[Congressional Record (Bound Edition), Volume 147 (2001), Part 5]
[House]
[Pages 6862-6869]
[From the U.S. Government Publishing Office, www.gpo.gov]



                     FIGHTING THE HIV-AID PANDEMIC

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2001, the gentlewoman from North Carolina (Mrs. Clayton) is 
recognized for 60 minutes.
  Mrs. CLAYTON. Mr. Speaker, I join with my colleagues today to talk 
about an issue that is causing great human devastation internationally 
and that continues to be a major health and quality-of-life problem 
domestically.
  The HIV-AIDS pandemic that now we refer to has deeply impacted the 
African continent, particularly sub-Saharan Africa. Sub-Saharan Africa 
has been far more severely affected by AIDS than any other part of the 
world. In 16 countries, all in sub-Saharan Africa, more than one in ten 
adults is infected with the HIV virus, affecting some 25 million 
people.
  According to the joint United Nations program on HIV and AIDS, three-
fourths of all deaths caused by AIDS are in sub-Saharan Africa since 
the beginning of the epidemic. It is estimated that one-half or more of 
all 15-year-old children may eventually die of AIDS in some of the 
worst affected countries, such as Zambia, South Africa and Botswana, 
unless, unless, the risk of contracting the disease is sharply reduced.
  Of the 34 million HIV-AIDS cases in the world, 24 million, or 70 
percent, are in Africa. In Zambia, 20 percent of the adult population 
is infected with HIV-AIDS. As a result of HIV-AIDS virus, 650,000 
children may have been orphaned, and 99,000 Zambians died in 1999.
  Zambia is centrally located among the sub-Saharan Africa nations, 
bordered by eight different countries. There is a growing effort to 
develop international disease-prevention intervention in Zambia because 
of its location and its diverse African culture and language group. I 
am encouraged that Duke University Medical School, along with other 
pioneers, including the University of Alabama, are developing an HIV-
AIDS intervention program in Zambia.
  Not only in Africa, but around the world, including Russia, China and 
India, the HIV pandemic continues to grow. There were 5.3 million new 
HIV infections worldwide during the year 2000, and 3 million people 
died as a result of AIDS, more annual deaths than ever before.
  I recently visited Botswana to see up close the destruction this 
disease has caused. Approximately 35 percent of Botswana's adult 
population is infected with HIV. AIDS has cut the life expectancy in 
Botswana by nearly 30 years. It has resulted in the death of so many 
people who otherwise would be in the prime of their life.

                              {time}  1930

  The visit strengthened my conviction to do my part in bringing 
awareness to this institution, and to work with my colleagues in 
Congress, the national government, States, the local government, health 
and human rights activists around the world, to do more for the people 
who have the virus and to do more to prevent the spread of the disease.
  We need to establish a partnership. We have heard of the African 
saying, ``It takes a village to raise a child.'' It will take a global 
village to adequately address the AIDS pandemic.
  While sub-Saharan Africa is disproportionately affected by the virus, 
it is by no means limited to Africa. As stated earlier, this truly is a 
global epidemic that has moved to be a pandemic.

[[Page 6863]]

  I was encouraged by the government of Botswana's response to the 
crisis in that country. This is truly an issue that remains a top 
priority with the President of that country. The government of Botswana 
has formed partnerships in an effort to help its citizens with the 
treatment and prevention of HIV-AIDS.
  The government is in partnership with the Bill and Melinda Gates 
Foundation to help set up youth centers that offer youth counseling 
services, and with the Ted Turner Foundation to provide programs and 
services to urban youth.
  They are also in the planning stage of partnering with the Gates 
Foundation and Merck to also bring about needed resources and medical 
care to fight the crisis. There still, however, is a great need to 
establish the health care infrastructure with trained health care 
providers to administer the medication or vaccine if this partnership 
is to have great impact.
  Soon after I returned from Botswana, I sponsored an HIV/AIDS round 
table discussion in my district that consisted of public health 
officials, community activists, HIV-AIDS case management, community 
health providers, and individuals suffering from HIV/AIDS. This round 
table was sponsored because my district in eastern North Carolina has 
an increased incidence of HIV. Eastern North Carolina accounts for 30 
percent of the State HIV disease reported recently, while only 
accounting for 12 percent of the North Carolina population. In my 
district, there are far more female HIV/AIDS cases as compared to the 
State average, and African Americans make up 87 percent of the new 
disease reported in my district. Clearly, this is an issue that is 
affecting us both domestically and internationally.
  I will stop now and yield to my colleague, the gentleman from 
Illinois (Mr. Rush), who also had an opportunity to visit Africa. He 
has been very active on the issue of AIDS. I am glad he is joining me 
in this special order.
  Mr. RUSH. Mr. Speaker, I thank the gentlewoman for yielding to me.
  Mr. Speaker, first of all, I want to commend my colleague, the 
gentlewoman from North Carolina, for this special order. It certainly 
shows her sensitivity, her commitment, and it shows that she is indeed 
the type of person who, throughout her tenure in the Congress and since 
I have known her, has taken the lead on issues that affect not only the 
citizens of this Nation but citizens all across the world. I commend 
her for this special order.
  Mr. Speaker, it is with great pride that I stand before this Chamber 
today to congratulate the South African people on their victory to 
obtain access to anti-AIDS drugs and other medicines at lower costs. 
AIDS activists, the South African government, and international 
organizations deserve a round of applause for their efforts.
  Also, I want to thank the 39 pharmaceutical companies for placing 
humanitarian concerns over profits by dropping their suit against the 
South African law and government.
  However, before we celebrate this victory in the war against HIV-
AIDS, we must pause and take stock of how far we still have to go. HIV-
AIDS is truly a ruthless enemy of humanity. More than 25 million 
Africans are now living with HIV, and last year alone, 2.4 million 
Africans died from the HIV/AIDS disease.
  HIV/AIDS shows no sign of relenting. It is estimated that each day 
16,000 more people become infected. Mr. Speaker, to put this tragedy 
into context, many companies in South Africa are forced to hire two 
employees for every single available position because mortality rates 
are so high.
  Even with the substantial discounts in the drug prices that the South 
African law garners, antiretroviral drugs will still cost around $300 
per year. Also, many regions of Africa do not have the resources 
necessary to distribute or administer these complicated medications.
  Rather, it must be made clear that these drugs, while desperately 
needed, treat HIV/AIDS and do not halt the spread of the disease. We 
must make prevention a priority if we are to win the war against HIV/
AIDS. This includes seeking a vaccine, distributing drugs that prevent 
transmission of AIDS from mother to child, and intensive educational 
efforts on how HIV/AIDS is contracted.
  Most importantly, more must be done to empower and assist women in 
poor countries. Women in poor countries now are the fastest-growing 
HIV-positive population.
  I want to commend the administration for its focus on the 
international fight against HIV/AIDS. The collaboration between 
Secretary of State Colin Powell and Health and Human Services Secretary 
Tommy Thompson to create a Marshall Plan to cope with the international 
HIV/AIDS crisis is, indeed, commendable.
  However, just like any other infectious disease outbreak, HIV/AIDS 
knows no border or countries. While we must focus on the international 
spread of HIV/AIDS, as my colleague indicated earlier, we cannot 
forsake efforts domestically.
  The President's budget takes a step backwards in the fight against 
HIV/AIDS domestically by freezing the Ryan White AIDS program funding. 
If we are to win the war against HIV/AIDS, we must expand our efforts, 
both domestically and abroad. Only then can we have a victory against 
this awesome enemy.
  Mrs. CLAYTON. Mr. Speaker, I want to thank the gentleman from 
Illinois for his thoughtful statement. He is right to commend the 
government of South Africa, as well as the pharmaceutical companies, in 
their withdrawing and the successful conclusion of the case that was 
against South Africa, because indeed, South Africa did not need that 
suit, and the people could not afford that.
  I also think it is a victory for the pharmaceutical companies that 
they saw the value of withdrawing the suit and trying to find ways of 
reducing the cost of their drugs, and understood the plight, that 
people were trying to import affordable drugs because they did not have 
the money. But even as they reduce it, there will be millions of people 
who just do not have enough money.
  So the gentleman is absolutely right in that. I want to applaud the 
gentleman for saying that we must make prevention, prevention, the key 
in our fight against AIDS. There is no cure for AIDS, but there is 
prevention from getting HIV. We can prevent that. There are ways to do 
that. We need to find ways to do it.
  I also agree with the gentleman, we cannot go backwards domestically 
in our fight. The budget that the administration, the Bush 
administration, has put forward certainly does not support his 
commitment to be very strong on AIDS. I applaud him, too, in terms of 
making AIDS an issue internationally, but also the budget needs to 
reflect and be supportive of that.
  Again, I thank the gentleman for his leadership.
  Mr. RUSH. I just want to say to my colleague, she is an inspiration 
in terms of the type of leadership she provides on this issue. As the 
gentlewoman knows, I also had the privilege of visiting Africa over 
this last month and was able to see firsthand the situation.
  Mrs. CLAYTON. What are some of the countries the gentleman went to?
  Mr. RUSH. We went to South Africa, Kenya, Nigeria, and North Africa; 
a North African country, Tunisia. But in South Africa, it was driven 
home most graphically the effects of this problem of HIV/AIDS and how 
it affects the children. A lot of folk do not realize that in South 
Africa, one of every three public school teachers is affected with 
AIDS. That means that the future of South Africa is definitely 
threatened by this dreaded disease.
  Mrs. CLAYTON. That is an interesting observation. I was reading 
something on the United Nations report. Poverty and HIV are related. 
AIDS is not a disease of poverty, but they become intertwined and 
connected because having AIDS moves one to the point where poverty will 
be the case.
  In fact, they said in this report that actually the more mobile, the 
more intelligent, and more educated person, those who had great access 
to move

[[Page 6864]]

around and resources to facilitate that, they were the ones getting the 
AIDS. So the teachers comment would be right in line with that 
statement. That is the future of that continent.
  Mr. RUSH. Really, one of the most salient examples is right here in 
this Nation. When HIV/AIDS first became known, it was not poor people 
who had it, it was educated people who were ignorant of not only the 
disease, but how to prevent the disease.
  Therefore, I agree, it is not a disease that strikes just those who 
are poor, it is those who are ignorant in terms of how the disease is 
contracted and those who have very little means to combat the disease, 
and also those who are unaware how to prevent the disease. It is a 
disease of ignorance more so than a disease of poverty.
  Part of what we have to do in our community, for the gentlewoman's 
recommendations, comments, and statements, we have to educate people 
about how to prevent the disease of HIV/AIDS, and how to conduct 
themselves in a manner that will not allow them to fall victim to the 
disease.
  Mrs. CLAYTON. I do not know in the gentleman's area, but I am looking 
at health statistics and I am seeing an increase in sexually-
transmitted diseases domestically. We see syphilis, other transmissible 
disease, things we thought were long cured or no longer existing. This 
is emerging again. Again, there is just a lack of vigilance in health 
standards or in protected hygiene, and in protected sex of adults, as 
well.
  Now, we are seeing not necessarily that one causes the other, but the 
vulnerability that one puts oneself in and one's body when they have a 
sexually-transmitted disease, it breaks down the immunity so the 
likelihood that one would be susceptible to HIV/AIDS is increased 
greatly.
  So we are having to almost educate people we thought knew these 
things and remind them that that is here. Certainly we have an 
education and prevention challenge, also, internationally.
  The gentleman is absolutely right, I think prevention is indeed the 
answer. That is why it makes it so troubling that the Ryan White funds 
are being reduced or flattened, because that is the outreach. We can 
prevent, we cannot cure. I think we ought to invest in research, and I 
commend that, but we do not have to do it either/or, we can do both. 
Why spend so much money in trying to treat a disease that we cannot 
cure when we have also the option to prevent the disease?
  So we need to take care of those who are affected, but we certainly 
need to be wise and prudent in investing in prevention. I thank the 
gentleman for emphasizing that part.
  Mr. RUSH. I just want to add that in my district and in my State, 
sexually-transmitted diseases are also on the rise. I certainly share 
the gentlewoman's comments. Syphilis, gonorrhea, all those diseases 
that we thought had been abolished, eliminated, they are on the rise, 
and primarily because information is not getting out to the people. 
Information is not getting out to them in the way that they 
communicate. There is no popular ad campaign dealing with this issue.
  We can see advertisements all across the television and the radio 
about every other thing except how to prevent HIV/AIDS. This is a real 
serious epidemic, pandemic, as the gentlewoman indicated, across the 
world, but it is an epidemic, and almost a pandemic in certain 
communities here in this Nation.

                              {time}  1945

  And the awareness is not there. The commitment is not there.
  I believe that the President needs to be reminded that he is sending 
two different types of messages here. They are contradictory. If the 
Secretary of HHS and the Secretary of State are developing a Marshall 
Plan for AIDS internationally, and at the same time he is withdrawing 
resources, vitally needed resources, dollars from the Ryan White 
program here in America, well, then, that sends a contradictory 
message. And he has to be clear. We need one voice, one approach to 
dealing not only with AIDS internationally but also to deal with the 
epidemic of AIDS right here at home.
  Again, I want to thank my colleague for her outstanding leadership on 
this particular issue.
  Mrs. CLAYTON. Well, I want to thank the gentleman for his leadership, 
because I know he has been very active in his community. I know a 
wonderful AIDS initiative the gentleman has in Chicago, the coordinated 
effort with all the medical schools working. I think it is probably one 
of the finest there is in the country in terms of that effort. So I 
thank the gentleman for his leadership.
  We have been joined, Mr. Speaker, by the gentlewoman from California 
(Ms. Millender-McDonald), who is very, very much engaged in this and 
has been engaged in it for a number of years. Her particular emphasis 
recently has also been with respect to women, but I know she is 
interested in all of it. I thank her for joining us.
  Ms. MILLENDER-McDONALD. I thank the gentlewoman from North Carolina, 
especially for her leadership on this. I can say unequivocally, though, 
that every member of the Congressional Black Caucus has made this a 
centerpiece, a priority, in this Congress as well as Congresses before 
and Congresses to come, because this is a very critical issue. And it 
is so timely today given that just last Saturday I had my fifth annual 
Minority Women and Children's AIDS Walk.
  Mrs. CLAYTON. We did not give the gentlewoman any peanuts this year. 
I usually give her peanuts every year to make sure they have energy 
when they make this great march.
  Ms. MILLENDER-McDONALD. Yes, the gentlewoman did give me peanuts. I 
had them from North Carolina. They were there, and we had them in the 
stuffed bags along with those from Alabama and Georgia.
  But the one thing that we are happy to say is that that has now 
presented us proceeds of over $600,000 that we are giving to different 
health facilities to treat persons, especially women and children, with 
this very deadly disease.
  It was years ago that someone told me about this disease; and I 
thought, well, I am in the State legislature, trying to pass laws, and 
I really do not have time for this. But it was not until that next year 
or so that someone brought me the facts, brought me the data; and that 
is when I said, no, that is not their problem, it is our problem and, 
more importantly, it is my problem to look at.
  We know that HIV/AIDS continues to devastate women throughout the 
world, and nowhere is it more overwhelming than on the African 
continent. As news reports tell us daily, AIDS in Africa has reached 
crisis proportions. In fact, it is a pandemic. Two-thirds of the 
world's 33 million AIDS-infected victims live on the African continent. 
Tragically, the epicenter of this disease is among African women, with 
profound effects on their children. More than nine-tenths of 8 million 
children were orphaned by AIDS last year, and those kids were in 
Africa.
  So when we ask ourselves, what can we do? Simply go around and have 
an outreach program, an education program on this devastation. No one 
needs to wait for groups like mine, the AIDS walk, or anyone else. 
Simply just go to your churches and your organizations and your schools 
encouraging folks to remain abstinent, because we cannot continue to 
see the devastation that is affecting our children and this deadly 
disease that is permeating communities of color.
  I have a bill that is called the Mother-to-Child Transmission bill 
which speaks of the drug therapy Nevirapine. Because if that drug is 
given to the mother, the child will not come out of the womb of the 
mother with this deadly disease. And programs like that new and 
inexpensive drug treatment that help prevent mother-to-child 
transmission need to be employed in Africa. This is what I am 
concentrating on at this point, trying to see whether we can get 
pharmaceutical companies to invest in Nevirapine on the continent of 
Africa. And not only that but in India, China, Eastern Europe and 
Central America. All of those areas we

[[Page 6865]]

have found now have a very alarming percentage of women and children 
who have been affected and contracted this deadly disease.
  Governments, corporations, nongovernmental organizations must 
coordinate their strengths and their projects in addressing major 
problem areas, including the critical absence of adequate 
infrastructure throughout the continent. I heard the gentlewoman from 
North Carolina (Mrs. Clayton) speak about that just a moment ago, 
because there has to be the infrastructure to deal and to help those 
who have been afflicted with this deadly disease. Ofttimes those who 
are in villages and tribes and other places do not have the adequate 
infrastructure. It is very important that we have and we look for 
funding to expand and to bring about the infrastructure that is needed, 
especially in Africa and in India.
  Local capacity must be developed through education of the masses, the 
search for a vaccine must be accelerated, and access to medicine must 
be expanded as well. I again call on this administration to include 
$150 million in its fiscal year 2002 budget for the World Bank AIDS 
Trust Fund.
  I was told just a month ago, and now in looking at the budget, that 
the Ryan White Act program has been cut. We can ill afford to do that. 
We must try to find some methodology by which we can include funds for 
this dreadful deadly disease. The President has spoken in very 
sensitive and very caring terms about persons afflicted with HIV/AIDS. 
We are asking now that we have that so that we can expand the outreach, 
expand the medicine, the therapy, and expand the education for this 
deadly disease.
  The landmark public-private partnership that was authored under the 
Global AIDS and Tuberculosis Relief Act of 2000 is designed to leverage 
contributions with additional resources from the international donor 
community as well as from the private sector. We all know that money 
alone, though, Mr. Speaker, will not solve this problem; but it is a 
vital part of the solution. These funds are necessary to implement HIV/
AIDS best practices in countries hardest hit by HIV/AIDS.
  While the HIV/AIDS disease continues to devastate humanity and the 
human element, and finding a cure seems far into the future, we cannot 
afford to give up. I will continue to fight and devote my time and 
energy to finding solutions to the myriad difficulties surrounding the 
treatment and fight against AIDS. I call on all of my colleagues to 
support local and international efforts to fight this deadly disease at 
home and abroad.
  Again, my colleague, the gentlewoman from North Carolina (Mrs. 
Clayton), I thank so much for her tenacity, for her leadership and for 
her ongoing support of all of the efforts we have put on this floor 
through legislation to try to find a cure for this.
  Mrs. CLAYTON. Well, I thank the gentlewoman for her leadership and 
for her statement; and I also thank her for bringing us up to date on 
her successful tradition and raising funds to combat and bring 
awareness to the whole issue of HIV/AIDS. And the gentlewoman is right 
to bring the attention to women and how it disproportionately affects 
women, not only in this country but in Africa.
  I think the gentlewoman is also right to bring the attention that we 
need to have more funds in order to do the work. We have been very 
fortunate in this country in the sense that it has not spread as fast, 
but because we have had efforts like those of the gentlewoman and 
others across the country, and because this Congress has been committed 
to it too. So we certainly do not want to go back. We are moving in the 
right direction to try to find both the appropriate care and 
medication, but we also want to try to provide prevention in all the 
communities. And to the extent that we pull that out, we will lose so 
much in that battle.
  Ms. MILLENDER-McDONALD. And may I please add that women now over 50 
we are finding by data, mostly African American women, are contracting 
this HIV/AIDS. And it is so devastating because they are fearful of 
disclosure, because their ministers will find out and family members. 
And it is a very hard thing when we talk with the women who are over 50 
who have now contracted this. So it is not just the young women, the 
young men; it is the older women as well.
  So we do have quite a battle, but I know with the help of the 
gentlewoman from North Carolina, and the help of this Congress, which 
the gentlewoman is right, there is not a Member who has not been 
sensitive to this issue, we will continue to do both.
  Mrs. CLAYTON. We are simply trying to raise their sensitivity with 
this. I just think people of good conscience cannot look at the 
epidemic and turn away. If you do, it says just volumes about where you 
are not, not where you are.
  Ms. MILLENDER-McDONALD. Like you said, I tried to put my head in the 
sand, but that head was lifted rather quickly when I saw the data that 
was presented to me. So I do not think anyone can really shy away from 
it.
  Mrs. CLAYTON. Again, I want to thank the gentlewoman for her 
contribution.
  Mr. Speaker, given the loss of lives AIDS has caused internationally, 
the destruction of entire communities, and the long-term impact of 
economic growth, we should strengthen our commitment and effort to 
fight the devastating disease. With children dying at the age of 15 or 
younger, with the life expectancy of only 45 years for children born in 
many countries now in the latter part of the 1900s and 2000 in Africa, 
clearly this is a human tragedy, an epidemic unknown to mankind and 
current civilization. To ignore the problem is to our peril. To know 
the impact of AIDS and to ignore it is indeed to our shame.
  Secretary Colin Powell has stated that HIV/AIDS is a national-
international security issue that the Bush administration plans to 
address, and I applaud them for that effort. I also applaud the 
pharmaceutical industry for dropping its lawsuit. We heard one of our 
colleagues talking about that earlier, the gentleman from Illinois (Mr. 
Rush), and to prevent the South African Government from importing 
cheaper anti-AIDS drugs and other medicines to respond to those who 
have the virus. Now we must increase the effort to provide affordable, 
and the emphasis is on affordable for Africa and affordable for those 
living in developing countries, affordable anti-AIDS drugs to all who 
need them.
  I challenge the pharmaceutical industry, countries worldwide, and the 
United States to engage in a collective effort to make available 
affordable necessary drugs to people affected by HIV and AIDS. It is 
important to form these partnerships, because even if cheaper drugs are 
purchased by countries, they still are out of reach for far too many. 
According to a recent Washington Post article entitled ``A War Chest to 
Fight AIDS,'' dramatic reductions in price for anti-retroviral drugs 
are key to treatment; but the cost would be now $400 or $500 per 
person, some 10,000, which is a great reduction, but there are many 
people, many people that do not make $400 per year and could not afford 
that.
  The United States must respond to this need by allocating more 
dollars than proposed by the Bush administration in their current 
budget. So I want to challenge them to really put more monies in there.
  I am greatly encouraged about the recent news that the world's 
richest countries are close to committing billions of dollars a year to 
fight against AIDS and other infectious diseases in parts of Africa, 
Asia, and the Caribbean where they have reached pandemic proportions. 
The World Bank and the United Nations would be involved in setting up a 
global trust fund to help countries suffering from the HIV and AIDS 
pandemic. Again, the United States must be a vital part of this effort 
and the trust fund.

                              {time}  2000

  A global trust fund, coupled with efforts introduced by the 
gentlewoman from California (Ms. Waters) and the gentlewoman from 
California (Ms. Lee), that would provide debt relief for these 
countries suffering greatest from

[[Page 6866]]

HIV-AIDS, this indeed would help relieve that burden. More than 6,000 
people die every day in African nations from AIDS, yet their 
governments lack sufficient financial resources to help them or to 
relieve the suffering.
  In addition to the burden of repaying the debt often incurred by 
unaccountable government officials, these countries also must pay user 
fees and interest for these medications. These conditions require 
action by this Congress. The legislation introduced by my colleagues 
and myself is extremely important and has bipartisan support. It means 
economic relief for those countries.
  There needs to be a comprehensive partnership waging a global 
campaign to prevent HIV and care for AIDS-affected patients. We are 
reminded of the complicated world surrounding global AIDS.
  In developing countries like Africa, AIDS is one of several burdens 
or conditions that must be endured. In Africa, often AIDS is in the 
midst of severe poverty, inadequate food, severe poverty, and lack of 
housing; therefore, the effect of AIDS has been and continues to make 
these problems worse. It has posed the greatest threat to the very 
generation of young people who are the most productive and are poised 
to take Africa into a brighter future economically.
  Those countries most affected by AIDS are oftentimes the same ones 
suffering from hunger and food insecurity. Nutrition and HIV operate in 
tandem at the level of both the individual and the community. For many 
individuals, nutrition deficiency probably makes people more 
susceptible to disease and infection. At the social level, food 
insecurity is a major cause for vulnerability to HIV.
  Reduced agriculture production is also one of the impacts of HIV. 
Therefore, the legislation, H.Con.Res. 102, Hunger to Harvest 
Resolution, A Decade of Concern for Africa, which has been introduced 
in the House by the gentleman from Iowa (Mr. Leach) and the gentleman 
from New Jersey (Mr. Payne), I am also a cosponsor, should be 
supported. This legislation will combat AIDS, provide education for all 
children, strengthen farming and small business, promote peace and good 
government. This legislation has a proposed commitment of $1 billion.
  The President and Congress must keep this as a top priority. The 
pharmaceutical companies must be urged to provide needed drugs to 
Africa at substantially reduced prices and may want to consider making 
that as a donation. Drugs should be made available not only to 
populations that can afford it, but also the populations who 
desperately need it. This is a declaration that no country has to fight 
this battle alone, and no nation should stand by without offering help.
  I am pleased to be joined by my colleague, the gentlewoman from Texas 
(Ms. Jackson-Lee) who has been a strong fighter and provides valuable 
leadership.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I was pleased to join the 
gentlewoman from North Carolina (Mrs. Clayton) in our recent trip to 
Botswana. Your leadership was evident there as we both listened to the 
briefings and visited sites where the persons who had full-blown AIDS 
were being cared for. We noted that they were in great need of hospital 
personnel, certainly more beds, but the individuals that were working 
were certainly working with a spirit that they were willing to fight 
the good fight.
  I think that is the spirit under which we come to the floor today, 
because I am sure as we debate and speak to this issue on the floor of 
the House, maybe Americans who may be much more informed about HIV-AIDS 
and HIV the infection, and then full-blown AIDS, might think that we 
are speaking too frequently and too often and all is well; and they 
know this is a disease, but it will not happen to them.
  I believe that it is important that the administration realize that 
the momentum that had been created, not in a partisan manner but in a 
bipartisan manner under the leadership of the past President, President 
Clinton, and Sandy Thurman whom we all worked with at the White House 
office. Her task was not easy, working with Members of Congress who had 
different perspectives, and then Congress working with several 
perspectives, but we finally came to the point of being able to focus, 
I think, about a year or two ago, $100 million on the AIDS issue. And 
then, of course, we came forward with a bill by the gentleman from Iowa 
(Mr. Leach) and the gentlewoman from California (Ms. Lee) which had to 
do with the Marshall Plan. We joined the gentlewoman from California 
(Ms. Waters) on debt relief, and now we are moving forward with 
legislation that both of us are cosponsoring.
  We have been on an journey. Even as we discuss the African Growth and 
Opportunity Act, some two sessions ago, or maybe the beginning of the 
106th Congress, there were several amendments to that trade bill. We 
had indicated that we would not let that trade bill move through the 
Congress without acknowledging if multinationals benefited from doing 
trade with Africa, that they needed to also engage in the issues of 
survival, and that was to put money aside. One of our pharmaceuticals 
did just that, put money aside to provide assistance.
  But I think there are some key elements that we need to focus on, and 
I would like to share with you these elements even though we may have 
already had this come to our attention. This is a plague. It is a 
pandemic. I note my comments on my remarks say ``biblical proportions'' 
because we think of the flood and we understand what that means. It has 
claimed 17 million lives in recent decades, and unlike the Black Plague 
in the 14th century in Europe, the means to control AIDS are known. We 
know prevention, and so we understand that.
  We are gratified that there has been some compromise on the lawsuit 
in South Africa, and we hope as South Africa begins to work steadily in 
its effort to fight the devastation in South Africa, we all accept that 
poverty is not good to help people get better. We do know that HIV is a 
virus that infects you and that it can result in full-blown AIDS.
  On the other side of full-blown AIDS there is the question of 
survival, how long and what kind of medication is available to you.
  So I think the focus should be to encourage the administration to say 
it will not work and we will not be successful if we start and stop. If 
we undermine the funding and the efforts that have been made to provide 
sub-Saharan Africa and other parts of Africa with the infrastructure 
that they need, the prescription drugs that they need, the medical 
personnel, support system that they need, then we are going to regress.
  I would like to speak to the fact that it is not just giving money to 
the continent, it is also looking at their problems. Botswana is a good 
example. They are a small country and they are trying to work against 
this tide. They have about a 39 percent infected population, yet the 
president is very sensitive to it. He speaks about it. He takes this to 
the national bully pulpit, and his constituencies are working very 
hard. His medical director or health director is working very hard. His 
physicians, his nurses are working very hard.
  What they said to me when I went to one of their sites, 
infrastructure is important. In order to get the drugs from the 
airport, they need good roads. In order to be able to monitor those who 
need to take the drugs, they need medical personnel.
  So our appropriations process should look at how we can 
constructively collaborate, the World Health Organization, USAID, 
United Nations, and how we get the right kind of funding and we do not 
want to see the funding undermined and diminished. In particular, we 
will see all of the progress that we have made clearly go back to point 
zero.
  As I spoke to an infected person who had been infected for 5 or 6 
years, living with AIDS, he said it was a great leap from when he was 
infected to now. Now his whole family knows of his condition. They are 
accepting and educated about it, and they are preventing it from 
spreading. This is the kind of

[[Page 6867]]

information that can be enhanced by the resources that we need.
  I indicated this was a pandemic. Since the beginning of this, over 80 
percent of all AIDS deaths have occurred in sub-Saharan Africa. By the 
end of 2000, there were an estimated 25.3 million people in sub-Saharan 
Africa living with HIV-AIDS, 70 percent of the total number of adults 
and 80 percent of the total number of children infected, worldwide.
  I do not want this to be seen as a condemnation of the continent. It 
is a wonderful continent. It is a continent that is seeking after 
technology. It is seeking after education and building schools. I 
believe the gentlewoman from North Carolina was excited about the 
opportunities for rural America in collaborating in agriculture. It is 
a continent that is alive.
  Frankly, I think we should view this as the potential dynamic of the 
world. As I traveled to India with the President, I believe last 
session, there was talk of its moving to India. There is talk of its 
moving to China. Those are huge population centers.
  Mr. Speaker, I rise to join my democratic colleague Representative 
Eva Clayton from North Carolina in expressing our concerns about the 
ravages of HIV/AIDS both abroad and in our own country. The African 
continent has been particularly hard hit by this deadly disease. For 
this reason I am in favor of any effort by this body to increase access 
to HIV/AIDS treatment and education throughout the world, but 
especially on the continent of Africa.
  HIV/AIDS has been declared the world's deadliest disease by the World 
Health Organization. HIV/AIDS has become a plague on the Continent of 
Africa of biblical proportions by claiming over 17 million lives in 
recent decades. Unlike the Black Plague in 14th century Europe, which 
took half as many lives, the means to control AIDS are known. I, too, 
rejoice in the good news that the pharmaceutical companies have 
withdrawn their lawsuit in South Africa so that the South African 
government can provide affordable HIV/AIDS drugs to those in need. 
However, most African and other foreign governments make no more than a 
modest level of effort to address the spread of the disease. For these 
reasons, I have and will continue to support additional funding for 
medication to be made available to the millions of poor around the 
world to fight the growing death toll attributed to HIV/AIDS.
  This crisis is having a direct impact on the future viability of many 
sub-Saharan African communities. I recently witnessed the effects of 
HIV/AIDS while I was traveling with Congresswoman Clayton and other 
congressional members in Botswana. This disease deprives nations of 
parents, workers, and teachers, destabilizing the social and economic 
framework of the nation.
  The impact of the HIV/AIDS epidemic on sub-Saharan Africa has been 
especially severe. Since the beginning of the epidemic, over 80 percent 
of all AIDS deaths have occurred in sub-Saharan Africa. By the end of 
2000, there were an estimated 25.3 million people in sub-Saharan Africa 
living with HIV/AIDS--70 percent of the total number of adults and 80 
percent of the total number of children infected worldwide. 3.8 million 
people were newly infected in this region in 2000 alone. There, over 
five thousand AIDS-related funerals occur per day.
  According to the UNAIDS Update report on HIV/AIDS infection rates, in 
many countries up to 35 percent of all adults are infected with the 
disease. Nearly 4.2 million of South Africa's 45 million people are 
infected with the virus, more than in any other country. The report 
also estimates that half of today's teenage population in parts of 
Africa will perish from HIV/AIDS. The most vulnerable group being 
affected by HIV/AIDS are the women of Africa; their infection rate is 
far greater than males. In sub-Saharan Africa, 55 percent of all adults 
living with HIV are women, and this rate is expected to continue to 
rise in countries where poverty, poor health systems and limited 
resources for prevention and care are present. What fuels the spread of 
this disease? Ignorance, misinformation, unsafe cultural practices, 
apathetic leadership and neglect by nations who have the resources to 
fight the disease.
  At least by the early 1990s, the world knew the size of the coming 
catastrophe in Africa and had the means available to slow its 
progression. Estimates from the World Health Organization in 1990 and 
1991 projected a caseload, and eventual death toll, in the tens of 
millions by 2000.
  Less than 20 years after doctors first described its symptoms, HIV 
has infected 57.9 million people. So far, nearly 22 million have died; 
this is roughly the population along the Amtrak route from New York to 
Washington, DC.
  Pharmaceutical corporation Bristol-Myers has pledged $115 million 
towards fighting this epidemic in sub-Saharan Africa. However, this 
effort will only benefit just a few of the millions of victims of HIV/
AIDS in Africa. We must do more.
  I offer that the drug manufacturers and the Congressional Black 
Caucus should be on the same side in this effort. It is only a matter 
of funding, and this Administration can take the lead in gathering from 
the global community of wealthier nations. Congress and drug 
manufacturers should make leading this effort a top priority. We could 
see an end to unnecessary deaths and suffering by the close of this 
year if we make the commitment to do so today.
  The cost of HIV/AIDS treatment for those living in the third world is 
estimated to be about $10,000 a year. It is estimated that even if 
treatment costs were reduced to only $1,000 a year it would still be 
far too expensive for Third World countries.
  Drug therapies that have significantly extended the lives of people 
living with HIV/AIDS in the United States and other developed countries 
could cost between $4,000 and $20,000 per person per year in sub-
Saharan Africa.
  In the United States, where the treatment has become standard, the 
AIDS-related mortality rate fell 75 percent in three years.
  The therapies, which use various combinations of antiviral drugs that 
emerged in Western countries five years ago have transformed the health 
and future of AIDS patients who took them.
  Since that time the gap in medical care between rich and poor 
countries has grown tremendously--our nation along with others should 
be ashamed at this condition.
  I would like to commend Congresswoman Clayton for her efforts to 
offer a clear perspective on the HIV/AIDS epidemic both internationally 
and domestically.
  Now, more than ever, the leadership of the United States is needed in 
order to avert a tragedy on the Continent of Africa. Therefore, I 
implore my fellow colleagues of the House to commit the desperately 
needed funds for this critical area.
  Many people have asked why this is important to the United States. 
Aside from the humanitarian perspective, HIV/AIDS has become a threat 
to our national security. HIV/AIDS undermines democracy and progress in 
many African nations and the developing world. Left to its own course 
HIV/AIDS will lead to political instability and may result in civil 
wars, which may affect the global balance of power as well as economic 
viability of many African nations. In many of these instances, our 
military service personnel may be pressed into service in order to 
defend American interest in any attempt to bring stability to those 
nations that decline into civil strife because of the ravages of HIV/
AIDS. HIV/AIDS, like any epidemic, cannot be contained in any specific 
geographical area. It does not discriminate between rich and poor 
nations. Unfortunately, when this dreaded disease came to our shores, 
many believed that it was a calamity only for homosexuals and drug 
users. But AIDS knows no boundaries. With globalization, we also must 
be conscious of the potential for AIDS and other infectious diseases to 
be carried across borders.
  The World Health Organization estimates that 36.1 million children 
and adults worldwide are living with HIV and/or AIDS. We must work to 
bring this tragic situation under control using all means at our 
disposal as a nation, which includes acting in a leadership capacity to 
encourage other nations to join in an effort to address this mammoth 
health crisis.
  I would ask my colleagues not to continue to bury their minds under 
useless words, but to apply our collective resources to find solutions 
to the problem of HIV/AIDS in Africa.
  Mrs. CLAYTON. Mr. Speaker, the gentlewoman is absolutely right. It is 
in Russia, China and India, as you indicated, so it is worldwide. In 
fact, there are 33 million people who have died of it, 33 million; 24 
million of them were in Africa. But HIV-AIDS is in Russia, China, India 
and other parts of Asia. This is something, if we fail to contain it 
where it is most severe, you are right, we will regret that later.
  Ms. JACKSON-LEE of Texas. That is why your special order this evening 
and this discussion is very important. I am hoping that people will not 
get tired of listening to how they can protect themselves and how they 
can help by indicating to their Members of Congress and indicating to 
the administration that this is a health problem of such proportion 
that any slow-up would be devastating.

[[Page 6868]]

  I do want to acknowledge that we have had some success with our 
corporations. I know that Bristol-Myers had put aside $115 million 
towards fighting the epidemic, but we need more of that along with the 
public complement, if you will, the public dollars. You can maximize 
them or match with private dollars, but they also send a signal about 
the fact that we are committed to the war.
  We did some of that when we went to the United Nations when, in 
actuality, the U.N. Security Council declared HIV-AIDS as a security 
risk for all of those very prominent world countries that are sitting 
around the U.N. Security Council. They were convinced that as their 
military personnel travels from place to place, if there is infection, 
the potential of the military becoming infected there and bringing it 
back home was enormous.
  I think if we can think along those lines, we begin not to be 
isolated about this issue. I know that when we were in Botswana, one of 
the doctors said if the number of people that were dying in sub-Saharan 
Africa were moved, it would be comparable to the United States, it 
would be almost like 13,000 persons a day dying in America.
  So the challenge that we have is to not frighten people into 
inaction. The challenge that we have to the President, although he has 
mandated a 4 percent across-the-board cut, which I think is going to be 
very difficult, and that is why there is a lot of debate about this 
$1.5 million tax cut, I hear $1.2 trillion, it is certainly something 
that troubles me, because I believe in giving the people back a return 
on their investment certainly.

                              {time}  2015

  I for one was for a straight out $60 billion tax cut this year, give 
it to people and infuse the economy, but I am really uncertain about 
whether we do have a $5 trillion surplus, and what is going to happen 
in this war against HIV/AIDS. I just want to steer back to personal 
experience and that is in my congressional district. I do not know if 
we have spoken about our own personal experiences, but I think we 
should.
  Mrs. CLAYTON. I did mention a little bit about the incidence 
increasing in my district. I live in a rural district, as the 
gentlewoman knows. She has been to my district. Sometimes in a rural 
area, we do not think what happens to cities happens to a rural area, 
like crime. We get crime, too. But surprisingly for a number of 
reasons, it has not been reported or people were not reporting 
themselves and all of a sudden the incidence is going up.
  In fact, we represent, in eastern North Carolina, a little more than 
my district, though, I represent about 30 percent of all the new HIV 
reported. We represent only 12 percent of the population in my 
district. So the disproportion of the increase has been that people are 
lax, they do not have the information, they are not taking the 
precaution, and also there is not this kind of sophisticated 
infrastructure both in community and education and medical to bring the 
awareness.
  We are now forming this partnership in the community to bring to the 
attention that in our local area, we do not have a pandemic, I am not 
trying to scare, as you say, people to things that are not there, but 
we are alarming them of what things are there and the potential. And 
people are coming forward to say what their conditions are, how they 
are struggling, either they do not have homes or once they know they 
have AIDS sometimes their family puts them out. There are all kinds of 
human tragedies and stories we hear.
  We have a cultural issue to look on, we have an education issue and 
an awareness issue. The gentlewoman is absolutely right. We have to 
focus on our local area as well.
  Ms. JACKSON-LEE of Texas. I think it is important that we have this 
discussion as it relates to our local areas. I was about to mention the 
fact that I had the United States Surgeon General in my district the 
entire day this past Monday, April 30. We started about 7:30 in the 
morning and went straight through to different health areas, different 
health facilities and different issues until about 5 o'clock.
  A part of our day was spent in focusing on the question of HIV/AIDS 
in Houston. In the 18th Congressional District, in particular my 
district, showed that 53 percent of the new AIDS cases were African 
Americans; and I have the highest number of those. This is not a 
condemnation. I hope we will step away from condemning because there 
are a variety of sources of contacting this disease, but the one thing 
that we knew was important, we focused on, and I know that might be 
what you are focusing on, is education and prevention and getting 
people tested.
  I was very delighted that one of my constituents, a Mr. Ernie 
Jackson, put forward a very, very powerful presentation on how we were 
collaborating with various community groups and various concerts, if 
you will, rallies to encourage people to come and be tested. We were up 
into the thousands. We are going to continue. I might compliment one of 
our famous gospel singers, Yolanda Adams, did a gospel concert. The 
tickets were given away free, and the persons were to be tested. But 
really what it shows is that we will have to be creative.
  Some of this we can do with just elbow grease, some of this we can do 
with private sector contributions or collaboration. The church or 
faith-based community, we are trying to get them involved and engaged, 
but we cannot afford to do this without Ryan White treatment dollars 
for the whole population here in the United States, now I am over into 
the United States, that will continue treating problems, without the 
public hospital system where many of these people go because they are 
uninsured or underinsured.
  Nor can we do this without the support of the funds that have been 
helping our various health agencies, in counseling money, prevention 
money and education money. And then let me just say and complement as I 
close, that we certainly cannot do this if we do not keep the Foreign 
Ops or the funding either under HHS or Foreign Ops that in particular 
goes to helping fight the pandemic internationally. It is crucial.
  I hope that we are not sounding like, forgive me for saying this, a 
broken record. I hope that this is not taken as ``we have heard this 
before.'' I really do. Because I think both of us saw this firsthand. 
We heard those numbers. We were startled; were we not?
  Mrs. CLAYTON. We were very startled.
  Ms. JACKSON-LEE of Texas. They clearly are not because people are not 
trying to overcome.
  Mrs. CLAYTON. I think we are all sensitive when we raise a flag and 
say this is a problem, that people will want to reject us because 
indeed we are repeating. But we have to do what we have to do to get 
them to know. I am confident that when people understand the 
seriousness of it, they will respond appropriately. I am hopeful that 
the education and prevention will get people aware enough to take some 
things in their own hands.
  I have also been startled by the increase of sexually transferred 
disease, which we thought had been abolished almost. That has been 
increasing. Again that is something people can take responsibility for 
and control. Education is a key in that. We need to get our churches 
involved. As you said, the condemnation needs to be put in perspective 
of educating people to take responsibility now that they know they need 
to do these things.
  You and I both are interested in the whole issue of teenage 
pregnancy, this is related. If indeed we do not involve our young 
people very early in the whole issue of abstinence and telling them 
about a far more productive life and giving them some opportunities to 
expand their life beyond being in an environment that is conducive to 
destructive behavior. In addition to that, we also have to be honest 
about the whole sexual education and protecting young people and giving 
them information that empowers them to know the consequences of their 
behavior. When they do that, again I have confidence, people will take 
information and use it for their advantage and become empowered because 
of it.
  Information is power. We ought to spread the good news that there are

[[Page 6869]]

things you can do. You can prevent it. Prevention is a key. In fact, 
the United Nations report says that as bad as the statistics are, this 
is someone addressing the United Nations, all the African heads, we are 
encouraged because there are practices we know that will work. They 
cited Brazil. They cited Uganda. They cited some other areas where they 
are beginning to be part of a fabric of showing that you can cut down 
the incidence of HIV. No cure for AIDS but you can cut down the 
incidence of HIV.
  Those are the kinds of things we want to bring awareness to. The 
partnership, the gentlewoman and I were struck, I know I was impressed 
by the partnership that had been formed in Botswana with the President 
of Botswana taking the lead and serving as the chair of that program. 
Yet although those resources were on the table, you are correct. We 
need the infrastructure. That is what we are working toward.
  Ms. JACKSON-LEE of Texas. I am not sure whether or not the word is 
getting out of the great work that is being done in Botswana. Certainly 
Uganda should be cited. I just briefly want to add that we need to 
include in our discussion malaria and tuberculosis. I was very 
gratified in the meeting I had in my district. A number of us have 
signed a list, if you will, to organize, to see how more resources can 
get into these American districts, these urban districts to help these 
communities. I think we should not step away from the resources that 
are needed nationally.
  Mrs. CLAYTON. I am glad the gentlewoman mentioned malaria as well as 
the tuberculosis, because there is data that shows that if a person has 
HIV and also contracts tuberculosis, that pulls the immunity down 
further and the likelihood of dying is increased. So you increase the 
chance of the person not living long with HIV but in fact causing the 
death. Malaria is another of those infectious diseases. There are 
treatments for malaria and there is prevention for tuberculosis. That, 
we can prevent. It does not cost a lot of money. There are vaccines and 
things we can do. We are hopeful that our colleagues and others who we 
know care about this issue will help. I am also encouraged by the 
present administration. Colin Powell has reaffirmed that this is a 
national security issue and that AIDS is going to be on their radar. We 
just want to make sure that the money will be there to support it.


                             General Leave

  Ms. CLAYTON. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days within which to revise and extend their 
remarks on the subject of my special order today.
  The SPEAKER pro tempore (Mr. Cantor). Is there objection to the 
request of the gentlewoman from North Carolina?
  There was no objection.
  Mrs. MORELLA. Mr. Speaker, I want to thank my good friend and 
colleague Congresswoman Eva Clayton for arranging this special order on 
AIDS in Africa. We are becoming more and more aware that--as CNN 
reported, the African AIDS epidemic is ``the worst health calamity 
since the Middle Ages and one likely to be the worse ever.''
  Statistics of the economic, social and personal devastation of the 
disease in sub-Saharan Africa are staggering.
  23.3 million of the 33.6 million people with AIDS worldwide reside in 
Africa.
  3.8 million of the 5.6 million new HIV infections in 2000 occurred in 
Africa.
  African residents accounted for 85 percent of all AIDS-related deaths 
in 2000.
  10 million of the 1.3 million children orphaned by AIDS live in 
Africa.
  Life expectancy in Africa is expected to plummet from 59 years to 45 
years between 2005 and 2010.
  Many experts attribute the spread of the virus to a number of 
factors, including poverty, ignorance, costly treatments, lack of sex 
education and unsafe sexual practices. Some blame the transient nature 
of the workforce. Many men, needing to leave their families to drive 
trucks, work in mines or on construction projects, engage in sex with 
commercial sex workers of whom an estimated 90 percent are HIV 
positive. In addition many men go untested and unknowingly spread the 
virus.
  Many of those infected cannot afford the potent combination of HIV 
treatment available in Western countries. In some countries only 40 
percent of the hospitals in some capital cities have access to basic 
drugs.
  While efforts are continuing to find an AIDS vaccine, many experts 
fear that some African countries hardest hit by the epidemic lack the 
basic infrastructure to deliver the vaccine to those most in need.
  More than 25 percent of working-aged adults are estimated to carry 
the virus. Counties have lost 10 to 20 years of life expectancy due to 
this disease.
  80 percent of those dying from AIDS were between ages 20 and 50, the 
bulk of the African workforce.
  40 million children will be orphaned by the disease by 2010. Many of 
these children will be forced to drop out of school to care for a dying 
parent or take care of younger children.
  Children themselves are being infected with the disease many through 
maternal-fetal transmission. While drugs like AZT have been proven 
effective in reducing the risk of an HIV positive mother infecting her 
newborn child, those drugs are too costly for most nations.
  However, today unprecedented opportunities exist to improve health 
around the world. The private sector, led by the Gates foundation, has 
provided additional resources for health programs in developing 
countries.
  Last weekend, members of the World Bank, the International Monetary 
Fund and the Group of Seven met in Washington and articulated the fact 
that HIV/AIDS is no longer just a health problem but a global health 
development problem, threatening to reverse many of the development 
gains made over the past half-century. What came out of these meetings 
was an agreement that what is needed is a war chest and a war strategy 
against HIV/AIDS.
  Money alone will not solve the problem--but it is a critical part of 
the solution. Total global support for HIV/AIDS in developing countries 
last year was under $1 billion, less than a third of the estimated need 
in Africa alone. For FY 2001 Congress provided $315 million to USAID 
for global HIV/AIDS, a $115 million increase over the previous year. 
USAID was instructed to provide $10 million for the International AIDS 
Vaccine Initiative; $15 million for research on microbicides and up to 
$20 million for the International AIDS Trust Fund at the World Bank. 
However, our forward progress must continue. The creation of new drugs 
and vaccines cannot stand alone and we must also continue to invest in 
the development of public health infrastructure. It is estimated that 
it will take as much as $6 billion to address the pandemic.
  The United States is uniquely positioned to lead the world in the 
prevention and eradication of HIV/AIDS. Some believe that the year 2000 
was a turning point in the international response to the epidemic. We 
can be encouraged by this trend; however, we must not become 
complacent. We must continue to provide the drugs, and the care to 
lessen the pain and the suffering of millions of men, women and 
children throughout the world who are infected with HIV.
  The Global Health Act of 2001 which I strongly support will provide 
an additional $275 million or HIV/AIDS, an additional $225 million for 
child survival, an additional $200 million for infectious diseases, an 
additional $200 million for international family planning services and 
an additional $100 million for maternal health.
  Mr. Speaker, the Global Health Act in conjunction with a global AIDS 
trust fund must be our goal. Confronting AIDS in Africa as well as the 
rest of the world is one of the most important international 
humanitarian battles we face today.

                          ____________________