[Congressional Record Volume 149, Number 25 (Tuesday, February 11, 2003)]
[House]
[Page H330]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                   FIGHTING DISEASES AROUND THE WORLD

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 7, 2003, the gentleman from Ohio (Mr. Brown) is recognized 
during morning hour debates for 5 minutes.
  Mr. BROWN of Ohio. Mr. Speaker, yesterday 1,100 people in India died 
from tuberculosis. Last month in sub-Saharan Africa, 225,000 people 
died from AIDS. Last year, more than 1 million people died from malaria 
around the world.
  The White House understands that AIDS, in tandem with tuberculosis, 
is literally the most devastating epidemic the world has seen since the 
bubonic plague of the 14th century. These diseases have killed 
millions. They have their sights set on millions more.
  The President laid out the problem well: nearly 30 million people 
have the AIDS virus in Africa; yet only 50,000 of them are receiving 
the medicine they need. The great Black Plague of Europe killed 25 
million people in the mid-1300s. Last year, there were an estimated 42 
million people living with HIV-AIDS around the world. There is little 
question that HIV, unless we take unprecedented, dramatic action to 
both prevent further spread and treat all those who require treatment 
with antiretrovirals and other medicines, will take a much greater 
social, political and economic toll than even the black plague.
  For the first time, the United States is devoting the necessary 
funding and joining the global fight against these three killers. The 
President has committed the funding, $10 billion in new money, to stem 
the growing tide of this epidemic; but we are not quite there.
  The limited number of targeted countries under the President's 
initiative and the small contribution to the global fund to fight AIDS, 
TB and malaria, $1 billion of the $10 billion, has stifled the applause 
that followed the President's announcement about how this 
administration would fight AIDS.
  The President is aiming at only 14 countries, 12 in sub-Saharan 
Africa where the devastation is greatest, and two in our hemisphere, 
Haiti and Guyana. The White House plan excludes Mexico, Bangladesh, 
Pakistan, China, India, Russia and Brazil where half the world's people 
live. It excludes 15 of the 22 high-burden TB countries which account 
for 80 percent of the world's TB population. If the administration is 
committed to addressing AIDS, it must also be committed to TB, the 
biggest killer of people with AIDS. We cannot fight one without 
fighting the other.
  Dr. Richard Feachem, executive director of the Global Fund, told me 
last week that a go-it-alone bilateral plan simply will not work. While 
economist and AIDS expert Jeffrey Sachs acknowledges the significance 
of the President's plan, he questioned the decision to limit support 
for the Global Fund. ``What has not worked is each individual donor 
planting a separate flag,'' and trying to solve the problem alone, he 
said.
  The Global Fund is a public-private partnership begun last year by 
U.N. General Secretary Kofi Annan, which draws contributions from 
governments, private corporations, faith-based organizations and 
foundations. The Global Fund already shows signs that it works. 
Government entities, in coordination with nongovernment organizations, 
submit 5-year plans. Each plan is unique to each country, not a one-
size-fits-all design which traditional foreign aid programs have too 
often been.
  The Global Fund recognizes cultural differences. What works in 
Christian Uruguay might not work in Moslem Bangladesh. No overriding, 
international political agenda is attached to the Global Fund's 
assistance. No litmus tests, only a judgment by the fund in 
collaboration with local citizens and health workers of what works best 
in each country.
  The Global Fund demands quantifiable results. The money supports 
activities, including access to health care services and purchase of 
drugs. If a country or an NGO fails to show results within 2 years, the 
money is cut off. Although 60 percent of the Global Fund's money goes 
to HIV-AIDS, 20 percent goes to TB and another 20 percent roughly to 
fight malaria. Fighting these diseases together is a cost-effective 
approach. For example, the infrastructure created in the treatment of 
TB has been proven to help in the treatment of AIDS, malaria and other 
diseases. To cure TB, a patient takes medication every day for about 6 
months given to him by a health care worker at a clinic or by a health 
care worker who has traveled to his home. Unlike a smallpox vaccine, 
regular interaction between health care workers and patients is 
necessary to cure TB.
  If we fully commit to the Global Fund, that means a minimum of $500 
million per year, 2 million patients will be treated for TB over the 
next 5 years, most of them for less than $100. Our investment in the 
Global Fund, rather than a unilateral U.S.-waged effort, will help 
leverage support from other countries.
  Funneling U.S. dollars through U.S. programs alone will not do much 
to promote a united global front against this global killer. In a very 
short time, the Global Fund has shown it is capable of tremendous 
progress. In the first two rounds of grants, the fund has approved 160 
proposals in 85 low-income countries.
  With significant U.S. funding, the fund will continue to support 
countries committed to addressing the epidemics killing their people. 
Without U.S. leadership, it will be a fund in name only and AIDS, TB, 
and malaria will remain a virtual death sentence in the developing 
world.

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