U.S. dispute grows over Libya funding

Sen. LIndsey Graham said Sunday the War Powers Resolution of 1973 is unconstitutional.Sens. McCain, Graham oppose de-funding Libya missionHouse Speaker Boehner warns Congress may cut funds over War Powers disputeU.S. officials say the limited U.S. role in Libya falls short of the law's scopeTen legislators are suing the government over the legality of the U.S. participation

Washington (CNN) -- Two influential Republican senators said Sunday they oppose any effort by House Republicans to cut funding for U.S. participation in the Libya military mission.

The comments by conservative Sens. John McCain of Arizona and Lindsey Graham of South Carolina came on the 90th day of the Libya campaign -- which House Speaker John Boehner says is the deadline in the War Powers Resolution for the Obama administration to get congressional authorization it has yet to seek.

Boehner, R-Ohio, said last week that cutting funding for the mission was an option that the Republican-controlled House will consider when it takes up a defense appropriations bill this week. He contended that President Barack Obama has failed to comply with the War Powers Resolution, and that the main tool Congress has to respond is to control the spending.

However, McCain and Graham told Sunday talk shows such a move would send the wrong signal and undermine NATO allies leading the Libya mission with U.S. support.

"If we do not continue this effort in Libya, if (Moammar) Gadhafi remains in power, it could have profound consequences," McCain said on the ABC program "This Week."

Graham, appearing on NBC's "Meet the Press," adhered to longstanding conservative dogma by declaring that the War Powers Resolution of 1973, which limits the ability of the president to unilaterally engage U.S. forces in combat, is unconstitutional.

He also said the ouster of Gadhafi, the Libyan leader, was in the U.S. national interest, because failure to do so would undermine the U.S. standing in the world, cause oil prices to rise and send Libyan refugees streaming across the border into an already fragile Egypt.

"The president's done a lousy job of communicating and managing our involvement in Libya, but I will be no part of an effort to de-fund Libya or to try to cut off our efforts to bring Gadhafi down," Graham said, later adding that Obama "needs to step up his game with Libya but Congress should sort of shut up and not empower Gadhafi."

Outgoing Defense Secretary Robert Gates also backed the Libyan mission, saying Obama was right to limit the scope of U.S. involvement and that he believes the president has complied with the War Powers Resolution.

"What was going on in Libya was considered vital interest by some of our closest allies. Those are the same allies that have come to our support and assistance in Afghanistan," Gates told CNN's "State of the Union." "And so it seems to me the kind of limited measured role that the president decided on, in support of our allies who did consider it a vital interest, is a legitimate way to look at this problem."

In a separate interview on "Fox News Sunday," Gates noted the war powers debate dates back several decades and administrations.

"Frankly, I think cutting off funding in the middle of a military operation when we have people engaged is always a mistake," Gates said, later adding: "I believe that President Obama has complied with the law, consistent in a manner with virtually all of his predecessors. I don't think he's breaking any new ground here."

In a letter to Obama last week, Boehner strongly disagreed, saying the president would be in violation of the War Powers Resolution starting Sunday for failing to secure congressional authorization.

Passed in 1973, the War Powers Resolution gives the president 60 days to get congressional approval for sending U.S. forces to war, followed by a 30-day extension to end the hostilities.

In response to Boehner's letter, the White House sent Congress a 32-page report that asserted Obama didn't need congressional authorization because the U.S. forces play only a supporting role in Libya and don't engage in what the War Powers Resolution defined as hostilities.

"We're obviously not changing our mission," White House Press Secretary Jay Carney said Friday, later adding: "What we have said is that our role in this mission, our support role and the kind of engagement we have right now, does not meet, in our legal analysis, ... the threshold set by the War Powers Resolution for congressional action."

Later Friday, Boehner said he specifically asked if the Justice Department's Office of Legal Counsel agreed with the administration's legal analysis, and that the White House's failure to answer that question made cutting funds for the mission a possibility.

"The House of Representatives will not allow the White House to continue skirting its obligations to the American people, this Congress, and the laws of this nation," Boehner said in a statement. "Over the coming week, our members will review all options available to hold the administration to account."

At the Justice Department, deputy spokesman Tracy Schmaler seemed to acknowledge that opinions differed over interpreting the mission's compliance with the War Powers Resolution.

"Our views were heard, as were other views, and the president then made the decision as was appropriate for him to do," Schmaler said.

On the ABC program, McCain called for passage of a resolution he drafted with Democratic Sen. John Kerry of Massachusetts that supports the Libyan mission, which he said would serve as congressional authorization under the War Powers Resolution.

House Republicans aren't the only ones challenging the Libya mission. A bipartisan group of 10 House members has filed a federal lawsuit challenging Obama's power to commit U.S. forces to the Libya mission.

Congressional opponents of the Libya mission include liberals such as Rep. Dennis Kucinich of Ohio, who generally oppose any war effort, as well as some Republicans who complain its objective of civilian protection fails to match the stated U.S. goal of Gadhafi's ouster. The opponents also say the Libya situation could become a stalemate that drains resources at a time of mounting federal deficits that must be addressed.

The White House, however, says incremental progress is occurring through increasing diplomatic, political and military pressure on Gadhafi to step down. Carney repeatedly emphasized this week that Obama had kept his word to the American people that the initial U.S. leadership role in the mission would get reduced to a supporting role, and no U.S. ground troops would take part.

Carney suggested that Boehner is playing politics with the issue, noting that he previously questioned the constitutionality of the War Powers Resolution in a 1999 debate over former President Bill Clinton's push to take part in NATO bombing during the Balkans conflict.

Boehner's complaints this week "stand in contrast to the views he expressed in 1999, when he called the War Powers act, quote, 'constitutionally suspect,' unquote, and warned Congress to, quote, 'resist the temptation to take any action that would do further damage to the institution of the presidency,'" Carney noted.

John Yoo, a former Bush administration lawyer now with the American Enterprise Institute, also challenged Boehner's position on the matter.

In an op-ed published Friday by the Wall Street Journal, Yoo -- known for bedrock conservative views -- wrote that Boehner and other Republican opponents of the Libya mission are playing politics by arguing about the War Powers Resolution instead of using their budgetary authority to cut funding for the Libya mission.

"By accusing President Barack Obama of violating the War Powers Resolution, House Republicans are abandoning their party's long-standing position that the Constitution allows the executive to use force abroad, subject to Congress's control over funding," Yoo wrote. "Sadly, they've fallen victim to the siren song of short-term political gain against a president who continues to stumble in national-security matters."

Yoo called the lawsuit filed by seven Republicans along with Kucinich and other Democrats an "utterly futile" legal effort, adding that "the Supreme Court has consistently turned away every case disputing the president's decision to start wars abroad, and there is no reason to think it will change its ways now."

"Lawsuits only distract attention from the real weapons that Congress has to get its way and hold a wayward president accountable," Yoo wrote, saying House Republicans instead could try to de-fund military operations or other spending programs, or refuse to lift the debt ceiling until Obama either halts U.S. participation in the mission or gets congressional support.

Another option would be to launch an impeachment effort against Obama, Yoo said, adding that "holding hands with isolationist Democrats out of political convenience is no way to defend the Constitution."

Even though the Senate in March unanimously passed a non-binding resolution supporting a no-fly zone over Libya, some Republicans now express total opposition to the U.S. support for that effort.

"Our policy in Libya is substantially flawed," Rep. Michele Bachmann, R-Minnesota, said during last week's debate of GOP presidential hopefuls. She cited a litany of complaints -- the supporting U.S. role, a lack of vital national interest, unknown elements in the Libyan opposition being helped -- and said Obama "was absolutely wrong in his decision on Libya."

In its report on the mission, titled "United States Activities in Libya," the administration said the cost of military and humanitarian operations through June 3 was about $800 million. It estimated the total cost through September 30 would be $1.1 billion.

"Given the important U.S. interests served by U.S. military operations in Libya and the limited nature, scope and duration of the anticipated actions, the president had constitutional authority, as commander-in-chief and chief executive and pursuant to his foreign affairs powers, to address such limited military operations abroad," the report said, adding: "The president is of the view that the current U.S. military operations in Libya are consistent with the War Powers Resolution and do not under that law require further congressional authorization, because U.S. military operations are distinct from the kind of 'hostilities' contemplated by the resolution's 60-day termination provision."

In response, Boehner spokesman Brendan Buck called the White House arguments "creative," adding that Obama as commander-in-chief "has a responsibility to articulate how U.S. military action is vital to our national security and consistent with American policy goals."

"With Libya, the president has fallen short on this obligation," Buck said.

CNN's Dana Bash and Terry Frieden contributed to this report.

CNN

Population experts demand funding for international family planning (OneWorld.net)

LONDON, May 30 (OneWorld.net) - A high-level population conference has appealed to international donors to step up financial support for family planning and reproductive health services in developing countries.

This call comes at a time when foreign aid for international family planning is one of the most divisive topics for US Congress to resolve in its FY2012 budget considerations. The US is the key global donor in this field.

Described by its organizers at University College London as the largest conference on population issues to be held this year, Population Footprints examined the capacity of the planet to sustain a human presence which is due to reach seven billion in October.

The six billion threshold was passed just 12 years ago. Earlier this month, the UN published an upward revision of its long term projections of global population.

Academics, campaigners and politicians attending the conference from around the world discussed what strategies might encourage a lower population trajectory. They addressed the troubling contexts of food security, climate change, migration and a skewed demographic profile in which richer countries have too few people of working age whilst the poorer countries have too many.

The debates were marked by disagreements between the participants, a point acknowledged in the closing summary by Professor Anthony Costello, Co-Director of the UCL Institute for Global Health.

"That doesn't matter," he said, "because what unites us is much greater. What unites all of us is that funding for women's health, maternal health, child health, fertility reduction, family planning - all the drivers for moving towards a stable population - is desperately needed."

Describing current global funding as "derisory", Professor Costello deplored that "the World Health Organization has seen its budget halved for reproductive health and family planning."

A downward trend in this area of funding was indeed a feature of the April compromise which saw Congress approve the US budget for FY2011. International aid for family planning and reproductive health was cut by 5% to $615 million.

The battle now turns to FY2012. President Obama's original request for $769 million will be subject to forces pulling strongly in both directions.

The objective to provide universal global access to reproductive health services by 2015 is included in the Millennium Development Goals, a set of commitments agreed by world governments.

There are 215 million women in developing countries with an unmet need for contraception. The cost of fulfilling this area of reproductive health alone is estimated at $3.6 billion.

Campaigners say that it is impossible to achieve the MDG target without significant new donor funding. They advocate that US support should rise towards $1 billion per annum.

However, many Republican members of Congress considered the FY2011 compromise to be too generous. They will press for further cuts for FY2012.

The UN Population Fund is a favored target. Its US support for FY2011 was slashed from $55 million to $40 million. Republicans are under lobby pressure to revert to the days of the Bush Administration when UNFPA was denied funding altogether.

The new Executive Director of UNFPA, Dr Babatunde Osotimehin, was a leading participant in the Population Footprints conference. Whilst he maintained a diplomatic silence on his budgetary relationship with the US government, Dr Osotimehin was unambiguous in his views about priorities for population policies. "If we protect women's rights, their ability to make choices, we will see a lot of difference in population," he told the conference.

The Ugandan Minister of State for Finance and Planning, Professor Ephraim Kamuntu, presented the same opinion in language designed to appeal to politicians, hard-pressed on delivering budgetary value for money. "We have done a study in Uganda which shows for every $1 you invest in reproductive health it saves you $3 eventually in health costs that result from non-spacing of children and complications in giving birth," he said.

Africa's rate of population growth is the highest of the world's continents, its numbers projected to double to 2 billion by 2050. But attitudes are changing, according to Eliya Zulu, Director of the African Institute for Development Policy.

"Unlike 15-20 years ago, more African people now want to limit their family size but they are not doing that because they do not have access to family planning," he said in a BBC World Service interview at the conference.

Several speakers referred to the long term decline in foreign aid for family planning. This trend was evidenced in a scrupulously factual presentation by Hania Zlotnik, Director of the UN Population Division. She demonstrated that, since 1996, donor assistance for family planning programmes has fallen by at least 50% in nearly all African countries.

"In most high fertility countries, contraceptive prevalence is increasing by less than 1% per year," she said. "At that rate it's going to take something like 30-40 years for them to meet the unmet need they already have."

Dr Mairo Mandara, a gynecologist from Nigeria, highlighted the extremes that exist in the poorest regions of the continent. In northern Nigeria, the average age at which girls are married is just 15. Only 3% have access to contraception. Nigeria's population of 158 million is the highest in Africa.

The Nigerian government has taken the initiative of embarking on its own programme of free family planning services. "Africa should fund family planning, not rely only on donors," Eliya Zulu told his followers on Twitter.

The share of funding between potential donors was not tackled in any detail but speakers were unwavering in their view of the priority for spending. Siri Tellier, former Director of UNFPA in Geneva, summed it up in population numbers: "the use of family planning will be the most important determinant in whether we go to 11 billion in 2050 or whether we go to 9 billion in 2050."

The Population Footprints conference was sponsored by The Leverhulme Trust and The Lancet medical journal.

* More Information:

Population Footprints - archived videos of the UCL conference

OneWorld Population Guide

OneWorld Gender and Development Guide

Yahoo! News

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HIV/AIDS: Drug Price Cuts Secured Amid Growing Funding Fears (OneWorld.net)

JOHANNESBURG, May 19 (IRIN/PlusNews) - Three international organizations have negotiated reductions on key first- and second-line, and paediatric antiretrovirals (ARVs) that will help countries save at least US$600 million over the next three years.

The Clinton Health Access Initiative (CHAI), the international drug purchasing facility UNITAID and the UK Department for International Development (DFID) made the announcement on 18 May.

The deal expected to affect most of the 70 countries comprising CHAI’s Procurement Consortium, features notable reductions in the prices of tenofovir (TDF), efavirenz, and the second-line ritonavir-boosted atazanavir (ATV/r) used in HIV patients who have failed initial, or “first-line”, regimens.

As part of the deal, the three bodies set price ceilings for more than 40 adult and paediatric ARVs with eight pharmaceutical manufacturers and suppliers, including Cipla Ltd, Matrix Laboratories and Autobindo Pharma.

Together these eight companies account for most ARVs sold in countries with access to generic drugs, according to David Ripin, scientific director of CHAI’s Drug Access Programme.

As a result, the cost of ATV/r is down by two-thirds from just three years ago. Meanwhile, a once-a-day fixed-dose combination (FDC) pill containing TDF and efavirenz will now cost countries less than US$159 per patient per year. In 2008, low-income countries paid about $400 per patient per year for the same pill.

How did they do it?

According to UNITAID and CHAI, this success is a product of increased demand for these drugs and more efficient manufacturing of the active ingredients, which are estimated to account for as much as 75 percent of generic ARV costs.

“When you make an active ingredient, you use a multistep chemical process,” Ripin told IRIN/PlusNews. “To reduce costs, you can look for a less expensive source of raw materials of which there are a few examples, including TDF ... or you can tinker with the chemical process used to make the product to make them more efficient.”

But Ripin added that doing either comes at a cost for pharmaceutical companies, for whom a change in raw material suppliers or manufacturing processes means re-applying for approval of the drug with regulatory bodies.

“Any time you change anything with the way you make a drug, you need to get regulatory approval,” he said. “You have to do a fair amount of work to prove that your product works just as well now as it did before.

“The pharmaceutical companies and generic manufacturers are fantastic at making these types of improvements… [but] they have a limited set of research and development resources available to them,” Ripin said. “They often need to make a decision where they are going to get a higher return on that research and development, and typically that comes from the introduction of new products on the market.”

According to Ripin, the key is providing companies with data on the large and growing markets for ARVs.

“We help companies evaluate for themselves whether it’s a worthwhile business opportunity,” he said. “The second key factor they have to consider is the competitive marketplace for their drugs, where there is an incentive for lower [production] costs and lower-priced products as they want to maintain their market share.”

CHAI also provides countries with data on best market prices for drugs to help inform national procurement, as was the case with South Africa’s recent ARV tender. Although South Africa is not expected to benefit from the new price cuts, the country has the largest ARV tender in the world, and could secure the drugs at competitive prices. In terms of the CHAI agreement, lower prices are available to members of the Procurement Consortium but are dependant on volumes ordered.

How low can we go?

TDF has become an important drug for many countries, including South Africa, hoping to implement the 2009 World Health Organization (WHO) HIV treatment guidelines, which recommend starting HIV patients on treatment sooner but also a shift away from more toxic ARVs to TDF.

However, the high cost of earlier treatment and better drugs has prohibited many countries from fully implementing the WHO recommendations. According to a recent report released by Medecins Sans Frontieres (MSF), both Malawi and Zimbabwe reversed their move to WHO guidelines due to financial constraints.

While new price reductions bring TDF’s price closer to that of the long-time and widely adopted first-line ARV Zidovudine, further drops in TDF’s price will have to be logged to ensure widespread uptake, said Brenda Waning, coordinator of market dynamics for UNITAID.

For Waning and others like MSF, the issue of sustainable funding for the HIV response looms large ahead of the June UN meeting on HIV/AIDS in New York, rumoured to be the last for years to come, according to MSF’s report.

“There has been a lot of attention on commodities and not at other major drivers of cost,” she told IRIN/PlusNews. “We have to look at other places in the health system where we can capture cost-effectiveness.”

In particular, Waning pointed to the potential savings associated with the roll-out of new point-of-care diagnostics, which, although not high on the global agenda, will help countries task shift such testing away from scarce doctors.

Although the cost remains high, introducting FDC would help governments save on ARV shipping, transportation and storage, while improving adherence and patient outcomes.

Want to Know More?

» OneWorld Topic Guide: HIV and AIDS

ALL THE LATEST GLOBAL HEADLINES

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HIV/AIDS: Drug Price Cuts Secured Amid Growing Funding Fears (OneWorld.net)

JOHANNESBURG, May 19 (IRIN/PlusNews) - Three international organizations have negotiated reductions on key first- and second-line, and paediatric antiretrovirals (ARVs) that will help countries save at least US$600 million over the next three years.

The Clinton Health Access Initiative (CHAI), the international drug purchasing facility UNITAID and the UK Department for International Development (DFID) made the announcement on 18 May.

The deal expected to affect most of the 70 countries comprising CHAI’s Procurement Consortium, features notable reductions in the prices of tenofovir (TDF), efavirenz, and the second-line ritonavir-boosted atazanavir (ATV/r) used in HIV patients who have failed initial, or “first-line”, regimens.

As part of the deal, the three bodies set price ceilings for more than 40 adult and paediatric ARVs with eight pharmaceutical manufacturers and suppliers, including Cipla Ltd, Matrix Laboratories and Autobindo Pharma.

Together these eight companies account for most ARVs sold in countries with access to generic drugs, according to David Ripin, scientific director of CHAI’s Drug Access Programme.

As a result, the cost of ATV/r is down by two-thirds from just three years ago. Meanwhile, a once-a-day fixed-dose combination (FDC) pill containing TDF and efavirenz will now cost countries less than US$159 per patient per year. In 2008, low-income countries paid about $400 per patient per year for the same pill.

How did they do it?

According to UNITAID and CHAI, this success is a product of increased demand for these drugs and more efficient manufacturing of the active ingredients, which are estimated to account for as much as 75 percent of generic ARV costs.

“When you make an active ingredient, you use a multistep chemical process,” Ripin told IRIN/PlusNews. “To reduce costs, you can look for a less expensive source of raw materials of which there are a few examples, including TDF ... or you can tinker with the chemical process used to make the product to make them more efficient.”

But Ripin added that doing either comes at a cost for pharmaceutical companies, for whom a change in raw material suppliers or manufacturing processes means re-applying for approval of the drug with regulatory bodies.

“Any time you change anything with the way you make a drug, you need to get regulatory approval,” he said. “You have to do a fair amount of work to prove that your product works just as well now as it did before.

“The pharmaceutical companies and generic manufacturers are fantastic at making these types of improvements… [but] they have a limited set of research and development resources available to them,” Ripin said. “They often need to make a decision where they are going to get a higher return on that research and development, and typically that comes from the introduction of new products on the market.”

According to Ripin, the key is providing companies with data on the large and growing markets for ARVs.

“We help companies evaluate for themselves whether it’s a worthwhile business opportunity,” he said. “The second key factor they have to consider is the competitive marketplace for their drugs, where there is an incentive for lower [production] costs and lower-priced products as they want to maintain their market share.”

CHAI also provides countries with data on best market prices for drugs to help inform national procurement, as was the case with South Africa’s recent ARV tender. Although South Africa is not expected to benefit from the new price cuts, the country has the largest ARV tender in the world, and could secure the drugs at competitive prices. In terms of the CHAI agreement, lower prices are available to members of the Procurement Consortium but are dependant on volumes ordered.

How low can we go?

TDF has become an important drug for many countries, including South Africa, hoping to implement the 2009 World Health Organization (WHO) HIV treatment guidelines, which recommend starting HIV patients on treatment sooner but also a shift away from more toxic ARVs to TDF.

However, the high cost of earlier treatment and better drugs has prohibited many countries from fully implementing the WHO recommendations. According to a recent report released by Medecins Sans Frontieres (MSF), both Malawi and Zimbabwe reversed their move to WHO guidelines due to financial constraints.

While new price reductions bring TDF’s price closer to that of the long-time and widely adopted first-line ARV Zidovudine, further drops in TDF’s price will have to be logged to ensure widespread uptake, said Brenda Waning, coordinator of market dynamics for UNITAID.

For Waning and others like MSF, the issue of sustainable funding for the HIV response looms large ahead of the June UN meeting on HIV/AIDS in New York, rumoured to be the last for years to come, according to MSF’s report.

“There has been a lot of attention on commodities and not at other major drivers of cost,” she told IRIN/PlusNews. “We have to look at other places in the health system where we can capture cost-effectiveness.”

In particular, Waning pointed to the potential savings associated with the roll-out of new point-of-care diagnostics, which, although not high on the global agenda, will help countries task shift such testing away from scarce doctors.

Although the cost remains high, introducting FDC would help governments save on ARV shipping, transportation and storage, while improving adherence and patient outcomes.

Want to Know More?

» OneWorld Topic Guide: HIV and AIDS

ALL THE LATEST GLOBAL HEADLINES

Yahoo! News

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For D.C., Budget Deal Revives School Voucher Program, Reinstates Ban on Abortion Funding

AP

Feb. 26: Washington Mayor Vincent Gray addresses the Democratic National Committee winter meeting in Washington.

The eleventh-hour budget deal to fund the federal government for the next five months includes two controversial policy riders that have infuriated Washington D.C. local leaders.

One bans Washington from spending its own money to provide abortions for low-income women and the other includes money to revive the city's school voucher program, which subsidizes private school tuition for needy students with federal funds.

In a Saturday morning tweet, Mayor Vincent Gray called both riders a "shameful violation of our right to govern ourselves."

"This is ludicrous," Gray said in statement."While one rider purports to provide educational aid to children in need, the other takes away desperately needed aid from poor women. Hypocrisy is alive and well in the United States Congress."

Gray called on all D.C. residents to voice their opposition to the "colonial status of the District of Columbia."

The GOP-led House voted to reinstate the program last month and passed a stopgap measure this week that included the abortion rider. But those bills had little chance to go any further with the Obama administration opposed to vouchers and the abortion rider. 

However, the Republicans were able to get those initiatives included in Friday night's deal that cut spending by $38.5 billion.

Congress eliminated the voucher program in 2009. Critics of vouchers, including teachers unions, say it draws money away from public schools.

Under the program, which began in 2004, more than 3,700 students, mostly black or Hispanic, have won scholarships which provide up to $7,500 in private-school tuition.

In 2009, the Obama administration lifted the ban on D.C. funding abortions. But earlier this year, House Republicans proposed reinstating the ban in a larger bill that would effectively make permanent a string of separate restrictions, including the so-called Hyde Amendment, which have to be renewed periodically by Congress.

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