[Congressional Record Volume 148, Number 150 (Tuesday, November 19, 2002)]
[Senate]
[Pages S11545-S11546]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           CONTINUING THE FIGHT AGAINST THE HIV/AIDS PANDEMIC

  Mr. BIDEN. Mr. President, it is with mixed feelings that I rise to 
speak on the HIV/AIDS bill that the Senate passed by unanimous consent 
tonight. This is the second time this year that the Senate passed a 
bill to combat the spread of HIV/AIDS overseas. As you recall, in July 
we unanimously passed a comprehensive bill to fight the deadly disease. 
The bill contained new authorities for the Department of Health and 
Human Services, authorized money for a contribution to the Global Fund 
for AIDS, Tuberculosis and Malaria, authorized the Secretary of the 
Treasury to enter into negotiations to improve the Heavily Indebted 
Poor Countries Initiative, and authorized funds for our bilateral 
assistance programs at the Agency for International Development.
  The funding levels and authorities provided in the bill the Senate 
passed in July reflected an understanding of the enormity of the 
problem, what it will take to address it, and the Senate's dedication 
to doing so. Unfortunately, our colleagues in the House of 
Representatives had neither the understanding nor the will to consider 
all of the provisions in the bill.
  Instead, the Republican led House slow rolled conversations and 
negotiations on the bill for so long that four months later we were 
still unable to come to an agreement on the original provisions in the 
Senate passed bill. What we are left with is a stripped down version of 
what the Senate passed. Our original bill authorized $2.172 billion in 
fiscal year 2003 and $2.576 billion in fiscal year 2004. The House 
insisted that we slash the title containing Health and Human Services 
authorities. The only version of the bill they would agree to 
authorizes a billion dollars less in fiscal year 2003 to fight HIV/AIDS 
overseas.
  The Senate provided $1 billion for the Global Fund to Combat AIDS, 
tuberculosis and malaria this fiscal year, giving a clear indication 
that we believe that the Fund is an important mechanism through which 
to meet the resource needs of countries highly affected by the disease. 
The compromise with the House authorizes $250 million less in fiscal 
year 2003.
  The Senate legislation included a bill I introduced in April which 
authorizes the Secretary of the Treasury to move forward with 
negotiations for deeper debt relief for poor countries--especially 
those facing a health crisis like HIV/AIDS. More debt relief provides 
poor countries more resources to devote to healthcare. The House 
insisted that we eliminate even Sense of Congress language about debt 
relief from the bill despite the fact that it is now clear--and the 
World Bank itself has recently announced--that unless the current debt 
relief program is enhanced, the debt levels of those poor countries 
will remain too high. How can we expect to developing nations 
struggling under crippling debt to adequately meet the needs engendered 
by a severe health emergency such as HIV/AIDS? We cannot.
  I am bitterly disappointed in the decisions made by our House 
colleagues on the issues I have outlined above. Time and time again we 
have been given information about the human consequences of the spread 
of the disease. Three million people died of AIDS in 2001, according to 
the Joint United Nations Program on HIV/AIDS. Over half a million of 
them were children. Over a million of them were women, who are the 
primary care givers in any society. There are currently over 40 million 
people living with AIDS.
  Time and time again, we have been alerted to the security 
implications of the spread of HIV. In January of 2000 the National 
Intelligence Council issued an estimate entitled the Global Infectious 
Disease Threat and Its Implications for the United States in which it 
states:

       The persistent infectious disease burden is likely to 
     aggravate and in some cases, may even provoke economic decay, 
     social fragmentation, and political destablization in the 
     hardest hit countries in the developing and former communist 
     worlds. . . . Some of the hardest hit countries in Sub-
     Saharan Africa--and possibly later in South and Southeast 
     Asia--will face a demographic upheaval as HIV/AIDS and 
     associated diseases reduce human life expectancy by as much 
     as 30 years and kill as many as a quarter of their 
     populations over a decade or less, producing a huge orphan 
     cohort.

  That same month the United Nations Security Council convened the 
first ever session on a health issue to discuss the security 
implications of HIV/AIDS.

  On October 1 of this year, the National Intelligence Council released 
another report, The Next Wave of HIV/AIDS: Nigeria, Ethiopia, Russia, 
India and China, which details the impact that HIV/AIDS is expected to 
have on those countries through the year 2010. The findings in the 
report were grim:
  International efforts to combat HIV/AIDS to date have not checked the 
spread of the disease in these countries.
  None of these five countries will be able to halt rising infection 
rates unless they channel more resources into education and health 
services--resources that these countries do not have.
  Vaccines are currently being developed and tested, however even if a 
vaccine is developed soon it will be ineffective against the HIV/sub-
types common in Ethiopia, Russia, China, India and Nigeria.
  A vaccine that is 75 percent effective would have to be given to 50 
percent of the population in order stop the spread of HIV, according to 
some experts.
  Given the security threat and humanitarian concerns that HIV/AIDS 
poses throughout the world, I wish that my House colleagues had dealt 
with all of the provisions in the Senate passed bill in a serious and 
constructive way. We need to use all of the resources at our disposal 
to deal with this threat because make no mistake, the threat is very 
real.
  There is no question that we are left with a bill that is 
significantly more parochial. However, I will say that there are some 
very good things in the legislation. First, we are able to keep the 
fiscal year 2004 authorization levels that were in the original Senate 
bill. $1.2 billion for the Global Fund to fight HIV/AIDS, Tuberculosis 
and Malaria in fiscal year 2004 is a much more realistic contribution, 
than the 2003 level.
  Second, the bill contains a provision which requires the 
administration to produce a report which outlines a comprehensive 
integrated strategy to combat the global HIV/AIDS pandemic. A 
scattershot approach will not stop the disease from spreading. In 
addition to being well funded, our programs must be well thought out.
  This bill establishes the position of Special Coordinator for HIV/
AIDS at the State Department, which I think is critical. As there are 
several agencies involved in providing assistance to fight the spread 
of HIV/AIDS overseas. In order to avoid duplication and omissions, it 
is imperative that there be an office which coordinates and oversees 
all the activities being carried out.
  Finally, the bill contains a section which asks the Agency for 
International Development to develop a plan to empower women to prevent 
the spread of HIV/AIDS. The plan is to include education for women and 
girls, and to provide access to programs which focus on economic 
independence for women such as micro-finance loans. In addition, this 
section authorizes money for product development of topical 
microbicides, medications which kill the HIV virus, that women can use 
to protect themselves without having to obtain the consent of an 
partner unwilling to use preventative measures.
  HIV/AIDS is the worst plague mankind has ever known. No corner of the 
globe is safe. It has hit hardest in the areas of the world with the 
least resources with which to respond. I would argue that we should 
help these nations on purely humanitarian grounds. To those for whom 
self-interest is a

[[Page S11546]]

stronger motivating factor, let me say this: the spread of HIV/AIDS 
poses very grave threats to economic growth and security in countries 
whose stability has a direct impact on our own. If we do not help 
address the threat now, it may well be to our detriment tomorrow. I 
urge the House to take up and pass the measure on which the Senate has 
just completed action.
  The fight is not over. Next year, I plan to reintroduce legislation 
to improve the Heavily Indebted Poor Countries Initiative so that 
countries dealing with the AIDS epidemic are better able to respond. I 
hope that my colleagues will support these efforts. It is also my 
sincere hope that the Senate will revisit the provisions that we 
dropped in order to reach compromise with our House colleagues. Failure 
to do so would be unwise.

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