[Congressional Record Volume 147, Number 164 (Friday, November 30, 2001)]
[Senate]
[Pages S12259-S12260]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CORZINE (for himself, Ms. Snowe, Ms. Cantwell, Mr. Dodd, 
        Mr. Leahy, and Mrs. Murray):
  S. 1752. A bill to amend the Public Health Service Act with respect 
to facilitating the development of microbicides for preventing 
transmission of HIV and other sexually transmitted diseases; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. CORZINE. Mr. President, I rise today to introduce legislation, 
the Microbicides Development Act of 2001. I am very pleased to be 
introducing this bipartisan bill along with my colleagues, Senators 
Snowe, Cantwell, Dodd, Leahy, and Murray. I extend my gratitude to 
Senator Cantwell, in particular, for her support and assistance in the 
development of this legislation. Additionally, I applaud the efforts of 
my colleague in the House of Representatives, Republican Congresswoman 
Connie Morella of Maryland, for her leadership on this important issue. 
We all believe this initiative is vital to the pursuit of combating the 
global HIV/AIDS crisis.
  As you know, tomorrow, December 1, is World AIDS Day. Twenty years 
ago, the Centers for Disease Control became aware of a virus that was 
claiming the lives of thousands of gay men in the United States. 
Throughout most of the 1980s, we thought of AIDS purely as a gay men's 
disease. Twenty years later, we find that we couldn't have been more 
wrong, as we have seen this disease spread globally to women, children, 
and heterosexual men, infecting and killing millions.
  Today, women and children are being impacted by this epidemic at 
alarming rates. Every day, 6,300 women worldwide become infected with 
HIV. In fact, women now represent the fastest growing group of new HIV 
infections in the United States. AIDS is the fourth leading cause of 
death among women aged 25 to 44 in this country. Unfortunately, I have 
seen the devastation that this disease is having on women, as New 
Jersey has the Nation's fourth highest HIV/AIDS infection rate among 
women, and the second highest infection rate among all adults.
  Despite this growing trend, however, there exists absolutely no HIV 
or STD prevention method that is within a woman's personal control. 
Condom use must be negotiated with a partner. We are all aware that for 
too many women, particularly low-income women in the developing world 
who reply upon a male partner for economic support, there is no power 
of negotiation. We know these women are at risk, yet, we expect them to 
protect themselves without any tools.
  Today we have the opportunity to invest in groundbreaking research 
that can produce these tools, and ultimately, empower women. 
Microbicides are self-administered products that women could use to 
prevent transmission of STDs, including HIV/AIDS. I say ``could,'' 
because due to insufficient research investments, no microbicides have 
been brought to market. This legislation would encourage federal 
investments for microbicide research through the establishment of 
programs at the National Institutes for Health, NIH, and the Centers 
for Disease Control and Prevention, CDC.
  In addition to investing new resources in microbicide research, the 
Microbicides Development Act will expedite the implementation of the 
NIH's 5-year strategic plan for microbicide research, as well as expand 
coordination among Federal agencies already involved in this research, 
including NIH, CDC, and the United States Agency on International 
Development, USAID. The bill also establishes Microbicide Research and 
Development Teams at the NIH. These teams will bring together public 
and private scientists and resources to research and development 
microbicides for the prevention of HIV and STD infection.
  The Microbicides Development Act of 2001 has the potential not only 
to save millions of lives, but also to save billions in health care 
costs. Every year, 15 million new HIV and other STD infections occur 
among Americans aged 15 and older. The direct cost to the U.S. economy 
of STDs and HIV infection is approximately $8.4 billion. When the 
indirect costs, such as lost productivity, are included, that figure 
rises to an estimated $20 billion.
  While new therapies are being developed to prolong the lives of 
individuals infected with HIV/AIDS--and we must continue developing new 
therapies--only prevention can truly ensure the safety and health of 
those vulnerable to infection. If we do not pay a small price now to 
invest in new prevention methods, we will pay a much higher price 
later.
  Federal support for microbicide research is crucial. Numerous small 
biotechnology companies and university researchers are actively engaged 
in microbicide research, but they are almost totally dependent on 
public-sector grants to continue their work and to test their products. 
Existing public sector grants for microbicides, however, are too small 
and too short-term to move product leads forward. According to the 
Alliance for Microbicide Development and other health advocates, in 
order to bring a microbicide to market within the next 5 years, current 
Federal investments in microbicide research should be increased to $75 
million this year. The NIH currently invests only $25 million a year, 
or 1 percent of its total HIV/AIDS budget, in such important research.
  This legislation will make microbicide research the priority it 
should be, a priority the Federal Government must have if it expects to 
save the lives of women and their children worldwide, who, 20 years 
after the first AIDS death, will otherwise become victims of a 
preventable disease.
  In closing, I would like to request that an opinion piece written by 
United Nations' Secretary General Kofi Annan that appeared in the 
Washington Post yesterday be included in the Record. In his comments 
recognizing World AIDS Day, Secretary Annan reiterates the importance 
of investing in new prevention methods as we continue to fight against 
AIDS.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                         No Letting Up on AIDS

                            (By Kofi Annan)

       Every day more than 8,000 people die of AIDS. Every hour 
     almost 600 people become infected. Every minute a child dies 
     of the virus. Just as life--and death--goes on after Sept. 
     11, so must we continue our fight against the HIV/AIDS 
     epidemic. Before the terrorist attacks two months ago, 
     tremendous momentum had been achieved in the fight. To lose 
     it now would be to compound one tragedy with another.
       New figures, released in advance of World AIDS Day, Dec. 1, 
     show that more than 40 million people are now living with the 
     virus. The vast majority of them are in sub-Saharan Africa, 
     where the devastation is so acute that it has become one of 
     the main obstacles to development. But parts of the Caribbean 
     and Asia are not far behind, and the pandemic is spreading at 
     an alarming rate in Eastern Europe.
       For too long, global progress in facing up to AIDS was 
     painfully slow, and nowhere near commensurate with the 
     challenge. But in the past year, for much of the 
     international community the magnitude of the crisis has 
     finally begun to sink in. Never, in the two long decades that 
     the world has faced this growing catastrophe, has there been 
     such a sense of common resolve and collective possibility.
       Public opinion has been mobilized by the media, 
     nongovernmental organizations and activists, by doctors and 
     economists and by people living with the disease. 
     Pharmaceutical companies have made their AIDS drugs more 
     affordable in poor countries, and a growing number of 
     corporations have created programs to provide both prevention

[[Page S12260]]

     and treatment for employees and the wider community. 
     Foundations are making increasingly imaginative and generous 
     contributions, both financial and intellectual--in 
     prevention, in reducing mother-to-child transmission, in the 
     search for a vaccine.
       In a growing number of countries, effective prevention 
     campaigns have been launched. There has been an increasing 
     recognition, among both donors and the most affected 
     countries, of the link between prevention and treatment. 
     There has also been a new understanding of the particular 
     toll AIDS is taking on women--and of the key role they have 
     in fighting the disease.
       The entire United Nations family is fully engaged in this 
     fight, working to a common strategic plan and supporting 
     country, regional and global efforts through our joint 
     program, UNAIDS. Perhaps most important, a new awareness and 
     commitment have taken hold among governments--most notably in 
     Africa.
       Last June the membership of the United Nations met in a 
     special session of the General Assembly to devise a 
     comprehensive and coordinated global response to the AIDS 
     crisis.
       They adopted a powerful declaration of commitments, calling 
     for a fundamental shift in our response to HIV/AIDS as a 
     global economic, social and development challenge of the 
     highest priority. They reaffirmed the pledge, made by world 
     leaders in their Millennium Declaration, to halt and begin to 
     reverse the spread of AIDS by 2015. And they set out a number 
     of further ambitious but realistic time-bound targets and 
     goals. Among them were commitments to reach, by 2005, an 
     overall target of annual expenditure on AIDS of $7 billion to 
     $10 billion per year in low- and middle-income countries; to 
     ensure, by 2005, that a wide range of prevention programs are 
     available in all countries; and to support the establishment 
     of a fund to help finance an urgent and expanded response to 
     the epidemic.
       Only seven months after I proposed this new international 
     facility to support the global fight against AIDS and other 
     infectious diseases, pledges to the fund stand at more than 
     $1.5 billion. The fund cannot be the only channel of 
     resources for a full-scale global response to AIDS. But what 
     is most heartening is the range of pledges that have been 
     made: from the world's wealthiest nations--starting with the 
     founding contribution from the United States last May--but 
     also from some of its poorest, as well as from foundations, 
     corporations and private individuals.
       It is clear that we have the road map, the tools and the 
     knowledge to fight AIDS. What we must sustain now is the 
     political will. Life after Sept. 11 has made us all think 
     more deeply about the kind of world we want for our children. 
     It is the same world we wanted on Sept. 10--a world in which 
     a child does not die of AIDS every minute.

  Ms. CANTWELL. Mr. President, I rise today with my colleagues Senators 
Corzine and Snowe to introduce the Microbicides Development Act of 
2001, and to recognize tomorrow, December 1, as World AIDS Day. As we 
reflect on the last 20 years of battling this disease, we need to 
remember the thousands of people here in the United States and the 
millions worldwide afflicted by HIV and AIDS.
  It is hard to believe that it has been 20 years since we first 
learned of the disease that would come to be known as Acquired Immune 
Deficiency Syndrome or AIDS. In those 20 years medical and 
pharmaceutical advancements have made HIV/AIDS more manageable for 
some, but a cure is yet to be found. And in those 20 years since we 
first learned of AIDS we have begun to see a changing face of AIDS 
across the country, as well as in my home State of Washington.
  Consider these facts.
  Twenty years ago, HIV infections attributed to sex between gay men 
accounted for nearly all HIV/AIDS cases in the country. Today, more 
than half-- 54 percent--of HIV infections are in different population 
groups: straight or bisexual women, or straight men. In fact, between 
the beginning of the AIDS epidemic and today, the proportion of women 
newly infected with HIV more than tripled-- from 7 percent to 23 
percent.
  Twenty years ago, HIV infections were primarily appearing in 
Caucasians. Today, HIV/AIDS is disproportionately affecting communities 
of color. Approximately two-thirds of all women and over 40 percent of 
all men reported with AIDS were black. Although Hispanics represent 13 
percent of the population, they accounted for 19 percent of new HIV 
infections in 1999.
  And one in four Washingtonians infected with HIV is under aged 22. 
Half are under 25. These are people that have grown up with the 
disease--they should be educated on prevention and they should know how 
to take care of themselves. But somehow complacency--whether from the 
new drugs and medical treatment--or from disease ennui--has replaced 
the message we want to be sending.
  We have long known that the only way to stop the advance of this 
terrible disease is through a coordinated and comprehensive approach to 
education, prevention and treatment. As a community we need to refocus 
our efforts and not allow complacency--especially among populations not 
traditionally associated with HIV/AIDS --to dictate the future. There 
must be a continued commitment to he eradication of this terrible 
disease.
  Before the end of today, several hundred people will become infected 
with AIDS. In these days of fear of Anthrax and discussions of 
bioterrorism we should not loose sight of the worst natural pandemic in 
human history. Twenty years after the U.S. Centers for Disease Control 
and Prevention first identified AIDS, I am afraid that this vast 
tragedy has become a little too familiar, and we may have become a 
little too complacent.
  The HIV/AIDS epidemic rages on, from Asia and Eastern Europe to the 
Caribbean and most tragically Africa. As AIDS has become an 
international crisis, its face has become that of humanity itself. I 
fear that AIDS may become the single greatest obstacle to global 
development humanity has ever faced.
  And while it is easy to become discouraged in the face of such a 
huge, heartbreaking calamity--the truth is we know how to stop the 
spread of AIDS. Through a coordinated and comprehensive program of 
education, prevention and treatment, we know that the epidemic can be 
greatly reduced in scope.
  To that end, I'm proud to join Senator Corzine in sponsoring the 
Microbicides Development Act of 2001. This bill increases authorization 
of funding for microbicide research at the National Institutes of 
Health and the CDC.
  Microbicides represent a novel and virtually unexplored area in STD/
HIV research. Microbicides can kill or inactivate the bacteria and 
viruses that cause STDs and AIDS. Despite their huge potential, 
microbicide research is underrepresented in the federal HIV research 
portfolio. Currently, Microbicide development represents only one 
percent of federal research in HIV/AIDS.
  Microbicides are unique in that they are under development as topical 
products--a cream or gel. This gives them a high degree of versatility 
and user control. This is especially important for women who are unable 
to or cannot ask their partner to use a condom to prevent spreading 
HIV. Development of a dependable, affordable and easy to use 
microbicide would represent a major breakthrough in AIDS prevention--
allowing populations like commercial sex workers to have more control 
over their own bodies. It is extremely important to prevent HIV 
transmission and serve women, a population increasingly at risk for HIV 
infection.
  Microbicide development is a fertile but unexplored anti-HIV research 
area. Pharmaceutical companies have generally concentrated on high 
return disease treatments and government-sponsored vaccine programs. 
While there are potential microbicides in the research and development 
pipeline, this bill encourages the pursuit of these promising compounds 
by increasing authorization for the current federal investment in 
microbial research in the next fiscal year.
  Through this bill, we will emphasize the work at the National 
Institutes of Health and the Centers for Disease Control and Prevention 
to develop products to prevent the transmission of AIDS for women. I 
can think of no new direction in AIDS prevention that has a larger 
potential--we know that the best preventatives must be easy to use and 
controlled by the user. I expect that microbicides will fill a new role 
in preventing the spread of HIV and AIDS. I thank Senator Corzine for 
his leadership on this issue and I urge my colleagues to support this 
bill.
                                 ______