[Congressional Record Volume 146, Number 52 (Tuesday, May 2, 2000)]
[House]
[Pages H2380-H2387]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
WORLD BANK AIDS MARSHALL PLAN TRUST FUND ACT
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 6, 1999, the gentlewoman from California (Ms. Lee) is
recognized for 60 minutes as the designee of the minority leader.
Ms. LEE. Mr. Speaker, first I would like to thank my colleagues for
allowing tonight's special order to be held to increase awareness of
the AIDS epidemic which is really scourging Africa and many other
developing nations throughout the world.
Sixty percent of the 16 million deaths, however, have been in sub-
Saharan Africa as a result of AIDS.
I would also like to applaud the leadership and commitment of the
gentleman from Iowa (Chairman Leach) and the gentleman from New York
(Mr. LaFalce), the ranking member, of the House Committee on Banking,
and also the gentleman from Missouri (Mr. Gephardt), our minority
leader, for addressing this huge crises in Africa and throughout the
world.
I believe that the diligence of the hearings and the markup held in
March of this year on H.R. 3519, the World Bank AIDS Prevention Trust
Fund Act, represents a necessary response to the urgency of the AIDS
crisis in Africa.
The World Bank AIDS Marshall Plan Trust Fund Act represents the most
effective bipartisan strategy to date possible to push this issue to
the national forefront.
As we work to establish partnerships and relationships with African
countries whether as health care experts, business persons, activists
or policymakers, it is critical that we unite to focus both attention
and resources on the global emergence of HIV and AIDS which wreaks
havoc in developing countries, most tragically in sub-Saharan Africa.
I have worked very closely with my colleague and dear friend,
Congressman Ron Dellums, who served with distinction in this body for
over 27 years. Congressman Dellums has been instrumental on focusing on
this initiative and building constituent and congressional support to
address the AIDS pandemic.
With his position as chair of the White House Council on AIDS and as
president of the Constituency for Africa, he has engaged in consistent
dialogue regarding this pandemic both here and within the United
States. And I want to thank him for his remarkable contributions.
Tonight we have Members who will talk about this huge pandemic. We
appreciate being allowed the hour of time.
Mr. Speaker, I yield to the gentlewoman from San Francisco,
California (Ms. Pelosi).
Ms. PELOSI. Mr. Speaker, I thank the gentlewoman for yielding. But
more importantly, I thank her for her tremendous leadership and
encouragement on calling to the attention of Congress and the country
the global HIV/AIDS issue and working with our former colleague,
Congressman Ron Dellums, on this.
Mr. Speaker, it is really exasperating. For years we have known about
the spread of global HIV and AIDS. For years Members of Congress have
appealed to both Democratic and Republican administrations to put this
issue on the agenda of the G-7.
What do they have to talk about that is more important than the
health, or lack thereof, of millions of people in Africa and throughout
the world? What has more of an impact on the economies of the
developing world than the health of its people?
Now it is being considered a national security issue at long last. I
commend the Clinton administration for making this very bold statement.
Frankly, it is long overdue.
The extent of the global AIDS epidemic is staggering. Over 23 million
people are infected with HIV in Africa, and nearly 14 million Africans
have already died from AIDS. The social, economic, and human cost of
the crisis is devastating entire nations. And this is just the
beginning.
In Asia and India, India already has more infected people than any
other nation. When I talk about Africa, I am talking about the
continent. In terms of India, one nation, 3\1/2\ million infected
people.
[[Page H2381]]
Experts are predicting that, without significant efforts to treat
those with HIV and prevent new infections, the number of people living
with HIV/AIDS in India could surpass the combined number of all cases
in all African countries within two decades.
{time} 1915
We clearly have a long way to go. These numbers are staggering, but
any single one of them is a tragedy and we should be motivated by it.
Think of all the orphans that this tragedy has produced. Some of
those orphans are HIV infected as well; but even among those who are
not, they have tremendous needs and, sadly, this was predictable.
We clearly have a long way to go. I am pleased that as a Nation we
are finally beginning to focus more of our attention and resources on
the global AIDS epidemic and that the National Security Council has
declared HIV/AIDS to be a national security threat.
I just want to inject a word here about our colleague, the gentleman
from Washington (Mr. McDermott), who has traveled the world on this
issue since he came to Congress, which is nearly I think it is over a
decade. So, again, this is no surprise and has been no secret. Even
though there has been a great deal of denial about it, the problem has
existed for a long time.
Many of us in Congress again have been working for years to draw
attention to this crisis. We know sadly from our own experience, in my
district in San Francisco when I came to Congress 13 years ago, 13,000
people had already died of AIDS in my district. Think of that, Mr.
Speaker, if that had happened in your district, how intolerable it
would be.
That is the only thing we should not tolerate in our society is the
HIV rate that is among us.
Funding for prevention, education, treatment, and care must be
increased dramatically and our commitment to the development of an AIDS
vaccine must be strengthened.
In terms of our funding, we also have to think internationally. We
have begged for the money that we have, about $147 million, and then
another $16 million or so for orphans each year; but we need 10 times
that to do our share globally in terms of HIV/AIDS.
I have introduced the Vaccines for the New Millennium Act in order to
create incentives for private sector biotech and pharmaceutical
companies to accelerate their research and development efforts for
vaccines against HIV, tuberculosis, and malaria. Vaccines are the best
hope to bring this epidemic under control.
It is about prevention. We must do all we can to facilitate
cooperation between the public and private sectors in order to bring
together the resources and expertise necessary to move quickly towards
effective vaccines.
In conclusion, Mr. Speaker, I want to again call to the attention of
our colleague the incredible leadership, well, it is believable so I
will just say the great leadership of our colleague, the gentlewoman
from California (Ms. Lee), on this subject. She has made it a priority.
She has developed legislation to meet this terrible challenge. She has
not been shy about the amount of money that this is going to require,
and she has been very, very bold as she has gone forth with this. She
has provided great leadership for us because she has a vision about
what she wants to accomplish. She has tremendous knowledge about the
subject we are dealing with. She has a plan. She has a plan, a good
plan, to attack the challenge; and she and her leadership is able to
attract a great deal of support for this cause.
So on behalf of the many people in my district who have died of HIV
and live with HIV and AIDS now, I want to commend her and thank her.
One final note is that this weekend I had the privilege of
participating in the march on Washington that some of our colleagues
were involved in, that we spoke to, the huge crowd, over 800,000
people; and one of the major issues on the agenda of the day was
increased funding for HIV and AIDS.
What is important for us to do is with all of our research for a
cure, which is very important, it must be relentless. Even though we
have some proteas inhibitors that prolong and improve the quality of
life, that those drugs must be available to everyone. We cannot say
that we are not engaged in research but the cure only goes to the
wealthy. The cure must be available across the board and across the
world. So I hope that we will be thinking in ways that are new and
different about this.
AIDS has been a model, really the mobilization, for support for
research, care, and prevention. That mobilization in our country has
been a model to other illnesses. Now the mobilization is on the
international and national scene, and we must not any longer ignore it.
Now that it has been declared a national security threat, at least
there is the attention focused at the right level on it.
I would have hoped that compassion for the millions of people who are
HIV infected would have been enough motivation, but we will take the
help wherever we can get it. Again, I thank the gentlewoman from
California (Ms. Lee) for her leadership, for the rallying cry she has
given; and we are all very, very pleased to follow her lead on this.
Ms. LEE. Mr. Speaker, let me just say thanks to my colleague, the
gentlewoman from San Francisco, California (Ms. Pelosi), for her very
strong support and also for her consistent work throughout the years on
behalf of peace and security throughout the world. I thank her very
much for everything that she does on behalf of all of our people, not
only in the Bay Area but throughout the country and the world.
The gentlewoman mentioned the whole issue of orphans in Africa and
the impact of the HIV/AIDS crisis on children. Last year I had the
opportunity to participate in a presidential delegation to Africa and
met with and witnessed some of the children who had been orphaned by
AIDS, many who had the virus. We are told now that there are 7.8
million children in southern Africa alone who are orphaned as a result
of AIDS; but by the year 2010, it is expected, if we do nothing, that
there will be 40 million children orphaned by AIDS; and this number, 40
million, is the number of children in our entire public school system
in the United States of America. Staggering numbers.
So I just want to thank all of the Members here tonight for helping
us raise the level of awareness for the country to really understand
the tremendous serious implications of what this whole virus presents
to us.
Now I would like to yield to my colleague, the gentlewoman from
Maryland (Mrs. Morella), who has been very instrumental in helping us
forge a bipartisan strategy to tackle this pandemic.
Mrs. MORELLA. Mr. Speaker, I want to thank the gentlewoman from
California (Ms. Lee) for her leadership on this issue and for yielding
me the time and for arranging this special global HIV/AIDS special
order; also my colleagues who are here and others who would like to be
here who do support the concept of recognizing that, as the Clinton
administration has, that worldwide AIDS crisis is a threat to the
United States national security and that, in fact, it could topple
foreign governments, touch off ethnic wars and reverse decades of work
in building free-market democracies abroad.
This declaration correctly raises the focus on this epidemic,
especially in Africa, which has been reported by CNN to be, quote,
``the worst health calamity since the Middle Ages and one likely to be
even worse,'' unquote.
Statistics of the economic, social and personal devastation of the
disease in sub-Saharan Africa are staggering. To mention some of them,
23.3 million of the 33.6 million people with AIDS worldwide reside in
Africa; 3.8 million of the 5.6 million new HIV infections in 1999
occurred in Africa. African residents accounted for 85 percent of all
AIDS-related deaths in 1999, and 10 million of the 13 million children
orphaned by AIDS live in Africa.
Life expectancy in Africa is expected to plummet from 59 years to 45
years between the years of 2005 and 2010.
Now, many experts attribute the spread of the virus to a number of
factors, including poverty, ignorance, costly treatments, lack of sex
education and unsafe sexual practices. Some blame the transient nature
of the workforce. Many men, needing to leave their families to drive
trucks, work in
[[Page H2382]]
mines or on construction projects, engage in sex with commercial sex
workers of whom an estimated 90 percent are HIV positive, and in
addition many men go untested and unknowingly spread the virus.
Many of those infected cannot afford the potent combination of HIV
treatments available in Western countries, and in some countries only
40 percent of the hospitals in some capital cities have access to basic
drugs.
While efforts are continuing to find an AIDS vaccine, many experts
fear that some African countries hardest hit by the epidemic lack the
basic infrastructure to deliver the vaccine to those most in need.
More than 25 percent of working-age adults are estimated to carry the
virus. Countries have lost 10 to 20 years of life expectancy due to
this disease, and 80 percent of those dying from AIDS were between ages
20 and 50, which is the bulk of the African workforce.
As was mentioned by the gentlewoman from California (Ms. Lee), 40
million children will be orphaned by the disease by 2010. Many of these
children will be forced to drop out of school to care for a dying
parent or take care of younger children. Children themselves are being
infected with the disease, many through maternal fetal transmission.
And while drugs like AZT have been proven effective in reducing the
risk of an HIV-positive mother infecting her newborn child, those drugs
often are too costly for most nations.
Legislation has been introduced by the gentleman from Iowa (Mr.
Leach) and the gentlewoman from California (Ms. Lee) which particularly
target the tragedy in sub-Saharan Africa. However, it also addresses
the worldwide AIDS crisis.
H.R. 3519, the World Bank AIDS Prevention Trust Fund Act, directs
that the U.S. Government should seek the establishment of a new AIDS
prevention trust fund at the World Bank. The bill authorizes U.S.
contributions of $100 million a year for 5 years in hopes of leveraging
that contribution to obtain contributions from other governments as
well as the private sector to reach $1 billion a year. The proceeds of
the trust fund would support AIDS education, prevention, treatment and
vaccine development efforts in the world's poorest countries,
particularly in sub-Saharan Africa.
The President has proposed $350 million to prevent the spread of AIDS
around the world. Under the President's proposal, funding will be
targeted where it is needed the most, in sub-Saharan Africa. The AIDS
Marshall Plan fund for Africa will help to ensure that the Federal
Government addresses this issue over the next several years. However,
studies indicate that Africa is just the tip of the iceberg. New HIV
and AIDS diagnosis are escalating in the Caribbean, Latin America,
Asia, and the Balkans at alarming rates.
Now the United States is uniquely positioned to lead the world in the
prevention and eradication of HIV and AIDS. The administration's
request, the AIDS Marshall Plan fund for Africa, the World Bank AIDS
Marshall Plan Trust Fund Act will provide the funding and the framework
to respond to the AIDS pandemic in Africa and throughout the world.
I would also like to mention legislation I have introduced to enhance
the research on microbicides which would enable and empower women to be
able to have a barrier against sexually transmitted diseases and HIV
and AIDS.
We can no longer afford to debate whether or not fighting global
disease is simply an idealistic crusade. Instead, we must recognize the
fact that it has clearly become a fiscal and national security
imperative.
The good news is that the United States is taking action. The bad
news is it is taking so long.
I conclude with a quote from a physician who directs AIDS prevention
at the CDC and he said, ``Oh, yeah, it is very late but better late
than never. You rarely get a second chance in an epidemic.''
I thank the gentlewoman from California (Ms. Lee) and the others who
have gathered here tonight to focus on this important crisis so that we
can do something to ameliorate it.
Ms. LEE. Mr. Speaker, I want to thank the gentlewoman from Maryland
(Mrs. Morella) for that very eloquent statement and for setting forth
the case and bringing out more statistics as it relates to this
pandemic, and also for her leadership on not only HIV/AIDS but also on
health care issues in general for our country.
Let me also mention that as the gentlewoman from Maryland (Mrs.
Morella) and the gentlewoman from California (Ms. Pelosi) indicated
earlier, AIDS threatens economic security but also human life. It has
been set forth in a Washington Post article, which I would like to put
into the Record, from today. It is titled, ``AIDS is Declared Threat to
Security. White House Fears Epidemic Could Destabilize the World.''
{time} 1930
HIV and AIDS in Africa has created also an economic crisis, crippling
Africa's workforce in many areas and creating even greater economic
instability where poverty is ever present. In many countries now,
companies are hiring two and three persons, two and three employees to
fill one job, because, of course, it is assumed that one or two will
die of AIDS.
In the Republic of Congo, according to the National Intelligence
Estimate, it indicates, this document indicates that the militias in
Anglo and the democratic Republic of Congo show an HIV prevalence rate
of 40 to 60 percent.
As the AIDS crisis grows, it will only exacerbate dangerous economic
and political instability.
Mr. Speaker, I would like to yield now to the gentleman from Illinois
(Mr. Davis), my colleague who throughout his life has been a consistent
supporter for justice and equality and health care for all throughout
our world. I want to thank the gentleman for being with us tonight.
Mr. DAVIS of Illinois. Mr. Speaker, I rise today in support of the
World Bank AIDS Marshall Plan Trust Fund Act. I also want to take this
opportunity to commend the gentlewoman from California (Ms. Lee) for
the outstanding leadership that she is providing on this issue. As a
matter of fact, I know that people were concerned when Representative
Ron Dellums decided to retire, but they knew that they had someone
waiting in the wings ready to take over and take charge and to follow
along with some of the tremendous work that he started, and I certainly
want to commend Ron, even though not being a current Member of
Congress, he is still providing valuable leadership on this issue
throughout the world.
As the most developed Nation in the world, we have an obligation and
a responsibility to share our technology and medical expertise with
developing nations. As a matter of fact, I come from a school of
thought which suggests that to those to whom much is given, much is
expected in return; therefore, we have not only an opportunity, but
also the responsibility to share the great wealth and the great
resources of this Nation.
Franklin Delano Roosevelt once said that the test of our progress is
not whether we add more to the abundance of those who have much, it is
whether we provide enough for those who have too little. And I submit
to you tonight that the continent of Africa is being stripped of its
most precious resource, its people.
Mr. Speaker, more than 11 million Africans have already died from
AIDS since its inception; that represents more than 70 percent of the
AIDS deaths worldwide. Another 23 million Africans are currently
infected with HIV or AIDS.
In South Africa alone, it is estimated that there are more than 1,500
new HIV infections each and every day. We can no longer afford to sit
back and do so little or in many instances do nothing about what is
happening throughout the world.
HIV/AIDS is a threat, yes, to our national security, but it is also a
threat to the security of the world community. I commend President
Clinton for his recognition of that fact as we have seen an increase in
the proposal of resources to deal with this problem, but those
increases that have been proposed are not even enough.
AIDS has a major impact on our trade with Africa. The World Health
Organization and other relief organizations were committed to ending
this dreaded disease some time ago, but, more importantly, if we
continue to do
[[Page H2383]]
nothing or little, eventually Africa will have a population of orphans
that is unthinkable. Currently, more than 13 million children have lost
one or both their parents to AIDS.
The statistics suggest that the number will reach 40 million by the
year 2010. Yes, we now have an opportunity, because we had a Marshall
Plan to rebuild Europe after the war. It is now time to apply the same
principles, the same practices, the same techniques, the same tactics
to help prevent the spread of HIV/AIDS in Africa.
Now, is the time for action. Each day that we wait, thousands more
are subjected to HIV/AIDS infection. And I say to the gentlewoman from
California (Ms. Lee), again, I am pleased to join with the gentlewoman
and all of those who have come to call for a massive infusion of
resources, similar to the Marshall Plan that we used after World War
II. If we could do it then, with the strong economy that we are
experiencing today there is nothing to prevent us from initiating and
implementing this magnificent effort that the gentlewoman and others
have put together to bring help, hope, and relief to our dying brothers
and sisters in Africa, but also to our dying brothers and sisters in
the American streets in every city, village, and hamlet of this Nation
and throughout the world. I thank and commend the gentlewoman for her
outstanding work.
Ms. LEE. I thank the gentleman. And I want to thank my colleague from
Illinois for his very eloquent remarks and his kind remarks and also
for bringing clarity to not only this issue but so many of the tough
issues which we deal with here in the United States Congress. I also
thank the gentleman for bringing this right back home, because this is
a global pandemic which we are dealing with. I thank the gentleman for
participating with us.
I would like to yield to the gentlewoman from Illinois (Ms.
Schakowsky), a colleague who has been really in the forefront
challenging the pharmaceutical companies to do the right thing, by
providing affordable drugs to those in need, not only in America, but
throughout the world.
Ms. SCHAKOWSKY. Mr. Speaker, I would like to join my colleagues in
thanking the gentlewoman from California (Ms. Lee) for being such an
outstanding leader and outspoken person on the issue of the global AIDS
crisis. It is a little bit hard to follow my colleague from Illinois
and his eloquence and his beautiful voice, but I appreciate the
opportunity to weigh in on this important issue.
I want to also express my continuing support for H.R. 3519, the World
Bank AIDS Marshall Plan Trust Fund Act, which is sponsored by the
gentlewoman from California and also the chairman of the Committee on
Banking and Financial Services from Iowa, and I am very proud to be a
cosponsor of that bill.
If enacted, H.R. 3519 would create a worldwide trust fund that is
administered by the World Bank and funded by governments, the private
sector, and international organizations. Nations would be able to
receive grants from the trust fund to address the HIV/AIDS crisis. The
bill would direct the United States to contribute $200 million a year,
and I hope it stays at no less than $200 million, to the fund for 5
years, the hope being that U.S. contributions would help leverage
contributions from others in the private sector and the international
community.
Although the passage of this bill would be a significant victory in
the battle against HIV/AIDS, it is a small drop in a very big bucket.
It is estimated that about $10 billion would be needed to fight AIDS in
Africa over the next 5 years, just to fight AIDS in Africa.
We must do much more if we want to seriously address the HIV/AIDS
epidemic that is killing millions of people worldwide, and the United
States has to lead the way. It is in our own best interests to do so,
because HIV/AIDS knows no borders and it threatens the stability of the
world, even more than conventional warfare.
I have been extremely concerned in the past by the actions of our
government on this issue. While a number of important initiatives have
been created and championed by the administration, and I do not want to
diminish those, I yet was dismayed when I realized efforts by other
nations were being blocked because of objections raised by the
pharmaceutical industry and in turn by our government. These were
efforts that would lower the cost of AIDS drugs by manufacturing
generics or importing them at a lower cost. We saw our own government
step in on the side of the pharmaceutical companies to prevent that.
I have been encouraged by recent comments by the administration that
appear to reflect a policy change on this issue. I hope that I will not
hear any more reports of our administration weighing in to prevent
others from addressing their own national emergencies. I would hope
that the United States would take advantage of every opportunity to
help other nations address this crisis, including relinquishing to the
World Trade Organization patents on AIDS drugs that are owned by the
United States and were developed using our own taxpayer funds.
I commend the administration and National Security Council for the
step taken this week in designating HIV/AIDS as a threat to our
national security. Indeed, HIV/AIDS stands to threaten this Nation and
others. I must say that I am truly surprised that there are individuals
in our Congress who would disagree and contend that the AIDS pandemic
is not a national security threat. I can only assume such individuals
have not been paying attention or just do not want to face the facts.
We have been hearing a number of those facts. Let me add to those a
few additional ones, and I think some bear reiterating.
AIDS is claiming more lives than all armed conflicts in the last
century combined. Twelve million men, women, and children in Africa
have already died of AIDS. Today in Africa, 5,500 people are buried
daily because of AIDS, and that number is expected to more than double.
AIDS is the leading cause of death in Africa, but also, and this is
very important, among young adult African-American men in the United
States as well. It is our problem.
Every day 11,000 people in Africa become infected, one every 8
seconds. According to the Director of the Office of National AIDS
Policy, it is estimated that by 2005 there will be more than 100
million, 100 million, HIV/AIDS cases worldwide.
Today in sub-Saharan Africa, one-fifth to one-third of all children
have already been orphaned by AIDS. We talked about the 40 million that
within the next decade may become orphans. HIV/AIDS runs high among the
world's militaries. The rapid loss of senior officers can mean
destabilization for those nations where the military plays a central
role.
It should be noted that the most effective means of halting the
spread of AIDS in the developed or developing world is the use of
effective prevention measures, including needle exchange programs and
condom distribution, the kinds of efforts that, unfortunately, have
been repeatedly opposed by the majority in this body.
I had the privilege of going with the President and other Members of
Congress to India and met in New Delhi in a very poor neighborhood
Naseem the barber, who was one of 10 barbers trained in New Delhi to
not only deliver a shave and a haircut and the neighborhood gossip, but
also information about AIDS prevention and a condom. This is a program
that is funded in part by USAID, by American taxpayer dollars, and a
good and important expenditure of funds.
Since the beginning of the epidemic, 410,800 people in the United
States have died from AIDS. Today it is estimated that as many as
700,000 people in the United States have AIDS. We cannot be lulled or
allow our children to become lulled into believing that the new drug
cocktails, the protease inhibitors, have conquered the disease. Our
policies cannot be driven by those who would say that the threat to our
national security that AIDS poses does not exist or by those who would
claim that it is simply a homosexual disease. It is not, it is a
heterosexual disease as well. That is very important.
I was proud to join the Vice President and our Ambassador to the
United Nations at a meeting of the United Nations Security Council in
January. During that session the Security Council addressed the issue
of HIV/AIDS in Africa. This marked the first time that the Security
Council looked at a health
[[Page H2384]]
issue in the context of a threat to global security. The Vice President
made the point that it is time for us to move beyond our classical
definition of security.
We have all talked about the staggering statistics, but I want to
just end by saying while I was honored to have the opportunity to
attend that historic meeting, I left feeling even more unsettled than I
expected. The fact that a United Nations panel considered the issue of
AIDS in the form of a security meeting and our National Security
Council has followed suit should be taken as both a move in the right
direction for the international community as well as a serious wake-up
call.
{time} 1945
We, the international community, are losing the fight currently
against AIDS. This beast knows no borders, it does not discriminate by
class, race, gender, or nationality. AIDS is not just a detriment to
the health of humanity; it is a global security threat and should be
addressed as such.
Again, I want to commend my colleague for her tireless effort on this
issue and look forward to the passage of H.R. 3519 when it is
considered by the entire House.
Ms. LEE. Mr. Speaker, I want to thank the gentlewoman from Illinois
(Ms. Schakowsky) for that very succinct and very profound statement and
also for her consistent hard work on this issue and many others that we
are dealing with here in the Congress.
Mr. Speaker, I yield 5 minutes to my colleague, the gentlewoman from
Los Angeles, California (Ms. Waters), whose life has been about
fighting injustices wherever they may occur. She has taken the lead
here in the United States Congress in terms of the whole HIV/AIDS
pandemic, both here in the United States and abroad. The gentlewoman
from California has been in the forefront of seeking peace and security
on the continent of Africa.
Ms. WATERS. Mr. Speaker, I would like to commend my friend and
colleague, the gentlewoman from California (Ms. Lee), for organizing
tonight's Special Order on the HIV/AIDS crisis in Africa and for her
general leadership on this issue. The gentlewoman from California (Ms.
Lee) is providing the kind of leadership that has caused this Congress
to finally focus on this crisis and on this epidemic. She is a Member
of Congress that served on the staff of one of the most esteemed
Members of Congress who is now retired, Congressman Ronald Dellums; and
Congressman Dellums decided earlier this year that he was going to give
priority time to this issue.
Even though he is away from Congress working in the private sector in
the health care industry, he decided that this is the most important
issue confronting the world today. So he uses most of his time now not
only speaking with Members of Congress, the President of the United
States, health organizations, pharmaceutical companies, the USTR. He
has just about spoken with everyone imaginable that has the power to do
anything about this issue. So as a result of the efforts of the
gentlewoman from California (Ms. Lee), working along with Congressman
Dellums and the rest of us, we are finally, I think, being heard on
this issue.
Mr. Speaker, I would like to commend President Bill Clinton for
recognizing the importance of United States support for international
HIV/AIDS treatment and prevention programs. Earlier this year, the
President requested an additional $100 million in funding for
international HIV/AIDS treatment and prevention programs. These funds
would be in addition to the $225 million that the United States is
currently spending on these programs.
The impact of the HIV/AIDS epidemic on sub-Saharan Africa has been
especially severe. Since the beginning of the epidemic, over 80 percent
of all AIDS deaths have occurred in sub-Saharan Africa. By the end of
1999, there were an estimated 23.3 million people in sub-Saharan Africa
living with HIV/AIDS. That is 70 percent of the total number of HIV-
infected people worldwide. In sub-Saharan Africa, there are over 5,000
AIDS-related funerals per day.
HIV/AIDS treatment and prevention efforts in sub-Saharan Africa are
complicated by poverty. Most Africans lack access to the most basic
health care services and only the wealthiest people in Africa can
afford HIV/AIDS medications and advancements in treatment therapies.
Furthermore, high illiteracy rates combined with low levels of
education funding have made prevention efforts more difficult.
Nevertheless, experience has proven that HIV/AIDS-prevention programs
can make a substantial difference if the programs are funded
sufficiently and implemented in an effective manner. Uganda in
particular has implemented a highly successful program which has
reduced HIV/AIDS infection rates by over 50 percent. I happen to have
been in Uganda when I was on one of my trips to Africa with the
President when he was there. I had an opportunity to visit the clinics
and to talk with people and to understand how seriously they had taken
this whole epidemic and how they were moving forward and providing
leadership on the continent; and it is working and it shows. Senegal
has also developed a successful HIV/AIDS prevention program. However,
effective HIV/AIDS treatment and prevention programs cannot be expanded
or implemented in other countries without substantial financial
assistance from the international community.
Mr. Speaker, H.R. 3519, the World Bank AIDS Marshall Plan Trust Fund
Act, was passed by the Committee on Banking and Financial Services on
March 15 of this year by a bipartisan majority thanks to the leadership
of the gentlewoman from California (Ms. Lee) and to our Chairman, the
gentleman from Iowa (Mr. Leach). This legislation would direct the
Secretary of the Treasury to enter into negotiations with the World
Bank for the creation of a World Bank AIDS trust fund to provide grants
to support HIV/AIDS treatment and prevention programs in less developed
countries, and I am proud to be a cosponsor of this bill.
Now, during the Committee on Banking and Financial Services'
consideration of H.R. 3519, I offered an amendment to the bill that
increased the amount of funds authorized to be appropriated for payment
to the World Bank AIDS trust fund from $100 million to $200 million per
year. While $200 million is still only a small fraction of what is
needed for HIV/AIDS programs, it would represent a significant
commitment of financial resources by the United States and set an
example for the international community.
Mr. Speaker, I know that at the time that I offered the amendment,
our Chairman was a little bit worried, because this is a difficult
issue; and at a time where we have competing interests and we have lots
of needs here in this country, it is very difficult sometimes to get
our Congress focused on a crisis like this someplace else. However, I
feel that the crisis is of such proportions that we must be aggressive
and we must be bold; and I still think $200 million is but a drop in
the bucket. I am worried now, I am worried that when this bill is on
the floor in a few days, that there will be an effort to reduce the
amount back to $100 million because of the fear that it will not be
passed if it is more than $100 million.
I would like to encourage support from my colleagues to keep the
amount at $200 million. Let us not go backwards. Let us move forward,
and let us stand up for what is right. I hope that the recent report
that was put out by the CIA and others and the work that has been done
now by the National Security Council identifying AIDS as a world threat
to peace will help our people to understand that we cannot retreat. We
must move forward. We cannot reduce the amount in this bill from $100
million to $200 million.
Mr. Speaker, I also offered another amendment that would allow the
World Bank trust fund to provide technical assistance to countries to
assist them in building the capacity to implement effective HIV/AIDS
treatment and prevention programs. I am pleased to report that both of
my amendments were passed by the Committee on Banking and Financial
Services.
The rest of the world does look to us for leadership, and I think
there is one other area that we have got to be profoundly supportive
of. I would just like to give a little background on that, if I may.
Most HIV/AIDS drug therapies are well beyond the reach, as I said, of
all but the wealthiest elites in sub-Saharan Africa. Drug therapies
that have
[[Page H2385]]
extended the lives of people living with HIV/AIDS in the United States
and other developed countries would cost between $4,000 to $20,000 per
person per year in sub-Saharan Africa. However, the gross national
product per capita in sub-Saharan Africa is only $503 per year. If
South Africa is excluded, the GNP per capita is only $308 per year.
Furthermore, according to the World Bank, no sub-Saharan African
countries spent more than $400 per person per year on health care
between 1990 and 1995.
The agreement on trade-related aspects of intellectual property
rights, known as TRIPS, is one of the international agreements enforced
by the World Trade Organization. The TRIPS agreement allows
corporations to benefit from patents over plants and medicines.
Corporations use their patent rights to force developing countries to
pay for the use of plants and medicines. In some cases, these plants
and medicines were developed by indigenous people in developing
countries who have been using them for hundreds of years. As a result
of the TRIPS agreement, many people in developing countries have been
denied lifesaving medicines because they cannot afford to pay for them.
In 1997, the South African government passed a law to make HIV/AIDS
drugs more affordable and available for its people. This law allows the
importation of commercial drugs from sources other than the
manufacturers, a practice called parallel importing, and authorizes the
South African government to license local companies to manufacture
generic drugs, a practice called ``compulsory licensing.'' The U.S.
pharmaceutical industry opposed this law and our own United States
Trade Representative attempted to pressure South Africa not to
implement it. Fortunately, USTR has recently announced in December of
1999 that it would be more flexible in its policies towards South
Africa's situation.
The amendment that I would love to have had passed in my committee
would have required the United States Government to encourage sub-
Saharan African countries to develop policies to make HIV/AIDS
medications available to their populations at affordable prices. It
would also require the United States Government to
encourage pharmaceutical companies to make HIV/AIDS medications
available to the populations of these countries at affordable prices.
More importantly, this amendment would direct the United States
representative to the WTO to encourage the World Trade Organization to
exempt sub-Saharan African countries from the TRIPS agreement and other
international agreements that prohibit them from implementing laws that
make HIV/AIDS medications available to their populations at affordable
prices. This would allow countries such as South Africa to enact
legislation to expand the availability and affordability of HIV/AIDS
medicines without worrying about WTO challenges to their laws.
Mr. Speaker, access to affordable medicine is essential for sub-
Saharan Africans living with HIV/AIDS. It should be the policy of the
United States and the WTO to encourage policies that increase the
availability and affordability of HIV/AIDS medicines in sub-Saharan
Africa, not to challenge or oppose such policies.
Again, the rest of the world looks to the United States for
leadership. It is essential that Congress pass the World Bank AIDS
Marshall Plan Trust Fund Act that has been initiated and guided by my
friend and colleague, the gentlewoman from California (Ms. Lee) and the
gentleman from Iowa (Mr. Leach); and it is equally essential that
Congress fully fund the President's request for international HIV/AIDS
treatment and prevention programs. Also, it is imperative that we do
not pare back the $200 million that we adopted in the Committee on
Banking and Financial Services, but rather support it and move forward
in a very proud way to join with other leaders in the world, some
countries much smaller than ours who are doing more to deal with this
crisis than we are doing. I am convinced we can do that.
Ms. LEE. Mr. Speaker, I want to thank my colleague from California
for her very profound statement and also for once again speaking the
truth and for making sure that this Congress and administration is
challenged to step up to the plate to provide adequate resources to
begin to tackle this pandemic at the proportion of which we see the
problem.
{time} 2000
Madam Speaker, I yield now to the gentlewoman from Houston, Texas
(Ms. Jackson-Lee), who has been a voice of reason, an advocate for
social justice both here and abroad, and who I had the privilege to be
with on our presidential delegation when we visited Southern Africa and
witnessed the devastation of HIV/AIDS' toll on the orphans in Africa.
Ms. JACKSON-LEE of Texas. Madam Speaker, I thank the gentlewoman from
California (Ms. Lee). She is very right that together we were
enormously moved, along with the gentlewoman from Michigan (Ms.
Kilpatrick) when we traveled to Southern Africa to witness firsthand
what many of us had seen before, but together on this presidential
mission.
Let me thank the gentlewoman for carrying forth the vision to help
with our former colleague, our dear friend, Ron Dellums, to form and
foster and nurture H.R. 3519, the World Bank AIDS Marshall Plan Trust
Fund Act, in collaboration with the gentleman from Iowa (Chairman
Leach). Let me thank the gentlewoman for that, because she has put the
engine behind the remorse, the devastation, the sadness, the high
emotions that have been brought about by understanding that since 1980,
in the 1980s, 16 million people have died from AIDS.
Madam Speaker, I would like to read into the Record just these simple
figures, if I can do this rather quickly, to elaborate on the enormity
of this pandemic tragedy with respect to AIDS.
The percentage of adult population infected with HIV or suffering
from AIDS in a number of countries in Africa: Zimbabwe, 25.9 percent of
the adult population. Botswana, 25.1. Many of these countries I
visited, particularly Botswana, a few years ago; and the numbers were
climbing then. I visited an AIDS clinic and talked to a woman who had
been infected and had lost her son. And I saw the pain of the country
trying to grapple with this. One of the issues, of course, was the
ability to have the pharmaceuticals to deal with this. The low cost of
those drugs is a necessity.
Namibia, 19.4 percent; Zambia, 19.1 percent. This is the percentage
of adult adoption. Swaziland, 18.5 percent; Malawi, 14.9; Mozambique,
14.2 percent; South Africa, 12.9 percent. I imagine these nations would
say these percentages are growing.
Rwanda, 12.8 percent; Kenya, 11.6 percent; Central African Republic,
10.8 percent; Ivory Coast, 10.1 percent; India, .82; U.S., .76.
Just another example. Number of 15-year-olds per 10,000 of that age
group who have lost their mothers or both parents to AIDS: Uganda,
1,100; Zambia, 890; Zimbabwe, 700; Malawi, 580.
The list goes on. The number of Africans that we understand die every
day from HIV/AIDS: 5,000, at least.
And so as I stand on the floor of the House, I can only ask that we
move quickly to support this legislation, to encourage the full funding
that the President has promoted to grab hold of this and declaring this
a national security issue, an international security issue; to
encourage Kofi Annan to embrace this as well in his commitment to bring
down the percentages of HIV infection by putting the resources of the
United Nations behind this; by acknowledging that this is the number
one killer of women 25 to 44 in the African-American population in the
United States.
Madam Speaker, I thank my community, who I marched with 2 weeks ago,
in recognizing that in pockets of the 18th Congressional District HIV/
AIDS is one of the number-one killers, and to commit to my constituents
in Houston as well to join them in the women's, and what I have
promoted, the Mothers' March Against AIDS that we will be promoting in
the next couple of months, and to say that we have to do more than
simply roll up our sleeves. We have to get in the fight and really
battle.
It is important to recognize that H.R. 3519, the Marshall Plan, the
same concept that we used after World War II, is long overdue and that
we must move this legislation along very quickly. It must pass out of
the House of Representatives. It must quickly pass out
[[Page H2386]]
of the Senate. We must get it to the President's desk, and we must act
on it.
It is likewise important that, as we move through the appropriations
process, we must recognize that 13 million children have lost one or
both of their parents to AIDS, and the number is projected to 40
million in the continent of Africa by 2010.
AIDS in sub-Saharan Africa accounts for nearly half all the
infectious disease deaths globally, and what that translates into is
TB. Many are suffering from pneumonia, and it leads into other
infectious diseases as well.
We well recognize that the Pentagon budget has been one of the
largest that we have had. That is why I believe it is so crucial that
we have acknowledged that this is a national security issue. With that
in mind, I can only say to the gentlewoman from California (Ms. Lee) in
thanking her for her leadership, this Special Order should not be one
in vain. It should be a Special Order of challenge, a special order
that energizes us as we provide through the committee process, each of
us who has any opportunity to encourage the faster process of this
legislation, we should ask that it be declared an emergency and that we
move it as quickly as we can to the floor of the House.
Madam Speaker, let me simply thank the gentlewoman for giving me the
opportunity to speak and yield back.
Madam Speaker I rise in support of HR 3519, the World Bank AIDS
Marshall Plan Trust Fund Act, introduced by Congresswoman Barbara Lee.
As the Clinton Administration formally recognized just a few days
ago, the spread of HIV/AIDS in the world today is an international
crisis that can no longer be ignored.
The National Security Council, which has never before involved itself
in combating infectious diseases, has formally designated the disease
as a threat to U.S. national security.
With the establishment of the White House interagency working group
on AIDS and the National Security Council's designation, America is
taking steps to lead in the fight against the global AIDS crisis.
As HR 3519 correctly reiterates, AIDS is a global emergency that is
devastating developing countries.
The creation of a World Wide trust for in which nations would be able
to obtain grants to address the needs of HIV/AIDS victim globally is
truly needed.
We know that 60% of those that have died from AIDS are in sub-Saharan
Africa. That is 16 million people since the 1980's.
An even more heart-wrenching statistic is that 13 million children
have lost one or both of their parents to AIDS and this number is
projected to reach 40 million by 2010.
AIDS in sub-Saharan Africa accounts for nearly half of all infectious
disease deaths globally.
Not since the bubonic plague of the Middle Ages, has there been a
more devastating disease.
I applaud the Clinton Administration's recent push to double the
budget request to $254 million to combat AIDS overseas.
However, I still believe that much more funding is needed to
adequately address this emergency epidemic.
When the Pentagon budget continues to spend more than this $254
million on obsolete aircraft, we are struck with the remaining gap in
the battle to tackle this global problem.
Consequently, Senior Clinton Administration officials clearly express
their frustration that by all estimates on HIV/AIDS, that nearly $2
billion is needed to adequately prevent the spread of this disease in
Africa per year.
Although I realize that this may not be politically feasible at the
time, we must take notice of the fact that if the National Security
Council can designate AIDS as a national security threat, then it is
time for this country to take affirmative steps to combat this
devastating tragedy in the international community.
AIDS is significantly shortening the life expectancy of all and will
continue to cut more years off people's lives if we do not take
responsibility for combating this disease.
I applaud my colleague Barbara Lee for her leadership. The AIDS
Marshall Plan Fund for Africa will help to ensure that the federal
government follows through on its recently stated plans to address the
international AIDS epidemic.
In conclusion, I also believe that the private sector has a major
role in fighting AIDS. In the African Growth and Opportunity, I
successfully included a sense of Congress amendment to cause
corporations doing business in Africa to set up a private fund that can
be utilized to also fight the AIDS devastation. That provision still
remains in the bill.
Ms. LEE. Madam Speaker, I thank my colleague from Texas once again
for participating with us this evening and also for participating and
fighting on all of the issues that we tackle here in Congress and for
her leadership on the whole HIV/AIDS crisis both here and abroad. I
say, Thank you very much, Congresswoman Jackson-Lee.
Madam Speaker, I now yield to the gentleman from Maryland (Mr.
Cummings), who has been consistent and very instrumental in forcing the
United States Congress to deal with the devastating effects of drugs
and the impact of drugs as it relates to the HIV/AIDS crisis. I thank
the gentleman very much for being with us tonight.
Mr. CUMMINGS. Madam Speaker, I thank the gentlewoman from California
(Ms. Lee) for yielding, and I want to thank her for all that she does
every day, everything that she does to put a face on this crisis. I
think so often, I think the philosopher Camus said that a lot of times
when we get so caught up in statistics, we forget that there are real
people behind those statistics.
Certainly, the ones that I will cite in a minute or two are quite
frightening. But the gentlewoman and I and many others who have visited
Africa know that these statistics have real faces behind them.
Madam Speaker, I rise today to address one of the most challenging
and life-threatening public health issues facing the global community:
HIV infection and AIDS.
This disease is now the world's deadliest with over 40 million
persons infected worldwide. And significantly, our President recently
declared AIDS as a national security threat. Not surprisingly, this
pandemic affects the most vulnerable citizens of our global community;
in fact, nearly 95 percent of infected persons live in developing
countries with, sub-Saharan Africa being hit harder than any other
region.
Let me mention some startling statistics. New HIV infections in
Africa have numbered more than 1.4 million each year since 1991. That
is an average of more than 3,800 new HIV/AIDS infections per day in
sub-Saharan Africa.
23.3 million adults and children are infected with the HIV virus in
the region which has about 10 percent of the world's population, but
nearly 70 percent of the worldwide total of infected people.
Life expectancy in these nations has been reduced by disease to
between 22 and 40 years.
In several sub-Saharan nations, more than one in four pregnant women
is infected with HIV/AIDS, and in many sub-Saharan nations one quarter
of all children have already been orphaned by AIDS, 13 million
children, the equivalent of all the children enrolled in our public
school system.
As leaders of this great Nation, we have a responsibility to take the
lead in efforts to overcome this AIDS pandemic. But in order to
effectively combat the disease, we must come to a full understanding of
two key issues. As Martin Luther King, Sr., said, ``[w]e cannot lead
where we do not go, and we cannot teach what we do not know.''
First, we must understand what accounts for this devastating spread
of this disease on the African continent. Just to name a few: lack of
quality health care, poverty, lack of education, armed conflict, lack
of jobs, and limited government assistance are all factors.
Second, we must come to an understanding that all sectors and all
spheres of society have to be involved as equal partners in combatting
this crisis. The health sector cannot meet this challenge on its own,
nor can one government or one nation.
So it is imperative that we have a collective global effort to
increase international AIDS spending in Africa and to improve the
health care infrastructures of African countries.
Mr. PAYNE. Mr. Speaker, I rise today in support of H.R. 3519, the
Marshall Plan Trust Fund. I know my colleague, Ms. Barbara Lee (CA),
has worked diligently on this issue for some time now and I am pleased
that this House is taken up this issue. Let me also thank the Chairman
of the Banking Committee, Congressman Jim Leach (IA), who is
responsible for moving this bill through the Committee.
The HIV/AIDS crisis is a transnational threat. It threatens not only
our public health but it is also a threat to our National Security.
According to the Washington Post, ``It has the potential to undo
decades of work in building free-market democracies abroad.''
On my visit to South Africa in December of last year, I visited an
HIV/AIDS clinic and saw
[[Page H2387]]
first hand the education and preventive ways to combat this virus. In
Soweto, South Africa, when the AIDS virus detonates this black township
of 3 million in a decade or so, the disease will wipe out about 600,000
people. This is almost six times as many people as the atomic bombs
killed in Hiroshima and Nagasaki.
Some estimates predict that more than 25% of the working age
population in South Africa will be infected with HIV by the year 2010.
The global spread of AIDS is reaching catastrophic numbers.
HIV/AIDS has greatly reduced the life span of the citizens of South
African countries. Life expectancy in Botswana has declined from 61
years five years ago to 47 years, and is expected to drop to 41 years
between 2000 and 2005. In Zimbabwe 1 out of every 5 adults is affected
and is significantly reducing population growth from 3.3%.
More than 33 million are infected and more than 14 million have died.
Of this number, more than 16 million people have died from AIDS since
the 1980s, 60% of them from sub-Saharan Africa. In 1998, 200,000 people
died from armed conflicts on the subcontinent, while AIDS has caused
about 2.2 million deaths.
Former Congressman Ronald Dellums, who is now the President of
Healthcare International Management Company, has conceived the AIDS
Marshall Plan for Africa as a means to bring treatment to those
affected with the HIV/AIDS virus. Also, the NAACP introduced a similar
measure declaring HIV/AIDS a crisis in Africa.
The Clinton administration has taken the right step to curb the
spread of AIDS. President Clinton recently declared $254 million to
prevent the spread of AIDS around the world.
Bristol-Myers, one of the largest pharmaceutical company and is
headquartered in the state of New Jersey, has also pledged their
support of $1 million to prevent the further spread of HIV and to care
for those affected by this devastating disease.
In conclusion, let me say that the spread of infectious diseases
poses a threat to our own health here in the U.S. We should support the
AIDS Marshall Plan and the Clinton administration's efforts to rid the
world of this deadly disease.
Mr. TOWNS. Mr. Speaker, I want to join my colleagues in their support
of H.R. 3519 the ``World Bank AIDS Marshall Plan Trust Fund Act.'' In
Testimony before the Committee on Government Reform, Sandra Thurman,
the Director of the Office of National AIDS Policy, sometimes called
the AIDS CZAR said that as of this moment, AIDS has killed 12 million
men women and children in Africa. Today and every day, AIDS in Africa
buries more than 5,500 men, women and children. And that number is
estimated to double in the next few years. AIDS has become the leading
cause of death in Africa.
But in order to understand the total dimensions of this tragedy, we
not only look at the dead, but we must also look at the living. It is
estimated that by the year 2010, 40 million children in Africa will be
orphaned by AIDS. These children will have lost their parents, and many
will have lost entire families. What will these children do? Who will
pay for their education? How will they get the basic necessities of
food, clothing and shelter? Who will teach them right from wrong? Forty
million children with no connection to society, no connection to
family, the community or each other will grow up to be forty million
adults who have no sense of past, present, or future. Forty million
people who are without moorings can and will destabilize a country, a
region, a continent and a world.
I know that the fate of Africa or Africans may not be a high priority
for many here. Many may not care about the AIDS virus or its victims.
But I don't know anyone here who does not care about children. I ask
you to do what you can to prevent the predictions of forty million
orphans from coming true. Lets find a way to keep their parents healthy
and alive. Lets find a way to provide medical assistance so that there
will not be 40 million orphans. The United States can and should be a
leader in the fight against this pandemic. We can not be the leader of
democracy and turn our backs on these families.
The SPEAKER pro tempore (Mrs. Biggert). The time of the gentlewoman
from California (Ms. Lee) has expired. All time has expired.
____________________