[Congressional Record Volume 147, Number 104 (Tuesday, July 24, 2001)]
[Senate]
[Pages S8132-S8133]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRIST (for himself and Mrs. Clinton):
  S. 1230. A bill to amend the Public Health Service Act to focus 
American efforts on HIV/AIDS, tuberculosis, and malaria in developing 
countries; to the Committee on Foreign Relations.
  Mr. FRIST. Mr. President, I rise to discuss critically important 
legislation that I am introducing today along with Senator Clinton to 
address the internatinal crises of HIV/AIDS, tuberculosis, and malaria. 
The threats of HIV/AIDS, tuberculosis, and malaria are not strictly 
American problems, they ignore national borders, threatening the entire 
world. Together, these three diseases cause over 300 million illnesses 
and five million death each year.
  We are all aware of the chilling global impact of HIV/AIDS, 22 
million have already died worldwide and more than three million in the 
last year alone. Sixty million are currently infected with HIV, a 
number that increases by 15,000 each day. In 2000, 2.4 million 
individuals died in Africa alone.
  Tuberculosis and malaria are also ravaging the developing world. 
Eight million people are infected with tuberculosis each year; over two 
million of whom die. There are over 400 million clinical cases of 
malaria diagnosed each year, resulting in over one million deaths. Over 
700,000 of those who die each year are children. Malaria is endemic to 
101 countries and territories.
  Not only do these three diseases produce over 50 percent of the 
deaths due to infectious diseases each year, but they also have complex 
disease patterns that result in them facilitating each other's spread. 
By weakening the immune system, infection with HIV increases 
susceptibility to both tuberculosis and malaria. Furthermore, the 
increasing number of multi-resistant tuberculosis cases is largely 
attributed to resistance developed in HIV-infected patients. Finally, 
in treating severe anemia that commonly accompanies illness due to 
malaria, untested blood transfusions create a method of HIV/AIDs 
spread.
  Historically, the United States has played a critical role in 
addressing international crises. There is perhaps no greater crisis 
that we face worldwide than the spread of deadly infectious disease. 
Therefore, we must provide the leadership to confront the

[[Page S8133]]

global HIV/AIDS, malaria, and tuberculosis epidemics. History will 
record how we respond to the call.
  We know what is needed to reverse the epidemic. Work by community-
based organizations, both religious and secular, has been the linchpin 
of grassroots success. As a surgeon, I have traveled to numerous areas 
of Africa, Sudan, Kenya, the Congo, and Uganda. I have performed 
operations in converted school houses and ill-equipped hospitals where 
I seen first-hand the great need, and the important role, that American 
involvement can play in providing hope through health education and 
treatment.
  We fight this battle in two ways--by improving primary prevention and 
expanding access to treatment. Actions to provide drugs to developing 
countries at dramatically reduced costs represent a promise to those 
currently suffering from AIDS. However, access to those treatments 
without appropriate health care infrastructure is a moot point. We must 
support the development of effective health care delivery systems, 
personnel training and infrastructure. We must also support programs 
targeting affected by AIDS, such as the millions of orphans.
  I have already introduced legislation with Senator Kerry, the 
International Infectious Diseases Control Act of 2001. This Act would 
direct the President to work with foreign governments, the United 
Nations, UN, the World bank, and the private sector to establish the 
Global AIDS and Health Fund to fight HIV/AIDS, malaria, and 
tuberculosis. This fund would provide grants to governments and non-
governmental organizations for implementation of effective and 
affordable HIV/AIDS, malaria, and tuberculosis programs, with initial 
priority to programs to combat HIV/AIDS.
  It is important to contribute to these international efforts not only 
by providing monetary support but also our time, our energy, and our 
expertise. Therefore, today Senator Clinton and I are introducing 
legislation to help mobilize our Nation's public health infrastructure 
in the fight against international HIV/AIDS, tuberculosis, and malaria. 
The Global Leadership in Developing an Expanded Response, GLIDER, 
initiative will place American health care providers in nations 
confronting the epidemics of HIV/AIDS, tuberculosis, and malaria and 
provide them with the tools to carry out prevention programs, care, 
treatment, and infrastructure development. In addition, it will 
evaluate current methods of treatment and levels of access to treatment 
and enhance disease surveillance. Finally, it will increase funding for 
research into treatment and vaccine development.
  The GLIDER initiative expands programs administered by the 
Departments of State, Health and Human Services, Defense, and Labor to 
ensure that U.S. government agencies are contributing their scientific 
and diplomatic expertise to the problems associated with the spread of 
HIV/AIDS, malaria, and tuberculosis throughout the world.
  This initiative, coordinated through the offices of the Secretary of 
State and Secretary of Health and Human Services, in collaboration with 
the Secretaries of Defense and Labor, targets four objectives: to 
promote and expand our primary prevention efforts, improve clinic-, 
community- and home-based care and treatment, provide assistance to 
those individuals who are affected by such diseases such as AIDS 
orphans and families, and assist with capacity and infrastructure 
development.
  The close partnership between the Departments of State and Health and 
Human Services will be crucial in ensuring that this program is run in 
complete coordination with national, regional and local initiatives, 
medial and scientific experts, non-governmental organizations, and 
diplomatic missions. I would like to take a moment to thank Secretary 
Thompson and Secretary Powell for their personal commitment to this 
issue. I know that they are working together to bring the full force of 
the Administration behind the efforts to combat HIV/AIDS, tuberculosis, 
and malaria. Their support and input has been invaluable in helping us 
to draft legislation that builds upon and enhances our efforts to 
combat infectious diseases worldwide.
  Another essential component to broadening the U.S. mandate for 
involvement in international health initiatives is the creation of the 
Paul Coverdell Health Care Corps, a Corps based on the Peace Corps and 
run through the Department of Health and Human Services. This Corps 
would provide assistance for the placement of health care professionals 
who wish to provide their services in developing countries dealing with 
the crises of HIV/AIDS, tuberculosis, and malaria. This legislation 
provides flexibility in the design of the program but ensures a wide 
variety of volunteer opportunities--both short-term and long-term 
projects, administered by the Ministries of Health, local communities, 
non-governmental organizations, both faith-based and secular, or the 
United States government.
  Where do we go from here?
  First, public-private partnerships are extremely important and should 
be encouraged to attack the pressing problems. This can take place 
through widespread support for the Global AIDS and Health Fund and by 
hastily enacting a vaccine development tax credit.
  Furthermore, we should promote access to high-quality health care by 
engaging the American public health infrastructure in a collaborative 
effort to address an epidemic that has no regard for international 
boundaries.
  We must enlist each stakeholder in the fight against HIV/AIDS. 
Political, ethnic, and religious leaders can coalesce support for 
prevention, care, and treatment programs as well as reduce stigmas 
attached to the disease--a crucial element to any prevention program.
  Finally, we must not lose sight of the importance of prevention when 
attempting to provide treatment. Likewise, we must not let the 
importance of treatment for those presently be forgotten in the rush to 
enhance awareness and prevention efforts.
  As Americans, our challenge has always been to work with other 
nations to create a better, safer world through courage, persistence, 
and patience.
  That is still our challenge today. And I have no doubt that, as a 
nation, and as a people, we will rise to it.
  The bipartisan legislation we are introducing today is an important 
step toward achieving these goals. I thank my cosponsors for their 
support. And, I look forward to working with all my colleagues to 
improve our international efforts to fight deadly infectious diseases 
by passing the GLIDER Act.
                                 ______