Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

Floor Speech

TOM LANTOS AND HENRY J. HYDE UNITED STATES GLOBAL LEADERSHIP AGAINST HIV/AIDS, TUBERCULOSIS, AND MALARIA REAUTHORIZATION ACT OF 2008 -- (Senate - July 16, 2008)

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Mr. BIDEN. Mr. President, let me say to both Senator Thune and to my colleague from North Dakota that I think the work they are doing here is first rate.

As a matter of fact, Senator Kyl, who is coming to speak on this amendment as well, and I have agreed to, through the Judiciary Committee and through the regular order of business, work on one aspect of the three pieces of this amendment: water, health, and law enforcement.

I think we are going to be joined by our colleague as well on further increasing the assistance to the Indian nation. It is not an exaggeration to say that it is fairly astounding how poorly, over the 35 years I have been here, we have treated the Indian nations.

An awful lot of people, at least in my neck of the woods, think because they read about some of these Indian nations that have gambling on their reservations and are making tens of millions of dollars that somehow all is well, that we do not have to pay much attention to the moral obligation we have and the treaty obligations--I will not get into all of that but the treaty obligations we have been making and breaking since the 1800s.

So I am reluctant--I was reluctant--to talk about beginning to chip away at this bill which Senator Lugar and I and many others have worked so hard on. But I conferred with my Democratic colleagues on the House side who have jurisdiction over this matter. And I wanted to make it clear to Senator Thune, because I do not want to make a commitment I cannot keep, that if and when we get to the point where--I do not speak for Senator Lugar, but I am prepared, on the Democratic side, to accept the amendment at the appropriate time. And I wanted to make it clear that I was kidding yesterday, and I will say in the Record, I want it noted that I am joking, but this is not a Russell Long ``acceptance of a voice vote.''

It used to be, in the old days when I got here, Russell Long would accept anything on a voice vote on a finance bill. And the joke was, before he got to the other side of the House, they were dropped. That is why most people asked for rollcall votes, to make it harder for the conference to drop amendments.

It is my commitment to my colleague that I have been told by the House that although they prefer nothing change in the bill, they are prepared to accept this amendment and that there is no intention of dropping this amendment.

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Mr. BIDEN. Mr. President, I will speak briefly, and then we are ready to vote on this amendment.

I would like to associate myself with the remarks of the Senator from Indiana, and I would add two points.

I am a fan of sunsetting legislation. There used to be a fellow who worked here with us named Lawton Chiles. He got here in 1970 and started sunsetting ideas, and I am a supporter. But here is the deal, what makes this different.

One of the problems in getting many of these African governments in particular to sign on to being recipients and participants in the PEPFAR legislation to save the lives of their own constituents has been the uncertainty of whether, if they start the program, it will, in fact, last. What they don't want to do, since they know they can't carry it themselves, they don't want to find themselves out there where they have made a promise, and it turns out that we decide, at some near-term date, to say no, we are out. That is not what the Senator is saying. He is not saying we are going to get out. He is saying we are going to review. I argue that, as the Senator from Indiana has, we are reviewing. There is built-in review here.

Let me mention one point. The Ministers of Health from 12 African countries wrote the Congress to express their concern, not about this amendment per se but about the impact of uncertainty around the reauthorization of PEPFAR and what impact it would have on their programs in their countries. They said this uncertainty will cost lives because providing these antiviral treatments for people living with HIV/AIDS or caring for orphans and vulnerable children is a long-term commitment, and if the partners can't be confident we are going to continue the program, they are going to be much less willing to enroll new patients and take on a financial responsibility they can't bear. I understand the intent. But it is particularly dangerous to apply it here.

By the way, we don't know whether it applies to PEPFAR specifically, to the tuberculosis program, to the HIV program. Does it apply to all the myriad pieces of this legislation that are holistically designed to prevent and treat the spread of these diseases and the prolonging of life?

The last point, we essentially have a sunset provision. It is only authorized for 5 years. At the end of 5 years, it is over. We have hortatory language saying it is our hope and expectation, if it works as well as we anticipate and works as well as it has in the past, it will be continued for another 5 years. But we can only authorize it for that 5 years.

For those reasons and others which I will not bore my colleagues with now, some of which, if not all of which, my friend from Indiana has already mentioned, I will at the appropriate time ask for the yeas and nays and suggest to our colleagues that we defeat the amendment.

Mr. President, we all want to see effective oversight of taxpayer dollars, but this amendment would exacerbate the very problems it is attempting to solve.

It would create an expensive new bureaucracy that would duplicate functions already being performed by numerous inspectors general, the Government Accountability Office, the Office of Management and Budget, and other outside organizations commissioned by Congress to carry out reviews of this program.

The Congress just spent the last year reviewing the HIV/AIDS, TB, and malaria programs.

The bill before the Senate is based on extensive field examination of the programs, on a GAO review and on an Institute of Medicine study.

We are considering a reauthorization based on the widespread view in Congress that these programs are working. We have a near consensus that they are some of the best foreign policy programs that we have. Why do we need another review at this stage to repeat what has just been done?

Furthermore, the Senate bill already mandates regular scrutiny by the inspectors general, by GAO, and the IOM.

Not only would this Sunset Commission be redundant, it could be harmful.

Under this amendment, AIDS, TB, and malaria programs would be abolished within 2 years after the commission's review--even if that review is positive--unless Congress acts to reauthorize them.

Aside from the fact that we don't want to be fighting to get these programs to the floor every 2 years, think about what message this would send to the world.

As I have said, last year, the ministers of health from 12 African countries wrote to the Congress to express their concern about the impact uncertainty around reauthorization of PEPFAR would have on HIV/AIDS programs in their countries.

They said that uncertainty could cost lives because providing antiretroviral treatment for people living with HIV/AIDS or caring for orphans and vulnerable children are long-term commitments, and if partners cannot be confident that the program is going to continue, they are going to be much less willing to enroll new patients for treatment.

This provision would only magnify that problem, calling into question the U.S. commitment to this program.

Finally, the amendment does not define what a program is. Is it PEPFAR itself? Is it our treatment programs? Is it a single grant to a faith-based organization working in Kenya?

PEPFAR is widely respected as a high-performing program that embraces what works and discards what doesn't.

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Mr. BIDEN. Mr. President, I have been instructed by the floor staff that they are running traps to make sure people are prepared for a vote. I hope we can do that because if we don't vote by 12:15, we probably will not get back on voting until after 4 because of some luncheons; that is, the caucus lunch, the leadership lunch. There is a Republican meeting as well.

In the meantime, if I could take a moment while that is being checked to suggest how maybe we will proceed, if we can, between now and 12:15, hopefully we will be able to get this vote in. Also, I spoke with Senator Kyl on the Dorgan-Thune, et al., amendment, which we are prepared to accept. He says he only needs to speak for a minute or two. My hope was that we could wrap up both those things. Maybe Senator Kyl is available, and we could move to the voice vote on that. In the meantime, if we don't vote by 12:15, there will be no votes until around 4 p.m.

One of the things I have learned, in a major bill such as this, if you lose momentum, it just takes longer. I would like to keep some momentum going.

I would like to suggest the absence of a quorum. Let's hang here for a few minutes to see if we can clear a vote on the amendment of the Senator from Texas.

I suggest the absence of a quorum.

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