United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003—Continued

Mr. President, I offer this amendment on my own behalf, along with Senators BOXER, MURRAY, and LEAHY.

First, I commend the leadership as well as the President for bringing this important issue of global HIV/AIDS to the floor this evening, although the hour is obviously very late.

While I am pleased with many aspects of this bill, and the commitment it represents, I do believe the bill is flawed in a very important and fundamental respect; and that is, with regard to the treatment of and concern for girls and women.

As many of us know who have traveled in Africa, the Caribbean, and other places where the HIV/AIDS pandemic has ravaged so many people, young girls, girls barely in their teens, adolescents, young women, are all too often the victims of this disease because of the way they are treated.

I believe in abstinence. I went to Uganda in 1997. I was impressed, as many of my colleagues have been, by what I saw with respect to the program that Uganda undertook and certainly the results.

But I am concerned that abstinence is not a prevention tool realistically available to many girls and women throughout Africa. So many of the prevention tools are controlled by men, and by customs and by traditions, in communities where the expectation may very well be for a young girl to be married at a very young age.
In Africa, the seroprevalence for women ages 15 to 17 is five times the rate it is for boys of the same age. Now, why does that happen? Certainly the leaders in Africa who are now undertaking their own campaigns against HIV/AIDS are well aware of the uphill climb they face.

Two years ago, Mozambique's Prime Minister, after a comprehensive study, found that there was an explanation for the higher rates among young women, and it was—and I quote him—

Not because the girls are promiscuous, but because nearly three out of five are married by age 18, [and] 40 percent of them [are married] to much older, sexually experienced men, who may expose their wives to HIV/AIDS. Abstinence is not an option for these child brides. Those who try to negotiate condom use commonly face violence or rejection.

That is why I have offered this amendment to specifically address not just women's health but also women's empowerment, because empowering women and girls is the clearest way to give them the tools to be able to not only say no but to actually implement that belief.

It is also imperative to reduce economic and other dependence, to combat gender discrimination and stigma, to recognize that the effective prevention strategies for women, who now represent the majority of people worldwide suffering from HIV/AIDS, must be addressed immediately, urgently, and with resources.

Research shows that the most effective policies are those that include an understanding of the relevance and impact of the roles that culture and society assign men, women, boys, and girls. But the bill that we are considering overlooks and neglects this important aspect of the problem.

Our amendment would correct that neglect by providing assistance for programs that increase women's access to female-controlled prevention technologies, including microbiocides when they become available; and by providing assistance for programs that improve the health education, and skills-building efforts for women and girls, increasing women's ability to protect themselves from unwanted sex, safeguarding themselves when they are sexually active, and reducing the stigma faced by women affected by HIV and AIDS.

One of the reasons the prevalence of HIV/AIDS among younger and younger girls is occurring in Africa is for two interrelated causes: One, because many of these young girls are available, they are healthy; and, secondly, because there is this myth that very young girls will not transmit HIV. And because we do not have widespread testing, many of the men do not even know that they are infected.

Thirdly, we have to recognize that gender inequality is a part of this epidemic. Women who lack access to education, or any kind of skills training, who are exposed to gender-based violence in their home or their larger community, who are sexually coerced or otherwise vulnerable, make up many of the victims that, unfortunately, suffer from HIV/AIDS.

We also should be boosting women's access to pre- and postnatal care, and increasing resources for female-headed households caring for orphans and victims of AIDS, as my colleague from California, Senator Boxer, so eloquently argued.

In addition, we should increase focus on other women's health threats, including cervical cancer, which can be caused by high-risk strains of human papilloma virus.

I hope we can assure we pay particular attention to young people.

Much of the language that is included in this amendment has already passed the Senate unanimously last year in S. 2525. It is not controversial, at least in this body.

I understand the fast track we are on, and the fact that the majority does not wish to have any amendments, but I hope that when we revisit this, as we must, in the appropriations process—when we take the bill and rid it of the contradictions and the conflicts that it inherently has in its language—that this amendment will be accepted. It will help to guarantee that we address these very particular problems that affect women.

When we are talking about women's health and looking at all of the problems women have, it is important that we not focus just on HIV/AIDS as though that is some separate, abstract problem that can be removed from cervical cancer and sexually transmitted diseases and other problems that women suffer from so grievously, not only in Africa but in many countries around the world.

I ask the positive, affirmative support of those who remain in the Chamber on a voice vote for this amendment that specifically stands up for the girls and women of Africa in this important cause we are now undertaking.