The act includes $6.3 billion for global HIV/AIDS, tuberculosis (TB), and malaria initiatives, of which $5.8 billion is appropriated to international HIV/AIDS initiatives, including $840.3 million for U.S. contributions to the Global Fund to Fight HIV/AIDS, TB, and Malaria. Congress exceeded the President's FY2008 request for global HIV/AIDS, TB, and malaria programs by $570.1 million (most of which was provided to the Global Fund) and by $4.7 billion for PEPFAR's entire five-year term. U.S. contributions to the Global Fund and the launching of two initiatives—the Prevention of Mother and Child Transmission Initiative and the President's Emergency Plan for AIDS Relief (PEPFAR)—have contributed to this growth. The President's Emergency Plan for AIDS Relief

On January 28, 2003, during his State of the Union Address, President Bush proposed that the United States spend $15 billion over the next five fiscal years to combat HIV/AIDS through PEPFAR. The President proposed channeling $10 billion to prevention, treatment, and care services in the 15 Focus Countries through GHAI, $4 billion to existing bilateral HIV/AIDS, TB, and malaria programs and research conducted in more than 100 non-Focus Countries, and $1 billion to the Global Fund. 108-25 , the U.S. Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act (the Leadership Act). Between FY2004 and FY2008, PEPFAR programs aim to support care for 10 million HIV-affected people, including children orphaned by AIDS; support the prevention of 7 million new HIV infections; and help 2 million people receive ARVs. Congress appropriates the bulk of PEPFAR funds to the GHAI account. In FY2008, the President proposed that the United States contribute $300 million to the Global Fund through Labor/HHS Appropriations. Congress provided $8.0 million, however, for the activities.
On January 28, 2003, during his State of the Union Address, President George Bush proposed that the United States spend $15 billion over five years to combat HIV/AIDS, tuberculosis (TB), and malaria through the President's Emergency Plan for AIDS Relief (PEPFAR). The President proposed that most of the spending on PEPFAR programs be concentrated in 15 countries. Of the $15 billion, the President suggested spending $9 billion on prevention, treatment, and care services in the 15 Focus Countries, where the Administration estimated 50% of all HIV-positive people lived. The President also proposed that $5 billion of the funds be spent on existing bilateral HIV/AIDS, TB, and malaria programs and research, and $1 billion of PEFPAR funds be reserved for U.S. contributions to the Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund). Between FY2004 and FY2008, PEPFAR aims to have supported care for 10 million people affected by HIV/AIDS, including children orphaned by AIDS; prevented 7 million new HIV infections; and supported efforts to provide anti-retroviral medication (ARV) to 2 million HIV-infected people.
From FY2004 through FY2008 Congress provided almost $20 billion to fighting the global spread of HIV/AIDS, TB, and malaria, some $5 billion more than the President proposed. The President's FY2008 budget request included about $5.8 billion for global HIV/AIDS, TB, and malaria efforts. The Administration proposed that the bulk of the funds, about $5.0 billion, be provided through Foreign Operations appropriations and that about $800 million be provided through Labor/HHS appropriations, of which $300 million would be reserved for a U.S. contribution to the Global Fund. Congress exceeded the President's request by some $560 million, providing $6.3 billion for global HIV/AIDS, TB, and malaria efforts, including some $840 million for a U.S. contribution to the Global Fund. This report reviews U.S. appropriations for treatment and prevention of the three diseases from FY2004 through FY2008. The report will not be updated; PEPFAR authorization expires in FY2008. Subsequent reports will analyze additional funding should the initiative be reauthorized.