[Congressional Record Volume 144, Number 16 (Thursday, February 26, 1998)]
[Extensions of Remarks]
[Pages E241-E242]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   PREVENTING THE TRANSMISSION OF HIV

                                 ______
                                 

                            HON. TOM LANTOS

                             of california

                    in the house of representatives

                      Thursday, February 26, 1998

  Mr. LANTOS. Mr. Speaker, earlier this month the Subcommittee on 
Health and Environment of the Commerce Committee held a hearing on 
``Preventing the Transmission of the Human Immunodeficiency Virus 
(HIV),'' at which a number of witnesses discussed the problems related 
to this serious health issue facing our nation. The subcommittee also 
considered legislation that has been introduced in the House relating 
to HIV transmission. I requested the opportunity to present a statement 
for inclusion in the record of the hearing, Mr. Speaker, because of the 
importance of this issue to my congressional district and because of 
the serious national importance of this health problem. Unfortunately, 
there is considerable misunderstanding of the issue and the best way to 
deal with it.
  Mr. Speaker, I ask that my statement to the Subcommittee on Health 
and Environment be placed in the Record, and I urge my colleagues to 
give thoughtful consideration to this important issue. It is probable 
that the House will be considering legislation involving the 
transmission of HIV later this year, and it is important that all of us 
here in this body be well informed on this issue.

                  Statement of Congressman Tom Lantos


Hearing of the Subcommittee on Health and Environment on Preventing the 
         Transmission of the Human Immunodeficiency Virus (HIV)

                      House Committee on Commerce

       Mr. Chairman, I thank you for conducting this hearing on 
     HIV transmission and prevention and for this opportunity to 
     express my support of our country's public health efforts in 
     dealing with this serious epidemic.
       As you know, the Center for Disease Control (CDC) reports 
     over 600,000 AIDS cases reported nationally since the 
     outbreak of the AIDS epidemic. Annually, 40,000 new HIV 
     infections are reported and approximately 650,000-900,000 
     Americans are diagnosed HIV-positive. According to the San 
     Francisco AIDS Foundation, California alone currently reports 
     over 100,000 cases which accounts for nearly 18% of all AIDS 
     cases in the U.S. Only New York reports a larger total number 
     of AIDS cases. These figures indicate precisely why the fight 
     against HIV transmission and infection is a top public health 
     priority.
       Despite these overwhelming numbers associated with HIV 
     infection, I am greatly encouraged by the fact that 
     California has recently reported a 60% decline in AIDS-
     related deaths in the first six months of 1997, as compared 
     to the first six months of 1996. And it is especially urgent 
     that we understand what has enabled California to 
     dramatically decrease its number of AIDS deaths and cases so 
     that we may reproduce these efforts and continue to 
     successfully combat the disease. Federal funding has been a 
     main impetus through which we have developed new drug 
     therapies, and we cannot underestimate the significance of 
     improved access to medical care and increased prevention 
     efforts in reducing AIDS transmission and fatalities.
       Our country needs to take an intelligent approach to the 
     AIDS epidemic. By intelligent approach, I mean that we need 
     to take into account how different populations are affected 
     by this disease. We now know that new HIV infections in the 
     U.S. occurs among people between the ages of 13 and 20. Young 
     gay and bisexual men experience disproportionately high 
     numbers of AIDS cases and HIV infections. We know that the 
     proportion of AIDS cases has risen among women and among 
     several minority groups, despite declining in several other 
     populations. The facts are compelling, and rather than ignore 
     these facts, we should direct our attention to specific 
     populations that have been specifically affected.
       Research and science are our tools; we should use them to 
     guide us in our federal policies. Because the scientific and 
     statistical findings in regards to HIV transmission indicate 
     significantly different proportions of HIV infection in 
     different population groups, I am fully supportive and a 
     proud cosponsor of H.R. 1219, the Comprehensive HIV 
     Prevention Act of 1997, introduced by my esteemed colleagues 
     Representative Nancy Pelosi (D-CA) and Representative 
     Constance Morella (R-MD). Their legislation will promote 
     targeted, primary prevention programs that effectively 
     consider the increasing challenge for high risk populations 
     such as people of color and women. H.R. 1219 would enhance 
     federal coordination and planning by giving authority and 
     responsibility for developing a strategic HIV prevention and 
     appropriations plan to the Secretary of HHS, in consultation 
     with an Advisory Committee. In addition, the bill will 
     authorize further research for investigating possible new HIV 
     infection sites. With its provisions for community-based 
     prevention programs, counseling and testing programs, 
     treatment and related services for rape victims, funding for 
     AIDS/HIV education and information dissemination, as well 
     as adolescent and school-based programs--the Pelosi-
     Morella act is a thorough and natural extension of current 
     HIV prevention programs in the United States. It will 
     approach HIV prevention through methods that are locally 
     defined, community-based, and that utilize at-risk 
     population targeting.
       In contrast, the HIV Prevention Act of 1997 (H.R. 1062) is 
     based upon a belief that identifying individuals who are HIV 
     positive, in and of itself, can prevent new infections. It is 
     a major setback to the progress we have been making in 
     implementing effective HIV prevention programs. Despite the 
     fact that no other disease is required to be reported by 
     federal mandate, and despite the fact that the CDC has not 
     requested that Congress create such an unprecedented mandate 
     for HIV, H.R. 1062 still calls for mandatory partner 
     notification.
       Furthermore, H.R. 1062 mandates reporting of HIV infected 
     people to the State public health officer and the CDC. Not 
     only should HIV reporting remain a state responsibility, but 
     this mandate is a coercive measure which would discourage 
     people at risk for HIV from seeking treatment and testing at 
     a time when we are making impressive breakthroughs in new 
     treatments. This measure would only hurt our efforts to slow 
     HIV transmission, a public health concern. There is no reason 
     for us to isolate and differentiate HIV from other sexually 
     transmitted diseases, nor to stigmatize HIV infected 
     citizens.
       The creation of a national partner notification program as 
     would be mandated by H.R. 1062 would also be an unnecessary 
     waste of resources. Furthermore, the Ryan White CARE Act 
     Amendments of 1996 already requires states to administer 
     partner/spousal notification programs as a condition of 
     receiving HIV care funding. The HIV Prevention Act of 1997 
     would prevent state and local officials from effectively 
     targeting their programs and making decisions to meet the 
     needs of their individual, unique

[[Page E242]]

     populations. We cannot tolerate a reductive one-size-fits all 
     solution to HIV infection, a complex epidemic.
       We should not simplify our efforts to prevent HIV 
     transmission. In fighting the epidemic of HIV, we have 
     learned a great deal from our colleagues in scientific 
     research. Because I believe that needle exchange programs 
     have proven to be an effective and cost-effective way of 
     reducing the spread of HIV, I am delighted to also be a 
     cosponsor of H.R. 2212, the HIV Prevention Outreach Act of 
     1997, introduced by Representatives Elijah Cummings and Nancy 
     Pelosi.
       A single clean syringe costs less than 10 cents, and 
     treatment for one HIV-infected individual costs over 
     $100,000. More than half a billion dollars in health care 
     expenditures could be avoided through the implementation of 
     needle exchange programs. There is a tragic cost to not 
     acting and implementing needle exchange programs. The 
     Cummings-Pelosi bill would end the ban on federal funding of 
     needle exchange programs, and along with H.R. 1219, it 
     enables us to battle AIDS in such a way that does not ignore 
     the inroads we have already made into how the disease has 
     affected certain populations.
       It is my pleasure to announce that I am not alone in my 
     sentiments about needle exchange. The findings of the 
     scientific community support my view that needle exchange is 
     a necessary and extremely efficient way of dealing with HIV 
     transmission. To date, six federally funded studies, 
     including a Consensus Development Conference by the National 
     Institutes of Health and also a study by the University of 
     California, San Francisco for the Centers of Disease Control 
     and Prevention, all demonstrate the effectiveness of needle 
     exchange in reducing an important risk factor for HIV 
     transmission. It is not a coincidence that by providing clean 
     needles to injection drug users who comprise nearly 50% of 
     newly infected HIV victims, we are slowing the spread of HIV 
     not only to those who will use the needles but to their 
     partners and their children as well.
       This information has found the ears of the American public, 
     approximately 66% of which support needle exchange. 
     Distinguished and respected public health organizations such 
     as the American Medical Association, the American Public 
     Health Association, as well as public officials and legal 
     groups such as the United States Conference of Mayors and the 
     American Bar Association have all heard the facts supporting 
     needle exchange and are supportive of preserving the 
     authority of the Secretary of Health and Human Services to 
     determine if federal funds can be used for needle exchange 
     programs.
       In the matter of HIV transmission and infection, we should 
     listen to what our scientific knowledge makes undeniable; we 
     need comprehensive programs such as those authorized by the 
     Pelosi-Morella bill, and we need to give our public health 
     officials the means to combat HIV through needle exchange, as 
     expressed through the Cummings-Pelosi bill.
       I urge the Congress not to delay the use of federal funds 
     for needle exchange programs. Furthermore, I want to 
     reiterate the importance of learning from our research 
     investigations of HIV infection and AIDS cases. The spread of 
     HIV has taken a specific path that we have traced, and that 
     we must take steps to counteract. The word is out that needle 
     exchange is a successful way of addressing HIV transmission. 
     The word is out that we can best approach this problem by 
     funding research and funding programs that will allow states 
     to target and address the specific developments of the HIV/
     AIDS epidemic. We need to lift the ban on federal funding of 
     needle exchange and to address the needs of children, women, 
     and minorities who are affected by AIDS and the HIV 
     infection.
       Thank you again for holding this important hearing. I hope 
     you will be supportive of state and local officials in their 
     efforts to combat HIV transmission and infection.

     

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