[Congressional Record (Bound Edition), Volume 149 (2003), Part 4]
[House]
[Pages 5223-5229]
[From the U.S. Government Publishing Office, www.gpo.gov]




                        GLOBAL HIV/AIDS PANDEMIC

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 7, 2003, the gentlewoman from California (Ms. Lee) is 
recognized for 60 minutes.
  Ms. LEE. Mr. Speaker, tonight's Congressional Black Caucus special 
order on the global HIV/AIDS pandemic is particularly timely given our 
current discussions on an authorization bill by the House Committee on 
International Relations. I want to thank the gentleman from Maryland 
(Mr. Cummings) for his leadership in the Congressional Black Caucus for 
organizing this very important discussion tonight.
  Three weeks ago, during the Congressional Black Caucus' special order 
celebrating Black History Month, I laid out the history of our caucus' 
work in the Congress on the global AIDS pandemic. I described how our 
involvement evolved in 1998 with a proposal put forth by my friend, 
colleague and a distinguished founding member of the Congressional 
Black Caucus, Congressman Ron Dellums, calling for an AIDS Marshall 
Plan. Since that time, support for these proposals has broadened beyond 
the Congressional Black Caucus to encompass a majority of Members of 
this Chamber on both sides of the aisle. I am especially proud of the 
progress that we have made over the years.
  For example, under the leadership now of our new leader, the 
gentlewoman from California (Ms. Pelosi), $42 million was amended to 
the fiscal year 2001 foreign operations bill to provide the first real 
increase in spending for our international AIDS programs. We passed the 
Global AIDS and Tuberculosis Relief Act of 2000, which was signed into 
law by President Bill Clinton and which established the framework for 
the global fund to fight AIDS, TB and malaria.
  And last year we came very close to reaching a compromise on H.R. 
2069, the Global Access to HIV/AIDS Prevention, Awareness, Education 
and Treatment Act which is a comprehensive global AIDS bill that passed 
the House in December of 2001 and which the Senate modified and passed 
in July of 2002. Yet there is still a tremendous amount of work for us 
to do, particularly now that the President has finally decided to 
support a significant boost in spending for our international AIDS 
programs.
  But what has the President really proposed and how does this proposal 
translate into action within the fiscal year 2004 budget which we 
received early last month? The President has said that the goal of his 
initiative is to prevent 7 million new infections per year and to 
provide treatment to over 2 million people who are infected with HIV, 
and to provide care for 10 million HIV-infected individuals and AIDS 
orphans. But where is the money for this proposal? Certainly it is not 
contained within the President's recent budget request to the Congress. 
In fact, the President only requested $450 million for his initiative 
in this coming year and a total of $1.8 billion for the entire 
international HIV/AIDS, TB and malaria portfolio. This is barely an 
increase of $400 million over the fiscal year 2003 budget of $1.4 
billion and is far below the figure of $2.6 billion that

[[Page 5224]]

the Congress was targeting for fiscal year 2004. Yet at the State of 
the Union address, the President described an immediate need for 
treatment for 4 million individuals infected with AIDS, individuals 
who, as the President described, have been told by their local 
hospitals, ``You've got AIDS. We can't help you. Go home and die.''
  What does the President say to these same people within his budget 
request? Additionally, the limited focus of the President's plan to 
just 25 percent of the 48 sub-Saharan countries is really very 
shortsighted. This kind of policy would neglect millions of individuals 
who are equally in need of assistance. But the most disconcerting 
portion of the President's proposal is his level of commitment to the 
global fund to fight AIDS, TB and malaria. Under the President's 
proposal, the global fund would receive only $200 million per year for 
the next 5 years. Yet at this moment, the fund is nearly bankrupt and 
has projected that it will require an additional $6.2 billion through 
2004 to meet the increasing number of grant requests that the fund is 
expecting.
  As a point of comparison, we recently approved $350 million in the 
fiscal year 2003 budget for the global fund. The AIDS authorization 
bills that we were working on last year would have provided between 
$750 million to $1 billion in fiscal year 2003. Clearly the 
congressional commitment to the fund exists. This was a bipartisan 
effort. It is especially critical that we provide funding now, given 
the recent election of Health and Human Services Secretary Tommy 
Thompson as chair of the executive board of the fund, in effect, making 
him the chief fund-raiser for the global fund.
  Despite these issues, I believe there is ample hope that the United 
States will make a substantive commitment to fighting the global AIDS 
pandemic. The groundwork that we laid in the last Congress among the 
original cosponsors of the House and the Senate AIDS authorization 
bills provides us with a real opportunity to jump start our work here 
in this House.
  So far, I have been very encouraged by the efforts of my colleagues 
on the House Committee on International Relations who are seeking to 
act quickly on a bipartisan AIDS authorization bill in this Congress. 
Chairman Hyde, Ranking Member Lantos and Congressman Leach, who also 
was my partner really in the Global AIDS and Tuberculosis Relief Act, 
have all displayed a commitment to working on a bill that builds upon 
our previous efforts in the last Congress.
  Currently, we are looking at an authorization of $15 billion over 5 
years, $3 billion per year, that matches the President's request at the 
State of the Union. The underlying structure of the bill is very 
similar to a compromise that we were working on at the end of the 107th 
Congress. I am very optimistic about our progress on this bill and I 
look forward to our continued dialogue with our colleagues in hopes 
that we will have a bill for markup in committee very soon.
  Mr. Speaker, I yield to the gentleman from Maryland (Mr. Cummings), 
the chair of our Congressional Black Caucus who has been a great leader 
on this issue, and so many other issues not only in Maryland but in the 
United States House of Representatives.
  Mr. CUMMINGS. I want to thank the gentlewoman for yielding. I also 
want to take a moment to thank her for consistently standing up for so 
many people who cannot stand up for themselves. I also thank her for 
consistently raising this issue, an issue that so often is put to the 
side, so often not put on the back burner but placed off the stove.
  Mr. Speaker, I rise today to speak on an issue that deeply troubles 
members of the Congressional Black Caucus as well as many other Members 
of this Congress, the President's emergency plan for AIDS relief.
  Mr. Speaker, the Bush administration's policy on HIV/AIDS and other 
global diseases affects us all. Infectious diseases know no borders. 
Because of this, prevention and treatment programs to address 
particularly dangerous diseases such as HIV/AIDS, tuberculosis and 
malaria must be swift and adequate. That is why I and other members of 
the Congressional Black Caucus, AIDS activist groups and the faith-
based community wrote a letter to President Bush on December 18, 2002, 
asking him to announce a presidential initiative to address this vexing 
problem.
  As a global community, we are at a crisis stage with these diseases. 
Adequate funding for the prevention and treatment of infectious 
diseases, especially HIV/AIDS, must come before it is too late. As the 
richest and most scientifically advanced Nation in the world, we have 
both the power and the responsibility to take the necessary actions to 
end this epidemic.
  Mr. Speaker, today more than 29.4 million Africans are living with 
HIV. Last year an estimated 2.4 million new infections occurred, while 
3.5 million people lost their lives to this disease. This is a problem 
of epidemic proportions. I can only imagine the pain and suffering of 
the millions of families, orphaned children and those afflicted with 
this disease waiting for relief in any form.

                              {time}  1730

  The time for action is now. Lives are wasting.
  That is why I applaud the President for his budget proposal which 
would provide $10 billion over 5 years to combat the AIDS crisis in 
Africa. This gesture indicates that he recognizes the need to show 
compassion for this epidemic through increased funding. However, the 
President also must act quickly if his compassion is to have any 
significant impact in preventing the needless suffering and death of 
more victims to this disease.
  Mr. Speaker, I say this because the President's plan provides only $2 
billion for 2004. This represents only 380 million in new funding 
dollars. This funding is insufficient and will not provide access to 
the necessary medical care and pharmaceuticals for individuals living 
with HIV and AIDS across the globe. The President's approach of slowly 
phasing in the funds writes off the lives of millions who need 
assistance not yesterday but right now.
  Mr. Speaker, in Africa it is estimated that more than 4 million 
people have a sufficiently advanced stage of HIV/AIDS to warrant anti-
retroviral treatment. However, currently only 50,000 are receiving that 
treatment. The importance of the anti-retroviral treatment for people 
suffering with HIV has been conveyed to the White House by the medical 
community. It is worth pointing out that the President admirably 
establishes a goal of providing anti-retroviral treatment to 2 million 
people infected with HIV. Despite this goal, he has only requested $450 
million for his Global AIDS Initiative. Given this limited allocation 
and the $300 minimum yearly cost per person of providing the necessary 
drug cocktails, it seems that the President has assured himself of 
falling short of this goal.
  Many in the global AIDS community, along with many members of the 
Congressional Black Caucus, believe that the only way to provide the 
cocktail to the millions that need it is through purchase of generic 
drugs. While publicly agreeing to this idea during the WTO negotiations 
in 2001, the United States has since refused to sign off on the 
implementing language last December that would have allowed poor 
countries to import generic drugs. This disconnect between rhetoric and 
actions need to be corrected. I urge the President to reconsider the 
United States's policy.
  In addition to the lethargic funding of HIV/AIDS treatment, the 
President's plan takes away $50 million from USAID's Infectious Disease 
program and includes a reduction to our contribution to the Global Fund 
by $150 million from the 2003 levels. These reductions are coupled with 
an insufficient economic commitment to the Global Fund to Fight AIDS, 
Tuberculosis and Malaria, for which President Bush has only designated 
$1 billion over the next 5 years.
  Mr. Speaker, this funding is woefully inadequate, as the global fund 
estimates that it needs $6.2 billion through 2004 to remain 
operational, $2.2 billion of which should come from the United States. 
The United States was instrumental in launching the Global Fund

[[Page 5225]]

to Fight HIV/AIDS, Tuberculosis and Malaria in 2001. This commitment 
must be maintained in order to provide the necessary money to grant 
applicants and existing grant programs to combat the disease in 2004.
  I am hopeful that with the recent election of Health and Human 
Services Secretary Tommy Thompson as chairman of the executive board of 
the Global Fund that the United States will commit itself to an 
increased financial and political involvement with the fund. I am 
confident that Secretary Thompson understands the urgency and direness 
of these horrible diseases, particularly HIV and AIDS, and I am 
confident that he will serve in the best interest of the fund.
  Finally, Mr. Speaker, in addition to the problematic pace of funding 
of the President's plan, I am particularly disturbed by recent press 
reports surrounding a February 11 State Department memo indicating that 
the President will extend the global gag rule to cover all of our 
bilateral programs. Any extension of the gag rule would be turning a 
blind eye to the facts and would greatly hinder the effectiveness of 
global HIV/AIDS programs. While abstinence is one important way to 
avoid contracting HIV/AIDS, it is more important to fully educate 
people of their options and provide integrated HIV/AIDS prevention 
services with family planning programs. Given the high levels of stigma 
and ostracism that people with AIDS face in much of the world, for 
prevention programs to be successful, they must be integrated into 
services that people are accustomed to accessing, including family 
planning and maternal health services.
  Stand-alone HIV/AIDS treatment programs, which the proposed family 
planning policy may require, will be a significant setback in the 
integration of prevention and treatment initiatives made to date. In 
some societies, women who are known to have HIV/AIDS stand to lose more 
than their lives. Their homes, livelihood, and even their children may 
be at stake. Thus it is highly unlikely that these women will go to a 
stand-alone HIV/AIDS clinic where the stigma associated with the 
disease would deter people from being tested or receiving counseling, 
prevention supplies, or health care.
  Women are key to halting the spread of the HIV/AIDS pandemic, 
especially in the developing countries of Africa. Fifty percent of 
those infected worldwide and 58 percent of AIDS victims in sub-Saharan 
Africa are women. If we are to be effective in our fight against HIV/
AIDS, we must ensure that women have access to treatment and support 
services free of stigma. We must empower them with education and 
assistance. The global gag rule handicaps this process, and it is poor 
policy in the fight to eradicate HIV/AIDS.
  I welcome the President's commitment to providing billions of dollars 
to fight the global pandemic of HIV/AIDS and other infectious diseases. 
However, the only way to truly defeat these diseases is to develop a 
comprehensive strategy, a plan which focuses on the rapid disbursement 
of funds to prevent the spread of HIV/AIDS, to treat and support people 
already infected, and to provide support for those nations who are 
losing their fight against this deadly disease.
  And with that, Mr. Speaker, I thank the gentlewoman for yielding.
  Ms. LEE. Mr. Speaker, I want to thank the gentleman from Maryland 
(Mr. Cummings) for that very eloquent and comprehensive statement and 
also once again for organizing the Special Order tonight.
  I yield to the gentlewoman from Michigan (Ms. Kilpatrick), who serves 
on the Committee on Appropriations and has been a real advocate for 
those who have no voice in the funding mechanisms of our United States 
House of Representatives.
  Ms. KILPATRICK. Mr. Speaker, I thank the gentlewoman from California 
(Ms. Lee) for continuing to be in the forefront of this issue. God 
loves her for it; and as we work together to build a better world, this 
is certainly one of the most important issues that we will face in our 
lifetime.
  As a member of the Committee on Appropriations, I am acutely aware, 
as most of the Members of the Congress are, what a tight budget we have 
this year and as we move into the next few years as we send our troops 
off in Afghanistan currently, soon to be Iraq with North Korea another 
possible war target. It is important, I believe, that as we do all of 
this, and I want to commend President Bush for making the statement in 
his State of the Union address, that we will spend more resources to 
fight HIV and AIDS.
  As most everyone knows in the world, the pandemic is spreading. 
Africa today, India, former Soviet Union, China, and right here in our 
own country, unprecedented numbers of people being infected with HIV 
and AIDS. So I am happy to commend President Bush on taking the first 
step as the leader of the free world to really begin to address the 
problem.
  Is it enough? No, it is not enough. We need to do better. We need to 
do more, and that is what we are talking about tonight, how we do more. 
It is not always money. When you are the leader of the world, you can 
do a lot of things that can help poor countries and other countries of 
the world. We can make it possible for generic drugs to be used in poor 
countries; and as was mentioned earlier, if the United States would 
step forward and sign an agreement that the World Trade Organization 
put forth, many of those poor countries could use generic drugs and 
would be able to treat the hundreds of thousands of people who are 
infected with HIV and AIDS; and I urge the President to come forward to 
work with the World Trade Organization to make sure that those 
pharmaceuticals are available for the poorest of the poor so they may 
treat themselves, save their families, and protect their children. It 
is most important, Mr. President; and I hope he will work in that vein.
  The gag rule that was mentioned, the gag rule, for those who do not 
know, is a rule put on some of our appropriations that says any country 
that teaches family planning may not be a recipient of the funds that 
have already been appropriated. Many of us think that is wrong. Family 
planning is just what it is; and many countries in the world, we of the 
United States and other countries of the world, help people to plan 
their families so they can live within the means that they have.
  By our putting the gag rule on the funds that will come forward for 
HIV and AIDS, it says that many of the countries will not be able to 
access those funds. We believe that the funds ought to be available for 
those countries, the poorest of the poor, who are infected, in this 
case, with HIV and AIDS; that the family services ought to be 
integrated. We have already heard that when the services are 
integrated, more people come and take part in those services and not 
just be treated with one illness, but may also have tuberculosis, may 
also have malaria, HIV. So then we are able to treat the entire 
illnesses of the people, and I hope that the President will reconsider 
and take the gag rule off his initiative for treating and helping with 
the AIDS pandemic.
  We can also relax and expand the rules for HiPC countries, the highly 
indebted poor countries of Africa. They cannot partake of this 
initiative because we need to expand who can participate. It would mean 
that some of those countries would have to match the dollars in some 
instances; but many have told me, and the president of Uganda, one of 
leaders in the world in treating and reducing the HIV pandemic, that 
they are ready, willing, and able to work with this country, but they 
need help. They need our leaders to free them up so that they can 
access and treat more people. From the generic drugs, making those 
available, that is one way we can help. Sometimes it is not always the 
money. Is the money enough? No, it is not. But we as the leaders of the 
world can do other things that will assist in those poor countries.
  AIDS, HIV, tuberculosis, malaria, as a member of the Committee on 
Appropriations Subcommittee on Foreign Operations, Export Financing and 
Related Programs, we fund those lines for countries all over the world. 
Why then in this initiative must we take money from the programs that 
are working well, the malaria, the tuberculosis program? We do not want 
to subtract

[[Page 5226]]

money from those to give to HIV. We want to make it a partner with our 
HIV dollars, not to rob Peter to pay Paul, but to make that as one pot 
of money so we can treat all of those and put the dollars in that are 
necessary.
  Is the money enough? No, it is not. But it is not always the money. 
There are other things that we can do to help. We can help by making it 
possible for some of the countries to be able to cancel their debt. In 
some instances 30, 40, 50 percent of the revenue of a country is used 
to cancel the debt. At a time when resources are low, at a time when 
countries are poor, we as leaders of the free world need to find a way 
that we can make arrangements to cancel some of that debt so those 
resources can be used to treat their own people in their own country.
  And I tell the President if he would stand up and make that a fact, 
work out some arrangements so some of the debt can be cancelled, those 
dollars then could be put back in those countries to treat the pandemic 
so we do not have to always use U.S. dollars. There is a way to address 
the problem. Is the money enough? No, it is not. But it is not always 
the money. Many times it is leadership.
  I want to commend President Bush for what he has already done, but I 
want him to know, and this Congress to know, there is much more that we 
can do. Make the generic drugs available, help with canceling the debt 
that the countries have, make sure that we get rid of and eliminate the 
gag rule that is not making it possible for some people to access the 
money.

                              {time}  1745

  In United States today, Africa, India, China and several other 
countries of the world, this is a real pandemic. Our role and our rule 
ought to be as responsible leaders in this community, leaders of the 
world, all 535 of us. What else can we do to relieve the illnesses, to 
break it down so that so many children will not be orphaned, so that so 
many families will not be left with nothing?
  There are things we can do, and it is not always the money. I contend 
that if we just did three of the things I mentioned today, cancelling 
the debt, the use of generic drugs, as well as making sure the gag rule 
does not stifle and eliminate those who need treatment, it would help. 
Is the money enough? No, it is not.
  But let us stand up and work together, Mr. President, with you. We 
are ready, we are willing and we are able. We just count on you to lead 
our country in this pandemic crisis that we see. HIV and AIDS is not 
going away. Family planning is a necessity. We need to work to 
integrate the services so that our families can be strong, so that our 
children can grow and live and have an intact family, and that we move 
forward as a United Nations of all of God's people.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (Mr. Bishop of Utah). The Chair would remind 
Members that remarks should be addressed to the Chair and not to 
others, such as the President.
  Ms. LEE. Mr. Speaker, I would like to thank the gentlewoman from 
Michigan for that very profound statement, for really highlighting the 
global dimensions of this pandemic and for continuing to be our eyes 
and ears on the Committee on Appropriations and ensuring that our 
resources are prioritized in a way that they are effective in 
addressing this pandemic.
  Mr. Speaker, I yield to the gentlewoman from California (Ms. Watson), 
a former ambassador, an individual who has chaired a senate health 
committee for many, many years in California, and one who serves now on 
the Committee on International Relations and has taken the lead on many 
HIV/AIDS initiatives, not just since she came to Congress, but 
throughout her career.
  Ms. WATSON. Mr. Speaker, I rise today to express concern with the 
President's $15 billion over 5 years proposal on HIV/AIDS funding for 
Africa. I commend the gentlewoman from California (Ms. Lee), the CBC 
and my Congressional colleagues who have worked selflessly to address 
this important global health issue.
  My question is, are we going to see the results that we need, given 
the proposed funding levels? HIV/AIDS knows no continental boundary, no 
religious belief, no government ideology, no sexual orientation, and, 
most significantly, HIV/AIDS is color-blind. HIV/AIDS does exploit 
those people who are information-deprived and the financially 
challenged.
  In our global community, many countries suffer from a lack of 
information and resources. On the continent of Africa, the HIV/AIDS 
epidemic has reached catastrophic proportions. There were 2.4 million 
new infections last year, and 3.5 million deaths. With over 29.4 
million Africans living with HIV, it would be foolish to turn a blind 
eye and wish the problem away or to think that the global HIV/AIDS 
pandemic does not affect the United States.
  Mr. Speaker, despite the size of the President's commitment to 
fighting HIV/AIDS, $15 billion over 5 years, $10 billion of which would 
be new funds, I stand disappointed by the size of his current budget 
request. HIV/AIDS funding has only been theoretically increased in the 
FY 2004 budget and many key programs will be underfunded. By providing 
over $2 billion for the coming year, of which $285 million is for 
research, and back-loading the bulk of the funding, the President's 
approach of slowly phasing in the funds will write off the lives of 
millions who need assistance now.
  Based on a budget analysis of this FY 2004 request, $1.71 billion, 
compared with the FY 2003 omnibus bill of $1.363 billion, the President 
is barely providing $380 million in additional funding this year. Mr. 
Speaker, this is a typical use of rhetoric that this administration 
utilizes too well. Congress must address this important global issue 
with the proper funding.
  The President is taking away nearly $15 million from USAID's 
Infectious Disease Program and is reducing our contribution to the 
global fund by $150 million from the FY 2003 levels. This kind of 
accounting is unacceptable and should not be included as part of the 
President's pledge for $10 billion in new money. How can this 
administration tell Congress and America that we will fight the HIV/
AIDS pandemic with $15 billion, and, at the same time, cut 
contributions to two major global programs?
  Lip service will not stop the virus. Lip service will not save people 
that are suffering and dying. Lip service will not provide a plastic 
bubble that keeps HIV/AIDS out of the United States.
  Mr. Speaker, directly after the tragic events of 9/11, President Bush 
asked for $40 billion to fund homeland security and emergency relief 
efforts. Congress moved quickly in a bipartisan manner to address our 
national security needs.
  HIV/AIDS funding is just as critical to our national security. 
National health is the cornerstone of our society. We have the money 
and are willing to use it when American ideals of life, liberty and the 
pursuit of happiness are challenged.
  I can think of no greater danger to the quality of American life than 
the very real threat that AIDS poses to undermining nation states 
around the world.
  Mr. Speaker, the only way to truly defeat HIV/AIDS is to develop a 
comprehensive strategy that utilizes the strengths of bilateral and 
multilateral institutions. The plan must also focus on the rapid 
disbursement of funds to prevent the spread of HIV/AIDS and to treat 
those individuals who are both infected and affected by the pandemic.
  I urge the President and all my colleagues to front-load the 
increases in global HIV/AIDS funding so that we can truly make a 
difference and confront the greatest health challenge of our time.
  Ms. LEE. Mr. Speaker, I want to thank the gentlewoman from California 
for her participation and for that very eloquent and very clear 
statement. I thank her for her commitment to health care issues in 
general.
  Mr. Speaker, I would like now to yield to the gentleman on the other 
side of the aisle, my colleague from

[[Page 5227]]

California (Mr. Cunningham). I mentioned earlier that this has been a 
bipartisan effort in establishing the global AIDS fund. We passed on a 
bipartisan basis the Global AIDS and Tuberculosis Relief Act of 2000 
with the gentleman from Iowa (Mr. Leach), and I think we see progress 
when we work together. So I am delighted my colleague would like to 
speak this evening.
  Mr. CUNNINGHAM. Mr. Speaker, I thank the gentlewoman for yielding.
  Mr. Speaker, sometimes we talk about millions and billions of dollars 
and we lose the faces that are connected with AIDS. I want to just put 
a face on AIDS and a small victory.
  Being on the Subcommittee on Labor, Health and Human Services and 
Education, we quite often go out to the National Institutes of Health 
in Bethesda. There I met a young African American. He walked up to me 
and says, ``Congressman, I have AIDS.'' He said, ``Every day I wake up 
and the only thing I think about is dying.''
  He said this was so, until a medical research breakthrough that has a 
procedure where he goes through hell about every 6 months, but it 
extends his life. What it is called is hope. This young man now, with 
some hope, has gone out and bought a home, where he would not before. 
He has bought stocks. He did not before.
  I would say that I am a fiscal conservative. Speaker Gingrich used to 
talk about diabetes, that if we could stop amputations and blindness, 
think of the money we would save, let alone the quality of life. Well, 
I would say that if we could better people's lives, stop the hospital 
visitations and AIDS, think of the money that will be saved for health 
care to provide those dollars for more and more people.
  I thank the gentlewoman. I would also challenge the Black Caucus. We 
did the first prostate cancer town hall meeting in Washington, D.C. I 
also sit on that committee. It was very successful, with Mayor 
Williams. We are going to have another one in the spring.
  The highest rate of prostate cancer is among African Americans, and 
the highest rate is in Washington D.C. We are going to have another one 
this spring, and I would invite the caucus to work with us and with 
Mayor Williams this spring when we are going to do that.
  Ms. LEE. Mr. Speaker, I thank my colleague from California for that 
very poignant statement and also for putting a face on what we are 
talking about today. Yes, it is hope that we all need, but it is 
resources also that provide that hope.
  Mr. Speaker, I would now like to ask the gentlewoman from the Virgin 
Islands (Mrs. Christensen) to come forward. She is a medical doctor, 
and with the Congressional Black Caucus in terms of her leadership on 
the Health Brain Trust, has been working on a variety of health care 
issues as they relate to the disparities we see within the African 
American communities, and one of those is prostate cancer. I am sure 
the gentlewoman, as I yield to her, would like to comment on that.
  Ms. CHRISTENSEN. Mr. Speaker, I thank my colleague for yielding. We 
will take the gentleman up on that offer. The gentleman and I co-
chaired a briefing here on the Hill back a few years ago. It was a 
pleasure to join the gentleman then, and we look forward to joining him 
in the spring.
  Mr. Speaker, when the President first announced the $15 billion in 
his State of the Union address, yes, we were very surprised. It sounded 
almost too good to be true. But we knew that at least our voices had 
been heard. The caucus and faith-based groups around the country, with 
the AIDS community, had long been calling on our President to provide 
the funding needed for global AIDS, and we thought initially that 
perhaps our requests and our pleas had been answered.
  But it was almost too good to be true. And I know the next day I 
joined the gentlewoman from California (Ms. Lee) and the gentlewoman 
from California (Ms. Waters) and others at a press conference, where we 
said, yes, we appreciate the fact that the President was reaching out 
and did appear to be responding, but we had many questions about what 
the $15 billion really meant.
  At that time I asked several questions: What might have been some of 
the restrictions placed on that money? Where would it have come from? 
Was this new money or was it going to be taken from other important 
programs? And today, as I stand here, I can tell you that there are 
restrictions, and, yes, it did come from other important programs, and 
that very little of it was really new money. Not only that, but the 
money is coming over a long period of time. The public health effort 
that we need now demands an infusion of a large amount of funding now.
  As I said, the CBC has been pushing for more funding on this issue 
for many, many, many years. Currently there are 29.4 million infected 
people, with 3.5 million Africans were newly infected just last year.

                              {time}  1800

  There were 3.5 million new infections. Despite the President's 
commitment to fighting HIV/AIDS at $15 billion over 5 years, $10 
billion of which may or may not be new funds, we are really 
disappointed by the size of the budget request for 2004. Based on a 
budget analysis of this fiscal year 2004 budget request compared with 
the fiscal year 2003 omnibus bill, the President is barely providing 
$380 million in additional funding this year. Rather, as I said, the 
administration is taking away nearly $80 million from the USAID 
infectious disease program, and reducing our contributions to the 
Global Fund by $200 million from projected fiscal year 2003 levels.
  Also, when we look at the President's commitment to the Global Fund 
to Fight AIDS, Tuberculosis, and Malaria, for which he has only 
designated $1 billion over the next 5 years, or $200 million per year, 
the Global Fund is a public-private partnership. It is an efficient, 
accountable, results-oriented mechanism for responding to these three 
killer diseases: AIDS, TB, and malaria. It is an innovative fund, and 
it operates under a technically rigorous and efficient process.
  Just last week, I read that I think it was Malawi had requested some 
funds, and those funds were not released because certain requirements 
had not been met. I think the Government of Malawi wanted to put the 
funds in a general account, so the funds were not released until Malawi 
made the alterations in their plans. That demonstrates the kind of 
oversight that the Global Fund does have and why it is so important, 
because of the way in which this funding is provided to the countries 
through a coordinated partnership coming from within that country, a 
community-based approach that knows where those funds are needed and 
can best apply those funds to the problem. This is the best place that 
the funds should be provided; and as I said, they should be provided up 
front.
  I also said at the time that I would have felt a lot more confident 
in the $15 billion if I had also heard that the U.N. population funds 
had been released; because, again, I had a lot of concern about were 
these funds actually going to be available. Later on, the President did 
say that he was going to take on some measures that would release these 
funds; but again, we read that they are going to be tied to whether 
abortion counseling is given.
  In many countries that need these funds, countries where HIV/AIDS is 
rampant, these are sometimes the only or the first line of defense for 
women, particularly, but men also, in terms of protecting themselves 
and getting the kind of information and counseling that they need to 
prevent HIV and AIDS.
  We had what we thought might have been good news just a couple of 
weeks ago about a vaccine, but we are very far off from a vaccine 
today. So prevention remains the best way to address this disease, and 
the U.N. population funds do provide that kind of prevention. We need 
to release those funds.
  We heard our colleague, the gentlewoman from Michigan (Ms. 
Kilpatrick), talk about the Mexico City language, the gag rule. These 
funds are needed. They are part of the process. We need to have them 
released.

[[Page 5228]]

  I also said at that time that I would have felt more confidence in 
the announcement of the funding if there had also been a concurrent 
announcement that the United States was going to support the release of 
the funds for Haiti.
  Haiti is one of those countries that is in the first round of the 
Global Trust Fund funding, the awards. But if they do not have the 
infrastructure in place, if they do not have the concurrent funding to 
have the health care infrastructure in place, those funds will not be 
able to be as effective as they would be otherwise. So in the absence 
of all of the other measures that need to be in place, the commitment, 
despite the pronouncement of $15 billion for global HIV and AIDS, still 
does not live up to the promise that we heard in late January during 
the President's State of the Union address.
  So I would call on the President and call on my colleagues to urge 
our President and to urge this administration to provide the level of 
funding; and I believe it should be somewhere in the area of, is it $2 
billion each year? And because the fund is now underfunded and will 
probably run out of funds after the second round, really, a country 
such as ours should be able to provide even more than this, since we 
have not funded it to our total amount over the last couple of years.
  Certainly $2.2 billion should come from our country. It will 
encourage other countries to increase their contributions to this fund. 
It is just not right for us to offer this promise of a global trust 
fund to allow them to give to three or four countries in the first 
round and several countries in the second round, and then to find that 
the funds have run out.
  Already, the Caribbean countries have been asked to cut back on their 
projected requests. They have had to cut that in half. We heard when we 
were in Barcelona that if we continue to address this pandemic with 
dribs and drabs of funding, with the same lack of commitment that we 
have seen over the past 20 years, that the numbers will double and 
quadruple, hundreds of thousands of people will become infected, and we 
will experience many more deaths, not only overseas but here at home, 
as well.
  So again, I am calling on the President and asking our colleagues for 
their support in providing the kind of funding that is needed to fight 
this global AIDS pandemic.
  Ms. LEE. Mr. Speaker, I want to thank the gentlewoman from the Virgin 
Islands (Mrs. Christensen) for her very comprehensive statement. I 
would like to commend her for her leadership with the Congressional 
Black Caucus in terms of sharing in our health brain trust. Just today 
we held a health brain trust with regard to the country of Haiti, and I 
am delighted that the gentlewoman raised Haiti in her presentation.
  Haiti is the most impoverished country in the Western Hemisphere. 
Ninety percent of all HIV and AIDS infections in the Caribbean are in 
Haiti. Over 300,000 people are infected and have been identified, and 
deaths from HIV and AIDS have left over 163,000 children orphans, so it 
is so important that we encourage the administration to release the 
funds that the gentlewoman from the Virgin Islands (Mrs. Christensen) 
mentioned in terms of the International Development Bank.
  Mr. Speaker, I yield to the gentleman from New York (Mr. Owens), my 
colleague and a real leader on behalf of our children and on behalf of 
the Caribbean, on behalf of those suffering and living with HIV and 
AIDS. I thank the gentleman for his participation this evening.
  Mr. OWENS. Mr. Speaker, I thank the gentlewoman for yielding to me. I 
would like to thank the chairman of the caucus, the gentleman from 
Maryland (Mr. Cummings), as well as the gentlewoman from California 
(Ms. Lee), for sponsoring this Special Order on AIDS. It is focused on 
AIDS help for Africa, but we cannot really separate AIDS in Africa from 
the pandemic that is sweeping over the whole world.
  We do not hear much talk about AIDS in India, but I assure the 
Members that it is a big problem there. It is a nation with a billion 
people and very densely populated, and in a few years their problem 
will be far greater than Africa's.
  We do not hear much about AIDS in China. They have kept it a secret, 
even from themselves, to the point it has gotten out of hand; and we 
are going to hear far more, again with a nation of more than a billion 
people. It is a pandemic sweeping the world.
  I stood up and applauded, along with the rest of my colleagues, when 
President Bush announced a special initiative on AIDS, $15 billion 
worth of resources behind that initiative, during his State of the 
Union address. We stood up and applauded.
  I would like to keep applauding. I would like to say to our 
colleagues, let us throw a positive spotlight on this and hope that by 
continuing to applaud and continuing to hold it up, it will be done and 
done right; that we will make some corrections on some of the problems 
we have heard enunciated tonight with the way in which it is being 
done, in robbing Peter to pay Paul, and a number of other things we 
have heard behind the scenes about certain people who do not agree with 
the President, and they are determined to sabotage it in the various 
agencies. We hope that will not happen.
  We hope this represents an example of the better angels in American 
foreign policy, the better angels of American leadership. Those angels 
have come forward time and time again, and they have always not only 
benefited the people that we helped, but they have benefited us.
  The better angels sometimes appear in terms of a military force. They 
went off to Europe to fight fascism, and the boys who died on the 
beachheads of Normandy and other places there were fighting first of 
all to get invaders out of a foreign land and to save Europe from 
fascism, but it certainly was also to save the rest of the world from 
fascism.
  During the aftermath of that war, World War II, we launched a 
Marshall Plan, a Marshall Plan which I think cost $20 billion in the 
currency of that time, $20 billion to help save the European countries 
from economic hardship and starvation, which would have led them into 
the bottomless pit of Communism. It was one of the best programs in 
terms of expenditures of money. We got more for our money through the 
Marshall Plan than from any other program that we had launched to 
contain Communism.
  We fought a war in Korea, we fought a war in Vietnam, always to stop 
the tide of Communism; but we paid billions and billions of dollars 
more, and we paid in lives. The Marshall Plan, which was a nonviolent 
plan, a plan using the economic might of America to go to the aid of 
people of Europe, was effective in stopping Communism in Europe. So we 
have reaped benefits from the better angels policies that we have put 
forward.
  Here is a chance to do it again. The pandemic is sweeping the world. 
We are helping to save ourselves. I speak as a Congressman from a 
district which is at the epicenter of the North American AIDS epidemic. 
The epidemic in North America, the epicenter is in Brooklyn; it is in 
Brooklyn in part of my district, an area called Brownsville and Fort 
Green, east New York, east Flatbush. There is a heavy Caribbean 
population in part of that area, and a large Haitian population in part 
of that area, so these things are not so foreign to us. Haiti is not 
that far away and the Caribbean is not that far away.
  We need to think in one other dimension, that is, that microbes are 
the most powerful force in the world, the most powerful living forces 
in the world. If Members have not read some of those books about 
microbes, how numerous they are and how they continue to multiply and 
change and mutate, then Members ought to become conversant with that.
  Microbes, the germs that create the AIDS problem, are constantly 
changing and mutating. If we do not move, as one of our speakers has 
said, if we continue the dribs and drabs and do not move in as rapid a 
way as possible with all the available resources that we can muster, we 
may have a situation where the microbes mutating will end us up

[[Page 5229]]

with something far more dangerous than we have now.
  AIDS is very complicated. One has to have intimate contact with a 
person to get AIDS from a person. There is nothing to say that the 
mutations will not take place and we will have some creatures flying in 
the air. The process of the way microbes mutate and viruses develop and 
so forth is such that it is not inconceivable that we could have a much 
worse problem affecting, or with the capacity to impact, much larger 
numbers of people.
  So when we help the people of Africa and anywhere else struggling 
under this problem at this particular point, we are also helping 
ourselves. We need to understand that. We are helping ourselves when we 
use our resources in this way to guarantee some kind of better quality 
of life, some kind of opportunity for people to be able to cope with 
it. With the help of outside forces from the high-tech world and the 
modernized, industrialized nations, maybe they will have a chance to 
get a grip or handle on it and be able to cope.
  These same countries are the places where Osama bin Laden and all the 
other terrorist leaders of the world will be recruiting people as they 
sink deeper into despair, as we have more and more orphan children. We 
have wars raging right now in many parts of the world, and children 
soldiers. Children soldiers are the backbone of those wars. So we 
cannot separate out the effort to stamp out AIDS from the other 
problems of the world. We can help ourselves a great deal if we listen 
to the better angels of our nature. If we use our resources to help 
people, we will end up helping ourselves a great deal. I think that is 
to be remembered as we go forward.
  Let us support the President and urge him to make certain that the 
problems that have been identified here are ironed out as rapidly as 
possible. Let us make sure that our credibility is not questioned 
because of something we are proposing that we are not delivering. Let 
us get all of our colleagues on board to try to stamp out this scourge 
that affects the whole Earth and could easily come home and affect 
large numbers of our own people.

                              {time}  1815

  Ms. LEE. Mr. Speaker, I want to thank the gentleman from New York 
(Mr. Owens) for his participation and for reminding us that really 
Africa is just the tip of the iceberg, and this is a global pandemic.
  Mr. Speaker, I yield to the gentlewoman from Texas (Ms. Jackson-Lee).
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I thank the distinguished 
gentlewoman and I thank her very much for the ability to share this 
afternoon.
  Mr. Speaker, I think it is important just to note to the public that 
is listening and to our colleagues that are a part of this debate is 
that the real crux is that this is a crisis of such magnitude that the 
fact that $5 billion is old money and not new money, causes us to 
desire the administration to reinvestigate their commitment to global 
AIDS and increase the funding.
  I think it is important to note, Mr. Speaker, that over the next 5 
years, 40 million children in Africa will be orphaned by way of losing 
1 or 2 parents to HIV/AIDS. It is clear that the Caribbean and India 
and China are facing the same kind of crisis. It is also clear that 
President Mbeki of South Africa has made it very clear that you cannot 
fight HIV/AIDS without fighting TB and malaria. And we only are getting 
$1 million over the next 5 years for TB and malaria when the Global 
Fund needs $6.2 billion to operate.
  It is extremely appropriate that Tommy Thompson, now the Chair of the 
Global Fund will look at these problems and acknowledge that we have 
got to do better. The other thing is, I think it is very difficult to 
be able to tell other countries when they are speaking the language of 
family planning that they can not get funding for HIV/AIDS, part of 
family planning is to save lives of women who may be infected with HIV/
AIDS.
  Truly we have a crisis, and I believe having gone to Africa in the 
first presidential trip in the term of the administration of President 
Clinton when we went and traveled to countries like Zambia, South 
Africa and Botswana, we saw what Africa could do. Now we know that they 
can do a lot with generic drugs. Distribution questions can be 
answered. I would simply say, Mr. Speaker, that it is imperative that 
we fight this battle together, link arms together to ensure that we do 
not orphan any more children around the world.
  Let me close by saying, Mr. Speaker, by saying this is a problem 
right in our own back yard. And I ask HHS to make sure that the 
minority fund for minorities that are fighting HIV/AIDS in our 
respective communities get to those minority agencies here in America. 
Because I hear over and over again, wherever I go, that those funds 
designated by the Congressional Black Caucus are not getting to those 
inner-city agencies and nonprofits to fight HIV/AIDS rights in our 
backyard. This is an issue for the President. The Global AIDS Fund is 
an issue for the President and the administration, and I hope that we 
can collectively work together because we should be committed to saving 
lives.
  Ms. LEE. Mr. Speaker, I want to thank the gentlewoman for her 
statement and for her leadership and for her patience on this special 
order.
  Let me yield to the gentlewoman from the District of Columbia (Ms. 
Norton), and I want to thank her also for her participation and her 
leadership this evening.
  Ms. NORTON. Mr. Speaker, quickly, I want to thank the gentlewoman for 
her sustained leadership on this issue.
  I want to focus on one issue and that is the failure to use 
multilateralism when it comes to AIDS policy. The unilateral approach 
we see here that we do not have a global approach to AIDS any more than 
we have the kind of global approach we need to war and to terrorism. In 
both, lives are at stake. The Global AIDS Fund is applauded all over 
the world because it is a low cost administered fund with great 
accountability, philanthropists serve on it. And what have we done?
  It is not clear whether we are setting up a new fund, a new entity. 
What is clear is we are giving only a billion dollars rather than the 
more than $2 billion that should go to that fund, so where is the rest 
of our money going to? Why are not we using this multilateral approach 
which would get the most bang for our dollar?
  I think the reason is we do not want to play by the same rules that 
the rest of the world is playing by. We want the global gag rule and 
the way to make sure we get a global gag rule is to pull our money out 
and deal with our money ourselves. That is a tragedy to take the gag 
rule and apply it to AIDS treatment.
  Imagine in Africa what AIDS means. It means a terrible stigma that 
you cannot get treatment in the same place that you get family planning 
is going to mean that many people will not get treatment at all. We 
want uni-
lateralism here to do what we tried to do with the Asian countries when 
we were recently discussing HIV prevention. We tried to delete the 
mention even of condoms there. We are trying to unilaterally impose our 
approach, an approach that we have imposed in our country, but 
democratically you can do that here, we are trying to impose that on 
the world. That is why we were seeing unilateralism here even as we 
have even unilateralism in much foreign policy since this President 
came into office. Lives are at risk. I ask that we go global when it 
comes to AIDS. I thank the gentlewoman for yielding.
  Ms. LEE. Mr. Speaker, I thank the gentlewoman from the District of 
Columbia for her participation and for her leadership.

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