[Congressional Record Volume 149, Number 17 (Thursday, January 30, 2003)]
[Senate]
[Pages S1814-S1816]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 250. A bill to address the international HIV/AIDS pandemic; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DURBIN. Mr. President, I rise today to draw the attention of the 
Senate and those following this proceeding to a global emergency many 
of us believe the last Congress did not adequately address.
  Imagine the public reaction that would ensue if every year the United 
States lost a population the size of the city of Chicago to HIV/AIDS-
related deaths; if every year the United States lost the number of 
children equal to the population of this city, Washington, DC, to HIV/
AIDS-related deaths. This is the reality the world faces.
  Imagine how bad the situation would have to be in the United States 
for the public to accept an HIV-positive muppet on Sesame Street, the 
popular television show geared to little kids ages 2 to 4. This is the 
reality of children's TV in South Africa.
  In 2001, 662,000 children lost either one or both parents to AIDS in 
South Africa.
  In 2002, 3 million children, defined as 15 years of age or younger, 
were reported to be living with AIDS in sub-Saharan Africa; 800,000 
children worldwide were newly infected with HIV last year.
  Last weekend I went with several of my colleagues to Haiti. The 
reason for that trip had a lot to do with a well-known rock singer 
named Bono whose group U2 is legendary in rock-and-roll history. But he 
has taken on a special mission, not only to make music, but to make the 
world more aware of the HIV/AIDS crisis. He is a very likable fellow. 
He has been a great lobbyist. This Irishman comes to Capitol Hill and 
opens every door.
  In my office, when he came to see me, I couldn't get over how many of 
my staffers took a great interest in HIV/AIDS just to be in the room 
when he sat down and talked about it. He has done such spectacular work 
with Democrats and Republicans, the executive branch, and the 
legislative branch. Then he had a tour, which was scheduled about 2 or 
3 months ago, in the Midwest. The tour was really to speak to the 
heartland of America about this issue of HIV/AIDS. He came to my City 
of Chicago. I was proud to meet with him and a group of African 
American clergy.
  Then he went out to a very conservative piece of real estate near the 
City of Chicago, the great Wheaton College. Wheaton College was where 
Billy Graham took his training before he went into the ministry. 
Wheaton College has a reputation of being pretty conservative, high-
minded in their values, dedicated to their religion and their belief. 
And they invited him, this outspoken Irishman, to speak to them about 
HIV/AIDS. It was a great presentation.
  At the very end there was some music, but most of it was very serious 
in that people talked about their life experiences. The thing I 
noticed, as the presentation was made, was that one of the doctors 
said: You Americans tend to want to look across the ocean for HIV/AIDS. 
You have it here in the United States, and don't forget it. But you 
also have it in your hemisphere in Haiti in a way that most people 
don't even appreciate.
  Last weekend I traveled to Haiti with several of my colleagues, 
including Senator Bill Nelson of Florida. But the leader of our codel 
was Senator Mike DeWine, a Republican of Ohio, and his wife Fran. Let 
me just say something for a moment about Mike DeWine. Mike and I had 
been friends since we were both elected to the House 20 years ago. He 
left for a period of time and ran for Lieutenant Governor of Ohio, then 
came back as a Senator from that State.
  Most people don't know Mike and his wife and family have a particular 
interest and dedication to Haiti and the poor people who live there. 
This trip was their eleventh trip to Haiti. Many Members of Congress 
are lucky to go to the same place far away once or twice in a lifetime. 
Think about the fact that Mike and Fran, people on their staff, 
continue to return to one of the poorest places on earth over and over 
and over again. It isn't just to take photographs. In fact, they do 
very little of that. It is to bring bags of toys and soccer balls, 
basic items, medical and otherwise, that the poorest people in our 
hemisphere need, to visit programs like one called Hands Together. 
Hands Together is something I never heard of before I got to Haiti, but 
I met Father Tom Hagan, who is the leader of Hands Together in Haiti, 
and Doug Campbell, his executive director, and they showed us a center 
which they have created in

[[Page S1815]]

one of the poorest slums on earth. It is called Cite Soleil. My French 
translation would be Sun City. But it is not always sunny in this city 
for the tens of thousands who live in the worst poverty.

  They created this little school and community center to teach 
children how to read and write on the condition that their parents also 
come in and learn. They provide basic food for these children. They 
invite in senior citizens who come in for the only meal of the day that 
is worthwhile, and they try to give them some encouragement and maybe 
some basic things they need to survive.
  They told us a story about the senior citizens being brought to the 
center. There is no place for them to go in this terrible slum. When 
they first started bringing them in, most were brought in in 
wheelbarrows. They could barely walk. The life expectancy in Haiti is 
51 years of age. If you are 60 or 70--I met people who are even older--
it is a rarity, but you obviously have some good genetics. But they 
were still struggling.
  At their center with Hands Together they offered these senior 
citizens a basic meal. I saw it. It was beans and rice with a few 
little peppers on the top of it, and a vitamin pill. In a matter of 
weeks, these same elderly people, who could barely walk and were 
brought in in wheelbarrows, were up and moving around, thanks to Hands 
Together and to Father Hagan.
  There is also the center where the kids are educated, called the 
Becky DeWine Center, named after Mike and Fran's late daughter. It is 
wonderful to see those children come in in their uniforms, 6 days a 
week. They want to be there, learning.
  The reason I tell you this as background is that amidst all this 
poverty, Haiti faces an AIDS epidemic which is unparalleled in our 
hemisphere. When Bono visited Wheaton College, he said to the students: 
This is a global crisis. It is in our backyard in the Caribbean. It is 
all across Africa. It is moving across India and Russia and China. We 
have to do something about it.
  It was that piece of information that led me to go to Haiti. I am 
glad I did. We set up a meeting at the ambassador's residence. 
Ambassador Brian D. Curran is our career ambassador. Previously he had 
been the ambassador to Mozambique. He let us meet with Bill Pape, who 
is known as ``Dr. Pop'' in the French pronunciation. What an impressive 
man. Here was a man who told us how he had decided as a public health 
leader in one of the poorest countries to try to eliminate the deaths 
of children, infants, from diarrhea, a terrible problem in the Third 
World. These poor children, who drink water that is contaminated, get 
sick with diarrhea and throwing up, become dehydrated and die.
  They put together a program that has virtually eliminated that as a 
challenge in Haiti. I am impressed. That is a big undertaking, and a 
lot of success was demonstrated. Now Dr. Pape and his organization, 
known as GHESKIO, an organization that is one of the earliest in terms 
of commitment to dealing with HIV and AIDS, have received a $10 
million-plus grant from the Global AIDS Fund to take on the AIDS 
epidemic in Haiti. Already he is able to demonstrate on the chart that 
just their first year or two of activity, the AIDS rate of infection is 
starting to come down ever so gradually. He believes he is on the right 
course to deal with this epidemic.
  Do you know where the Global AIDS Fund money comes from? Some of it 
comes from us, taxpayers who contribute to the Global AIDS Fund. As we 
contribute and he is successful, fewer children are infected; fewer 
children are orphaned. There is more hope for their future.
  I left that visit to Haiti inspired again, as I am every time I visit 
some of the poorest places in the world. You might think it is 
depressing to see people living in the worst squalor imaginable, to see 
them holding beautiful little babies as they stand right next to open 
sewers that pigs are rooting through, to see dogs that are so skinny 
they can barely walk, to see the living conditions which are so 
horrible. You would think that would be so depressing, but you will 
find in every one of these places stories of courage, not just the 
mothers and fathers struggling to keep the family together, but people 
like Father Tom Hagan and Hands Together and Doug Campbell who come 
into that setting and say: Let us help.
  There are many others. I just mentioned Hands Together. There is 
World Vision, CARE, Catholic Relief Services. The list goes on. Thank 
goodness they are there. I am glad I had a chance to see it.
  When we came back here to Washington, I came back with a renewed 
dedication and determination to really work on this issue of global 
AIDS.
  Today, I am introducing the Global Coordination of HIV/AIDS Response 
Act. The 107th Congress failed to pass AIDS authorizing legislation. We 
should have. President Bush has said in his State of the Union Address 
that AIDS will be a top priority in terms of global health.
  I am a proud Democrat. I take exception to many things this President 
has done. Let me be the first to stand up and cheer President George W. 
Bush. That was the right thing to do. That is the right thing for 
America to do. I will be standing by his side whenever he needs me. I 
hope we all join him. The United States should lead the world in 
fighting this epidemic.
  The President said he is going to commit $15 billion over the next 5 
years to his new emergency plan for AIDS relief. He said only $10 
billion of this is new funds. We need to sit down with OMB and see what 
that actually means. The funding sources may be somewhat blurry, but 
the commitment was made, and that is a wonderful step forward.
  I also want to say that the Secretary of State, Colin Powell, has 
been an exceptional leader on this issue. He has taken grief for it 
because it involves some issues of controversy here in the United 
States.
  Uganda--where I visited several years ago--successfully fought the 
AIDS epidemic with what they call the ABC plan, a public health 
education plan which doesn't have a lot of money for wonder drugs, but 
it has a lot of determination and resources dedicated to fighting AIDS. 
The ABC plan is very basic in countries with limited education, limited 
resources: A, abstinence when it comes to sexual activities; B, to be 
faithful to one partner; C, if you are going to ignore the other two, 
use a condom. It is that simple.
  The PRESIDING OFFICER. The Senator has exceeded the 10-minute limit.
  Mr. DURBIN. I ask unanimous consent for an additional 10 minutes.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. DURBIN. Secretary of State Colin Powell has been open and candid 
about using all of these things to deal with AIDS. When I told him 
Senator Mike DeWine and I had been successful on the Senate floor in 
putting in $180 billion more on the global AIDS fight, a big smile 
crossed his face.
  Today, 42 million people worldwide are living with HIV/AIDS--5 
million were newly infected last year. We have seen 3.1 million AIDS-
related deaths in 2002. Each year, AIDS deaths claim more than the 
entire population of Chicago. Life expectancy has dropped below 40 
years of age in 10 countries in sub-Saharan Africa. AIDS has already 
erased 15 years of progress in the worse affected countries. Despite 
our efforts to date, this epidemic continues its deadly spread across 
the globe. As the disease spreads, unraveling social structures and 
decimating populations, the national security implications for the 
United States multiply--in number as well as intensity.
  Last year, the National Intelligence Council released a report 
supplying grave statistics for ``the next wave.'' In 5 of the world's 
most populous countries, the number of HIV-infected people will grow 
from 14 million to 23 million currently to an estimated 50 million to 
75 million by 2010.
  The disease infiltrates national armies, as well as the public 
sector, weakening the country's ability to govern and respond to 
regional threats. As the number of infections grows, the cost of 
fighting HIV/AIDS overwhelms national governments and competes for the 
same funds they need to maintain their economy and basic social 
structure.
  Most governments face a lose-lose situation: Either they fight AIDS 
and underfund the infrastructures necessary to sustain continued 
immunity, or they continue to build the infrastructures while HIV/AIDS 
decimates

[[Page S1816]]

any progress, and they fall victim to it and watch their state crumble.
  On every continent, AIDS is traveling along social fault lines and 
exploiting the weaknesses, hurting both lives and economies.
  HIV/AIDS is a national security issue that is as important to our 
time as the war on terrorism. It is an economic issue, a health and 
safety issue, and it is a moral issue. Without comprehensive action, 
the HIV/AIDS epidemic will worsen, demanding even more attention and 
funding. That is why I introduce this bill to reset global AIDS as a 
top priority in this Congress.
  The main purpose of the bill is to provide a comprehensive response 
to the AIDS pandemic and acknowledge the growing need for resources. In 
the form of specialized initiatives, my bill will focus on the growing 
number of AIDS orphans, the lack of health professionals in AIDS-
ravaged countries, and the lack of access to affordable treatment for 
the majority of those afflicted with HIV/AIDS.
  I have designed the Global CARE Act to achieve four major goals: 
Better coordination of our own agencies in fighting global AIDS; the 
provision of programs that address all components necessary to support 
a comprehensive response to HIV/AIDS, including prevention, treatment, 
care, and investment in broader health systems and national economies; 
increased accountability for the health and policy objectives we will 
seek to achieve with our financial and human investment; and the 
ability to mobilize the most effective human capacity-building tools to 
address the HIV/AIDS pandemic.
  Last year, I introduced a version of this bill which authorized $2.5 
billion in global AIDS spending for fiscal year 2003. For fiscal year 
2004, I have proposed authorization levels of $3.35 billion. The United 
States, unfortunately, only contributed $1 billion to fighting this 
epidemic in 2002. With the passage of the Durbin-DeWine amendment, the 
Senate allocated $1.525 billion in its fiscal year 2003 appropriations 
bills. This is a breakthrough--a 50-percent increase by the United 
States in its commitment.

  But these funding levels are still far short of the goal. To meet the 
need, our target for fiscal year 2004 should be in the $3.35 billion 
range. Frankly, when you look at the world this year, the global need 
just to fight HIV/AIDS stands at $8.2 billion. Despite these good 
efforts by the United States, we can do more. But other countries in 
the world can do more as well. Let them join the President and the 
Congress in our commitment to this fight. We have been shortchanging 
this epidemic for too long. We take tiny steps in pursuit of a 
challenge that is racing away from us.
  Because the spread of this disease remains in its infancy, we have to 
look at it in more serious terms. We must do more for the 42 million 
people worldwide who are living with HIV/AIDS, and we have to 
understand that the disease is not going to wait for our political 
determination.
  A 15-year-old boy in Botswana faces an 80-percent chance of dying 
from AIDS. We have to change his future. To do that, the Global CARE 
Act addresses this epidemic aggressively and honestly. I hope this bill 
will provide a basic blueprint for the United States, and I hope we can 
join on a bipartisan basis in passing it. I hope my colleagues who read 
my remarks and follow this debate will believe, as I do, that the 
President has given us a great opportunity on a bipartisan basis to 
stand together and tell the world that this caring Nation is committed 
to dealing honestly and effectively with the global AIDS crisis.
                                 ______