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FOREIGN OPERATIONS, EXPORT FINANCING, AND RELATED PROGRAMS APPROPRIATIONS FOR 1999
TESTIMONY OF MEMBERS OF CONGRESS AND OTHER INTERESTED INDIVIDUALS AND ORGANIZATIONS
Tuesday, March 31, 1998.
UNICEF
WITNESS
TERRY PEEL, SPECIAL ADVISOR TO UNICEF
Mr. CALLAHAN. We will begin and let the first star witness approach the bench. Mr. Peel, welcome back. It is good to see you.
Mr. PEEL. Thank you, Mr. Chairman.
Mr. CALLAHAN. It is good to see you. Good morning to you.
Mr. PEEL. It is good to see you.
Mr. CALLAHAN. I think we have about 30 or maybe 40 witnesses today so if you all would respect the time of the committee by making a brief presentation of your request—53 witnesses. Mr. Peel.
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Mr. PEEL. Thank you, Mr. Chairman. Two years ago, children in India told me please give us back our childhood, give us back our smiles, don't let our childhood wither away. I think that is a very strong statement. It is strong enough to bring me back here to appear on the other side of this table after sitting over there for almost 20 years. And it is a real pleasure to be back here as the Special Advisor for the U.S. Committee for UNICEF to talk about UNICEF and the need to help children through UNICEF around the world.
I think that I should start by thanking all of you. This committee really has been the leader in Congress in helping children. It goes back to when Mr. Obey was Chairman of the committee. Child Survival was made an issue; funding was provided; low cost solutions were undertaken.
And now, Mr. Callahan, as Chairman you have widened that, increased Child Survival, set up a children's fund with the support of Ms. Pelosi I know this committee is committed as ever to helping children. I want to tell you today that it has had its effect. There are 20 million children alive today that would not be alive except for what has been done through UNICEF and other programs during the last decade.
Three million children a year are alive because of immunization programs; a million children because of oral rehydration therapy. 12 million children are born that would be retarded except for programs for iodization of salt and other programs like that. Kiwanis International has been working on it and is going to be testifying. Polio has been eliminated in the Western Hemisphere through programs through Rotary International and through UNICEF. All of these things are helping the world's children.
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And if you would bear with me for a second, I would like to tell you a little bit about some of these children who have been helped so that you can get a feeling for what the effect has been. Carol Bellamy, who is the Executive Director of UNICEF, asked me to try to find out what has been the value of the billion dollars that the United States provided to UNICEF over the last decade. I went to three continents and talked to the recipients of this assistance.
One of them is Elsy Lopez. Elsy Lopez is a child in El Salvador who was immunized during the war. UNICEF and the Catholic Church worked with the government and worked with the resistance to stop the war for a day. Only 10 percent of the children in rural El Salvador were immunized during the war.
I met Elsy Lopex and asked her if she had her immunization card. Her mother went in and brought out a box, and in that box wrapped very carefully was this immunization card, and the box was sealed tight. It would be like we would keep a valuable in a safety deposit box.
Many children her age in this town are dead because they were not immunized. They were killed by measles. But this child is alive. She holds her immunization card here, and it is a proud treasure.
Moses Omandi is a boy who was abandoned in Kisumu, Kenya, when he was 11 years old. He was given up for dead, living underneath a railroad trestle when he was found. He was taken to a UNICEF-sponsored program at the Overcomer Center there.
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Three years later when I talked to him and interviewed him, he said, ''I could be president of the country some day. It could happen. It could be.'' And this child is a remarkable child who might not be here today except for these UNICEF programs.
In Firozabad, India, these girls are part of the group that were chanting, ''Give us back our childhood. Give us back our smiles.'' These girls were all working in the glass factory in Firozabad, India. They were working eight to nine hours a day, six days a week, and this is Shabana and Sudesha.
These two girls are very happy now. They are in school. They are getting health care. They are being treated as children, something they like very much. And there are 50,000 of these children that are working in various factories in this town. These kids now have a life—they actually have a dream—somewhere that they can go.
My recommendation is that it is time that UNICEF be provided $105 million this year. UNICEF has been level funded at $100 million for the last six years. I think everyone is extremely grateful that that has happened in terms of not being reduced. But if we are going to meet the goals of the year 2000 for children, we are going to have to have a little bit more of a movement here, another $5 million added.
Carol Bellamy is working on streamlining UNICEF. She is getting 90 percent of the staff out of New York into the field working with children. And I think if you can see fit to try to find this additional $5 million, you are going to bring back a lot of smiles and a lot of childhood to these children. So thank you very much.
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Mr. CALLAHAN. I might tell you that Hugh Downs, your Honorary Chairman, visited with us, and the Administration, as you may know, actually requested a reduction in Child Survival, although they did recognize a Child Survival account this year so we are making progress. But I don't know how Ms. Pelosi feels or the other members of the committee feel. But since we are going to increase the Administration's request by 10 percent, I don't know why we can't increase UNICEF's—a portion of that by 10 percent as well.
Ms. PELOSI. Oh, 10.
Mr. PEEL. Well, that is even better.
Mr. CALLAHAN. At least five percent. Ten percent of the increase is what I meant. So we will do what we can, Terry, and we appreciate your presentation and recognize the value of your program. Nancy?
Ms. PELOSI. I just want to thank Terry and support what the Chairman said about the Child Survival account. Certainly we have to have a higher number than the Administration requested, and hopefully the $105 million for UNICEF will be a reality for us to support, too. Thank you, Terry, for what you do and for your presentation this morning.
Mr. PEEL. Thank you very much.
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Mr. CALLAHAN. Next, Robert Moore and at the same time if David Beckman would come forward, it may save us some time. We will recognize Mr. Moore first.
Tuesday, March 31, 1998.
KIWANIS INTERNATIONAL
WITNESS
ROBERT MOORE, VICE PRESIDENT
Mr. MOORE. Mr. Chairman, we are very happy to be here today before this subcommittee in support of a program to eliminate the cause of preventable mental retardation in children. And specifically I would like to inform the committee on what Kiwanis International is doing in this cause. I am a vice president of Kiwanis International and we have a quarter of a million members in the United States with more than 6,000 clubs located in every state in the nation.
In my private life, I am an attorney living in Venice, Florida, but I was born in Kentucky, and I am celebrating today, if you watched the ball game last name. Accompanying me is Bo Shafer, who is an independent insurance agent from Knoxville, Tennessee. He is also one of the vice presidents of Kiwanis, and he is celebrating because of what happened Sunday.
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Mr. Chairman, Kiwanis members from around the world have established children as their primary interest and have adopted a service program that is called Young Children: Priority One, which is working with boys and girls prenatal through age five.
We have nearly 600,000 youth and adult members of the Kiwanis family of clubs that have declared the world their community and have joined with the United Nations Children's Defense Fund to help virtually eliminate iodine deficiency disorders around the globe.
We want to thank you and members of this committee, Mr. Chairman, for the efforts you have made on behalf of children. Funding provided by this committee through the Child Survival and Disease account has provided funds for child survival, micronutrients, and other programs that have helped children and have aided us in our cause to eliminate iodine deficiency disorders.
More than 1.5 billion people, over half of which are children, in more than 115 countries are at risk of iodine deficiency disorders. Iodine deficiency disorders result in high levels of still births, mental and physical disabilities, and thyroid problems as evidenced by the prevalence of goiters in children and adults.
In addition, recent studies have indicated that the IQ where you have iodine deficiency disorder is 15 points lower than normal in the whole populations, and that micronutrient malnutrition in its various forms resulting in a reduction of GDP by as much as 15 percent.
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The solution is very simple and has been available since the 1920's. We eliminated iodine deficiency disorders basically in the United States and in many other western nations through the iodization of salt. And you may recognize the Morton Salt can, but they are working with us in this project.
And a teaspoon of iodine is all that a person needs during their lifetime, but you can't take this one teaspoon and take care of it. It has to be introduced over a period of time, and that is why salt is the best vehicle.
But only for a few pennies per person we are going to be able to iodize salt in all the other parts of the world, and it can prevent iodine deficiency disorders—the iodization of salt. It reverses many existing conditions and improves the mental capabilities and productivity in iodine deficient populations.
UNICEF has credited Kiwanis contributions to date with preventing over 5 million children from being born mentally disabled each year. And thousands of Kiwanis clubs have already reached over $27 million in pledges and gifts towards a $75 million commitment that we have made to help eliminate iodine deficiency disorders.
The Kiwanis contribution will provide the resources necessary to trigger the local investments and programs needed to virtually eliminate iodine deficiency disorders by the year 2000. Mr. Chairman, we have a good working partnership with UNICEF, and UNICEF has made it possible for Kiwanis members and their supporters to demonstrate what the private sector can do for children.
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It has been estimated that every dollar invested in elimination of iodine deficiency disorders will reduce social costs by $20. And countries that eliminate iodine deficiency disorders will, therefore, not only help their children, but also reduce dependency on country and foreign assistance. One of the words or phrases I use in speeches I give is these countries will become consumers of our products and not our charity, and we believe that.
So we would ask this committee to consider taking three actions in support of eliminating the cause of preventable mental retardation in children. First, we would ask that you join Kiwanis in making it known to the American people the importance of eliminating this disorder.
Second, we are asking that the committee support our partner, UNICEF, by providing them with the $105 million in funding for the upcoming fiscal year or 10 percent more than they are getting now, as I just heard you all discussing.
And, finally——
Mr. CALLAHAN. It is 10 percent of the increase over the Administration's request.
Mr. MOORE. Well, it is just that. Finally, I urge you to encourage the U.S. Agency of International Development to provide additional funding to support the Kiwanis-UNICEF Iodine Deficiency Program because the more funds made available for this program, the faster we can cure the problem.
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I heard the words of a popular song, ''For Such a Time as This,'' I think sums up what Kiwanis is attempting to do. It said, ''We can't change what has happened, but we can change what will be.'' So, Mr. Chairman, many other world health issues require billions of dollars and many years of effort to reach their objective. The elimination of iodine deficiency disorders can be done within two years.
With the support of people around the world and this committee, it is within our grasp to point with pride as we enter the next century that iodine deficiency disorders have been removed from the earth forever. And we would appreciate your consideration for this project.
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Mr. CALLAHAN. Thank you.
Mr. SHAFER. Let me say—see, I am a hillbilly—but we thank you so much for your consideration.
Mr. CALLAHAN. Well, you are welcome. I think the committee is supportive of what you do. I know I am and I know Nancy is, and I, as a matter of fact, sent a guy to see you. In fact, he is the Chairman of the Ways and Means Committee Bill Archer's son who lives in Texas.
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Dr. Ren Archer has a program that Texas needs help with, and that is the eradication of tuberculosis on the border. It is an acute problem, and I have suggested that he come to the Kiwanis Club or at least some agency like the Rotary or the Kiwanis in order to get them involved in a doable, inexpensive project to eliminate tuberculosis on the borders.
Mr. MOORE. As you know, the district organization that we have in Kiwanis, since you have been a Kiwanian, but our districts are doing many things in the immunization in those areas on their own, but we are cooperating together on the worldwide view to eliminate iodine deficiency disorder because we believe we can take care of our communities and our world community.
In Florida, when I was governor, we started the immunization program that has raised the immunization rate of children from age five and below from 63 percent to over 80—in the high 80s, so we are doing that locally, but we are really committed also to this worldwide service.
Ms. PELOSI. Wonderful, wonderful.
Mr. CALLAHAN. They asked if you joined a Kiwanis Club. Did you hear that?
Ms. PELOSI. He said he wanted us to join Kiwanis in making known——
Mr. MOORE. Well, we will ask you to join Kiwanis, and Bo may even have an application.
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Ms. PELOSI. When I first went to speak to the Kiwanis Club, I was the only woman in the room, but I know things have changed since then.
Mr. MOORE. Yes, ma'am, they have changed. They have changed. Thank you very much.
Ms. PELOSI. I know you do wonderful work, and you are a model to the rest. Thank you.
Mr. MOORE. Thank you very much.
Mr. CALLAHAN. Mr. Beckman.
Tuesday, March 31, 1998.
FAITH ACTION FOR PEOPLE
WITNESS
DAVID BECKMAN, PRESIDENT, BREAD FOR THE WORLD
Mr. BECKMAN. Thank you, Mr. Chairman, and Ms. Pelosi. We are really glad to have you here. I am David Beckman. I am the President of Bread for the World, and this morning I am speaking on behalf of 22 churches and faith-based groups that follow the foreign aid budget. We try to make our perspective or forge a perspective in response to what the Bible teaches about the kind of world that God wants us to build.
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First, I would like to commend you, this committee, and Congress for increasing funding last year for international affairs and especially for IDA and other programs that help to reduce poverty around the world. We think the University of Maryland studies on U.S. public opinion show that most Americans support the kind of foreign assistance that we lobby for and foreign assistance that really helps people in need and helps them be more productive.
In my oral testimony, I would like to just highlight a couple of areas where we think you should direct more money and a couple of areas where you can send less money. First, on more money, we would urge you to find ways to increase funding for development assistance in Africa.
Hunger is pervasive in Africa. Hunger is on the increase, but as the President's trip has instructed a lot of us, there are a lot of promising developments in Africa. There are a lot of things that we can invest in that can help Africans come out of the decline they have been in and continue the renaissance that some countries are now in.
In particular, I would like to call your attention to the Africa: Seeds of Hope bill, which Doug B. Ryder and Lee Hamilton are introducing in the House today. This is Bread for the World's offering of letters this year so we will mobilize something like 100,000 letters to Congress from people all over the country urging some modest adaptations of various instruments of the U.S. Government in ways that would get more resources to the African farmer and to struggling rural communities.
We think President Mandela was right in saying that although trade with Africa is important, it is not enough. Poor countries need aid as well, and also especially that rural, isolated areas need the roads repaired. They need rural credit, they need agricultural extension, agricultural research that is relevant.
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And what the Africa: Seeds of Hope bill does is to identify a number of ways in which AID could direct more resources to African farmers, African rural development. The bill urges continued U.S. leadership in IFAD. Also, the bill encourages OPEC to start doing business in rural Africa. We think that is feasible and would be a way of, without tapping more into the appropriations process, to get more money to African farmers.
So I would encourage you and I would ask you and your staff and other committee members to consider the Africa: Seeds of Hope bill, to give it your support. I think these are really reasonable proposals that would go a long way to reduce poverty and hunger in Africa and one way that they might eventually actually become law as amendments to the appropriations bill. So we really hope that you will be supportive of this initiative.
The second area where we would like to suggest that more money should be spent is in the area of debt reduction. As you know, the Pope and Archbishop Tutu and church leaders around the world have been talking about a Jubilee 2000, trying to celebrate the year 2000, the turn of the millennium by some initiatives to reduce the overhang of unpayable and punishing debt in many countries.
In our own country we have bankruptcy procedures so that if somebody gets in real trouble and can't possibly pay off their debt, creditors are treated fairly, but there is a time when you move on and go to the future. But among the developing countries, there are a bunch of developing countries that have debts that are 15–20 years old.
The creditors are never going to be paid, but the cost of carrying that debt is real, and the cost is partly paid by kids who don't get to go to school and people who die because there is not medicine in the country and so forth.
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Jim Wilkinson has said that he thinks that debt reduction is going to be one of the major issues in the next few years in the area of international development. And it is certainly an issue on which a lot of church people across the country are going to be engaged and urging increased activity. We hope you will approve the President's request for funding for debt relief and for the African Development Fund.
We also would ask that you would urge the Administration to get the HIPC initiative going in a more aggressive way. That is a really positive step forward, but we think that it is dragging, that it could extend to more countries more quickly and with deeper debt reduction. More generally, we would just like you to open the door to discussion about ways to resolve this overhang of unpayable and in many cases really hardship debt as we move toward the year 2000.
Then the two areas where we would suggest you might spend less money, first is aid to the Middle East. We really applaud the fact that this committee last year put a ceiling on aid to the Middle East. And at some point it seems to us clear that there ought to be some reallocation from the Middle East to areas of greater need. Maybe this is the year.
We also suggest that you could cut money from the narcotics program. Some of the money goes to security forces in other countries that have a record of human rights abuses, and we just don't think it makes much difference. We don't think it works very well. There is the Rand Corporation study which suggests that it takes $20 out of the foreign aid budget to get as much cocaine use reduction as you can get for $1 through drug treatment programs. So we think that is a place you could take some money and put it into things that are more important. Thanks for your attention. I really appreciate your leadership.
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Mr. CALLAHAN. Thank you, Mr. Beckman.
Ms. PELOSI. Thank you.
Mr. CALLAHAN. Mr. Sever and Mr. Moody.
Tuesday, March 31, 1998.
ROTARY INTERNATIONAL
WITNESS
DR. JOHN SEVER, PROFESSOR OF PEDIATRICS
Dr. SEVER. Chairman Callahan, good morning.
Mr. CALLAHAN. Good morning.
Dr. SEVER. Ms. Pelosi.
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Ms. PELOSI. Good morning.
Dr. SEVER. Thank you for this opportunity to testify on behalf of Rotary International today in support of the polio eradication activities of the U.S. Agency for International Development. I would like to invite both of you to become members of Rotary as soon as possible. As you know, sir, Rotary is an organization worldwide with 1.2 million members. We have over 7,000 clubs in the United States, and we are fully committed to helping children and specifically for the eradication of polio.
I am Dr. John Sever. I am Professor of Pediatrics in Infectious Diseases at the Children's Hospital here in Washington, DC. I am here today representing a broad coalition of health advocates, including Rotary International, the March of Dimes Birth Defects Foundation, the American Academy of Pediatrics, Task Force on Child Survival and Development, and the U.S. Committee for UNICEF, to seek your continued support for the global eradication of polio.
Allow me first on behalf of Rotary and the coalition to express our sincere gratitude. In fiscal year '97 and '98, you recommended that $25 million be allocated for polio eradication, and those were the activities of the Agency for International Development. And the full Congress ratified your recommendation both years.
The target for the eradication of polio is the year 2000 with certification worldwide by the year 2005. At that point, we will be able to stop immunizing for polio for the rest of eternity. So with that target, this will achieve not only the eradication of polio and the suffering, but a tremendous savings financially throughout the world.
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Although the United States has had no polio since 1979, we continue to immunize our children at a cost of about $230 million a year. Worldwide, the cost is about $1.5 billion a year just for polio immunization.
Thanks to your appropriations and the international effort to eradicate polio, we have made tremendous strides, and you have a graph in the handout which shows this tremendous reduction in numbers of cases so that we anticipate less than 3,500 cases reported during this last year. And the expectation is this will be down to zero by the year 2000, just a couple years away. We are well on target for achieving that goal if we continue to pursue it.
The remaining major areas that still have some polio are in South Asia and Africa. So AID has been one of the driving forces to help work on that effort of eradicating polio in those areas. They specifically have been targeting the intention to stop Asia and Africa in the last two years.
We are advised by AID that if funded for 1999 their planned polio eradication activities will include $16 million for polio eradication in Africa, $4 million to support India's national immunization days to complete their eradication, and then $5 million for surveillance in South Asia, Europe, and related activities.
The United States' commitment to the eradication of polio on behalf of the United States Government has stimulated other countries to give their support. Belgium, Canada, Finland, France, Italy, Korea, Norway, Sweden, Switzerland, Japan, Australia, Denmark, and the United Kingdom are among the countries that have now joined and followed American's lead in announcing special grants for the global eradication of polio.
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By the time polio has been eradicated, Rotary International will have expended well over $400 million in this effort, along with hundreds of thousands of hours in volunteer effort. It represents the largest private contribution to the public health ever made.
For fiscal year 1999, we request the $25 million earmark for global polio eradication in the USAID budget through their polio eradication initiative for delivery of vaccine and the development of infrastructure to complete that program. This would maintain the funding at the FY '98 level and ensure the U.S.A. remains a decisive factor in the success of global eradication.
In addition, we are seeking report language similar to that included in 1998 specifying that this funding is meant to be in addition to the resources for regular immunization of AID and is intended to supplement other related activities.
Lastly, we would ask that the committee again request a report by December 1, 1998, on AID's plans for full implementing of programs. Polio eradication is an investment, but few investments are as riskfree and can guarantee such an immense return within a very specified period. This will be our gift to the children for the 21st century. Thank you very much.
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Mr. CALLAHAN. Well, thank you. Let me first of all say that you epitomize what civic clubs are all about worldwide. Your program is reaping tremendous benefits for humanity, and all Rotarians should be proud.
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On a personal level, if you would convey my regards to Herb Brown, one of your predecessors and president of Rotary International, and also to Mrs. Fleming. Mrs. Fleming uses her maiden name. I know her husband, but she is President of the Rotary Club in Mobile. But I said that we are probably going to give you very favorable consideration simply because of the request made by Mrs. Fleming of the Mobile Rotary Club. Nancy?
Ms. PELOSI. That is good. Well, any way you can give favorable consideration to this very worthwhile request is good. Thank you for what you do. It is so impressive.
Dr. SEVER. Thank you very much.
Tuesday, March 31, 1998.
INTERACTION
WITNESS
JIM MOODY, PRESIDENT
Mr. CALLAHAN. Good morning, Jim. How are you this morning?
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Mr. MOODY. Good morning, sir. Nancy——
Ms. PELOSI. Hi, Jim.
Mr. MOODY [continuing]. Mr. Chairman, Charlie.
Ms. PELOSI. Welcome to a former colleague.
Mr. MOODY. It is nice to be with you. I am pleased to be back among my former colleagues and to testify for InterAction this morning—my brand new job.
Ms. PELOSI. Congratulations.
Mr. MOODY. Thank you for doing that. Let me thank you for the many courtesies and helpful considerations you have provided when I was here as VP of IFAD. First, let me also thank you, Mr. Chairman and Ms. Pelosi, for being strong supporters of child survival and disease prevention programs. Your leadership has literally saved thousands of lives of children in the developing world.
We are here today to ask you to consider taking additional steps that will save still more lives and give millions of other children in the developing world an opportunity to have a future worth living and a future that is also good for our country.
InterAction, as you probably know, represents 159 different private and voluntary American organizations, PVOs, that work overseas in sustainable development, humanitarian, and refugee assistance. InterAction seeks to give voice to the common values and commitments of these nonprofit organizations and their millions of members across the United States. It also directly serves its members by setting high standards of management and fiscal accountability for PVO in their field operations.
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As someone who like you wants the private sector to actively help solve problems both here and abroad, I believe that PVOs show America at its very best—private citizens pitching in with their money and/or time to make the world better, cleaner, safer.
American PVOs can often respond to humanitarian emergencies, can combat hunger, foster grassroots village development more economically faster and are effectively than sometimes a government-only approach can do. But relatively little government help can also multiply the on-the-ground achievements of these organizations.
From having served overseas and visiting a number of countries, I believe that America has an enormous opportunity at this time in history to alleviate suffering among the poorest and most afflicted people and leave this planet a better place for us all.
That is something that the American public wants us to do when we can do it cost effectively and when they comprehend the stakes and when they perceive how only a few public dollars when coupled with private dollars can make a huge impact.
And I believe you know every dollar that private volunteer organizations receive from government is matched by more than $3 from the American public in a critical public-private partnership that both leverages resources and meets urgent human needs.
Now, while our membership is diverse with 159 different organizations, we share a common interest not only to respond to basic human needs of shelter, food, safety, but also enable people to improve their own lives with their own efforts, to help them obtain the tools, the institutions, the technology, and the policy environment to do that, and also to reduce the level of turmoil, violence, and upheaval. All of these goals are directly in the U.S. national interest and certainly consistent with our country's best values.
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Over the past several years, cuts in some of the most effective forms of foreign assistance have fallen disproportionately on the development of humanitarian programs, both bilateral and multilateral, that assist people most in need. You have been helpful in restoring some of those in the last budget, and I hope you will do so again. I am sure you will.
In fiscal 1999, we hope that Congress will more closely match resources to America's international interests, our obligations, and our opportunities. We have 10 specific recommendations. I will try to move through them fairly fast.
Number 1, development assistance. InterAction and its members urge you to approve at least the eight percent increase for bilateral development assistance and to build on and expand last year's efforts to restore deep and serious cuts that occurred in the last several years in those areas of humanitarian and grassroots programs.
While our members deeply appreciate the efforts that you and this committee have made to support child health care, basic education, and the fight against internationally contagious diseases, and we have just heard excellent testimony on one of those, our experience in the field clearly shows that achieving sustainable gains in these efforts also requires investment in complementary activities such as grassroots agricultural development, microcredit and microenterprise, soil erosion protection, local farm-to-market roads, and policy improvements such as price liberalization to enable small farmers to grow more cash crops and thus increase family income.
InterAction supports the higher development assistance number requested by the Administration and specifically supports the request for the microcredit program particularly for start-up entrepreneurial loans under $300 that go mostly to small business women, who, by the way, have the best repayment record.
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We also support the $400 million request for voluntary, noncompulsory—repeat—noncompulsory family planning programs that enhance pre- and post-natal health of mother and child, and which directly support child survival in the critical first year of life.
When I was in Bangladesh as a Peace Corps volunteer, a typical Bengali woman 35 years of age will have had 10 pregnancies which were spaced so close together that a large number of her children, usually four or five, did not survive.
To now space her pregnancies meant those children that were born actually could survive better, had more strength, the mother's body was restored to its strength, and she could bear those pregnancies, and those children who were born ended up living if she was able to space her pregnancies.
Number 2, the development funds for Africa. We urge at least 800 million be designated for DFA for programs in the sub-Sahara where, as you know, poverty, food insecurity, poor health systems, underdeveloped markets, rapid population growth, and environmental degradation threaten both human opportunity and regional stability. Carefully targeted development assistance in this region can—if it is carefully targeted—make a huge difference.
Number 3, debt restructuring. Despite the vast natural wealth and future potential, some poor countries, especially in Africa, currently face unsustainable debt obligations. And rather than repeat my comments, I will simply identify what Mr. Beckman of Bread for the World said a few moments ago.
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Number 4, international programs and organizations. We urge full funding for the requested levels for those institutions within the IO&P budget, including those UN agencies which are doing a good job in humanitarian, nutrition, and sustainable development objectives which are important to the American people. We also support the $5 million request for UNICEF.
Number 5, refugee and migration assistance. Refugee protection and migration assistance continues to be a major priority for the InterAction community. We urge you to provide at least 695 million for regular migration and refugee assistance, which is 45 million above the Administration's request.
This level of appropriation will also help the urgent funding needs of the United Nations High Commissioner for Refugees, which is facing a $651 million shortfall for '98. We also support a $50 million appropriation for the emergency refugee and migration assistance account, which is the usual yearly amount, rather than the Administration's request——
Mr. CALLAHAN. Jim, let me interrupt. We would be glad to receive your written statement.
Mr. MOODY. Okay.
Mr. CALLAHAN. We can't give every witness 20 minutes, even though you are a former colleague.
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Mr. MOODY. No, that is fine. I don't want special treatment. Let me just mention that food aid is number 7, environment is number 8—I will give you the details on that—increased funding through PVOs is number 8, and number 10 is IDA, which you have already heard about. I would be glad to answer any questions.
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Mr. CALLAHAN. Thank you, Jim. Any questions?
Ms. PELOSI. I would just like to say, Mr. Chairman, that anytime anybody gets discouraged around here, they should just come here on public witness day and hear Kiwanis, the Rotary, UNICEF, InterAction, Faith Action for People, and the list goes on and on, and it will go on and on. But thank you so much for your testimony. Good luck in your new job.
Mr. MOODY. Thank you.
Mr. CALLAHAN. Dr. Burke and Father Drinan.
Tuesday, March 31, 1998.
AMERICAN SOCIETY OF TROPICAL MEDICINE AND HYGIENE
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WITNESS
DR. DONALD S. BURKE, DIRECTOR, CENTER FOR IMMUNIZATION RESEARCH, JOHNS HOPKINS UNIVERSITY
Dr. BURKE. Good morning, Mr. Chairman. I am Dr. Burke from the Johns Hopkins University where I am the Director of the Center for Immunization Research. I represent the American Society of Tropical Medicine and Hygiene, a society of 3,500 members who specialize in research and practice of tropical medicine and international health.
A strong U.S. agenda in infectious diseases is crucial to our national interest. A few years ago, more than 27 million Americans traveled internationally, many of these becoming exposed to international disease threats. In the last 25 years, a total of 30 new human pathogens have been recognized as newly discovered diseases.
These diseases have an enormous impact on the lives of millions of persons. Each year, acute respiratory infections such as pneumonia kill 4.4 million people, about 4 million of which are children. Diarrheal diseases, including cholera, typhoid, and others, killed 3.1 million people. The list goes on. I don't need to give you the entire list.
A few months ago, I participated in USAID's consultation on how best to spend the supplemental $50 million appropriation for infectious diseases last year that was put into the bill. And we decided that that should be directed to tuberculosis, malaria, and drug-resistant bacteria.
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And the reason was that these are existing threats today that needed attention today, but we did have considerable discussion about whether or not we should be looking to tomorrow, whether or not we should be trying to design programs that could anticipate the next local pandemic, the next AIDS, the next influenza. We decided that there was insufficient funding to do that, and we needed simply to target those existing threats today, the tuberculoses, the malarias, and the like.
We had hoped that there would be continued funding for this kind of program in the future. But we noticed that the infectious disease supplement has just dropped back now by $18 million from what it was last year, and that the total appropriation is back to the base line again, which means that some of that infectious disease money looks like it is going to have to be taken out of some of the allowance for child survival and disease control among children. We think that this is probably not the best way of doing business for the future.
Mr. CALLAHAN. You say it was dropped back how much?
Dr. BURKE. I have the numbers right here, sir. It would be the child survival total budget is down from $550 million last year to 503 this year, and the infectious disease——
Mr. CALLAHAN. At their request?
Dr. BURKE. The request—the presidential request.
Mr. CALLAHAN. I see. So they didn't drop you last year?
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Dr. BURKE. No. It wasn't last year. That is correct, sir.
Mr. CALLAHAN. It is not going to be because of 550 being reduced?
Dr. BURKE. No.
Mr. CALLAHAN. You weren't given the 550?
Dr. BURKE. Yes, that is correct. This year's budget is what I am addressing, sir. But of that, $24 million is the decrease in this new $50 million for infectious disease research which means it is a one-shot deal and, unfortunately, won't be able to be sustained if that is the case.
The child survival programs—you heard about polio immunization, which has been spectacularly successful within a number of other spectacular successes as well. Infant mortality worldwide has dropped from 130 to 60 per thousand live births over the last couple of decades. Child mortality has fallen from 180 to 80. These are spectacular changes worldwide in our ability to help children grow up around the world. A large part of that has been through these programs that have been supported by USAID and the child survival program.
Immunizations against measles have also decreased the number of measles deaths by 83 percent, and measles is also targeted for elimination from the Americas by the year 2000. So that any cut in these programs to me seems probably not the best investment and strategy.
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Mr. Chairman, the control of global infectious disease is not just a development issue, it is also a national security issue and one of concern to all of our citizens. By controlling infectious diseases worldwide, we not only provide development assistance, but we also reduce the risk of spread of virulent organisms to our own populations.
Investments in global infectious disease control are clearly a win-win for the United States. By helping others, we protect ourselves. We strongly urge you to restore the appropriations to last year's levels. Thank you very much.
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Mr. CALLAHAN. Thank you, doctor.
Ms. PELOSI. Thank you, doctor.
Mr. CALLAHAN. Father Drinan.
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Tuesday, March 31, 1998.
WORLD HUNGER EDUCATION SERVICE
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WITNESS
FATHER ROBERT DRINAN, LAW PROFESSOR, GEORGETOWN UNIVERSITY
Mr. DRINAN. Good morning, Mr. Chairman, and members. It is like coming home again. I thank you for all the work that you have done for the poor around the world. I speak here as a member of the Board of World Hunger Education Services. This is a nongovernmental group that tracks starvation and other afflictions around the world.
I have been specializing in international human rights since I left the Congress in 1981. And I come here today particularly to speak about North Korea. A survey has been done—several surveys—and I have left this with my testimony—that at least—to the effect that at least a million people have died recently in North Korea, and the facts are grim.
Children and the elderly are dying at extraordinary numbers. People are leaving the large cities in the north, and they are not finding anything outside, and as a result epidemic levels of communicable diseases are taking lives even more than starvation.
We are familiar with this in Rwanda and other countries, and we are almost blind to it in this particular country, which is so invisible. And the organization that I represent here today has tracked this for a long time, and we present evidence to you that is really startling, that at least 1 million people have perished and another million are migrating from North Korea to China, and that sufficient food is simply not available. And in my testimony, I gave you a map of North Korea and what is happening.
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What is the situation? The World Food Program has recommended that 658 metric tons be supplied. The United States has responded with promises to ship 200,000 metric tons, but, Mr. Chairman and members, it seems from all of the evidence that I have seen and this group that I represent have seen that at least 1.2 million tons of food is necessary. That means that only a very small portion of what is desperately needed in North Korea will actually be furnished.
It seems to me that without being rhetorical, what is transpiring in North Korea is genocide. You see a totalitarian regime here that protects its own people and the Communists and that of the army, but for the other people, they just don't care about these people.
Mr. Chairman, when President Clinton looked so sorrowful in Rwanda, I wondered whether another President will someday be coming back from North Korea and say that we allowed genocide to occur. We were not responsive to this, and we allowed apathy and ignorance to overcome that.
Mr. Chairman, it is a narrow window of opportunity. People are starving now and dying, and we hope that you will use your influence and the understanding of this subcommittee to assist these human beings who are now dying before our very eyes.
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Mr. CALLAHAN. Thank you, Father.
Ms. PELOSI. Mr. Chairman——
Mr. PACKARD. Mr. Chairman, are we allowed to ask questions of the witness?
Mr. CALLAHAN. Yes.
Mr. PACKARD. What assurances, sir, do we have that the food actually gets to the hungry in North Korea, not——
Mr. DRINAN. Congressman, that is a very difficult problem. All I know is that we—all of us will regret five or ten years from now if we say, well, we didn't even try. The difficulties are there, but that with good will, with the international entities and with UNICEF, with all of the agencies, somehow at least we can save some of these people. But my point is that it would be very ignoble, it would be unforgivable if we say, well, we didn't try because of the difficulties.
Mr. PACKARD. Thank you, Father.
Mr. KINGSTON. Father, are you the lead agency in this?
Mr. DRINAN. No.
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Mr. KINGSTON. Who is the coordinating agency?
Mr. DRINAN. Well, I don't want to say who is the lead agency. Maybe there is no lead agency. That is one of the problems.
Mr. KINGSTON. Well, the reason why I am asking is because getting to Mr. Packard's question, the recent article about Save the Children and some of the other very, very well thought of name brand world children saving-type organizations where they had fictitious kids and the ads about 70 cents a day will save, you know, 10 lives and all this, and it showed that so much of that was actually fraudulent, there is an increasing concern about the lack of coordination and the potential, you know, maybe corruption if you want to use that word—I don't know another one for it right now—but that is why the efficiency of kind of how the food doesn't go to the army, how it gets to the people is really important to us.
And I think what we would like to see is some assurances that the well-intended organizations, as noble as the cause is, still have a practical side of this is how the nuts and bolts of food distribution works.
Mr. DRINAN. I agree with you totally, and during my 10 years in Congress, I saw that about the problems within the Congo. All I can say, sir, is that this group that I represent and all of the other groups in this area recognize the acute need of a million people or more people in North Korea and that you people are able with all of your resources to work it out. ''When there is a will, there is a way.''
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Ms. PELOSI. Mr. Chairman.
Mr. CALLAHAN. Yes, Ms. Pelosi.
Ms. PELOSI. I had promised my Chairman at the beginning of the day that I would speak sparingly in the interest of hearing from our witnesses longer. But since our colleagues asked the question of North Korea and food distribution, I thought I would speak briefly. First, I want to thank you, Father Drinan, for bringing your considerable prestige to bear on this important issue.
As a member of the Intelligence Committee, I visited North Korea in August. Not many people are let in, but we were there, and I think we were allowed in mostly because they wanted us to see how hungry the people were. It was a loss of face for them, but people were eating leaves and grass. The children and the elderly were the most neglected because they were not as useful to them, as you said, as the military and some of the other workers. It is a terrible tragedy.
My point is that we did meet with some of the NGOs—World Vision, Catholic Relief and others and learned how the food was being distributed by these organizations themselves, not by the government because the fear was if the government distributed food, the government and the army would eat and the people would not.
So the distribution was through the organizations [a], and [b] while it is true that maybe some of it might be siphoned off somehow or other to the military, the fact is if we didn't send the food, these children wouldn't eat at all. So we had to take a little bit of a chance on a small percentage of it going astray in order to reach as many of these people as possible.
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I have seen poverty all over the world as a member of this committee and the Intelligence Committee, but I never saw the poverty of spirit that I saw in North Korea—the starvation plus the brainwashing. We have such a responsibility because they don't really even know how bad off they are.
Mr. DRINAN. Thank you for that eloquent statement, and that is all backed up and documented by the statement that I left in connection with my testimony.
Ms. PELOSI. Thank you, Father Drinan.
Mr. CALLAHAN. Dr. Hopewell and Ms. Schwethelm.
Tuesday, March 31, 1998.
INTERNATIONAL UNION AGAINST TUBERCULOSIS AND LUNG DISEASE
WITNESS
DR. PHIL HOPEWELL, DIRECTOR OF THE MODEL T.B. CENTER IN SAN FRANCISCO
Dr. HOPEWELL. Thank you, Mr. Chairman. My name is Phil Hopewell. I am a Professor of Medicine at the University of California in San Francisco and Associate Dean of the School of Medicine based in San Francisco General Hospital. I am also the immediate past President of the American Thoracic Society and the North American Region of the International Union Against Tuberculosis and Lung Disease. And it is on behalf of the International Union Against Tuberculosis and Lung Disease that I am here today.
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The IUATLD, to give you the shorthand version, is the oldest nongovernmental organization that has been involved in the international fight against tuberculosis. We are obviously very concerned that tuberculosis be recognized as the global problem that it is.
I would like to thank you and the committee for that recognition and for the funding that was provided to USAID in their infectious disease initiative. In fact, we are quite pleased with USAID's response and the initiative that they have undertaken that as you have heard in previous testimony includes tuberculosis as a major component.
As you are probably aware, there has been considerable progress in the United States in bringing tuberculosis back under control after several years of increasing case rates. It now has been decreasing consistently, but that in the global scale is a real drop in the bucket.
It is estimated that there are between 7 and 8 million new cases of tuberculosis occurring in the world each year, that there are approximately 3 to 3.5 million deaths from tuberculosis occurring each year. It is the single largest infectious killer of persons worldwide.
It accounts for about 100,000 childhood deaths, and it tends to kill people in the most productive years of their lives, so there are major secondary effects from tuberculosis occurring in adults on their families, their children particularly.
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Tuberculosis is a great model of a global pathogen. It can be transferred from across national boundaries in latent form without being able to be detected, only to cause disease that develops in the receiving country. In the United States, we are now up to between 35 and 40 percent of the cases resulting which are occurring in persons who were born outside the United States; generally in countries with high prevalence of tuberculosis. So this is truly a global problem, and it is one that has been declared a global emergency by the World Health Organization.
In addition to the sheer numbers of tuberculosis cases that occur each year, there is a problem with multiple drug- resistant tuberculosis. Organisms that cause tuberculosis that now are becoming progressively more resistant to the antimicrobial agents that are used to treat the disease so, in essence, the disease is becoming or may become an untreatable one because of the progressive development of drug resistance.
This occurs in the United States and in developing countries as well, and because, again, of the global nature of the disease, we certainly will be seeing what occurs in developing countries in the U.S. because of the globalization of population movements and the economy.
With that as background, the IUATLD has five specific recommendations that we would like to present. The first of these is to continue to support, as you have, USAID's efforts to work in developing a comprehensive global strategic plan for tuberculosis. This should be in concert with the Centers for Disease Control, with WHO, with MIH, and with organizations such as the IUATLD and other involved nongovernmental organizations.
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This plan is really essential to coordinate and make for the most efficient utilization of resources that are already being provided and that we hope will continue to be provided. In fact, the only thing worse than no plan and no tuberculosis control is poor tuberculosis control or poorly planned tuberculosis intervention because that generates drug resistance.
The second recommendation is to encourage USAID to create a Tuberculosis Technical Advisory Committee that will assist in the development, implementation, and monitoring of their tuberculosis control efforts. As I said, USAID has begun a very productive dialogue with important partners in the area, and we commend them for the consultative process that they have initiated. This needs to be formalized in the way of a Technical Advisory Committee, and we think this is of strategic importance to the United States.
Third, encourage USAID support of an international surveillance network to monitor tuberculosis and to monitor drug-resistant tuberculosis. This kind of network must be part of a global plan for tuberculosis control.
The fourth recommendation is to encourage USAID to fund training for tuberculosis control experts through the Fogarty International Center. This effort has already been initiated in a kind of pilot way, but there needs to be more formal recognition of the need for the training of a cadre of persons who are sophisticated and capable in their understanding of tuberculosis as it occurs in developing countries.
The Fogarty Center, as you know, has a highly successful model for training experts in AIDS control. They have begun to develop efforts in tuberculosis control, but this really needs to be further supported.
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We recommend that USAID jointly fund this training of TB control experts through the Fogarty International Center. A commitment of $2 million, a very modest investment, would go a long way toward developing the human resources necessary to carry on the global tuberculosis program.
And fifth and finally, the U.S. through USAID should provide funding for tuberculosis control efforts or for assistance with tuberculosis control efforts in nations with the highest prevalence of tuberculosis. There are a number of countries that could be identified. The ones that are of specific importance to the United States include Mexico, the Philippines, and Vietnam, the three countries of which receive the largest number of persons who subsequently develop tuberculosis, but there are many other countries that would be logical recipients of such aid as well.
With that, let me just conclude by saying that the International Union Against Tuberculosis and Lung Disease and the American Lung Association, which is the American constituent of the IUATLD, are committed to elimination of tuberculosis. We think this is a feasible goal, but it can't occur without a firm commitment on the part of the Federal Government. Thank you very much for the opportunity to comment.
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Ms. PELOSI. Thank you very much. I am pleased to welcome our witness from the University of California-San Francisco, and thank you for this presentation. It is a very, very important issue.
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Mr. CALLAHAN. Is the Fogarty Center part of your operation?
Dr. HOPEWELL. That is part of NIH.
Mr. CALLAHAN. Part of NIH. Are you familiar with the problem along the Texas-Mexico border that I mentioned?
Dr. HOPEWELL. I didn't hear you mention it, but I am familiar with it.
Mr. CALLAHAN. Do you have any way to contact Dr. Ren Archer?
Dr. HOPEWELL. Yes.
Mr. CALLAHAN. That is a very serious problem facing this hemisphere. If we could concentrate on it—we have the opportunity.
Dr. HOPEWELL. Right. In fact, there is a meeting on April 19 that Dr. Archer has called.
Mr. CALLAHAN. Thank you. Ms. Schwethelm.
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Tuesday, March 31, 1998.
PROJECT HOPE
WITNESS
BETTINA SCHWETHELM, DIRECTOR OF MATERNAL AND CHILD HEALTH PROGRAMS
Ms. SCHWETHELM. Mr. Chairman, members of this committee, as Director of Maternal and Child Health Programs at Project HOPE for the last nine years, I am very pleased to be here in front of this subcommittee and also speak on behalf of other PVOs that are working with USAID in partnership with USAID on child survival programs.
HOPE is an acronym for Health Opportunities for People Everywhere. This phrase really describes the mission of Project HOPE. In partnership with people in communities around the world, we try and attain lasting health improvements, and our commitment is really to the most vulnerable groups in this world, to women, infants, and young children.
USAID and Project HOPE have been close partners in the child survival program since 1985. During these 13 years, the child survival program has supported HOPE activities in Belize, Brazil, Peru, Guatemala, Honduras, Nicaragua, Ecuador, Haiti, and Malawi, Mozambique, and Indonesia.
As members of this committee who have supported child survival over the past 13 years, you know that child survival programs do save lives, and many of the previous testimonies have focused on this. So I would really like to focus on some different issues, some different aspect of the child survival program, and that is the child survival program's creative capacity. And I would like to focus on seven different points.
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Child survival programs create capacity at the family and household level. They create capacity at the community level; in local PVO staff; in local partners; at PVO headquarters; in the PVO community overall; and, finally, in the American people.
First, at the household level, mothers and other caregivers are taught essential knowledge so that they can treat mild diseases like mild diarrhea and colds in the home, but they know when to seek care outside from trained providers. This education really empowers parents because they have the information that they need to protect the well-being of their children.
Second, child survival programs strengthen the capacities of communities through the development of local organizations and local leadership. Let me give you two brief examples. In Guatemala, Project HOPE has worked with a community that approached Project HOPE. Together, we wrote a proposal. We solicited local funding. This community provided in-house and labor to remodel the house into a clinic. They signed up members.
People were paying very, very small fees, and this community now has a small clinic that provides services to members at no fee and services to other people at a small cost. This is a community that previously had to travel eight hours to reach a hospital and seek health care for their children.
Another example are community volunteers in Guatemala that have been trained in child survival. These volunteers followed international case management protocols of treating and diagnosing pneumonia, and it is really exhilarating to see a semiliterate volunteer in a hut in the distant highlands of Guatemala diagnosing pneumonia like a physician would and providing the first treatment of antibiotics and saving the life of a child that way.
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Third, child survival programs build capacity in the local established PVOs. With one exception, Project HOPE only employs country nationals in its child survival programs. At the beginning of a new project, we identify young, bright professionals. We train them to become child survival leaders in their communities.
To give you an idea of how significant this leadership development has been, Project HOPE alone, in managing 25 child survival projects over the past 13 years, has directly trained approximately 400 child survival leaders in 11 countries in communities around the world.
These individuals continue to train and orient others. The other PVOs—30 PVOs that have participated in USAID child survival programs can claim similar accomplishments. Clearly, this is a very large and growing network that exists around the world of child survival leaders that would not be there without the child survival program. This is a network that needs to continue and be strengthened.
Fourth, child survival programs build capacity of local institutions, including national ministries of health, NGOs, and other organizations. By participating in the child survival program and through joint problem solving, these institutions become empowered and better equipped to meet the health needs of their people and by absorbing many of the child survival leaders that PVOs have trained, these institutions are strengthened.
The child survival program also provides the seeds for new organizations to emerge. In Malawi, for example, where Project HOPE has worked with the private sector tea and coffee estates, we have helped to establish a new NGO that is taking over Project HOPE's technical leadership for private estates without USAID and Project HOPE funding in the years to come.
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Fifth, child survival programs build capacity at the headquarters level. I started nine years ago with Project HOPE. I was the first professional supporting child survival programs. Now, there are seven health professionals providing support to our programs around the world.
And more than just strengthening technical capabilities, the child survival program has also allowed us to extend our child survival expertise into related programs. For example, Project HOPE has developed a village health bank program that combines credit with child survival interventions and child survival messages.
The resulting program has resulted in health improvements that exceed child survival or credit programs alone. A similar example is what food PVOs are doing with Public Law 480 where they are integrating child survival into the food distribution programs.
Six, PVO programs—child survival programs build capacity within the PVO community at large. In the last few years, child survival has become a vehicle for collective sharing of ideas. For example, in Honduras, Project HOPE is working with CARE, no longer in competition but sharing lessons learned together. The recent creation of CORE has brought together the 30 child survival PVOs around the table sharing and exchanging lessons learned.
The subcommittee should note that PVOs have also brought a lot to the table. Project HOPE in receiving about $20 million in child survival funding has brought $11 million of contributions of private donors and corporations to the child survival program. And that leads me to my final point.
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Child survival programs increase the capacity of the American people to care about child survival. They can participate by supporting PVOs in strengthening child survival around the world, and in this we are benefiting not as individuals, but collectively as a nation with moral standing in the world community. As we know, as other countries are healthy, they are more apt to be politically stable and be good future economic partners.
After 13 years, the benefits of the child survival program in terms of capacity building have exceeded the expectations of many people. In child survival communities throughout the world, coverage rates have increased and knowledge is being strengthened.
However, you all know that to change behavior is a long-term objective, and to make sustainable long-term improvements, we need to continue to invest in child survival to reap the results of the years of efforts that we have put into child survival. In 1990 at the UN World Summit, the United States committed itself to measurably improving the quality of life of the world's children.
It is unthinkable that now a prosperous United States will enter the next century having backed away from doing its part to measurably reduce the most devastating fact in human life, the loss of a child.
Chairman Callahan, we are deeply grateful to you and your subcommittee for having been such a champion to child survival. I thank you for the opportunity to speak on behalf of this program and appreciate your effort in assuring continued funding to this program. Thank you.
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Mr. CALLAHAN. Thank you. I will assure you that the committee is going to very seriously consider my draft which is going to increase the Administration's request. I am disappointed that the Administration for years or at least the three years I have been Chairman has actually not requested or recognized the child survival account. This year, to their credit, they recognized it, but they requested a decrease, which I don't think is the right way to go. And I imagine that the committee is going to in this instance give the Administration more than they have requested, but we thank you for your testimony.
Ms. SCHWETHELM. By the way, we are working with Dr. Ren Archer. He is a former Hopi, and we have programs across the border, and TB is one of the areas that we are working with him on.
Mr. CALLAHAN. Very good. Thank you very much. Congressman Pallone.
Tuesday, March 31, 1998.
USAID PROGRAM
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WITNESS
HON. FRANK PALLONE, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW JERSEY
Mr. CALLAHAN. We would be happy to receive your written testimony if you have any. We have 53 witnesses today.
Mr. PALLONE. I have a written statement, and I am not even going to address the issues in there other than Armenia and India. The other issues I will just submit for the record. I did want to mention though with regard to the USAID program, Mr. Chairman, is that you approve the Administration's overall request—funding levels for USAID managed programs.
And I mention that in particular because I visited both Armenia and India recently, and I saw very well managed AID programs there that really are making a difference. So that is the only general thing I will mention to you today.
If I could get to Armenia and Nagorno Karabagh, I know that the Armenian National Committee (ANC) and the Armenia Assembly have both submitted testimony or will at some point, and I want to support their statements. They are basically in agreement on a lot of the things that I would say, and, of course, Congressman Porter, who is a member of your subcommittee, I imagine is going to pretty much say the same thing.
But I wanted to say you really did a wonderful job, and all of us in the Armenia caucus were very happy with what you did in the last fiscal year. First, it was the first time we had the direct aid to Nagorno Karabagh. You had the discretionary funding for sort of a Caucasus fund, and I really think that is the way to go in the future, that we really need to provide a funding program, if you will, for infrastructure that brings these various countries together. That is so important.
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And also you did have it earmarked at a significant level, and you maintained for the most part Section 907, so I just basically am requesting that you build it on that. The Administration has come in and asked for a decrease in the amount earmarked for Armenia. We think it should be increased.
We are requesting $100 million rather than the $87.5 million that was there last year. They have requested nothing for Nagorno Karabagh, which I think was a mistake because the needs assessment showed clearly that there was a need, and we would like to see that amount increased as well.
I guess I wanted to say just by way of background, and I am going to be brief, that when I went to Armenia and Karabagh this year, they still have major hardships. They are still being blockaded on almost all sides. Their only access for goods is usually from Georgia, which has severe problems with criminal elements, or through Iran, and I don't think I even have to say anymore about their having to travel through Iran.
Also, they continue to move towards market reforms. Their GNP continues to grow despite the blockades, and now they have had two very successful elections. The election for president was in its second round yesterday, and although there have been some suggestions that there were some problems, clearly everyone is saying it is much better than it was in the past. So everything is positive despite the fact that they are under this really terrible blockade.
Let me just get to a couple specifics. With regard to Nagorno Karabagh, I am asking for $20 million for Karabagh. But in addition, if you remember last year you were very specific about the fact that this aid was supposed to go to Karabagh.
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And what happened is that the USAID or the State Department is basically interpreting the money to go to victims of the Karabagh conflict, which means that a significant portion of it may go to Azerbaijan. That wasn't what you intended, and I would like you not only to put the $20 million in, but to make it clear that this goes to Karabagh.
And also if it could be mentioned that the money could be used for rebuilding and reconstruction of infrastructure that was damaged during the war because apparently they are not allowing it to be used for that. So if that could be put in there, that would be very helpful.
With regard to Section 907, I am just asking you again to maintain it intact. There is still $130 million in assistance that goes to Azerbaijan through the NGOs, but if we don't have Section 907 in place, then Azerbaijan will say, well, it doesn't matter that we continue this blockade, and there won't be any sanctions. It isn't really a terrible sanction because they are still getting humanitarian assistance through NGOs, but we have got to have some expression of the fact that they shouldn't be continuing with the blockade.
And also last year you put in language about strict enforcement of the Humanitarian Corridor Act, which, of course, the Administration keeps waiving that every year. But I would like to have that language in again because it shows how much you support the concept of the Humanitarian Aid Corridor Act.
I just wanted to say with regard to India again, you don't have the problem I gather in the subcommittee or the full committee in this annual exercise we go through on the floor where they try to cut all or most of the development assistance to India. But I just want to say again thank you for not going that.
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In India, the economic liberalization continues. They just had an election. You know, 300 million people voted. They changed parties in that election there. Their market economy and reforms continue. You know, we are their largest trading partner, and there is just no justification—I mean, just so you all know, and I think you do—for this cut in development assistance because what those who want to cut say is that this should be an independent Punjab.
The reality is that the Sikhs now control the government in Punjab. There is a coalition government of Sikhs and Hindus that works very well together and won again in the elections that were held for the national legislature just a few weeks ago. And it also doesn't make any sense to cut development assistance in the name of human rights.
I mean, the bottom line is that this money goes to help people who need to be fed, need to be educated, and for natural disasters. Why do you want to cut it for that purpose? And the other thing too is that India has made a lot of progress. They have a National Human Rights Commission. Punjab has a State Human Rights Commission, and they are going after the people that have perpetrated human rights violations. So, again, I just want to thank you for your support.
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Mr. CALLAHAN. The committee did recognize the reconstruction needs in Nagorno Karabagh, but we left it in a pot of money that is available only or when and if the Minsk agreement is achieved. We are confident there will be peace in the region. That is the reason we put the reconstruction money in there. If indeed there is a peace agreement, then your international contributions towards the $60 million that we put in there would turn into $600 million.
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Mr. PALLONE. You are talking about the caucuses?
Mr. CALLAHAN. Right, yes. So we have prepared all of that, and with respect to Azerbaijan, I mean, we want to encourage them with a carrot. And we put a carrot there for them to encourage, and I hope the elections turn out with I imagine Robert DeNiro or whatever his name is—the guy that looks like Robert DeNiro is going to win.
Mr. PALLONE. He I am told—at least the press reports seem to indicate that he is winning substantially.
Mr. CALLAHAN. And Mr. Morningstar has given his indication that there is going to be some money released in April of an additional $7 million for Karabagh.
Mr. PALLONE. For Karabagh.
Ms. PELOSI. Mr. Chairman, you said the humanitarian money for Karabagh?
Mr. CALLAHAN. Yes.
Ms. PELOSI. Oh, that is great.
Mr. PALLONE. Yes. No, I agree. My only problem with the Karabagh money is the way it was interpreted because I thought it was very clear that you said that was for Karabagh. But as far as the caucus fund is concerned, I think that is the way to go in the future. And even if it isn't all spent now because of the situation there, in the long run you have go to try to bring these countries together and making those kind of infrastructure improvements will help.
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Mr. CALLAHAN. Mike, any questions?
Mr. FORBES. No.
Ms. PELOSI. I am just glad Ambassador Morningstar is releasing the humanitarian part of the $12 million pot because that is a carrot to promote the Minsk agreement as well.
Mr. PALLONE. Absolutely. Thank you.
Ms. PELOSI. Thank you for your energetic leadership.
Mr. PALLONE. Thank you for all of your help.
Mr. CALLAHAN. Michael Barnes and Hobart Gardiner—former Congressman Michael Barnes.
Tuesday, March 31, 1998.
U.S. COMMITTEE FOR UNDP
WITNESS
MICHAEL D. BARNES, CO-CHAIR
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Mr. BARNES. Good morning, Mr. Chairman.
Mr. CALLAHAN. Good morning.
Ms. PELOSI. Welcome, Mr. Barnes, former colleague.
Mr. BARNES. Thank you very much.
Mr. CALLAHAN. Your statement will be accepted by the committee, and we would ask that you be brief in your presentation.
Mr. BARNES. Thank you, Mr. Chairman, will do. I have a relatively long statement for the record. I appreciate your accepting that. I appear this morning not as a former member of Congress, but as Co-Chair of the United States Committee for the United Nations Development Program.
As you know, my Co-Chair, our former colleague Claudine Schneider, appeared before the subcommittee last year in support of UNDP. And I come before you this morning also obviously as an American citizen but also as a businessman and a lawyer active in work outside the United States and committed to a strong U.S. foreign policy and strong U.S. leadership in international affairs.
There was a question of one of my heroes, Father Drinan, a few minutes ago about North Korea and what agency plays the coordinating role. As you know, UNDP is the lead UN agency with respect to development around the world. It plays a coordinating role; in fact, has coordinators throughout the world funded through UNDP to coordinate all the United Nations development operations. And UNDP is planning on an active role in that capacity in North Korea as well. UNDP, of course, is the largest international, multilateral, grant-based development organization in the world by far.
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I want to take just a second, Mr. Chairman, to thank you and your colleagues on the subcommittee because we know that it was due to your hard work last year that the United States returned to its traditional position as the number 1 donor to UNDP. As a member of the U.S. Committee for UNDP, I want to thank you on behalf of everybody in this country who supports the work of that organization for the strong support that you have shown and your leadership on that.
I have got good news to report to the subcommittee this morning. UNDP has made real progress in implementing a far-reaching internal reform process with stronger accountability, a culture of cost consciousness, and a sharper focus on its country operations.
The increase that this subcommittee provided to UNDP last year has helped to make that reform possible, and I am submitting for the record a detailed explanation of the reforms that UNDP has undertaken and has been able to undertake in part because of the efforts of your subcommittee and the U.S. Congress.
As I said, in my work I travel all over the world, and I have witnesses the progress made by developing countries in recent years in their move toward establishing more democratic institutions, market economies, greater protection of human rights. And I can tell you from my own personal observation that UNDP has played a very significant role in promoting that kind of positive change around the world.
I understand, Mr. Chairman, you are going to be going to Central America in the next few days. I would urge you to take a look at UNDP operations in Central America. I know you will be impressed that the work that they have done in Nicaragua, El Salvador, and throughout the region has been enormously important in helping those countries move forward.
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When I was in the Congress in the 1980s, Central America was a tragic situation creating great controversy here in this building and in our country. Today, Central America is advancing in ways that wouldn't have been thinkable 10 years ago, and a lot of the credit for that should go to the United Nations Development Program, and there are very professional people on the ground in Central America today. I hope you will have a chance to meet some of them and see their work, Mr. Chairman.
Let me just make a couple of other quick points. As I said, last year we were able to get the U.S. back to the lead donor role in UNDP. As you know, the head of UNDP has always been an American—from the very beginning has always been an American. It is currently an American. That is under challenge by our friends around the world who note that they give a much higher per capita contribution to UNDP than we do.
One of our former colleagues, Brad Morse, was a great leader at UNDP. And, yes, Seth is doing a great job. I hope that the Congress will recognize that it is in our own interest to continue to have the leadership role at UNDP.
GAO has done an excellent study that I commend to your attention which indicates that UNDP is actively promoting the interest and values of the United States of America through its activities around the world. I am not going to go into the details because we don't have the time.
I mentioned the reforms. I would just stress in closing, Mr. Chairman, that you will see in Central America, as you would see if you went to Africa or Asia or anywhere in the world, the extraordinary role that UNDP is playing to help literally billions of people around the world improve the quality of their lives.
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The American people in every survey I have ever seen support funding when they know that it goes to really help people improve their lives, and that is what the United Nations Development Program is successfully doing every day in countries all over the world.
Even in a place where it is as difficult as it is in North Korea, which you were discussing earlier, they are the coordinating agency making sure that when assistance goes there, it doesn't go to the regime, it doesn't go to the military, it, in fact, goes to help the people.
The major UNDP program in North Korea, for example, is an agricultural program helping people improve the organization of their agriculture so that they can grow the food and not have to depend on food sent from our country to feed the millions of people who are starving there. That is just one example. There are thousands we could cite all over the world. Thank you, Mr. Chairman.
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Mr. CALLAHAN. We try, Mike, to look at projects that you all are involved in when we make trips such as to Guatemala last year we made and looked at some of your projects. And we certainly will on our trip to Central and South America this time.
Mr. BARNES. Thank you very much.
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Mr. CALLAHAN. We thank you. Let me also apologize to all of you for the limited amount of time we have, but we have 53 witnesses today. And it doesn't mean that we are not interested in your project or your organization, and we are not appreciative of your many contributions. It means that we want to give everyone an opportunity to testify. So if we seem rather impatient, it is not because of anything other than respect for all of you because we want to hear from all of you, and this is the only date we have available.
Ms. PELOSI. Thank you, Mike.
Mr. CALLAHAN. All right. Mr. Gardiner.
Tuesday, March 31, 1998.
INTERNATIONAL EXECUTIVE SERVICE CORPS
WITNESS
HOBART C. GARDINER, PRESIDENT
Mr. GARDINER. Thank you, Chairman Callahan and members of the committee, for the opportunity to speak to you about the International Executive Service Corps. You have my prepared statement so I am just going to highlight some points for you.
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We closely measure results of our projects over the years. We sent out over 20,000 volunteer men and women who donated over a million days on the job in the past 33 years. The value of those donated services exceeds $500 million. They help clients produce over $5 billion in increased production. The clients have contributed in excess of $200 million.
In just one year, the companies we assist, our clients, have purchased $13 million in exports from the United States this last year. That is just one year, not a total of 33 years, which is in excess of $2 billion.
Over 25 countries have improved their economies to the point where we have closed shop and left the country. In those countries, IESC has helped break the cycle of dependency. We think it is better to give a hand up than a handout. Our objective is to help them create their own wealth. Nineteen other nations have followed our example and started an executive service corps similar to ours.
Additionally, we have helped U.S. companies form joint ventures and other connections with our clients in four particular countries—Turkey, Romania, Mexico, and the Czech Republic. We have contacted 2,500 companies in this country as a result of that activity, which has resulted in 36 transactions at a value of $100 million. Thus, we help U.S. business compete in this world of global economy.
Let me mention a few things about Russia. We paid particular attention to this complex country, its erratic movement toward democracy and a market economy. We started over 700 projects in Russia, which require a considerable flexibility, adaptability, persistence, time, and the patience of a saint. While we have 13,000 men and women in our skills bank who registered, their willingness to serve is there, but we have very few saints.
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Nonetheless, we made a strong impact. We have helped them sell state-owned businesses to private hands. We have helped them with the transition to democracy and administration and law, and we have helped them in defense conversion to civilian goods.
The help we have given them with regard to administration and law is now going to be strengthened by a new program we are going to innovate, which has to do with regulatory reform. We want to create a favorable client for U.S. direct investment. We don't want to create joint ventures and have U.S. investors invest in a climate which is not conducive to stability.
We are helping Panama with the transition from U.S.
management of the Canal Zone to Panamanian management. Before I became CEO in IESC, I was in charge of their operations in Latin America and the Caribbean. We have done more projects in Latin America and the Caribbean than any other continent. That is not the case today. Now, we do just a little bit over 10 percent in Latin America and the Caribbean.
But there is an expression in Spanish, and it means bad things don't come along but for a good reason. This has forced us to innovate and to come up with other ways of coping. We now have a business development program we formed in a partnership with Programa Bolivar.
They are located in Caracas, Venezuela, and this partnership is to create joint ventures and other strategic alliances between U.S. companies and small to medium-sized enterprises in Latin America. So our objectives continue. Basically, it is to help the private enterprise develop in the host country. It is also now aimed at connecting U.S. business with business partners in developing countries.
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We are going to use more electronic communications and distance learning technologies to reduce overhead and increase participation. We intend to remain friendly, flexible, and efficient because we represent the United States.
We hope, therefore, that you appropriate abundantly to aid for programs such as ours because we depend on them, and we feel that what we do is a very rewarding investment. And with 13,000 executives in our skills bank, we can do a lot more. We only used one for every 13 in our skills bank in the past several years.
We are a people-to-people program, and I am reminded of a proverb I have heard in Russia. They appreciate what we do because they feel we care. The proverb is that a tree derives its strength from its roots, and a man derives his strength from his friends. And our program makes many, many friends around the world. One client told us that our people are not consultants, they are implementors. They work as much with their head as with their heart. Thank you, Mr. Chairman.
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Mr. CALLAHAN. When you are in Panama trying to teach people how to run businesses or start businesses and you have the opportunity to talk to government officials, you might emphasize to the Panamanian Government the importance of transparency in contractual arrangements with American business people because they know very little about it.
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I know that you are down there trying to teach the Chinese to run the port operations of the Panama Canal, and that has been very distressing to me to see how far we have fallen with respect to our operational capabilities in Panama. Any questions for either Mike or Mr. Gardiner?
Ms. PELOSI. Except to thank them for excellent testimony. Thank you.
Mr. CALLAHAN. Thank you very much. Congressman Greenwood.
Tuesday, March 31, 1998.
MICROCREDIT
WITNESS
HON. JAMES C. GREENWOOD, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF PENNSYLVANIA
Mr. GREENWOOD. Good morning, Mr. Chairman and colleagues. I think the deal we made with your staff is to squeeze me in, and I will be brief so I will do that. I am here to talk to you about microcredit, and I will tell you I am not an expert on microcredit, but I am here because last year I had the opportunity to be in Uganda and to visit an operation called FINCA, which is a beautiful example of microcredit at work.
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We went to this little village in Uganda, which is, as you all know, one of the most downtrodden, impoverished nations in Africa. We went out to a little village, and the women there participate in this program by borrowing $50, and I think $50 to $75 is the maximum, are able to take that $50 and open up a business in fishing, open up a beauty parlor, open up a pharmacy, open up a little sewing shop.
It was extraordinary to open up a little shop, a little place raising chickens. They would take this money, and all of a sudden become perfect examples of entrepreneurs. Empower themselves within their families where they had no cultural history of empowerment given the culture of that country, and then methodically pay back those funds. It is a magnificent program.
I think the funding has declined from something like $137 million down to $111. My recommendation would be to fund it at a level of $160 million. Following is a quick example of the degree to which the sense of a hand up and not a handout is working there.
As we sat in the hot sun in this village in Uganda and listened to these women come up and tell their tales one at a time, Congressman Jefferson I think it was, realized the power of a couple of American dollars in that community. He passed a note around saying let us all give them $20 to contribute towards their fund, and we were all prepared to do that. And when we put our $20 bills in a pot and took it to them, they said no, we don't take charity here. We take loans and we pay them back.
I think that it was an eloquent testimony to the fact that we have taught them through this program the value of work, entrepreneurialship, and making it on their own and not accepting charity. And so, I would encourage you in your wisdom to do as much as you can for that program.
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Mr. CALLAHAN. We support it and so has the committee.
Mr. GREENWOOD. I know that.
Mr. CALLAHAN. Any questions?
Ms. PELOSI. Thank you so much.
Mr. CALLAHAN. Mr. Jollivette and also Dr. Lee Reichman.
Tuesday, March 31, 1998.
UNIVERSITY OF MIAMI NORTH-SOUTH CENTER
WITNESS
CYRUS M. JOLLIVETTE, DIRECTOR OF GOVERNMENT RELATIONS
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Mr. JOLLIVETTE. Good morning, Mr. Chairman and members of the subcommittee. I am Cyrus Jollivette. I am Vice President for Government Relations at the University of Miami in Coral Gables, Florida. I appear today on behalf of several of my colleagues at the university who are doing the type of research work at our School of Medicine that I will be talking about and involved in the kinds of discussions at our North-South Center that I will be talking about. The other Center is the International Center for Health Research at the School of Medicine.
First of all, Mr. Chairman, I want to commend you and the members of the subcommittee for the significant and invaluable efforts in providing $50 million last year for the communicable diseases initiative at USAID.
Like the subcommittee, my colleagues and I believe that it is imperative that the nation address the threat of infectious diseases by responding to what has been a dramatic increase and, in fact, a resurgence of communicable diseases affecting children and adults by assisting developing countries to develop their ability to protect and care for their people and by stopping the spread of these communicable diseases in developing countries.
The University of Miami International Center for Health Research is located in Miami, a major gateway city to Latin America and the Caribbean. The major goals of the Center are to investigate biological characteristics of causative microbial agents, to study the risk factors related to the spread of these infections, including interactions between nutritional status and susceptibility, as well as to develop innovative preventive strategies.
An important role of the Center involves collaborative infectious disease control and prevention efforts to broaden expertise of indigenous Latin American and Caribbean health professionals, and link laboratory science and epidemiology with public health strategies and policymaking processes.
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The Center's priority is to strengthen programs for the control of major infectious diseases, particularly malaria, dengue, TB, and cholera. Emphasis is also placed on programs aimed at preventing the spread and reducing the impact of HIV infection and other sexually transmitted diseases.
The magnitude and the gravity of the current emerging and reemerging infectious disease situation in the region of the Americas really is a critical concern. In order to develop an effective system for disease surveillance, control, and prevention, a strong and stable research infrastructure in close cooperation between scientists of the United States and Latin American and Caribbean countries are essential.
Enhanced research and training efforts need to be established in the areas involving the most prevalent infectious diseases, including those that I have mentioned before. A complex interaction between nutritional status and susceptibility as well as disease progression and control of these infections needs to be investigated, along with the basic research and all the aspects of disease processes and public health strategies.
Infectious diseases are the leading cause of death worldwide, causing 17 million of the 52 million deaths each year. Emerging infectious diseases have also adversely impacted the U.S., and this is evidenced my colleagues tell me by the fact that the death rate from infectious diseases in the U.S. has increased by more than 50 percent since 1980. And in 1996, infectious diseases in the U.S. were ranked as the third leading cause of death.
My colleagues believe that this trend will continue in the future since infectious microbes can easily travel across borders from other parts of the world and be introduced into the United States threatening our national health and security. Controlling disease outbreaks and factors promoting them in other countries is important not only for humanitarian reasons, but also to prevent these diseases from entering the United States.
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We respectfully seek the subcommittee's support for $2 million for the International Center for Health Research at the University of Miami to strengthen and expand its research and prevention efforts in Central America and the Caribbean. I had submitted earlier a more lengthy statement which I ask that you would include in the record.
I would just mention briefly the other Center at the University of Miami, which is the North-South Center, whose mission is to promote better relations and to serve as the catalyst for change among the United States, Canada, and the nations of Latin America and the Caribbean.
We believe that this Center, which was established at the university in 1984 and has been receiving Federal support since 1990 initiated by former Congressman Dan Persell, is a reflection of the belief that our nation benefits when the great issues of the Western Hemisphere are analyzed and debated by private sector and nongovernmental groups under the auspices of a neutral forum.
The North-South Center is a respected independent public policy institution that is fully cognizant of its special responsibilities attached to its Federal support. This Center has served this function most successfully.
Mr. Chairman, that concludes my remarks. I would be pleased to answer any questions that you might have about the North-South Center or the International Center for Health Research at the University of Miami.
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Mr. CALLAHAN. Thank you.
Tuesday, March 31, 1998.
UNIVERSITY OF MEDICINE AND DENTISTRY OF NEW JERSEY
WITNESS
DR. LEE REICHMAN, EXECUTIVE DIRECTOR, NEW JERSEY MEDICAL SCHOOL, NATIONAL TUBERCULOSIS CENTER
Dr. REICHMAN. Mr. Chairman and members of the committee, thank you very much. I am Lee Reichman. I am a physician who is appearing before you as Executive Director of the New Jersey Medical School, National Tuberculosis Center, at the University of Medicine and Dentistry in New Jersey, which is a founding component of the International Center for Public Health at University Heights Science Park in Newark, New Jersey.
I am also a former President of the American Lung Association and a former Vice Chair of the International Union Against Tuberculosis and Lung Disease. I am a member of the World Health Organization's Committee on the Global Tuberculosis Epidemic.
One week ago today was World Tuberculosis Day, designated as an official United Nations day to commemorate the announcement of the discovery of the organism that causes tuberculosis by Robert Koch in Berlin in 1882. At that time, there was great rejoicing as tuberculosis was the world's greatest killer. Today, however, embarrassingly, tuberculosis is still the greatest killer of any single infection and will kill more people in 1998 than it did in 1882, the year of Koch's announcement.
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But the global TB epidemic will shortly change. Last year, this committee wisely insisted that USAID turn its previously neglectful eyes on emerging and reemerging infections, one named major threat being tuberculosis. And I thank you, Mr. Chairman, and Mr. Frelinghuysen, and the rest of the subcommittee for achieving this major breakthrough.
Having served on an ad hoc USAID consultation advising them on this new initiative, I can report that they are already running with the ball, although we still need a global plan to be sure the support is appropriately used, and we certainly need to have a formal Tuberculosis Technical Advisory Committee to help them in their effort.
This committee's leadership in insisting that USAID take up the meaningful programs in tuberculosis will certainly lead to an increased profile for disease, increased educational efforts, along with increased interest in pharmaceutical and device manufacturers, which will translate into increased safety for the hundreds of thousands of Americans working in defense with multinational corporations.
And I call your attention to this morning's Business Week, a cover story, ''War Against the Microbe. How Drug Makers are Fighting Back Against the Global Resurgence of Infectious Disease,'' just out today. They probably did it because they knew I was testifying.
I am especially here to speak about the International Center for Public Health, a new strategic initiative that is creating a world class infectious disease research and treatment complex at University Heights Science Park, Newark, New Jersey, a Federal enterprise community neighborhood.
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The Center is a $78 million anchor project that will total 161,000 square feet and house three tenants—the Public Health Research Institute of New York City moving to New Jersey, the New Jersey Medical School National Tuberculosis Center, and the New Jersey Medical School Department of Microbiology and Molecular Genetics.
The International Center for Public Health is a priority project of the University of Medicine and Dentistry of New Jersey, Rutgers University, and New Jersey Institute of Technology, Essex County College, and the City of Newark.
The International Center's core partners have already had a major impact on activities of critical worldwide health importance such as implementing a $12 million TB control program for Russian prisons, funded by the George Soros Foundation.
The most notable part of this story is the fact that for several years the WHO and the Centers for Disease Control and Prevention had been totally unsuccessful in convincing Russia with its monumental tuberculosis problem to adopt the WHO's highest priority DOTS strategy—that is Directly Observed Therapy Short course for tuberculosis.
Last July, a site visit team from the Public Health Research Institute and our National Tuberculosis Center visited Moscow, strongly recommended that the Soros project not be carried out unless the Russian Ministry of Health adopted the DOTS strategy.
In response in September, U.S. Secretary of Health and Human Services Shalala announced at the Gore-Chernomyrdin Commission meeting that the Russian Ministry of Health would indeed be using the DOTS strategy. And we expect that the new Minister of Health to uphold this commitment. This is humbly submitted as an example of the effect of the International Center for Public Health's significant role in international disease control efforts.
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Through the leadership and direction of our Governor Christine Todd Whitman, in October 1997 a memorandum of understanding was signed between the State of New Jersey, University Heights Science Park, UMDNJ, and the Public Health Research Institute to commit $60 million of state loan and grant funds toward development of the $78 million International Center.
Presently, the Science Park partners and the International Center for Public Health tenants are seeking the remaining $16 million from Federal and private sources as groundbreaking scheduled for 1999. The International Center for Public Health and University Heights Science Park seeks your support for the International Center, and on behalf of the UMDNJ, I want to thank the committee for the opportunity to present this request.
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Mr. CALLAHAN. We thank you, doctor. And as you well know, Congressman Frelinghuysen is one of your biggest supporters. And you are blessed to have him on this committee as far as your causes are concerned.
Dr. REICHMAN. Thank you.
Ms. PELOSI. Yes. And, Mr. Chairman, not to forget your interest in this hemisphere north and south——
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Mr. CALLAHAN. Yes. And also the infectious diseases, tuberculosis particularly. We have spoken to several people this morning about the problems along the Mexican border, that we really need to check that as quickly as we can.
Dr. REICHMAN. Thank you.
Mr. CALLAHAN. Thank you very much. Congressman Walsh.
Tuesday, March 31, 1998.
INCREASED FUNDING LEVELS
WITNESS
HON. JAMES WALSH, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK
Mr. CALLAHAN. Good morning, Jim.
Mr. WALSH. Good morning, Mr. Chairman. Thank you for allowing me to testify today. I just wanted to say thank you again to you and members of the subcommittee for your fine work and very important work that you do and especially for the leadership and the sponsorship that you have taken up with the child survival funds. That money is some of the best money that we appropriate for, and it is making marked differences in kids' lives throughout the world. And it is certainly to the credit of this subcommittee for making that issue a priority.
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As you know, the USAID has a new initiative, vitamin A supplementation and are requesting additional resources to combat iodine deficiency, which I saw firsthand when I was a Peace Corps volunteer. Just two cents two to three times a year can cut child mortality by—my statistics say 23 percent by providing these capsules of vitamin A.
Giving vitamin A to pregnant women in developing countries can reduce maternal death rates by 40 to 50 percent. It is a remarkable figure, and the results given the cost of the program is truly phenomenal.
The doctor testifying before me just spoke to you about tuberculosis. The Tuberculosis Control Program is essential. You included it in last year's budget. I hope you will continue to support it. It is the world's largest infectious killer. I contracted tuberculosis when I was in Nepal.
Fortunately, I was diagnosed early on and treated, and the only major impact it had on my life was it convinced me to quit smoking cigarettes, which I did the day that I was diagnosed. But given proper medication and diet and so forth, I had no problems. But that is not the case with millions and millions of other people around the world. It is a terrible disease, and we need to do a better job.
I also would like to put an oar in the water for the International Fund for Ireland. $19.6 million has been appropriated by the subcommittee over the years, and it is critical now. I bookmark the Irish Times and the Belfast Telegraph, and I try to read both views of what is going on in Ireland each day.
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And Senator Mitchell, who was our person on the spot there, has entered into sort of an end game now with Prime Minister Blair and Prime Minister Ahern in Ireland and the principal