[Congressional Record Volume 169, Number 202 (Thursday, December 7, 2023)]
[Senate]
[Pages S5847-S5849]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                          WORLD AIDS DAY 2023

  Mr. CARDIN. Mr. President, this past Friday, December 1, we marked 
the 35th anniversary of World AIDS Day. World AIDS Day serves as a 
reminder of the global struggle to end AIDS, an opportunity to honor 
those we have lost while supporting those who are living with or at 
risk of the HIV virus, and as a unifying call to continue working 
toward a day when HIV is no longer stigmatized or a public health 
threat.
  Thirty-five years ago this year, World AIDS Day was established, 
marking the first international day for global health. Since then, 
World AIDS Day has adopted targeted themes to raise awareness and 
encourage international cooperation. This year's theme in the United 
States, ``Remember and Commit,'' focuses on paying tribute to those we 
have lost to HIV/AIDS, emphasizing our collective responsibility to 
act. Through remembrance, we draw strength and determination to 
redouble our efforts in fighting this global crisis and support those 
living with HIV both here and abroad. The 2023 campaign reminds us that 
each one of us can make a difference while promoting the importance of 
compassion, empathy, and solidarity in the face of adversity. And it 
reminds us that as citizens of the world, the United States must 
continue to provide a helping hand to countries less fortunate than 
ours in bringing an end to the AIDS pandemic.
  Since the first cases of AIDS were reported in the U.S. in June 1981, 
more than 700,000 people in the U.S. have died from HIV-related 
illnesses. In 2021, over 36,000 people were diagnosed with HIV in the 
U.S., and more than 1.1 million people in our country are currently 
living with this virus, with

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many more at risk of HIV infection. In 2021, there were 32,100 
estimated new HIV infections in the U.S. My home State of Maryland is 
not immune; during 2022, 751 Marylanders over 13 years old were newly 
diagnosed with HIV, and over 31,000 Marylanders were living with the 
disease.
  Recent data show that minority populations continue to remain 
disproportionately affected by HIV/AIDS. In 2021, Black Americans 
accounted for 40 percent of HIV diagnoses, while Hispanic/Latino 
Americans accounted for 29 percent of HIV diagnoses. We must work 
harder to address persistent health inequities and end the disparities 
in access to prevention, care, and treatment.
  World AIDS Day reminds us that HIV is not just a medical issue. It is 
a human rights issue. Criminalization, discrimination, and social 
stigmas continue to impact the most vulnerable populations across the 
globe. In sub-Saharan Africa, where the United States proudly invests 
the majority of our global HIV spending, violence and discrimination 
against women and girls continues to fuel the epidemic. Children who 
are orphaned or otherwise affected by HIV face a range of challenges 
from child labor, to the worst forms of exploitation.
  Fortunately, thanks to scientific advances, the U.S. Food and Drug 
Administration--FDA--has now approved more than 30 medicines to treat 
HIV infection, including the new class of antiretroviral drugs, which 
have transformed HIV from a death sentence to a chronic but manageable 
disease. They help extend and stabilize the lives of those living with 
HIV while also dramatically reducing the risk of HIV transmission. This 
makes it all the more imperative that all people who need HIV treatment 
have access to it.
  We are fortunate to have premier scientific research institutes 
within my home State of Maryland working together to combat this deadly 
virus, including the National Institutes of Health--NIH--the Walter 
Reed Army Institute of Infectious Disease Research, the Institute of 
Human Virology at the University of Maryland, and Johns Hopkins 
University. Not only have these organizations substantially led 
scientific advancements with respect to HIV/AIDS, they have also played 
an important role in reducing the number of new cases among Marylanders 
and affording those living with HIV the opportunity to continue living 
full lives.
  As a result, Maryland has reached significant milestones in reducing 
HIV case numbers; my State went from ranking seventh among all the U.S. 
States and territories to 12th in 2 years. Baltimore City, Montgomery 
County, and Prince George's County have been participants in the 
Department of Health and Human Services--HHS--Ending the HIV Epidemic 
in the U.S. Program, which is working to reduce new HIV transmissions 
by 75 percent by 2025 and by 90 percent by 2030. This multi-year 
program will infuse 48 counties; Washington, DC; San Juan, PR; and 
seven States that have a substantial rural HIV burden with the 
additional expertise, technology, and resources they need to reduce 
transmission. Public health initiatives the Maryland Department of 
Health has implemented--including safer-sex education programs, free 
HIV self-tests, condom distribution, and access to prophylactic 
medication--have been instrumental in reducing new infections. 
Additionally, city and county needle exchange programs have broadened 
efforts to reduce the circulation of used syringes, provide testing for 
infectious diseases such as HIV, and extend resources for the treatment 
of substance use disorders.
  Thanks to the Affordable Care Act--ACA--Americans diagnosed with HIV 
or at risk of transmission have more meaningful access to healthcare 
coverage and health insurance. Today, Americans cannot be dropped or 
denied coverage because of preexisting health conditions such as 
asthma, cancer, HIV, or COVID-19. The ACA also gives States the option 
to expand Medicaid, the largest payer for those who need HIV treatment 
in the country, and so far, 41 States have expanded Medicaid coverage. 
I look forward to seeing the remaining States join this list.
  The ACA has also established new standards and essential benefits 
that certain health plans must cover. Benefits such as prescription 
drug services, hospital inpatient care, lab tests, HIV screening, 
preexposure prophylaxis or PrEP, and other preventive services aim to 
preserve the health of those with HIV while mitigating further 
transmission. Under the ACA, most health insurance plans must provide 
preventive services, including HIV testing for those aged 15 to 65, as 
well as PrEP for HIV-negative adults at high risk of HIV infection. I 
am proud to have served as a cosponsor of the PrEP Access and Coverage 
Act, which would expand access to PrEP and work to reduce the existing 
disparities in access. Legislation like this is especially important in 
light of recent threats to PrEP access, such as a Texas judge's ruling 
in Braidwood Management v. Becerra, a decision which has the potential 
to result in thousands of unnecessary HIV infections.
  I commend the Biden-Harris administration for publishing the National 
HIV/AIDS Strategy for the United States (2022-2025) to provide a 
roadmap to accelerate efforts to end the HIV epidemic in our country by 
2030. These are bold targets facilitated by the White House's Office of 
National AIDS Policy, ONAP. The Strategy builds on our country's 
progress and lessons learned from the prior national strategies and 
seeks to leverage new tools and opportunities to address the challenges 
that remain. I share President Biden's determination to address the 
disproportionate impact of the epidemic on marginalized populations 
like the LGBTQI+ community and racial and ethnic minorities.
  We must remember, however, that HIV remains a grave public health 
challenge around the world. In 2022, 39 million people lived with HIV 
globally. Last year, roughly 630,000 people died from AIDS-related 
illnesses. Only 57 percent of children aged 14 and younger had access 
to treatment in 2022, compared to 77 percent of those aged 15 and over. 
We must redouble our efforts to close this gap and guarantee lifesaving 
HIV treatment to all who need it and to prevent more HIV infections. 
And it can be done.
  This year, President Biden commemorated the 20th anniversary of the 
U.S. President's Emergency Plan for AIDS Relief--PEPFAR--honoring the 
25 million lives that have been saved worldwide in the fight to end 
HIV/AIDS as a public health crisis. Since its inception in 2003, the 
PEPFAR program has changed the trajectory of the HIV epidemic around 
the globe, representing an extraordinary commitment to global health, 
aiming to prevent, diagnose, and treat HIV infections. Over nearly 20 
years, five mission babies have been born AIDS free, 7 million orphans 
have been supported, and 20 million people are on lifesaving treatment 
medications. PEPFAR has also demonstrated the value of strong health 
systems in managing and anticipating other pandemics. Much of the 
staff, infrastructure, and technology that was developed through PEPFAR 
proved instrumental in the COVID-19 response in countries that would 
otherwise not have the capacity to deliver treatment and vaccines. But 
we have not crossed the finish line yet. The next 5 years are critical 
to meet the goal of ending the global HIV/AIDS epidemic by 2030. The 
U.S. must continue to show global health leadership and facilitate 
cooperation with our foreign partners and allies.
  We must continue to invest in the communities and local leaders that 
know their own health needs best. All people, regardless of age, sex, 
gender identity, sexual orientation, race, ethnicity, religion, 
disability, geographic location, or socioeconomic circumstance, should 
have access to prevention, treatment, and care. International partners, 
academic partners, faith-based organizations, and civil society are 
counting on us to continue our support for their long-held efforts to 
ending AIDS. This is why I call on my colleagues on both sides of the 
aisle to once again step forward in faith and courage and join together 
to secure PEPFAR's reauthorization.
  Most importantly, I want to recognize those living with HIV/AIDS 
across the globe. Your demand for dignity and access to healthcare has 
shown us what is possible when the world works together to fight a 
public health scourge, and in accordance with that spirit, we will 
prevail in doing so. We must recommit ourselves to continuing this

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fight because success is within our reach.

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