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Floor Statement HIV/AIDS -- Haiti and Guyana

Location: Washington, DC


Mr. President, I was pleased to attend an event at the White House on Tuesday, in which President Bush urged Congress to act quickly in passing an emergency plan for global HIV/AIDS relief. I applaud the President for his remarks and for his commitment to easing the worldwide suffering caused by the HIV/AIDS pandemic. I also thank Secretary of State Colin Powell and my colleagues in the House and Senate for their leadership in fighting this dreaded disease. I especially commend Senators LUGAR, BIDEN, FRIST, SANTORUM, and DURBIN for their tireless efforts and dedication to this fight, as well as Representatives HYDE and LANTOS. I thank you all and am encouraged that we will soon pass a comprehensive global AIDS relief initiative.

As President Bush so correctly said on Tuesday:

"Fighting AIDS on a global scale is a massive and complicated undertaking. Yet, this cause is rooted in the simplest of moral duties. When we see this kind of preventable suffering -- when we see a plague leaving graves and orphans across a continent -- we must act."

The President is absolutely right. This is a moral issue. And we, as a nation and as a people, have an obligation to do something. We, as a nation and as a people, have the ability to fight this disease, and it is our duty to help ease this grave and global public health crisis.


In February, Mr. President, I made my 12th trip to Haiti and first visit to Guyana -- both nations in our Hemisphere that President Bush has cited as countries in dire need of our assistance in fighting HIV/AIDS. We traveled there to learn more about the AIDS situation and to determine what kind of health infrastructure is in place to fight the disease.

What we saw on these visits was devastating -- too many children and adults dying of this horrible disease and too few drugs to go around to help treat them and keep them alive. Without question, HIV/AIDS is a human tragedy of grave proportion -- not just in Africa, but right here in our own Hemisphere.

When you travel to the AIDS infested regions of the world, as my wife Fran and I have -- and as many of my colleagues have, like Majority Leader FRIST, and Senator INHOFE, Senator DURBIN, Senator NELSON of Florida, and Senator CHAFEE -- when you travel to these places and when you see the children with AIDS -- when you hold them, touch them and talk to the people who care for them -- when you know these children in all likelihood are going to die, it truly does change you forever. And, when you leave those countries and when you leave those children, you know you cannot just leave. You know you have to try to do something to help.

My trip in February reinforced what I already knew about the devastation of the disease in Haiti, and it allowed me see what efforts are now underway in Guyana. I'd like to take a few minutes to tell my colleagues about what we learned on that visit. I was pleased that Senator CHAFEE and his wife, Stephanie, were able to join Fran and me on that trip. We learned a great deal about what is and is not being done in both of these impoverished nations.

I was fortunate to have Senator DURBIN and Senator NELSON of Florida and his wife, Grace, and Congressman Kendrick MEEK, join me in an earlier trip to Haiti in January, where we saw the tragic effects of the abject poverty and the disease that engulf Haiti today. While there is some miraculous work being done in Haiti to ease the suffering -- work by people, like Father Tom Hagan and his organization, "Hands Together" -- there remains a great deal of work to be done.

Mr. President, when you view the HIV/AIDS rates in Haiti and Guyana in the context of the disease's overall prevalence rate in our Hemisphere -- Haiti has the highest rate and Guyana the third highest -- the moral imperative of helping these two troubled nations becomes very clear.

In Haiti, today, a nation of approximately 8 million people -- 300,000 currently live with AIDS. Guyana follows close behind. In Guyana -- a nation of roughly 800,000 people, 35,000 have been identified as HIV-positive or as having AIDS. Of those 35,000 people, only 200 -- less than one percent -- are getting anti-retroviral drug treatment -- and only one of those 200 people -- only one, Mr. President -- only one is a child.

Consequently, the disease is having a devastating impact on these nations and especially on the children. In Haiti, there are more than 150,000 orphans due to AIDS. This number has been increasing for over a decade and is expected to rise even more.

Specifically, the percentage of Haitian AIDS orphans has gone from 7% in 1990 to 43% in 2001 and is estimated to increase to 49% by 2010 -- that would be a 7-fold increase in 20 years. The rates are equally troubling in Guyana. In 1990, there were no children orphaned due to AIDS, but by 2001, 21% of orphans in Guyana were the result of AIDS and that number is projected to double to 41% by 2010.

Not only is AIDS orphaning these children, Mr. President, but many of them are also suffering from the disease. Today, in Haiti, there are hundreds of orphanages, but less than a handful are serving or even taking children who have AIDS or are HIV-positive. We visited one of these orphanages in February. It is a place called Arc en Ciel [ark - en - see - el] or "Rainbow House Orphanage." Here is a place that sits in what used to be the summer home of the Duvalier family -- Papa Doc and Baby Doc. After the Duvaliers left power, the place was abandoned and ransacked.

A Canadian couple -- Danielle and Robert Penette [pen - et] came in and restored the home, and today, it is a wonderfully bright, cheery, clean, and beautifully maintained orphanage for about 37 Haitian children -- 30 of whom are HIV-positive or already have AIDS.

What we saw there was truly inspiring -- children playing and laughing and learning in the classroom. They sang songs for us. They seemed happy and healthy and content. They didn't seem like orphans at all, really, but more like one big, happy -- and healthy -- family. It is hard to imagine that any of these little children are sick.

Of the HIV-positive children at the Rainbow House orphanage, 15 are receiving anti-retroviral drugs -- and, hose 15 children are the ones really in need of the drugs right now. The important lesson we learned about what is happening at the Rainbow House is this: By simply providing love and consistent nutrition, reliable health care, and clean water, the Penettes were making an unbelievable impact on the quality of life for those very sick little children. What they, in effect, are doing is prolonging the time it takes before these children actually need to be on AIDS treatment drugs.

There are other places in Haiti, Mr. President, places where there are good, decent, loving people, like the Penettes, who are also working miracles. For example, at another orphanage we visited in January, we saw wonderful people doing the best they could to care for some very sick, very malnourished children. At this particular orphanage, many children are brought there ready to die. But, these good people -- saints, really -- they love these children, and they care for them, and they feed them and give them what little medicine they have access to -- and these caretakers bring many of the dying children back to life.

But, tragically, for many of these children -- especially the children with AIDS -- there is only so much these caretakers can do. They can give them love, and they can give them food and clean water, but they can't give them the drugs they need to survive.

At this orphanage, they have an entire floor just for AIDS babies. And, what you see when you go there will change you forever. It is truly tragic -- row after row of steel cribs with babies at various stages of the disease -- none of whom are receiving any sort of anti-retroviral drug treatment. I remember seeing a little boy -- he was about four or five years old -- named Francois [franz - wah]. He had AIDS and was very close to death. He was laid out on a makeshift bed on the cold, concrete floor. He had an I.V. attached to him, and he was getting some fluids, but the caretakers explained that he was no longer able to keep any food down and that because of that, he would die within days. There were no drugs available to treat him and so the caretakers were doing what they could to give him love and make him comfortable in the little time he had remaining.

I will never forget that child, Mr. President -- I will never forget that child for the rest of my life.

Another little boy who I will never forget appeared the opposite of little Francois [franz - wah]. This little boy was about seven years old, and also has AIDS, but he seemed to be very healthy. He was lively and content and thriving. But, that won't last. Very likely, he's going to die. He's going to die because the chances are so slim of him ever getting any anti-retroviral drugs when he actually needs them. He's going to die a needless death.

When you see children like that, Mr. President -- children who are healthy now and could remain healthy if treated properly -- you feel so helpless, because you know they are eventually going to die if we don't do something. And that is why, Mr. President -- that is why we must try to do something. We must save these children.


Take a look at the photograph behind me.


This is a picture of one of the many AIDS babies we saw and held during our visit. When you look at that innocent, helpless little child -- a child who has acquired AIDS at no fault of her own -- you realize that we, as a nation, have a moral obligation to help. Children, like this little girl -- who, in all likelihood, has already died -- will continue to die because they aren't getting the drugs they need. And they aren't getting those drugs, Mr. President, because we aren't doing enough to get them there.


Mr. President, we cannot just walk away from nations like Haiti and Guyana and say that this problem is too big for us to fix.

We cannot walk away and say that these are resource-strapped, third world countries, and there is nothing we can do.

We cannot walk away and say that we shouldn't funnel more resources into those nations because it will be too difficult to get compliance with the reforms -- that a lack of education and a weak and feeble infrastructure will impede any progress.

We cannot walk away and simply say that there is no hope.

The fact of the matter is, Mr. President, that despite the enormity of the despair, there is an equal, if not greater, amount of hope. There is hope because we can help, and there is hope because a great deal is being done already. Let me explain.

Guyana, for example, has an energetic President -- President Jagdeo [jog - day - oh] -- and a dedicated Health Minister -- Leslie Ramsammy -- who are committed to fighting this disease and building a health infrastructure in their nation that will save lives. They have a long way to go, but I am encouraged by their current education efforts and by their commitment to getting more treatment drugs into their nation.

As they work to build this infrastructure, they can learn a great deal from a couple of success stories in Haiti.

First, there is Dr. Bill Pape [pop], who was with us at the White House earlier this week. He is the Director of GESHKIO, a health organization with 27 clinics in the Port-au-Prince area dedicated to the prevention and treatment of AIDS. I have met with Dr. Pape several times in the past, and I am always amazed at what he is accomplishing.

Through his work, Dr. Pape is showing that in places as poor as Haiti -- a nation with an average yearly per capita income of only $250 and a nation where there are very limited health resources -- HIV/AIDS treatment and prevention can -- and does -- work.

At the 27 GESHKIO clinics, they see over 11,000 children, of whom 589 are HIV-positive. Sadly, of those children, only 29 (15 from Arc en Ciel) are on anti-retroviral drugs. At the same time, though, GHESKIO is working hard to treat infected mothers to help prevent mother-to-child HIV transmission. At Dr. Pape's clinics, they have found that 30% of children were being born with HIV/AIDS if the mother was HIV-positive and not receiving treatment. But, of the HIV-positive mothers receiving treatment, only 8.7% of the children born are HIV-positive. The medical science is clear -- if we can reach these mothers early enough, before they give birth to that child who will have AIDS because the mom has AIDS and if we can get medical treatment to the mother and get her the proper drugs -- we can save that child. And, we can save that child, Mr. President, at comparatively little economic cost. Think of the savings -- not just in dollars and cents, but in lives saved!

Mr. President, I was pleased to have the opportunity in February to also meet with Dr. Paul Farmer, who is fighting AIDS in the rural and remote parts of Haiti. He runs an organization called "Partners in Health" and operates clinics in Cange [conj] and Lascahobas [loss - co - ha - bis]. Dr. Farmer is making tremendous progress.

Since 1999, they've tracked a population of 3500 HIV/AIDS patients and have been able to treat more than 350 of them with anti-retroviral drugs. Of those receiving drugs since 1999, zero percent -- no one -- has died. Yet, tragically, of those not receiving drug treatment, 35% have died.

Both Dr. Pape and Dr. Farmer have received grants from the Global AIDS Fund to supplement their efforts. And what that tells us is that we are willing to invest in efforts that working and saving lives. But, while Dr. Farmer and Dr. Pape have empirically proven that there is success in treatment in a third world nation -- that there is hope -- we still must do more. We must act -- and we must act now.

I am encouraged that we have been moving forward in terms of our AIDS spending level -- a level that has gone up significantly over the last few years. I want to compliment my colleagues on the Appropriations Committee, especially Senator STEVENS, for his efforts and dedication to increasing our funds to fight AIDS.

Earlier this year, Senator DURBIN and I were successful in amending the FY03 Omnibus Appropriations bill to include an additional $100 million to fight the global AIDS pandemic.

That money will go a long way. And, if that money is used to implement a holistic approach to fighting AIDS, I believe we can make significant advances worldwide. That means focusing funds on education and prevention and treatment -- treatment in terms of mother-to-child transmission, treatment of mothers who already have children, and treatment of all infected adults. This type of comprehensive approach, Mr. President, can and will make a difference.


I'd like to turn my colleagues' attention to two other photographs from our trip to Guyana. In these pictures you will see two men stricken with AIDS. They are patients at the only public hospital in the nation's capital of Georgetown. When you look at these pictures, you can see the anguish in their eyes and their suffering, and it is heartbreaking.

Though the staggering and shocking statistics can be at once overwhelming and seemingly unreal, when you hold babies dying from the disease or when you see the very real faces of the people suffering from it -- as in these photographs -- it moves you. It changes you, and you are never the same again.



In a guest column recently in the Washington Post, prominent AIDS activist, Bono [bon - oh], quoted something President Harry Truman once said. Truman said: "I trust the people because when they know the facts, they do the right thing." That is certainly the case, I believe, when it comes to the global AIDS crisis.

We have the opportunity, Mr. President, to do the right thing. And, I believe we will do the right thing.

The House plans to take final action on its bill today. And, I am encouraged by the continued good faith efforts of my colleagues here in the Senate to come through on the U.S. commitment to dedicate resources to fight this devastating disease.


Mr. President, every 50 seconds, a child somewhere in the world dies of an AIDS-related illness and another becomes infected with HIV. We have to do something to stop this. The United States has an obligation to lead this fight, and we are leading and moving forward. I look forward to continuing to work with my colleagues as we move ahead

It is our duty.

It is our moral obligation.

And, it is the right thing to do.

I thank the Chair and yield the Floor.

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