[Congressional Record Volume 149, Number 78 (Friday, May 23, 2003)]
[Senate]
[Pages S7119-S7121]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
GLOBAL HEALTH AND THE PRESIDENT'S BUDGET
Mr. LEAHY. Mr. President, I rise to speak on a far more serious
matter. I listened to the speech the President gave at the Coast Guard
Academy a few days ago. I must say that this Democrat agrees with so
many of the things the President said. I was especially pleased to hear
him speak about the importance of foreign aid to America's security.
But I became concerned after I looked behind the rhetoric of the
President's speech. I wanted to see if the President's own budget
request reflected his words. It does not.
At the Coast Guard Academy, the President spent a good deal of time
talking about the global AIDS crisis, the worst public health threat in
human history. I commend President Bush for that. He has shown great
leadership on AIDS, although a bipartisan group in Congress has been
pushing for action on AIDS for years.
The bill we passed last week, an authorization bill, authorized $15
billion over 5 years to combat AIDS , tuberculosis and malaria. It is
an important step forward. It showed that we are beginning to take the
AIDS pandemic seriously. But before we all applaud ourselves and pat
ourselves on the back, let's have a dose of reality. This was an
authorization bill. It does not appropriate any money.
For all intents and purposes, it is like writing a check without
enough money in the bank. I can recall a meeting on a different subject
where someone was offering a pledge of close to $1 billion to fund an
initiative. Kidding around, I said: I will double that. I will give you
my check for $2 billion. In fact, I had $138 in a checking account.
That is what we have done here. By passing the AIDS authorization
bill, we have promised to write a check without enough money in the
bank.
Let me explain. The President's budget request contains only about
half of the $3 billion authorized for AIDS for fiscal year 2004. It
remains to be seen whether the promise of that bill--a promise with
which I agree--will be fulfilled. To do that, the President is going to
have to submit a budget amendment for the balance of these funds.
It also remains to be seen whether the Foreign Operations
Subcommittee will get the allocation that supports that amount.
The bill we passed also authorized $1 billion for the global fund to
fight AIDS and TB and malaria. Again, another promise. For fiscal year
2004, the President has only budgeted $200 million for the Global Fund,
that is one-fifth of the amount we authorized. In addition, it is a cut
of $150 million from what was appropriated last year.
There is another problem. While the President's fiscal year 2004
budget for foreign operations does include approximately $1.2 billion
to combat HIV/AIDS, it robs Peter to pay Paul to pay for increases in
HIV/AIDS programs, as the President's budget cuts other essential
international health programs anywhere from 5 to 63 percent.
Let's take a look at the chart. The information on this chart,
incidentally, is from the United States Agency for International
Development.
Child survival and maternal health programs are cut by 12 percent.
These are the programs that provide lifesaving child immunizations.
They also help to reduce needless pregnancy-related deaths each year.
People will be astounded when they hear how many of these types of
deaths occur each year. Six hundred thousand deaths. Many of these
deaths could be easily prevented if we just put more resources into
these programs. Instead, the President's budget cuts these programs by
12 percent.
It would cut programs for vulnerable children by 63 percent.
It would cut programs to combat other infectious diseases such as
measles.
Measles kill 1 million children--not 100,000 or 200,000--but 1
million children a year. Again, this is something which is easily
preventable. Every one of us can just go to the doctor's office and get
our children and grandchildren immunized against measles. In many poor
nations, parents and grandparents do not have that luxury. They need
our help.
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Does the President's budget show leadership on this issue? No. It
cuts the programs which help combat measles, as well as polio, SARS,
and other deadly diseases by 32 percent.
These are not my numbers, these are the administration's numbers.
These numbers are in the President's budget.
Are we in favor of stopping children in poor countries from dying of
measles? Of course we are. Are we in favor of fighting SARS? Of course
we are. Are we in favor of fighting polio? Of course we are. Who is
going to say they are against it? No one.
But, when you look at this budget, there are cuts to these and other
critical international health programs. These cuts also include
programs for disease surveillance. In the past, these funds for disease
surveillance have been used to strengthen the World Health
Organization's ability to respond quickly to outbreaks like SARS.
Everybody in this Chamber knows we will have another outbreak of
either SARS or, perhaps, something far worse. There is no question that
we need disease surveillance programs, because every one of these
diseases is just one airplane trip away from the United States. Why
would we want to cut funds for these programs?
The President's budget would also cut funds for drug resistance,
which is a looming public health crisis. Many lifesaving antibiotics
are already virtually useless because of resistance caused by the
misuse of these drugs. The President's budget cuts funds to combat drug
resistance.
While the President's budget would increase funding to combat AIDS--
although nowhere near the amount promised in the bill we passed last
week--it does so by cutting the budget for other global health
programs.
These cuts will hurt children the most in countries where vaccines
costing a few pennies make the difference between life and death. That
is not acceptable.
If somebody said to us, look at those five children, you can save
their lives by spending a dollar, would we do it? Of course, we would
do it. Why then does the President's budget do the opposite by cutting
these programs? I find this deeply troubling.
These are not Democratic or Republican programs. I have been joined
time and again by colleagues on the other side of the aisle who support
these initiatives in both the Senate and the House.
Mr. President, anyone who knows anything about public health knows
that building the health infrastructure in developing countries is
essential if you are going to effectively combat AIDS. It is the same
thing with child nutrition. It is the same thing with maternal and
reproductive health. You don't fight AIDS in a vacuum. It isn't an
either/or proposition. People who are malnourished, who are in poor
health, who have weak immune systems, who are at risk of other
infections, are far more vulnerable to AIDS. It is common sense.
In addition to helping to combat AIDS, these international health
programs are vitally important for their own sake. They save millions
of lives for very little money. They fight diseases that we eradicated
in the U.S. years ago. When I was growing up, the municipal pool would
close in the summer because of polio. You never hear of such things
anymore. We should be doing the same thing overseas with these types of
diseases--making them a thing of the past.
Over the past 5 years, we have built up these global health programs,
and each year they yield more and more results. It would be
unconscionable to cut these programs. But that is exactly what the
President is asking Congress to do--cut these programs.
Last week, Republicans opposed our amendments to correct some serious
problems in the AIDS bill--problems they acknowledged. They said we
could not take time to get the bill right, because we needed to act
quickly so the President could point to this bill as a sign of U.S.
leadership at the Group of Eight meeting in France next month.
Let's be serious. If the White House had wanted, they easily could
have supported those amendments and made this a better bill. We also
could have made sure that this bill got to the President's desk in
plenty of time. It is clear to me that the other side's opposition had
a lot more to do with political ideology than the President's travel
schedule. And, that is simply not enough to justify the provisions in
the bill that are going to make it more difficult to prevent the spread
of AIDS. As a result, the President will go to France with an AIDS bill
that is only half funded.
In addition, he is going to use that bill to urge other nations to do
more to fight AIDS. Now, I agree that other nations should do more.
This is not something the U.S. could or should do alone. But the world
should ask the President, the leader of the wealthiest nation on earth,
whether he is going to back up his own words with deeds.
When he asks others to do more, as he should, his own budget should
not slash funding for the Global Fund to Fight AIDS and for other
international health programs. The world should also ask why the United
States is spending less than 1 percent on programs to combat poverty,
including global health. After all, we are the wealthiest Nation on
Earth. It is not only in our security interests, but also our moral
responsibility, to do more.
Mr. President, at the Coast Guard Academy, President Bush spoke about
other important foreign aid programs, such as the Peace Corps, Famine
Fund, and the Millennium Challenge initiative. Not surprisingly, these
are some of the programs his foreign aid budget favors.
But he did not mention that his budget not only slashes funding for
global health but also for development assistance, which pays for
everything from children's education, to agriculture research, to
democracy building. His budget cuts food aid and assistance to
refugees--the world's most vulnerable people. And, we have all seen the
images of refugee camps around the world. People pushed from their
homes because of famine or war or natural disasters often end up living
in horrendous conditions.
This is not compassionate conservatism. It may conserve money, but it
is not compassionate. It is shameful.
More to the point, the President's national security strategy
recognizes the essential role of foreign aid. While we read about the
importance of foreign aid in his national security strategy, we don't
see it in his budget request.
Look at this chart. Food aid is cut by 17 percent. International
disaster assistance for floods and earthquakes and wars is cut by 18
percent.
We hear a lot of speeches on the floor talking about our moral
responsibility to the rest of the world.
While we may feel good about giving these speeches, I do not feel
good about the lofty rhetoric that bears little resemblance to reality.
And, unfortunately, we have another great example of this in the
President's budget request. Great speeches, bad reality.
The President should do what he says. He should do what he is asking
others to do. He should submit a budget amendment for the $3 billion
authorized to fight AIDS. He also should request the funds to prevent
the cuts to other vital global health programs.
Most importantly, he should start treating foreign aid for what it
is: a critical investment in America's security. Less than 1 percent of
the Federal budget is used to combat the conditions that cause poverty
and conflict around the world. This is woefully inadequate. It
shortchanges America's future. It invites insecurity.
One would have thought that if September 11 taught us anything, it
was that business as usual is no longer tolerable. As I have said
before, the President deserves credit for his Millennium Challenge
initiative. It provides some additional foreign aid funds.
But, I ask Senators to look behind the curtain to see how it is
funded. Some is new money. Sadly, the rest is from cuts to other
essential programs.
And let's keep things in perspective. Before we congratulate
ourselves too much, let's remind everyone that the Millennium
Challenge, on an annual basis, amounts to less than what my own little
State of Vermont of 600,000 people spends on public education. That is
not a serious response to the challenges we face.
I also credit the President for his famine fund initiative, but I
question what the real point is. He already has the authority he needs
to respond to famines. The problem is that his fiscal year 2004 budget
would cut title II food aid by more than the amount the famine fund
would add. Again, robbing
[[Page S7121]]
Peter to pay Paul. Unfortunately, both Peter and Paul are starving.
If we are going to lead, and especially if we are going to ask others
to do more, we are going to have to stop playing shell games with the
foreign aid budget. Leadership is good policy. Leadership means
resources. Leadership means ideas. Leadership is not a press release.
Senator Feinstein, Senator Hagel, Senator Smith, and so many others,
Democrats and Republicans, have spoken out about the need for
substantially more resources to protect America's interests abroad.
When are we going to stop talking and start acting?
As I have told the President before, I would strongly support him on
these issues. But, I am not going to support empty rhetoric. I want to
see the money. It is one thing to go on foreign trips and talk to
leaders and say: Look at this AIDS authorization bill I have. But, it
does not make much sense if the money is not there. And, in this
budget, the money is not there.
I call on the President: Let's forget the politics. Let's come up
with the right ideas on AIDS. Let's come up with the right ideas on the
Millennium Challenge Account. But, once we have the right policies,
let's put real resources behind these policies. And, to pay for these
increases, we should not cut programs for global health, disaster
assistance, refugees, food aid, development assistance, and
immunizations.
Let's get rid of the rhetoric. Let's put some reality in there. If we
do that, then the United States can show the promise and the moral
leadership a great Nation should show.
Mr. President, I suggest the absence of a quorum.
The PRESIDING OFFICER. The clerk will call the roll.
The assistant legislative clerk proceeded to call the roll.
Mr. FRIST. Mr. President, I ask unanimous consent that the order for
the quorum call be rescinded.
The PRESIDING OFFICER. Without objection, it is so ordered.
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