[Congressional Record Volume 164, Number 179 (Tuesday, November 13, 2018)]
[House]
[Pages H9488-H9491]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                      PEPFAR EXTENSION ACT OF 2018

  Mr. ROYCE of California. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 6651) to extend certain authorities relating to 
United Sates efforts to combat HIV/AIDS, tuberculosis, and malaria 
globally, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 6651

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``PEPFAR Extension Act of 
     2018''.

     SEC. 2. INSPECTORS GENERAL AND ANNUAL STUDY.

       Section 101 of the United States Leadership Against HIV/
     AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7611) 
     is amended--
       (1) in subsection (f)(1)--
       (A) in subparagraph (A), by striking ``2018'' and inserting 
     ``2023''; and
       (B) in subparagraph (C)(iv)--
       (i) by striking ``four'' and inserting ``nine''; and
       (ii) by striking ``2018'' and inserting ``2023''; and
       (2) in subsection (g)--
       (A) in paragraph (1), by striking ``2019'' and inserting 
     ``2024''; and
       (B) in paragraph (2)--
       (i) in the heading, by striking ``2018'' and inserting 
     ``2024''; and
       (ii) by striking ``September 30, 2018'' and inserting 
     ``September 30, 2024''.

     SEC. 3. PARTICIPATION IN THE GLOBAL FUND TO FIGHT AIDS, 
                   TUBERCULOSIS, AND MALARIA.

       Section 202(d) of the United States Leadership Against HIV/
     AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 
     7622(d)) is amended--
       (1) in paragraph (4)--
       (A) in subparagraph (A)--
       (i) in clause (i), by striking ``fiscal years 2009 through 
     2018'' and inserting ``fiscal years 2004 through 2023'';
       (ii) in clause (ii), by striking ``2018'' and inserting 
     ``2023''; and
       (iii) by striking clause (vi); and
       (B) in subparagraph (B)--
       (i) by striking clause (ii);
       (ii) by redesignating clauses (iii) and (iv) as clauses 
     (ii) and (iii), respectively;
       (iii) in clause (ii) (as redesignated by clause (ii) of 
     this subparagraph)--

       (I) in the first sentence, by adding at the end before the 
     period the following: ``or section 104B or 104C of such 
     Act''; and
       (II) in the second sentence, by striking ``for HIV/AIDS 
     assistance''; and

       (iv) in clause (iii) (as redesignated by clause (ii) of 
     this subparagraph), by striking ``2018'' and inserting 
     ``2023''; and
       (2) in paragraph (5), by striking ``2018'' and inserting 
     ``2023''.

     SEC. 4. ALLOCATION OF FUNDS.

       Section 403 of the United States Leadership Against HIV/
     AIDS, Tuberculosis, and Malaria Act of 2003 (22 U.S.C. 7673) 
     is amended--
       (1) in subsection (b), by striking ``2018'' and inserting 
     ``2023''; and
       (2) in subsection (c), in the matter preceding paragraph 
     (1), by striking ``2018'' and inserting ``2023''.
  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
California (Mr. Royce) and the gentleman from New York (Mr. Engel) each 
will control 20 minutes.
  The Chair recognizes the gentleman from California.


                             General Leave

  Mr. ROYCE of California. Mr. Speaker, I ask unanimous consent that 
all Members may have 5 legislative days in which to revise and extend 
their remarks and include extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from California?
  There was no objection.
  Mr. ROYCE of California. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise in support of H.R. 6651, the PEPFAR Extension Act 
of 2018.
  Twenty years ago, I was honored to serve as the chairman of the 
Africa, Global Health, Global Human Rights, and International 
Organizations Subcommittee on the House Foreign Affairs Committee. 
During my tenure, everywhere I went, particularly in southern Africa, 
hospitals were full and classrooms sat empty as teachers fell ill. Life 
expectancy plummeted, and economies deteriorated across the continent. 
Tens of millions of children were orphaned across Africa when mothers, 
fathers, teachers, soldiers, factory workers, and health professionals 
died.
  The AIDS pandemic that ravaged sub-Saharan Africa and parts of Latin 
America, Eastern Europe, and Asia was so bad that, in 2000, the U.S. 
intelligence community identified HIV/AIDS as a major threat to U.S. 
economic and national security.
  To address this, a diverse, bipartisan coalition of administration 
officials, Members of Congress, faith leaders, advocates, and NGOs 
joined with President Bush to launch the most significant global 
response to a single disease in our history. Authorized by Congress in 
2003, and later reauthorized in 2008 and 2013, the President's 
Emergency Plan for AIDS Relief, known today as PEPFAR, quickly became 
the most successful U.S. foreign aid program since the Marshall Plan.
  Today, through PEPFAR, the U.S. is supporting 14 million people with 
lifesaving treatment, which helps stabilize societies and shrink the 
pool of new infections. More than 85 million people have received 
voluntary testing and counseling, while more than 2 million babies born 
to HIV-positive mothers have been born AIDS-free.
  By strategically targeting resources and holding partners 
accountable, PEPFAR has helped reduce new infections among the most 
vulnerable groups, particularly young women and adolescent girls. It 
has done so by as much as 40 percent.
  Just last month, I returned to southern Africa and witnessed the 
impact of PEPFAR for myself. Parents are surviving; the workforce is 
recovering; and health systems are becoming stronger. This is 
tremendous progress for which we all should be extremely proud.
  But now is not the time for retreat. There remains more to be done.
  The PEPFAR Extension Act of 2018 provides a framework for PEPFAR's 
continued success while addressing new challenges. Among other 
improvements, this act extends a requirement for the inspectors general 
for the State Department, the U.S. Agency for International 
Development, and the Department of Health and Human Services to conduct 
joint oversight and joint audit plans. It also extends annual reporting 
requirements, which contributes to continued and effective 
congressional oversight.
  The United States cannot and should not fight this fight alone. That 
is why this act ensures that our programs are complemented by an 
effective, efficient, and accountable Global Fund to Fight AIDS, 
Malaria and Tuberculosis. That fund is accountable.
  This is a sensible, bipartisan approach that will enable the United 
States, through PEPFAR, to continue to help partner countries expand 
access to treatment, prevent new infections, and achieve epidemic 
control.
  Mr. Speaker, I urge my colleagues to support this timely, important, 
lifesaving measure, and I reserve the balance of my time.
  Mr. ENGEL. Mr. Speaker, I yield myself such time as I may consume, 
and I rise in strong support of this measure.
  Let me, first of all, as I have so many times before, thank Chairman 
Royce for his leadership in advancing this lifesaving legislation, as 
well as Representative Smith, the bill's author.
  I also want to acknowledge my friend from California, Congresswoman 
Barbara Lee, one of the lead sponsors not just of this bill, but of the 
2003 legislation that originally authorized PEPFAR. She is the chair of 
the Congressional HIV/AIDS Caucus and a tireless champion in the fight 
to end HIV/AIDS, and I salute her tremendous leadership. She was 
talking about this when very few people were, and look at what we have 
accomplished.
  Fifteen years ago, the idea that we would one day talk about an 
``AIDS-free generation'' would have seemed like fantasy. At the time, 
this disease had killed more than 20 million people,

[[Page H9489]]

another 42 million were infected, and a mere 50,000 people in Africa 
had access to lifesaving treatments that were still relatively new.

                              {time}  1700

  Enter PEPFAR, the President's Emergency Plan for AIDS Relief, the 
largest commitment by any country in the world to combat a single 
disease. Today, thanks to PEPFAR, 14 million men, women, and children 
are receiving treatment. More than 85 million people were tested for 
HIV last year. New diagnoses among young women and girls, a 
particularly vulnerable population, have dropped dramatically. And more 
than 2 million babies have been born HIV-free to mothers living with 
HIV.
  When President George W. Bush signed PEPFAR into law in 2003, he 
said: ``We will keep our commitment until we have turned the tide 
against AIDS.'' I think that will be President Bush's legacy, the 
positive force he was for PEPFAR and helping people living with AIDS.
  The bill we are now considering is the newest chapter in that 
commitment. It extends key provisions that have allowed PEPFAR to 
succeed. It also enables Congress to continue its oversight role so 
that PEPFAR's vital work plows ahead while we make sure taxpayer 
dollars are put to use efficiently and effectively.
  In my view, that oversight role has become especially important. 
PEPFAR thrived in the previous two administrations, and I regret that 
the current administration has twice sought deep cuts to efforts to 
fight AIDS. If these cuts were enacted--and, thankfully, Congress has 
rejected the requests--it would set us back more than 2 decades. We 
would see the first spike in new HIV infections worldwide since 1995. 
It would negate the enormous work and billions invested over the past 
15 years.
  At the same time, the administration has reimposed and expanded the 
global gag rule, the so-called Mexico City policy. I think it is a 
wrong approach. This approach to healthcare is denying so many people 
their right to comprehensive healthcare from providers they trust. It 
has ripple effects that hamper our work to combat HIV/AIDS.
  For example, a Mozambican Association for Family Development clinic 
tested nearly 6,000 patients for HIV over a 3-month period between July 
and September of last year. Then the global gag rule went into force, 
and the clinic lost its funding. During the next 3-month period, just 
671 patients were tested for HIV, a decline of nearly 90 percent.
  This is not something that we should just fathom. For 15 years, 
PEPFAR has been a model of what can be achieved through bipartisan 
cooperation. I hope that the administration will return to that 
consensus by ending its budget requests and lifting the global gag 
rule, which evidence shows is utterly at odds with the goals of PEPFAR. 
We cannot have budget cuts for something like this.
  Only then will it be possible to accelerate the progress achieved 
over the last 15 years and finally realize our goal of an AIDS-free 
generation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. ROYCE of California. Mr. Speaker, I yield 3 minutes to the 
gentleman from New Jersey (Mr. Smith). Mr. Chris Smith is chairman of 
the Foreign Affairs Subcommittee on Africa, Global Health, Global Human 
Rights, and International Organizations, and he is the author of this 
bill.
  Mr. SMITH of New Jersey. Mr. Speaker, I thank the chairman for his 
leadership on this bill, and Eliot Engel and Barbara Lee. We were there 
when George W. Bush signed this legislation. We were sitting next to 
each other.
  This has made an enormous difference in the lives of so many people. 
I call on our colleagues to support the PEPFAR Extension Act of 2018, 
which authorizes funding for each of the next 5 years for comprehensive 
programs designed to prevent or provide treatment for people suffering 
from HIV/AIDS, malaria, and/or TB throughout the world.
  Because of the vision of George W. Bush--and here in the House, it 
was Henry Hyde and Tom Lantos as chairman and ranking member--since 
2003, PEPFAR has saved an estimated 16 million lives. Today, 13 
countries are on track to control their HIV/AIDS epidemic by 2020.
  When the President signed it, he said, and I quote in part: ``HIV/
AIDS is one of the greatest medical challenges of our time. . . . 
Across Africa, this disease is filling graveyards and creating orphans 
and leaving millions in a desperate fight for their own lives.''
  He went on to say: ``In the face of preventable death and suffering, 
we have a moral duty to act, and we are acting.''
  Today, according to the U.S. Department of State, PEPFAR is the 
largest commitment by any nation to address a single disease in all of 
history. Before PEPFAR, only some 50,000 people in Africa had access to 
lifesaving antiretroviral treatment. That number has since increased to 
approximately 14 million people receiving treatment for HIV and AIDS. 
Thanks to antiretrovirals, some 2.2 million babies have been born HIV-
free to HIV-positive moms.
  Since the start of PEPFAR, new HIV infections have declined between 
41 percent to 76 percent, depending on the country, and, again, more 
than 16 million people have been saved. Yet the need for this 
legislation continues to be absolutely compelling because so much more 
needs to be done.
  The Trump administration's 2018 PEPFAR report to Congress sounds the 
alarm, noting that, according to UNAIDS, nearly 37 million people are 
living with HIV globally; however, only 20.9 million are getting 
treatment.
  They point out that we must continue to act decisively and 
strategically with our resources and bring other donors in high HIV-
burdened countries to the table. Otherwise, we all risk an epidemic 
that rebounds beyond the global community's capacity to respond.
  The time to act is now. Every week, 32,000 people are infected with 
HIV globally. Of all the new HIV infections in adolescents in the 
region, nearly 75 percent are among females, and they are up to 14 
times more likely to contract HIV/AIDS than young men.
  Mr. Speaker, I urge my colleagues to support this lifesaving 
legislation, and again, I thank my colleagues. I thank the Speaker and 
Kevin McCarthy for bringing this legislation to the floor.
  Mr. Speaker, I rise to urge House passage of my bill--H.R. 6651--the 
PEPFAR Extension Act of 2018, which authorizes funding for each of the 
next five years for comprehensive programs designed to prevent or 
provide treatment for people suffering from HIV/AIDS, malaria or TB 
throughout the world. (Current funding is approximately $6 billion per 
year).
  Because of the vision of President George W. Bush and here in the 
House the leadership of the Foreign Affairs Committee Chairman Henry 
Hyde joined by Ranking Member Tom Lantos, since 2003 the President's 
Emergency Plan for AIDS Relief or PEPFAR has saved an estimated 16 
million lives, and 13 countries today are on track to control their 
HIV/AIDS epidemic by 2020.
  When President Bush signed the U.S. Leadership Against HIV/AIDS, 
Tuberculosis and Malaria Act into law in 2003--Barbara Lee and I were 
actually sitting together at the ceremony--President Bush said:
  ``HIV/AIDS is one of the great medical challenges of our time . . . 
Across Africa, this disease is filling graveyards and creating orphans 
and leaving millions in a desperate fight for their own lives. They 
will not fight alone . . . The legislation I sign today launches an 
emergency effort that will provide $15 billion over the next five years 
to fight AIDS abroad . . . In the face of preventable death and 
suffering, we have a moral duty to act, and we are acting . . .''
  Today, according to the U.S. Department of State, ``PEPFAR is the 
largest commitment by any nation to address a single disease in 
history. Through PEPFAR, the U.S. government has invested over $80 
billion dollars in bilateral HIV/AIDS and tuberculosis programs.''
  Before PEPFAR, only some 50,000 people in Africa had access to 
lifesaving antiretroviral treatment. That number has since increased to 
approximately 14 million people receiving treatment for HIV and AIDS. 
Thanks to antiretrovirals, some 2.2 million babies have been born HIV-
free to HIV positive mothers. Since the start of PEPFAR new HIV 
infections have declined between 41-76%. And again, more than 16 
million lives have been saved.
  Yet, the need for this legislation is absolutely compelling, because 
there is much more to be done. The Trump Administration's 2018 PEPFAR 
Report to Congress sounds the alarm noting that:

``according to UNAIDS, nearly 37 million people are living with HIV 
globally; however, the number of those on treatment is currently 20.9 
million. While treatment access has increased

[[Page H9490]]

by more than 160 percent since 2010, there is still much more to do to 
ensure everyone is virally suppressed, especially children and 
individuals under age 35. Constant evaluation of program 
implementation, epidemic data, and partner performance is essential to 
continue to accelerate our impact. We must continue to act decisively 
and strategically with our resources and to bring other donors and 
high-HIV-burden countries to the table; otherwise, we all risk an 
epidemic that rebounds beyond the global community's capacity to 
respond. The time to act is now. Every week, 32,000 people are infected 
with HIV globally, including 6,900 young women and 3,000 children, and 
19,000 people die of AIDS-related illnesses. In sub-Saharan Africa, 
adolescent girls and young women are especially affected. Of all the 
new HIV infections in adolescents in the region, nearly 75 percent are 
among females; they are up to 14 times more likely to contract HIV/AIDS 
than young men.''
  I introduced H.R. 6651 joined by a group of bipartisan original 
cosponsors to ensure the continuation of this extraordinarily effective 
lifesaving initiative--and the time to act is now.
  This PEPFAR extension includes an amendment to extend programs aimed 
at supporting Orphans and Vulnerable Children--an initiative that 
assists over six million individuals--with support from multiple 
organizations, including Catholic Relief Services and World Vision. I 
would like to thank my Democratic colleague, and original cosponsor, 
Barbara Lee for her outstanding commitment to this issue.
  I also wish to commend the leadership shown by Chairman Ed Royce, 
Ranking Member Engel, Ileana Ros-Lehtinen--Ileana, we will miss you--
and my colleague on the Africa subcommittee, Ranking Member Karen Bass.
  I would also like to thank the staff who worked on this extension, 
coordinating with advocacy groups and helping bring this bill to the 
floor--Luke Murray from the Leader's office, Joan Condon and Catherine 
Rowland from the House Foreign Affairs Committee majority and minority, 
Diala Jadallah and Janette Yarwood from Representative Lee's and 
Representative Bass's office, and Piero Tozzi from my subcommittee. I 
also want to thank the many advocacy groups who weighed in with support 
and work tirelessly day-in-and-out to bring relief to those afflicted 
by HIV/AIDS and their family members.
  Mr. ENGEL. Mr. Speaker, I yield 3 minutes to the gentlewoman from 
California (Ms. Lee), one of the lead sponsors of this bill.
  Ms. LEE. Mr. Speaker, first, let me thank our ranking member, Mr. 
Engel, for yielding me time but also for his hard and diligent work and 
for being a real champion for our global health programs. I thank the 
gentleman very much for his kind words.
  Let me also thank House Foreign Affairs Committee Chairman Royce and 
the chair of the Africa Subcommittee, Chris Smith, for their dedication 
to strengthening PEPFAR. It has really been a pleasure working with 
them from day one on this lifesaving legislation.
  I cannot forget the late Chairman Henry Hyde and our ranking member, 
Tom Lantos, who worked so hard--Chris, you remember this--in making 
sure that this legislation stayed on track and that it was bipartisan.
  Also, to our current ranking member of the House Africa Subcommittee, 
Congresswoman Karen Bass, I have to acknowledge her and thank her for 
her tremendous leadership, as well as the Congressional Black Caucus 
because it was the Congressional Black Caucus that supported me in my 
work with President Bush and, thankfully, our leader, Nancy Pelosi, who 
helped with this transformational legislation. It was many years ago, 
so I just have to salute and thank them.
  I also thank my colleague Congresswoman Betty McCollum, because she 
never let us forget that we insisted on must-have efforts in this 
legislation on behalf of vulnerable children and orphans.
  As the coauthor of this critical legislation, I am very proud, as I 
said, to continue now with this legislation, which really is the legacy 
of bipartisan leadership and support for PEPFAR and the Global Fund.
  Mr. Speaker, this PEPFAR Extension Act of 2018 is extremely 
important. It would reauthorize PEPFAR and the Global Fund for 5 years.
  PEPFAR is, arguably, one of the most efficient and effective foreign 
assistance programs in history. At the time that PEPFAR was established 
in 2003, only 50,000 people were treated in sub-Saharan Africa. Thanks 
to strong bipartisan support for PEPFAR over the last 15 years, PEPFAR 
now supports lifesaving HIV treatment for more than 13.3 million people 
in more than 50 countries.
  Our investments in PEPFAR have also allowed 2.2 million babies to be 
born HIV-free, and more than 6.4 million orphans, vulnerable children, 
and their caregivers are provided with assistance under these programs.
  Now, I remember the very first individual--I believe his name was 
John Roberts--whom I met in Uganda. He was alive. He was so happy. He 
was raising a family. I believe he was a teacher. He had tears in his 
eyes when I met him, and he told me to make sure I thanked the United 
States of America for these lifesaving drugs and for the program.
  But we can't allow these successes to lull us into complacency. While 
we have made unprecedented strides in the fight against HIV and AIDS, 
the need for robust investments in these programs is more important.
  The SPEAKER pro tempore (Mr. Poe of Texas). The time of the 
gentlewoman has expired.
  Mr. ENGEL. Mr. Speaker, I yield the gentlewoman from California an 
additional 2 minutes.
  Ms. LEE. Mr. Speaker, we have made unprecedented strides in the fight 
against HIV and AIDS. The need for robust investments, though, is more 
important than ever.
  A report released by The Lancet in July found that the HIV pandemic 
is not on track to end and that little progress has been made in 
reducing new infections over the past decade. Tens of millions of 
people will require access to sustained antiretroviral treatment for 
decades to come.
  According to PEPFAR, every week, 32,000 people are infected with HIV 
globally, including 6,900 young women and 3,000 children. Mr. Speaker, 
19,000 people die of AIDS-related illnesses each week.
  Without a renewed global effort to address HIV, we really do risk the 
epidemic rebounding. We cannot allow that to happen. That is why we 
must reject any attempts--any attempts--by the Trump administration to 
cut any funding for PEPFAR and the Global Fund, and fight against the 
imposition of the global gag rule, which is already affecting access to 
critical healthcare services around the world.
  Support for PEPFAR and the Global Fund has never been a partisan 
issue. We cannot allow that to change now.
  I urge a ``yes'' vote on the bill, and I want to thank my colleagues 
so much for their support and for helping us work through these very 
tough negotiations this time. We will move forward and, hopefully, find 
solace in the fact that we can wipe AIDS from the face of this Earth by 
2030.
  Mr. ROYCE of California. Mr. Speaker, I yield 2 minutes to the 
gentlewoman from Florida (Ms. Ros-Lehtinen). She is the chairwoman 
emeritus of the Committee on Foreign Affairs, an original cosponsor of 
this bill, and the co-chair of the HIV/AIDS Caucus here in the House.
  Ms. ROS-LEHTINEN. Mr. Speaker, I am so proud to be an original 
cosponsor, along with Chairman Royce and our wonderful ranking member, 
Mr. Engel, of the PEPFAR Extension Act, which has been led by our 
colleague Chris Smith of New Jersey and my friend Ms. Barbara Lee of 
California.
  This bill will build upon the success of PEPFAR, which has been a 
transformative program in fighting HIV/AIDS, this epidemic, worldwide.
  PEPFAR has supported lifesaving antiretroviral treatments for close 
to 14 million people, a nearly fivefold increase over the last 10 
years. Since the program's inception, nearly 2 million HIV-free babies 
have been born to HIV-infected mothers.
  This program has also contributed directly to the stability, to the 
security, and to the economic growth of countries around the globe.
  When President George W. Bush called on Congress to take action in 
responding to the global crisis of HIV 15 years ago, Republicans and 
Democrats stood together, just as we are standing together tonight, to 
authorize this program. Time and time again, PEPFAR has been 
reauthorized with overwhelming bipartisan support.

  I will forever cherish, Mr. Speaker, standing in the Oval Office as 
President George W. Bush signed this essential program into law. I am 
so proud of what we as a Nation have accomplished

[[Page H9491]]

through this incredible program. With the help of our global partners, 
every day, we are closer to achieving an AIDS-free generation.
  I urge all my colleagues to give it their full support. I thank the 
Chairman, Mr. Ranking Member, Ms. Lee, and Mr. Smith.
  Mr. ENGEL. Mr. Speaker, I yield 2 minutes to the gentlewoman from 
Minnesota (Ms. McCollum), who is a great advocate for those living with 
HIV/AIDS.
  Ms. McCOLLUM. Mr. Speaker, I rise in support of this legislation 
reauthorizing the President's Emergency Plan for HIV/AIDS Relief, 
commonly referred to as PEPFAR, for an additional 5 years until 2023.
  When this law was established in 2003, I was very proud to be a 
member of the International Relations Committee. Thanks in large part 
to the bipartisan leadership of Chairman Henry Hyde and Ranking Member 
Tom Lantos, the original bill included dedicated funding that required 
that at least 10 percent of the funds be used for orphans and 
vulnerable children.

                              {time}  1715

  I thank Chairman Royce and Ranking Member Engel, and I thank Chairman 
Smith and Ranking Member Bass for maintaining support for the dedicated 
OVC funding and ensuring this provision was restored when the Foreign 
Affairs Committee marked up this bill in September.
  Today, at least more than 12 million children worldwide have lost at 
least one parent to HIV/AIDS, and at least 80 percent of these children 
live in sub-Saharan Africa.
  Of the 1.8 million children living with HIV/AIDS, only half have the 
necessary antiretroviral treatment; and without this treatment, it is 
expected that 80 percent will not make it to their fifth birthday.
  The dedicated OVC funding in this bill ensures that these children 
will continue to be a priority in our fight against HIV/AIDS in 
responding directly to physical, emotional, and economic impacts HIV/
AIDS has on vulnerable children.
  The OVC programs protect children from contracting HIV/AIDS, expand 
access to high-quality healthcare services, work directly with families 
and communities to strengthen capacity and resilience building, and 
give these children a future.
  We still have work to do, and these programs, we know they are 
effective, and we know that they are working. As of September 2017, 
PEPFAR had provided care and support to more than 6.4 million orphans 
and vulnerable children and their caregivers worldwide.
  I thank the Foreign Affairs Committee's leadership for ensuring this 
critical funding provision was included in the final version of the 
bill.
  Mr. ROYCE of California. Mr. Speaker, I reserve the balance of my 
time.
  Mr. ENGEL. Mr. Speaker, I yield myself the balance of my time.
  Let me close and let me say that, as the sponsor of the last PEPFAR 
reauthorization in 2013, I am proud to be a part of this effort. And I 
again thank Chairman Royce; Congresswoman Lee; the chair and ranking 
member of our Africa, Global Health, Global Human Rights, and 
International Organizations Subcommittee, Representatives Smith and 
Bass; and Congresswoman Ros-Lehtinen as well.
  I also thank Ambassador Deborah Birx, the U.S. Global AIDS 
Coordinator and U.S. Special Representative for Global Health 
Diplomacy, for her tireless work to ensure PEPFAR's success.
  Mr. Speaker, over the last 15 years, PEPFAR has been nothing short of 
revolutionary. It is a humanitarian and global health triumph, with 
very few rivals across history, but it is still a work in progress.
  An AIDS-free generation remains aspirational, certainly more within 
reach than it was a few years ago, but still a vision that we need to 
keep working for. If we reverse course, if we slash funding for these 
efforts, it would undermine our own efforts with foolish policies. We 
stand to lose so much of what has been achieved.
  I am glad to support this bipartisan measure which would keep us on 
the right course, and I again urge the administration to agree with 
what Congress has done, not to cut funding in this much-needed help. I 
am pleased to support the bill. I ask all Members to do the same, and I 
yield back the balance of my time.
  Mr. ROYCE of California. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, the Committee on Foreign Affairs, with the help of our 
ranking member, Mr. Eliot Engel, has worked across both Chambers of 
Congress. We have worked across party lines. We have worked to craft a 
bill that preserves congressional prerogatives and advances U.S. 
interests and helps save lives.
  I again thank Mr. Chris Smith, because H.R. 6651 does all of that. It 
does not contain new authorized appropriations, nor does it affect 
direct spending or revenues. It does not create new programs or include 
major new policy provisions. It is, in other words, a noncontroversial 
bipartisan measure that extends critical PEPFAR authorities and the 
transparency requirements that expired on September 30 of 2018.
  Congress has reauthorized, now, this program twice before, and I 
thank the U.S. Global Aids coordinator, Ambassador Birx, for her 
steadfast commitment to making PEPFAR as efficient and effective as 
possible.
  And, of course, I want to again thank all of the sponsors--
Representatives Smith, Ros-Lehtinen, Engel, and Lee--for championing 
this effort and doing so from the very start.
  And, finally, I thank Joan Condon on my staff, who has been 
instrumental in seeing this important legislation over the finish line 
and who has long worked for effective U.S. assistance programs that 
both save lives and reinforce the moral stature of the United States 
around this globe.
  The success of these efforts, the success of this program will 
forever be measured by the lives it has saved. I urge my colleagues to 
support this bill, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from California (Mr. Royce) that the House suspend the rules 
and pass the bill, H.R. 6651, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  The title of the bill was amended so as to read: ``A bill to extend 
certain authorities relating to United States efforts to combat HIV/
AIDS, tuberculosis, and malaria globally, and for other purposes.''.
  A motion to reconsider was laid on the table.

                          ____________________