[Congressional Record Volume 146, Number 59 (Monday, May 15, 2000)]
[House]
[Pages H3016-H3025]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              WORLD BANK AIDS MARSHALL PLAN TRUST FUND ACT

  Mr. LEACH. Mr. Speaker, I move to suspend the rules and pass the bill 
(H.R. 3519) to provide for negotiations for the creation of a trust 
fund to be administered by the International Bank for Reconstruction 
and Development or the International Development Association to combat 
the AIDS epidemic, as amended.
  The Clerk read as follows:

                               H.R. 3519

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``World Bank AIDS Marshall 
     Plan Trust Fund Act''.

     SEC. 2. FINDINGS AND PURPOSES.

       (a) Findings.--The Congress finds the following:
       (1) According to the Surgeon General of the United States, 
     the epidemic of human immunodeficiency virus/acquired immune 
     deficiency syndrome (HIV/AIDS) will soon become the worst 
     epidemic of infectious disease in recorded history, eclipsing 
     both the bubonic plague of the 1300's and the influenza 
     epidemic of 1918-1919 which killed more than 20,000,000 
     people worldwide.
       (2) According to the Joint United Nations Programme on HIV/
     AIDS (UNAIDS), 33,600,000 people in the world today are 
     living with HIV/AIDS, of which approximately 95 percent live 
     in the developing world.
       (3) UNAIDS data shows that among children age 14 and under 
     worldwide, 3,600,000 have died from AIDS, 1,200,000 are 
     living with the disease; and in one year alone--1999--an 
     estimated 570,000 became infected, of which over 90 percent 
     were babies born to HIV-positive women.
       (4) Although sub-Saharan Africa has only 10 percent of the 
     world's population, it is home to 23,300,000--roughly 70 
     percent--of the world's HIV/AIDS cases.
       (5) Worldwide, there have already been an estimated 
     16,300,000 deaths because of HIV/AIDS, of which 13,700,000--
     over 80 percent--occurred in Sub-Saharan Africa.
       (6) According to testimony by the Office of National AIDS 
     Policy, an entire generation of children in Africa is in 
     jeopardy, with one-fifth to one-third of all children in some 
     countries already orphaned and the figure estimated to rise 
     to 40,000,000 by 2010.
       (7) The 1999 annual report by the United Nations Children's 
     Fund (UNICEF) states ``[t]he number of orphans, particularly 
     in Africa, constitutes nothing less than an emergency, 
     requiring an emergency response'' and that ``finding the 
     resources needed to help stabilize the crisis and protect 
     children is a priority that requires urgent action from the 
     international community.''
       (8) A 1999 Bureau of the Census report states that the 
     average life expectancy in the Republic of Botswana, the 
     Republic of Zimbabwe, the Kingdom of Swaziland, the Republic 
     of Malawi,

[[Page H3017]]

     and the Republic of Zambia has decreased from approximately 
     age 65 to approximately age 40--the lowest life expectancy in 
     the world--due to high mortality rates from HIV/AIDS.
       (9) A January 2000 unclassified United States National 
     Intelligence Estimate (NIE) report on the global infectious 
     disease threat concluded that the economic costs of 
     infectious diseases--especially HIV/AIDS--are already 
     significant and could reduce GDP by as much as 20 percent or 
     more by 2010 in some sub-Saharan African nations.
       (10) According to the same NIE report, HIV prevalence among 
     militias in Angola and the Democratic Republic of the Congo 
     are estimated at 40 to 60 percent, and at 15 to 30 percent in 
     Tanzania.
       (11) The HIV/AIDS epidemic is of increasing concern in 
     other regions of the world with UNAIDS reporting, for 
     example, that there are 6 million cases in South and South-
     east Asia, that the rate of HIV infection in the Caribbean is 
     second only to sub-Saharan Africa, and that HIV infections 
     have doubled in just two years in the former Soviet Union.
       (12) Despite the grim statistics on the spread of HIV/AIDS, 
     some developing nations--such as Uganda, Senegal, and 
     Thailand--have implemented prevention programs that have 
     substantially curbed the rate of HIV infection.
       (13) AIDS, like all diseases, knows no boundaries, and 
     there is no certitude that the scale of the problem in one 
     continent can be contained within that region.
       (14) According to a 1999 study prepared by UNAIDS and the 
     Francois-Xavier Bagnoud Center for Health and Human Rights at 
     the Harvard School of Public Health, HIV/AIDS is spreading 
     three times faster than funding available to control the 
     disease.
       (15) The United Nations Secretary General has stated ``[n]o 
     company and no government can take on the challenge of AIDS 
     alone,'' and that what is needed is a new approach to public 
     health--combining all available resources, public and 
     private, local and global.''
       (16) The World Bank, declaring AIDS not just a public 
     health problem but ``the foremost and fastest-growing threat 
     to development'' in Africa, has launched a new strategy for 
     HIV/AIDS in Africa, declaring it a top priority for the Bank 
     on that continent.
       (17) The World Bank estimates that for Africa alone 
     $1,000,000,000 to $2,300,000,000 annually is needed for 
     prevention in contrast to the approximately $300,000,000 a 
     year in official assistance currently available for HIV/AIDS 
     in Africa.
       (18) Accordingly, United States financial support for 
     medical research, education, and disease containment as a 
     global strategy has beneficial ramifications for millions of 
     Americans and their families who are affected by this 
     disease, and the entire population which is potentially 
     susceptible.
       (b) Purposes.--The purposes of this Act are to prevent the 
     spread of HIV/AIDS and promote its eradication, prevent human 
     suffering, and to mitigate the devastating impact of the 
     disease on economic and human development, social stability, 
     and security in the developing world, through the creation of 
     a trust fund which is designed to--
       (1) work with governments, civil society, non-governmental 
     organizations, the Joint United Nations Program on HIV/AIDS 
     (UNAIDS), the International Partnership Against AIDS in 
     Africa, other international organizations, donor agencies, 
     and the private sector to intensify action against the HIV/
     AIDS epidemic and to support essential field work in the most 
     affected countries to assist in the development of AIDS 
     vaccines; and
       (2) seek to leverage financial commitments by the United 
     States in order to mobilize additional resources from other 
     donors, the private sector, nongovernmental organizations, 
     and recipient countries to combat the spread of HIV/AIDS.

 TITLE I--NEGOTIATIONS FOR THE CREATION OF A WORLD BANK AIDS TRUST FUND

     SEC. 101. TRUST FUND TO ASSIST IN HIV/AIDS PREVENTION, CARE 
                   AND TREATMENT, AND ERADICATION.

       The Secretary of the Treasury shall seek to enter into 
     negotiations with the International Bank for Reconstruction 
     and Development or the International Development Association, 
     and with the member nations of such institutions and with 
     other interested parties for the creation of a trust fund 
     which would be authorized to solicit and accept contributions 
     from governments, the private sector, and nongovernmental 
     entities of all kinds and use the contributions to address 
     the HIV/AIDS epidemic in countries eligible to borrow from 
     such institutions, as follows:
       (1) Program objectives.--The trust fund would provide only 
     grants, including grants for technical assistance, to support 
     measures to build local capacity in national and local 
     government, civil society, and the private sector to lead and 
     implement effective and affordable HIV/AIDS prevention, 
     education, treatment and care services, and research and 
     development activities, including affordable drugs. Among the 
     activities the trust fund would provide grants for would be 
     programs to promote best practices in prevention, including 
     health education messages that emphasize risk avoidance; 
     measures to ensure a safe blood supply; voluntary HIV/AIDS 
     testing and counseling; measures to stop mother-to-child 
     transmission of HIV/AIDS, including through diagnosis of 
     pregnant women, access to cost-effective treatment and 
     counseling and access to infant formula or other alternatives 
     for infant feeding; and deterrence of gender-based violence 
     and provision of post-exposure prophylaxis to victims of rape 
     and sexual assault. In carrying out these objectives, the 
     trust fund would coordinate its activities with governments, 
     civil society, nongovernmental organizations, the Joint 
     United Nations Program on HIV/AIDS (UNAIDS), the 
     International Partnership Against AIDS in Africa, other 
     international organizations, the private sector, and donor 
     agencies working to combat the HIV/AIDS crisis.
       (2) Priority.--In providing such grants, the trust fund 
     would give priority to countries that have the highest HIV/
     AIDS prevalence rate or are at risk of having a high HIV/AIDS 
     prevalence rate, and that have or agree to carry out a 
     national HIV/AIDS program which--
       (A) has a government commitment at the highest level and 
     multiple partnerships with civil society and the private 
     sector;
       (B) invests early in effective prevention efforts;
       (C) requires cooperation and collaboration among many 
     different groups and sectors, including those who are most 
     affected by the epidemic, religious and community leaders, 
     nongovernmental organizations, researchers and health 
     professionals, and the private sector;
       (D) is decentralized and uses participatory approaches to 
     bring prevention care programs to national scale; and
       (E) is characterized by community participation in 
     government policymaking as well as design and implementation 
     of the program, including implementation of such programs by 
     people living with HIV/AIDS, nongovernmental organizations, 
     civil society, and the private sector.
       (3) Governance.--
       (A) In general.--The trust fund would be administered as a 
     trust fund of the International Bank for Reconstruction and 
     Development. Subject to general policy guidance from the 
     President of the United States and representatives of the 
     other donors to the trust fund, the Trustee would be 
     responsible for managing the day-to-day operations of the 
     trust fund.
       (B) Selection of projects and recipients.--In consultation 
     with the President and other donors to the trust fund, the 
     Trustee would establish criteria, that have been agreed on by 
     the donors, for the selection of projects to receive support 
     from the trust fund, standards and criteria regarding 
     qualifications of recipients of such support, as well as such 
     rules and procedures as would be necessary for cost-effective 
     management of the trust fund. The trust fund would not make 
     grants for the purpose of project development associated with 
     bilateral or multilateral development bank loans.
       (C) Transparency of operations.--The Trustee shall ensure 
     full and prompt public disclosure of the proposed objectives, 
     financial organization, and operations of the trust fund.
       (D) Advisory board.--
       (i) Appointment.--The President of the United States and 
     representatives of other participating donors to the trust 
     fund would establish an Advisory Board, and appoint to the 
     Advisory Board renowned and distinguished international 
     leaders who have demonstrated integrity and knowledge of 
     issues relating to development, health care (especially HIV/
     AIDS), and Africa.
       (ii) Duties.--The Advisory Board would, in consultation 
     with other international experts in related fields (including 
     scientists, researchers, and doctors), advise and provide 
     guidance for the trust fund on the development and 
     implementation of the projects receiving support from the 
     trust fund. Once the Advisory Board is established, the 
     Secretary of the Treasury shall ensure that the Trustee 
     provides the Advisory Board complete access to all 
     information and documents of the trust fund necessary to the 
     effective functioning of the Advisory Board.

            TITLE II--UNITED STATES FINANCIAL PARTICIPATION

     SEC. 201. LIMITATIONS ON AUTHORIZATION OF APPROPRIATIONS.

       In addition to any other funds authorized to be 
     appropriated for multilateral or bilateral programs related 
     to AIDS or economic development, there are authorized to be 
     appropriated to the Secretary of the Treasury $100,000,000 
     for each of fiscal years 2001 through 2005 for payment to the 
     trust fund established as a result of negotiations entered 
     into pursuant to section 101.

                           TITLE III--REPORTS

     SEC. 301. REPORTS TO THE CONGRESS.

       (a) Annual Reports.--Not later than 1 year after the date 
     of the enactment of this Act, and annually thereafter for the 
     duration of the trust fund established pursuant to section 
     101, the Secretary of the Treasury shall submit to the 
     appropriate committees of the Congress a written report on 
     the trust fund, the goals of the trust fund, the programs, 
     projects, and activities, including any vaccination 
     approaches, supported by the trust fund, and the 
     effectiveness of such programs, projects, and activities in 
     reducing the worldwide spread of AIDS.
       (b) Appropriate Committees Defined.--In subsection (a), the 
     term ``appropriate committees'' means the Committees on 
     Appropriations, on International Relations, and on Banking 
     and Financial Services of the House of Representatives and 
     the Committees on Appropriations, on Foreign Relations, and 
     on Banking, Housing, and Urban Affairs of the Senate.

                 TITLE IV--HIV/AIDS PREVENTION AND CARE

     SEC. 401. STRENGTHENING LOCAL CAPACITY IN SUB-SAHARAN AFRICA 
                   TO IMPLEMENT HIV/AIDS PREVENTION AND CARE 
                   PROGRAMS.

       Title XVI of the International Financial Institutions Act 
     (22 U.S.C. 262p--262p-7) is amended by adding at the end the 
     following:

     ``SEC. 1625. STRENGTHENING LOCAL CAPACITY IN SUB-SAHARAN 
                   AFRICA TO IMPLEMENT HIV/AIDS PREVENTION AND 
                   CARE PROGRAMS.

       ``The Secretary of the Treasury shall instruct the United 
     States Executive Director at the International Bank for 
     Reconstruction and Development to use the voice and vote of 
     the

[[Page H3018]]

     United States to encourage the Bank to work with Sub-saharan 
     African countries to modify projects financed by the Bank and 
     develop new projects to build local capacity to manage and 
     implement programs for the prevention of human 
     immunodeficiency virus (HIV) and acquired immune deficiency 
     syndrome (AIDS) and the care of persons with HIV/AIDS, 
     including through health care delivery mechanisms which 
     facilitate the distribution of affordable drugs for persons 
     infected with HIV.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Iowa (Mr. Leach) and the gentleman from New York (Mr. LaFalce) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Iowa (Mr. Leach).
  Mr. LEACH. Mr. Speaker, I yield myself such time as I may consume.
  (Mr. LEACH asked and was given permission to revise and extend his 
remarks.)
  Mr. LEACH. Mr. Speaker, I rise in support of one of the most 
important healthcare initiatives in modern times, the creation of a 
World Bank AIDS Trust Fund.
  There are few issues more difficult to discuss in public life than 
the AIDS issue, but any sense of historical perspective requires that 
Congress recognize that it is quite likely that no issue in the world 
is more consequential.
  In parts of Africa where the epicenter currently resides, as well as 
South Asia and the Caribbean where the disease is fast moving, AIDS and 
the precipitating HIV virus have jumped well beyond the population 
groups considered most at-risk in America.
  Millions of women now have the HIV virus and it is being transferred 
in the womb to the unborn. Out of a sense of self-preservation for 
mankind itself, if not simply humanitarian concern for those affected, 
this disease must be eradicated whatever the cost.
  The purposes of H.R. 3519 are straightforward: To prevent the spread 
of HIV/AIDS and promote its eradication, prevent human suffering and 
mitigate its effects on economic development and security through a 
World Bank-administered trust fund that would work with governmental 
and nongovernmental organizations and leverage United States 
contributions to mobilize additional resources from other donors, 
including the private sector.
  The bill before us, which has captured the attention of medical and 
development professionals working to combat the HIV/AIDS crisis around 
the world, was passed by the Committee on Banking and Financial 
Services on March 15 by a strong bipartisan 27-to-4 vote.
  The committee has been in regular contact with the administration 
regarding the development of this legislation, as well as our floor 
amendment, and I am pleased to inform Members that we received today a 
statement announcing that the administration strongly supports the 
passage of H.R. 3519.
  At the dawn of the 21st century, the world confronts one of the most 
serious and urgent public health challenges in the history of mankind. 
According to the United States Surgeon General, AIDS will soon become 
the worst epidemic of infectious disease in recorded history, eclipsing 
both the bubonic plague of the 1300s and the influenza epidemic of 1918 
to 1919, which killed more than 20 million people worldwide.
  Already 16.3 million have died from AIDS and more than 33 million are 
living with this deadly disease. Indeed, the global AIDS epidemic might 
fairly be described as a disease of biblical proportions.
  The statistics in the global AIDS crisis, particularly in sub-Saharan 
Africa, are stunning. Although it only has 10 percent of the world's 
population, sub-Saharan Africa accounts for 80 percent of global AIDS 
deaths and nearly 70 percent of the world's current HIV/AIDS cases. The 
African continent is also confronted with an unprecedented number of 
orphaned children from AIDS.
  At the committee's March hearing, Mary Fisher, the founder of the 
Family AIDS Network, who eloquently addressed the Republican Convention 
in 1992, testified about her recent trip to Africa. She told the 
committee that what dominates the African landscape is orphans, acres 
of orphans; orphans raising orphans because there is no one else left 
to do it. Tough children take to the streets. Weak children die of 
starvation. Many just sit, docile and sick, a vast human ocean of 
orphans, mostly infected and doomed.
  While Africa is the current epicenter of the disease, it is moving 
towards Asia and nothing would be a greater mistake than to think that 
oceans are boundaries capable of containing the spread of diseases of 
this nature. At this time, for instance, there is an alarming increase 
in the HIV/AIDS infection rate in the Caribbean and in parts of South 
and Southeast Asia, as well as the Newly Independent States of the 
former Soviet Union.
  As bleak as the global picture is, it nevertheless must be understood 
that there are prevention and education strategies that are effective 
against the spread of HIV/AIDS. Statistics from Uganda and Senegal in 
Africa and from Thailand and Asia demonstrate the positive impact of 
strong prevention programs. Encouragingly, those strategies can be 
applied in other countries as well.
  The innovative approach outlined in the World Bank AIDS Marshall Plan 
Trust Fund Act holds out the promise of catalyzing a much stronger 
global response to the AIDS epidemic. Implicit in approaches involving 
Bretton Woods institutions is the possibility of attracting additional 
contributions from other donors, including, as uniquely authorized in 
this bill, the private sector.
  For a modest $100 million per year contribution in the table from the 
United States, we have the prospect of leveraging multibillion dollar 
contributions from other public and private donors over the next 5 
years.
  It is my hope that some of the resources made available in this 
initiative could be applied to ultimately achieving a desperately-
needed medical breakthrough in developing an AIDS vaccine, but until 
the day that such a vaccine is available, the only vaccine we have is 
what Dr. Peter Piot of UNAIDS calls a social vaccine, that is education 
and prevention efforts.
  H.R. 3519 is directly targeted at maximizing this social vaccine 
through education and prevention initiatives.
  In conclusion, let me stress that America has a particular obligation 
to do everything within its power to prevent and ultimately eradicate 
HIV/AIDS, particularly among those most vulnerable, our children both 
here and abroad.

                              {time}  1715

  Mortality may be a part of the human condition, but all of us have an 
obligation to put an end to those conditions that precipitate premature 
death, particularly at very young ages.
  For the country that leads the world in wealth and research capacity 
to abdicate its responsibility to confront forth rightly this 
biblically proportioned humanitarian crisis would be morally derelict.
  I am honored to join my colleagues, the gentleman from New York (Mr. 
LaFalce) the distinguished gentlewoman from California (Ms. Lee), the 
gentleman from New York (Mr. Gilman), the gentleman from Oklahoma (Mr. 
Coburn), and the gentlewoman from Maryland (Mrs. Morella) and so many 
others in pressing for congressional action in this crisis, and urge my 
colleagues to give it their support.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LaFALCE. Mr. Speaker, I yield 2 minutes to the distinguished 
gentleman from Missouri (Mr. Gephardt), the minority leader.
  (Mr. GEPHARDT asked and was given permission to revise and extend his 
remarks.)
  Mr. GEPHARDT. Mr. Speaker, I rise in strong support of the World Bank 
AIDS trust fund legislation we are considering today. I commend the 
gentlewoman from California (Ms. Lee) and the gentleman from Iowa (Mr. 
Leach), the authors of this legislation, for their leadership and hard 
work in not only calling attention to the magnitude of the HIV/AIDS 
pandemic, but in developing an important initiative that will help 
address this horrible problem.
  I believe that the global HIV/AIDS crisis is the preeminent moral 
issue of our time. Yet, most Americans do not know very much about the 
crisis and the devastation that this disease has caused in Sub-Saharan 
Africa and other nations and continents around the world. In fact, the 
future of Africa may well be at risk, and the consequences of the 
failure to act may condemn future generations to a deadly cycle of 
poverty and chronic illness.

[[Page H3019]]

  It is simply impossible to imagine lasting political or social 
progress in Africa without forcefully addressing the increasing toll 
that this disease is exacting on her people. Most of us who live in 
nations with high standards of living cannot become complacent about 
our success and good fortune, and ignore the millions of fellow human 
beings whose struggle to achieve political, economic, and social 
progress is in such jeopardy. We have to significantly increase the 
efforts we have made to date if we are to succeed in helping other 
peoples curb the HIV/AIDS pandemic.
  So we must increase international funding for vaccine research, for 
efforts to stop the spread of the HIV virus, and for the care of those 
already infected. We must also address the crushing debt problem with 
which too many of the poorest nations in the world are saddled.
  I commend the administration for its efforts in these areas, and 
fully support its budget request, which calls for much needed increases 
in next year's funding.
  Because our response must be multifaceted, the World Bank trust fund 
that would be established by the Leach-Lee legislation will play a very 
important part, as well, by bringing together multinational, private 
sector, and nongovernmental resources to fight HIV/AIDS.
  I urge all of my colleagues on both sides of the aisle to support 
this important initiative. Again, I commend the gentleman from Iowa 
(Mr. Leach) and the gentlewoman from California (Ms. Lee) for a job 
well done.
  Mr. LaFALCE. Mr. Speaker, I yield myself such time as I may consume.
  (Mr. LaFALCE asked and was given permission to revise and extend his 
remarks.)
  Mr. LaFALCE. Mr. Speaker, H.R. 3519 is a bill which can mean life 
instead of death for millions of people. H.R. 3519 primes a pump of 
worldwide resources to fight one of mankind's deadliest enemies, AIDS.
  The Acquired Immune Defense Syndrome is sweeping our planet. It is 
striking us without discrimination as to age, gender, income, race, 
religion, or nationality. Our Surgeon General has estimated that this 
will soon be the worst plague to strike mankind in all recorded 
history, worse than the bubonic plague of the 1300s, worse than the 
worldwide influenza epidemic of the early 1900s; worse than any other 
illness in the history of the world.
  So a broad, a global, a coordinated defense against this scourge must 
come. It has been unmercifully slow in coming. However, it is coming, 
and this bill is a very major part of it.
  Mr. Speaker, H.R. 3519 is aimed at inclusiveness in the HIV/AIDS 
battle. Our Treasury Secretary is directed to initiate negotiations 
within the World Bank, its members, and other interested parties to 
create a trust fund to receive resources from any entity to combat HIV 
and AIDS through grants.
  The bill as amended today authorizes a U.S. contribution of $100 
million to the AIDS-targeted trust for each fiscal year from 2001 to 
2005. We know our contribution will be leveraged many fold by 
additional contributions from such an open community of donors. A 
figure of at least $1 billion per annum is possible.
  Secondly, our bill, entitled the ``World Bank AIDS Marshall Plan 
Trust Fund Act,'' is very flexible. Trust fund resources can be 
deployed globally. This is not merely a reaction to a crisis in Africa 
or the growing threat in Eastern Europe. The transborder character of 
AIDS is fully recognized.
  Further, no single line of attack is elevated over another. There 
will be no priority given a prevention over a cure or a cure over a 
prevention.
  The findings of our Committee on Banking and Financial Services fully 
demonstrate that we cannot delay. Thousands, tens of thousands, are 
infected daily. Until AIDS can be brought to heel globally, no matter 
what the success of steps to stem it domestically might be, the virus 
will threaten us. Even now it is believed incidence of strains largely 
found outside the United States, and having different characteristics 
from our predominant strain B are rising domestically. This bill is a 
highly productive path for a global counterattack. I urge its unanimous 
passage.
  Mr. LEACH. Mr. Speaker, I yield 3 minutes to the distinguished 
gentleman from New York (Mr. Gilman), chairman of the Committee on 
International Relations.
  (Mr. GILMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. GILMAN. Mr. Speaker, I thank the gentleman for yielding me the 
time.
  Mr. Speaker, I am pleased to rise in strong support of H.R. 3519, 
which addresses the urgent need for global resources by leveraging the 
U.S. contribution to a World Bank AIDS trust fund of $100 million 
annually over the next 5 years to mobilize potentially more than $1 
billion a year from other governmental and private sector donors for 
grants to operations working to combat, to eradicate, and to mitigate 
the impact of the AIDS virus throughout the world.
  I want to commend the gentleman from Iowa (Mr. Leach), the 
distinguished chairman of our Committee on Banking and Financial 
Services, and the gentlewoman from Texas (Ms. Lee), for sponsoring this 
important measure.
  Mr. Speaker, the AIDS pandemic may soon become the most deadly 
infectious disease in modern times, eclipsing the influenza epidemic 
earlier this century that caused some 20 million deaths worldwide.
  Recent estimates place the AIDS death toll at over 16 million people 
and rising. Over 33 million people are living with this disease, and 
most of these infected live in the developing world. Therefore, until 
this terrible disease is eradicated, our efforts to promote economic 
development and democratic practices are going to be impeded as the 
meager resources of these infected developing societies are drained by 
this terrible scourge.
  Sub-Saharan Africa has been particularly hard hit. This bill 
encourages prompt action in that region of the world. However, no area 
of the world has been spared the ravages of this deadly disease. It is 
rapidly spreading today in Asia and throughout the Pacific Rim at an 
alarming pace.
  As this disease continues to spread, the international health 
economic and security implications are very serious and require the 
unique leadership of our Nation. The Committee on International 
Relations will be holding hearings soon to identify ways in addition to 
this measure in which our Nation can effectively combat AIDS and other 
infectious diseases that are not only a human tragedy of immeasurable 
proportions, but also pose a threat to the health and well-being of the 
American people.
  In our own State of New York, the spread of the West Nile virus 
epidemic last year is a testament to the need to remain vigilant about 
the global threads of AIDS and all other infectious diseases.
  Accordingly, Mr. Speaker, I urge my colleagues to join in strong 
support of H.R. 3519 so that our Nation can lead the world community in 
seeking more private and public contributions to combat the deadly AIDS 
virus. Not only is it in our national interest to do so, but it is the 
right thing to do so.
  Mr. LaFALCE. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
California (Ms. Lee), the principal coauthor of this bill.
  Ms. LEE. Mr. Speaker, I rise today to express strong support for the 
World Bank AIDS Marshall Plan Trust Fund Act, H.R. 3519.
  First, I would like to thank the gentleman from Iowa (Chairman Leach) 
for his wisdom and commitment to ensure that Congress is on the right 
side of history and that we address this pandemic in a bipartisan 
fashion.
  Also, I would like to thank my colleagues, the gentleman from 
Missouri (Mr. Gephardt), the minority leader, the ranking member, the 
gentleman from New York (Mr. LaFalce), the gentleman from New York 
(Chairman Gilman), and the Congressional Black Caucus, especially the 
gentlewoman from California (Ms. Waters) and the gentlewoman from the 
Virgin Islands (Mrs. Christensen), for demonstrating leadership in 
moving this issue forward in the spirit of bipartisanship and 
cooperation.
  Finally, I also would like to acknowledge the contributions of my 
predecessor and dear friend, Mr. Ron Dellums, for remaining committed 
to the fight as a public citizen, and raising

[[Page H3020]]

consciousness throughout the world regarding this pandemic.
  The World Health Organization has proclaimed that HIV/AIDS is the 
world's deadliest disease. It has ravaged Sub-Saharan Africa, claiming 
13.7 million lives. Today, 23.3 million adults and children are living 
with HIV and AIDS. AIDS is decimating the continent and leaving behind 
millions of orphans in its wake. By the year 2010, the number of 
orphans in Africa will equal the number of children in America's public 
schools.
  An estimated 6,000 people die in Africa every day due to AIDS. Since 
I introduced my original bill last August, H.R. 2765, of which most 
provisions are retained in this bill, 1.8 million people have perished. 
The survival of a continent is at stake.
  This is not only a humanitarian crisis, it is an emerging economic 
catastrophe. Teachers are disappearing from classrooms. Skilled workers 
are vanishing from production plants.
  Over the past year, our Nation's moral compass has pointed us in the 
direction that guides us now to address the AIDS crisis globally and 
most profoundly in Africa. However, I remind Members again that the 
AIDS crisis in Africa is only the epicenter. The Caribbean, Asia, 
India, Latin America, and the Balkans are only ticking time bombs. In 
our own country, people of color are being disproportionately hit by 
HIV and AIDS.
  The Clinton administration has rightfully recognized AIDS as a 
national security threat and has issued an executive order to provide 
access to HIV/AIDS pharmaceuticals and medical technologies. This is a 
step in the right direction. The President has also issued a statement 
of administration policy in support of the World Bank AIDS Marshall 
Plan Trust Fund Act.
  Mr. Speaker, I include for the Record the Statement of Administration 
Policy issued by the Executive Office of the President.
  The document referred to is as follows:

                   Statement of Administration Policy


        h.r. 3519--world bank aids marshall plan trust fund act

       The Administration strongly supports the passage of H.R. 
     3519, which would increase international efforts to combat 
     the global spread of HIV/AIDS, and agrees with its sponsors 
     that there is a critical need for new sources of funding in 
     order to combat this growing pandemic effectively. The 
     President's FY 2001 Budget requests a $100 million increase 
     for HIV/AIDS prevention, treatment, and related activities, 
     bringing the total HIV/AIDS funding (exclusive of research) 
     in FY 2001 to $342 million. The current U.S. efforts to 
     combat global HIV/AIDS are by far the largest among bilateral 
     and multilateral donors. In addition, the Administration has 
     proposed a $50 million contribution to the Global Alliance 
     for Vaccines and Immunization (GAVI) and new tax credits to 
     help spur the development and distribution of vaccines for 
     HIV/AIDS and other diseases that result in millions of deaths 
     every year in the developing world.
       The Administration believes that H.R. 3519 takes an 
     important step towards our common objective of increasing the 
     international effort to combat this pandemic. We believe that 
     additional flexibility in negotiating the exact structure of 
     the multilateral funding mechanism will ensure that this 
     mechanism will best meet the objectives of other donors and 
     the requirements of recipient countries and organizations, 
     and therefore will maximize our ability to increase other 
     donor participation. The Administration looks forward to 
     working with the Congress to address this goal. We also note 
     that H.R. 3519 raises constitutional concerns regarding the 
     President's exclusive authority in foreign affairs to 
     represent, and negotiate on behalf of, the United States.
       The Administration remains fully committed to other high 
     priority international initiatives and to the funding levels 
     proposed in the President's Budget for HIV/AIDS programs and 
     other critical components of our existing international 
     affairs budget request. A new multilateral funding mechanism 
     will take time to become operational and effective, and 
     therefore the passage of the President's FY 2001 Budget for 
     HIV/AIDS programs is imperative and will result in immediate 
     assistance in the fight against global HIV/AIDS.

  Mr. Speaker, AIDS, like all diseases, knows no boundaries. There is 
no guarantee that the scale of the problem on one continent can be 
contained in that region. In fact, it is just the opposite.

                              {time}  1730

  So I want to leave on one thought. An old Swaziland proverb says, 
``There is a poisonous snake in our house. If we do not get it out, it 
will kill us all.''
  Left unaddressed, AIDS will wipe out Africa. Today, as the world 
watches, Congress must step up to the plate and hit a home run. Vote 
yes for final passage of H.R. 3519, the World Bank AIDS Marshall Plan 
Trust Fund Act.
  Mr. LEACH. Mr. Speaker, I yield 2 minutes to the distinguished 
gentlewoman from Maryland (Mrs. Morella), a great friend.
  Mrs. MORELLA. Mr. Speaker, I thank the gentleman from Iowa for 
yielding me this time.
  Mr. Speaker, I certainly want to salute and commend the gentleman 
from Iowa (Chairman Leach) and the gentlewoman from California (Ms. 
Lee) for introducing this very important legislation, the World Bank 
AIDS Marshall Plan Trust Fund Act, and to the leadership for scheduling 
it for consideration today. This legislation would provide $500 million 
over 5 years for HIV and AIDS treatment, prevention, and research, 
beginning in Africa.
  Over the past several months, an incredible amount of attention has 
been directed to the devastating plight Africans are facing due to the 
AIDS crisis. More than 11 million Africans have died from AIDS. This 
represents more than 70 percent of AIDS deaths worldwide.
  The spread of AIDS in Africa has increased economic instability, is 
causing serious food and agricultural destabilization and will result 
in a severe drop in life expectancy rates.
  Thirteen million children have lost one or both of their parents to 
AIDS, and life expectancy is expected to plummet from 59 years to 45 
years between 2005 and 2010.
  This bill directs the U.S. Government to 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 the hopes of 
leveraging that contribution to obtain contributions from other 
governments as well as private sector companies 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 United States is uniquely positioned to lead the world in the 
prevention and eradication of HIV and AIDS. H.R. 3519 responds to this 
crisis.
  Again, I thank the gentleman from Iowa (Chairman Leach) and the 
gentlewoman from California (Ms. Lee) for introducing this legislation. 
I certainly urge support by this House of this legislation.
  Mr. LaFALCE. Mr. Speaker, I yield 3\1/2\ minutes to the distinguished 
gentlewoman from California (Ms. Waters), ranking member of the 
Subcommittee on Domestic and International Monetary Policy, the 
subcommittee with jurisdiction over the World Bank, and one of the 
chief promoters of this legislation.
  Ms. WATERS. Mr. Speaker, I would like to thank the gentleman from New 
York (Mr. LaFalce) for the time that he has allocated to me today.
  Mr. Speaker, I rise to express my support for H.R. 3519, the World 
Bank AIDS Marshall Plan Trust Fund Act, and I would like to commend the 
gentlewoman from California (Ms. Lee) for her leadership on this 
critical issue.
  H.R. 3519 was passed by the Committee on Banking and Financial 
Services on March 15 by a bipartisan majority. This regulation 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 
the countries of sub-Saharan Africa and other less developed countries. 
I am proud to be a cosponsor of this bill.
  However, I must say I am deeply dismayed that the funding authorized 
by this bill is only half of what had been approved by the Committee on 
Banking and Financial Services. During the Committee on Banking and 
Financial Services's 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.
  Although my amendment was passed by the Committee on Banking and 
Financial Services, the leadership, the Republican leadership, reduced 
the funding back to only $100 million before bringing the bill to the 
floor today without any discussion with those of us

[[Page H3021]]

who worked so hard to double that amount. This undemocratic reduction 
was done without a unanimous-consent request, without a rule from the 
Committee on Rules, without any opportunity for the Members of the 
House to debate it.
  Given the magnitude of HIV/AIDS epidemic in sub-Saharan Africa, this 
reduction of funding is dangerously unwise. In sub-Saharan Africa, 
there are over 5,000 AIDS-related funerals every day. Since the 
beginning of the HIV/AIDS 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. This is 70 percent of the total number of HIV-infected people 
worldwide.
  The National Intelligence Council of the Central Intelligence Agency, 
the CIA, released a report in January of this year on the threat of 
HIV/AIDS and other infectious diseases to our national security.
  According to this report, ``Some of the hardest hit countries in sub-
Saharan Africa, and possibly later in South and Southeast Asia, will 
face a demographic upheaval as HIV/AIDS and associated diseases reduce 
human life expectancy by as much as 30 years and kill as many as a 
quarter of their populations over a decade or less, producing a huge 
orphan cohort. Nearly 42 million children in 27 countries will lose one 
or both parents to AIDS by 2010; 19 of the hardest hit countries will 
be in sub-Saharan Africa.''
  Despite the urgency of this epidemic, Congress has not demonstrated a 
willingness to commit the resources necessary to stop the spread of 
this devastating disease.
  I am thankful for this $100 million. It should be more. I know that 
the gentleman from Iowa (Mr. Leach) worked very hard on this. To tell 
my colleagues the truth, because he is so fair all the time, I was a 
little bit disappointed that this had happened without any discussion, 
without my knowing and others knowing, who had worked so hard to 
increase it, that it would come to the floor in this manner.
  All we have is $100 million. We do not have the $200 million. 
Certainly we are not going to turn it down. I support it. I hope we can 
do better in the future.
  Mr. LEACH. Mr. Speaker, I yield 2\1/2\ minutes to the distinguished 
gentleman from Oklahoma (Mr. Coburn) who has quite constructively added 
some language on best practices techniques from his medical background 
for this bill. I am very appreciative.
  Mr. COBURN. Mr. Speaker, I thank the gentleman from Iowa for yielding 
me this time. I thank the committee for the manner in which they worked 
with us.
  For $4 a baby, we can prevent HIV infection in Africa, $4. That is 
all it takes, one dose of nevirapine, and the pregnant woman who has 
HIV for her child not to become infected. That is the minimal that we 
can do.
  This bill brings forward the first of many challenges that the world 
is going to face in terms of HIV. About 3 months ago, I met with 
directors, AIDS directors of 21 African countries and visited with them 
about what they were doing. My hope is, as we pass this bill and we 
assess the success that I know that is going to take place in Africa, 
because we have already seen major changes in two countries, Uganda and 
Senegal, my hope is that, as we vote for this, that we will apply the 
same common sense to the AIDS epidemic in America.
  See, the same women, African-American women are being unduly hit by 
this disease. The same children, African-American children in America 
are five times more likely to contract this disease than a white child. 
An Hispanic child is three times more likely to contract this disease.
  So as we vote to help Africa in this dreaded disease, and this will 
be great help, it will make a tremendous difference, we will have not 
ever spent $100 million more effectively than the money that is going 
to be authorized in this program, please look at how we handle HIV in 
this country, and let us not let another baby get infected in this 
country, the wealthiest country in the world. Let us not allow people 
to continue to be ignorant about HIV and this infection.
  I thank the gentleman from Iowa (Mr. Leach), chairman, and the 
gentleman from New York (Mr. LaFalce), ranking member, for this bill. 
It has my wholehearted endorsement.
  Mr. LaFALCE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
the Virgin Islands (Mrs. Christensen).
  Mrs. CHRISTENSEN. Mr. Speaker, I rise today in support of H.R. 3519, 
the World Bank AIDS Marshall Plan Trust Fund Act. I want to commend the 
bill's prime sponsors, the gentleman from Iowa (Mr. Leach), chairman of 
the Committee on Banking and Financial Services, and the gentlewoman 
from California (Ms. Lee) for their efforts in bringing this important 
and vitally needed bill to the floor today.
  I want to particularly recognize and thank the gentlewoman from 
California (Ms. Lee) for her leadership in fighting HIV and AIDS in 
people of color globally and on all fronts.
  Mr. Speaker, the enormity of the deadly impact of AIDS on the people 
and countries of Africa has been at crisis proportions for a long time 
and has long called us to act.
  Since the onset of the epidemic, more than 11 million Africans have 
died from AIDS, representing more than 70 percent of AIDS death world 
wide. Although we have made small steps in the recent past today, we 
begin to respond more appropriately.
  In addition to this measure, I applaud President Clinton for his 
recognition of AIDS as a national security threat and a doubling of his 
budget request to prevent the spread of HIV around the world.
  The bill before us today will bolster this effort, and that of 
private pharmaceutical companies such as Glaxo-Welcome, Bristol Myers-
Squibb, Boeringher Ingelheim, Hoffman-LaRoche, and Merck & Co., and 
others who have also pledged to join this effort by helping to ensure 
that the Federal Government commits to addressing this issue over the 
next several years.
  Out of compassion for our fellow human beings, and in recognition of 
our compelling economic and humanitarian interests in combatting 
infectious disease in developing countries around the world, although 
it falls short of what we had hoped for, I urge my colleagues to 
support passage of this bill.
  Mr. LaFALCE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
the District of Columbia (Ms. Norton).
  Ms. NORTON. Mr. Speaker, I very much thank the gentleman from New 
York for yielding me this time and for his work on this bill. I 
especially appreciate the work of the gentleman from Iowa (Chairman 
Leach) who worked so productively, and the gentlewoman from California 
(Ms. Lee) for whom this has been a priority issue for a long time.
  H.R. 3519 has important breakthrough potential to level substantial 
funding from those who have it to those who do not. The spectrum of 
urgent needs in Africa from prevention to treatment and research is 
exhausting to even contemplate. This is why the President has indicated 
that AIDS worldwide is a national security issue. History, I think, 
will reveal him to be prescient in his understanding of the 
implications of the developed Nations in failing to move more rapidly. 
The Vice President has said the same thing when he made a historic 
appearance before the UN Security Council.
  In this country, we have our own AIDS epidemic of major and tragic 
proportions in the minority communities. But this epidemic pales beside 
the plague in Africa that sees 11 million men women and children 
exposed and become HIV positive every single day. It is decimating an 
entire generation right at the time when Africa is in the throes of 
Nation building with democracy finally taking hold in many countries 
when one needs young educated people most. This funding hastens the 
time when urgently needed fundings can go directly to where they are 
most needed.
  I congratulate the gentleman from Iowa (Mr. Leach) and the 
gentlewoman from California (Ms. Lee) for moving us ahead on this 
urgent issue.
  Mr. LaFALCE. Mr. Speaker, I yield 2 minutes to the distinguished 
gentlewoman from Ohio (Mrs. Jones), a member of the Committee on 
Banking and Financial Services, who has worked very hard on this, too.

[[Page H3022]]

  (Mrs. JONES of Ohio asked and was given permission to revise and 
extend her remarks.)
  Mrs. JONES of Ohio. Mr. Speaker, AIDS is a very important and 
security issue in our country and across the world. I thank the 
gentleman from Iowa (Chairman Leach) and the gentlewoman from 
California (Ms. Lee), my ranking member, for proceeding on the issue of 
a Marshall Plan for Africa.
  The epidemic and devastating effects of AIDS have impacted our 
country greater than the deaths attributed to war. The United Nations 
reported that while war and conflict took about 200,000 people in 1998, 
AIDS and HIV took about 2.2 million.
  I recall, in fact, having had an opportunity to go to an Africa Today 
conference in Seattle. At that Seattle conference, an epidemiologist 
testified that there were grandparents in Africa taking care of as many 
as 25 to 30 of their grandchildren because their children have been 
devastated by the disease of AIDS.

                              {time}  1745

  The United Nations took up the security issue on the issue of AIDS 
this year when seven of the great leaders from the continent of Africa 
were there to talk to the United Nations.
  I am pleased that my colleagues have supported and presented this 
issue, and I rise in support of H.R. 3519 and thank my ranking member 
for the opportunity to be heard.
  Mr. LaFALCE. Mr. Speaker, how much time is remaining on each side?
  The SPEAKER pro tempore (Mr. Pease). The gentleman from New York (Mr. 
LaFalce) has 2\1/2\ minutes remaining, and the gentleman from Iowa (Mr. 
Leach) has 6\1/4\ minutes remaining.
  Mr. LaFALCE. Mr. Speaker, may I ask if the gentleman from Iowa would 
be willing to share some of his time.
  Mr. LEACH. Mr. Speaker, I would like to reserve 3 minutes for myself, 
but I would be happy to recognize someone on the other side.
  The SPEAKER pro tempore. The Chair will be pleased to recognize 
whomever the gentleman yields to, and for how much time?
  Mr. LaFALCE. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Millender-McDonald).
  Ms. MILLENDER-McDONALD. Mr. Speaker, I thank the gentleman from New 
York (Mr. LaFalce), the ranking member, for his leadership on this 
issue, and really thank my dear friend and colleague, the gentlewoman 
from California (Ms. Lee), for her tenacity and her leadership in 
pushing until this bill came to this floor.
  It is so incredibly important that we support this piece of 
legislation. We have recognized by the statistics that have been 
presented to us all today how devastating it is in areas of Africa; in 
fact, all over Africa. It is really seen as a pandemic, and I urge my 
colleagues, everyone in this House, to support this.
  As the cochair of the International HIV/AIDS, I have also seen this 
devastation now rising in places of India, Central America, Eastern 
Europe and other places, and we recognize that this disease is 
seamless. It has no borders. It has no respect for age, ethnicity or 
anything else. So I urge all my colleagues to look at this bill, vote 
the bill out, and make sure that we are addressing the most egregious 
disease that has ever hit the face of this country and the world.
  In a bill that I had, Mr. Speaker, I had certain components as 
prevention, education, and making sure that research as to vaccine was 
a part of this bill. I am happy that that was inserted into the bill 
and I urge support.
  Mr. Speaker, we cannot speak enough on a bill of this magnitude, on 
an issue of this magnitude. I am happy that the administration is 
supporting it, and I urge all my colleagues to support this bill.
  Mr. Speaker, AIDS is potentially the greatest health catastrophe to 
humankind. It knows no borders and strikes individuals regardless of 
age, race, gender, national origin, or social class. More than 
16,000,000 men, women and children have died of AIDS. More than 
33,600,000 people are living with HIV, and nearly all of them will die 
of AIDS-related complications within the next two decades. UN-AIDS 
estimated that there were 5,600,000 newly-infected people with HIV in 
1999, including an estimated 2,300,000 women and approximately 570,000 
children.
  Ninety-five percent of people worldwide living with HIV live in the 
world's poorest countries. With poor health systems, weak economies, 
poverty, and limited access to resources, the epidemic will grow even 
more over the next quarter century without immediate intervention.
  There also are potential security implications in poor countries 
where the increase in HIV-infected military personnel is gradually 
weakening the capacity of militaries to defend their nations, maintain 
civil order, and deploy peacekeepers. Child soldiers and girl `wives', 
some also HIV-infected, are a byproduct of a dwindling pool of adult 
recruits. Sustained education, prevention, and treatment programs for 
military personnel.
  Alongside H.R. 3519, I authored this session H.R. 4140, ``The 
International HIV/AIDS Partnership Prevention Act of 2000'' that 
addresses the global HIV/AIDS challenge in all world regions. From 
Africa, Asia, the Caribbean, Latin America, Eastern and Central Europe 
and Russia, we must pull together world resources including our own to 
combat this disease.
  Let me close by underscoring the human rights elements to this 
crisis. In our expedience to overtake this disease and bring education, 
prevention, and treatment to those infected with HIV/AIDS, we must not 
overlook their basic human rights.
  I hope when this bill comes to Conference Committee that we will 
assure women, children and men around the world that we care for their 
human rights as well as their physical well being. I am reminded of the 
early days of the epidemic here in America when we had to grapple with 
broad social policy issues like privacy and discrimination.
  I hope, Mr. Speaker, that when this House passes HIV/AIDS 
legislation, we will require that any government or organization can 
receive funds only if the government or organization, as the case may 
be, certifies that its laws, policies, and practices, as appropriate, 
do not punish or deny services to victims based on age, ancestry, 
color, disability, gender, national origin, race, religion, sexual 
orientation, and political status.
  If we add this clause to our legislation, we not only will bring 
physical care and treatment to persons with HIV/AIDS but will also 
guarantee respect for their human and civil rights.
  Mr. Speaker, I am pleased that this bill reflects so many of the 
issues I raised in H.R. 4140. I hope that this Congress will pass a 
global HIV/AIDS bill and we will move one step forward toward 
conquering this disease.
  Mr. LEACH. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
California (Ms. Pelosi).
  Ms. PELOSI. Mr. Speaker, I thank the distinguished chairman of the 
Committee on Banking and Financial Services for yielding me this time, 
and for his leadership on this very, very important issue. I am very 
pleased to join him and the distinguished ranking member, the gentleman 
from New York (Mr. LaFalce), and thank them for bringing this to the 
floor.
  I want to join them and others in commending my colleague, the 
gentlewoman from California (Ms. Lee), for her tremendous and 
relentless leadership on this issue.
  Mr. Speaker, we all know the statistics, and they are staggering. 
George Bernard Shaw once said, ``The sign of a truly intelligent person 
is that he or she is swayed by statistics.'' And these statistics, as I 
say, are not only swaying, they are staggering.
  I think it would be interesting for our colleagues to know why this 
bill is so important and the wisdom of it. And I particularly want to 
commend the gentleman from Iowa (Mr. Leach) for his work on the World 
Bank Trust Fund aspect of this. So our colleagues know, $100 million a 
year over 5 years, largely focused on prevention, counseling, testing, 
treatment and care. They all must be increased dramatically. But the 
need for education, counseling, and testing is severe. Because of all 
the numbers we have heard about AIDS in Africa, my understanding is 
that 95 percent of those who are HIV infected, without the full-blown 
cases of AIDS, 95 percent of those people do not know that they are HIV 
infected.
  So prevention, prevention, prevention is what we must do. We must 
prevent people from getting this and prevent them, therefore, from 
spreading it when they do not even know in 95 percent of the cases that 
they have it.
  The funding provided by the World Bank AIDS Trust Fund will help the 
nations of sub-Saharan Africa move forward on all of these fronts while 
strengthening their capacity to provide HIV/AIDS treatments and other 
health care services that are vital for survival of the millions of 
Africans who are living with HIV/AIDS.

[[Page H3023]]

  I support this legislation and commend the gentlewoman from 
California (Ms. Lee), the gentleman from Iowa (Mr. Leach) and the 
gentleman from New York (Mr. LaFalce), the three L's, for their hard 
work on this effort. It is a matter of life and death. Their leadership 
is to be respected by all of us and their legislation to be supported.
  Mr. LaFALCE. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, when we hear the two words ``bubonic plague,'' we think, 
very often, of the worst plague that man has known. But that is wrong. 
That was in the 1300s, but it is not the worst.
  When we think of the major plagues of this century and of all time, 
we think too of the world-wide influenza epidemic that in 2 years 
killed over 20 million people. That is far more than were killed in 
World War I and World War II. And yet AIDS is worse than either of 
those two.
  AIDS is a disease of biblical proportions. It requires an immediate 
response. It requires at the very least the passage of this bill.
  Mr. LEACH. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, this is principally a humanitarian issue. Secondarily, 
but accurately, as the President has suggested, it is a national 
security threat. Tertiarily, it is an economic challenge. According to 
the Global AIDS Policy Coalition at Harvard, AIDS has already cost the 
world GDP in excess of $500 billion.
  I raise this cost issue because frequently, in legislative bodies, we 
have to consider cost-benefit analysis. It is clear that the cost to 
eradicate and cure this disease is less than the cost of the disease 
itself in GDP terms. More importantly, it is far more costly in terms 
of lost minds and lost souls.
  Mr. Speaker, this is the first significant new step emanating from 
Congress to deal with this disease. The gentlewoman from California 
(Ms. Waters) has valid concerns about how much we are dedicating to it. 
Hopefully, this step can be built upon in the future.
  In conclusion, I would like to thank the gentlewoman from California 
(Ms. Lee) and her dedication to this cause. I would also like to thank 
her predecessor, Ron Dellums, who, as a private citizen, is devoting 
his life to this challenge. I would be remiss if I also did not thank 
our staff, Cindy Fogleman, Jamie McCormick, Gary Parker, Jeanne 
Roslanowick, and Dick Peterson.
  Finally, I would suggest that the Congressional leadership is to be 
congratulated. The gentleman from Missouri (Mr. Gephardt), the minority 
leader, has made this a seminal part of his concerns in this Congress. 
My own leadership, the Speaker, the gentleman from Illinois (Mr. 
Hastert), and the majority leader, the gentleman from Texas (Mr. 
Armey), have allowed this bill to come to the floor despite what many 
consider to have very controversial implications.
  I believe, though, despite the controversy, this body is obligated to 
act, and act in a humanitarian way, and so I urge as strong a vote as 
possible on this initiative.
  Ms. SCHAKOWSKY. Mr. Speaker, I want to express my continuing support 
for H.R. 3519, the World Bank AIDS Marshall Plan Trust Fund Act, is 
sponsored by the chairman of the Committee on Banking and Financial 
Services and the gentlewoman from California. I am very proud to be a 
cosponsor of that bill.
  If enacted, H.R. 3519 would create a worldwide trust fund that is 
admiminstered 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 $100 million a year 
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. I must say that, while I am happy this bill 
seems to have the support necessary for passage, I am extremely 
disappointed that the amount of annual U.S. contributions to the fund 
under this bill will be $100 million instead of $200 million, the 
amount approved by the House Banking Committee.
  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 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, 
because it threatens the stability of the world, even more than 
conventional warfare.
  AIDS is claiming more lives than all the 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.
  There is no doubt this bill is a necessary move in the right 
direction. Again, I commend my colleagues for their tireless efforts on 
this issue, and I urge all members to vote in support of H.R. 3519.
  Mr. BENTSEN. Mr. Speaker, I strongly support this legislation, of 
which I am a co-sponsor. I also want to recognize and honor the 
original sponsor of this legislation, Chairman Jim Leach of the House 
Banking Committee for his leadership in bringing this important issue 
to the floor today and for that of our colleague Representative Barbara 
Lee, who has been the main champion of this critical issue. Working 
with the Chairman on the House Banking Committee, we were able to 
approve this bi-partisan legislation out of the full committee in March 
by a vote of 27 to 4.
  Under this bill, the U.S. Treasury Department will negotiate with the 
World Bank and its members to establish a trust fund to solicit 
contributions from governments, the private sector and other non-
governmental organizations to provide grants to address the global HIV/
AIDS epidemic. The grants provided by the trust fund would support 
measures to implement and establish effective HIV/AIDS prevention 
measures as well as fund new research and development activities in the 
countries hardest hit by the epidemic. Participating countries with the 
highest rates of HIV/AIDS infection rates would receive priority under 
this legislation, and must agree to implement national strategies to 
combat HIV/AIDS. For payment to the World Bank HIV/AIDS trust fund, the 
bill authorizes $100 million in each year from Fiscal Year 2001 through 
2005 for a total of $500 million over five years.
  Almost 34 million people live with HIV/AIDS, of which about 95 
percent live in the developing world. Approximately 16.3 million people 
have died of HIV/AIDS, with over 80 percent of those deaths occurring 
in sub-Saharan Africa, which accounts for only 10 percent of the world 
population. Worldwide, about 5.6 million new infections will occur this 
year, with an estimated 3.8 million in sub-Saharan Africa--3.8 million 
people will contract HIV. Every day, 11,000 additional people are 
infected--1 every 8 seconds. All told, over 34 million people in 
Africa--double the population of the State of Texas--have been infected 
with HIV since the epidemic began, and an estimated 13.7 million 
Africans have lost their lives to AIDS, including 2.2 million who died 
in 1998.
  Each day, AIDS kills 5,500 men, women, and children. By 2005, if 
policies do not change, the daily death toll will not be 5,500, it will 
be 13,000--double what it is now--with nearly 5 million AIDS deaths 
that year alone, according to the White House Office of AIDS Policy. 
AIDS has surpassed malaria as the leading cause of death in Africa, and 
it kills many times more people on that continent than war. The overall 
rate of infection among adults is about 8 percent, compared with a 1.1-
percent infection rate worldwide. In some countries of southern Africa, 
20 to 30 percent of the adults are infected. AIDS has cut life 
expectancy by 4 years in Nigeria, 18 years in Kenya, and 26 years in 
Zimbabwe. AIDS is swelling infant and child mortality rates, reversing 
the declines that had been occurring in many countries during the 1970s 
and 1980s. Over 30 percent of all children born to HIV-infected mothers 
in sub-Saharan Africa will themselves become HIV infected.
  There are many explanations for why this epidemic is sweeping across 
sub-Saharan Africa. Certainly the region's poverty, which has deprived 
much of Africa from effective systems of health information, health 
education and health care, bears much of the blame. Sub-Saharan Africa 
becoming the only region in the world in which women are infected with 
HIV at a higher rate than men, may also play a role. HIV/AIDS is 
becoming a major woman's issue. AIDS has largely impacted the 
heterosexual community in Africa, and it has established itself in such 
a way that it sweeps across and wipes out entire villages. Because of 
the region's poverty, all too often treatment of AIDS sufferers with 
medicines that can result in long-term survival has not been widely 
used in Africa.

  Despite these sobering statistics, there is a bit of good news. 
Uganda is making significant headway with regard to prevention. Since

[[Page H3024]]

1992, the Ugandan government's very frank and high-profile public 
education efforts have helped to reduce the incidence of HIV infection 
by more than 15 percent. Thanks to recent medical research, there are 
now effective drugs that combat HIV/AIDS. For example, some recent 
pilot projects have had success in reducing mother-to-child 
transmission by administering the anti-HIV drug AZT, or a less 
expensive medicine, Nevirapine, during birth and early childhood.
  New studies indicate that Nevirapine can reduce the risk of mother-
to-child transmission by as much as 80 percent. NVP is given just once 
to the mother during labor, once to the child within 3 days of birth. 
Taking three or four pills can mean that a child is prevented from 
being born with HIV. In fact, for $4 a tablet this drug regime has 
created an unprecedented opportunity for international cooperation in 
the fight against AIDS. Currently, however, less than 1 percent of HIV-
infected pregnant women have access to interventions to reduce mother-
to-child transmission. Administered in a treatment regimen known as 
HAART--highly active antiretroviral therapy--antiretroviral drugs can 
allow people living with AIDS to live a largely normal life and use of 
the drugs can lead to long-term survival rather than early death. Such 
treatment is proven highly effective in developed countries, including 
our very own.
  But despite these positive signs, there are many fronts on which 
there has been very little progress. Virtually no one has access to 
drugs to treat the disease. Prevention is unquestionably the most 
important element of the equation, but treatment cannot be ignored. 
Poverty should not be a death sentence--not when the infectious disease 
that is destroying African society can be treated.
  Even beyond the human tragedy, there are vast economic costs to this 
epidemic. AIDS affects the most productive segment of society. It is 
turning the future leaders of the region into a generation of orphans. 
The United States and the other industrialized nations of the world 
have the power to make these life-savings drugs more affordable and 
accessible to Africans. If the U.S. and other G-7 nations fail to 
engage and address this crisis now, I fear we will be forced to address 
it in more costly terms, both economic and militarily in the future. we 
turn our backs on Africa, truly, at our own long-term risk.
  I urge my colleagues to join with me in supporting this critical 
legislation to address the global HIV/AIDS epidemic.
  Ms. KILPATRICK. Mr. Speaker, I support H.R. 3519 and commend my 
colleagues, Mr. Leach of Iowa and Ms. Lee of California, for their 
initiative in crafting this piece of legislation.
  Some 50 million people in developing nations are infected with the 
HIV virus. Sub-Sahara Africa, a region which I have had the privilege 
to visit more than once, has been far more affected by AIDS than any 
other part of the world. According to one report, 23 million adults and 
children are infected with HIV in that part of the world. They have 
about 10 percent of the world's population, and 70 percent of the 
world's HIV-infected people. In the African continent, 13.7 million 
people have already lost their lives to AIDS, and we shall surely see 
those numbers increase dramatically unless we step up our efforts to 
combat this worldwide epidemic.
  An epidemic of such Biblical proportions is too overwhelming for just 
a handful of countries to attack. The AIDS epidemic requires the active 
involvement of our multilateral institutions, and that is precisely the 
objective of H.R. 3519. This bill establishes a World Bank Trust Fund 
to provide international grants to combat the spread of HIV/AIDS. The 
grants would provide significant levels of funding for HIV/AIDS 
treatment, prevention and research in developing countries.
  Recently, the House and Senate sent to the President the African 
Trade and Opportunity Act. This bill will open new economic 
opportunities for the continent, provide African countries with greater 
access to U.S. markets and consequently attract greater foreign 
investment. Africa needs these investments and market access 
opportunities to lift up its economy. However, it will never reach the 
road of economic prosperity as long as the HIV/AIDS epidemic continues 
to subjugate the African people. Until a cure is found, all other 
issues are of secondary importance.
  President Clinton and his administration want to increase resources 
to fight AIDS abroad in fiscal year 2001. The World Bank AIDS Marshall 
Plan Trust Fund Act will help to ensure that the federal government 
will continue to address this issue over the next several years. The 
resources supplied by these efforts will go toward distributing 
medications which can prolong the life of HIV-infected people and 
improve their quality of life. This is significant when one considers 
that many African countries have national annual medical budgets of as 
little as $6 per person. This bill will help these countries set up 
treatment, prevention and education programs. In return the benefiting 
countries must agree to implement a national HIV/AIDS program and 
undertake a commitment to work with multiple partners including those 
affected by the disease, religious and community leaders, health 
professionals and other entities.
  The bill authorizes $100 million in each of the following five fiscal 
years through fiscal year 2005. These funds would be authorized in 
addition to any other funds authorized for multilateral or bilateral 
programs related to HIV/AIDS or economic development. As a Member of 
the Appropriations Committee, I want to assure the sponsors of this 
legislation that I will work with them to obtain a fair share of 
funding in this year's appropriations cycle.
  I join those who urge my colleagues to support this bill. This is 
timely legislation, and it deserves the approval of this chamber.
  Mr. CASTLE. Mr. Speaker, I am in support of the World Bank AIDS 
Marshall Plan Trust Fund Act, H.R. 3519. I have seen first hand the 
devastation that AIDS has had on Africa, and I firmly believe that the 
United States and the rest of the developed world must act now to end 
the suffering and hardship caused by this terrible disease.
  I cannot overstate my strong belief that H.R. 3519 is desperately 
needed legislation, and I am proud to be a cosponsor. Quite simply, 
passing this bill is the right thing to do. When I recently visited 
Zimbabwe, Nigeria, and South Africa, I was overwhelmed by the impact 
that AIDS was having, not only on those inflicted with the disease, but 
also on the thousands of orphans that the disease creates. In some 
countries, one-fifth to one-third of the children have already been 
orphaned by the disease.
  The AIDS epidemic presents us with an unprecedented humanitarian 
challenge. The numbers for Africa are numbing--more than 23 million 
adults and children currently infected with the virus and, to date, 
almost 14 million AIDS-related deaths. Infection rates in some 
countries are in the 20 to 26 percent range.
  In light of these statistics, the U.S. Surgeon General warns that 
AIDS will soon surpass the bubonic plague as the worst epidemic of 
infectious disease in recorded history. Of the 33.6 million AIDS cases 
worldwide, 70 percent are in Africa. While I can cite these statistics, 
it is impossible to find any words to describe the magnitude of the 
human suffering and what amounts to be the potential destruction of an 
entire continent, not to mention the harm to those countries beyond 
Africa's borders.
  H.R. 3519's call for an international response to the AIDS crisis in 
Africa is a reasonable step towards making sure that the people who 
need our help get it. While the United States alone cannot solve the 
AIDS crisis, it can provide leadership. Only the coordinated response 
of the developed world provides hope. In this regard, I was especially 
pleased to see last week that five of the world's leading 
pharmaceutical companies have agreed to drastically reduce the price 
that they charge in the world's poor countries.
  However, it is important to understand that the United States and the 
developed world will never be able to effectively deal with the 
pandemic without the cooperation of the governments in the countries 
affected. Of all of the provisions in H.R. 3519, one of its most 
important provisions is the one that establishes the priority for 
making trust fund grants. In directing funds to programs in countries 
at the most risk, the law will factor in a government's level of 
commitment to combating the AIDS epidemic in determining whether a 
program should receive trust fund money.
  As we have seen in countries such as Uganda and Senegal, active 
political support at the highest levels of government is essential to 
making sure the limited funds are not wasted. On this point, I 
emphasize with what I can only describe at total bewilderment the 
failure of some African leaders to face the AIDS epidemic. While we can 
provide financial support, the leadership and will to fight the 
epidemic must come from within Africa.
  Funds are too scarce and the magnitude of what we are facing too 
great to invest in programs that are destined to fail because they lack 
the necessary internal support.
  In closing, I want to thank Chairman Leach and Congressman LaFalce 
for their leadership on this bill. It is desperately needed, and I urge 
my colleagues to vote for it.
  Mr. NADLER. Mr. Speaker, I strongly support H.R. 3519, the World Bank 
AIDS Marshall Plan Trust Fund. I am proud to be a cosponsor of this 
important bipartisan legislation, which would address one of the 
greatest crises facing the world today, the tremendous spread of AIDS 
in Africa.
  The AIDS epidemic has ravaged the nations of Africa, with over 23 
million people estimated to be living with AIDS today in sub-Saharan 
Africa alone. Most heartbreaking is the effect this disease has had on 
the children of that continent. Roughly 8 million children in Africa 
are orphaned due to AIDS today and this number is expected to reach 
nearly 40 million in ten years.

[[Page H3025]]

  The World Bank Trust Fund would harness the power of the world's 
public and private sectors to combat this devastating situation. This 
public-private partnership is a great example of the role the United 
States can play as an international leader in public health. This bill 
demonstrates that we have the resources and the bill to help those who 
are suffering with this terrible disease.
  Along with the recent steps taken by the Clinton Administration and 
several major pharmaceutical companies to ensure that affordable 
treatments are available in Africa, this bill would go a long way 
toward finally eradicating the spread of AIDS in Africa and bring some 
relief to a much beleaguered part of the world.
  I applaud the efforts of all of those who have worked hard on this 
bill and I urge my colleagues to support it.
  Mr. LEACH. Mr. Speaker, I have no further requests for time, and I 
yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Iowa (Mr. Leach) that the House suspend the rules and 
pass the bill, H.R. 3519, as amended.
  The question was taken; and (two-thirds having voted in favor 
thereof) the rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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