THE DEPARTMENT OF STATE, FOREIGN OPERATIONS AND RELATED PROGRAMS APPROPRIATIONS ACT, 2008 -- (House of Representatives - June 21, 2007)
Mr. PITTS. Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, United Nations program on HIV/AIDS report estimates that there are 40 million people infected with HIV/AIDS worldwide, and like everyone else, I am deeply saddened by this reality.
However, I am also filled with hope because recent evidence indicates that the current prevention strategy is helping to produce behavioral change that has significantly decreased people's risk of contracting this deadly disease.
The current HIV/AIDS prevention strategy was carefully crafted in the PEPFAR authorization bill to reflect a balanced approach, and the good news is that this balanced approach is working.
The PEPFAR authorization bill, which became law in 2003, included a provision that required one-third of the 20 percent for prevention funding, that is approximately 7 percent of the total PEPFAR funds, to be spent on abstinence and fidelity programs.
Prior to the implementation of this spending directive, the U.S. promoted an unbalanced condoms-only approach. The U.S. remains the largest distributor of condoms in the world. But for the first time the behavior factor is getting real attention under the current program rules. And the result: falling HIV/AIDS prevalence rates in 7 of the 15 focus countries.
The current prevention strategy is based on the comprehensive ABC model, first established in Uganda, developed by Uganda. The ABC model stands for A, abstinence; B, be faithful; C, condoms. A comprehensive, balanced approach.
After implementation of this model in Uganda, the number of young males age 15 to 24 reporting premarital sex decreased from 60 percent in 1989 to 23 percent in 1995. For females, the decline was 53 percent to 16 percent. The program actually helped change the behavior in women and men, a fact I hope my colleagues take seriously.
Opponents of this approach claim that behavioral change is unrealistic. Dr. Edward Green, a researcher at Harvard University, was an opponent of the ABC model and in particular of abstinence until he saw what happened in Uganda. He testified before the Energy and Commerce Committee saying: ``Many of us in the AIDS and public health communities did not believe that abstinence or delay and faithfulness were realistic goals. It now seems we were wrong.''
Not only has Uganda seen a society transformed by behavioral change, we can now add Kenya, Zimbabwe, Ethiopia, Namibia, Tanzania, and Zambia to the list of countries that are experiencing a decrease in HIV/AIDS prevalence rates.
Experts continue to testify to the fact that behavioral change continues to be the key indicator of HIV/AIDS prevention. Yet for some reason, some of my colleagues have decided to make a crucial provision of this successful strategy optional. This crucial provision ensures that the ``abstinence'' and ``be faithful'' components are incorporated into the approach. Never mind the fact that PEPFAR is expected to be reauthorized later this year, and never mind the fact that the reauthorization might be the more appropriate forum to debate this critical component that was agreed to.
Some of my colleagues argue that we need a comprehensive approach, but I remind them that abstinence and fidelity education are fundamental to the comprehensive ABC approach.
Some of my colleagues argue that we need an approach that saves lives. I remind them that the ABC model, with the A and the B spending requirement intact, is continuing to save more and more lives. In countries that have relied predominantly on condom distribution, HIV/AIDS prevalence rates have not improved. Meanwhile, countries that promote behavioral change have seen significant improvement.
Mr. Chairman, a balanced, evidence-based approach is essential if we are going to effectively fight HIV/AIDS in Africa. The current policy is the balanced approach. It is the evidence-based approach. It is the approach that is working. Why change what works?
I urge my colleagues to vote for my amendment and keep abstinence and fidelity in the AIDS program, and in doing so, to vote for an approach that is saving lives.
Mr. Chairman, I reserve the balance of my time.
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Mr. PITTS. Mr. Chairman, I didn't know I was going to get a biblical lesson here, but I would just ask the man rhetorically, is abstinence biblical? Is faithfulness biblical? That's what we're speaking on behalf of.
I yield 2 minutes to the gentleman from Nebraska who is a member of the Africa Subcommittee, Mr. Fortenberry.
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Mr. PITTS. Mr. Chairman, there is flexibility in the existing program. Countries can apply for a waiver. Every country that has applied has received a waiver. Our friends say that all they want to do is provide flexibility and more condoms.
Well, for 20 years of fighting AIDS, the bureaucrats who run these programs tried the same approach over and over again. It never worked. When Uganda came up with a comprehensive approach that would, they still opposed it.
Well, the buck stops here in Congress, and we told them in 2003 to do what works, and it's working. Without this amendment, this bill will allow them to go back to the failed policies of the passed. So many on the other side are saying we need to listen to the other experts on the ground; we need to follow their advice.
That's true. They even raise this point with the Centers for Disease Control in a letter signed by several of my colleagues on the other side of the aisle, including the distinguished subcommittee chairwoman, Mrs. Lowey. That letter highlighted the report that was written by the world's leading HIV/AIDS experts, was endorsed by more than 100 leaders from 36 countries, people like the President of Uganda, people like Archbishop Desmond Tutu and the HIV/AIDS director of the World Health Organization, researchers from Johns Hopkins and other leading medical institutions.
Allow me to quote from what these people, the experts, are saying about what's working to reduce AIDS prevalence: ``When targeting young people for those who have not started sexual activity, the first priority should be to encourage abstinence or delay of sexual onset, hence emphasizing risk avoidance as the best way to prevent HIV and other sexually transmitted infections, as well as unwanted pregnancies.'' Abstinence, behavior change, that is what the experts are stressing. I agree, the experts know best.
They are saying that a comprehensive approach that includes behavioral change is crucial to winning the fight against AIDS.
Mr. WOLF. Would the gentleman yield?
Mr. PITTS. I would yield.
Mr. WOLF. Would the gentleman be saying Archbishop Desmond Tutu would be basically supporting your amendment?
Mr. PITTS. That's the quote that I read from the statement he signed.
Mr. WOLF. Nobel Prize winner Bishop Tutu from South Africa supports the amendment.
Mr. PITTS. That's correct.
Mr. WOLF. I mean, is there a greater expert, from both moral and understanding than that?
Did the gentleman say there have been waivers granted?
Mr. PITTS. That's correct. Every country that requested waivers has received one.
Mr. WOLF. Every single country. I think the gentleman has made the case.
I yield to the gentleman.
Mr. PITTS. Mr. Chairman, I submit for the Record the copies of the letters and the statement.
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Mr. PITTS. Mr. Chairman, I rise to oppose the Lowey amendment because it does not address the underlying problem. Whether we support pro-abortion organizations through cash donations or items of cash value, the result is the same. The amendment before us today attempts to undermine the Mexico City policy. The Mexico City policy exists to draw a bright line between U.S. family planning policy and abortion. However, it appears that there are some out there who wish to blur this line. Mr. Chairman, a blurred line is what leads to coercive abortions and forced sterilizations.
The Mexico City policy is critical for several reasons. First, money is fungible. Every U.S. tax dollar or commodity that goes to an abortion provider frees up funds to pay for more abortions and more pro-abortion lobbying. Secondly, our population grantees are seen as representatives of the United States in the countries in which we operate. When organizations prominently associated with United States family planning programs perform and promote abortions, people in these countries logically associate these activities with the United States.
It is important to note that this policy does not in any way reduce funds for family planning. As this chart shows, before Smith-Stupak, there are $441 million for international family planning, including contraceptive commodities. After Smith-Stupak, there will still be $441 million for international family planning, including contraceptive commodities. It simply requires that any foreign nongovernmental organizations that receive taxpayer dollars agree not to perform or actively promote abortions.
I urge my colleagues to oppose the Lowey amendment, support the Smith-Stupak amendment to restore the Mexico City policy and to protect the taxpayers' rights to neither directly nor indirectly fund abortion.
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