Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008 - Continued
Floor Speech
TOM LANTOS AND HENRY J. HYDE UNITED STATES GLOBAL LEADERSHIP AGAINST HIV/AIDS, TUBERCULOSIS, AND MALARIA REAUTHORIZATION ACT OF 2008--Continued -- (Senate - July 16, 2008)
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Mr. DODD. Madam President, I rise in strong support of the Global HIV/AIDS, tuberculosis, and malaria reauthorization bill and urge its immediate passage. As a member of the Senate Foreign Relations Committee and chairman of its Subcommittee on Western Hemisphere, Peace Corps, and Narcotics Affairs, I can say that of all the global challenges we face, few are more daunting in scope or immediate in need than the scourge of HIV/AIDS. In so many parts of the world, the global HIV/AIDS pandemic threatens to undermine all of our other efforts to bring stability and prosperity to the world.
As a result of the original law Congress passed in 2003, the United States has provided lifesaving drugs to nearly 1.5 million men, women and children; supported care for nearly 7 million people, including 2.7 million orphans and vulnerable children; and prevented an estimated 150,000 infant infections around the world. Through this law alone, we as a nation have shown the world that Americans are a compassionate, caring and generous people. It is a spirit I know to be true throughout our remarkable country. Our sustained commitment to the treatment, prevention, and care of HIV/AIDS globally through this law has helped us make great strides toward helping repair our Nation's image overseas so badly damaged by the war in Iraq. So, I tell my colleagues, the eyes of the world are upon us. We must reauthorize this program and we cannot wait another day to do it.
I want to thank and commend the chairman and ranking member of the Senate Foreign Relations Committee, Senator Biden and Senator Lugar, for crafting this bipartisan legislation that will continue the success of the 2003 law and make many important improvements to the program. I would like to take a minute to highlight a few of what I believe are the most critical improvements. Following that, I want to go into a bit more detail about provisions in this bill that I am proud to have authored, along with my colleague Senator GORDON SMITH, relating to the prevention of mother-to-child transmission of HIV and the treatment of children living with this disease.
To begin with, the bill increases the authorization of appropriations to $50 billion, allowing for incremental increases in funding over the course of the next 5 years. HIV/AIDS killed more than 2 million people last year, including 330,000 children under the age of 15, and an estimated 2.5 million people including 420,000 children were newly infected. These numbers are staggering. Absent an increase in our funding commitment, we may well lose all the hard-fought gains we've made against this disease.
The bill also eliminates the restrictive ``one-third earmark'' limiting prevention funding to abstinence-until-marriage programs. The Institute of Medicine and the Government Accountability Office, GAO, both concluded that the one-third abstinence earmark unduly limited flexibility for the people implementing HIV/AIDS programs on the ground. In fact, the GAO found that in order to meet the one-third spending requirement, country teams reported having to divert funds from prevention of mother-to-child transmission services.
The bill sets several key targets for HIV/AIDS prevention, treatment and care as well as targets to expand the health care workforce in order to help achieve staffing levels recommended by the World Health Organization. The bill moves from a reliance on a health care workforce that was already in place in the developing world under the original law to investing new funds to train new health care workers and paraprofessionals, especially nurses and doctors, under the reauthorization bill. The various targets in the bill will help move the program toward sustainability over the long term. That can only be achieved by a bold, sustained effort to train and retain new health care workers, including adding new workers to the most rural of areas.
The legislation repeals the provision in current law barring the admission into the U.S. of individuals who are HIV positive or have AIDS. This policy is an international embarrassment and its repeal should be maintained in the final bill. Because of this law, the President has to seek a waiver from his own State Department to invite guests to White House events related to this program. The U.S. cannot even host an international conference on HIV/AIDS. The time to repeal this statutory ban that discriminates solely on the basis of an HIV/AIDS diagnosis is long past due.
I would like to take a moment now to highlight a couple of key provisions included in this bill that were drawn from legislation I introduced earlier this year with my colleague, Senator GORDON SMITH. Our bill, the Global Pediatric HIV/AIDS Prevention and Treatment Act, and the bill before us today set a target for the prevention and treatment of mother-to-child transmission of HIV that, within 5 years, will reach 80 percent of pregnant women in those countries most affected by HIV/AIDS in which the U.S. has such programs.
The bill also calls for integrating care and treatment with prevention of mother-to-child transmission programs, increasing access of women in these programs to maternal and child health services, and a timeline for expanding access to prevention of mother-to-child regimes. The ultimate goal of these policy improvements is to improve the health outcomes of HIV-affected women and their families and to improve followup and continuity of care.
I also want to thank the chairman and ranking member of the Foreign Relations Committee for including an amendment I offered in committee that will convene a prevention of mother-to-child expert panel which will report to the Office of the Global AIDS Coordinator and the public within a year on a plan for the scale-up of mother-to-child transmission prevention services. This provision was not included in the House-passed bill but I urge my colleagues to maintain it in the bill that is sent to the President.
We can prevent the transmission of HIV mother-to-child. We know how to do it. In the industrialized world, the standard of care involving a complex drug regimen has reduced mother-to-child transmission rates to as low as 2 percent. By the end of 2007, 34 percent of HIV-infected pregnant women around the world received the medicines they need to prevent transmission of HIV to their babies, a substantial increase from 14 percent in 2005. While this is considerable progress, still almost two-thirds of HIV-positive pregnant women did not receive the medicines necessary to prevent the transmission of HIV to their baby. That is why the target in the bill is so crucial.
I am in the unique position of serving on both the Foreign Relations Committee and the Health, Education, Labor and Pensions Committee where I have spent many years working to improve the health and welfare of children and families. We have made great strides through the Ryan White CARE Act program in this country toward ensuring that children and their families receive adequate, family-centered care and treatment for HIV/AIDS. In the United States, we have reached a point where a child living with HIV/AIDS no longer faces certain death. Thanks to antiretroviral, ARV, therapy, many children born infected with HIV/AIDS now have the opportunity to grow up healthy. However, long-term survival remains a dream that eludes most of the 2.5 million HIV-infected children around the world.
Globally, HIV/AIDS infection rates in children continue to outpace the rate at which they are treated. Every day approximately 1,100 children across the globe are infected with HIV, the vast majority through mother-to-child transmission during pregnancy, labor or delivery or soon after through breastfeeding. Approximately 90 percent of these infections occur in Africa.
With no medical intervention, HIV-positive mothers have a 25 to 30 percent chance of passing the virus to their babies during pregnancy and childbirth. Without proper care and treatment, half of these newly-infected children will die before their second birthday and 75 percent will die before their fifth. Sadly, although children represent close to 16 percent of HIV infections, they are only 10 percent of those receiving treatment.
That is why the bill before us today also includes a 5-year target that the number of children receiving care and treatment for HIV/AIDS is proportionate to their infection rate in each country funded under this program. One cannot lag behind the other and, with passage of this bill, they won't.
I thank the chairman and ranking member again for working with me to include these vital provisions for children and families. I believe they will have an enormous impact on the long-term health and survival of the millions of men, women and children affected by HIV/AIDS.
I would be remiss if I did not take a moment to highlight an area where I believe the bill regrettably does not incorporate the lessons learned over the past 5 years about addressing HIV/AIDS, and that is the lack of language in the bill facilitating linkages between HIV/AIDS activities and family planning activities.
I recognize that Members have strong feelings on this issue. But family planning providers serve millions of women in developing countries that are now at the center of the global HIV/AIDS pandemic. Moreover, it is critical that this program continue to support voluntary family planning counseling and referral as a core component of prevention of mother-to-child transmission and other HIV-service programs. I look forward to working to ensure that this program links HIV/AIDS activities and family planning activities.
With that, I urge my colleagues to act quickly to pass this bill to reauthorize a program that has helped save the lives of millions of men, women and children. The President has asked Congress to pass the bill. The leading organizations advocating for reauthorization of this program have called on Congress to pass the bill. The House has already passed the bill. It is time for the Senate to do the same. I implore my colleagues to put aside their differences and support passage of this bill.
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