Citizens for Global Solutions

HEALTH AND ENVIRONMENT | 109th Congress

FOREIGN AID, HIV/AIDS, WATER, AND SANITATION ON AGENDA FOR 109TH CONGRESS

In his most recent budget, President Bush proposed modest increases in funding for global poverty, health, and development. Meanwhile, Senate Majority Leader Bill Frist (R-TN) hinted at a new initiative to improve access to clean water and sanitation.

Bush requested $22.8 billion for foreign aid and $3.4 billion for international HIV/AIDS programs in the budget that he recently submitted to Congress for the coming year. Both requests will likely meet firm resistance from Republicans in Congress, who have fought consistently fought similar increases in the past and will face exceptional pressure to reduce overall spending in this budget.

The bulk of each increase is intended for two initiatives that Bush proposed in his first term, the Millennium Challenge Account (MCA) and the President’s Emergency Plan for AIDS Relief (PEPFAR). The MCA, which distributes aid money to poor countries making marked progress on transparency, economic freedom, and human rights, is slated to take in $3 billion for FY06, double what it received this year. Its allocation accounts for approximately half of the increase in total aid spending in the new budget, with most of the rest going to traditional foreign assistance programs.

Despite the increase, the Bush Administration is well off track from its original commitment to the MCA. Last year, House Republicans trimmed his $2.5 billion request for this year by $1 billion, and he originally projected next year’s MCA allocation at $5 billion, a full $2 billion greater than his request.

Moreover, none of these requests or projections, even if fully funded by Congress, would bring the United States in line with its international commitments. The U.S. has repeatedly agreed to allocate 0.7% of its Gross National Product (GNP) for development assistance; the President’s requests, fully funded, would raise our contribution to roughly 0.2% of U.S. GNP, which still ranks near last among developed nations.

The parallels between the President’s foreign aid request and his global HIV/AIDS programs request are uncanny. Just as much of the foreign aid increase goes to the MCA, intended as an alternative to traditional development assistance, the bulk of global AIDS funding will go to PEPFAR ($1.4 billion request), proposed by Bush in 2003 as an alternative to the effective UN Global Fund to Fight AIDS, Tuberculosis, and Malaria ($300 million request).

Critics charge that PEPFAR emphasizes abstinence and fidelity in marriage over at the expense of proven risk reduction techniques, like distributing condoms and clean hypodermic needles. PEPFAR has also been assailed for undermining support in the U.S. for the Global Fund.

Senator Frist’s proposals, while promising, are as yet undeveloped. According to Congressional Quarterly, at a hearing of the Senate Committee on Commerce, Science, and Transportation, Frist announced that he would spearhead 2 new legislative efforts, to increase access to fresh water in developing countries and to establish a Global Health Corps.

The Global Health Corps will be modeled on the Peace Corps, which has been widely hailed as an effective instrument both for assisting developing communities to address their needs and for building trust and good feelings between the U.S. and developing countries. “[Global Health] Corps members would serve as shining examples of the American peoples’ charity and good will,” Frist said. “Its members would serve for the good of humanity and, in so doing, these doctors, nurses, technicians, and scientists would become ambassadors of peace.”

Frist, who also called water and sanitation conditions in developing countries, “a crisis,” at the Committee hearing, plans to direct government and private sector funds to address the problem. 1.2 billion people currently live without clean water and a whopping 2.4 billion, nearly 40% of the world’s population, lack access to basic sanitation. At the 2002 World Summit on Sustainable Development in Johannesburg, South Africa, the U.S. joined the international community in committing to halve both of these numbers by 2015.

Frist has not yet submitted legislation on either the Global Health Corps or new clean water and sanitation initiatives, but his status as Senate Majority Leader ensures that when he does, neither will go unnoticed.

Updated February 18, 2005

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