[Congressional Record Volume 147, Number 86 (Wednesday, June 20, 2001)]
[Extensions of Remarks]
[Pages E1164-E1165]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          SHAME ON MR. NATSIOS

                                 ______
                                 

                       HON. JANICE D. SCHAKOWSKY

                              of illinois

                    in the house of representatives

                        Wednesday, June 20, 2001

  Ms. SCHAKOWSKY. Mr. Speaker, it is a disgrace that a high ranking 
U.S. government official is still collecting taxpayer dollars after 
making disparaging, discriminatory, and inaccurate comments about the 
people of Africa who are suffering from the ravages of HIV/AIDS. 
President Bush should dismiss Andrew Natsios, the new Administrator of 
the U.S. Agency for International Development at once.
  Instead of offering the United States' assistance to help the 
infected people of Africa receive the treatment they desperately need, 
Mr. Natsios stated that our efforts will not work because Africans 
``don't know what Western time is,'' and thus cannot take drugs at 
proper times. He went on to say that if you ask Africans to take 
medicine at a certain time, they ``do not know what you are talking 
about.'' How disgraceful. The Administrator of our nation's lead agency 
for international development and assistance should educate himself 
about AIDS treatment and about the peoples of the world before he 
reveals astonishing ignorance as well as prejudice. It's time for Mr. 
Natsios to go and for the Bush Administration to instead appoint a real 
leader who will bring honor back to this distinguished agency.
  I wish to share with my colleagues an op-ed, which appeared in the 
Washington Post on Friday, June 15, 2001 by Amir Attaran, Dr. Kenneth 
A. Freedberg, and Martin Hirsch, respected experts in the field of AIDS 
research and international development. They comment on Mr. Natsios' 
remarks and proposed plans for U.S. funding and involvement in Africa 
and they make a very persuasive case for Mr. Natsios' immediate 
dismissal.

               [From the Washington Post, June 15, 2001]

                           Dead Wrong on AIDS

       (By Amir Attaran, Kenneth A. Freedberg and Martin Hirsch)

       Andrew Natsios, the Bush administration's new chief of the 
     U.S. Agency for International Development (USAID), has made a 
     very bad start with regard to one of his agency's primary 
     missions: dealing with the scourge of AIDS in Africa. Natsios 
     has made comments recently on the prevention and treatment of 
     the disease in Africa that are, to say the least, disturbing, 
     if not alarming.
       His comments appeared last week in the Boston Globe and in 
     testimony before the House International Relations Committee. 
     On both occasions he argued strenuously against giving 
     antiretroviral drug treatment (the AIDS treatment used in the 
     United States today) to the 25 million Africans infected with 
     HIV.
       Although Natsios agrees that AIDS is ``decimating entire 
     societies,'' when it comes to treating Africans, he says that 
     USAID just ``cannot get it done.'' As Natsios sees it, the 
     problem lies not with his agency but with African AIDS 
     patients themselves, who ``don't know what Western time is'' 
     and thus cannot take antiretroviral drugs on the proper 
     schedule. Ask Africans to take their drugs at a certain time 
     of day, said Natsios, and they ``do not know what you are 
     talking about.''
       In short, he argues that there is not a great deal the 
     agency he leads can do to help HIV-positive Africans. Under 
     his guidance, USAID will not offer antiretroviral treatment 
     but will emphasize ``abstinence, faithfulness and the use of 
     condoms'' as the essence of HIV prevention. (He also supports 
     distribution of a drug that blocks transmission of the 
     disease from mother to child, and drugs to fight secondary 
     infections.) While this might save some of those not yet 
     infected with the virus, it in effect would condemn 25 
     million people to death, and their children to orphanhood.
       As the administration's man in charge of international 
     assistance, including helping Africans with AIDS, Natsios 
     should know better. His views on AIDS are incorrect and fly 
     in the face of years of detailed clinical experience.
       Take the issue of whether AIDS should be dealt with by 
     prevention or treatment. In backing prevention to the total 
     exclusion of treatment, Natsios favors only modest changes in 
     the strategies that USAID has relied on for the past 15 
     years, which by themselves have clearly failed to stem the 
     pandemic. This is why expert consensus now agrees that 
     prevention and treatment are inseparable--or, in the 
     authoritative words of the UNAIDS expert committee, ``their 
     effectiveness is immeasurably increased when they are used 
     together.''

[[Page E1165]]

       The same conclusion has been reached by countless other 
     experts, including 140 Harvard faculty members who recently 
     published a blueprint of how antiretroviral treatment could 
     be accomplished. Harvard physicians are now treating patients 
     in Haiti, and others are achieving similar treatment 
     successes in Cote d'Ivoire, Senegal and Uganda.
       It is also disturbing that Natsios chooses to exaggerate 
     the difficulties of AIDS treatment, as if to singlehandedly 
     prove it would be impossible throughout Africa. Whether 
     Africans can tell ``Western time'' or not is irrelevant; 
     nearly all antiretroviral drugs are taken only twice a day--
     morning and evening. Sunrise and sunset are just as good as a 
     watch in these circumstances. Nor is Natsios correct when he 
     says the drugs have to be ``kept frozen and all that.'' Not a 
     single antiretroviral drug on the market today needs 
     freezing. In fact, some bear warnings not to freeze them.
       Natsios also said that ``the problem with [delivering] 
     antiretrovirals . . . is that there are no roads, or the 
     roads
       Natsios says that antiretroviral drugs are ``extremely 
     toxic,'' so that as many as ``forty percent of people . . . 
     who are HIV positive do not take the drugs . . . because they 
     get so sick from the drugs that they cannot survive.'' This 
     is a view shared by no one in the medical establishment 
     today. Clinical and epidemiological studies by the Centers 
     for Disease Control and the National Institutes of Health 
     have shown that these drugs are safe for most people and 
     prolong life by many years.
       Two facts are clear.
       The first is that, in Abidjan and Johannesburg, as in 
     Manhattan, AIDS prevention and treatment must go hand in 
     hand. And we can accomplish this if the Bush administration 
     contributes adequately to an international trust fund for 
     that purpose (it has so far promised only $200 million, or 
     just 72 cents per American).
       The second fact is that Andrew Natsios, by virtue of his 
     unwillingness to acknowledge the first fact and his 
     willingness to distort the true situation in Africa before 
     Congress, is unfit to lead USAID and should resign.

     

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