[Congressional Record Volume 154, Number 43 (Thursday, March 13, 2008)]
[Senate]
[Pages S2148-S2149]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KYL (for himself, Mr. Coburn, Mr. Craig, and Mr. Bunning):
  S. 2762. A bill to prioritize the provision of assistance to combat 
HIV/AIDS, tuberculosis, and malaria to in-need countries; to the 
Committee on Foreign Relations.
  Mr. KYL. Mr. President, I rise today to call attention to the 
reauthorization of the President's Emergency Plan for AIDS Relief, also 
known as PEPFAR.
  The program authorized in 2003 provided $15 billion over 5 years to 
the cause of AIDS relief in parts of the world ravaged by that disease. 
PEPFAR was a demonstration of the American people's desire to help 
those in need.

[[Page S2149]]

  The 2003 legislation was also a demonstration of the American 
people's desire that their generosity not be wasted, as they have seen 
before with so many other aid programs. To that end, the legislation 
required that the lion's share of the funds be devoted to treatment of 
patients in need.
  It encouraged accountability and transparency and it funded programs 
that could demonstrate results, such as the requirement that one third 
of prevention funds be spent on abstinence education programs--a 
decision that has kept countless persons from getting infected with HIV 
since 2003.
  It is therefore mind boggling to me that recent reauthorization 
proposals the bill passed by the House Foreign Affairs Committee last 
week and the bill scheduled for mark up by the Senate Foreign Relations 
Committee today--would take such giant steps backward.
  The bill originally introduced in the House would have eliminated the 
conscience clause, which protects humanitarian and medical 
professionals involved in these programs from having to participate in 
prevention and treatment methods that they find morally or religiously 
objectionable. Wisely, this provision was kept in the bill passed by 
the House committee, though it is substantially watered down--to the 
point of being nonbinding--in the Senate Foreign Relations Committee 
bill.
  The original House bill struck the requirement that organizations 
that receive PEPFAR grants be opposed to prostitution and sex 
trafficking. That these commonsense provisions were even in danger of 
being dropped in the reauthorization of PEPFAR is sadly telling. It 
appears the Senate Foreign Relations Committee chose not to challenge 
such an unimpeachable provision of law.
  And, unlike the majority on the House Foreign Affairs Committee, 
which backed down from including many troubling provisions on abortion 
and family planning demanded by far left groups, it appears the Senate 
Committee bill would pander to the so-called ``family planning'' 
agenda.
  I am also deeply troubled that both the House Foreign Affairs 
Committee and Senate Foreign Relations Committee reauthorization 
proposals remove the requirement that at least fifty-five percent of 
the funds in the program be spent on treatment of AIDS patients. This 
provision was an important check on bureaucratic wastefulness and 
``make work'' and it must be preserved.
  Additionally, the requirement that thirty-three percent of PEPFAR 
prevention funds be spent on abstinence education, removed by the 
majority in last year's omnibus appropriations process, has not been 
restored in either of these two reauthorization proposals. In fact, all 
that remains in the tatters of that requirement in either of these 
bills is something only a bureaucrat could love: in the event a future 
AIDS coordinator chooses to ignore abstinence education, a report must 
be sent to Congress.
  What is more, both of these reauthorization proposals include 
provisions that appear to undermine protections for intellectual 
property, the same protections that are necessary to ensure that 
innovation and research into life-saving medications continue.
  While I am sure the sponsors of these two proposals are well-meaning, 
they further increase support for TB and malaria programs, even though 
the U.S. is already the largest contributor to TB and malaria programs 
through the Global Fund. Sadly, the Global Fund has become synonymous 
with graft and multilateral bureaucratic waste in many countries. We 
should not be duplicating those existing programs. We owe it to the 
American taxpayer, and those people suffering from these dreaded 
diseases, to fix the problems that abound in the Global Fund.
  Lastly, but most significantly, both reauthorization proposals more 
than triple the expenditure for PEPFAR--something we simply cannot 
afford. PEPFAR 2003 authorized $15 billion over 5 years for emergency 
AIDS relief. Not satisfied with a mere doubling of this program as 
requested, both of these proposals would provide $50 billion over 5 
years.
  As I have noted already, the American people are a generous people. 
Our annual foreign aid budget reflects this generosity. However, this 
ability to give is not limitless.
  Need I remind my colleagues, our economy is in distress. The 
presidential candidates on the other side are calling for a Federal 
Government bailout of homeowners facing foreclosure: with $50 billion, 
we could provide 235,157 homeowners with such a bailout.
  Moreover, Congress just passed, and the president just signed, a 
program to provide Americans with checks intended to stimulate the 
economy. While I have doubts that this plan will succeed, I note that 
with this $50 billion, 157 million tax filers could be given rebate 
checks of $318.47.
  Alternatively, with $50 billion, we could ``fully fund'' both No 
Child Left Behind and the Individuals with Disabilities Education Act 
at their authorized levels for one year.
  Congress is beginning the annual budget cycle and we are daily 
confronted with requests for more and more federal spending. Already, 
key leaders in the budget process are threatening that if they don't 
get their way on domestic spending, they will add their spending to the 
forthcoming but overdue War Supplemental or will short circuit the 
budget process with a continuing resolution or yet another omnibus. 
Agreeing to this massive increase is not the way to discipline what is 
already shaping up to be a budget train wreck.
  Governing is about choosing. By agreeing to this increase to $50 
billion, neither the House nor Senate committees are governing. They 
are taking the easy course of action: spending.
  I supported the President's Emergency Plan for AIDS Relief in 2003. I 
could reluctantly support doubling that amount over the next five 
years. But adding another $20 billion on top of that is too much.
  We cannot lose sight of the sacrifices of millions of Americans who 
work hard and pay the taxes that support these programs. $50 billion is 
too much.
  I cannot support a bill that so dramatically spends beyond what we 
can afford and so wantonly ignores accountability and transparency 
tools that safeguard the generosity of the American people.
  This legislation can still be salvaged.
  Yesterday, I cosponsored legislation with the Senator from Oklahoma, 
Dr. Coburn, and the Senator from North Carolina, Mr. Burr, that sets 
some key principles that must be a part of the reauthorization.
  Earlier today, I introduced a bill that would prohibit the extension 
of PEPFAR funds away from their core purpose, helping the neediest 
countries. This legislation must also be a part of the reauthorization 
of PEPFAR.
  I support the PEPFAR program and I believe that it is worth passage 
if funded at a responsible authorization level with at least the kind 
of commonsense policy, accountability, and transparency provided in the 
2003 bill.
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