[Congressional Record (Bound Edition), Volume 146 (2000), Part 5]
[Extensions of Remarks]
[Pages 7094-7095]
[From the U.S. Government Publishing Office, www.gpo.gov]


[[Page 7094]]

              WORLD BANK AIDS MARSHALL PLAN TRUST FUND ACT

                                 ______
                                 

                               speech of

                            HON. BARBARA LEE

                             of california

                    in the house of representatives

                          Tuesday, May 2, 2000

  Ms. LEE. Mr. Speaker, please submit the following article into the 
Record.

             [From the Washington Post, Sun. Apr. 30, 2000]

 AIDS Is Declared Threat to Security--White House Fears Epidemic Could 
                           Destabilize World

                          (By Barton Gellman)

       Convinced that the global spread of AIDS is reaching 
     catastrophic dimensions, the Clinton administration has 
     formally designated the disease for the first time as a 
     threat to U.S. national security that could topple foreign 
     governments, touch off ethnic wars and undo decades of work 
     in building free-market democracies abroad.
       The National Security Council, which has never before been 
     involved in combating an infectious disease, is directing a 
     rapid reassessment of the government's efforts. The new push 
     is reflected in the doubling of budget requests--to $254 
     million--to combat AIDS overseas and in the creation on Feb. 
     8 of a White House interagency working group. The group has 
     been instructed to ``develop a series of expanded initiatives 
     to drive the international efforts'' to combat the disease.
       Top officials and some members of Congress contemplate much 
     higher spending levels. The urgency of addressing AIDS has 
     also touched off internal disputes over long-settled 
     positions on trade policy and on legal requirements that aid 
     contractors buy only American supplies.
       The new effort--described by its architects as tardy and 
     not commensurate with the size of the crisis--was spurred 
     last year by U.S. intelligence reports that looked at the 
     pandemic's broadest consequences for foreign governments and 
     societies, particularly in Africa. A National Intelligence 
     Estimate prepared in January, representing consensus among 
     government analysts, projected that a quarter of southern 
     Africa's population is likely to die of AIDS and that the 
     number of people dying of the disease will rise for a decade 
     before there is much prospect of improvement. Based on 
     current trends, that disastrous course could be repeated, 
     perhaps exceeded, in south Asia and the former Soviet Union.
       ``At least some of the hardest-hit countries, initially in 
     sub-Saharan Africa and later in other regions, will face a 
     demographic catastrophe'' over the next 20 years, the study 
     said. ``This will further impoverish the poor and often the 
     middle class and produce a huge and impoverished orphan 
     cohort unable to cope and vulnerable to exploitation and 
     radicalization.''
       Dramatic declines in life expectancy, the study said, are 
     the strongest risk factor for ``revolutionary wars, ethnic 
     wars, genocides and disruptive regime transitions'' in the 
     developing world. Based on historical analysis of 75 factors 
     that tend to destabilize governments, the authors said the 
     social consequences of AIDS appear to have ``a particularly 
     strong correlation with the likelihood of state failure in 
     partial democracies.''
       Another mobilizing factor is American politics. African 
     American leaders, such as former representative Ron Dellums 
     (D-Calif.) and Rep. Jesse L. Jackson Jr. (D-Ill), have 
     adopted the cause of AIDS in Africa. Their interest is 
     converging with that of long-standing AIDS activists in the 
     United States and Europe, where the course of the epidemic 
     has been slowed by preventive efforts and life-saving 
     combinations of anti-retroviral drugs. They are angry at 
     policies that price those medicines beyond the reach of the 
     developing world.
       In June, those activists disrupted Vice President Gore's 
     presidential campaign announcement in Carthage, Tenn., and 
     two other speeches that week--``blindsiding us completely,'' 
     as one senior adviser put it. The activists, and several 
     senior Clinton administration officials, say that pressure 
     accelerated the White House's response.
       There is no recent precedent for treating disease as a 
     security threat. So unfamiliar are public health agencies 
     with the apparatus of national defense that one early task 
     force meeting was delayed when co-chairwoman Sandra Thurman, 
     whose Office of National AIDS Policy is across the street 
     from the White House, could not find the Situation Room.
       For all the stakes they now describe, Clinton 
     administration officials do not contemplate addressing them 
     on a scale associated with traditional security priorities. 
     Gore's national security adviser, Leon Fuerth, freely 
     acknowledged that the 2001 budget request of $254 million to 
     combat AIDS abroad--a sum surpassed, for example, by drone 
     aircraft in the Pentagon budget--provides ``resources that 
     are inadequate for the task.'' He called the work of the task 
     force ``an iterative process'' aimed at slowing the plague's 
     rate of increase and alleviating some of its effects. Before 
     this year, federal spending on AIDS overseas remained 
     relatively flat.
       Other officials noted that the United States has endorsed 
     U.N. Secretary General Kofi Annan's declared five-year goal 
     of reducing the rate of new infections by 25 percent. That 
     falls close to the CIA's best-case, and least probable, 
     scenario. Because such a turn of events would demand 
     resources from U.S. allies and multinational bodies, the new 
     White House group has been instructed to ``develop a series 
     of expanded initiatives to drive the international efforts.''
       Fuerth, a member of the ``principals committee'' that takes 
     up the most important foreign policy questions, told 
     representatives from 16 agencies on Feb. 8 that the panel 
     wanted a package of proposals for Clinton within several 
     weeks. The working group is scheduled to finish drafting its 
     proposals in May. Fuerth said the government is looking for 
     ``the kind of focus and coordination on this issue that we 
     normally strive for on national security issues.''
       ``The numbers of people who are dying, the impact on 
     elites--like the army, the educated people, the teachers--is 
     quite severe,'' he said. ``In the end it was a kind of slow-
     motion destruction of everything we were trying, in our 
     contact programs and our military-to-military programs, to 
     build up, and would affect the viability of these societies, 
     would affect the stability of the region. . . . In the world 
     that we're facing, the destiny of the continent of Africa 
     matters. And it isn't as if this disease is going to stay put 
     in sub-Saharan Africa.''
       Twenty-three million people are infected in sub-Saharan 
     Africa, with new infections coming at the rate of roughly 
     5,000 a day, according to World Health Organization figures. 
     Of 13 million deaths to date, 11 million have been in sub-
     Saharan Africa. In the developing world, the disease spreads 
     primarily through heterosexual contact.
       The intelligence estimate portrays the pandemic as the bad 
     side of globalization. Accelerating trade and travel--along 
     with underlying conditions favorable to the disease--are 
     pushing much of Asia, and particularly India, toward ``a 
     dramatic increase in infectious disease deaths, largely 
     driven by the spread of HIV/AIDS,'' the intelligence report 
     said. ``By 2010, the region could surpass Africa in the 
     number of HIV infections.'' The number of infections now is 
     relatively low, but the growth rate is high and governments 
     have been slow to respond.
       Infections are also growing rapidly, and largely unchecked, 
     in the former Soviet Union and Eastern Europe. The 
     intelligence estimate said this growth will ``challenge 
     democratic development and transitions and possibly 
     contribute to humaniarian emergencies and military conflicts 
     to which the United States may need to respond.'' The report 
     also anticipates that ``infectious disease-related trade 
     embargoes and restrictions on travel and immigration also 
     will cause frictions among and with key trading partners and 
     other selected states.''
       ``The thing that's most staggering, and people are just 
     begnning to grasp, is that Africa is the tip of the 
     iceberg,'' Thurman said. ``We are just at the beginning of a 
     pandemic the likes of which we have not seen in this century, 
     and in the end will probably never have seen in history.''
       Senior administration officials, some of them apparently 
     frustrated, said that the government does not dispute 
     estimates by the Joint United Nations Program on HIV/AIDS 
     that it would take nearly $2 billion to fund adequate 
     prevention in Africa, and a like sum for treatment. What the 
     United States has been spending, by contrast, ``is a rounding 
     error for county budgets'' in Fairfax and Montgomery 
     counties, said one disgusted official.
       ``I don't have a fantasy that we're going to go to the Hill 
     and get $5 billion to build Africa's health care 
     infrastructure,'' said one senior Africa policymaker. ``We're 
     trying to determine effective steps that need to be taken, 
     and can be taken, right now.''
       After initial resistance from U.S. Trade Representative 
     Charlene Barshefsky, the government has agreed in principle 
     to encourage cheaper access to life-saving drugs by relaxing 
     hard-line positions that protect U.S. drugmakers' 
     intellectual property. Gore has said publicly that the United 
     States does not rule out the use by afflicted countries of 
     locally made or imported generics of drugs under patent by 
     American companies. Assistant Trade Representative Joseph 
     Papovich has written to the governments of Thailand and South 
     Africa with new formulas for resolving intellectual property 
     disputes on such medicines.
       But several participants in the government effort said the 
     practical meaning of the change, if any, will have to be 
     decided at the Cabinet level or by Clinton personally. An 
     early test comes in May, when Barshefsky's office decides 
     whether South Africa should be removed from the ``watch 
     list'' of countries facing potential trade sanctions. South 
     Africa is on that list because it passed a law the United 
     States initially described as threatening to the intellectual 
     property of American drug manufacturers.
       With the prospect of substantial new spending, agencies 
     ranging from the Centers for Disease Control and Prevention 
     (CDC) and National Institutes of Health to the Labor 
     Department are fighting over the allocation of funds. 
     Undersecretary of State

[[Page 7095]]

     Frank Loy, meanwhile, is said by participants to be resisting 
     the emerging consensus that the international AIDS effort 
     should be centered in Thurman's office.
       The task force has also battled over proposals to amend the 
     Foreign Assistance Act, which requires all taxpayer-funded 
     aid to come from American suppliers. Public health agencies 
     want exceptions for condoms and AIDS test kits, which can be 
     acquired more cheaply overseas. Congress willing, the task 
     force is likely to recommend that change.
       The high-profile attention from the top is ``raising this 
     issue in ways that leaders [of afflicted nations] can't 
     ignore it,'' one White House official said. Richard C. 
     Holbrooke, the U.S. ambassador to the United Nations, used 
     his rotation as Security Council president in January to 
     declare a month on Africa. He made AIDS the subject of the 
     first Security Council meeting of 2000 and invited Gore to 
     speak. When Clinton traveled to India in March, he 
     successfully pressed the government to issue a joint 
     declaration on AIDS.
       Pervading the recent U.S. effort is a strong sense among 
     participants of time misspent. The virulence of the pandemic 
     are accurately foreseen, and ``the United States didn't 
     exactly cover itself with glory,'' said one close adviser to 
     Clinton.
       ``We saw it coming, and we didn't act as quickly as we 
     could have,'' said Helene D. Gayle, a physician who directs 
     AIDS prevention at the CDC. ``I'm not sure what that says 
     about how seriously we took it, how seriously we took lives 
     in Africa.''
       Peter Piot, a virologist who heads the United Nations AIDS 
     efforts in Geneva, said ``the good news is that the U.S. 
     government is mobilizing. The bad news is that it took so 
     long. This is not a catastrophe that came out of the blue. It 
     has been clearly coming for at least 10 years.''
       Asked about those comments, Thurman looked pained.
       ``Oh yeah,'' she said softly. ``It's very late. But better 
     late than never. You rarely ever get a second chance in an 
     epidemic.''

     

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