Lantos Never Compromised Principle; Why is Bono?

The nation mourns Congressman Tom Lantos (D-CA), a Holocaust survivor who served in the House of Representatives for 28 years and who died Monday. Lantos never caved in to forces of ideology, throughout his entire life, that suggested we should accept the politics of a few trying to claim power over many. His life is a triumph of courage, personal and political, over ideology for the sake of raw power.

Lantos also understood bipartisanship meant working across party lines to achieve real and genuine compromise, as he did with Rep. Henry Hyde, the Chairman of Foreign Affairs when the President's Emergency Plan for AIDS Relief (PEPFAR) was originally authorized and Lantos was in the minority. When PEPFAR was passed, the "E" in it standing for "Emergency," compromise was important. But even then Lantos did not compromise principle, working to balance competing ideas to address an urgent situation.

The reauthorization of PEPFAR this year, while every bit as important, need not be seen as an "emergency" and should not fall victim to political "expedience." Democrats won a majority, in part, because voters are fed up with social conservative ideologues. As such, the goal for PEPFAR reauthorization must be sustainable, workable programs that apply lessons from the first five years moving forward. The final bill should honor the convictions of Chairman Tom Lantos.

In a press release four days before he died, Lantos chided ideological Republicans on the committee, including Rep. Chris Smith, Rep. Steve Chabot, and Rep. Mike Pence, saying,

Henry [Hyde], God rest his soul, joined me and many of our colleagues five years ago in ensuring that a bipartisan bill became law by creating a $15 billion program that has saved countless lives in some of the poorest countries in the world. That legislation included compromises on issues important to those of us who were then in the minority. It is a shame that the current minority is failing to honor this spirit of compromise and is willing to endanger a valuable U.S. foreign policy program addressing one of the most serious health care challenges that humanity faces today.

But it is not only social conservative ideologues on the House Foreign Affairs Committee that should be called out. It's not just Wendy Wright from Concerned Women for America, or Pastor Rick Warren trying to be an Evangelical moderate but never far from conservative ideologues. Some AIDS advocates seem too willing to appease, even though they know the scientific data, see the problems created by ideological politicians first-hand, and hear what public health experts around the world say:

  • PEPFAR's 33 percent abstinence-only earmarks prevent wider success and should be eliminated;
  • Failure to integrate reproductive health and HIV prevention endangers women and girls, failing to meet them where they receive health services, where the most could be done to prevent HIV. This is especially true in macho cultures where females cannot negotiate sex or access contraception to protect themselves from disease;
  • Local implementation of public health strategies, prevention and education efforts should not be dictated by politics, rather guided by people on the ground who know how to reach the most vulnerable populations;
  • Family planning and contraceptive services, according to the World Health Organization, should be available through other health interventions to prevent mother-to-child transmission.

Despite gathering and promoting much of this data and working to promote better understanding of the AIDS pandemic, Bono's Debt AIDS Trade Africa and the Global AIDS Alliance are suggesting that Democrats on the Foreign Affairs Committee give in to ideological demands of the far-right. The bill is not even marked up or out of committee where less ideological Republicans can work with Democrats to strengthen the bill.

Tom Lantos' last efforts before he died called for bipartisanship that can achieve real results, not appeasement.

Noting the mountains of evidence the World Health Organization and Institutes of Medicine have gathered in the first five years of PEPFAR, all encouraging a shift to longer term sustainability and emphasizing the importance of local implementation, Lantos said,

Facts are driving the reauthorization of the Global HIV/AIDS program, not ideology. The draft global HIV/AIDS reauthorization bill actually supports and increases the number or references to abstinence and faithfulness education as part of the integrated ‘ABC’ prevention approach. Yes, it removes the 1/3 abstinence-only earmark, which was included in the 2003 law over strong Democratic objections, because that restriction has proven to be hampering the effectiveness of programs in the field.

Bipartisanship is not an end we should seek for political expedience, but a means to improving public health policy and making certain that PEPFAR experience, public health data, and science prevail so that good money doesn't follow bad. Continuing to support failed abstinence-only programs with 33 percent earmarks that tie the hands of cultures vastly different than ours, binding them to narrow social ideologies that even the vast majority of Americans don't support, makes no sense.

Tom Lantos understood that, and so should Bono, DATA, the One Campaign and the Global AIDS Alliance. This is the moment to fight for what's right against ideologues who contributed to the spread of the AIDS pandemic for the first 25 years, and continue to stigmatize many.

Efforts by Democrats in Congress to improve PEPFAR based on proven scientific and public health methods, collected during the first five years of the program, should be strongly supported — especially by AIDS advocates — over the efforts of Republican ideologues that are trying to weaken the Lantos Bill.

More money on bad policies is not the way to confront this epidemic. There is no reason to cave to ideologues like Chris Smith, Mike Pence and Steve Chabot in the name of bipartisanship – especially when it flies in the face of sound public health policies.

If the Democrats, working with moderate Republicans who will not ignore scientific and public health data, cannot produce a dramatically improved bill, it may be better to wait for the new President and Congress, and raise awareness of the failures of conservative ideologues between now and the November election. PEPFAR money will continue to flow, and the chance for a better bill that can address problems on the ground will be vastly improved with a strong mandate for reality over ideology in the 2008 election.

Let the people who stand in the way of improving PEPFAR answer these questions:

1. Why shouldn’t Congress act on the recommendation by the Institutes of Medicine and the Government Accountability Office to remove the requirement that at least 33% of prevention funds be spent on abstinence-until marriage programs?

2. Under the current PEPFAR, countries have already asked to not have the abstinence earmark apply to them because it does not work. Why not listen to local public health experts?

3. While there are a range of ways to prevent HIV, we know that in practicality none of them on their own are always effective, so isn’t there a moral obligation to make all the tools available to people?

4. Given the savings – in lives and in money – for full scale up of prevention efforts, wouldn’t it be prudent to promote every prevention tool and behavior change available in a way that meets a country’s needs?

5. Who should be deciding what public health strategies work best in any country?

6. Do you believe people should be able to choose to use contraceptives?

7. Can you imagine that an HIV positive person may actually want to choose to not become pregnant and may live in a culture where women and girls cannot negotiate sex?

8. Should PEPFAR money be targeted to the most vulnerable populations to stem the spread of AIDS, and should local public health officials be able to determine who is most vulnerable in their communities?

9. Some Members of Congress have had sex with people other than their spouses – should their spouses have the information and services to protect themselves from HIV and other sexually transmitted infections?

10. Shouldn't reality trump ideology when it comes to preventing disease?

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  • invalid-0

    As an active Democrat from PA I mourn Tom Lantos. His integrity and moral base were beyond the reach of even the most vile character assasins on the Far Right. Scott, thank you for this indepth yet succinct article. You describe how a Congressional Committee should do its work, and under Tom Lantos DID do its work. I am concerned about the influence that well meaning but clueless celebrity ambassodors for a cause may exert on the deliberative process that is necessary to introducing and getting GOOD legislation passed in the United States. Bono needs to educate himself about this.

  • invalid-0

    Bipartisanship is not an end we should seek for political expedience, but a means to improving public health policy and making certain that PEPFAR experience, public health data, and science prevail so that good money doesn't follow bad.

    This is perfect, Scott. I couldn't agree more. If we see bipartisanship used as an end unto itself, then it's politics for politics sake. This is supposed to be about creating policies that work for our citizens. If they don't, what's the point?


  • invalid-0

    Scott is jumping to conclusions here about Global AIDS Alliance’s activities, without citing any evidence supporting his allegations.

    In fact, if you read the GAA document that he cites you will see that in no way does it call for appeasing the opposition. Our statement makes clear our strong support for science-based programs and expanded protections for women’s health and rights.

    We have shared these messages with some of the opponents of Lantos’ bill and urged them to be more flexible, in the spirit of compromise, which Lantos himself cites as important in the statement quoted above.

  • amanda-marcotte

    Sometimes I think liberal allies don't realize that you have to fight in politics. The opposition says boo and all too often, we roll over. Conservatives are always ready to roll; we should take a page out of their book.

  • scott-swenson

    David, thanks for the comment and I sincerely hope you and GAA take us up on our invitation to write a piece for the site clearly stating your position. But really, everyone knows that the words in a press release often paper over positions at a negotiating table. Here’s hoping that both are as in synch with the release as you suggest, and that everyone holds firm to a strong position against the vocal minority of radical right ideologues. That would be welcome news to many.

    Be the change you seek,

    Scott Swenson, Editor

  • invalid-0

    The above post is not an accurate characterization of Bono’s or ONE’s/DATA’s (we’ve merged) position on PEPFAR. We along with many others in the HIV/AIDS community have been pushing at least $50b over 5 years with new aggressive targets for treatment, care and prevention, as well as TB and malaria (all in the original bill). We support training more health care workers to continue to shift PEPFAR from an emergency response to a sustainable response. We support the Global Fund and a greater investment in prevention efforts.

    We have NOT weighed in on some of the social issues that are dividing the 2 sides. We HAVE encouraged all sides to pursue a bipartisan bill. We believe the bipartisanship that Tom Lantos and Henry Hyde, along with so many others, created 5 years ago has been tremendously valuable to the fight against AIDS. It shouldn’t be lost if at all possible. We recognize there are serious disagreements over policy in this bill, as there are on most major pieces of legislation. We do not believe the pursuit of bipartisanship to be “appeasement” of one side to another; rather it is an increasingly rare moment when both sides negotiate to reach a common goal…in this case saving lives. We hope both sides will do that.

    Tom Lantos was an inspiration to all of us. Bono was very honored to be asked by his wife Annette to speak at his memorial service this morning.

    Tom Hart, DATA/ONE

  • invalid-0

    As someone daily engaged in the effort to pass a global AIDS reauthorization act, I want to raise what i believe are myths being perpetuated by some in this debate.


    Myth one: The 2003 Global AIDS Act was bipartisan. That is true *only* if you count votes, not if you look at what actually happened. As one leading Democratic staffer stated recently, "this was not bipartisan; we were rolled."


    First, the Democrats had lost control of the Senate, did not have control of the House and did not have much power to effectuate anything. Inflammatory and vague amendments to the draft bill—I was there—were put forth and adopted in the House Committee in 2003–including the abstinence earmark and the prostitution pledge–and were adopted by party line vote. Moreover, where people disagreed, they were tarred–as they are now being tarred by Representatives Smith and Pitts–as being in league with "abortionists, pimps, and brothel owners." Not exactly the kind of rhetoric that makes you wanna sit, have a beer and figure out your common ground.


    In the Senate, then-Majority Leader Frist, under pressure from the White House, ditched his own bill–earlier written with Senator Kerry and passed by unanimous consent in the Senate–in favor of a highly partisan House bill. The vote then held at 2:30 in the morning after long days of debate on budget and other matters. Debate was limited as were amendments. Again, not what i think of when people throw around this nice-sounding word called "bipartisan."


    So let's get real. Last time one party had power and used it to advance their "vision" of the world and now this time another party has power *backed by substantial amounts of evidence of what works and what is needed in the field.*


    I must ask my colleagues: what do you mean by bipartisan as regards this bill? Lots of money thrown at now deeply discredited prevention programs? Legal restrictions that actually result in greater levels of violence against women in sex work to feed their kids? That is unethical, bad public health policy, breach of human rights, and a disservice to the American taxpayer.


    Myth Two: Can't we all just get along? The word compromise continues to be thrown around as if it were a no-brainer. But you can not compromise on something where there is no shared value. Example one: Evidence now shows unequivocally and implementers are arguing strongly that contraceptives should be offered to HIV positive women who themselves wish to delay childbearing, space their next birth or not bear any more children. The World Health Organization says that offering voluntary family planning services to HIV positive women is one of the four pillars of good prevention of maternal-to-child transmission programs.


    The Catholic Church does not feel *anyone* should *ever* use contraception. One side believes in the free will of people to choose whether and when to bear a child; the other believes you should have no sex or only unprotected sex. Where is the compromise?


    Finally, I would like to ask if ONE, which is at least in theory a coalition that is supposed to reflect the will and opinions of its partners, is still a coalition, or having merged with DATA, now an independent organization? A coalition uses open processes to reflect the vision and opinions of its partners. An independent organization articulates its own position. Is ONE speaking as ONE/DATA/Bono, or is ONE a coalition. AJWS is an original coalition partner of ONE, and this is confusing at best.


    Having said all this, I want to thank Scott for opening up this debate in this forum. What I feel is critical here is healthy critique and transparency within our community so that we hold ourselves mutually accountable. I keep asking people what we mean by "compromise" and "bipartisan" and why anyone should compromise with a small group of representatives from the radical right to whom real evidence means virtually nothing. Those of us who have been fighting for the rights and health of groups like women, youth, men who have sex with men, and others are no longer willing to throw huge sums of money at ideological programs with no evidence to show they work. What evidence, i would ask, is there for keeping the ab earmark in place?


    And how can anyone "stay out of" these issues? There are 7 new infections for every person put on treatment. You can't ask for $50 billion and stay out of questions on how it is spent to prevent new infections, especially when we face health and other crises at home. You are by default *in* those issues when working on this bill. Not dealing with them publicly is a sly nod to the side that wants to further marginalize what people need most—effective, evidence-based prevention strategies that will reduce the number of new infections dramatically. At least let's state our positions clearly.


    Jodi Jacobson, American Jewish World Service.