Statements on Introduced Bills and Joint Resolutions

Floor Speech

STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS -- (Senate - March 07, 2008)

By Mr. BIDEN (for himself, Mr. Lugar, Mr. Kennedy, and Mr. Sununu):

S. 2731. A bill to authorize appropriations for fiscal years 2009 through 2013 to provide assistance to foreign countries to combat HIV/AIDS, tuberculosis, and malaria, and for other purposes; to the Committee on Foreign Relations.

Mr. BIDEN. Mr. President, today I am pleased to join Senators Lugar, Kennedy, and Sununu in introducing legislation to reauthorize our Government's effort to combat HIV/AIDS, tuberculosis, and malaria overseas. Entitled the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008--in recognition of the great service to this issue by our recently departed friends from the House of Representatives--the bill would continue and expand the revolutionary public health program begun 5 years ago at the initiative of President Bush.

In his State of the Union address in 2003, the President announced a dramatic proposal--to spend $15 billion over 5 years to combat HIV/AIDS globally, particularly in sub-Saharan Africa, which has been hardest hit by the pandemic. Congress responded promptly, authorizing the full amount requested by the President just a few months later.

In the last 5 years, the work of the U.S. Government and its implementing partners around the world has been nothing short of miraculous. Well over a million people have been saved from almost certain death by the provision of anti-retroviral drugs. Mr. President, 150,000 babies have been born without HIV because of efforts to prevent the transmission of the disease from mothers who were so infected. Millions of people suffering from AIDS have received treatment and care. Over two million orphans and vulnerable children have received care, education and support. Across Africa, in communities large and small, we have given millions of people hope for a better and longer life.

Even the most optimistic among us would not have predicted these dramatic results. History will record that this was President Bush's finest hour--he challenged our Government, and the governments in Africa, to respond to one of the most profound crises of our time. They have met and exceeded that challenge. While implementation of the program has not been problem-free, it has proceeded at a pace and scale that was unimaginable to most of us. The credit for this success goes to thousands of dedicated people serving here and abroad, and to the American people, for their generosity in supporting this program.

We cannot, however, rest on this success. We have made progress, but the disease is still winning. Thousands of new infections occur every day. For every person enrolled in a treatment program last year, six more became infected.

Last spring, the President challenged us again--to reauthorize the program at a level of $30 billion over the next 5 years. In the course of last summer and fall, the Committee on Foreign Relations has closely reviewed the President's request and the operation of our current programs. To review the programs in the field, teams of committee staff traveled to most of the 15 ``focus'' countries that have received the bulk of the funding. They visited dozens of clinics, hospitals, and care centers. They talked to hundreds of government officials, community members and health staff working against the disease, people living with HIV/AIDS, and children orphaned by the disease. We have learned what is working--and more important, what is not working. Last fall, the committee held formal hearings to take testimony from experts from within and without the Government. The committee has also closely reviewed numerous studies performed by government agencies and nongovernmental organizations working in this field.

The Congress is now ready to act, and we are ready to respond to the President's call. The bill that we introduce today will reauthorize the Global HIV/AIDS programs for the next 5 fiscal years. It will provide authorization of appropriations of $50 billion over this period, of which $9 billion is devoted to fighting malaria and tuberculosis, two diseases that are also major causes of death in the developing world. This higher figure is justified because the President's figure of $30 billion is too low--it will barely keep pace with inflation, as we are already funding current programs at a rate above $6 billion a year. Additionally, the President's request dealt only with HIV/AIDS, although the initial legislation in 2003 covered all three deadly diseases.

The bill that we introduce will keep the basic framework of the program intact, but makes important adjustments based on lessons learned over the past 5 years. First, the bill removes most earmarks in the original law that delineated the percentages that should be devoted to treatment, to care, and to prevention. A major, congressionally mandated study by the Institute of Medicine, as well as one by the Government Accountability Office, concluded that these earmarks unduly limit flexibility for the people implementing the programs. We need to lift these restrictions in order to let our Government and local officials tailor their responses to local conditions. The only earmark that is retained is a 10 percent allocation for orphans and vulnerable children, for which there appears to be universal support.

The bill also seeks to coordinate our HIV/AIDS programs with other health and development programs. The disease does not exist in a vacuum. Across the developing world, people afflicted with HIV/AIDS face many other health and economic challenges. We need to better coordinate all of our health programs to promote efficiencies and expand the number of people we reach. Nutrition is the best example of how we could positively affect people's lives by improving our coordination. The bill promotes local health capacity--an enormous challenge in Africa in combating this disease. Further, the bill pushes the U.S. Government to plan for the long-term. We need to move from responding to an emergency toward building sustainability--so our local partners that have the resources can take over this effort, with our technical assistance.

Perhaps most important, this legislation attempts to put major emphasis on prevention. Simply put, we cannot win the fight against HIV/AIDS unless we expand and improve efforts to prevent its spread. Such efforts must include the so-called ``ABC'' approach--abstinence, being faithful, and proper use of condoms. But they must involve much more; in some places successful prevention will require major societal and cultural change that must be initiated and led by local governments and leaders.

Last week, the House Committee on Foreign Affairs approved a reauthorization bill on a bipartisan basis. The legislation was sponsored by the acting chairman, Mr. Berman, and the ranking member, Ms. Ros-Lehtinen. It is endorsed by the President, who, having just returned from visiting Africa, personally urged several of us to act quickly on the reauthorization bill. The bill that we introduce today mirrors the compromise in the House in several major respects, which will facilitate a prompt conference with the other body.

In partnership with Senator Lugar, who chaired our committee when the original legislation was approved in 2003, I have scheduled a markup in the Committee on Foreign Relations next week. I am hopeful of strong support to report the bill, and that the full Senate will act on the bill soon after the Easter recess.

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