Sen. Coburn, M.D. A doctor should know better.

It appears as if the all-hands-on-deck mobilization of AIDS activists around the reauthorization of the President's Emergency Plan for AIDS Relief (PEPFAR) is having an effect on the lethargic Senate.

On Wednesday, in response to activist pressure, Sen. Barack Obama (D-IL) posted a statement of support for the PEPFAR bill,in which he urged Senate leadership to bring the bill to a vote and signed on as a cosponsor. And, according to the ONE campaign, Sen. John McCain (D-AZ) also verbally pledged on Thursday to cosponsor. As Katie Smith of ACT UP Philadelphia put it, "Now that the de facto leaders of both parties are cosponsors, it gives us all the more leverage to get this bill passed."

Over the last couple of weeks, global AIDS activists from groups such as Health GAP, Global AIDS Alliance, AIDS Healthcare Foundation and many others have been using backchannels and Senate office visits to brandish the threat of a major multicity protest on June 26 (See "Now or Never!" above) if Senate leadership fails to schedule a vote on the PEPFAR legislation -- known as the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 -- before July 7. That date is the beginning of the next Group of Eight nations meeting in Japan. Passing PEPFAR would give President Bush the credibility to insist that Japan and Europe also make multibillion dollar contributions to fighting AIDS globally.

The Lantos/Hyde bill would boost PEPFAR funding to $50 billion over the next five years, with the goal of getting 3 million people in poor countries on treatment and preventing 12 million new HIV infections. $9 billion would be use to fight tuberculosis and malaria. Despite healthy bipartisan support for the legislation, a group of seven conservative senators led by Sen. Tom Coburn (R-OK) are holding up the PEPFAR reauthorization vote, claiming the bill is too expensive and not focused enough on treatment. Numerous editorials have excoriated this group for short-sightedness.

Unbending Reid

Not everyone is happy about the flurry of PEPFAR activism. The June 26 demo will target Senate Majority Leader Harry Reid (D-NV) and Minority Leader Sen. Mitch McConnell (R-KY) for failing to brush aside the objections of the Coburn 7. When asked about next week's protest Reid spokesman Jim Manley told the Update , "This is a total misreading of the situation. Sen. Reid is working hard to send the legislation to the president as quickly as possible. They should take their demonstration elsewhere and spend time focusing on the Republicans."

Smith responded, "As long as the bill remains in limbo, we will continue to demand that Sen. Reid stand up to Sen. Coburn and pass the bill now." Sen. McConnell's office did not respond to request for comment.

The national mobilization of AIDS advocates also resurrected some lingering bitterness about compromises that advocates made to gain bipartisan support for the PEPFAR reauthorization. At least two organizations concerned with reproductive health repeated their unwillingness to support the Lantos/Hyde bill because of new provisions that ensure support for abstinence-only programs. Director of Advocacy for the American Jewish World Service called the Lantos/Hyde bill a "step backward" in terms of its abstinence-only provisions. Sexuality and Information Council of the U.S.'s William Smith worried that the amount of money on the table was making other advocates "blind" to PEPFAR's failure to provide comprehensive prevention.