With wrangling over reauthorisation of the US President’s Emergency Plan for AIDS Relief (PEPFAR) continuing this week, where do Barack Obama and John McCain stand on the issue? Both candidates have endorsed the legislation. Obama and McCain officially added their names to the list of bill cosponsors on June 18 while the bill was being negotiated in the Senate. Both received large home made gold medallions from HIV/AIDS activists proclaiming the Senators to be “Global AIDS Superheroes”. But, in reality, the candidates have done little to advance the bill’s passage.

Supporters of the bill, which would authorise PEPFAR for an additional 5 years, hoped for final passage before the G8 summit in Japan this week. But after sailing through the House of Representatives on a 308-116 vote in April, the bill was stymied in the Senate by conservative Republicans. Initially, a group of seven Senators, led by Tom Coburn of Oklahoma, opposed loosening restrictions on funding allocations for treatment, were concerned about broadening the programme’s scope, and objected to its US$50 billion price tag. Negotiators made good progress in reaching an agreement but objections persisted this week. Senate Majority Leader Harry Reid, tired of waiting for resolution, made a procedural move on July 9 that could force a vote on the measure in the next few days. Advocates are optimistic the measure will be approved.

Although Obama’s endorsement of the reauthorisation measure was dramatic, it was not his first action on the bill. As a member of the Senate Foreign Relations Committee, Obama added an amendment to the legislation during committee consideration. The provision requires the National Institutes of Health to expedite a federal strategic plan to support research and development of microbicides for developing countries.

Obama’s presidential campaign says the Senator is determined to ensure the US continues to be a global leader in the fight against AIDS. He and his wife Michelle were publicly tested for the virus during a visit to Africa in 2006 in an attempt to reduce stigma associated with the disease.

HIV/AIDS doesn’t seem to be as high a priority for McCain. Last year, when asked by a reporter whether taxpayer subsidised contraceptives should be distributed in Africa to fight HIV, McCain appeared confused. “The upshot was that McCain said he did not know this subject well, did not know his position on it, and relied on the advice of Senator Tom Coburn, a physician and Republican from Oklahoma”, The New York Times reported. Despite the gaffe, McCain’s campaign issued a statement on World AIDS Day in December saying he has “consistently supported the most aggressive global AIDS program in the history of this pandemic, the President’s Emergency Plan for AID Relief (PEPFAR)”. Activists say they hope McCain will continue to be a vocal supporter of the programme, but concerns remain. “He stepped up to the plate on this bill, but his track record on AIDS issues has many shortcomings”, said Health GAP Grassroots Organiser Kaytee Riek.

Both candidates could do with a primer on current AIDS statistics. Obama’s website lists at 40 million the number of HIV/AIDS infected individuals worldwide, a number UNAIDS recalculated last fall. New estimating and surveillance methods moved the total to 33.2 million. In his World AIDS Day speech, McCain cited 40 million AIDS orphans. UNAIDS puts the figure at 15 million.

In developments on domestic health issues, strategies to reduce spending outlined by the McCain campaign this week focused on “cheaper drugs” through re-importation and faster introduction of generics. Also cited was the promotion of better coordinated, more accessible care with an emphasis on the prevention and control of chronic diseases.  Medicare and Medicaid were listed in the document as reform targets in McCain’s plan to balance the federal budget by 2013, but details were not provided.

Meanwhile, a national grassroots group consisting of more than 100 unions, health providers, and activist organisations is pushing broader health reform. Health Care for America Now is planning a $40 million advertising campaign during the remainder of the 2008 election cycle to urge candidates to support universal health coverage. The group is advocating retaining private insurance, but developing public alternatives to help the 47 million Americans without coverage. It also is calling for increased regulation of insurance companies. 

Nellie Bristol

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This entry was posted on Thursday, July 10th, 2008 at 4:18 pm and is filed under US Election. You can follow any responses to this entry through the RSS 2.0 feed. You can trackback from your own site.