
Department of Health and Human Services (HHS) al s o conducts HIV/AIDS programs
overseas. Its Global AIDS P revention (GAP) P rogram, which was active i n 2 4 countries
in FY2001, supports efforts t o s trengt hen HIV prevention, as well as treatment and care,
a n d t o improve health infrastructure. The C DC is funded t hrough t he Departme nts of
Labor, Health and Human Services, a nd Education, and Related Agencies Appropriations ,and
f o r FY2002, $143.763 million h as been appropriated for its international HIV/AIDS
activities (P.L. 107-116).
The Labor, HHS Appropriations meas ure also s et s aside $10 million for the Global
HIV/AIDS in the W orkplace In itiative o f t he Department of Labor (DOL). Acco rding t o
the Department, t his p rogram’s strategi c plan has th ree components: prevention education
i n t h e workpl ace; wor k p l a c e pol i cy d evel opm ent addressi ng t h e i ssues of st i gm a and
discrimination; and capacity building activities for governments, em ployers, and l abor to
strengthen national responses.
The Department of Agriculture Appropriations for FY2002 (P.L. 107-76) sets aside
$25 million i n S ection 416(b) food aid t o mitigat e t he effects o f AIDS o n communities
overseas (P.L. 107-76, Section 727). The S ection 416(b) program was created by the
Agricultural Act of 1949 and p rovides for the donation of s urplus food commodities.⁷
In the Department of Defense (DOD) Appropriations f o r F Y 2002 (P.L. 107-117),
$14 million h as been earmarked for t he DOD HIV/AIDS prev en tion education p rogram
for A fri can arm ed forces. T hi s p rogram , w hi ch i s bei n g i m p l em ent ed by t h e N aval Heal t h
Research Center (NHRC) in San Diego, assists A fri can militaries in establishing
HIV/AIDS policies for their p ersonnel, in ad apting HIV/AIDS p revention p rograms for
use b y African armed forces, and in developing i n t e r v e n tions to reduce high risk
behaviors.
Another source of funding for i nternational HIV/AIDS efforts i n FY2002 and b eyond
will be the m ultilateral Global Fund to Fi ght AIDS, Tuberculosis, and Malaria. The Fund
is headquartered in Geneva, S witz erland, and s ta r t i n g i n April 2002, it is ex pected to
make its first grants t o combat t he epidemic. Grant applications have be e n r e c eived
from “country partner” teams, including government, non-go v e rnmental organiz ations,

⁴ U.S. Congress. House. Committee on Appropriations. Foreign Operations, Export Financing,
and Related Appropriations Bill, 2002. H.Rept. 107-142, J uly 17, 2001.
⁵ H.Rept. 107-345.
⁶ For more i nformation, see t he Initiative’s website: [ http://www. iavi .org] .
⁷ CRS Issue Brief IB98006, Agricultural Export and Food Aid Programs , c ontinuously updated.

and t he private s ector. It i s ex p ected that about 80% of the Fund’s grants will be targeted
toward co mbating t he AIDS ep idemic,⁸ although t he Fu n d h a s n o t made a s pecific
commitment in this regard.
T h e U n i ted S tates has pledged $500 million t o t he Fund, including $100 million
appropriated in t he FY2001 Supplemental Appropriations Act (Table 1 ) and $200 million
pledged for each of fiscal years 2002 and 2003. To date, C o n g ress has m ade available
$300 million, as indicated in Table 1 .
Table 1. Appropriations for U .S. C ontributions to the Global Fund
to Fight AIDS, Tuberculosis, and M alaria
($millions)
Supplemental Appropriations Act, Fiscal Year 2001 (P.L. 107-20) 100
Foreign Operations Appropriations Act, 2002 (P.L. 107-115)^a
Child Survival and Health Pr ograms Fund 50^a
Bilateral economic assistance, FY2002 and previ ous years 50
Labor, Health and Human Services Appropriations, 2002 (P.L. 107-116) 100^b
Total300
^a.^A^cco^r^dⁱⁿ^g^t^o^t^h^e^legⁱ^slatioⁿ^,^“^u^p^t^o^”^th^is^am^o^uⁿ^t^m^a^y^b^e^p^r^o^vⁱ^d^e^d^.
^b^.^A^cco^r^dⁱⁿ^g^t^o^t^h^e^legⁱ^slatioⁿ^,^$²⁵^m^illioⁿ^“^m^a^y^”^b^e^tr^an^sf^er^r^e^d^f^r^o^m^t^h^e^Natioⁿ^a^l^Iⁿ^s^titu^te^o^f^A^ller^g^y^aⁿ^d
^Iⁿ^f^ectio^u^s^Diseases^o^f^th^e^N^atioⁿ^a^l^Iⁿ^s^titu^tes^o^f^H^ealth⁽^N^I^H⁾^aⁿ^d^$⁷⁵^m^illioⁿ^f^r^o^m^N^I^H^b^u^ildⁱⁿ^g^s
^an^d^f^acilities^f^uⁿ^d^s.
In reporting t he conference version o f t he FY2002 Fo reign Operations
Appropriations to the House fl o o r , R e p . J im Kolbe, Chairman of the House
Appropriations Subcommittee on F o r ei gn Operations, s ai d he was assuming t hat $40
million of t he contribution s pecified in the bill would come from t he $435 million C hild⁹
S u rvival HIV/AIDS earmark, and the conference report (H.Rept. 107-345) stated that $10
million would t o b e t aken from t he amount set asi de for i nfectious diseases other t han
AIDS, primarily malaria and tuberculosis. Both of t hese earmarks are part of the C hild
Survival and Health Programs Fund. The Administration i s currently planning to provide
$50 million of t he U.S. contribution t o t he Global Fund in this way.
The Forei gn Operations Appropriations al so stat ed t h at an o t her $50 million could
be taken for the Global F u n d contribution from b ilateral economic assistance funds
appropriated for FY2002 and p revious fiscal years. However, the Administration h as not
taken u p t his option, and t he source of the remaining $50 million o f t he FY2002 pledge
to the Global Fund remains t o b e d etermined. Discussions involving USAID and HHS
on this issue are reportedly underway.

⁸ H.Rept. 107-142. For more on t he Fund, see its website at [http://www.gl oba lfundatm.org] .
⁹ Congressional Record, December 19, 2002, p. H10443.

Table 2. Appropriations for W orldw ide HIV/AIDS Programs
$millions
P r ogram F Y 2001 F Y 2002
Child Survival HIV / AIDS earma rk 300 (P.L. 106-429)^a 435 (P.L. 107-115)^b
International AIDS V accine Initiative 10 ( P.L. 106-429) 10 (P.L. 107-115)
Other HIV /AIDS f unds in the 15 (H.Rept.106-997)^c 40 (H.Rept. 107-345)^d
Foreign Operations Appropriations
CDC i nternational HIV /AIDS earma rk 104.527 (H.Rept. 106-1033)^e 143.763 (P.L. 107-116)
DOL AIDS i n t h e W or kp l a c e 10 (H.Rept. 106-1033) 10 (H.Rept. 107-342)^f
Initiative
Section 416(b) Food Aid 25 ( H.Rept. 106-948)^g 25 (P.L. 107-76)^h
DOD HIV / AIDS pr e ve n t i o n e duc a t i o n 10 (P.L. 106-259)ⁱ 14 (P.L. 107-117)^j
with African armed f orces
Total 474.527 677.763^k
^a.^F^o^rei^gⁿ^O^peratⁱ^oⁿ^s^,^E^x^port^Fⁱⁿ^an^ciⁿ^g^,^an^d^R^el^at^ed^Prog^ram^s^A^ppropri^a^tⁱ^oⁿ^s^A^c^t^,^2001.^N^o^t^e^t^h^e
^p^o^ssib^ility^,^m^en^tioⁿ^e^dⁱⁿ^t^h^e^tex^t^,^t^h^a^t^$⁴⁰^m^illioⁿ^o^f^t^hⁱ^s^a^m^o^uⁿ^t^co^u^l^d^b^e^u^sed^a^s^p^ar^t^o^f^a
^c^o^nt^rⁱ^b^u^tⁱ^oⁿ^t^o^t^he^G^l^o^b^a^l^F^und^t^o^Fi^ght^A^I^D^S^,^T^ub^e^r^c^u^l^o^si^s,^aⁿ^d^M^a^l^a^rⁱ^a^.
^b.^F^o^rei^gⁿ^O^peratⁱ^oⁿ^s^,^E^x^port^Fⁱⁿ^an^ciⁿ^g^,^an^d^R^el^at^ed^Prog^ram^s^A^ppropri^a^tⁱ^oⁿ^s^A^c^t^,^2002.
^c^.^U^.^S.^Co^ngr^e^ss.^H^o^use^.^M^a^ki^ng^Appr^oprⁱ^a^tⁱ^ons^f^o^r^F^or^ei^gn^O^p^er^atⁱ^ons^,^E^xpor^t^Fⁱ^nanci^ng,^and^Rel^a^t^e^d
^Pr^ogr^am^s^A^ppr^oprⁱ^a^tⁱ^ons^f^o^r^t^he^Fi^s^c^al^Y^e^ar^Endi^ng^Sept^em^ber^30,^2001,^and^f^o^r^O^t^h^er^Pur^pos^es^.
^C^oⁿ^f^eren^ce^R^e^port^t^o^A^ccom^p^an^y^H^.R^.^4811.^O^r^dered^t^o^b^e^p^riⁿ^t^ed^O^c^t^ober^24,^2001.
^d^.^U^.^S.^Co^ngr^e^ss.^H^o^use^.^M^a^ki^ng^Appr^oprⁱ^a^tⁱ^ons^f^o^r^F^or^ei^gn^O^p^er^atⁱ^ons^,^E^xpor^t^Fⁱ^nanci^ng,^and^Rel^a^t^e^d
^Pr^ogr^am^s^A^ppr^oprⁱ^a^tⁱ^ons^f^o^r^t^he^Fi^s^c^al^Ye^a^r^Eⁿ^dⁱ^ng^Sept^em^ber^30,^2002.^C^oⁿ^f^eren^ce^R^e^port^t^o
^A^ccom^p^an^y^H^.R^.^2506.^Ordered^t^o^b^e^p^rin^t^ed^Decem^ber^19,^2001.
^e^.^U^.^S.^Co^ngr^e^ss.^H^o^use^.^M^a^ki^ng^O^mⁿⁱ^bus^C^ons^olⁱ^dat^ed^and^Em^er^gency^Suppl^em^ent^a^l^A^ppr^oprⁱ^a^tⁱ^ons
^f^o^r^Fⁱ^s^cal^Y^ear^2001.^C^oⁿ^f^eren^ce^R^e^port^t^o^A^ccom^p^an^y^H^.R^.^4577.^Ordered^t^o^b^e^p^rin^t^ed^Decem^ber
^15,^2000.
^f^.^U^.^S.^Co^ngr^e^s^s^.^H^o^u^s^e.^M^a^ki^ng^Appr^oprⁱ^a^tⁱ^ons^f^o^r^t^he^D^e^par^t^m^ent^s^of^L^abor^,^H^eal^t^h^and^H^u^m^aⁿ
^Ser^vⁱ^ces^,^and^Educatⁱ^on,^and^Rel^a^t^e^d^A^genci^e^s^f^or^t^h^e^Fⁱ^s^cal^Y^ear^E^ndi^ng^Sept^em^ber^30,^2002,^and
^fo^r^O^th^er^Pu^rp^o^s^es^.^C^on^f^e^ren^c^e^R^eport^t^o^A^ccom^p^an^y^H^.R^.^3061.^Ordered^t^o^b^e^r^eported^D^ecem^ber
^19,^2001.
^g.^U^.^S.^Co^ngr^e^ss.^H^o^use^.^Making^Appr^opr^iations^for^A^gr^icultu^r^e^,^R^ur^al^Development,^Food^and^Dr^ug
^Admⁱⁿⁱ^s^t^r^a^tⁱ^on,^and^Rel^a^t^e^d^A^genci^e^s^f^or^t^h^e^Fⁱ^s^cal^Y^ear^E^ndi^ng^Sept^em^ber^30,^2001,^and^f^o^r^O^t^h^er
^Pur^pos^es^.^C^oⁿ^f^eren^ce^R^e^port^t^o^A^ccom^p^an^y^H^.R^.^4461.^O^r^dered^t^o^b^e^p^riⁿ^t^ed^O^c^t^ober⁶^,^2000.
^h^.^A^g^ricu^ltu^re,^R^u^r^al^Dev^e^lopm^en^t,^Food^an^d^D^ru^g^A^dmⁱⁿ^is^tration^,^an^d^R^elated^A^g^en^cies^A^ppropriation^s
^A^c^t^,^2002.
ⁱ^.^D^e^part^m^eⁿ^t^of^D^e^f^eⁿ^s^e^A^ppropri^a^tⁱ^oⁿ^s^A^c^t^,^2001.
^j^.^D^e^part^m^eⁿ^t^of^D^e^f^eⁿ^s^e^A^ppropri^a^tⁱ^oⁿ^s^A^c^t^,^2002.
^k^.^A^g^ain^,ⁿ^o^te^th^e^p^o^ssib^ility^th^at^$⁴⁰^m^illioⁿ^o^f^t^hⁱ^s^a^m^o^uⁿ^t^m^a^y^b^e^p^u^t^to^w^a^r^d^a^c^oⁿ^tr^ib^u^tioⁿ^t^o^t^h^e^Glo^b^a^l
^Fund^fo^r^A^I^D^S,^T^u^b^e^r^c^ul^o^sⁱ^s^,^a^nd^M^a^l^a^rⁱ^a^.