[Congressional Record Volume 147, Number 90 (Tuesday, June 26, 2001)]
[Senate]
[Pages S6886-S6887]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                           HIV/AIDS EPIDEMIC

  Mrs. CLINTON. Mr. President, we are in the midst of this very 
important debate about a Patients' Bill of Rights. I am hoping that 
before we break for the Fourth of July recess, the doctors, nurses, 
patients, and families of America will have the relief for which we 
have all waited for a very long time: making it clear doctors should be 
making our health care decisions; that nurses, not bookkeepers, should 
be at our bedsides; and that the Patients' Bill of Rights will be a 
reality.
  I rise today because we have to consider our broad needs for health 
care not only in our country but around the world. Today as we meet and 
debate a Patients' Bill of Rights to make sure that Americans have 
access to the best health care in the entire world, there are millions 
of people around the world who do not have that opportunity or that 
right. I speak specifically of those who are suffering from HIV/AIDS.
  We should be supporting vigorously the United Nations General 
Assembly on Meeting the Global HIV/AIDS Challenge and urging them to 
consider creative tools, such as debt relief, in efforts to combat HIV/
AIDS.
  As the general assembly is meeting in special session in New York to 
try to come up with a strategic blueprint for fighting HIV/AIDS 
worldwide, it is imperative that we in America appreciate that this 
worldwide epidemic has nowhere near crested. Africa is ravaged. It has 
just begun to affect India, China, and Russia. This is an epidemic of 
historic proportions, and it needs a response that is historically 
appropriate.
  Almost 60 million people worldwide have been affected by HIV/AIDS, 
and over 20 million men, women, and children have died. If current 
trends continue, 50 percent or more of all 15-year-olds in the most 
severely affected countries will die of AIDS or AIDS-related illnesses.
  We are in the middle of summer vacation. We have many families and 
young people visiting our Capitol. We are always so happy to have them 
here and for them to take a few minutes to see their Government in 
action, but it is just chilling to imagine American 15-year-olds facing 
bleak futures as orphans or victims because they were born to infected 
mothers.
  Every American should be concerned with what is going on beyond our 
borders. We should also be concerned because when it comes to disease 
today, there are no borders. People get on jet planes, people travel 
all over the world. There is no disease that is confined to any 
geographic area any longer. We have to recognize that for us to worry 
about the HIV/AIDS epidemic in Africa and Asia is not only the right 
thing to do, it is the smart thing to protect ourselves and to protect 
our children.
  It is also important to recognize that the groundbreaking drug 
treatments that are keeping people with HIV/AIDS alive today are not 
available to those who suffer elsewhere. Less than 1 percent of HIV-
infected Africans, for example, have access to life-extending 
antiretroviral medications. The challenges facing us are great, and we 
should work together to combat this global emergency.
  I strongly support the formation of a global fund for infectious 
diseases such as AIDS, but also including tuberculosis and malaria. We 
are seeing tuberculosis and malaria in our own country. We are seeing 
the spread of malaria, which used to be confined to a tropical belt, 
beginning to move northwards, in part, I believe, because of global 
warming and desertification, so the mosquitos can travel further north 
and find hosts who traditionally have not suffered from malaria.

  Tuberculosis is becoming epidemic in many parts of the world. In 
Russia, drug-resistant tuberculosis is a major killer.
  I believe we should have a global fund to combat these infectious 
diseases, and I am very pleased the United States, private donors, and 
some other nations have taken steps to address the need for money as 
articulated by Secretary General Kofi Annan. We need between $7 billion 
to $10 billion annually. It is my hope that through a public-private 
partnership we are able to continue to invest in promoting prevention, 
treatment, and eventually a vaccine to prevent this devastating 
disease.
  I am old enough to remember polio as a scourge that affected my life. 
I can remember my mother not letting me go swimming in the local 
swimming pool because of polio. I remember as though it were yesterday 
when the announcement of a vaccine was made. What a sense of relief 
that spread through my house and all of our neighbors, and we all lined 
up to get that shot we thought would protect us from what had been, up 
until then, such a serious, overhanging cloud in the lives of young 
people, as well as older people.
  HIV/AIDS extracts a severe economic toll on nations worldwide. The 
disease spreads so rapidly. No one is immune from it. It has grave 
consequences for societies, and it threatens the interest

[[Page S6887]]

of peace and prosperity around the world.
  HIV/AIDS alone will reduce the gross domestic product of South Africa 
by $22 billion, or 17 percent, over the next decade. That is why I 
believe debt relief must also be part of any conversation about a 
broader global HIV/AIDS strategy.
  While most African countries spend less than $10 per capita on health 
care, they spend up to five times that amount in debt service to 
foreign creditors. In fact, the burdens of debt repayment have come 
into direct conflict with public health efforts in some instances. For 
example, structural adjustment programs have sometimes required 
governments to charge user fees for visits to medical clinics, a 
practice that stands in the way of effective prevention and treatment 
programs. As discussions of global HIV/AIDS prevention proceeds, 
consideration should be given to the role of international debt relief 
in the overall plan to combat HIV/AIDS.
  I have written to the U.N. General Assembly President Harri Holkeri 
to express my support for his efforts and to urge inclusion of debt 
relief strategies in any effort that comes out of the general assembly.
  I also urge our own Government to look more closely at what we can 
do. In the last administration, we forgave a lot of our bilateral debt 
for the poorest of the nations, but we should look at expanding beyond 
the circle of the poorest of the poor to the next poorest of the poor, 
and we should also look at our multilateral debt.
  I am hoping I will find support on both sides of the aisle for a 
sense-of-the-Senate resolution I will be submitting to express the 
policy view that debt relief can and should be an important tool.
  I have visited African countries. I have visited Asian countries. I 
have visited HIV/AIDS programs. I have been in places where 12-year-old 
girls who were sold into prostitution by their families have come home 
to die in northern Thailand.
  I have been in programs in Uganda which have done probably the best 
job I know of in Africa certainly to spread the message about how to 
prevent HIV/AIDS. I have listened to the songs that were taken out into 
villages to tell villagers about this new disease that nobody really 
knows where it came from or how it arrived, but to warn people about 
its deadly consequences.
  I was fortunate and privileged last year to participate in the United 
Nations discussion about AIDS, and I sat with AIDS orphans: A young boy 
from Uganda whose father and then mother died of AIDS, leaving him 
responsible for his younger brothers and sisters; a young boy from 
Harlem whose mother died of AIDS; a young boy from Thailand who was 
also orphaned by this terrible disease.
  In some parts of Africa now, one will only find children, and most of 
them are orphans. The rate of infection ranges from 15 to 35 percent, 
and I am deeply concerned we are still in some parts of the world in a 
state of denial about HIV/AIDS.
  Certainly, both India and China face tremendous challenges to educate 
their population about this disease and to avoid practices that might 
spread it. It is commonplace in some parts of China for very poor 
villagers to sell their blood to make a little money. In so doing, they 
are subjecting themselves to the possible transmission of this terrible 
disease.
  In other parts of Africa and Asia, even the best intentions to 
immunize children against measles or other communicable diseases lead 
to tragedy because the sterilization is not up to par and needles are 
reused, leading to the infection of people with HIV/AIDS.
  I have long maintained there is a deep, profound connection between 
the economic health of a nation and the physical health of that 
nation's people. That is why we have to act now to address the HIV/AIDS 
pandemic.
  There is so much the United States can and should do. We have the 
finest health care system in the world. We are the richest nation that 
has ever existed in the history of the world. We not only should care 
about people in other parts of the world because of this disease, but 
we should act in our own self-interest because there will be many parts 
of the world where it will be difficult, potentially even dangerous, to 
travel if the entire social structure and economy collapses because of 
the strain of HIV/AIDS, where tourists and business people from America 
will be told they should not go to do business. Suppose they are in an 
accident or suffer injury and might need medical care and that medical 
care might not be deliverable because the health care system has 
collapsed under the weight of HIV/AIDS.
  I look forward to working with my colleagues in the Senate and in our 
United States delegation to the United Nations General Assembly special 
session on these and other desperately needed proposals to halt and 
reverse the social and economic damage caused by HIV/AIDS and the 
direct and immediate threat this pandemic poses to America and 
Americans. I urge my colleagues and I urge our Government and the 
United Nations to look deeply into the concept of forgiving debt in 
return for nations doing what we know works to prevent, treat, and 
eventually find a vaccine for this terrible disease.
  I yield the floor.

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