Public Law No. 110-293 is the reauthorizing legislation of the President's Emergency Plan for AIDS Relief (PEPFAR), originally authorized in 2003.
The 2008 Act authorizes up to $48 billion for PEPFAR through 2013, an increase from the $15 billion originally authorized for the first five years in 2003. It also eliminates a statutory ban prohibiting HIV-positive foreigners from entering the United States, which made HIV the only disease for which there was a de facto statutory ban requiring a special waiver. Since the passing of the Act, regulations have also been issued removing HIV from the Department of Health and Human Services' list of diseases of publlic health significance, ending the HIV ban as of January 4, 2010. For more information on the lifting of the ban, see, CHLP's Know Your Rights fact sheet.
Regardless of this progress, some of the Act's policies are subject to criticism for continuing certain policies of the 2003 Act. In particular, many organizations oppose the Act's prohibition on funding for organizations that do not adopt organization-wide positions opposing commercial sex work, limiting the ability or organizations to work with the sex-worker community to prevent exploitation and promote safer practices. This provision has been the source of an ongoing legal challenge, Alliance for Open Society International v. United States Agency for International Development, 430 F.Supp.2d 222 (S.D.N.Y 2006), since its inclusion in the 2003 Act. Also, policies promulgated under PEPFAR, though not written into the law, also restrict the kinds of programs that may be funded, prohibiting the funding of safe needle exchange programs for intravenous drug users, despite the proven efficacy of such programs. Moreover, although the new Act no longer requires that one-third of the funds for prevention efforts be directed toward programs that promote abstinence-only programs, the Act requires a report to Congress if less than half of HIV prevention funds in a particular country be spent on abstinence and fidelity programs. Recent studies have demonstrated abstinence-only programs to be ineffective and, in many countries, marriage increases a woman's risk of contracting HIV.