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National Defense Authorization Act for Fiscal Year 2007

Location: Washington, DC




Mr. BIDEN. Mr. President, I rise to thank my colleagues for accepting an amendment that I introduced on behalf of myself, Senator Bingaman, and Senator Carper to fully protect the health of our military personnel. The majority of this amendment is the same language the Senate included in last year's Defense Authorization bill clearly establishing the Vaccine Healthcare Centers, or VHCs, role in force protection and treatment. That language was not retained in conference. Instead, a GAO report was mandated. While the GAO report will be helpful in refining the organization and missions of the VHCs, it is important to clearly establish their role today.

The GAO report will not be completed until next year. In addition to the language the Senate passed last year, this amendment includes one additional area for GAO to investigate and a requirement that the Department of Defense examine and plan for its future vaccination needs. Both necessary steps to determining the optimal structure for the centers.

I should also point out to my colleagues that this amendment does not add any funding to the bill. The centers are currently being funded at $6 million a year with global war on terror funds. This amendment does not change that.

Let me explain more thoroughly what the vaccine health care centers do. As our military operates around the globe, they are protected from common illnesses like the flu and from common travel concerns, like yellow fever for sub-Saharan Africa, by vaccinations. In addition, they are vaccinated to protect them from biological warfare agents like anthrax or smallpox.

These force protection measures are critically important, but they only work if military personnel are confident that the vaccines themselves are not dangerous or that the side-effects can be treated.

Vaccines, even those generally considered safe, are still drugs put into the body. For that reason, there are always a small number of personnel whose bodies will have an adverse reaction to a ``safe'' vaccine. In order to deal with this, the Vaccine Healthcare Centers Network was established in 2001.

The centers act as a specialized medical unit and center of excellence that can provide the best possible clinical care to any military member, Active-Duty, Guard, or Reserve, or their family that has a severe reaction. They also advise the Department of Defense regarding vaccine administration policies and educate military health care professionals regarding the safest and best practices for vaccine administration. Their overall mission is to promote vaccine safety and provide expert knowledge to patients and physicians.

Why is this so important? As many of you know, the number of adults who get regular vaccines is fairly small. While we have civilian specialists who deal with childhood vaccinations and problems that might develop, the population of adults regularly vaccinated with anything more than the flu vaccine is small. No civilian expertise exists in this area because the cases are rare and infrequent.

In the military, the reverse is true. Military personnel are regularly vaccinated for travel, for threats relating to their theater of operation, and for things like the flu. Even in the military, though, the cases are rare and spread throughout the force. It is difficult for the average base physician to develop the expertise needed to recognize the problem and to provide the best treatment. In order to effectively develop proper treatments, there must be a centralized center to capture the information on those who experience severe problems.

Here are some specifics:

Last year, 2005, the VHCs managed over 700 cases of adverse reactions to mandatory vaccines.

Each military service made use of the help and care offered by the VHCs--48 percent of their cases were in the Army, 29.6 percent of their cases were in the Air Force, 13 percent of their cases were in the Navy and Marine Corps, and 2.4 percent of their cases were in the Coast Guard.

Since being founded, as part of their ongoing educational effort, the VHCs have developed and distributed over 50,000 immunization took kits to improve vaccinations throughout DOD.

The VHCs are leading the effort to properly characterize and develop treatments for serious reactions to the smallpox vaccine and the anthrax vaccine. In many cases, they collaborate with outside researchers and analysts by providing the large sample population needed to develop case definitions and clinical guidelines.

Since beginning their work in 2001, the VHCs have handled a total of 2,049 cases. Their yearly case load has gone up 83 percent since 2001.

The over 2,000 cases treated demonstrates clearly the need for postvaccination treatment expertise. In all of these cases, base or post doctors did not have the expertise to adequately treat sick personnel. Given that these are mandatory vaccinations, we have an absolute moral obligation to make sure that those made sick by them get the best possible treatment. Much as the military developed a unique expertise in treating those exposed to nuclear radiation, in this new era of proliferating biological threats we must now develop an expertise in postvaccination treatments.

This has all been done by an extremely small staff--only one full-time doctor, three nurse practitioners, and five educators and support staff at each of the four regional facilities. The value and medical services they have provided to the entire military family--Army, Navy, Air Force, Marines, and Coast Guard--has been extraordinary.

Make no mistake, military personnel and their dependents are more confident in the vaccination programs because of the VHCs. When personnel do suffer adverse reactions, reports are extremely positive regarding the care they now get from the centers and we do not see individual cases becoming national news and fear spreading throughout the force.

Why do we need the language I am proposing? The reason is simple. Despite the May 9, 2006, testimony from the Deputy Assistant Secretary of Defense for Force Health Protection and Readiness to the House Committee on Government Reform touting the centers as DOD's answer to adverse anthrax vaccine reactions, the centers are still not clearly established in law and face regular funding battles.

The VHCs were created in minimally worded report language from the fiscal year 2001 Labor-HHS Appropriations conference report. It is time to recognize their role and varied responsibilities with a proper authorization.

In addition, it is time to make sure they have clear and regular funding. For the past 5 years, the VHCs have been funded by the Army alone, primarily with global war on terror funds. I applaud the Army for recognizing the need for the centers and providing those funds from their wartime allocation. But, I am concerned that this is not sustainable and it is not what Congress intended. The Army is only the executive agent for what is supposed to be a defense-wide service. Even though almost half, 45 percent, of those treated by the VHC came from the Air Force, Navy and Marines, and Coast Guard, none of those services is willing to provide their fair share of the yearly $6 million bill. The Army cannot sustain this and the people that would lose are injured military personnel from the other services who will not be able to access expert care.

In recent years, the decision by the other services not to provide a portion of the funding for the centers has led to proposals to eliminate some of their operations. If all or part of the VHC network is dismantled, the technical expertise built up over the past 5 years will be dispersed. It will be almost impossible to reconstitute that highly specialized knowledge when we need it in the future. We cannot just hope that the 708 personnel who sought treatment last year will just get better on their own.

This amendment seeks to clarify that the vaccine health care centers must exist, while also mandating a thorough review of their organization and functions. Next year, when we have the GAO study and the Pentagon's study, Congress can act on any worthwhile recommendations. In the meantime, we cannot leave this vital force protection and treatment center in limbo, nor can we leave the entire burden on the Army.

As biological threats grow from both naturally occurring diseases like bird flu to weaponized agents like anthrax, force protection clearly demands a good vaccination program. Equally clearly, that program must include quality care for those who suffer adverse events in every service, not just the Army.

As we look to the future, the need for vaccinations is only likely to grow. For that very reason, we established Project BioShield. At this point, there is no civilian equivalent to the vaccine health care centers network, but there is an initial collaborative effort between the VHCs and the Centers for Disease Control and Prevention. This collaboration must be encouraged so that we can take advantage of the VHCs knowledge should a mass civilian inoculation become necessary. If the VHCs are dismantled, that knowledge will be lost and may not be easily recovered or recreated.

At the end of the day, this is very simple. We simply cannot mandate that military personnel take these vaccines and then abandon them when a problem arises. There should be no ambiguity about the authority for the vaccine health care centers to continue their excellent work.

If military personnel are injured because of their service to this Nation, whether it be needing a prosthetic limb or long-term treatment for an adverse vaccine reaction, we have an absolute obligation to give them the best possible care.

Anything less is unconscionable.

For that reason, I am thankful that my colleagues have agreed and that this vital amendment has passed the Senate.



Mr. BIDEN. Mr. President, I appreciate the support of Chairman Warner and Senator Levin in agreeing to accept amendment No. 4424 to S. 2766, which I have sponsored.

Section 1023 relates to a counternarcotics authority granted to the Department of Defense in the fiscal year 1998 Defense Authorization Act. P.L. 105-85, specifically section 1033 of that Act. The original provision, enacted in 1997, gave the Department authority to provide counterdrug support to the Governments of Peru and Colombia, including authority to transfer riverine patrol boats to those Governments, and to maintain and repair equipment used for counter-drug activities by those Governments. In recent years, the so-called 1033 authority has been expanded to cover the other countries in the Andes, and to Afghanistan and many of its neighboring states.

The bill now before the Senate would expand the list of eligible governments still further, to include a long list of countries in Asia, the Americas, and Africa. It also provides the Department the authority to transfer aircraft to eligible governments.

The amendment I have proposed to section 1023 would ensure that the transfer of aircraft is subject to section 484(a) of the Foreign Assistance Act of 1961, which requires that the United States retain title to aircraft made available to a foreign country primarily for narcotics-related purposes, unless the President makes a national interest determination and so notifies Congress. The requirement that such aircraft be made available only on a loan or lease basis has been the law for 20 years, since the enactment of the Anti-Drug Abuse Act of 1986, P.L. 99-570, and no good argument has been offered as to why it should not apply to Department of Defense programs. Simply put, the requirement strengthens the ability of the United States to make sure that the aircraft provided is used for the intended purpose.

In my view, section 484(a) already does apply to Defense Department counternarcotics programs. By its terms, it applies to any aircraft ``made available to a foreign country primarily for narcotics-related purposes'' under the Foreign Assistance Act of 1961 or ``under any other provision of law.'' This expansive statutory language makes clear that any U.S. Government agency providing aircraft to a foreign government for counterdrug purposes must retain title to that aircraft. Yet inquiries to the Department of Defense officials about whether the authority provided in section 1023 of S. 2766 would be governed by section 484(a) have proven inconclusive. So that there is no doubt about this question, I have proposed this amendment, which I understand the managers of the bill have agreed to accept.


Mr. BIDEN. Mr. President, last Thursday, we passed by a 99-to-1 vote an emergency spending bill to support our troops in Iraq and Afghanistan and provide relief to the victims of Hurricane Katrina. Unfortunately, behind closed conference doors, a key provision of both the House and Senate versions was stripped out--an amendment, introduced by Representative BARBARA LEE and myself, that would bar any funds from being used to establish permanent U.S. military bases in Iraq or to control Iraq's oil.

I voted to support our troops, though I was surprised that my amendment was removed in conference after not a single Senator spoke against it during the floor debate. By removing the ``no permanent bases'' amendment, we make life more difficult for our men and women in uniform and undercut our Nation's broader effort against terrorism. So I am happy that my amendment has now been accepted as part of the Defense authorization bill.

It is straightforward, clear, and simple: It affirms that the United States will not seek to establish permanent military bases in Iraq and has no intention of controlling Iraqi oil. I will repeat what I said 6 weeks ago: While it may be obvious to Americans that we don't intend to stay in Iraq indefinitely, such conspiracy theories are accepted as fact by most Iraqis. In an opinion poll conducted by the University of Maryland in January, 80 percent of Iraqis--and 92 percent of the Sunni Arabs--believe we have plans to establish permanent military bases. The same poll found that an astounding 88 percent of Sunni Arabs approve of attacks on American forces.

Why do Iraqis believe we want permanent bases? Why do they think we would subject ourselves to the enormous ongoing costs of Iraq in blood and treasure? Do they think we want their sand? No, they think we want their oil. To my mind, the connection between these two public opinion findings is incontrovertible.

Before you dismiss these as simple conspiracy theories, remember what Iraqis have been through in the past three decades: three wars and a tyrannical regime that turned brother against brother and made paranoia a way of life. And there is a longer history, too: 400 years of British and Ottoman occupation have led to a deeply ingrained suspicion of a foreign military presence.

These views extend well beyond Iraq. In a 2004 Pew Charitable Trust survey, majorities in all four Muslim states surveyed--Turkey, Pakistan, Jordan, and Morocco--believed that control of Mideast oil was an important factor in our invasion of Iraq. Our enemies understand the boon these misconceptions provide to their recruiting efforts and use them as a rallying cry in their calls-to-arms. Last year, in a letter intercepted by the U.S. military, Ayman al-Zawahiri, the deputy leader of al-Qaida, wrote to the recently killed Jordanian terrorist Abu Musab al-Zarqawi: ``The Muslim masses ..... do not rally except against an outside occupying enemy.''

Our military and diplomatic leaders understand that countering this vicious propaganda requires clear signals about our intentions in Iraq. And they have done just this: GEN George Casey, the ground force commander in Iraq, told the Committee on Armed Services last September: ``Increased coalition presence feeds the notion of occupation.'' At the same hearing, GEN John Abizaid, the commander of all U.S. troops in the Middle East, told Congress: ``We must make clear to the people of the region we have no designs on their territory or resources.'' In March, the American Ambassador to Iraq, Zalmay Khalilzad, told an Iraqi television station that the United States has ``no goal in establishing permanent bases in Iraq.''

Unfortunately, this clarity has been clouded by mixed messages from the senior-most decision-makers in the Bush administration: To my knowledge, President Bush has never explicitly stated that we will not establish permanent bases in Iraq. And both the Secretary of Defense and the Secretary of State have left the door open to do just that. On February 17, 2005, Secretary Rumsfeld told the Committee on Armed Services: ``We have no intention, at the present time, of putting permanent bases in Iraq.'' ``At the present time'' is not exactly an unequivocal statement.

On February 15, 2006, at the Senate Foreign Relations Committee hearing, Senator KERRY asked Secretary Rice: ``Is it, in fact, the policy of the administration not to have permanent bases in Iraq?'' Rather than answering the simple one word, ``Yes,'' Secretary Rice said during a 400-word exchange on the question: ``I don't want to in this forum try to prejudice everything that might happen way into the future.'' Just last Thursday, columnist Helen Thomas asked the White House Press Secretary to unambiguously declare that the United States will not seek permanent bases in Iraq. Again, the Press Secretary could not unequivocally declare this to be the case.

These mixed messages are confusing to the American people and the Iraqi people alike. They feed conspiracy theories and cede rhetorical space to our enemies. They make it that much more difficult to win the battle for the hearts and minds of 1.2 billion Muslims in the world. Our success in that battle will determine our success in the struggle between freedom and radical fundamentalism. Against this backdrop, I believe that it is incumbent upon us to speak where the administration has not.

My amendment will have no detrimental effect on the military operations of our Armed Forces in Iraq or their ability to provide security for Iraqi oil infrastructure. United Nations Council Resolution 1546 recognizes that the American and coalition forces are present in Iraq at the invitation of the Iraqi Government and that their operations are essential to Iraq's political, economic, and social well-being. In his first speech to the Iraqi Parliament last month, Prime Minister Nuri al-Maliki endorsed that resolution. We are anxious for the day when Iraqis can take control of their own destiny, but the Iraqis are suspicious of our intentions and are growing increasingly impatient.

This amendment may not in itself change a lot of minds on the ground or in the region, but it can mark the beginning of a sustained effort to demonstrate through words and deeds that we have no intention of controlling Iraq's oil or staying there forever. I believe it is our duty to do so.

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