[Congressional Record Volume 154, Number 51 (Wednesday, April 2, 2008)]
[House]
[Pages H1894-H1902]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




PROVIDING FOR CONSIDERATION OF H.R. 5501, TOM LANTOS AND HENRY J. HYDE 
  UNITED STATES GLOBAL LEADERSHIP AGAINST HIV/AIDS, TUBERCULOSIS, AND 
                  MALARIA REAUTHORIZATION ACT OF 2008

  Mr. McGOVERN. Mr. Speaker, by direction of the Committee on Rules, I 
call up House Resolution 1065 and ask for its immediate consideration.
  The Clerk read the resolution, as follows:

                              H. Res. 1065

       Resolved, That at any time after the adoption of this 
     resolution the Speaker may, pursuant to clause 2(b) of rule 
     XVIII, declare the House resolved into the Committee of the 
     Whole House on the state of the Union for consideration of 
     the bill (H.R. 5501) to authorize appropriations for fiscal 
     years 2009 through 2013 to provide assistance to foreign 
     countries to combat HIV/AIDS, tuberculosis, and malaria, and 
     for other purposes. The first reading of the bill shall be 
     dispensed with. All points of order against consideration of 
     the bill are waived except those arising under clause 9 or 10 
     of rule XXI. General debate shall be confined to the bill and 
     shall not exceed two hours equally divided and controlled by 
     the chairman and ranking minority member of the Committee on 
     Foreign Affairs. After general debate the bill shall be 
     considered for amendment under the five-minute rule. The bill 
     shall be considered as read. All points of order against 
     provisions of the bill are waived. Notwithstanding clause 11 
     of rule XVIII, no amendment to the bill shall be in order 
     except those printed in the report of the Committee on Rules 
     accompanying this resolution. Each such amendment may be 
     offered only in the order printed in the report, may be 
     offered only by a Member designated in the report, shall be 
     considered as read, shall be debatable for the time specified 
     in the report equally divided and controlled by the proponent 
     and an opponent, shall not be subject to amendment,

[[Page H1895]]

     and shall not be subject to a demand for division of the 
     question in the House or in the Committee of the Whole. All 
     points of order against such amendments are waived except 
     those arising under clause 9 or 10 of rule XXI. At the 
     conclusion of consideration of the bill for amendment the 
     Committee shall rise and report the bill to the House with 
     such amendments as may have been adopted. The previous 
     question shall be considered as ordered on the bill and 
     amendments thereto to final passage without intervening 
     motion except one motion to recommit with or without 
     instructions.
       Sec. 2.  During consideration in the House of H.R. 5501 
     pursuant to this resolution, notwithstanding the operation of 
     the previous question, the Chair may postpone further 
     consideration of the bill to such time as may be designated 
     by the Speaker.

  The SPEAKER pro tempore (Mr. Salazar). The gentleman from 
Massachusetts is recognized for 1 hour.
  Mr. McGOVERN. Mr. Speaker, for the purpose of debate only, I yield 
the customary 30 minutes to the gentleman from Florida (Mr. Diaz-
Balart). All time yielded during consideration of the rule is for 
debate only. I yield myself such time as I may consume. I also ask 
unanimous consent that all Members be given 5 legislative days within 
which to revise and extend their remarks on House Resolution 1065.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Massachusetts?
  There was no objection.
  Mr. McGOVERN. Mr. Speaker, House Resolution 1065 provides for the 
consideration of H.R. 5501, the Tom Lantos and Henry J. Hyde United 
States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria 
Reauthorization Act of 2008, a structured rule. The rule provides for 2 
hours of general debate and makes in order four amendments, each of 
which is debatable for 10 minutes.
  Mr. Speaker, all Members of this House should be very proud of the 
bipartisan collaboration and careful compromises that have resulted in 
the underlying bill before us today, H.R. 5501, the Tom Lantos and 
Henry J. Hyde United States Global Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Reauthorization Act. I wish to express my 
appreciation to the work of the gentleman from New Jersey, Congressman 
Donald Payne, the chairman of the Subcommittee on Africa and Global 
Health, and Subcommittee Ranking Member Chris Smith, as well as House 
Foreign Affairs Committee Chairman Howard Berman and Ranking Member 
Ileana Ros-Lehtinen. And, like all of my House colleagues on both sides 
of the aisle, I am grateful that the committee named this bill after 
the great leaders of the Foreign Affairs Committee, Chairmen Tom Lantos 
and Henry Hyde, who guided the original 2003 act into law. May the 
collegial spirit of these two great champions for global health guide 
us all during today's debate.
  Mr. Speaker, H.R. 5501 would authorize $50 billion over the next 5 
years for U.S. global programs that address the prevention, care, and 
treatment of HIV/AIDS, tuberculosis, and malaria. It strengthens, 
sustains, and expands a program that is universally recognized as one 
of the shining accomplishments of the Bush administration.
  The challenge for this reauthorization is to move our HIV/AIDS 
programs beyond the emergency phase first called for under the 
President's Emergency Program For Aids Relief, or PEPFAR, and make them 
sustainable over the long term. Over the past 5 years, we have 
literally gone from watching people die from HIV/AIDS to watching 
people live and return to productive lives in their communities.
  The 2003 Act provided $15 billion over 5 years; H.R. 5501 provides 
$50 billion, a direct response to the needs identified over the past 5 
years for life-saving medicines and well-trained, effective national 
health care systems.
  The 2003 law relied upon the health care workforce and infrastructure 
already in place in developing countries. In a farsighted move, Mr. 
Speaker, today's bill invests in strengthening HIV-related health care 
systems and building the capacity of the health care workforce in these 
nations. Under this legislation, funds will be used to train some 
144,000 new health care workers over the next 5 years to care for 
people infected with HIV.
  This is just a start on easing the severe shortage of health care 
workers in the developing world, and it is our hope that other donor 
nations will follow our lead. If there is ever to be a hope that these 
programs can become self-sustaining, health care capacity must be 
significantly strengthened in countries hard hit by HIV/AIDS.
  The 2003 bill focused on creating new programs to tackle the HIV/AIDS 
crisis. This reauthorization builds stronger linkages between our 
global HIV/AIDS initiatives and existing programs designed to alleviate 
hunger, improve health care, bolster education, and increase income 
security and stable livelihoods, an approach endorsed by the 
President's Global AIDS Coordinator in February in his annual report to 
Congress. These changes ensure that our HIV/AIDS programs no longer 
operate in isolation from our other development priorities, and that 
the expertise and benefits from these other programs are provided in an 
effective manner to HIV/AIDS affected individuals, families, and 
communities.
  In addition, the bill increases U.S. contributions to the Global Fund 
for HIV/AIDS, Tuberculosis, and Malaria, and provides benchmarks to 
improve the transparency and accountability of the Global Fund.
  And while the majority of the funding authorized in H.R. 5501 is 
focused on the prevention, care, and treatment of HIV/AIDS-infected 
people and communities, I would like to emphasize that the bill 
specifically authorizes $4 billion over 5 years for a comprehensive 
strategy to combat tuberculosis, and $5 billion for the prevention, 
treatment, control, and elimination of malaria. In addition, it better 
integrates our HIV/AIDS programs with the diagnosis, testing, 
counseling, treatment, prevention, care, and health care treatment 
needed in the fight against TB and malaria.
  Mr. Speaker, H.R. 5501 also removes the requirement that one-third of 
all funds for HIV/AIDS prevention be dedicated to abstinence-only 
programs. Over the past 5 years, this restriction has proven to hamper 
the effectiveness of our health care efforts in the field, as 
documented by two recent independent reports produced by the Government 
Accountability Office, GAO, and President Bush's own Office of 
Personnel Management. This reauthorization now requires the Executive 
to promote a balanced prevention program that includes every element of 
abstinence, being faithful, and condoms, the ABC approach toward HIV 
transmission prevention.
  Mr. Speaker, H.R. 5501 also allows U.S.-supported family planning 
organizations to provide HIV/AIDS testing and counseling services. This 
will ensure that many more women of reproductive age receive vital 
information related to their HIV status, as well as HIV/AIDS education.
  Mr. Speaker, we all need to recall that 20 million men, women, and 
children have perished from HIV/AIDS; 40 million people around the 
world are HIV positive; and each and every day another 6,000 people are 
infected with HIV. It is a moral imperative that we act strongly, 
decisively, and continue to address this crisis in a forward-looking 
manner.
  Five years ago, President Bush acted to meet a perceived emergency as 
the AIDS epidemic spread out of control. During that period, the United 
States has provided drug treatment to nearly 1.5 million people. We 
have given supportive care to another 6.6 million, including 2.7 
million orphans and vulnerable children. And, our programs have 
prevented an estimated 150,000 infant infections. During this first 5-
year phase of programming, U.S. bilateral programs to combat HIV/AIDS, 
tuberculosis, and malaria were expanded to 114 countries. Today, the 
U.S. now supports programs in 136 countries, including programs funded 
by the United States and administered through the Global Fund.
  We can all be proud of this record of accomplishment, but there is so 
much more left to do. Now we must work on making these initial gains 
sustainable, our programs even more effective, and expanding them to 
reach an even greater number of HIV/AIDS affected communities.
  Specifically, over the next 5-year period, H.R. 5501 aims to:
  Prevent 12 million new infections;
  Provide anti-retroviral treatment for 3 million people, including 
450,000 children;

[[Page H1896]]

  Provide medical and other care for 12 million people, including 5 
million orphans;
  And, train over 140,000 health care workers in the developing world.
  Mr. Speaker, addressing global HIV/AIDS is one of the moral 
imperatives of our time. And while history will no doubt judge our 
response, it is more important that each of us recognizes that we can 
truly make a difference in the lives of millions of people right here 
and right now.
  H.R. 5501 represents a genuine bipartisan compromise. I urge my 
colleagues to adopt this rule and to support the underlying 
legislation, H.R. 5501.
  I reserve the balance of my time.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I would like to 
thank the gentleman from Massachusetts (Mr. McGovern) for the time, and 
I yield myself such time as I may consume.
  During his 2003 State of the Union address, President Bush outlined a 
bold new plan to confront and combat the scourge of HIV/AIDS, 
tuberculosis, and malaria. Congress followed through and passed the 
U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act, known 
as the President's Emergency Plan For Aids Relief, PEPFAR, authorizing 
$15 billion in assistance to combat these diseases for fiscal years 
2004 through 2008. That was the largest commitment ever by any nation 
for an international health initiative fighting a single disease.
  Since its enactment in 2003, the programs created by this landmark 
legislation have made admirable progress in combating those horrible 
diseases.

                              {time}  1045

  So far more than 1.4 million people have received life-preserving 
antiretroviral treatment, over 2.7 million HIV/AIDS-affected orphans 
have received care, and many millions more have received instruction on 
how to protect themselves from infection. Tens of millions of people 
have received malaria and tuberculosis prevention or treatment 
services.
  Even though this program has achieved remarkable successes, there is 
more that we can do. Tuberculosis still kills an estimated 2 million 
people each year and is the leading cause of death for people with 
AIDS. One million people die from malaria each year. AIDS is the 
world's fourth leading cause of death.
  The devastating consequences of these diseases are plaguing sub-
Saharan Africa. Over 22.5 million people are living with HIV, and 
approximately 1.7 million additional sub-Saharan Africans were infected 
with HIV last year. Just last year this horrible AIDS epidemic claimed 
the lives of an estimated 1.6 million people in that region. More than 
11 million children have been orphaned by AIDS. Many families are 
losing their income earners. Health services are overburdened. Life 
expectancy in sub-Saharan Africa is now 47 years. Economic activity and 
social progress is impeded.
  We must do all we can to prevent these tragedies.
  The underlying legislation, justly and appropriately named the Tom 
Lantos and Henry Hyde United States Global Leadership Against HIV/AIDS, 
Tuberculosis, and Malaria Reauthorization Act of 2008, will 
dramatically augment our commitment to fight these horrible diseases 
with an increase of approximately $35 billion in funding for a total of 
$50 billion over 5 years.
  Some of my constituents are immigrants from Haiti and have family and 
friends in their land of origin. I often hear about the disastrous 
effects that HIV/AIDS is having on that country. As of 2007, Haiti had 
an HIV rate of almost 4 percent. Thankfully, since Congress passed 
PEPFAR we have invested over $300 million to help Haiti combat the AIDS 
pandemic by building on existing clinic and community-based health 
resources; expanding a network of satellite connections to the Centers 
of Excellence to permit instant review of difficult cases; training 
staff members of health care facilities that provide prenatal, 
gynecological and maternity care in provision of prevention of mother-
to-child HIV transmission; and enhancing the lab network for clinical 
sites to support the diagnosis and treatment of HIV and other 
associated infections. I am pleased the legislation will also now cover 
several other countries that were previously not part of PEPFAR.
  As I said yesterday in the Rules Committee, when we look upon our 
work in Congress many years from now, I can think of nothing that we or 
anyone else will be able to point to that is of more importance than 
this admirable effort by the great and generous American people, this 
massive effort proposed by President Bush here in the United States 
House of Representatives during his State of the Union Address of 2003, 
the President's Emergency Plan for AIDS Relief.
  I would like to thank Chairman Berman and Ranking Member Ros-Lehtinen 
and Chairman Payne and Ranking Member Smith for their marvelous 
bipartisan, very hard work on this important issue. I also wish to 
thank them for naming this landmark program for two ultimately 
respected colleagues of ours who have recently left us, Henry Hyde and 
Tom Lantos. This is truly a fitting tribute for two remarkable human 
beings and public servants.
  Mr. Speaker, I reserve the balance of my time.
  Mr. McGOVERN. Mr. Speaker, I reserve the balance of my time.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I yield 5 minutes to 
the distinguished ranking member of the Committee on Foreign Affairs 
who has had such an important role and hand in this legislation, the 
gentlewoman from Florida (Ms. Ros-Lehtinen).
  Ms. ROS-LEHTINEN. Mr. Speaker, I thank my good friend from Florida 
for the time.
  Mr. Speaker, I rise also in support of the House's consideration of 
the Tom Lantos and Henry Hyde United States Global Leadership Against 
HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008.
  This is an important measure which will ensure that our efforts to 
save the lives of so many people afflicted with the scourge of AIDS, 
tuberculosis and malaria continue in a rigorous, holistic way.
  The continued success of the program that was brought to life 5 years 
ago by our late colleagues, Henry Hyde and Tom Lantos, is a matter of 
vital importance to us here in the United States.
  As President Bush said in his recent trip to Africa: ``I want the 
American people to understand that when it comes to saving lives, it is 
in our national interest. It is in our security interest to help 
alleviate areas of the world from hopelessness. It is in our moral 
interest to save the lives of others.''
  So, Mr. Speaker, that is precisely what the bill before us is about. 
The program that we are authorizing today, commonly known as PEPFAR, is 
now recognized as perhaps the most successful foreign assistance 
program of the United States of America since the Marshall Plan.
  Just as the Marshall Plan protected American lives then by helping to 
stabilize a continent ravaged by war, PEPFAR is protecting Americans 
lives today by helping to stabilize a continent ravaged by disease. 
PEPFAR does more than just express American compassion, it supports 
American security.
  As an illustration of this important point, I would like to quote 
from a letter that I received from our former House colleague from 
Wisconsin, the Honorable Mark Green, who is now serving as the United 
States ambassador to the United Republic of Tanzania. Ambassador Green 
said the following: ``We are approaching the 10th anniversary of the 
terrorist bombings of Embassy Dar es Salaam and Embassy Nairobi. And I 
can't help but note that General Wald, the former deputy commander of 
the U.S. European Command, has called HIV/AIDS the third greatest 
threat to U.S. national security.''
  Yes, this bill is less than perfect in some aspects. All compromises 
are, Mr. Speaker. But it is a good bill, one that will save millions of 
lives around the world and help to maintain stability in a key region.
  As Chairman Hyde said during the markup of the original Leadership 
Act in 2003: ``Congress is so equally balanced that it is very 
difficult on controversial matters, on expensive matters, on matters 
that have different blocks who have different points of view to reach 
an agreement. In a situation like this, compromise is the heart and 
soul of the process.''

[[Page H1897]]

  He added: ``We cannot please the left and the right and the center. 
We can't please the libertarians and the archconservatives and the 
Republicans and the Democrats with legislation that would have done all 
of these magic properties, but we can do our best and we have done our 
best.''
  In 2003, Mr. Speaker, we did do our best and created a program that 
demonstrated compassion to so many since its enactment.
  Today, the House has an opportunity to do its best again.
  Today, for the sake of the fathers, the mothers, and the children who 
are victims of HIV/AIDS, as well as tuberculosis and malaria, today we 
can follow in the steps of Henry Hyde and Tom Lantos, demonstrating 
that American compassion that distinguishes our Nation and our people 
above all others.
  Mr. Speaker, I believe that this is a balanced bill. I believe that 
this is a bill that will save many lives and protect American security.
  Mr. McGOVERN. Mr. Speaker, I yield myself 20 seconds.
  Mr. Speaker, I just want to again commend the gentlewoman from 
Florida (Ms. Ros-Lehtinen) for her incredible work on this bill. And 
for the Record, there is bipartisan appreciation for her strong and 
passionate commitment to ending the scourge of HIV/AIDS, tuberculosis 
and malaria.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, it is my privilege 
to yield 3 minutes to the gentleman from Georgia (Mr. Gingrey), a 
physician who does so much on issues of health day in and day out 
throughout the United States, and, as on this issue, throughout the 
world.
  Mr. GINGREY. Mr. Speaker, at the risk of being labeled the skunk at 
the annual fragrance picnic, I do rise today in opposition to this 
structured rule.
  I know compromises have been made to improve the underlying 
legislation, but I think there is plenty of room for additional 
improvement. Just because we have a good program, to increase the 
spending from $15 billion to $50 billion, I wonder if there is 
justification for that.
  But here we are again, Mr. Speaker, considering a rule that restricts 
debate on another Republican-created program for which the Democratic 
majority is now proposing a massive expansion.
  We already have more than our share of entitlement programs right 
here in the United States. And to me, it now appears the majority is on 
the verge of using taxpayer dollars to create a global entitlement 
program. Remember, Mr. Speaker, PEPFAR, the President's Emergency Plan 
for AIDS Relief, was created back in 2003 to provide emergency relief 
for AIDS.
  I will certainly say as a physician, that of course I am encouraged 
by the increased desire in the bill to also help fight against 
tuberculosis and malaria. However, Mr. Speaker, we should not devise a 
plan to treat these diseases without defining how to actually buy 
sufficient medications to provide the necessary care. The majority said 
that a treatment floor was not included in this bill as it was in the 
original legislation because the cost of medications have decreased. 
That may be true, yet while it has more than tripled the price tag for 
the PEPFAR expansion as I said in this bill, it has not tripled the 
number of people that it plans to reach with medication. So if the cost 
of medications have gone down, I think they have and the majority 
states they have, shouldn't the massive increase in the cost of this 
program be matched by a proportionate increase in the people that we 
target through the program?
  Mr. Speaker, I was at the Rules Committee yesterday. I offered an 
amendment to just simply say keep that floor of 55 percent of the money 
going to treat the patient. The Rules Committee, unfortunately, did not 
make that in order.
  Since the majority is not allowing adequate input on this 
legislation, particularly from the minority, I would urge my fellow 
Members to vote against this rule, give us a chance to go back and make 
some of the needed changes in an otherwise good bill.
  Mr. McGOVERN. Mr. Speaker, I reserve the balance of my time.

                              {time}  1100

  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, it's my privilege to 
yield 4\1/2\ minutes to the distinguished gentleman from Florida, also 
a physician, Dr. Weldon.
  Mr. WELDON of Florida. I thank the gentleman for yielding. I rise in 
strong opposition to this rule, and very strong opposition to the 
underlying bill.
  And let me just say from the outset that I used to take care of AIDS 
patients before I came to this Congress back in 1994. I was one of only 
two physicians in a county of 400,000 people that was seeing AIDS 
patients. And I have announced my retirement, my intent to leave the 
House of Representatives at the conclusion of this Congress, and I will 
most likely go back to seeing patients in January. And I may, indeed, 
be seeing AIDS patients again.
  Let me additionally say that I'm very concerned about the situation 
in Africa. Indeed, I have gone to Africa twice in my term of service 
here in the Congress specifically to look at the issue of helping in 
Africa with the issues of AIDS and malaria and TB, and so I think I 
have credibility to be able to say I care, I'm concerned. But this 
underlying bill and this rule that restricts any cutting amendments, in 
my opinion, is just excessive.
  Years ago, when the President originally came up with PEPFAR, he came 
to me and asked me to help him with his plan, and I did. And I actually 
thought his plan was very, very generous, $3 billion a year. And when 
he gave his State of the Union message just a few months ago indicating 
that he wanted to double the size of this from $3 billion to $6 billion 
a year, I personally thought that was excessive. When you look at all 
the problems we have with health care access for Americans, the 
problems that we have with transportation infrastructure, the problems 
that we have in fighting the war in Iraq, Afghanistan, the homeland 
security issues, I thought to take this program from $3 billion a year 
to $6 billion a year was excessive and over the top.
  But now we have before us today an underlying bill to not increase it 
by 100 percent, which is what the President was asking for, but to 
increase it by over 200 percent. That's the underlying bill. And the 
Democrat leadership of the House under the Democratic Rules Committee 
is saying, well, no, we don't want any cutting amendments.
  Now, let me tell you a little bit of why I am so passionately upset 
about it. Yesterday, NASA announced that, with the retirement of the 
space shuttle, they are going to be laying off over 6,500 people in 
east central Florida, my congressional district. That is a huge amount 
of people. It has a huge economic impact on the State of Florida. And 
for us to be putting our astronauts on Russian rockets, we're going to 
have to sign a contract with the Russians for the construction of these 
rockets, we're essentially going to be laying off people in Florida and 
hiring people in Russia with U.S. taxpayers.
  Now, this Congress, under this Democratic leadership, is saying that 
we have no choice, we cannot afford to continue to fly the shuttle in 
2011, 2012, 2013. We cannot afford to bring the new rocket system 
online any sooner than 2005 or 2006, we don't have the money, while we 
have all this money to send $50 billion to Africa for AIDS. Now, again, 
let me just say, I understand this is a terrible problem. I don't even 
mind increasing the Africa AIDS account. And what, to me, is insult on 
top of injury, my staff has informed me that they have $1 billion in 
this account unspent that they are working to try to spend. So, they 
can't even spend all the money that we're sending them over there, and 
we want to send them a 240 percent increase?
  Now, I know every Member of this House can get up and give a speech 
like this; they have water projects in their district, they have health 
care clinics in their district. In my particular case, it's pretty 
significant. We've got over 6,000 people who are going to get a pink 
slip. So, for us to say we can't fly the shuttle beyond 2010 because we 
can't afford it, but that we can somehow find $50 billion to send to 
Africa, to me is just way over the top. I can't justify that back home.
  I'm opposing this rule. I'm going to vote against the underlying 
bill. And I thank the gentleman for yielding me time. I appreciate it.
  Mr. McGOVERN. Mr. Speaker, I just want to remind my colleagues that 
the

[[Page H1898]]

underlying debate is not about the space program, it's about whether 
we're going to end the terrible scourge of HIV/AIDS, malaria and 
tuberculosis that has cost the lives of countless individuals across 
this planet. This is a moral imperative. And I am proud of the 
bipartisan work done by Democrats and Republicans working together to 
accomplish this bill.
  At this time, I would like to yield 3 minutes to the gentlewoman from 
the Virgin Islands (Mrs. Christensen).
  Mrs. CHRISTENSEN. Thank you for yielding.
  Mr. Speaker, I rise today in full support of the rule and of H.R. 
5501, a bipartisan bill to reauthorize and expand the President's 
Emergency Plan for AIDS Relief.
  I want to particularly applaud the increase in funding from $15 to 
$50 billion over 5 years, and the inclusion of the Caribbean countries 
in this reauthorization.
  In this regard, I want to especially thank and applaud my colleagues, 
Mr. Fortuno, who introduced the Caribbean amendment, Congresswoman 
Yvette Clarke, who cosponsored it, as did I, Chairman Donald Payne, who 
included the increased funding and whose work with Congresswoman 
Barbara Lee ensured that these provisions were included, as well as 
Chairman Rangel, who began the Caribbean effort 4 years ago.
  The expansion to include all Caribbean nations as focus countries was 
greatly aided by the hard work of Caribbean Health Ministers whose 
collective and tireless efforts raised awareness about the impact of 
HIV/AIDS in the Caribbean. I also want to thank the Pan Caribbean 
Partnership Against HIV/AIDS (PANCAP) not only for their support of 
this bill, but for the important leadership role that they have and 
continue to take to address HIV/AIDS in the Caribbean region.
  Over the past 5 years, PEPFAR has literally saved the lives of more 
than one million people and has had a significant positive impact on 
those most affected by and most at risk for HIV infection, women and 
girls.
  Congresswoman Lee and I had the opportunity to visit several PEPFAR 
sites and partners in South Africa late last year and saw the great 
work that they are doing. It was also clearly evident, though, that 
more was needed.
  The additional funding will help to expand the number of focused 
countries under PEPFAR. It will help to ensure that the innovative and 
effective efforts that have been launched not only continue, but help 
other hard-hit nations get access to the resources they desperately 
need to address HIV/AIDS within their borders.
  While two Caribbean nations, Haiti and Guyana, are, as they should 
be, currently prioritized as focus countries under PEPFAR, there are 14 
other nations in this region, which is second only to sub-Saharan 
Africa in terms of HIV/AIDS prevalence, in need of help. In the 
Caribbean today, AIDS is one of the leading causes of death in the 15-
44 age group.
  Many Caribbean nations not currently receiving PEPFAR assistance 
absorb millions of dollars in debt every year. Leaders in the Caribbean 
maintain that high HIV/AIDS prevalence rates can overwhelm the region's 
health care capacity, destabilize economies, and compromise Caribbean 
nations' sociopolitical infrastructure. In fact, Assistant Secretary 
General of the Organization of American States, the Honorable Albert 
Ramdin, stated in January of last year that ``HIV/AIDS, if not 
effectively and urgently tackled, poses a clear threat to the 
sustainable development, social stability and human security of the 
Caribbean.''
  Making all Caribbean countries eligible is clearly the right thing to 
do. H.R. 5501, while it includes the region, lays the foundation to 
have the 14 Caribbean nations specifically listed in the bill that will 
be sent to the President for his signature.
  I urge all of my colleagues to support the rule and to support H.R. 
5501, rightly named to honor the service of Chairman Hyde and Chairman 
Lantos.
  Mr. Speaker, I rise today in full support of H.R. 5501--a bill which 
will reauthorize the President's Emergency Plan for AIDS Relief, 
PEPFAR. I want to thank and applaud my colleagues, Congressman Fortuno 
who introduced the Caribbean amendment, Congresswoman Clarke who 
cosponsored it as did I, Chairman Payne and Congresswoman Lee who 
ushered it and many other parts of the bill through the committee.
  Congresswoman Lee and I had the opportunity to travel to South Africa 
around World AIDS Day last year to visit PEPFAR sites and participate 
in and see the work they were doing first hand. There was great work 
being done, but the need for more was also clearly evident.
  The success of PEPFAR is well documented. With the support offered 
through PEPFAR over the last 5 years, many of the world's hardest hit 
nations have been able to launch integrated HIV/AIDS prevention, 
treatment and care programs that have prevented new HIV infections, 
brought life-saving medications and other treatments and services to 
those living with HIV. As a direct result, PEPFAR has literally saved 
the lives of more than 1 million people and has had a noted and 
positive impact on those most affected by and most at risk for HIV 
infection: women and girls.
  In fact, in the 15 focus countries, more than 6 in every 10 of the 
individuals with HIV currently on antiretroviral treatment as a result 
of direct PEPFAR support are women and girls.
  Given the continued burden of HIV/AIDS in the world's most vulnerable 
nations, there is no doubt that this critically important bill not only 
should be reauthorized, but that it should be increased. We were 
pleased that the President indicated a willingness to increase it in 
his State of the Union message this year. And I want to especially 
recognize Chairman Payne for successfully increasing the fund to $50 
billion over the next 5 years.
  This additional funding will help to expand the number of ``focus 
countries'' which currently are prioritized under PEPFAR. Additionally, 
it will help ensure that the forward-thinking and effective HIV/AIDS-
related efforts that have been launched not only continue, but that 
other nations that are hard hit by this pandemic will have access to 
the resources they desperately need to address HIV/AIDS within their 
borders.
  Mr. Speaker, despite the many successes associated with PEPFAR, we 
know that there is an entire region--the Caribbean--which has been and 
remains in desperate need of assistance in battling against HIV/AIDS. 
While two Caribbean nations--Haiti and Guyana--are, as they should be, 
currently prioritized as focus countries under PEPFAR, there are 14 
other nations in the region that together comprise the second-hardest 
hit region in the world; second only to sub-Saharan Africa in terms of 
HIV/AIDS prevalence.
  Mr. Speaker, in the Caribbean today, AIDS is one of the leading 
causes of death among adults aged 15-44 years of age. In some countries 
in the region, AIDS is the leading cause of death among individuals in 
this age group; a disturbing reality, because AIDS is taking its 
ultimate toll on Caribbean residents during their most productive life 
years, thus compromising many Caribbean nations' economic, social and 
political growth and stability.
  Adding to the region's challenges with HIV/AIDS is the well-
documented high population mobility. We know that many Caribbean 
nations--whose commitment to and effectiveness in addressing HIV/AIDS 
is stifled not because of the absence of political will, but because of 
the absence of resources--offer universal access to HIV/AIDS 
medications, care and other services.
  In fact, Mr. Speaker, many Caribbean nations, not currently receiving 
PEPFAR assistance, absorb millions of dollars in debt every year 
providing treatment and care not only to their residents with HIV, but 
to all individuals on their shores seeking HIV/AIDS care and treatment.
  These Caribbean nations have been doing what is right not only to 
address HIV/AIDS head on, but to lay the groundwork to beat this 
pandemic. And so, I rise today to encourage all of my colleagues--on 
both sides of the aisle--to support this legislation, which lists these 
14 Caribbean nations as ``focus nations,'' to support these nations' 
efforts to prevent new HIV infections and to expand access to life-
saving AIDS medications to those living with HIV infection.
  Mr. Speaker, because of all of the above, I want to especially single 
out Congressman Fortuno for his leadership on this issue and 
shepherding this amendment through the committee process and ensuring 
it became a part of the final bill. I also want to recognize Chairman 
Rangel who was the first to begin this process 4 years ago.
  This amendment might not have been possible without the hard work of 
nearly a dozen Health Ministers in the Caribbean and their collective 
and tireless efforts to raise awareness about the impact of HIV/AIDS in 
the Caribbean and to include 14 Caribbean nations as ``focus 
countries'' in this bill. I also want to thank the Pan Caribbean 
Partnership against HIV and AIDS, PANCAP, not only for their support of 
this bill, but for the important leadership role that they have and 
continue to take to address HIV/AIDS in the Caribbean region.

[[Page H1899]]

  Mr. Speaker, as the only African-American physician in Congress and 
as the only representative from the English-speaking Caribbean, I can 
tell you--firsthand--that based on the surveillance data reported in 
the latest UNAIDS report, we know that the entire Caribbean region 
without adequate and targeted support from PEPFAR, is now and will 
continue to experience the same devastating impact from HIV/AIDS 
documented throughout nations in sub-Saharan Africa. Ambassador of and 
Health Ministers in Caribbean countries to the United States maintain 
that high HIV/AIDS prevalence rates can overwhelm the region's health 
care capacity, destabilize economies and compromise Caribbean nations' 
sociopolitical infrastructure.
  In fact, Assistant Secretary General of the Organization of American 
States Albert Ramdin stated in January 2007 that, ``HIV/AIDS, if not 
effectively and urgently tackled, poses a clear threat to the 
sustainable development, social stability, and human security of the 
Caribbean.''
  The time to act is now; now is when we should support a bill that not 
only will tackle on of our most pressing international public health 
challenges, but that will do so in a manner that is medically, 
epidemiologically, regionally and fiscally responsible today. I, 
therefore, urge all of my colleagues to support H.R. 5501 so that it 
may pass in the House of Representatives and so that we may lay the 
path necessary to ensure that during conference, the 14 Caribbean 
nations listed in this bill are included in the bill that is sent to 
the President for enactment. It not only is the right thing to do, but 
it is the smart and responsible thing to do.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I yield 4 minutes to 
the distinguished gentleman from Texas (Mr. Culberson).
  Mr. CULBERSON. Mr. Speaker, there is no more noble endeavor that we 
can engage in than to cure human diseases. All of us in Congress I 
think have an obligation to be sure that we are, for example, doubling 
the investment we make in the National Institutes of Health, in the 
National Science Foundation, in the research work that they're doing to 
identify and cure human diseases at the earlier stages.
  I represent the Texas Medical Center, and I'm proud to do so. Those 
institutions, the greatest in the world, the Andy Anderson Cancer 
Center, Texas Children's Hospital, Baylor University of Texas Health 
Science Center is doing research today, particularly on nano research, 
where we have the potential, within the next 10 to 15 years, of being 
able to identify in a child before she's born genetic predisposition to 
certain diseases, for example, like Lou Gehrig's disease, or diabetes, 
or cystic fibrosis. These genetically-based diseases can be identified 
before a child is born using nanotechnology, reinjecting, for example, 
nano sponges with a protein fix back into the mother's amniotic fluid. 
The child would then take up those nano sponges. And we can cure 
diseases in children before they are born.
  We have the potential, if we will just invest in the National 
Institutes of Health and their competitive peer reviewed grant process, 
if we will just invest the money that's needed right here in America 
for the National Science Foundation, we have the ability to detect 
cancer when it's only a few hundred cells in the body using 
nanotechnology and gold nano shells that will attach to the cancer 
cells and destroy them before they turn into a tumor.
  We have not adequately invested in our own scientific and medical 
infrastructure in the United States, first and foremost, before you 
even begin to talk about curing disease globally. We have not secured 
our border. The southern border is essentially wide open and 
unprotected in areas other than Del Rio and Laredo. What are we doing 
to make sure that we've done all that we can do here at home first and 
foremost for our own folks?
  But then finally, and most importantly, and the reason I'm so spun up 
about this, is the fact that this Democrat Thelma and Louise Congress, 
Obama-Hillary-Pelosi Democrat Congress, is managing this economy of the 
United States like Thelma and Louise, driving right off the cliff.
  I urge you to go to gao.gov and look at the Fiscal Wake-Up Tour that 
David Walker has put up on the Web site. The Comptroller of the United 
States has notified us formally that we are spending money so 
irresponsibly, so rapidly that the Standard & Poor's and Moody's has 
already formally notified the Treasury that they are beginning the 
process of downgrading U.S. Treasury bonds.
  The Comptroller has told us that by the year 2020, in 12 years, young 
people who are 18, if you're listening, by the time you turn 30, 
Medicare is bankrupt, Treasury bills will be graded as junk. Let me 
repeat that, Treasury bills are on a path to be graded as junk bonds if 
we don't stop spending money and focus on the bare essentials. Every 
American already owes $175,000 a person.
  This bill creates a worldwide entitlement to anyone in the world that 
has AIDS or malaria or tuberculosis at U.S. taxpayer expense. It's 
unaffordable. It's unacceptable. It is utterly irresponsible at a time 
of record national debt, record deficits, record Federal spending that 
we need to reign in, otherwise America is going to become Argentina. 
The dollar is rapidly becoming the peso. It's time for this Thelma and 
Louise Democrat Congress to quit spending money on things that are not 
absolutely essential to this Nation's survival.
  Let us focus on protecting the United States of America and quit 
spending my daughter's money that she does not have and driving our 
kids and our grandchildren deeper into debt. It is irresponsible. It 
is, frankly, criminal, in my opinion, to drive up the national debt and 
the deficit to record levels.
  It is a noble, good thing to try to cure disease in Africa. Why don't 
we focus on clean drinking water, for example, if you really want to 
fix disease in Africa. Quit spending my children's money that they 
don't have.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair will remind Members to direct 
their comments to the Chair.
  Mr. McGOVERN. Mr. Speaker, I yield myself such time as I may consume.
  To be honest, Mr. Speaker, I find it stunning that a Member from the 
Republican Party would come up here and talk about the debt that our 
children have been forced to inherit. I will remind my colleagues that 
when Bill Clinton left office, we had a surplus. After the leadership 
of George Bush and the Republican Congresses, we are now in historic 
record debt. I now have inherited a debt tax.
  I am all for investing more in medical research. I would much rather 
do that, quite frankly, than invest in tax cuts for Donald Trump or 
more subsidies to Big Oil companies or more tax giveaways to big 
corporations that are gouging the American taxpayer.
  But what we have here, Mr. Speaker, is a bill to save lives. This is 
a moral imperative. It is a product of bipartisan collaboration. This 
is something that we can be proud of. This is something the American 
people, I think, support overwhelmingly.
  And so, we don't need any lectures about the mess this economy is in. 
This President and the Republican Congresses have driven this economy 
into a ditch, and we're trying to get us out of that ditch.
  So, I would urge my colleagues to focus on what is being debated here 
today, which is a bill to save lives, to end the scourge of HIV/AIDS, 
malaria and tuberculosis. This is a worthy goal. This is something that 
we should be committed to. And I think that the bipartisan 
collaboration that has produced this deserves to be praised and not 
ridiculed.
  Mr. Speaker, I reserve the balance of my time.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I yield an 
additional minute to Mr. Culberson of Texas.
  Mr. CULBERSON. I want to thank Mr. McGovern for his thoughtful 
response and point out that over the last 60 years, the Republicans 
have been in control of the Congress for I think about 14 of that. We 
were in control about 12 years, and then I think there were 2 or maybe 
4 years under Eisenhower that the Republicans were in control. So, 
Democrats have controlled the Congress for the overwhelming majority of 
the last 60 years.
  I got here in 2001. And I can tell you, Mr. McGovern, and you're a 
thoughtful, good man, I enjoy working with you, that I personally, on 
behalf of my constituents, have voted against every major spending 
initiative that the White House has pushed on us because I recognized 
this problem the comptroller has put out before us. I voted

[[Page H1900]]

against the farm bill. I voted against the Medicare Prescription Drug 
bill. I voted against the No Child Left Behind Act. I voted against the 
AIDS in Africa bill the last time it came up because we cannot continue 
to spend money that our children cannot afford to pay. The money we 
spend today will be paid by our kids and our grandchildren. And that's 
the fundamental message here, Mr. McGovern.
  I would encourage everyone in this Congress, and I know you're a 
thoughtful guy, why don't we focus on providing clean drinking water. 
Let's convert existing foreign aid in Africa to clean drinking water, 
which I've lead the effort to provide $500 million. Focus on clean 
drinking water and research here in America.
  Mr. McGOVERN. Mr. Speaker, let me just yield myself 20 seconds.
  I appreciate the gentleman's response. I would just remind the 
gentleman again, and everybody, that this is a bill about saving lives. 
And this is a bill that is supported by the head of the Republican 
Party, the President of the United States. And so, I am proud to join 
in support of this bipartisan collaboration.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1115

  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, it is my privilege 
to yield 3 minutes to the distinguished gentleman from Puerto Rico, who 
is a leader on issues of health and has so much contributed to this 
important legislation, Mr. Fortuno.
  Mr. FORTUNO. Mr. Speaker, I rise in support of H.R. 5501. This bill 
reauthorizes critically important legislation. PEPFAR, which is a 
testament to the American people's generosity of spirit, has achieved 
remarkable success. Because of PEPFAR, millions of sick and vulnerable 
people beyond our borders have received an essential education, 
treatment and care. There are men in Nairobi, women in Hanoi and 
children in Port-au-Prince who are alive today because of PEPFAR. That 
knowledge should give us great pride. It should also fill us with a 
sense of humility, born of the understanding that we have helped create 
something larger than ourselves.
  I am gratified that the bill we consider today, appropriately named 
after two beloved chairmen of the Foreign Affairs Committee who devoted 
themselves to the cause of fighting AIDS, preserves the careful 
compromises that gave life to this life-giving program.
  I want to highlight an aspect of H.R. 5501 that has not received much 
attention. In February 2007 I introduced H.R. 848, which called for the 
addition of 14 Caribbean nations as so-called ``focus countries'' under 
PEPFAR.
  As the representative of nearly 4 million U.S. citizens residing in 
Puerto Rico, I am particularly aware that the people of the Caribbean 
have always been good friends and neighbors of our country. We share a 
unique and resilient bond. The sons and daughters of the Caribbean who 
have ventured north to our shores have enriched the life of this 
Nation.
  H.R. 848 was cosponsored by Congresswomen Donna Christensen and 
Yvette Clarke, who have been tireless advocates of individuals living 
with HIV/AIDS, and I commend them for their work. We were heartened 
when the language of H.R. 848 was included in H.R. 5501.
  H.R. 5501 reflects a bipartisan agreement forged through 
deliberations among Democrats and Republicans on the Foreign Affairs 
Committee, the White House, and the State Department's Office of the 
Global AIDS Coordinator. Each of these groups recognized that the 
United States can do more to help the people of the Caribbean fighting 
the AIDS pandemic that is ravaging their communities.
  Adopting a regional approach to fighting AIDS in the Caribbean, as 
H.R. 5501 does, is the right thing and the smart thing to do. There are 
currently 15 focus countries targeted for increased assistance under 
PEPFAR. Only two, Haiti and Guyana, are in the Caribbean. But the AIDS 
pandemic has produced a humanitarian crisis that affects the region as 
a whole.
  Along with sub-Saharan Africa, the Caribbean is the most severely 
impacted region in the world. In 2007 there were 230,000 adults and 
children living with HIV, 17,000 new HIV infections, a 1 percent 
prevalence rate, and 11,000 AIDS-related deaths. Statistics like this 
can have a mind-numbing effect. We must remember that behind each of 
these numbers lies a tragic story of human suffering.
  In addition, the AIDS pandemic in the Caribbean poses a significant 
national security threat to the United States, because the disease 
undermines political stability and economic development in the region 
that President Bush has called our ``third border.''
  Current spending by the United States to combat AIDS in the Caribbean 
is not sufficient to address the problem. Setting aside funding to 
Haiti and Guyana, U.S. assistance to the Caribbean has remained 
stagnant and, in fact, even decreased slightly.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. LINCOLN DIAZ-BALART of Florida. I yield the gentleman 30 
additional seconds, Mr. Speaker.
  Mr. FORTUNO. In closing, I want to emphasize this point. By adding 
these Caribbean nations, Congress does not seek to substitute its 
judgment for the judgment of the experts at the State Department in 
determining how PEPFAR money will be allocated. These fact-intensive 
decisions will and should ultimately be made by OGAC. But expanding the 
list of so-called focus countries in this manner does send a strong and 
clear message from this Congress that the broader Caribbean region 
should be considered for a reasonable amount of additional funding. And 
I believe this is a message that we can all support.
  Mr. McGOVERN. I reserve my time, Mr. Speaker.
  Mr. LINCOLN DIAZ-BALART of Florida. I yield 3 minutes to the 
distinguished gentleman from California (Mr. Rohrabacher).
  Mr. ROHRABACHER. Mr. Speaker, I just came from a meeting with local 
doctors from my district. They told me that there is a severe shortage 
of funds necessary to care for America's senior citizens. We are having 
trouble finding the money to even take care of our returning veterans. 
Millions of Americans are facing foreclosure on their homes.
  And now, with all of these challenges that we're facing at home, we 
are being asked to spend $50 billion to fight AIDS in Africa? This is 
as absurd and as irresponsible as it gets.
  Where are we going to get the $50 billion for Africa?
  Well, we can lower spending for our own people. We can raise taxes, 
which would likely throw us into a recession and leave us even less 
money for our people at home. Or of course we can borrow it. Yes, if we 
borrow it, it will probably come from Communist China and make 
ourselves even more vulnerable to their pressure.
  We have exported our manufacturing base to China already, and now we 
want to borrow even more from these dictators so we can give that money 
away to others?
  It is terrible that millions of Africans are suffering AIDS. But we 
cannot afford such totally irrational generosity. This is benevolence 
gone wild.
  We can't afford to shortchange our own people, to raise taxes, or to 
borrow it. Yet, we expect the American people to absorb another $50 
billion hit for someone else?
  We can't take care of our own veterans when they come home from the 
war. We can't take care of our elderly. We have people who can't take 
care of their own health needs, and are at risk of losing their homes. 
And we are going to spend $50 billion in Africa?
  Mr. Speaker, we have big hearts, but we need to use our brains. We 
cannot afford this type of $50 billion generosity. It's going to cost, 
this will cost the American people their way of life. It will cost them 
their health care, their education for their children. It'll cost our 
veterans.
  Our economy is facing a catastrophic setback because of the 
irresponsible spending and taxing policies of the Federal Government. 
And now we're going to exacerbate that problem by making believe that 
we can still afford to save the world by funding every worthwhile cause 
out there.
  I'm not in any way suggesting that helping people with AIDS in Africa 
is not a worthwhile endeavor. But the fact is, we've got to use our 
heads, or we will have serious negative consequences on our own people. 
$50 billion is way out of line, is way out of line.

[[Page H1901]]

  It would be wonderful to help the people of Africa through this AIDS 
crisis by transferring tons of cash into African accounts. But I 
suggest to you that, as experience shows, just sending that much money 
will not cure AIDS in Africa, and will have serious repercussions on 
our standard of living and the quality of life of our own people.
  I ask my colleagues to vote against this type of nonsense. Watch out 
for the American people.
  Mr. McGOVERN. Mr. Speaker, let me yield myself such time as I may 
consume.
  Again, I find it somewhat ironic to listen to the gentleman's 
comments who has no problem supporting a $3 trillion war in Iraq that 
has resulted in 4,000 American soldiers dead, tens of thousands 
wounded; and on top of all that, not even paying for the war, just 
putting it on the credit card so our kids and our grandkids have to pay 
for it. Many of my friends on the other side of the aisle who have 
supported tax cuts for the richest of the rich and decided that it 
wasn't important to pay for it; instead, put it on the credit card and 
on the backs of our kids; who have voted for budgets to cut veterans 
health and to cut money for health care in general. And what we have 
been trying to do is to make up for the indifference of so many years.
  You know, the gentleman presents a false choice. What we're trying to 
do here is actually respond to a humanitarian crisis in a bipartisan 
way. I mean, I don't often stand with the President of the United 
States, but I do on this. He's right. We can't ignore the HIV/AIDS 
crisis or the crisis with regard to malaria and tuberculosis around the 
world.
  This is a moral imperative. And I will tell you, in addition to being 
a moral imperative, it makes sense for the United States to take a 
leadership role and encourage the rest of the world to step up and to 
provide the resources to combat these scourges.
  This is the right thing to do. I'm proud of this bipartisan 
collaboration of this bill. And I hope all my colleagues will support 
it.
  I want to yield 1 minute to the gentleman from Florida, my colleague 
on the Rules Committee, Mr. Hastings.
  Mr. HASTINGS of Florida. I thank my esteemed colleague on the Rules 
Committee for yielding 1 minute.
  I regret very much my colleague, who is my friend from California, 
had to be about his business because I wanted to respond directly to 
him dealing specifically with his comments as if this legislation is 
directed only to Africa.
  This legislation wisely expands to the Caribbean basin. And I urged 
yesterday in the Rules Committee that people understand that American 
tourists visit these places and, in many instances, it is in our best 
interest to make sure that these kinds of humanitarian concerns are 
taken care of.
  Haiti is involved in this legislation. And I doubt seriously if 
there's anybody that doesn't believe that we should be about the 
business of trying to help Haiti.
  My colleague from Massachusetts (Mr. McGovern) just said that it is 
the right thing to do. It is the humanitarian thing to do. It is the 
right thing to do. And lest we ignore the extraordinary problem we have 
here in the Nation's Capital on HIV/AIDS, lest we ignore the need to 
expand the Ryan White Act, failure to do these things causes us to do 
so at our peril. This is de minimis by comparison to what is needed or 
what is required.
  Mr. LINCOLN DIAZ-BALART of Florida. I would ask my friend if he has 
any other speakers.
  Mr. McGOVERN. I am the final speaker on our side.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, I will be asking for 
a ``no'' vote on the previous question so that we can amend the rule 
and allow the House to consider a change to the rules of the House to 
restore accountability and enforceability to the earmark rule.
  Under the current rule, so long as the chairman or the sponsor of a 
bill, joint resolution, conference report, or manager's amendment 
includes either a list of earmarks contained in a bill or a report, or 
a statement that there are no earmarks, no point of order lies against 
the bill. This is the same as the rule in the last Congress.
  However, under the rule as it functioned under the Republican 
majority in the 109th Congress, even if the point of order was not 
available on the bill, it was always available on the rule as a 
``question of consideration.'' Because the Democratic Rules Committee 
specifically exempts earmarks from the waiver of all points of order, 
they deprive Members of the ability to raise the question of earmarks 
on the rule.
  This amendment will restore the accountability and enforceability of 
the earmark rule to where it was at the end of the 109th Congress to 
provide Members with an opportunity to bring the question of earmarks 
before the House for a vote.
  Last year the distinguished new Speaker said that if she were to 
become Speaker of the House, she would require all earmarks to be 
publicly disclosed and would ``put it in writing.'' However, as we have 
seen, this Congress, the majority have not fulfilled their promise.
  Mr. Speaker, I ask unanimous consent to insert the text of the 
amendment and extraneous materials immediately prior to the vote on the 
previous question.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Florida?
  There was no objection.
  Mr. LINCOLN DIAZ-BALART of Florida. I yield back the balance of my 
time.
  Mr. McGOVERN. Mr. Speaker, H.R. 5501 is one of the most important 
foreign policy global health bills this Congress will pass this year. 
We have literally gone from, 5 years ago from standing helplessly by 
and watching people die of HIV/AIDS, to watching people live and take 
up productive lives in their communities. The impact is far-reaching.
  For example, Mr. Speaker, let me highlight just one sector of 
development that has broad bipartisan support in this Congress, basic 
education. We all know that education is key to lifting countries out 
of poverty. And HIV/AIDS creates barriers to education.
  Teacher deaths and absenteeism due to HIV/AIDS compound problems of 
quality and access in education systems that already face teacher 
shortages.
  Children are often pulled out of school to care for a family member 
with HIV/AIDS or, when a parent dies, they're forced to take care of 
younger siblings rather than attend school.
  HIV/AIDS affected children who are able to attend school often face 
discrimination and are sometimes segregated from other children or 
denied admission entirely by teachers or school administrators.
  Young people with little or no education are more than twice as 
likely to contract HIV as those who have completed primary education.
  But under this bill, and as we continue to better integrate our HIV/
AIDS programs with our other development priorities, schools can become 
hubs of care and support for orphans and vulnerable children by 
providing psychological support, nutrition and basic health care and 
support to OVC caregivers.
  In a 32-country demographic and health survey, women with post 
primary education were four times more likely than illiterate women to 
know the basic facts about HIV/AIDS, and three times more likely to 
know that HIV can be transmitted from mother to child.
  Oxfam estimates that if all children completed primary education, 
700,000 new cases of HIV/AIDS in young people could be prevented each 
year, totaling 7 million cases in one decade.
  Mr. Speaker, for these and so many other reasons, this bipartisan 
bill deserves our support. I urge my colleagues to support this rule 
and to support the underlying bill, H.R. 5501.
  The material previously referred to by Mr. Lincoln Diaz-Balart of 
Florida is as follows:

Amendment to H. Res. 1065 Offered by Mr. Lincoln Diaz-Balart of Florida

       At the end of the resolution, add the following:
       Sec. 3. That immediately upon the adoption of this 
     resolution the House shall, without intervention of any point 
     of order, consider in the House the concurrent resolution (H. 
     Con. Res. 263) to establish the Joint Select Committee on 
     Earmark Reform, and for other purposes. The concurrent 
     resolution shall be considered as read. The previous question 
     shall be considered as ordered on the concurrent resolution 
     to final adoption without intervening motion or demand for

[[Page H1902]]

     division of the question except: (1) one hour of debate 
     equally divided and controlled by the chairman and ranking 
     minority member of the Committee on Rules; and (2) one motion 
     to recommit.
                                  ____

       (The information contained herein was provided by 
     Democratic Minority on multiple occasions throughout the 
     109th Congress.)

        The Vote on the Previous Question: What It Really Means

       This vote, the vote on whether to order the previous 
     question on a special rule, is not merely a procedural vote. 
     A vote against ordering the previous question is a vote 
     against the Democratic majority agenda and a vote to allow 
     the opposition, at least for the moment, to offer an 
     alternative plan. It is a vote about what the House should be 
     debating.
       Mr. Clarence Cannon's Precedents of the House of 
     Representatives, (VI, 308-311) describes the vote on the 
     previous question on the rule as ``a motion to direct or 
     control the consideration of the subject before the House 
     being made by the Member in charge.'' To defeat the previous 
     question is to give the opposition a chance to decide the 
     subject before the House. Cannon cites the Speaker's ruling 
     of January 13, 1920, to the effect that ``the refusal of the 
     House to sustain the demand for the previous question passes 
     the control of the resolution to the opposition'' in order to 
     offer an amendment. On March 15, 1909, a member of the 
     majority party offered a rule resolution. The House defeated 
     the previous question and a member of the opposition rose to 
     a parliamentary inquiry, asking who was entitled to 
     recognition. Speaker Joseph G. Cannon (R-Illinois) said: 
     ``The previous question having been refused, the gentleman 
     from New York, Mr. Fitzgerald, who had asked the gentleman to 
     yield to him for an amendment, is entitled to the first 
     recognition.''
       Because the vote today may look bad for the Democratic 
     majority they will say ``the vote on the previous question is 
     simply a vote on whether to proceed to an immediate vote on 
     adopting the resolution . . . [and] has no substantive 
     legislative or policy implications whatsoever.'' But that is 
     not what they have always said. Listen to the definition of 
     the previous question used in the Floor Procedures Manual 
     published by the Rules Committee in the 109th Congress, (page 
     56). Here's how the Rules Committee described the rule using 
     information from Congressional Quarterly's ``American 
     Congressional Dictionary'': ``If the previous question is 
     defeated, control of debate shifts to the leading opposition 
     member (usually the minority Floor Manager) who then manages 
     an hour of debate and may offer a germane amendment to the 
     pending business.''
       Deschler's Procedure in the U.S. House of Representatives, 
     the subchapter titled ``Amending Special Rules'' states: ``a 
     refusal to order the previous question on such a rule [a 
     special rule reported from the Committee on Rules] opens the 
     resolution to amendment and further debate.'' (Chapter 21, 
     section 21.2) Section 21.3 continues: Upon rejection of the 
     motion for the previous question on a resolution reported 
     from the Committee on Rules, control shifts to the Member 
     leading the opposition to the previous question, who may 
     offer a proper amendment or motion and who controls the time 
     for debate thereon.''
       Clearly, the vote on the previous question on a rule does 
     have substantive policy implications. It is one of the only 
     available tools for those who oppose the Democratic 
     majority's agenda and allows those with alternative views the 
     opportunity to offer an alternative plan.
  Mr. McGOVERN. I yield back the balance of my time, and I move the 
previous question on the resolution.
  The SPEAKER pro tempore. The question is on ordering the previous 
question.
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. LINCOLN DIAZ-BALART of Florida. Mr. Speaker, on that I demand the 
yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX, further 
proceedings on this question will be postponed.

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