[Congressional Record Volume 154, Number 80 (Thursday, May 15, 2008)]
[Senate]
[Pages S4273-S4274]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         PEPFAR REAUTHORIZATION

  Mr. DURBIN. Mr. President, I rise this evening to speak for a few 
moments about another hold that has been placed on critically important 
legislation.
  Anyone who follows what we do here on the floor of the Senate or in 
the House of Representatives knows that many of us on the Democratic 
side have disagreed with President Bush as to his policies. Over the 
last 7 years, there have been ample opportunities to vote against the 
President's policies, whether it is on the invasion, the war in Iraq, 
or economic policies that brought us to this sorry stage of the 
American economy, with working families struggling to pay their bills 
and to survive.
  I have opposed President Bush's economic policies and many other 
things during the course of his administration. But there was one 
moment I can still recall when the President gave a State of the Union 
Address and announced that the United States would try to lead the 
world in dealing with the global AIDS epidemic. On the Democratic side, 
I joined many of my colleagues, standing and applauding President Bush 
for that announcement. Though I may disagree with him on many issues, I 
salute him for his special efforts to deal with the global epidemic of 
AIDS and tuberculosis and malaria.
  The President established a program known as the President's 
Emergency Plan for AIDS Relief, commonly known as PEPFAR. This 
important program is up for reauthorization so that it can continue to 
save lives across the world.
  They have renamed it in honor of two men who served in the House of 
Representatives--one a Democrat, Tom Lantos; the other a Republican 
from Illinois, Henry Hyde. It is known as the Tom Lantos and Henry J. 
Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, 
and Malaria Reauthorization Act.
  The Senate Foreign Relations Committee considered this bill and 
passed it out 18 to 3--an overwhelming bipartisan vote. Our colleagues 
in the House passed a similar measure with an overwhelming vote at the 
end of March of this year.
  The President has urged Congress to send him the bill before the end 
of the year. President Bush takes great pride in this bill. He believes 
it is one of the hallmarks of his tenure in office and administration. 
I join him. I think it is his most positive achievement as President of 
the United States.
  The purpose of this bill is to prevent 12 million new infections; 
support

[[Page S4274]]

treatment for at least 3 million people; provide care for another 12 
million, including 5 million very vulnerable children.
  That kind of assistance helps to save lives, and it is an important 
step not only from a humanitarian viewpoint but also to alert the world 
as to our real values in America. We are in a struggle across the world 
now. Many of our harshest critics paint a picture of the United States 
that is not close to reality. This kind of legislation, where the 
United States puts investment in the health care of people around the 
world, tells the right story about who we are and what we believe.
  There is a sad ending, regrettably, as is too often the case in the 
Senate. This bill--despite the President's support, despite broad 
bipartisan support in the House and the Senate--is being blocked by 
several Republican Senators. Seven of my colleagues across the aisle, 
who have publicly identified themselves, have stopped the consideration 
of this bill to deal with the global AIDS epidemic. Those Senators are 
Senators Coburn, DeMint, Sessions, Chambliss, Vitter, Bunning, and 
Burr.
  Now, former Bush speech writer, Michael Gerson, issued a scathing 
criticism of this Republican hold in a recent article in the Washington 
Post. I quote him when he says:

       It is the nature of the Senate that the smallest of 
     minorities can impede the work of the majority. But it takes 
     a conscious choice--an act of tremendous will and pride--for 
     members to employ these powers against an AIDS bill with 
     overwhelming bipartisan support.

  Mr. Gerson is right. I appreciate and share his sentiments and the 
frustration that comes with them.
  There is broad bipartisan support for this measure. There are 
literally lives on the line. The President says we need it. Who would 
disagree? Virtually all of us on both sides of the aisle have applauded 
the President's efforts and voted for funding the PEPFAR program. Our 
ability to save the lives of millions of people around the world 
depends on a parliamentary maneuver in the Senate, where seven 
Republican Senators have put a hold on a bill to try to fight the 
global AIDS epidemic.
  Many of my friends on the other side of the aisle support this bill 
enthusiastically. Even those with concerns about it are willing to 
concede this has been a remarkably successful program.
  Since 2003, when we were treating only 50,000 people in sub-Saharan 
Africa, the PEPFAR and Global Fund now reach nearly 2 million people, 
primarily on the continent of Africa. That is an amazing record of 
progress in 5 years. That has literally changed the situation in 
Africa.
  I went to Africa 7 or 8 years ago and did not go looking for the 
global AIDS epidemic. But you could not avoid it. Everywhere you 
turned, in every country I visited, terrible stories were being told 
about the people who were dying, how it was necessary to hire two 
teachers for every grade in school because one was likely to die before 
the end of the school year. It was awful. There was no hope. People 
would not go for tests to see if they were positive because learning 
that information led them nowhere--just the knowledge of impending 
doom.
  Well, Mr. President, that has changed. Because of PEPFAR and the 
Global Fund, because of the efforts of the Gates Foundation, because of 
the efforts of former Presidents Bill Clinton and George H.W. Bush, we 
now find medications and treatment available in Africa. People are 
going forward to be tested so they do not unnecessarily expose someone 
else to the disease and so they can seek treatment at an early stage 
and live a long life.
  The world has changed in Africa because of this program. But the 
program is about to expire, and these seven Republican Senators are 
standing in the path of reauthorizing that program.
  When they were asked why they opposed this program being 
reauthorized, one of the Senators argued that it has gone beyond its 
original mission of treating AIDS and now is dealing with other issues. 
This critic of the program, my Senate colleague, called it ``mission 
creep.'' I wish that Senator could go to Africa and see it firsthand.
  To argue that adding nutrition, safe water, and sanitation programs, 
treatment of tuberculosis and malaria, and protection of vulnerable 
populations is somehow beyond the scope of the original bill is to 
ignore reality.
  I went to a portion of Nairobi, Kenya, to one of the larger slums, 
which has some 600,000 people and a rampant AIDS epidemic. Well, it is 
being treated with drugs and testing, and we are making some progress, 
but they took me to a small area where a group of parents who were 
infected with HIV were sitting and watching their children play.
  I looked on as several of the women who were sitting there looked as 
if they were about to die, they were so emaciated. I said to the person 
with me: It is a shame they didn't have access to the drugs. The person 
said: They have access to the drugs. They are taking the drugs. They 
just don't have access to food.
  These drugs don't work on a hungry person and an empty stomach. So 
when the critics of this PEPFAR reauthorization argue against food and 
nutrition as part of the program, they are ignoring the obvious. If you 
want to treat a woman with a child, and you want the drugs to work, she 
needs basic nutrition. That has to be part of the program. It does no 
good to give these drugs to a starving, dying person.
  Maintaining the status quo, as some of my Republican colleagues who 
oppose this bill prefer, would deny the progress we have made under 
President Bush. This bill creates a program that is sustainable and 
maintains our essential leadership role in the fight against AIDS, TB, 
and malaria.
  Some on the other side may disagree, and let me tell you, it is their 
right to disagree. But I think the honorable thing to do, the right 
thing to do, is to bring their disagreement to the floor and to offer 
an amendment. If they want to change the program, so be it. That is why 
we are here. We should consider the merits of their amendment and vote 
it up or down. Then, depending on the outcome, they can decide whether 
they want to vote for or against the bill.
  But to hold this bill indefinitely, when 12 million lives hang in the 
balance, I have to agree with Mr. Gerson, it is a conscious decision--
as he said: ``an act of tremendous will and pride.''
  I urge my Republican colleagues: Please, please reconsider this hold. 
I find it very difficult to understand how some of these same 
colleagues can go to our Prayer Breakfast regularly and pray for the 
poor and suffering in the world and come to the floor of the Senate and 
put a hold on a bill that would provide nutrition and drugs to people 
who will die without it. I do not understand that. I hope they will 
reconsider.
  Recently, President Bush traveled to Africa. He was greeted with 
great warmth and hospitality by a continent grateful for his efforts in 
the fight against AIDS. The Senate should not turn its back on what the 
President and America have achieved. We should move quickly to 
reauthorize the U.S. commitment to global AIDS relief. The efforts of 
these seven Senators holding this important bill should not stop us 
from doing the right thing for the millions of people around the world 
whose lives literally depend on it. I am going to urge my colleagues, 
as often as I can, to drop this hold on this bill to allow the Senate 
to debate and pass this important legislation.

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