[Congressional Record Volume 149, Number 125 (Thursday, September 11, 2003)]
[Senate]
[Pages S11410-S11411]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          RYAN WHITE CARE ACT

  Mr. FRIST. Mr. President, I would like to make some comments 
regarding the Ryan White CARE Act and the Labor-HHS appropriations bill 
that we passed yesterday.
  Twenty two years ago, the Centers for Disease Control published a 
case study that involved five patients infected with a mysterious 
virus. At the time, I was a third-year surgical resident at the 
Massachusetts General Hospital in Boston. I remember, vaguely, those 
first cases and the worrying

[[Page S11411]]

questions. What was it? How was it transmitted? Could it travel by air? 
Should we be afraid?
  As reports of the illness grew, so did the public anxiety. Never 
before had we seen a virus with such power to destroy--to destroy 
cells, cellular function, to destroy lives, families, and entire 
communities.
  During my surgical residency, we began to treat blood in the 
operation room as potentially toxic, potentially deadly. We began 
wearing double gloves, masks in the operating room. And we took these 
precautions to protect ourselves, not our patients. The emergence of 
HIV/AIDS changed the practice of medicine, public health, and it 
changed the public consciousness.
  Fast forward to 2003. The Centers for Disease Control and Prevention 
estimate that between 850,000 and 950,000 Americans are infected with 
HIV/AIDS. One quarter of them do not know they have it and for the 
first time in many years we are seeing an increase in rate of HIV 
infection.
  CDC experts estimate that, since the virus was first identified, 
500,000 Americans have died from AIDS-related illnesses.
  The number of new infections among adolescents is rising, and rising 
disproportionately among minorities. AIDS is the leading cause of death 
among African Americans 25-44 years of age. It is the second leading 
cause of death among Latinos of the same age group. In Shelby County in 
my home State, African Americans comprise 45 percent of the population, 
but make up 75 to 85 percent of county residents infected with the 
virus.
  Over the course of more than 20 years of treating patients, I have 
seen first hand the deadly results of HIV infection. I have also seen 
the devastation it wreaks across entire communities: mothers who 
unknowingly transmit the virus to their newborns; children who suffer 
the double curse of being HIV positive and orphaned by parents taken by 
the disease.
  Fortunately, since those early days, researchers have discovered 
methods to double the life expectancy of people with HIV/AIDS. They 
have developed new and powerful drugs for the treatment of HIV 
infection, and researchers continue making advances in the treatment 
and prevention of AIDS-related opportunistic infections. We may not yet 
have a cure, but we are working around the clock to find one.
  Key to this effort has been the Ryan White CARE Act first passed in 
1990. The Ryan White CARE Act forms a unique partnership between 
Federal, local and State governments; nonprofit community 
organizations, health care and supportive service providers. For the 
last decade, this legislation has successfully provided crucial support 
services for low-income, uninsured and underinsured people with HIV/
AIDS.
  In particular, through the AIDS Drug Assistance Program, the CARE Act 
has helped patients gain access to life saving drugs.
  In 2000, more than 125,000 people living with HIV and AIDS received 
drug therapy because of this provision. Without the CARE Act, none of 
these individuals would have had the necessary resources to get the 
drugs they need which can total a whopping $12,000 per year.
  And when we say the CARE Act, we must pay proper tribute to the 
American taxpayer who is making this compassionate intervention 
possible.
  Paradoxically, because of our success in decreasing AIDS mortality, 
however, the total number of individuals living with HIV disease 
continues to climb; and more individuals are becoming dependent on 
these programs. But success should not breed failure.
  Congress has demonstrated its commitment to ensuring the availability 
of funds to meet this need by increasing funding for Ryan White 
programs from $656 million when I entered the Senate in 1995 to more 
than $1.9 billion last year. The bill passed yesterday provides more 
than $2 billion for these programs, an increase of almost $24 million.
  I know many are concerned that, because of State funding shortfalls, 
some States have begun to restrict their AIDS drug assistance programs. 
This year, Congress has provided more than $20 billion in fiscal relief 
to the states. It is my hope that some of those funds will be used to 
improve and maintain access for HIV patients.
  I thank the chairman for the hard work he has put into crafting the 
Labor-HHS bill that is currently before us. In 1996, I had the pleasure 
of working with Senator Kassebaum to reauthorize the Ryan White CARE 
Act and put in place a number of essential improvements. Again in 2000, 
when the law was up for reauthorization, I worked with Senator Kennedy 
and Senator Jeffords, among others, to put in place another round of 
critical improvements.
  I know that Chairman Specter faces many challenges in developing this 
important legislation every year, and I commend him for his leadership.
  He did an excellent job in securing Senate passage of this bill under 
certain constraints. It is my hope that we will be able to address this 
issue further in conference, in next year's budget cycle, and through 
the upcoming reauthorization of these vital programs.
  I close with a report from my home State of Tennessee. This morning a 
gentleman named Albert Jones came to visit my office. Mr. Jones is the 
executive director of New Directions, Incorporated, an organization 
based in Memphis which serves people infected with HIV/AIDS.
  He and representatives from the National Minority AIDS Council came 
to describe what they encounter down in Shelby County and what they 
think we need to do to fight the epidemic.
  What Mr. Jones hears most from HIV/AIDS patients is that they need 
better access to health care services. Getting to and from treatment is 
often the biggest obstacle. He also urges us to support early treatment 
for HIV/AIDS, so that HIV becomes a chronic rather than fatal disease.
  Mr. Jones had a colleague who recently died of AIDS. He tells me that 
his colleague was so engrossed in his work, so dedicated to the cause, 
that he worked right up until the day he went to the hospital the very 
last time.
  By passing the Ryan White CARE Act yesterday, may we honor this man's 
strength and commitment by continuing the fight against HIV/AIDS here 
and around the world.

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