Pence Delivers Policy Speech at Ball State University on Global HIV/AIDS Funding

Date: Feb. 6, 2008
Location: Muncie, IN
Issues: Foreign Aid

The President's Emergency Plan for AIDS Relief:
A Program Under Attack

Prepared Remarks of Rep. Mike Pence
February 6, 2008

Thank you for that warm introduction, and thank you for having me. I always feel privileged to come to Ball State University, and this is no exception. I would like to take this opportunity to thank your President, Dr. Jo Ann Gora, and the faculty and staff here for your warm hospitality. I also would like to thank the students who are here today for taking time out of their busy schedules to attend this discussion of how the United States has led and can remain a world leader in fighting one of the greatest human tragedies of our time, the global HIV/AIDS pandemic.

In January 2003, President Bush said in his State of the Union address to Congress, "To meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief - a work of mercy beyond all current international efforts to help the people of Africa..." Congress heeded the call, and the President's Emergency Plan for AIDS Relief, better known as PEPFAR, was born.

PEPFAR put the world on notice that America will not ignore despair and desperation. It has shown the world that America is committed to bettering the lives of people around the globe, especially in Africa, who suffer from HIV/AIDS. I am proud to have supported the passage of PEPFAR on the floor of the U.S. House of Representatives in 2003, and I am hopeful that it can be reauthorized without delay in this session of Congress.

The need for PEPFAR is clear. The HIV/AIDS pandemic has infected more than 60 million people worldwide, and it has killed more than 25 million people. In its wake, HIV/AIDS has orphaned 14 million children. To call this a crisis is not an understatement.

Today, nearly 70% of people in the world who are afflicted with HIV/AIDS reside in Africa. Within that continent there are whole countries where more than one-third of the adult population is infected.

More startling, if current infection rates continue, new epicenters for the disease are likely to arise out of India, China, and Eastern Europe, with numbers that could surpass Africa in as few as two years.

Despite these troubling projections there is cause for hope. Recent reductions in the price of antiretroviral, or ARV, drugs and greater ease of use of these drugs have made therapy for people infected with HIV/AIDS possible on a much larger scale. ARV drugs are commonly known as a "drug cocktail" that is used to suppress the HIV/AIDS virus in infected people. The price of ARV drugs has fallen from more than $12,000 to under $300 per year per individual since the start of PEPFAR. In addition, ARV drug treatment regimens have been greatly simplified.

Much work remains to increase individual access to life-extending ARV drug therapy worldwide. The number of people actually receiving ARV drug treatment remains remarkably low. In Africa, where more than 4 million people have a sufficiently advanced stage of the disease to warrant ARV drug treatment, only about 50,000 people are receiving it.

In addition to making ARV drug treatments more widely available for those people who have been infected, the global community must work just as hard to prevent infection in those people who have not yet been infected. In Africa today, 14,000 people each day are diagnosed with HIV/AIDS. Lowering this infection rate through prevention will halt the advance of the HIV/AIDS pandemic, save lives, and ultimately increase stability in Africa and other regions of the world.

In the countries across the world where the United States is combating HIV/AIDS, PEPFAR seeks to:

• Encourage bold leadership, at every level, to fight HIV/AIDS;
• Apply best practices within our bilateral programs in concert with host governments' national HIV/AIDS strategies; and
• Encourage all partners to coordinate activities, adhere to sound management practices, and harmonize monitoring and evaluation efforts.

In the fifteen most heavily impacted countries of the world, known as "focus countries" under this program, the United States' goals are to support in an accountable and sustainable way:

• Prevention of 7 million new HIV infections;
• Treatment of 2 million HIV-infected people; and
• Care for 10 million people infected and affected by HIV/AIDS, including orphans and vulnerable children.

PEPFAR attempts to fulfill these goals, not only by providing medicine and health care to those in need, but also by providing funding resources for evidence-based programs that have been successful at preventing infection. These programs also respect the pro-family, pro-life cultures of the countries in which they are implemented.

Currently within PEPFAR , these pivotal provisions exist in forms such as the ABC Model, which stands for Abstinence, Be faithful, and Consistent and Correct Condom use. It is absolutely essential that we preserve these prevention methods that focus on behavioral change. Working with faith-based and non-governmental organizations on the local level, in particular through the ABC Model, has produced undeniable results.

Uganda has seen HIV prevalence drop from 30% of the population to 5% in a little more than ten years. In contrast, Botswana's heavy promotion of condoms has proven to be counter-productive. Botswana continues to have the highest HIV prevalence in the world. Currently, 36% of the country's 1.6 million people are HIV-positive. By 2010, more than 50% of the country's children will be AIDS orphans and the average life expectancy will have fallen from 47 years to 27 years.

In cooperation and support of the ABC model, faith-based organizations are able to provide a particularly important service through PEPFAR in many African communities. In fact in many countries, as many as 80% of all citizens participate regularly in religious life and services. Religious leaders implementing the practical prevention model in place in the current program have enormous reach and authority.

It is not enough to send billions of dollars to Africa without sending values-based techniques that work to fight the spread of HIV/AIDS by changing behavior.

It is imperative that efforts be focused on youth as well as adults. Half of all new infections occur in individuals between the ages of 14 and 24. Delaying sexual intercourse by even a year can have significant impact on the health and well-being of adolescents and on the spread of the epidemic in communities.

Girls in countries in Africa with a high HIV-prevalence rate are at significantly higher risk of acquiring HIV, especially from older partners. In some communities, as many as 20 % of girls aged 15 to 19 are infected compared to just 5 % of boys.

PEPFAR is set to expire this year. If Congress does not reauthorize the program, the severity of the HIV/AIDS pandemic will only worsen in the global community, and millions more will suffer. Given not only the serious nature of this humanitarian crisis, but also the amount of hard-earned taxpayer dollars invested in the effort to fight global HIV/AIDS, it is essential that Congress act quickly and wisely to ensure that America continues its commitment.

President Bush has called for an increase in funding from $15 billion to $30 billion in PEPFAR spending over the next five years, and I support this increase. This week in Congress the House Foreign Affairs Committee, on which I serve, will begin the process of reauthorizing PEPFAR by taking up a bill entitled "The Global HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008."

This bill not only reauthorizes PEPFAR for an additional five years, but it also provides for increased funding. Many Americans would rightly think that this bill would have strong bi-partisan support. Unfortunately, the committee proceedings scheduled for this week in Congress seek to undermine and dilute this powerful plan. Provisions included in the reauthorization bill would open PEPFAR funding streams to those organizations overseas that lead the world in promoting and providing abortions. The American people's money, given generously to regions of the world that are being ravaged by HIV/AIDS, is in danger of being severely hijacked in order to subsidize international abortion clinics like Planned Parenthood.

Last week when the President called for continued support for this very important initiative in his final State of the Union address, he insisted that Congress must "maintain the principles that have changed behavior and made this program successful." The current draft of this reauthorization is no longer the program envisioned by the President and embraced by Congress. Under the new bill, PEPFAR would no longer be a program focused solely on prevention and treatment of HIV/AIDS. Instead, it would be converted to a program that, with increased funding, could take lives through abortion rather than save lives through prevention and medication. PEPFAR is a successful program that is under attack.

Under the changes being proposed this week, the Democrat Majority has proposed doing away with funding requirements for abstinence and be faithful programming, two programs that are making a significant difference. Removal of these funding requirements would effectively eliminate all available funding for two critical strategies for reducing HIV infection and prevalence rates.

Furthermore, the Democrat majority in Congress has chosen to mandate the integration of reproductive health services into the PEPFAR program. This would transform a successful strategy to reverse the HIV/AIDS pandemic into a mega-funding pool for organizations with an abortion promotion agenda.

Under the reauthorization legislation, PEPFAR would be transformed into a family planning promotion program. But, U.S. global family planning programs already have an existing budget of nearly $400 million dollars for fiscal year 2008, an existing set of program guidelines, and most importantly, the Mexico City Policy restrictions on which organizations can access these funds. Under the Mexico City policy America's family planning dollars are prevented from going to organizations that provide abortions. Family planning programs should not be allowed to hijack the valuable funding directed at prevention and treatment of HIV/AIDS.

PEPFAR must be reauthorized, and I strongly support doing so. However, I have grave concerns about the direction that the current reauthorization bill is taking. I intend to fight these objectionable provisions in the Foreign Affairs Committee and to work for a clean reauthorization bill of which all Americans can be proud. PEPFAR must remain solely devoted to prevention of HIV infection and relief for the millions around the world suffering from HIV/AIDS. It must preserve the abstinence and be faithful programs that are producing real change. And, as Congress reauthorizes PEPFAR, we must draw a clear line in the sand to distinguish between money clearly designated for fighting HIV/AIDS and funds that will be used to take innocent life.

Too much is at stake in the world for Congress not to reauthorize PEPFAR. My promise to you, as your representative in Washington, is that I will do all that I can to ensure that America's commitment to fighting the HIV/AIDS pandemic in Africa and around the globe will continue, and continue in a manner that best reflects the nature of America's compassion and its devotion to saving lives.