[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.

                          ____________________