[Congressional Record Volume 147, Number 92 (Thursday, June 28, 2001)]
[Senate]
[Pages S7088-S7090]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. BOXER (for herself and Mr. Smith of Oregon):
  S. 1120. A bill to amend the Foreign Assistance Act of 1961 to 
increase the authorization of appropriations for fiscal year 2002, and 
to authorize appropriations for fiscal year 2003, to combat HIV and 
AIDS, and for other purposes; to the Committee on Foreign Relations.
  Mrs. BOXER. Mr. President, this week, as the United Nations meets to 
prepare a global strategy to combat the growing worldwide HIV-AIDS 
crisis, I am proud to introduce legislation aimed at ensuring that the 
United States continues to be a leader in the fight against this deadly 
disease.
  I am pleased to once again join my good friend and colleague from 
Oregon, Senator Smith, in introducing this bill. Last year, we teamed 
up to offer the Global AIDS Prevention Act that doubled funding for the 
United States Agency for International Development's HIV-AIDS programs. 
Not only was this legislation included in broader international health 
legislation which became law, it was also fully funded for the current 
fiscal year. This year, we are looking to build upon last year's 
success by again doubling the amount USAID spends on fighting the 
global HIV-AIDS epidemic.
  The Global AIDS Research and Relief Act would authorize $600 million 
in each of the next two fiscal years. It is designed to complement 
international HIV-AIDS relief efforts so that a truly global response 
can be implemented in sub-Saharan Africa, Latin America, Southeast 
Asia, Russia, and all places where people are suffering from this 
epidemic.
  In the 20 years since AIDS was first recognized, 22 million people 
worldwide have died from the disease, and 36 million more are living 
with HIV or AIDS today. Of those living with the disease, 95 percent 
live in the developing world where advanced technology to combat AIDS 
is not readily available. It is predicted that AIDS will soon become 
the deadliest infectious epidemic in world history, surpassing the 
Plague, which killed an estimated 25 million people.
  This new chapter in the AIDS epidemic is especially tragic because 
its growth is preventable. While there is no cure for this horrible 
disease, progress is being made. New medical breakthroughs afford HIV-
positive people a much greater life expectancy than they would have had 
ten years ago. Unfortunately, these efforts are not reaching the 
Nations whose people need help the most. By increasing authorization 
for USAID to establish and expand these valuable initiatives in 
developing countries, our bill helps to remedy this disparity in the 
quality of care.
  Specifically, the bill addresses the need for increased voluntary 
testing and counseling, so that we can educate people and keep its 
spread in check. With this funding authorization, the USAID will be 
able to provide more for the most vulnerable constituencies, children 
and young adults. The money will be used for drugs like neviropine, 
which is given to expectant HIV-positive mothers to prevent the spread 
of the infection to their unborn children.
  The United States is a trendsetter in efforts to address the pandemic 
of HIV-AIDS. Through the work of USAID, we have instituted prevention, 
care, and treatment programs in some of the hardest-hit countries in 
sub-Saharan Africa. The Centers for Disease Control and Prevention has 
worked with partners in other countries to expand treatment programs. 
Other agencies such as the Department of Labor, the Department of 
Agriculture and the Department of Defense are contributing to the 
effort to end the spread of AIDS. But far more remains to be done.
  I urge my colleagues to support this measure and ask unanimous 
consent that the text of the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1120

       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 ``Global AIDS Research and 
     Relief Act of 2001''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) AIDS.--The term ``AIDS'' means the acquired immune 
     deficiency syndrome.
       (2) Association.--The term ``Association'' means the 
     International Development Association.
       (3) Bank.--The term ``Bank'' or ``World Bank'' means the 
     International Bank for Reconstruction and Development.
       (4) HIV.--The term ``HIV'' means the human immunodeficiency 
     virus, the pathogen, which causes AIDS.
       (5) HIV/AIDS.--The term ``HIV/AIDS'' means, with respect to 
     an individual, an individual who is infected with HIV or 
     living with AIDS.

     SEC. 3. FINDINGS AND PURPOSES.

       (a) Findings.--Congress makes the following findings:
       (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 1300s 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), more than 36,100,000 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 15 and under 
     worldwide, more than 4,300,000 have died from AIDS, more than 
     1,400,000 are living with the disease; and in 1 year alone--
     2000--an estimated 600,000 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 more than 25,300,000--
     roughly 70 percent--of the world's HIV/AIDS cases.
       (5) Worldwide, there have already been an estimated 
     21,800,000 deaths because of HIV/AIDS, of which more than 80 
     percent occurred in sub-Saharan Africa.
       (6) According to UNAIDS, by the end of 1999, 13,200,000 
     children have lost at least one parent to AIDS, including 
     12,100,000 children in sub-Saharan Africa, and are thus 
     considered AIDS orphans.
       (7) At current infection and growth rates for HIV/AIDS, the 
     National Intelligence Council estimates that the number of 
     AIDS orphans worldwide will increase dramatically, 
     potentially increasing threefold or more in the next 10 
     years, contributing to economic decay, social fragmentation, 
     and political destabilization in already volatile and 
     strained societies. Children without care or hope are often 
     drawn into prostitution, crime, substance abuse, or child 
     soldiery.

[[Page S7089]]

       (8) The discovery of a relatively simple and inexpensive 
     means of interrupting the transmission of HIV from an 
     infected mother to the unborn child--namely with nevirapine 
     (NVP), which costs $4 a tablet--has created a great 
     opportunity for an unprecedented partnership between the 
     United States Government and the governments of Asian, 
     African, and Latin American countries to reduce mother-to-
     child transmission (also known as ``vertical transmission'') 
     of HIV.
       (9) According to UNAIDS, if implemented this strategy will 
     decrease the proportion of orphans that are HIV-infected and 
     decrease infant and child mortality rates in these developing 
     regions.
       (10) A mother-to-child antiretroviral drug strategy can be 
     a force for social change, providing the opportunity and 
     impetus needed to address often longstanding problems of 
     inadequate services and the profound stigma associated with 
     HIV-infection and the AIDS disease. Strengthening the health 
     infrastructure to improve mother-and-child health, antenatal, 
     delivery, and postnatal services, and couples counseling 
     generates enormous spillover effects toward combating the 
     AIDS epidemic in developing regions.
       (11) A January 2000 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.
       (12) The HIV/AIDS epidemic is of increasing concern in 
     other regions of the world, with UNAIDS estimating that there 
     are more than 5,800,000 cases in South and Southeast 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 2 years in the former Soviet Union.
       (13) Russia is the new ``hot spot'' for the pandemic and 
     more Russians are expected to be diagnosed with HIV/AIDS by 
     the end of 2001 than all cases from previous years combined.
       (14) Despite the discouraging 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.
       (15) 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--
       (1) help prevent human suffering through the prevention, 
     diagnosis, and treatment of HIV/AIDS; and
       (2) help ensure the viability of economic development, 
     stability, and national security in the developing world by 
     advancing research to--
       (A) understand the causes associated with HIV/AIDS in 
     developing countries; and
       (B) assist in the development of an AIDS vaccine.

     SEC. 3. ADDITIONAL ASSISTANCE AUTHORITIES TO COMBAT HIV AND 
                   AIDS.

       Paragraphs (4) through (6) of section 104(c) of the Foreign 
     Assistance Act of 1961 (22 U.S.C. 2151b(c)) are amended to 
     read as follows:
       ``(4)(A) Congress recognizes the growing international 
     dilemma of children with the human immunodeficiency virus 
     (HIV) and the merits of intervention programs aimed at this 
     problem. Congress further recognizes that mother-to-child 
     transmission prevention strategies can serve as a major force 
     for change in developing regions, and it is, therefore, a 
     major objective of the foreign assistance program to control 
     the acquired immune deficiency syndrome (AIDS) epidemic.
       ``(B) The agency primarily responsible for administering 
     this part shall--
       ``(i) coordinate with UNAIDS, UNICEF, WHO, national and 
     local governments, other organizations, and other Federal 
     agencies to develop and implement effective strategies to 
     prevent vertical transmission of HIV; and
       ``(ii) coordinate with those organizations to increase 
     intervention programs and introduce voluntary counseling and 
     testing, antiretroviral drugs, replacement feeding, and other 
     strategies.
       ``(5)(A) Congress expects the agency primarily responsible 
     for administering this part to make the human 
     immunodeficiency virus (HIV) and the acquired immune 
     deficiency syndrome (AIDS) a priority in the foreign 
     assistance program and to undertake a comprehensive, 
     coordinated effort to combat HIV and AIDS.
       ``(B) Assistance described in subparagraph (A) shall 
     include help providing--
       ``(i) primary prevention and education;
       ``(ii) voluntary testing and counseling;
       ``(iii) medications to prevent the transmission of HIV from 
     mother to child;
       ``(iv) programs to strengthen and broaden health care 
     systems infrastructure and the capacity of health care 
     systems in developing countries to deliver HIV/AIDS 
     pharmaceuticals, prevention, and treatment to those afflicted 
     with HIV/AIDS; and
       ``(v) care for those living with HIV or AIDS.
       ``(6)(A) In addition to amounts otherwise available for 
     such purpose, there is authorized to be appropriated to the 
     President $600,000,000 for each of the fiscal years 2002 and 
     2003 to carry out paragraphs (4) and (5).
       ``(B) Of the funds authorized to be appropriated under 
     subparagraph (A), not less than 65 percent is authorized to 
     be available through United States and foreign 
     nongovernmental organizations, including private and 
     voluntary organizations, for-profit organizations, religious 
     affiliated organizations, educational institutions, and 
     research facilities.
       ``(C)(i) Of the funds authorized to be appropriated by 
     subparagraph (A), priority should be given to programs that 
     address the support and education of orphans in sub-Saharan 
     Africa, including AIDS orphans and prevention strategies for 
     vertical transmission referred to in paragraph (4)(A).
       ``(ii) Assistance made available under this subsection, and 
     assistance made available under chapter 4 of part II to carry 
     out the purposes of this subsection, may be made available 
     notwithstanding any other provision of law that restricts 
     assistance to foreign countries.
       ``(D) Of the funds authorized to be appropriated by 
     subparagraph (A), not more than 7 percent may be used for the 
     administrative expenses of the agency primarily responsible 
     for carrying out this part of this Act in support of 
     activities described in paragraphs (4) and (5).
       ``(E) Funds appropriated under this paragraph are 
     authorized to remain available until expended.''.

  Mr. SMITH of Oregon. Mr. President, I rise today to join my colleague 
Senator Boxer to introduce the ``Global AIDS Research and Relief Act of 
2001.'' This important legislation increases the authorization for 
USAID to carry out its prevention, treatment and care programs to $600 
million for fiscal years 2002 and 2003. These additional resources will 
help prevent human suffering through the prevention, diagnosis and 
treatment of HIV/AIDS.
  The world is facing a global health problem of disastrous proportions 
in the global HIV/AIDS pandemic. In the past year, this issue has 
received much needed attention from the international community and the 
U.S. Government. But, unfortunately, our efforts and the efforts of 
other governments, the private sector, and foundations have not been 
enough and the pandemic continues to wreak havoc on the lives of 
millions of people around the world. The United States plays a key role 
in the global effort and our bill seeks to strengthen those efforts.
  Over 58 million people have already been infected with HIV/AIDS and 
36 million people are living today with HIV/AIDS. Of those living with 
the disease, over 95 percent live in the developing world where the 
economic and social structures in those countries are being destroyed. 
Sub-Saharan Africa is truly an epicenter for this disease, but 
increasingly, people are becoming infected in Asia, the Caribbean, and 
Eastern Europe. Soon, HIV/AIDS will become the worst infectious disease 
epidemic in recorded history, causing more deaths than both the bubonic 
plague of the 1930s and the influenza epidemic of 1918-1919.
  Young adults and children have been particularly hard hit by the 
pandemic. Among children under the age of 15, more than 4.3 million 
have died of AIDS and more than 1.4 million are living with AIDS. Just 
last year, 600,000 young people became infected and over 90 percent 
were babies born to HIV-positive mothers.
  HIV/AIDS is also hitting those between the ages of 15--24. In some 
sub-Saharan African countries, the infection rates are more than 40 
percent in this population. These high infection rates will have a 
significant impact on the social and economic health of developing 
nations. The United States Census Bureau has found the life expectancy 
in sub-Saharan Africa has fallen almost 30 years within a decade. By 
2010, it is estimated that the average life expectancy in Botswana will 
be 29 years of age, 30 years in Swaziland, 33 years in Namibia, and 36 
years in South Africa. Millions of young adults are losing their lives 
and this will significantly impact the economic and political viability 
of these Nations. Some Nations are estimated to have a reduced GDP of 
at least 20 percent or more by 2010 due to decreased productivity of 
its workers. Over the past thirty years, the United States has invested 
millions of dollars in democracy building programs and economic 
stabilization programs. HIV/AIDS has quickly erased much of this 
progress.
  As we look to the future of the world, we are also confronted by the 
problem of AIDS orphans. USAID estimates that there will be 44 million 
orphans by 2010. Without a parent or family to

[[Page S7090]]

care for them, many will be drawn into prostitution, crime, substance 
abuse or child soldiery. Furthermore, without stability many of these 
children will not seek help when they are sick. AIDS threatens to 
reverse years of steady progress of child survival in developing 
countries.
  The prevalence of HIV/AIDS in the young will have a significant 
impact on the economic future of the world. The pandemic is 
contributing to economic decay, social fragmentation, and political 
destabilization in already strained and volatile societies. These 
factors are of particular concern in South and Southeast Asia, the 
Caribbean, Eastern Europe, and the former Soviet Union where the 
pandemic is just beginning to become a problem. It is estimated that 
there are more than 5.8 million cases in South and Southeast Asia and 
the rate of HIV infection in the Caribbean is second only to sub-
Saharan Africa. Russia is the new ``hot spot'' for HIV/AIDS. More 
Russians are expected to be diagnosed with HIV/AIDS by the end of 2001 
than all cases from previous years combined. Many of these countries do 
not yet have prevention, treatment and care programs in place and we 
must equip our federal agencies with the resources and flexibility 
needed to address the pandemic in all of these areas.
  The United States is seen as a leader in efforts to address the 
epidemic. We contributed almost $500 million to fight HIV/AIDS in 
fiscal year 2001. Through programs at the U.S. Agency for International 
Development, we have instituted prevention, care and treatment programs 
in some of the worst hit countries in sub-Saharan Africa. At the 
Centers for Disease Control and Prevention, we have worked with 
partners in other countries to expand treatment and home-based care 
programs. Other agencies, including the Department of Labor, the 
Department of Defense, and the Department of Agriculture have 
contributed in their areas of expertise.
  This legislation recognizes the growing problems encountered by 
children around the world and instructs USAID to make efforts to 
prevent mother-to-child transmission and orphan programs a major 
objective of their program. Through coordination with UN agencies, 
national and local governments, non-governmental organizations and 
foundations, the U.S. government shall implement effective strategies 
to prevent vertical transmission of HIV. Further, the bill states that 
the agency must strengthen and expand all of its primary prevention and 
education programs.
  This bill also calls on USAID to continue to provide support to 
research that will help the world to understand the causes associated 
with HIV/AIDS in developing countries and assist in the development of 
an effective AIDS vaccine.
  I believe the ``Global AIDS Research and Relief Act of 2001'' can 
make a profound difference in the lives of millions of people facing 
the HIV/AIDS epidemic. I ask all my colleagues to join us and support 
this legislation at this critical moment in the spread of the disease.
                                 ______