[Congressional Record Volume 154, Number 16 (Thursday, January 31, 2008)]
[Senate]
[Page S547]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REID (for Mrs. Clinton):
  S. 2584. A bill to establish a program to evaluate HIV/AIDS programs 
in order to improve accountability, increase transparency, and ensure 
the delivery of evidence-based services, to the Committee on Foreign 
Relations.
  Mrs. CLINTON. Mr. President, today I rise to introduce the PEPFAR 
Accountability and Transparency Act, a bill that will increase our 
ability to research and identify the most effective interventions in 
combating global AIDS. As we work to increase funding for the 
President's Emergency Plan for AIDS Relief, PEPFAR, I believe we must 
also insure that we maximize our investment in programs that have been 
found effective in preventing infections and delivering care to as many 
people as possible.
  Through the years, the science known as operations research--the 
ability to identify what is working and what is not working in our 
treatment, prevention, and care interventions--has helped to improve 
the effectiveness of the health care delivery system that we have 
established and enhanced with U.S. funding.
  Take, for example, the issue of mother to child transmission of HIV. 
In the U.S., cases of perinatal HIV transmission have dropped 
markedly--from more than 1,000 in 1991 to less than 100 in 2005--
largely due to access to critically needed, life-extending drugs. But 
in the developing world, where fewer than 10 percent of HIV positive 
pregnant women, about 1 out of every 3 children born to mothers with 
HIV end up with the virus--a wholly preventable situation. The field of 
operations research is allowing us to understand how we can, in low 
resource settings, improve testing, education, and treatment options 
that reduce cases of perinatal transmission.
  There are many other areas where the data from operations research 
can transform our ability to maximize the U.S. investment in global 
AIDS funding--through measuring the impact of our prevention education 
efforts, to understanding how addressing gender inequality can reduce 
HIV infection, to ensuring that treatment is delivered in a way that 
extends the lives of people with HIV.
  This legislation will require the Government to develop a strategic 
plan to improve program monitoring, evaluation and operations research. 
With this plan, we can determine the effectiveness of the interventions 
we are funding, so that we can replicate those that are working well, 
and examine ways to improve those that do not have the outcomes that we 
expected. The bill would also increase the dissemination of research 
findings, so that those working in low-resource settings would be able 
to easily learn and implement cost-effective interventions in their 
communities.
  I am proud to support increases for PEPFAR, but I also believe that 
we must ensure that these increases are targeted toward effective 
programs that reach as many people as possible. This legislation will 
help us achieve that goal. I look forward to working with my colleagues 
in the Senate to support this legislation and operations research as we 
move forward with PEPFAR reauthorization.
  Mr. President, I ask unanimous consent that a letter of support be 
printed in the Record.
  There being no objection, the material was ordered to be placed in 
the Record, as follows:

                                        Elizabeth Glaser Pediatric


                                              AIDS Foundation,

                                                 January 28, 2008.
     Hon. Hillary Rodham Clinton,
     Washington, DC.
       Dear Senator Clinton: On behalf of the Elizabeth Glaser 
     Pediatric AIDS Foundation, I would like to express our strong 
     support for the PEPFAR Accountability and Transparency Act. 
     We appreciate your leadership in expanding the important role 
     of operations research, program monitoring, and impact 
     evaluation research in the President's Emergency Plan for 
     AIDS Relief (PEPFAR) and applaud your efforts in maximizing 
     U.S. financial commitment to the global AIDS pandemic.
       Significant advances have been made over the last twenty-
     five years in HIV/AIDS prevention, care, and treatment to 
     improve the lives of children and families affected by HIV/
     AIDS across the globe. Yet, while scientists and doctors have 
     learned a great deal about HIV, how to prevent the spread of 
     HIV, and how to treat those already infected, insufficient 
     focus has been placed on putting many of those advances into 
     action on the frontlines of the pandemic. Operations research 
     is becoming increasingly important in determining what 
     approaches work best in the field and ensuring that this 
     knowledge is applied on a broader scale.
       Your legislation will help ensure that we maximize the 
     lifesaving impact of PEPFAR resources by elevating operations 
     research as a priority in PEPFAR, improving accountability, 
     and strengthening transparency. Specifically, the legislation 
     directs the Office of the Global AIDS Coordinator to work in 
     collaboration with federal agencies, country governments, and 
     implementing partners to develop a five-year strategic plan 
     to prioritize operations research, program monitoring, and 
     impact evaluation research projects and establish timelines 
     for action.
       Thank you for your leadership and commitment to this issue. 
     We look forward to working closely with you to ensure that 
     children, women, and families worldwide benefit from this 
     important piece of legislation.
           Sincerely,
                                                 Pamela W. Barnes,
                            President and Chief Executive Officer.
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