[Congressional Record Volume 149, Number 64 (Thursday, May 1, 2003)]
[Senate]
[Pages S5641-S5643]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         THE HIV-AIDS EPIDEMIC

  Mr. DeWINE. Mr. President, a number of us had the honor of attending 
an event at the White House on Tuesday in which President Bush urged 
Congress to act quickly in passing an emergency plan for global HIV/
AIDS relief.
  I come to the Senate floor this afternoon to applaud the President 
for his remarks and for his continuing commitment to ease the worldwide 
suffering caused by the HIV/AIDS epidemic around the world.
  I also want to thank Secretary of State Colin Powell and also my 
colleagues in both the House of Representatives and in the Senate for 
their leadership in fighting this dread disease. There are so many 
people to thank. Let me commend Senators Lugar, Biden, Frist, Santorum, 
Durbin, and Kerry for their tireless efforts and their dedication to 
this fight, as well as Congressmen Henry Hyde and Tom Lantos for their 
great leadership and their great vision. I am encouraged by what they 
have done with their leadership.
  I believe we will soon pass a comprehensive global AIDS relief 
initiative. As the President said, time is not on our side. It is 
imperative that we in the U.S. Congress move quickly. As President Bush 
so correctly said on Tuesday:

       Fighting AIDS on a global scale is a massive and 
     complicated undertaking. Yet, this cause is rooted in the 
     simplest of moral duties. When we see this kind of 
     preventable suffering--when we see a plague leaving graves 
     and orphans across a continent--we must act.

  The President of the United States is absolutely right. This is a 
moral issue. We as a nation and as a people have an obligation to act. 
We as a nation and we as a people have the ability to fight this 
disease. We have the tools. And it is our duty and it is our obligation 
to help ease this grave and global public health crisis.
  In February, I made my 12th trip to Haiti and my first visit to 
Guyana, both nations in our hemisphere that President Bush has cited as 
countries in dire need of our assistance to fight this HIV/AIDS 
problem. We traveled there to learn more about the AIDS situation and 
determine what kind of health infrastructure is in place to fight the 
disease. What we saw in these visits was devastating, with so many 
children and adults dying of this horrible disease and too few drugs to 
go around to help treat them and keep them alive.
  Without question, HIV/AIDS is a human tragedy of grave proportions--
not just in Africa but right here in our own backyard in our own 
hemisphere.
  When you travel to the AIDS-infested regions of the world, as my wife 
Fran and I have, and as so many of my colleagues here in the Senate 
have, such as Majority Leader Frist, Senator Inhofe, Senator Durbin, 
Senator Nelson of Florida, and Senator Chafee, when you see the 
children with AIDS, when you hold them, when you touch them, when you 
talk to the people who care for them, when you know that these children 
will in all likelihood die, it truly does change you forever. Then when 
you leave those countries, and when you leave those children, you know 
you cannot just leave; you know you have to try to do something to 
help.

  Our trip in February reinforced what we already knew about the 
devastation of the disease in Haiti, and allowed us to see what efforts 
are now underway in Guyana.
  This afternoon, I would like to take a few minutes to tell my 
colleagues about what we learned on that visit.
  I was pleased that Senator Chafee and his wife Stephanie were able to 
join Fran and me on that trip. We learned a great deal about what is 
and what is not being done in both of these impoverished nations.
  We were fortunate to have Senator Durbin and Senator Nelson of 
Florida and his wife Grace and Congressman Kendrick Meek join us on an 
earlier trip to Haiti in January, where we saw the tragic effects of 
the abject poverty and disease that engulfs Haiti today.
  While there is certainly some miraculous work being done in Haiti to 
ease the suffering--work done by people such as Father Tom Hagan and 
his organization Hands Together--there remains so much work to be done.
  When you view the HIV/AIDS rates in Haiti and Guyana in the context 
of the disease's overall prevalence rate in our hemisphere--Haiti has 
the highest rate and Guyana, either the second or third highest rate--
the moral imperative of helping these two troubled nations becomes 
absolutely crystal clear.
  In Haiti today, a nation of approximately 8 million people, 300,000 
currently live with AIDS--300,000 people out of a country of 8 million 
people.
  Guyana follows close behind. In Guyana, a nation of roughly 800,000 
people, 35,000--35,000--have been identified as HIV positive or as 
having AIDS. Of those 35,000 people who have been identified as HIV 
positive or as having AIDS, only 200--less than 1 percent--are getting 
antiretroviral drug treatment. Of those 200, only one--only one--is a 
child. So virtually none of the children in Guyana are getting any kind 
of drug treatment at all--virtually none. Only one child in all of 
Guyana is getting any drug treatment for AIDS. What a great tragedy.
  Consequently, the disease is having a devastating impact on these 
nations, and especially on the children.
  In Haiti, there are more than 150,000 orphans due to AIDS. This 
number has been increasing for over a decade and is expected to rise 
even more. Specifically, the percentage of Haitian AIDS orphans has 
gone from 7 percent in 1990 to 43 percent in 2001 and is estimated to 
increase to 49 percent by 2010. That will be a sevenfold increase in 20 
years.
  Rates are equally troubling in Guyana. In 1990, there were no 
children orphaned due to AIDS, none, but by 2001, 21 percent of the 
orphans were the result of AIDS, and that number is projected to double 
to 41 percent by 2010.
  Not only is AIDS orphaning these children, but many of them are also 
suffering from the disease.
  Today, in Haiti, there are hundreds of orphanages spread throughout 
the country, hundreds actually just in the capital of Port-au-Prince, 
but there are less than just a handful that are serving or even taking 
care of children who have AIDS or who are HIV positive.
  We visited one of these orphanages in February, one of the orphanages 
that is taking care of children with AIDS. It is a wonderful place. It 
is a place called Arc en Ciel or ``Rainbow House Orphanage.'' This is a 
place that is doing just wonderful work.

  A Canadian couple--Danielle and Robert Penette--came in and restored 
the home there, and today it is a wonderful, bright, cheery, clean, and 
beautifully maintained orphanage for about 37 Haitian children. I think 
about 30 of them actually are HIV positive or already have AIDS.
  What we saw there was truly inspiring: children playing, laughing, 
and learning in the classroom. They sang songs for us. They were happy 
and healthy and content. They did not seem like orphans at all really 
but more like one big happy family--one healthy family. It was hard to 
imagine that any of these little children were sick at all.
  But of the HIV-positive children at the Rainbow House Orphanage, 
about 15 of them are currently in need of antiretroviral drugs. Those 
15 children, fortunately, are now receiving these drugs.
  One of the important lessons we learned about these children and 
about the Rainbow House is that by providing these drugs, and by 
providing love and consistent nutrition--this good health care--clean 
water, the Penettes, this wonderful couple, are making an unbelievable 
impact on the quality of life for these very sick children.
  What they, in effect, are doing is prolonging the time it takes 
before these children actually need to be on AIDS treatment drugs. So 
half the children are not even on the drugs yet. Half of them are on 
the drugs.

[[Page S5642]]

  There are other places in Haiti, places where there are good, decent, 
loving people, such as the Penettes, who are also working miracles.
  For example, at another orphanage we visited in January, we saw 
wonderful people doing the best they could to care for some very sick, 
very malnourished children. At this particular orphanage, many children 
are brought there who are on the verge of death. The parents bring them 
there to try to save them.
  The good people who run these orphanages--saints really--love these 
children. They care for them. They feed them, give them what little 
medicine they have access to. These people bring many of these dying 
children back to life. They save them and they nourish them.
  But, tragically, for many of these children, they have AIDS. 
Unfortunately, the people who care for them in these orphanages--these 
other orphanages--do not have access to what the Penettes have; that 
is, the lifesaving drugs, antiretroviral drugs to keep these children 
with AIDS alive.
  They can give them love. They can give them food and clean water--and 
that helps--but they cannot give them the drugs that ultimately will 
save them.
  At this orphanage that Fran and I saw, they have an entire floor just 
for children--these young babies with AIDS. What you see when you go 
there really does change you forever. It is truly tragic--row after row 
of steel cribs with babies at various stages of disease, none of whom 
are receiving any sort of antiretroviral drug treatment.
  I remember seeing a little boy. He was about 4 or 5 years old, a 
little boy whose name was Francois. He had AIDS. The day we were there, 
when we saw him, he was very close to death. He was laid out on a 
makeshift bed on the cold, concrete floor. He had an IV attached to 
him, and he was getting some fluids.
  The wonderful people who were caring for him explained that he was no 
longer able to keep any food down. They explained to us that he would 
probably die within a couple days.
  There were no drugs available to treat him. So the people who were 
caring for him, were loving him, nurturing him, were doing what they 
could to give him the love they could and to make him as comfortable in 
the little time this poor little boy had remaining. I will not ever 
forget that little boy. I will not forget him for the rest of my life. 
I don't think anybody else who was in our group and who saw that little 
boy will forget him either.
  Another little boy I won't forget was about 7 years old. He also had 
AIDS. But he appeared to be, when you looked at him, very healthy. He 
was lively and content and thriving. But when we talked to the people 
in the orphanage, sadly we found out that will not last because this 
little boy also has AIDS. Very likely, unless something changes, unless 
drugs are made available to him, this little 7-year-old boy, who I also 
can't get out of my mind, will also eventually die.
  His death will be a needless one because these drugs are available. 
It is just that the folks caring for this little boy do not have access 
to them. Money is not available. The drugs are not available. That is 
an injustice. It is wrong. It is a human tragedy.
  When we see children who are healthy now and who could remain healthy 
if treated properly, we feel so helpless because we know they are 
eventually going to die if we don't do something. That is why we must 
try to do something. I believe we must take action to save these 
children.
  This is one of the children my wife Fran and I had the opportunity to 
see at the orphanage I just described in Haiti. This is one of the 
little children who does in fact have AIDS. This is one of the little 
children who does not have access today to the drugs that will save 
this child. So when the President talks about a moral imperative, as he 
so eloquently does, and says we in the United States have a moral 
obligation to stop the suffering, to reach out and help these children, 
these are not just statistics. These are children who are in Africa, 
Asia, Haiti, Guyana. This is just one of the real faces of the 
children.
  This is a picture of one of the many AIDS babies we saw and actually 
held when we were in Haiti. When you look at that innocent, helpless 
little child, a child who has acquired AIDS through no fault of her 
own, you realize we as a Nation have a moral obligation to help. 
Children like this little girl, who in all likelihood may have already 
died in the time that has passed since we were in Haiti, will continue 
to die because they are not getting the drugs they need. These drugs 
are available, but they are not getting them.
  It is clear we are not doing enough. It is also clear this Congress 
must act. We cannot just walk away from nations such as Haiti and 
Guyana and these children and say this problem is too big for us to 
fix. We cannot walk away and say these are resource-strapped Third 
World countries and there is nothing we can do. We cannot walk away and 
say we should not funnel more resources into those nations because it 
will be too difficult to get compliance with the reforms; in other 
words, that lack of education and a weak and feeble infrastructure will 
impede any progress. We cannot walk away and simply say these are poor 
people, illiterate people, and we cannot teach them how to take the 
drugs. We cannot walk away and say there is no hope, because the 
evidence is that is not true. There is hope.
  The evidence is good doctors have already demonstrated, in countries 
like Haiti, that no matter how poor, how illiterate, people can take 
the drugs. They can do it very well and effectively, and their lives 
can be saved. In fact, doctors in Haiti have already demonstrated--Dr. 
Pape, Dr. Farmer, who I will talk about in a moment--through the 
compliance rate, in other words, the rate people taking these drugs and 
doing it consistently and saving their own lives, that they can do it 
just as well as you or I can do it in the United States or someone who 
has AIDS in the United States can do it.

  The fact is, despite the enormity of the despair, there is an equal 
if not greater amount of hope. There is hope because we can help. There 
is hope because a great deal is being done already. In Guyana, there is 
an energetic President, President Jagdeo, and a dedicated health 
minister who are committed to fighting this disease and building a 
health infrastructure in their nation that will in fact save lives. 
They have a long way to go, but I am encouraged by their current 
education efforts and by their commitment to getting more drug 
treatment into their nation. As they work to build this infrastructure, 
they can learn a great deal from the success stories in Haiti. I will 
tell you a couple.
  First there is Dr. Bill Pape who was with us at the White House just 
2 days ago and who the President talked about and cited as a great 
example. He is director of GESHKIO, a health organization with 27 
clinics in the Port-au-Prince area dedicated to the prevention and 
treatment of AIDS. I met with Dr. Pape several times in the past. I am 
always amazed at what this man has accomplished. Through his work, Dr. 
Pape is showing that in places as poor as Haiti, a nation with an 
average yearly per capita income of only $250, a nation where there are 
very limited health resources and, frankly, a nation with all kinds of 
problems with the government, HIV treatment and prevention can and does 
work.
  At the 27 GESHKIO clinics, they see over 11,000 children, of whom 589 
are HIV positive. Sadly, of those children, only 29 are currently on 
antiretroviral drugs, but that is changing. At the same time, GESHKIO 
is working hard to treat infected mothers to help prevent mother-to-
child HIV transmission.
  At Dr. Pape's clinics, they have found 30 percent of children were 
being born with HIV/AIDS if the mother was HIV positive and not 
receiving treatment. But of the HIV-positive mothers receiving 
treatment, only 8.7 percent of the children born are HIV positive. 
Clearly, this shows what can be accomplished, and this is one of the 
President's major initiatives--the mother-to-child transmission. It 
shows what you can do when you can go from a 30 percent AIDS incidence 
to at least 8.7, and possibly even lower. Think of all the children 
whose lives are being saved, who are not getting HIV, who are not HIV 
positive because of that.
  Mr. President, the medical science is clear: If we can reach these 
mothers

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early enough before they give birth to that child who will have AIDS 
because the mom has AIDS, and if we can get medical treatment to the 
mother and get her the proper drugs, we can save that child. We can 
save that child at comparatively little economic cost. We should think 
of the savings not just in dollars and cents, but in lives saved.
  I was pleased to have the opportunity in February to also meet with 
Dr. Paul Farmer, who is fighting AIDS in the rural and remote parts of 
Haiti. He runs an organization called ``Partners in Health'' and 
operates clinics in Cange. Dr. Farmer is making tremendous progress. 
Since 1999, his organization has tracked a population of 3,500 HIV/AIDS 
patients and has been able to treat more than 350 of them with 
antiretroviral drugs. Of those receiving drugs since 1999, zero 
percent--no one--has died. Yet, tragically, of those not receiving drug 
treatment, 35 percent, so far, have died.
  Both Dr. Pape and Dr. Farmer have received grants from the Global 
AIDS Fund to supplement their efforts. And I point out that money is 
being put into proven organizations that can get the job done. This 
tells us we are willing to invest efforts that are working and making a 
difference and saving lives. While Dr. Farmer and Dr. Pape have 
empirically proven there is success in treatment in a Third World 
nation, and there is hope, we still must do more. We must act, and we 
must act now.
  I am encouraged we have moved forward in terms of our AIDS spending 
level--a level that has gone up significantly over the last few years. 
I compliment my colleagues on the Appropriations Committee, and 
particularly Senator Ted Stevens for his efforts and dedication to 
increasing our funds to fight AIDS.
  Earlier this year, Senator Durbin and I were successful in amending 
the fiscal year 2003 omnibus appropriations bill to include an 
additional $100 million to fight the global AIDS pandemic. That money 
will go a long way. If that money is used to implement a holistic 
approach to fighting AIDS, I believe we can make significant advances 
worldwide. That means focusing funds on education and prevention and 
treatment--treatment in terms of mother-to-child transmission, 
treatment of mothers who already have children, and treatment of all 
infected adults. This type of comprehensive approach can and will make 
a difference.
  Let me turn my colleagues' attention to two other photographs from 
our recent trip to Guyana. You will see two men who are stricken with 
AIDS. They are patients of the only public hospital in that nation's 
capital of Georgetown. When you look at these pictures, you can see the 
anguish in these poor men's eyes. You can see their suffering and you 
can certainly see their heartbreak. This shows you the ward in this 
hospital in Georgetown. This poor gentleman has AIDS. Though the 
staggering and shocking statistics can be at once overwhelming and 
seemingly unreal, when you hold babies dying from the disease, or when 
you see the real faces of these men, the people suffering, as in these 
photographs, it has to move you. It changes you. It certainly makes the 
statistics real.

  Mr. President, in a guest column recently in the Washington Post, 
prominent AIDS activist Bono quoted something President Harry Truman 
once said. This is what Truman said:

       I trust the people because when they know the facts, they 
     do the right thing.

  That certainly is the case, I believe, when it comes to the global 
AIDS problem. We have the opportunity to do the right thing. I believe 
we will do the right thing.
  The House plans to take final action on its bill today, and I am 
encouraged by the continued good-faith efforts of my colleagues in the 
Senate. We are moving forward on a bipartisan basis. The majority 
leader, Dr. Bill Frist, has been a real leader in this. My colleague, 
Senator Lugar, on a bipartisan basis, is working with others and moving 
forward on this as well. I am encouraged that we will be able to get a 
bill put together.
  Mr. President, every 50 seconds a child somewhere in the world dies 
of an AIDS-related illness, and another becomes infected with HIV. We 
have to do something to stop this. The United States has an obligation 
to lead this fight, and we are leading it and moving forward. I look 
forward to continuing to work with my colleagues as we move ahead. It 
is our duty, it is our moral obligation, and it is the right thing to 
do.
  I yield the floor.

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