[Congressional Record Volume 146, Number 99 (Wednesday, July 26, 2000)]
[Senate]
[Pages S7688-S7689]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HATCH:
  S. 2940. A bill to authorize additional assistance for international 
malaria control, and to provide for coordination and consultation in 
providing assistance under the Foreign Assistance Act of 1961 with 
respect to malaria, HIV, and tuberculosis; read the first time.


            global aids and tuberculosis relief act of 2000

  Mr. HATCH. Mr. President, earlier today, we approved the Helms 
substitute to H.R. 3519, ``Global AIDS and Tuberculosis Relief Act of 
2000.'' I was pleased to support this legislation, recognizing the need 
for our country to support an enhanced effort to prevent and treat AIDS 
and tuberculosis abroad.
  I was pleased to work with Chairman Helms, Senator Biden, Senator 
Frist, Senator Smith of Oregon, and other members of the Senate Foreign 
Relations Committee as this legislation was finalized, and, indeed, I 
want to work closely with them on our continuing efforts to address the 
problems of infectious diseases in the developing world.
  For the reasons I will lay out today, I believe the aid we make 
possible in H.R. 3519 should be expanded to embrace not only HIV/AIDS 
and TB, but also malaria as well. In fact, I think it essential to make 
sure our foreign assistance program in Africa and the developing world 
coordinates its activities closely among these three diseases.
  With the support of Chairman Helms, Senator Biden, and Senator Frist 
in the Senate, and Chairman Leach in the House of Representatives, I 
have drafted companion legislation to H.R. 3519 which make certain that 
U.S. efforts for all three diseases are well-coordinated.
  Accordingly, I rise today to introduce S. 2940 the ``International 
Malaria Control Act of 2000''.
  The World Health Organization estimates that there are 300 million to 
500 million cases of malaria each year. According to the World Health 
Organization, more than 1 million persons are estimated to die due to 
malaria each year.

[[Page S7689]]

  The problems related to malaria are often linked to the devastation 
of two other terrible diseases--Acquired Immunodeficiency Disease, that 
is AIDS, and tuberculosis. One of the unfortunate commonalities of 
these diseases is that they all ravage sub-Saharan Africa and other 
parts of the underdeveloped world.
  In addition to the one million malaria related deaths per year, about 
2.5 million persons die from AIDS and another 1.5 million people per 
year die from tuberculosis.
  The measure I introduce today centers on malaria control and calls 
for close cooperation among federal agencies that are charged with 
fighting malaria, AIDS, and TB worldwide.
  According to the National Institutes of Health, about 40 percent of 
the world's population is at risk of becoming infected. About half of 
those who die each year from malaria are children under nine years of 
age. Malaria kills one child each 30 seconds.
  Although malaria is a public health problem in more than 90 
countries, more than 90 percent of all malaria cases are in sub-Saharan 
Africa. In addition to Africa, large areas of Central and South 
America, Haiti and the Dominican Republic, the Indian subcontinent, 
Southeast Asia, and the Middle East are high risk malaria areas.
  These high risk areas represent many of the world's poorest nations 
which complicates the battle against malaria as well as AIDS and TB.
  Malaria is particularly dangerous during pregnancy. The disease 
causes severe anemia and is a major factor contributing to maternal 
deaths in malaria endemic regions. Research has found that pregnant 
mothers who are HIV-positive and have malaria are more likely to pass 
on HIV to their children.
  ``Airport malaria,'' the importing of malaria by international 
aircraft and other conveyances is becoming more common as is the 
importation of the disease by international travelers themselves; the 
United Kingdom reported 2,364 cases of malaria in 1997, all of them 
imported by travelers.
  In the United States, of the 1,400 cases of malaria reported to the 
Centers for Disease Control and Prevention in 1998, the vast majority 
were imported. Between 1970 and 1997, the malaria infection rate in the 
United States increased by about 40 percent.
  In Africa, the projected economic impact of malaria in 2000 exceeds 
$3.6 billion. Malaria accounts for 20 to 40 percent of outpatient 
physician visits and 10 to 15 percent of hospital visits in Africa.
  Malaria is caused by a single-cell parasite that is spread to humans 
by mosquitoes. No vaccine is available and treatment is hampered by 
development of drug-resistant parasites and insecticide-resistant 
mosquitoes.

  Our nation must play a leadership role in the development of a 
vaccine for malaria as well as vaccines for TB and for the causal agent 
of AIDS, the human immunodeficiency virus--HIV. In this regard I must 
commend the President for his leadership in directing, back on March 
2nd, that a renewed effort be made to form new partnerships to develop 
and deliver vaccines to developing countries. I must also commend the 
Bill and Melinda Gates foundation for pledging a substantial $750 
million in financial support for this new vaccine initiative.
  The private sector appears to be prepared to help meet this challenge 
as the four largest vaccine manufacturers, Merck, American Home 
Products, Glaxo SmithKline Beecham, and Aventis Pharma, have all 
stepped to the plate in the quest for vaccines for HIV/AIDS, TB and 
malaria. We must all recognize that the private sector pharmaceutical 
industry, in close partnership with academic and government scientists, 
will play a key role in the development of any vaccines for these 
diseases.
  Among the promising developments in recent months has been Secretary 
Shalala directing the National Institutes of Health to convene a 
meeting of experts from government, academia, and the private sector to 
address impediments to vaccine development in the private sector. 
Another goal of this first in a series of conferences on Vaccines for 
HIV/AIDS, Malaria, and Tuberculosis, held on May 22nd and 23rd, was to 
foster public-private partnerships.
  These ongoing NIH Conferences on Vaccines for HIV/AIDS, Malaria, and 
Tuberculosis will address three basic questions: what are the 
scientific barriers to developing vaccines for malaria, TB and HIV/
AIDS? What administrative, logistical and legal barriers stand in the 
way of malaria, TB and HIV/AIDS vaccines? And, finally, if vaccines are 
developed how can they best be produced and distributed around the 
world?
  Each of these questions will be difficult to answer. Developing 
vaccines for malaria, TB, and HIV/AIDS will be a difficult task. While 
each vaccine will be different, there are commonalities such as the 
fact that the legal impediments and distributional issues may be very 
similar. Also, there is an unfortunate geographical overlap with 
respects to the epidemics of malaria, TB, and HIV/AIDS. Ground zero is 
sub-Saharan Africa.
  So while the ultimate goal is to end up with three vaccines, we must 
be mindful that there is a close societal and scientific linkage 
between the tasks of developing and delivering vaccines and therapeutic 
treatments for those at risk of malaria, TB and HIV/AIDS worldwide.
  While the greatest immediate need is clearly in Africa and in other 
parts of the developing world, citizens of the United States and my 
constituents in Utah stand to benefit from progress in the area of 
vaccine development.

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