SPEAKERS CONTENTS INSERTS
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2003
UNITED STATES LEADERSHIP AGAINST HIV/AIDS, TUBERCULOSIS, AND MALARIA ACT OF 2003
MARKUP
BEFORE THE
COMMITTEE ON
INTERNATIONAL RELATIONS
HOUSE OF REPRESENTATIVES
ONE HUNDRED EIGHTH CONGRESS
FIRST SESSION
ON
H.R. 1298
APRIL 2, 2003
Serial No. 108–33
Printed for the use of the Committee on International Relations
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Available via the World Wide Web: http://www.house.gov/international—relations
COMMITTEE ON INTERNATIONAL RELATIONS
HENRY J. HYDE, Illinois, Chairman
JAMES A. LEACH, Iowa
DOUG BEREUTER, Nebraska
CHRISTOPHER H. SMITH, New Jersey,
Vice Chairman
DAN BURTON, Indiana
ELTON GALLEGLY, California
ILEANA ROS-LEHTINEN, Florida
CASS BALLENGER, North Carolina
DANA ROHRABACHER, California
EDWARD R. ROYCE, California
PETER T. KING, New York
STEVE CHABOT, Ohio
AMO HOUGHTON, New York
JOHN M. McHUGH, New York
THOMAS G. TANCREDO, Colorado
RON PAUL, Texas
NICK SMITH, Michigan
JOSEPH R. PITTS, Pennsylvania
JEFF FLAKE, Arizona
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JO ANN DAVIS, Virginia
MARK GREEN, Wisconsin
JERRY WELLER, Illinois
MIKE PENCE, Indiana
THADDEUS G. McCOTTER, Michigan
WILLIAM J. JANKLOW, South Dakota
KATHERINE HARRIS, Florida
TOM LANTOS, California
HOWARD L. BERMAN, California
GARY L. ACKERMAN, New York
ENI F.H. FALEOMAVAEGA, American Samoa
DONALD M. PAYNE, New Jersey
ROBERT MENENDEZ, New Jersey
SHERROD BROWN, Ohio
BRAD SHERMAN, California
ROBERT WEXLER, Florida
ELIOT L. ENGEL, New York
WILLIAM D. DELAHUNT, Massachusetts
GREGORY W. MEEKS, New York
BARBARA LEE, California
JOSEPH CROWLEY, New York
JOSEPH M. HOEFFEL, Pennsylvania
EARL BLUMENAUER, Oregon
SHELLEY BERKLEY, Nevada
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GRACE F. NAPOLITANO, California
ADAM B. SCHIFF, California
DIANE E. WATSON, California
ADAM SMITH, Washington
BETTY McCOLLUM, Minnesota
CHRIS BELL, Texas
THOMAS E. MOONEY, SR., Staff Director/General Counsel
ROBERT R. KING, Democratic Staff Director
DANIEL FREEMAN, Counsel/Parliamentarian
MARILYN C. OWEN, Staff Associate
C O N T E N T S
MARKUP OF
H.R. 1298, To provide assistance to foreign countries to combat HIV/AIDS, tuberculosis, and malaria, and for other purposes
Amendment offered by the Honorable Henry J. Hyde, a Representative in Congress from the State of Illinois and Chairman, Committee on International Relations
Amendment offered by the Honorable Joseph R. Pitts, a Representative in Congress from the State of Pennsylvania
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Substitute amendment offered by the Honorable Barbara Lee, a Representative in Congress from the State of California, to the amendment offered by the Honorable Joseph R. Pitts
Amendment offered by the Honorable Sherrod Brown, a Representative in Congress from the State of Ohio
Amendment offered by the Honorable Dana Rohrabacher, a Representative in Congress from the State of California
Amendment offered by the Honorable Grace F. Napolitano, a Representative in Congress from the State of California
Amendment offered by the Honorable Nick Smith, a Representative in Congress from the State of Michigan
Amendment offered by the Honorable Howard L. Berman, a Representative in Congress from the State of California
Amendment offered by the Honorable Jeff Flake, a Representative in Congress from the State of Arizona
Amendment offered by the Honorable Tom Lantos, a Representative in Congress from the State of California, to the amendment offered by the Honorable Jeff Flake
Perfecting amendment offered by the Honorable Howard L. Berman, to the amendment offered by the Honorable Tom Lantos to the amendment offered by the Honorable Jeff Flake
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Amendment #1 offered by the Honorable Betty McCollum, a Representative in Congress from the State of Minnesota
Amendment #2 offered by the Honorable Betty McCollum
Amendments offered en bloc by the Honorable Katherine Harris, a Representative in Congress from the State of Florida, and the Honorable Jo Ann Davis, a Representative in Congress from the State of Virginia
Amendment offered by the Honorable Joseph R. Pitts
Amendment offered by the Honorable Christopher H. Smith, a Representative in Congress from the State of New Jersey
Amendment offered by the Honorable Tom Lantos to the amendment offered by the Honorable Christopher H. Smith
LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE RECORD
The Honorable Henry J. Hyde: Prepared statement
APPENDIX
The Honorable Joseph R. Pitts: Prepared statement
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The Honorable Barbara Lee: Prepared statement
The Honorable Joseph Crowley, a Representative in Congress from the State of New York: Prepared statement
The Honorable Earl Blumenauer, a Representative in Congress from the State of Oregon: Prepared statement
The Honorable Adam B. Schiff, a Representative in Congress from the State of California: Prepared statement
UNITED STATES LEADERSHIP AGAINST
HIV/AIDS, TUBERCULOSIS, AND MALARIA ACT OF 2003
WEDNESDAY, APRIL 2, 2003
House of Representatives,
Committee on International Relations,
Washington, DC.
The Committee met, pursuant to call, at 10:25 a.m. in Room 2172, Rayburn House Office Building, Hon. Henry J. Hyde (Chairman of the Committee) presiding.
Chairman HYDE. The Committee will come to order.
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Pursuant to notice, I now call up H.R. 1298, the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003, for purposes of markup and move its favorable recommendation to the House.
Without objection, the bill will be considered as read and open for amendment at any point.
[H.R. 1298 follows:]
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Chairman HYDE. The Chair yields himself 5 minutes for purposes of a statement.
What I will do is make a statement, then Mr. Lantos will make a statement, and the rest of the Members may submit statements for the record, which will be included in the record.
I expect a rather disconnected morning because of the votes on the Floor, which is unfortunate, because this is very important legislation. So I would entreat you, when you vote, to make it a point to come back as promptly as you can so we can finish this bill.
I have a prepared statement for the opening of this session, but I am going to just make a few remarks and tell you why I think this is an important piece of legislation.
I have been studying a little history, and I have been reading about the bubonic plague, which was also called the black plague because of the blotches that appeared on people's skin. I learned there were three bubonic plagues, the 6th century, the 14th century, and the 17th century; and, all told, 275 million people died as a result of the bubonic or black plague. People did not realize it was transmitted through fleas, which were infected by swine and other means.
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It started in China, and since China was a big trading nation, the traders from Italy brought it back to Sicily, and it spread through Europe. One-third of Europe died as a result of this plague.
I thought to myself, what a horrible, unspeakable curse visited on humanity.
Well, we have the same thing now in the AIDS epidemic, pandemic. The numbers are unspeakably high. The horror, the pain, the creating of entire villages of orphans because the adults are dead or dying from this plague. It seemed to me if you could do something to stop this, to divert it, to slow it down, to cure it, to fight it, you have a moral obligation to do so if you have the resources.
Now, tough as everything is, and we can always find places to spend money domestically, I suggest to you that an AIDS pandemic touches our national security, touches our civilization, touches our humanity, and we can leverage other countries to put money in to help treat and cure and prevent and educate and fight this terrible disease.
I also believe there is a moral imperative to do so. We do so much in this Congress that is of tertiary importance, that is, I don't want to say drivel, but so unimportant, resolutions pointing with pride, viewing with alarm, but not doing a great deal for humanity. Here is a chance to do something for humanity.
Now this Congress is so equally balanced that it is very difficult on controversial matters, on expensive matters, on matters that have different blocks who have different points of view to reach an agreement. I just plead with you to understand, in a situation like this, compromise is the heart and soul of the process. We cannot please the left and the right and the center, we can't please the libertarians and the archconservatives and the Republicans and the Democrats with a piece of legislation that would have all of those magic properties, but we can do our best, and we have done our best.
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Mr. Lantos has been a giant in terms of cooperation; and his staff and my staff have been meeting with other staffs to iron out the points of difficulty. I suggest we have not given everything that everybody wants to everybody, but we have tried, and I suggest and I plead with you to understand that compromise is necessary if we are to move forward and count for something in this fight.
This is worth doing. This is critical. So I entreat you to bear that in mind as we vote on amendments and as we move toward sending this to the Floor and helping leverage other money from other countries to turn the tide on this terrible scourge.
Now, with pleasure, I yield to my friend, the Ranking Democrat, Mr. Lantos.
[The prepared statement of Mr. Hyde follows:]
PREPARED STATEMENT OF THE HONORABLE HENRY J. HYDE, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS, AND CHAIRMAN, COMMITTEE ON INTERNATIONAL RELATIONS
Good morning. Today the Committee will consider H.R. 1298, the United States Leadership Against HIV/AIDS Act of 2003. AIDS is a topic familiar to this Committee. In addition to numerous oversight and legislative hearings held by this Committee during the last Congress as well as House passage of a more modest version of this legislation, the topic is increasingly woven into the oversight work of our regional subcommittees.
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AIDS is a disease that affects and afflicts women, men and children. AIDS is caused by a virus that is changing the face of families in Africa, Asia, Europe, and the Americas. AIDS creates orphans and broken families.
AIDS is a pandemic that is erasing the gains of human development. AIDS is responsible for a catastrophic reduction in the life expectancy of tens of millions of people with whom we share this planet. Not a day goes by when Americans are not exposed to images of AIDS and its destructive impact.
To date, 40 million people are infected and 25 million have died of AIDS worldwide, including more than 3 million in the last year alone. More than 8,600 persons die daily from complications of this disease. Tragically, the number is growing, and by the year 2010, 80 million persons worldwide could be dead of this disease.
The HIV/AIDS pandemic is more than a humanitarian crisis. Increasingly, it is a threat to the security of the developed world. Left unchecked, this plague will further rip the fabric of developing societies, pushing fragile governments and economies to the point of collapse. So to those who suggest that the United States has no stake in this pandemic, let me observe that the specter of failed states across the world certainly is our business. Afghanistan certainly became our business when that failed state became fertile ground for terrorism. We do not need more Afghanistans.
In this regard, Africa is a central concern. Today radical Islam is spreading in several African countries, especially Nigeria. This threatens to undercut democracy and make Nigeria a failed state. It is in our interest to counter this movement by doing what we can to help build democracy and a growing economy in Nigeria and elsewhere. The spread of HIV/AIDS frustrates this most important mission.
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We also have a strong interest in seeing the development of professional African militaries; militaries capable of maintaining stability in their country, but also capable of contributing to peacekeeping operations elsewhere in Africa. Yet an examination of HIV/AIDS rates among the armed forces of key African countries, including Nigeria, South Africa, and Kenya, reveals infection rates between 30 and 40 percent. HIV/AIDS is a national security issue for those countries hit by the pandemic, and for us.
Today we are here to build on the bipartisan work accomplished last year, and mark up an updated AIDS bill that focuses on treatment, prevention and care—a bill that, for the first time, authorizes treatment for more than 2 million people; a bill that takes the necessary step of creating a single coordinator to ensure cohesion and unity of effort among the various agencies of the United States government that can contribute to our overall AIDS effort. This measure updates the AIDS-related authorities in the Foreign Assistance Act—authorities for the President to support the widest variety of AIDS treatment and prevention programs overseas. It endorses prevention programs that stress sexual abstinence and monogamy as a first line of defense against the spread of this disease and authorizes United States participation in the Global Fund to Fight AIDS, Tuberculosis and Malaria.
The AIDS virus is one of the great moral challenges of our era, for it is a scourge of unparalleled proportions in modern times. It is the right thing to do for our children, our country, and our world. Although daunting, let us not fail to meet this challenge.
Let me now turn to my good friend and colleague, Tom Lantos, who played a critical role in developing this legislation.
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Mr. LANTOS. Thank you, Mr. Chairman.
Before commenting on the legislation, I want to commend your staff, the outstanding staff of Barbara Lee and on my staff, Peter Yeo, Pearl Alice Marsh and David Abramowitz, for the extraordinary job they did in creating this legislation with countless compromises and very imaginative solutions.
Mr. Chairman, today's markup of our bipartisan HIV/AIDS bill once again testifies to your true leadership and vision as Chairman of our Committee. It is also a testament to the hard work and commitment of Congresswoman Barbara Lee and Congressman Jim Leach, who launched the bipartisan effort to address the global HIV/AIDS crisis several years ago.
I deeply admire and strongly support you, Mr. Chairman, in this effort as we collectively seek to translate compassion and concern for the victims of the dreadful disease through effective legislative action.
Mr. Chairman, as our Nation wages war in Iraq, we are demonstrating today that the American people can and must fight on many fronts to protect our interests, promote our values and to provide hope to captive, destitute and vulnerable people across the globe.
We have waited too long to address the global HIV/AIDS crisis in a truly systematic and comprehensive way. We cannot wait another day.
Today's markup is historic. This morning we are considering perhaps the most ambitious piece of legislation in this Committee's long history, the $15 billion authorized in the United States Leadership Against HIV/AIDS, Tuberculosis and Malaria Act of 2003 is an enormous sum by any measure. It is five times—I repeat, Mr. Chairman—five times the amount we considered authorizing for the cause just last year.
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For those of us who have long called for a real commitment of resources to address the HIV/AIDS crisis, our day has arrived.
As impressive as these amounts appear, they are no more than this crisis demands. Every day AIDS claims the lives of thousands of innocent men and women, old and young, sick and able-bodied, destitute and affluent, unemployed and professional, African, Asian, American, atheist and faithful.
This disease does not discriminate. It targets us all. In so doing, it ruins families, communities and whole nations; and it fuels violence and bloodshed across borders.
The political, economic, social and health impacts of HIV/AIDS cannot be contained in one region or one population. It is a global human challenge that demands a global humanitarian response with the United States in the lead.
This challenge, Mr. Chairman, has special meaning for me and for members of the San Francisco Bay area congressional delegation. In much of the world, the HIV/AIDS pandemic is an emerging humanitarian crisis. For our community, it has been a persistent crisis that has haunted us for 2 decades.
When I was first elected to Congress in 1980, the death toll from this unknown killer was just beginning to mount in cities across our Nation, targeting the greater San Francisco Bay area. Horror stories from innocent victims of this incurable disease were slowly percolating into the public's consciousness. Now, 2 decades later, we all know too well the true identity, the evil nature, the deadly impact and the global proportions of the HIV/AIDS virus.
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The bill before us provides three important lessons we have learned locally to apply to our international efforts to combat AIDS.
First, we have learned that treatment, as well as prevention, is critical to containing the virus. The majority of the funding we provide in this bill will ultimately be used for treating those afflicted by HIV/AIDS.
Second, bringing the necessary resources and expertise to bear demands strong international cooperation. Our bipartisan legislation applies this lesson by authorizing up to $1 billion for the global fund, perhaps the money we can spend to combat HIV/AIDS worldwide.
Finally, Mr. Chairman, this crisis demands sustained attention and strong leadership. Our bill organizes our government and rallies the private and nongovernmental sectors to tackle this crisis systematically. Should our legislation become law, the United States will not simply be continuing its episodic engagement, but it will be committing to a long-term campaign to defeat this disease.
In his State of the Union address 3 months ago, the President issued a challenge to the Congress to join him in a new global campaign to combat HIV/AIDS. Today, we take up the President's challenge; and we fully fund this bold initiative. An overwhelming bipartisan vote in our Committee today to report this bill favorably will give this effort new momentum and bring the President's vision, a vision many of us share, a step closer to reality.
The time for words has passed, and the time for action has arrived in our struggle against HIV/AIDS. I urge all of my colleagues to take action today to advance this historic legislation.
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Chairman HYDE. I thank the gentleman for his statement.
Without objection, any Member may place his or her opening statement in the record of today's proceedings.
I have a series of perfecting amendments at the desk which all of the Members have before them. I ask unanimous consent they be considered en bloc and they be considered as read. The clerk will designate the amendments.
Ms. RUSH. Amendment to H.R. 1298, offered en bloc by Mr. Hyde.
Chairman HYDE. Without objection, the amendments will be considered en bloc and will be considered as read.
[The en block amendment follows:]
86302b.AAB
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86302b.AAC
86302b.AAD
86302b.AAE
86302b.AAF
86302b.AAG
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86302b.AAH
86302b.AAI
86302b.AAJ
86302b.AAK
86302b.AAL
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86302b.AAM
86302b.AAN
86302b.AAO
86302b.AAP
86302b.AAQ
Chairman HYDE. The Chair is recognized for 5 minutes to explain the amendments.
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The Hyde amendments en bloc make approximately 44 technical and substantive changes to H.R. 1298 and have been negotiated with Republican and Democratic Members of the Committee as well as the White House.
The first category of amendments are technical in nature. They include:
Adding the Caribbean as an area of particular emphasis throughout the bill, given the high prevalence of HIV/AIDS in certain Caribbean countries.
Updating or correcting figures relating to the HIV/AIDS pandemic.
Correcting typographical, drafting or errors or other non-substantive omissions.
The second category of amendments are substantive. They were requested by Republican and Democratic Members of this Committee. These amendments include:
Including ''faith-based'' as a modifier along with community-based organizations, at the request of Republican Members and pro-family groups.
Adding a finding on prostitution and its relation to HIV/AIDS.
Requiring additional information on the effects of drug resistance in the required ''Report on Treatment Activities by Relevant Executive Branch Agencies.''
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Adding a new paragraph authorizing ''Comprehensive HIV/AIDS Public Private Partnerships'' under the heading ''Activities Supported'' in section 301 of the bill.
Adding language that ensures no funds under this act may be used to promote or advocate the legalization or practice of prostitution or sexual trafficking.
The third category of amendments were requested by the White House, which may be technical or substantive and, which broadly described, ensure that the HIV/AIDS coordinator established in this bill is vested with sufficient authorities and duties. I will not detail one by one these amendments, but they comprise by weight the majority of the language in the amendments en bloc.
Examples are inserting the word ''clinical'' before ''medical interventions'';
Inserting the word ''public health'' before ''problem'';
Changing ''shall'' to ''should'', authorizing a pilot program, instead of requiring it, et cetera, and et cetera.
Mr. Lantos.
Mr. LANTOS. Thank you, Mr. Chairman.
Mr. Chairman, I strongly support this Hyde en bloc amendment, and I thank you and your staff for your hard work in putting it together.
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As you have indicated, these amendments en bloc contain many technical fixes to the legislation and several major improvements to the underlying bill. They contain an initiative offered by Ed Royce and Bob Menendez to promote public-private partnership on HIV/AIDS, which I believe makes an important contribution to the bill. They also contain an amendment by a new Member of our Committee, Betty McCollum of Minnesota, to increase the security and safety of HIV/AIDS drug supplies overseas.
Mr. Chairman, the en bloc amendments also significantly increases the powers given to the HIV/AIDS coordinator at the Department of State. I believe that a strong HIV/AIDS coordinator will improve dramatically the delivery of U.S. HIV/AIDS assistance overseas. But it is also very important that the coordinator continue to work through the Agency for International Development, the Centers for Disease Control and other relevant Federal agencies which have a long-standing and developed expertise on all of the areas covered by this legislation.
I intend to continue to work with you, with the White House and our colleagues in the Senate to fine tune the coordinator language, to strike the proper balance; and I strongly urge all of my colleagues on the Democratic side to support the Hyde en bloc amendments.
Chairman HYDE. I thank the gentleman.
Is there any further discussion?
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If not, the question occurs on the Hyde amendments en bloc. All those in favor, say aye; opposed, nay.
The ayes have it. The amendments en bloc are adopted.
Are there any other amendments?
Mr. Pitts.
Mr. PITTS. Thank you, Mr. Chairman.
Do you have the amendment?
Chairman HYDE. Does the gentleman have an amendment at the desk?
Mr. PITTS. They should have given it to you, yes.
Chairman HYDE. Will the clerk designate the amendment? Do you have it?
Ms. RUSH. I don't have it.
Chairman HYDE. The clerk will read the amendment.
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Ms. RUSH. Amendment offered by Mr. Pitts:
''Page 19, line 19, insert the following (and redesignate subsequent paragraphs accordingly):
''(3) provide that the reduction of HIV/AIDS behavorial risks shall be the priority of all prevention efforts in terms of funding, education messages, and activities, and provide further that, while condom use can be a part of successful HIV/AIDS strategy, promoting abstinence from sexual activity and substance abuse, encouraging monogamy and faithfulness and eradicating prostitution, the sex trade, rape, sexual assault and sexual exploitation of women and children shall be given preference in strategies to reduce HIV/AIDS behavioral risks.''
[The amendment offered by Mr. Pitts follows:]
86302a.eps
Chairman HYDE. The gentleman from Pennsylvania is recognized for 5 minutes.
Mr. PITTS. Thank you, Mr. Chairman.
Instead of funding failed schemes of the past, H.R. 1298 should contain a provision giving priority for funding to abstinence programs. This is what has worked and will continue to work better than social marketing of condoms in Uganda.
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This strategy has worked. Look at the facts. In the 1980s, Uganda instituted what we know as the ABC program, A, abstinence before marriage; B, being faithful to one PARTNER; and then, C, condoms only if A and B are not practiced.
As you can see from this chart, the Uganda model has produced remarkable results. HIV infection rates have plunged from 21 percent to 6 percent since 1991; and the success caused Dr. Edward Green, a senior research scientist at Harvard, to remark on the program,
''Many of us in the AIDS and public health communities didn't believe that abstinence or delay and faithfulness were realistic goals. It now seems we were wrong.''
By contrast, if you look at this chart, in Kenya, a country that has not adopted the ABC approach to the disease, the HIV infection rate has risen dramatically. As you can see, Uganda's program works, while in Kenya, the commitment to the failed policy of condom distribution continues to cause AIDS deaths.
The countries in Africa which have the highest levels of condom availability relative to male population, like South Africa and Kenya, have some of the highest HIV prevalence rates in the world. A 2003 U.N. AIDS review of condom effectiveness concluded,
''There are no definite examples yet of generalized epidemics that have been turned back by prevention programs based primarily on condom promotion.''
The success of the Uganda program prompted the USAID Administrator, Andrew Natsios, to declare the priorities of the ABC program official United States policy on December 24, 2002.
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An adoption of this legal requirement would change the prevention paradigm in a way that reflects science and the President's priorities and the success of the ABC program in Uganda and elsewhere. This is what works, Mr. Chairman. Funding abstinence from sexual activity and substance abuse works.
Let me just mention that, in 1989, 41 percent of all males in Uganda had more than one sex partner. The ABC program cut this number in half by 1995. For Ugandan women, the decline was even more dramatic, from 23 percent to 9 percent. The amendment will ensure that these funds save more lives by moving taxpayer dollars away from failed schemes of the past and to life-saving strategies that have proven to save lives.
In conclusion, we should fund programs that work. We need to encourage people to avoid behavior that puts them at risk of contracting HIV. Because this works, I urge the Committee to adopt this prioritization amendment.
Chairman HYDE. Mr. Lantos.
Mr. LANTOS. Thank you, Mr. Chairman.
Mr. Chairman, I am opposed to the amendment offered by my friend; and I will ask my colleagues to vote for a substitute amendment that our colleague, Ms. Lee, will present.
I am disappointed that we are debating this amendment to give overwhelming priority to abstinence and to downgrade the importance of education and the proper use of condoms as a method to prevent the spread of HIV/AIDS. I would like to remind all Members of our Committee that we approved similar legislation 18 months ago that contained no references to the importance of abstinence in preventing the transmission of HIV/AIDS. That bill was approved by a 32 to 4 vote. In contrast, the bill before us emphasizes the importance of abstinence in six different places.
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My objection to the language in this amendment is that it states that priority in funding should be given to promoting behavioral change, and it specifically excludes the correct use of condoms as a behavior of change.
The amendment that we will offer properly indicates that the correct use of condoms, together with abstinence and being faithful, should all be priorities in promoting behavioral change. We support the ABC strategy that has been embraced by Christians, Muslims and secular leaders all over Africa but firmly reject giving priority of funding to any one method.
I urge all of my colleagues to support the Lee substitute amendment when it is offered.
Chairman HYDE. Mr. Smith of New Jersey.
Mr. SMITH OF NEW JERSEY. Thank you very much, Mr. Chairman.
First of all, let me thank you for your leadership. This bill is a work in progress, but what leaves here today, it should be clearly understood, will be further looked at when we get to the Floor and conference. This is just the first step. But I thank you for your openness.
I share your concern, as do many other Members, about this modern-day bubonic plague that has enveloped the world. We must take effective action. But that is the key, Mr. Chairman, that the action be the most effective course that we can possibly chart.
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It seems to me that Mr. Pitts, in his amendment which mirrors the Administration's policy and that which he just pointed out, Andrew Natsios, the Administrator of USAID, has articulated as U.S. policy, does give prioritization to that which works and that which works the best.
It is amazing to me that over the 1990s we heard very little about the ABC approach. It was mentioned but not mentioned all that often. It certainly didn't make its way into U.S. policy the way it should have, because it wasn't part of the paradigm of how we should treat the AIDS epidemic.
There was, I would respectfully suggest, a false course that we were taking that the only way to mitigate this modern-day plague was by embarking on a very aggressive initiative of condom distribution throughout the world; and we have seen that that does not work. It does work when it is put in a ladder of effectiveness, in which it comes in number three, as it did when it was tested in Uganda.
I would point out, and Mr. Pitts made brief mention to this, that Edward Green, who is the senior research scientist at the Harvard Center for Population and Development Studies, stated in his testimony on March 20 before the Energy and Commerce Committee that he has spent most of his life not as an academic just looking at these problems but as a person in the field who was a social marketer of condoms, and he promoted that extremely aggressively over the 1990s.
He has pointed out in his testimony that the brightest spot of all, when you talk about the AIDS epidemic, can be found in Uganda, where infection rates have declined from 21 percent to 6 percent since 1991. In his very powerful testimony, which I hope every Member will take the time to read, he said it must be acknowledged, in his words, that program emphasis on condom provision and promotion alone does not seem to have paid off. He points out that countries of Africa that have the highest levels of condom availability relative to the male population, like Zimbabwe, Botswana, South Africa and Kenya, also have some of the highest HIV prevalence rates in the world. He makes the point that Uganda's ABC model, which has condoms coming in third, is the way to mitigate this crisis.
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It seems to me that Mr. Pitts has it right, and it is my hope that we will defeat the Lee amendment when it is offered.
I yield back the balance of my time.
Chairman HYDE. The gentlewoman from California, Ms. Lee.
Ms. LEE. Thank you, Mr. Chairman.
First, let me thank you and Mr. Lantos for negotiating, I think, a very balanced and very reasonable and very promising bill.
I am opposed to the amendment offered by Mr. Pitts and have a substitute at the desk on which I am asking consideration. I ask unanimous consent that the amendment be considered as read.
Chairman HYDE. The clerk will designate the amendment.
Ms. RUSH. The substitute amendment offered by Ms. Lee to the amendment offered by Mr. Pitts.
Chairman HYDE. Without objection, further reading of the substitute is dispensed with.
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[The substitute amendment offered by Ms. Lee follows:]
86302b.eps
Chairman HYDE. The gentlewoman is recognized for 5 minutes.
Ms. LEE. Thank you, Mr. Chairman.
First, let me once again thank our staffs and Members of this Committee for negotiating a bill on which we on both sides of the aisle have come to agreement.
This pandemic is deadly, as we all know. Mr. Chairman, I thank you and Mr. Lantos for also recognizing the moral imperative which we have to address this in a way that we know the United States of America should address this pandemic. This disease requires each and every method to be addressed, each and every aspect of how to reduce the transmission of HIV/AIDS to be incorporated in our approach.
My amendment broadens this and includes basically the promotion of the effective use of condoms as a method. This is very important, because we know that all methods, again, as I said earlier, must be incorporated if we are going to address this deadly disease.
I just want to review for a minute the information with regard to Uganda to give you a bit more—or at least a broader understanding of the Uganda success.
First of all, the abstinence-only advocates have shown Uganda's ABC—which is abstain, be faithful, use a condom approach—as being effective. But the case studies show not the importance of abstinence-only programs but the effectiveness of a multifaceted approach to HIV prevention that includes condoms. That is the key in Uganda's success story.
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In fact, the abstinence component of the ABC program had really only moderate success and contributed only marginally to the decline of the disease. Although fewer young women aged 15 to 17 had actually ever been sexually active, sexual activity among young women and young men, excuse me, age 15 to 17 remained unchanged.
Also, the percentage of sexually active 15- to 17-year-old girls who were unmarried was higher in the year 2000, which was about 59 percent more than in 1988, when it was 46 percent.
Condom use for unmarried women and men, on the other hand, rose substantially, from 39 percent of young men and 7 percent of young women in 1995 to 50 percent and 13 percent respectively in 2000.
So it is very important, Mr. Chairman, that we understand the full implications and impact of the Uganda success story and understand that condom use that was part of that Uganda model is primarily responsible for its success rate.
So I ask for full support of this amendment. It is very reasonable. All it does is put back in the language that we actually negotiated on a bipartisan basis that we had agreement upon.
I yield back the balance of my time; and thank you, Mr. Chairman, for your good work.
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Chairman HYDE. Thank you.
The gentleman from Pennsylvania is recognized for 5 minutes.
Mr. PITTS. Thank you, Mr. Chairman.
I rise to oppose the Lee amendment.
First of all, the secondary amendment does not prioritize abstinence above condom use. It puts condom use on equal footing with abstinence. It was the prioritization of abstinence and monogamy in Uganda that has worked, that has saved lives.
The World Health Organization data reports that the proportion of Ugandan young males age 15 to 24 reporting premarital sex decreased from 60 percent in 1989 to 23 percent in 1995, and for females the decline was from 53 percent to 16 percent. The USAID report, the number 6 finding, says condom social marketing has played a key but evidently not the major role.
So we are not saying that condoms don't play a role. We are saying that abstinence and monogamy are to be prioritized—and then condom use.
The figures that we have show the fact that condom use has actually become quite high among those who would use them the most, those relatively few who still have multiple partners. But condom use in Uganda is not higher than those of other countries, and the ABC approach still recognizes that some people cannot or will not avoid risky sexual activity.
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So, in the words of the USAID review, there is little convincing evidence that inconsistent condom use provides any protection. So I would urge defeat of the Lee amendment and adoption of the prioritization of abstinence and monogamy before condom use.
Chairman HYDE. Ms. Watson of California.
Ms. WATSON. I would like to thank the Chair and Barbara Lee and others who have a deep understanding of what we confront.
I would like to advise the Committee that you cannot use one country on the continent of Africa as a model for the countries that need to be assisted with the programs and funds that we would authorize in this bill. What you must understand is that you have cultural and traditional patterns that differ not only from country to country but from village to village. If you want to influence a particular village, you would have to go to the chief and you would have to convince the chief that behavorial patterns that go back for thousands of years need to be changed.
I talk out of experience. When we had a cholera outbreak in the Federated States of Micronesia, I, as the Ambassador, called an emergency military team in from Guam; and I thought, oh, we could just go into the villages and tell them to change behavior.
Number one, the villagers said everyone in a combat uniform must stay out; and we learned through practicality that we had to convince the chief to take the message in to his people.
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Time is needed to educate the people. You start with the leadership first. Abstinence is just one option toward a behavioral change, but you have to understand that AIDS is spreading so rapidly throughout these populations that we cannot say set a priority on this method or that method. You have to do what works best in a particular locale.
So that is the reason why the Lee amendment is so important, because it expands the number of options that indeed can show results and benefits.
I would say, please oppose the Pitts amendment and support the Lee amendment, because it fits the set of circumstances that we are dealing with on the continent of Africa.
Thank you, Mr. Chairman.
Chairman HYDE. Mr. Pence of Indiana.
Mr. PENCE. I move to strike the last word.
Chairman HYDE. The gentleman is recognized for 5 minutes.
Mr. PENCE. Thank you, Mr. Chairman.
I want to associate myself with people on both sides who have expressed admiration for your and Ranking Member Lantos' commitment, moral commitment on this issue and agree strongly with your assertion that we are about a moral imperative in moving this legislation.
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But it strikes me, as I rise to support the Pitts amendment and oppose the secondary amendment by Ms. Lee, that as we undertake a moral imperative, Mr. Chairman, I think it is important that we do it morally and we do it in a way that in some way reflects the moral character of the people of the United States of America. As we prepare to deploy literally billions of dollars to stem the tide of this scourge of AIDS on this continent, that we do so with some effort to reflect not only the values of the American people but the positive experience with those values on the continent of Africa as we do so.
I was very moved by the gentlewoman former Ambassador's comments that preceded me and would associate myself with them. The suggestion that there are cultural differences village to village in Africa would go without saying. The assertion that abstinence and being faithful to one partner are one option and also her assertion that we have to offer the best option to people, it is on that point that we differ strongly.
Mr. Chairman, I would just offer respectfully that, with regard to HIV prevention, abstinence works every time, regardless of the culture, regardless of what side of the planet we are on. Abstinence and monogamy work every single time.
The gentleman from Pennsylvania's amendment is simply not about constricting the ability of organizations to promote condom use, but it is about saying that we will look at the experience of our own Nation, our own values; we will be guided by the likes of our own common sense; and we will try and do that which we know does work every time, to use the gentlewoman's words.
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She also said, you have to do what works best. The ABC approach with its extraordinary record in Uganda has proven that again and again. If we, Mr. Chairman, are to do right, it seems, by the people of Africa, and truly address this scourge for humanity, it strikes me that we ought to do so with a common-sense approach that builds on what works.
The ABC approach simply says abstinence, B for be faithful to one partner, and then C for use of condoms, in that order, reflects the best values of our experience and the best values of the American people.
I truly believe that, to borrow the gentlewoman's phrase, it is the best option, and strongly support the Pitts amendment and respectfully oppose the secondary amendment.
Mr. SMITH OF NEW JERSEY. Will the gentleman yield?
Mr. PENCE. I will yield.
Mr. SMITH OF NEW JERSEY. I just want to thank Mr. Pence for his very well-chosen words. We are all about the same thing here. We want to mitigate this crisis, and God willing, end it as soon as possible; and it is all about how we get from here to there, how we encourage this in the strongest way possible. It seems to be that where you put your money is the way you encourage something. You will get more of what you subsidize. It is not just Uganda that has adopted the ABC approach. Jamaica, Senegal, Ethiopia, and Kenya are in the process of moving into these proven means.
As Mr. Pence pointed out, this is an effective way of doing it; and it seems to me that if you prioritize everything, you prioritize nothing. To say that everything needs to be treated with the same emphasis means that nothing is treated with the same emphasis.
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The ABC model derives itself from the three-pronged approach of abstinence, being faithful, and then condom use. Nothing whatsoever in Mr. Pitts' amendment precludes the use and promotion of condoms. It just presents what has been working, and that is the model that was first adopted by Uganda. It needs to continue being replicated and expanded elsewhere.
I thank my friend for yielding.
Mr. PENCE. Reclaiming my time, I appreciate the gentleman from New Jersey and yield back.
Chairman HYDE. Mr. Brown of Ohio.
Mr. BROWN. Mr. Chairman, thank you. Strike the last word.
I rise in support of the Lee amendment to the amendment. I hear this debate about what works in Uganda, what might not work in Uganda, and I don't think the issue is what works in Uganda. All of us are happy with the successes of the program in Uganda. I don't know that we know all the facts of why, but we all applaud that. But it is a question of letting individual nations decide. It is a question of local control. It is a question of not one size fits all but let's let these nations decide.
You look at what works in Christian Brazil may or may not work in Muslim Bangladesh. What works in Uganda may or may not work in the Ivory Coast or Russia or Estonia. I don't know why we should tell these countries that this is the model, this works in Uganda, so this is the model by which we are going to judge or the standard to which we are going to hold all of these other countries and all of these other programs.
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I think one of the real advantages of the global fund, and we will talk more about that later, is the global fund is already involved in 85 countries; and the fund's premise—first of all, it is accountable, because money is withdrawn if the program is not working. But primarily the global fund works with an NGO or health ministry or a village government or national government and fits what works in that country. The global fund is not making judgments, saying it works in Uganda, it is going to work everywhere else. Maybe it will, maybe it won't. Let the nations decide, let the NGOs endemic in the nations decide, let the local governments, the health ministries, let local people decide what works.
I hear my friends on the other side of the aisle always talk about local control, except when States rights don't fit a certain agenda. But they always talk about local control, States rights, one size fits all. It is a bad concept.
Now, because it is our decision, our values that we want to implant on other countries, we want to put that in program after program. I don't think so. If we are consistent in believing that, in local control and rejecting one size fits all, whether it is everywhere in the United States or everywhere in the world, we will support the Lee amendment, because it does allow for the best programs to work in every circumstance. That is what our end goal is.
My friend, Mr. Smith from New Jersey, we all want the same thing, to deal with these terrible infectious diseases, the 21st century plague that is every bit as bad or maybe worse than the plague of seven centuries ago. We all care about this. Let's let each country and community and each NGO figure out what is best for those countries. That is why the Lee amendment makes sense; that is why the Pitts underlying amendment doesn't.
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I ask for support of the Lee amendment.
Chairman HYDE. Mr. Smith of Michigan.
Mr. SMITH OF MICHIGAN. Mr. Chairman, I would respectfully request that everybody consider there is not a whip stitch of difference between these two amendments. The previous speaker made a lot of points that I think make sense. The gentlewoman from California made good points. I would suggest to you, after visiting with some Ambassadors from many of those countries, that one reason the Uganda model works is because it was locally developed.
But here again, let me call to your attention—and I support the Pitts amendment and not the substitute because of the fact that the Pitts amendment says condom use can be part of a successful HIV/AIDS strategy. So, to me, the Pitts amendment simply says that it is not going to be the first effort, the top priority, simply to hand out condoms. I think that is an appropriate way to go. What we should continue to encourage is the development of local programs, because that is going to increase the chance that those programs work.
Ms. LEE. Will the gentleman yield for just a second?
Mr. SMITH OF MICHIGAN. Certainly.
Ms. LEE. Let me say very briefly that it doesn't make sense to prioritize the strategies that will be used. This is such an insidious disease that whatever strategy works should be the strategy that we support. What my amendment does is provide all of the strategies in a comprehensive fashion so that all of them have equal footing.
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Many of the success stories were successful and are successful because condom use is part of an overall strategy to attack this pandemic. Prioritizing one strategy versus the other does not do us any good and does not help reduce the infection rate.
Mr. SMITH OF MICHIGAN. Reclaiming my time, I think you make a lot of correct and good points, but, here, again, the way I read the Pitts amendment, it simply says that using condoms and handing out condoms cannot be the first, the top priority. It says it is a useful part of any HIV/AIDS strategy, but it can't be the top priority. I think that is appropriate.
Mr. LANTOS. Will the gentleman yield?
Mr. SMITH OF MICHIGAN. If I have any time left, I would be glad to.
Mr. LANTOS. There is a difference between the amendment of Mr. Pitts and the substitute amendment. The amendment of Mr. Pitts puts priority funding on one method. The substitute amendment does not provide for priorities. This is a fundamental, substantive difference.
I think the issue has been thoroughly debated, and I would like to request that we move on to a vote.
Mr. SMITH OF MICHIGAN. Not on my time. Reclaiming my time, again, you can look at the glasses, coming up from the bottom or down from the top, but here again, consider the possibility of reading the Pitts amendment the way that I do, and that says that passing out condoms cannot be a top priority.
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I yield back the balance of my time.
Chairman HYDE. The Chair has been asked to suggest as a motto for this Committee, ''Brevity is the soul of eloquence.'' I have refused to do that.
Mr. SMITH OF MICHIGAN. Mr. Chairman, I really didn't talk too long.
Chairman HYDE. This is a valuable debate, and so we will certainly continue.
Mr. Meeks.
Mr. MEEKS. Thank you, Mr. Chairman. I move to strike the last word.
Chairman HYDE. The gentleman is recognized for 5 minutes.
Mr. MEEKS. I, too, want to thank the Chairman and the Ranking Member and Ms. Lee and all the Members of this Committee for this bill, in bringing this bill to the forefront. I think it is significantly important that, as the Chairman and other Members pointed out, this is the black plague of the 21st century, and probably far worse than the black plague is this dreaded disease.
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I hear my colleagues on the other side of the aisle in reference to the Pitts amendment. However, I think that the message about morality, the morality that we want and the value that we want to export to other parts of the world, particularly where this disease is, is that we in America value human life, and we want to save life at all costs. We want to make sure that we preserve human life.
I think that simply we are saying to these other nations that, no matter what you do, if you are looking to save lives, whether it be by abstinence, whether it be by be using a condom, whether it be by whatever method, take and make sure that life comes first. We are not going to prioritize for you, because we want you to use what works for you.
But understand the importance of saving a human life and saving a generation of people as opposed to sending a message that, well, you have got to save lives, but save them the way that we prioritize for you to save them. I think that is the wrong message for us to send.
And Ms. Lee's amendment simply talks about all of the things that we are all talking about, but it just says, look, we value life. You decide within your cultures, as the Ambassador said, what is the best way for you to do it. Just get it done, and we are going to help you do it. And I think that is all there is, and I just think—I don't understand why we are having to impose upon individuals a priority of funding when the message that we simply should be sending out here is that we want to end this dreaded disease. We want to help you end it, and because in God's sight what is most precious to us is life itself. And that is more important than anything else, and I yield back the balance.
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Chairman HYDE. The gentlelady from Virginia, Mrs. Davis.
Mrs. DAVIS. Thank you, Mr. Chairman, and I agree with my colleague Mr. Meeks that we should be sending the message that we do care about life. That is why I totally support Mr. Pitts' amendment which says that we care enough about it that we would educate them and show them that abstinence is really the only proven way to avoid this dreaded disease. And we are not saying that you can't issue condoms. That is nowhere in Mr. Pitts' amendment. He is just saying simply that we should have abstinence as a priority.
I am 100 percent in agreement with Mr. Pitts' amendment, and I thank Ms. Lee for her secondary amendment, but it does not give the priority to abstinence, and so I urge the defeat of Ms. Lee's amendment and support Mr. Pitts'.
Chairman HYDE. The gentleman from California, Mr. Schiff.
Mr. SCHIFF. I move to strike the last word, Mr. Chairman.
Chairman HYDE. The gentleman is recognized for 5 minutes.
Mr. SCHIFF. And I will observe your injunction about brevity even if there is no wit in what I have to say.
I want to just emphasize that while I recognize that the use of condoms offends the beliefs or sensibilities of some, what really is at issue here is what is most efficacious in dealing with this pandemic. That really has to be our first, second and only priority. And in that light, I urge your support for the Lee substitute.
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What is most efficacious in saving lives may vary from country to country, and indeed even within a country, from village to village. We should not at this distance decide what strategy will be most successful in attacking this problem. The Lee substitute doesn't prioritize one or the other. It doesn't seek to micromanage this health crisis. It says here is a whole panoply of strategies that can be effective, and at the local level you will have to decide what is most effective in light of the customs and the traditions and the conditions of a particular village or country that is most efficacious. And while that may not be most palatable in light of the sensitivities of some of our Members, the bottom line is saving lives. In that respect there is no substitute for the Lee substitute, and I urge your support.
Chairman HYDE. The gentleman from Colorado, Mr. Tancredo.
Mr. TANCREDO. Thank you, Mr. Chairman.
If this were any other disease, if we were, for instance, debating an amendment that would allow for the provision of a particular drug that we knew was effective in dealing with a particular disease, if that were the case, of course there would be no debate. We would simply approve that measure because we know that that particular drug serves the purpose of dealing with that particular disease.
This, of course, is made more complex because the issues are behavioral in nature with which we are dealing and not strictly with a drug that we know is a panacea. What we do know is that there is a way of dealing with this disease. It is the one drug—if you substitute the word ''drug'' for ''behavior,'' it is the one way we know works. And so it is peculiar at least for us to be debating some other priority rather than to be saying that this is what works. We know it. We have the evidence. It is empirically provable, but we so fear the kind of repercussions that might come because we are talking about behaviors that we shy away from in direct discussion. Even if it will cost lives, we shy away from it.
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We should not shy away from it. We should do exactly what we know works. We should put our money and we should encourage everybody else to put their efforts into what we know works, just like we would if we were debating this issue and had the perfect drug to fit the particular problem. It is not a drug, but it is a behavior. We do know what works. We should support the Pitts amendment and defeat the Lee amendment.
Mr. PAYNE. Would the gentleman yield?
Mr. TANCREDO. I have yielded my time.
Chairman HYDE. The gentleman from New Jersey, Mr. Payne.
Mr. PAYNE. Thank you very much.
I would first like to commend President Bush for taking this initiative, this war that saves lives. I was very impressed by his announcement that came up when 10 billion of new monies were announced, and I think it is a step in the right direction.
I would just like to say that this issue is certainly important, and I think that all of us are saying the same thing. However, when we do look at the Ghana model, because I had head-to-head discussions, person-to-person discussions, with President Museveni—at one point abstinence was always a belief of his as a strong support from organizations. As a matter of fact, probably 60 or 70 percent of their overall budget at that time came from religious, primarily Catholic, organizations, and there was a very strong move on abstinence, which is very good. He had to really be convinced that condoms should also be introduced.
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We had the discussions, and I recall when there was a change because abstinence was not going to be the only thing that would work. I said that to say that I think that in some areas, if we did the prioritizing of condoms, for example, there are many military units in Africa, conflicts because borders were drawn by European powers. They are porous. They divide really ethnic groups. One side of the river is one country; one side is the other country. And there have been a lot of conflicts, and so you have a lot of men who are in the military. Now, unfortunately, when persons are away from their homes for long, long, long periods of time, abstinence sometimes becomes very difficult, they say. Therefore, condoms in that instance would be, in my opinion, the first discussion about prevention of HIV and AIDS.
Secondly, in Uganda there was a strong educational component, and I think that that is very important. That is how the villages knew that this disease was so prominent, because they went around and they did it in their local ethnic costumes and dialects, and they educated people about what it is, how devastating it is. Many people didn't know. Many people were not literate so far as writing was concerned. Some of them had their own dialects. And so there was a strong educational component which talked about the disease and then talked about the different ways that it can be prevented.
The other thing is that, you know, there should always be the question of polygamy. In some countries polygamy is an accepted part of their faith. You can have more than one wife, and the other wives, of course, are expected to be loyal. However, multiple lives—wives in polygamy, polygamous communities, could almost become a problem when you say that abstinence is really the first priority, just because of cultures.
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You find truck drivers in some of the countries, very bad roads, deep pits in the road, break down, and these overloaded trucks, many times drivers are out for weeks and weeks and weeks at a time. It is sometimes very difficult for persons on the road for months at a time, and that is how some of those trips are.
There should be abstinence, but in many instances that does not occur. In some places there is such a barren kind of a subsistence, mud huts with thatched roofs with no movie theaters, no TVs, no radios, no employment, just some agriculture, and walking long distances to get water.
You have to put yourself in other people's places, and I have been to those places, all of them. I have walked those roads. I have driven those roads. I have been in those war-torn areas.
And so I just said all that to say that we need, ourselves, when we try to foster our way on other people, to know abstinence works. We also know that the next best thing is condoms. And so I would hope that——
Chairman HYDE. The gentleman's time has expired.
Mr. PAYNE [continuing]. That we would support the Lee amendment. Thank you.
Chairman HYDE. Thank you.
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The Chair would like to entertain one more speaker and then get to the question, if that is possible. And so the Chair recognizes Mr. Ackerman.
Mr. ACKERMAN. I thank you, Mr. Chairman.
You know, listening to this debate, we realize how much we really don't know. I don't know if behavior is a drug or drugs include behavior. It just doesn't strike me that it really does. But I think that we are really walking all around the real issue here, which is confusing, at least to me. I just want to thank everybody for expressing their tremendously sincere and deeply held views, but this is really a religious discussion, and this is a discussion about life and where life begins and when life begins. And I am not smart enough, as some people might be, or think they might be, to conclude that life begins at conception, or life begins at birth, or life begins with semen, or life begins at whenever. But I do think that when somebody comes along smart enough to show us conclusively when life begins, that we might really have an answer to all of these rather perplexing questions. But until that time, I think people have to make their own decisions, and societies have to do their own thing, and we have to be helpful in any way that we can to prevent the loss of what we all know and can agree on is life.
These are existing, living human beings who can come down with terrible diseases such as HIV/AIDS, which could be prevented. Certainly if it is sexually transmitted, not having sex is 100 percent effective. But not in every society or culture are we going to be able to impose our will or the will of a minority or even the will of our entire Nation upon an individual culture so far away, or even on a single individual anywhere in the world.
And I think that what we have to do is, knowing that abstinence works, encourage it, and to provide all of the other alternatives as well. When people are able to make all those choices among choices that can work, that are each and every one of them effective, why limit it or steer people away from a decision. If they don't have what some people might consider, in their view, the moral road, the religious thing to do, to abstain, or to be faithful, and they are going to, in the views of some, violate some religious precept and err in their ways, why should that person have to come down with a terrible disease?
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It makes no sense, I would think, that in our great society, where we have so many different religions, and we speak so loudly and proudly about diversity in this country and how we tolerate everybody's ideas and religious concepts and practices without any interference, that we would seek to impose our own deeply held religious views upon others as to what will happen to them if they, in our view, misbehave. I respect all of those who believe so strongly that life begins at any stage that they think it begins at, but I am confused when I see those who hold that view and also share with those of us who believe in religious diversity, that at the same time they can say, let us remove choices based on my view of religion, what my view of what my Bible and my God says to me.
I think the Lee amendment is good. It talks about each of the choices that are effective and allows people to make that choice. If we want to help people—my mother used to say, if you want to help me, help me my way. And I think there is a wisdom to that. My grandmother used to think the best thing for illness was chicken soup, and there is a scientific debate about that, whether chicken soup is better than penicillin. And different people choose different paths and do what is best for them in order to help themselves. And I think, Mr. Chairman, in this great society of ours, where religious tolerance is one of our greatest priorities, that we should not impose our religious views upon others——
Chairman HYDE. The gentleman's time has expired.
Mr. ACKERMAN [continuing]. Even though they be far away.
Chairman HYDE. The gentleman's time has expired.
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The question occurs on the Lee substitute to the Pitts amendment. All those in favor, say aye.
Opposed, nay.
The Chair is in doubt. The clerk will call the roll.
Ms. RUSH. Mr. Leach.
[No response.]
Ms. RUSH. Mr. Bereuter.
[No response.]
Ms. RUSH. Mr. Smith from New Jersey.
Mr. SMITH OF NEW JERSEY. No.
Ms. RUSH. Mr. Smith votes no.
Mr. Burton.
Mr. BURTON. No.
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Ms. RUSH. Mr. Burton votes no.
Mr. Gallegly.
Mr. GALLEGLY. No.
Ms. RUSH. Mr. Gallegly votes no.
Ms. Ros-Lehtinen.
[No response.]
Ms. RUSH. Mr. Ballenger.
Mr. BALLENGER. No.
Ms. RUSH. Mr. Ballenger votes no.
Mr. Rohrabacher.
Mr. ROHRABACHER. No.
Ms. RUSH. Mr. Rohrabacher votes no.
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Mr. Royce.
Mr. ROYCE. No.
Ms. RUSH. Mr. Royce votes no.
Mr. King.
[No response.]
Ms. RUSH. Mr. Chabot.
Mr. CHABOT. No.
Ms. RUSH. Mr. Chabot votes no.
Mr. Houghton.
Mr. HOUGHTON. Yes.
Ms. RUSH. Mr. Houghton votes yes.
Mr. McHugh.
[No response.]
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Ms. RUSH. Mr. Tancredo.
Mr. TANCREDO. No.
Ms. RUSH. Mr. Tancredo votes no.
Mr. Paul.
Mr. PAUL. No.
Ms. RUSH. Mr. Paul votes no.
Mr. Smith from Michigan.
Mr. SMITH OF MICHIGAN. No.
Ms. RUSH. Mr. Smith votes no.
Mr. Pitts.
Mr. PITTS. No.
Ms. RUSH. Mr. Pitts votes no.
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Mr. Flake.
Mr. FLAKE. No.
Ms. RUSH. Mr. Flake votes no.
Mrs. Davis.
Mrs. DAVIS. No.
Ms. RUSH. Mrs. Davis votes no.
Mr. Green.
Mr. GREEN. No.
Ms. RUSH. Mr. Green votes no.
Mr. Weller.
Mr. WELLER. No.
Ms. RUSH. Mr. Weller votes no.
Mr. Pence.
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Mr. PENCE. No.
Ms. RUSH. Mr. Pence votes no.
Mr. McCotter.
Mr. MCCOTTER. No.
Ms. RUSH. Mr. McCotter votes no.
Mr. Janklow.
Mr. JANKLOW. No.
Ms. RUSH. Mr. Janklow votes no.
Mrs. Harris.
Mrs. HARRIS. No.
Ms. RUSH. Mrs. Harris votes no.
Mr. Lantos.
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Mr. LANTOS. Yes.
Ms. RUSH. Mr. Lantos votes yes.
Mr. Berman.
Mr. BERMAN. Yes.
Ms. RUSH. Mr. Berman votes yes.
Mr. Ackerman.
Mr. ACKERMAN. Yes.
Ms. RUSH. Mr. Ackerman votes yes.
Mr. Faleomavaega.
[No response.]
Ms. RUSH. Mr. Payne.
Mr. PAYNE. Yes.
Ms. RUSH. Mr. Payne votes yes.
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Mr. Menendez.
Mr. MENENDEZ. Yes.
Ms. RUSH. Mr. Menendez votes yes.
Mr. Brown.
Mr. BROWN. Yes.
Ms. RUSH. Mr. Brown votes yes.
Mr. Sherman.
[No response.]
Ms. RUSH. Mr. Wexler.
Mr. WEXLER. Yes.
Ms. RUSH. Mr. Wexler votes yes.
Mr. Engel.
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Mr. ENGEL. Yes.
Ms. RUSH. Mr. Engel votes yes.
Mr. Delahunt.
Mr. DELAHUNT. Yes.
Ms. RUSH. Mr. Delahunt votes yes.
Mr. Meeks.
Mr. MEEKS. Yes.
Ms. RUSH. Mr. Meeks votes yes.
Ms. Lee.
Ms. LEE. Yes.
Ms. RUSH. Ms. Lee votes yes.
Mr. Crowley.
Mr. CROWLEY. Yes.
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Ms. RUSH. Mr. Crowley votes yes.
Mr. Hoeffel.
Mr. HOEFFEL. Yes.
Ms. RUSH. Mr. Hoeffel votes yes.
Mr. Blumenauer.
Mr. BLUMENAUER. Yes.
Ms. RUSH. Mr. Blumenauer votes yes.
Ms. Berkley.
Ms. BERKLEY. Yes.
Ms. RUSH. Ms. Berkley votes yes.
Mrs. Napolitano.
Mrs. NAPOLITANO. Yes.
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Ms. RUSH. Mrs. Napolitano votes yes.
Mr. Schiff.
Mr. SCHIFF. Yes.
Ms. RUSH. Mr. Schiff votes yes.
Ms. Watson.
Ms. WATSON. Yes.
Ms. RUSH. Ms. Watson votes yes.
Mr. Smith of Washington.
Mr. SMITH OF WASHINGTON. Yes.
Ms. RUSH. Mr. Smith of Washington votes yes.
Ms. McCollum.
Ms. MCCOLLUM. Yes.
Ms. RUSH. Ms. McCollum votes yes.
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Mr. Bell.
Mr. BELL. Yes.
Ms. RUSH. Mr. Bell votes yes.
Mr. Hyde.
Chairman HYDE. No.
Ms. RUSH. Mr. Hyde votes no.
Chairman HYDE. Mr. Sherman is——
Mr. SHERMAN. How am I recorded?
Ms. RUSH. You are not recorded.
Mr. SHERMAN. Please record me as aye.
Ms. RUSH. Mr. Sherman votes yes.
Chairman HYDE. Mr. Leach.
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Mr. LEACH. I vote yes.
Ms. RUSH. Mr. Leach votes yes.
Chairman HYDE. If all have voted who wish, the clerk will report.
Ms. RUSH. Mr. Chairman, on this vote there are 24 ayes and 20 noes.
Chairman HYDE. Then the substitute amendment is agreed to.
The question occurs on the Pitts amendment as amended by the Lee substitute. All those in favor, say aye.
Opposed, nay.
The ayes have it, and the Pitts amendment as amended by the Lee substitute amendment is agreed to.
Are there further amendments?
The gentleman from Pennsylvania.
I am sorry, I am supposed to recognize a Democrat.
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Mr. BROWN. I am one of those, Mr. Chairman.
Chairman HYDE. Yes, you are, and more.
Mr. BROWN. To the third power and proud of it.
I have an amendment at the desk, Mr. Chairman.
Chairman HYDE. The clerk will designate the Brown amendment.
Ms. RUSH. Amendment offered by Mr. Brown of Ohio. Page 49, line 25.
Chairman HYDE. Without objection, further reading of the amendment is dispensed with, and the gentleman is recognized for 5 minutes in support of his amendment.
[The amendment offered by Mr. Brown follows:]
86302c.eps
Mr. BROWN. Thank you, Mr. Chairman. I have not had a chance to thank both the Chairman and the Ranking Member, Mr. Lantos, for their terrific work in dealing with the scourge, including obviously not just HIV, but TB and malaria.
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The work of this Congress is well documented in the last 5 years in combatting a disease that most of us in our community thought had been consigned to some sort of oblivion, tuberculosis. Few of us know people who have TB. Few of us read very much about TB. Only 6 years ago Congress voted 0 dollars for international TB control, and very little through public health departments domestically until the early 1990s when there was the terrible TB outbreak in New York City. Even then the Nation did not learn a lot about TB, but we now are again—we are seeing how severe a problem tuberculosis is worldwide.
Twelve million people a year die from tuberculosis. In the country of India, 1,100 people die from tuberculosis. We know that in Africa, between 40 and 50 percent of the deaths from HIV are actually deaths from tuberculosis. One-third of the world's people carry the tuberculosis bacteria in their bodies. Most of them will never get TB because it usually becomes full-blown TB when an immune system is weakened from HIV/AIDS or malnutrition, or a particularly frail older person might have the TB that he or she has carried for decades. That bacteria is developed into full-blown TB.
But in the case of TB, this is a disease we know how to combat. We can do it inexpensively. Congress went from 0 dollars for TB 5 years ago internationally to $80 million in our appropriations last year, and in a developing world the tuberculosis patient can be cured for as little as $100. Multidrug-resistant TB is obviously a more significant, more expensive problem, and in the developing world is often a death sentence.
The best way to prevent TB is to cure those sick with the disease. One person with TB, it is estimated, can affect 10 to 15 others in a year. We can no longer wait to aggressively expand treatment; tuberculosis is becoming more of a problem in this country, especially with the growth of TB in a place like Russia, where they are letting more and more of their TB patient inmates out of prison. They have had a prison furlough program in Russia where people who are in prison for property crimes, 300,000 inmates, about one-third of the inmate population, over a 4-year period will be released on the prison furlough program. Ten percent of those people have tuberculosis; 25 percent of that 10 percent have multidrug-resistant TB. Those people will fly. They will be tourists; some of the people from whom we are more likely to contract TB when we travel to those countries.
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I am offering this amendment because language on how TB money is spent is critical. TB is as big a threat as AIDS, yet USAID monies have simply not been used as effectively as we would like with TB. I had a meeting last year with USAID at which they could not give me any data as to how many patients were treated, how effectively the money was spent, how many lives were saved, how many drugs they were buying. When asked for this information, they couldn't come up with it. That is why there should be considerable concern in Congress that USAID has not been able to do that.
This amendment is not an earmark, doesn't say we spend X number of dollars on TB. It is a technical direction to USAID. The majority of the money should be spent on drugs, on patient services, on training of health workers. Most Members would agree, all public health officials agree, that is the most effective use of the money.
I am offering this amendment because it is important to change the way USAID is doing business. I respect the work USAID does, however, in this instance they simply have not been as effective as they could, because they haven't accounted for how their money is spent. We have used report language. It has not proven effective in the past. Congress can give USAID direction to make sure that that money is spent on curing patients, and we can do that with this amendment. It will matter to save the lives literally of thousands, tens of thousands, perhaps hundreds of thousands of people around the world.
Mr. Chairman, I yield back the balance of my time and ask support for the amendment.
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Chairman HYDE. The Chair recognizes himself for 5 minutes.
I would suggest to the gentleman that we have worked very carefully with him and with his staff. We have made specific references in the bill to the DOTS (Directly Observed Treatment Shortcourse) plus including language that instructs the President that he shall give priority to activities that increase DOTS coverage and treatment of multidrug-resistant TB, et cetera.
Mr. Burton.
Mr. BURTON. Mr. Speaker, down here. I just have one question if I might ask it, Mr. Chairman.
Chairman HYDE. Yes.
Mr. BURTON. What is the Global Tuberculosis Drug Facility?
Chairman HYDE. The Global Tuberculosis Drug Facility.
Mr. BURTON. Yes. It is the last four words in the amendment, if somebody could answer that.
Mr. BROWN. It is not my time. I will be glad to answer.
Chairman HYDE. May I return to my statement?
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Mr. BURTON. Well, I thought you were through with your statement. I am sorry, Mr. Chairman, but can I get an answer to that after your statement?
Chairman HYDE. Yes. Staff is looking it up, and we will give it to you in several languages, I am going to suggest the most difficult of which will be English.
It is suggested, Mr. Brown, that if you would accept an amendment changing the words ''shall ensure that not less than 75 percent of the money'' to ''should ensure,'' we will accept your amendment. Absent that, we feel it is assigning too much, 75 percent, to one program, and there are other effective programs in this field, and we don't want to eliminate them.
But we realize the merit of what you are saying. We have suggested that it shall be given priority, and now we will suggest that it should ensure, if the gentleman will take that, we will take your amendment.
I yield to the gentleman from Ohio.
Mr. BROWN. And may I answer the global fund while I think about the second question, Mr. Chairman?
Chairman HYDE. If you have an answer for him.
Mr. BROWN. I do, Mr. Chairman. I have worked on tuberculosis with you in some cases for many years. The global fund was created as part of the World Health Organization. It is actually the program that works on TB eradication, elimination, reduction, cures around the world. And interestingly, Mr. Chairman, more information than Mr. Burton might want, the new Director General of the World Health Organization taking office in July was the head of the global TB fund, the stop TB program.
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Chairman HYDE. I thank you for filling in that gap.
Mr. LANTOS. Could you give it to us in French now?
Chairman HYDE. Would the gentleman accept the suggestion to change the word ''shall'' to ''should''?
Mr. BROWN. Mr. Chairman, not being a lawyer, and not understanding the difference, I would—no, I—Mr. Chairman, I am concerned about this. The short answer is I will reluctantly, but if I could take 20 seconds to elaborate on that. I am concerned that we have for 6 years given money to USAID and not seen the response we ought to be getting from them when they haven't been able to tell us the information about how they are doing it. And while I understand all the things that can happen in conference committee, and I understand your comments, I will accept it. But I hope that this Committee can go on record as really pushing USAID to do the right thing here and spend this money where they should, and report back to us that they have been able to, and quantify those numbers.
Chairman HYDE. Without objection, the gentleman's motion to delete the word ''shall'' in the third line of his amendment and change it to ''should'' is agreed to. The question occurs on the gentleman's amendment as modified. All those in favor, say aye.
Opposed, nay.
The ayes have it, and the amendment is agreed to.
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And are there further amendments?
Mr. ROHRABACHER. Mr. Chairman.
Chairman HYDE. Who is seeking recognition?
Mr. ROHRABACHER. I have an amendment at the desk.
Chairman HYDE. Mr. Rohrabacher.
[The amendment offered by Mr. Rohrabacher follows:]
94
86302d.eps
Mr. ROHRABACHER. Mr. Chairman, I have an amendment at the desk that basically will provide essential support for the orphans and vulnerable children that are left behind from this AIDS epidemic. This amendment fences off 10 percent of all authorized appropriations that go for this AIDS epidemic to orphans and vulnerable children.
The United Nations estimates that there will be 20 million orphans from AIDS by 2005. Very few of those are receiving any support. Experts estimate that health care education, psychological support can be provided for perhaps as little as $50 per child per year. I am therefore proposing that the United States Government contribute $300 million per year, and that is what this amendment would basically do, from the funds that we are talking about that go to AIDS to meet our share of the global commitment to combat this unaddressed crisis.
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Faith-based organizations and community-based organizations are the best ones to provide support for extended families to these orphans and other care providers.
Chairman HYDE. If the gentleman would yield. We are prepared to accept the gentleman's amendment.
Mr. ROHRABACHER. All right. Thank you very much.
Chairman HYDE. But Mr. Lantos would like to comment thereon.
Mr. Lantos.
Mr. LANTOS. Mr. Chairman, I want to commend my friend from California. I strongly support his amendment. There are over 17 million Africans who died from HIV/AIDS-related diseases since the late 1970s, leaving more than 13 million orphans in sub-Saharan Africa alone. Most of these children do not have AIDS, but are in danger of slavery, criminal violence, dying of childhood diseases or being forced into prostitution to survive. Mr. Rohrabacher's amendment will include as part of the sense of Congress in section 402 the option of using 10 percent of available funds to service the specific needs of the orphans and vulnerable children, and I strongly support his amendment.
Chairman HYDE. The question occurs on the Rohrabacher amendment. All those in favor, say aye.
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Opposed, nay.
The ayes have it. The amendment is agreed to.
There are two votes on the Floor, and the Chair will recess the Committee until 1:30, and I again plead with you to come back so we can finish this bill.
The Committee stands in recess.
[Recess.]
Chairman HYDE. The Committee will come to order.
The Chair recognizes Mrs. Napolitano for purposes of amendment.
Mrs. NAPOLITANO. Thank you, Mr. Chairman.
The amendment that I am proposing is on behalf of Congresswoman Juanita Millender-McDonald——
Chairman HYDE. The clerk will designate the amendment.
Ms. RUSH. Page 70, after line 12——
Chairman HYDE. Without objection, further reading of the Napolitano amendment is dispensed with, and the gentlewoman is recognized for 5 minutes.
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[The amendment offered by Mrs. Napolitano follows:]
86302e.eps
Mrs. NAPOLITANO. Thank you, Mr. Chairman. I should have started with that to begin with. My apologies.
The amendment that I am requesting be added to H.R. 1298 deals with giving priorities to eligible applicants that are currently administering a program of proven intervention to HIV-positive individuals.
While much attention is being paid to preventing mother-to-child transmission, the MTCT, of HIV/AIDS, we must turn to addressing the needs and the rights of that child to grow up with parents, so that means the children are not orphaned before they can walk. We must ensure the best delivery of service to strengthen these families, and we must ensure that these people are ready to provide those families.
I refer to section 312 of your bill that states that the U.S. Government response to pandemics should place a high priority on the prevention of mother-to-child transmission, the care and treatment of family members——
Chairman HYDE. Would the gentlewoman yield? I have a deal for the gentlewoman. If she will yield back her time, we will accept her amendment.
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Mrs. NAPOLITANO. I will so yield willingly. Thank you, sir.
Chairman HYDE. The question is on the passage of the Napolitano amendment. All those in favor, say aye.
Those opposed, nay.
The ayes have it. The amendment is agreed to.
Mr. SMITH OF NEW JERSEY. Mr. Chairman, I have an amendment at the desk.
Chairman HYDE. Mr. Nick Smith is next, if he will sit down and give us his amendment.
Mr. SMITH OF MICHIGAN. I will sit down.
Mr. Chairman, this amendment does not reduce the $15 billion over 5 years, but reflects what was put in our House budget resolution, plus it reflects what the White House——
Chairman HYDE. If the gentleman will cease. Do you have an amendment at the desk? The clerk will designate the amendment.
Ms. RUSH. Amendment offered by Mr. Smith of Michigan, page 73——
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Chairman HYDE. Without objection, further reading is dispensed with, and the Chair is pleased to recognize the gentleman from Michigan.
[The amendment offered by Mr. Smith of Michigan follows:]
86302f.eps
Mr. SMITH OF MICHIGAN. Mr. Chairman, I apologize.
Mr. Chairman, the amendment reflects what was in the House Budget Committee, and it reflects what the White House and OMB have recommended in their budget. Instead of starting at $3 billion a year, it starts at $2 billion, and then gradually increases spending $4 billion the last year, with their suggestion that in order to, if you will, get organized, they would like to have more in the outyears and start a little more gradually in the earlier years.
So the amendment reflects what both our House budget and OMB have suggested as far as a phase-in and a gradual increase in spending over the 4 years, but not diminishing the $15 billion over the 5-year period.
I would yield back.
Chairman HYDE. I thank the gentleman.
The Chair recognizes Mr. Lantos.
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Mr. LANTOS. Thank you very much, Mr. Chairman.
I want to commend my friend from Michigan for proposing an amendment which I will be compelled to oppose. His amendment, which is well-intentioned, is superfluous because the language of our compromise legislation allows for rolling over funds which were not used in earlier years. So if theoretically only $2.5 billion could be spent rationally and properly in the first year, the half-billion dollars overage would be pushed on to the next year, or, if necessary, even the following year.
I think we have arrived at a carefully crafted and painfully negotiated compromise, and I think it would be singularly unfortunate to begin to unravel it. Therefore, I am compelled to oppose my good friend's amendment.
Chairman HYDE. The Chair recognizes himself for 1 minute to suggest that the figure in the bill has been painfully negotiated, and Mr. Lantos and I have reached an agreement on this amount. So I will stand by our agreement, with regret, because Mr. Smith makes a good point that may have some viability later on, I don't know, but for now I want to stick with our agreement. So I regretfully have to vote against it.
Mr. LANTOS. I would like to add the word ''regretfully'' to my comments as well.
Mr. SMITH OF MICHIGAN. I would also like to use that word, Mr. Chairman.
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Would the Chairman yield for a second?
Chairman HYDE. Surely, and not regretfully either.
Mr. SMITH OF MICHIGAN. It seems to me by not accepting this amendment, we cut out some of the flexibility of incorporating the program and having the authorization that will allow that funding to grow. It seems that there is some reasonableness, even though the negotiation has been painstakingly agreed to on this bill, to simply have the flexibility, as I have said. In fact, I have a former African Ambassador on my staff, and he is convinced also that starting gradually and expanding the program has a great deal of merit in terms of having effective funding.
So, this goes up to $4 billion by the fifth year, and so I just add that last appeal to however you consider this amendment.
Chairman HYDE. Is there any further discussion? If not, the question occurs on the amendment offered by the gentleman from Michigan. All those in favor, say aye.
Opposed, nay.
In the opinion of the Chair, the noes have it.
Mr. SMITH OF MICHIGAN. I request a rollcall.
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Chairman HYDE. The gentleman requests a rollcall. The clerk will call the roll.
Ms. RUSH. Mr. Leach.
[No response.]
Ms. RUSH. Mr. Bereuter.
Mr. BEREUTER. Aye.
Ms. RUSH. Mr. Bereuter votes yes.
Mr. Smith of New Jersey.
[No response.]
Ms. RUSH. Mr. Burton.
[No response.]
Ms. RUSH. Mr. Gallegly.
[No response.]
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Ms. RUSH. Ms. Ros-Lehtinen.
[No response.]
Ms. RUSH. Mr. Ballenger.
[No response.]
Ms. RUSH. Mr. Rohrabacher.
[No response.]
Ms. RUSH. Mr. Royce.
[No response.]
Ms. RUSH. Mr. King.
Mr. KING. No.
Ms. RUSH. Mr. King votes no.
Mr. Chabot.
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[No response.]
Ms. RUSH. Mr. Houghton.
Mr. HOUGHTON. Yes.
Ms. RUSH. Mr. Houghton votes yes.
Mr. McHugh.
[No response.]
Ms. RUSH. Mr. Tancredo.
[No response.]
Ms. RUSH. Mr. Paul.
[No response.]
Ms. RUSH. Mr. Smith from Michigan.
Mr. SMITH OF MICHIGAN. Yes.
Ms. RUSH. Mr. Smith votes yes.
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Mr. Pitts.
Mr. PITTS. Yes.
Ms. RUSH. Mr. Pitts votes yes.
Mr. Flake.
Mr. FLAKE. Yes.
Ms. RUSH. Mr. Flake votes yes.
Mrs. Davis.
Mrs. DAVIS. Yes.
Ms. RUSH. Mrs. Davis votes yes.
Mr. Green.
Mr. GREEN. Yes.
Ms. RUSH. Mr. Green votes yes.
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Mr. Weller.
Mr. WELLER. No.
Ms. RUSH. Mr. Weller votes no.
Mr. Pence.
Mr. PENCE. Yes.
Ms. RUSH. Mr. Pence votes yes.
Mr. McCotter.
[No response.]
Ms. RUSH. Mr. Janklow.
Mr. JANKLOW. Yes.
Ms. RUSH. Mr. Janklow votes yes.
Mrs. Harris.
Mrs. HARRIS. Yes.
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Ms. RUSH. Mrs. Harris votes yes.
Ms. RUSH. Mr. Lantos.
Mr. LANTOS. No.
Ms. RUSH. Mr. Lantos votes no.
Mr. Berman.
Mr. BERMAN. No.
Ms. RUSH. Mr. Berman votes no.
Mr. Ackerman.
Mr. ACKERMAN. No.
Ms. RUSH. Mr. Ackerman votes no.
Mr. Faleomavaega.
[No response.]
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Ms. RUSH. Mr. Payne.
[No response.]
Ms. RUSH. Mr. Menendez.
Mr. MENENDEZ. No.
Ms. RUSH. Mr. Menendez votes no.
Mr. Brown.
Mr. BROWN. No.
Ms. RUSH. Mr. Brown votes no.
Mr. Sherman.
[No response.]
Ms. RUSH. Mr. Wexler.
Mr. WEXLER. No.
Ms. RUSH. Mr. Wexler votes no.
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Mr. Engel.
Mr. ENGEL. No.
Ms. RUSH. Mr. Engel votes no.
Mr. Delahunt.
[No response.]
Ms. RUSH. Mr. Meeks.
Mr. MEEKS. No.
Ms. RUSH. Mr. Meeks votes no.
Ms. Lee.
Ms. LEE. No.
Ms. RUSH. Ms. Lee votes no.
Mr. Crowley.
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Mr. CROWLEY. No.
Ms. RUSH. Mr. Crowley votes no.
Mr. Hoeffel.
Mr. HOEFFEL. No.
Ms. RUSH. Mr. Hoeffel votes no.
Mr. Blumenauer.
[No response.]
Ms. RUSH. Ms. Berkley.
Ms. BERKLEY. No.
Ms. RUSH. Ms. Berkley votes no.
Mrs. Napolitano.
Mrs. NAPOLITANO. No.
Ms. RUSH. Mrs. Napolitano votes no.
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Mr. Schiff.
Mr. SCHIFF. No.
Ms. RUSH. Mr. Schiff votes no.
Ms. Watson.
[No response.]
Ms. RUSH. Mr. Smith of Washington.
Mr. SMITH OF WASHINGTON. No.
Ms. RUSH. Mr. Smith of Washington votes no.
Ms. McCollum.
Ms. MCCOLLUM. No.
Ms. RUSH. Ms. McCollum votes no.
Mr. Bell.
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Mr. BELL. No.
Ms. RUSH. Mr. Bell votes no.
Mr. Hyde.
Chairman HYDE. No.
Ms. RUSH. Mr. Hyde votes no.
Chairman HYDE. Mr. Leach.
Mr. LEACH. No.
Ms. RUSH. Mr. Leach votes no.
Chairman HYDE. Mr. Ballenger.
Mr. BALLENGER. Yes.
Ms. RUSH. Mr. Ballenger votes yes.
Chairman HYDE. Mr. Royce.
Mr. ROYCE. Yes.
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Ms. RUSH. Mr. Royce votes yes.
Chairman HYDE. Mr. Delahunt.
Mr. DELAHUNT. No.
Ms. RUSH. Mr. Delahunt votes no.
Chairman HYDE. Mr. Payne.
Mr. PAYNE. No.
Ms. RUSH. Mr. Payne votes no.
Chairman HYDE. Ms. Watson.
Ms. WATSON. No.
Ms. RUSH. Ms. Watson votes no.
Chairman HYDE. Have all voted who wish?
Mr. Chabot.
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Mr. CHABOT. Yes.
Ms. RUSH. Mr. Chabot votes yes.
Chairman HYDE. Mr. Rohrabacher.
Mr. ROHRABACHER. How am I recorded?
Ms. RUSH. Mr. Rohrabacher has not voted.
Mr. ROHRABACHER. I am voting yes.
Chairman HYDE. Mr. McCotter.
Mr. MCCOTTER. Yes.
Ms. RUSH. Mr. McCotter votes yes.
Chairman HYDE. The clerk will report.
One more vote. Mr. Blumenauer.
Mr. BLUMENAUER. No.
Ms. RUSH. Mr. Blumenauer votes no.
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Chairman HYDE. The clerk will report.
Ms. RUSH. Mr. Chairman, on this vote there are 15 ayes and 25 noes.
Chairman HYDE. And the amendment is not agreed to.
Are there further amendments?
Mr. BERMAN. Mr. Chairman.
Chairman HYDE. Mr. Berman of California.
Mr. BERMAN. I have an amendment at the desk.
Chairman HYDE. The clerk will report the amendment.
Ms. RUSH. An amendment offered by Mr. Berman, page 54, line 4——
Chairman HYDE. Without objection, further reading of the amendment is dispensed with, and the gentleman is recognized for 5 minutes in support thereof.
[The amendment offered by Mr. Berman follows:]
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82
86302g.eps
Mr. BERMAN. Thank you very much, Mr. Chairman. This is a last-minute amendment, and I very much appreciate the assistance of your staff to ensure that it was drafted properly.
The purpose of the amendment is simply to recognize the critical role played by Medicines for Malaria Venture, a nonprofit, private-public partnership founded in 1999 by the World Health Organization (WHO), the World Bank, national governments, private foundations and the pharmaceutical industry.
Malaria kills between 1 and 3 million people every year, including a large number of children and pregnant women. The malaria parasite is growing increasingly resistant to existing drugs. Estimates indicate that antimalarial drugs in current and recent use tend to lose effectiveness over a 3 to 6 year period. The development, therefore, of new drugs is critical.
There is little private investment in this area because it is simply not profitable. That is where the Medicines for Malaria Venture comes in. Their goal is to register one new antimalarial drug every 5 years, beginning in the year 2010. This rapid development cycle is critical if we are hopeful to be able to control the malaria epidemic.
The WHO describes this particular venture as the premier public-private partnership for developing new malaria drugs. The amendment simply makes Medicines for Malaria Venture eligible for funds appropriated to combat malaria, similar to language in the bill that recognizes other public-private partnerships, including the Global Alliance for Tuberculosis Drug Development and the Malaria Vaccine Initiative, and I ask support for the amendment.
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I yield back.
Chairman HYDE. Is there further discussion? If not, the question is on the Berman amendment. All those in favor, say aye.
Those opposed, nay.
The ayes have it. The amendment is agreed to.
Are there further amendments?
Mr. Flake.
Mr. FLAKE. Mr. Chairman, I have an amendment at the desk.
Chairman HYDE. The clerk will designate the amendment.
Ms. RUSH. We have two.
Chairman HYDE. Which of the two amendments are you offering?
Mr. FLAKE. The restriction on the Global Fund with regard to sponsors of terrorism.
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Chairman HYDE. Do you have that?
Ms. RUSH. Yes.
Amendment offered by Mr. Flake, page 30, line 20——
Chairman HYDE. Without objection, further reading of the Flake amendment is dispensed with, and the gentleman is recognized for 5 minutes in support of his amendment.
[The amendment offered by Mr. Flake follows:]
86302h.eps
Mr. FLAKE. Thank you, Mr. Chairman.
This is quite a simple amendment. It states that if the Global Fund distributes any of these funds toward any government, toward the people of a country whose government is listed on our State Department as sponsors of terrorism, that we not provide any funding in the following year to the Global Fund.
There is nothing in the amendment that prohibits the United States from sending direct aid to any of these countries or the people in these countries. In fact, the United States has given humanitarian aid to some people in these countries that are listed as state sponsors of terrorism. The key difference here is that the Global Fund is giving aid directly through the governments of these countries. My amendment simply says that it is inappropriate that American taxpayer dollars be used to help fund the hand that terrorizes us.
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My amendment doesn't necessarily decrease the amount of funds that go to HIV/AIDS treatment or prevention, and if the Global Fund insists on funding state-sponsored terrorism, the United States could simply shift money elsewhere that would have gone to the Global Fund into direct bilateral or direct aid. The money could still go to HIV treatment. It simply says that it shouldn't be distributed through the Global Fund because the Global Fund deals directly with governments.
With that, I yield back.
Mr. PAYNE. If the gentleman would yield——
Mr. LANTOS. I am happy to yield to my friend, once I am recognized.
Mr. PAYNE. I would like to know what countries. I have been trying to get your amendment straight. Could you tell me the countries that you have in mind? That might make it easier.
Mr. FLAKE. Well, the State Department has a list of countries.
Chairman HYDE. Without objection, the gentleman is granted an additional 2 minutes. Go ahead.
Mr. FLAKE. There are seven countries listed as state sponsors of terrorism: Iran, Iraq, Syria, Libya, Cuba, North Korea and Sudan. In the past I believe the Global Fund has distributed funding through Iran, North Korea and the Sudan.
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Mr. LANTOS. Mr. Chairman?
Chairman HYDE. The Chair recognizes Mr. Lantos.
Mr. LANTOS. Mr. Chairman, I am deeply concerned about the amendment offered by my friend from Arizona, and I have a substitute at the desk, and I ask its consideration at this time.
Chairman HYDE. The clerk will designate the substitute.
Ms. RUSH. Amendment offered by Mr. Lantos to the amendment offered by Mr. Flake. Page 1, beginning——
Chairman HYDE. Without objection, further reading is dispensed with. The gentleman is recognized for 5 minutes in support of his substitute amendment.
[The amendment to the amendment offered by Mr. Lantos follows:]
86302i.eps
Mr. LANTOS. Mr. Chairman, I understand that the gentleman from Arizona is concerned that amounts authorized by this bill could go to terrorist governments. Of course, as I have said, the HIV/AIDS pandemic is a humanitarian crisis that crosses borders without discrimination as to what kind of government is in control of a country. In fact, people may be suffering more in those countries because of the nature of the governments that support terrorism.
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My second degree amendment would assure that the United States' contribution to the Global Fund be reduced by the amount spent during the previous year by the fund in countries that have been designated by the United States as state sponsors of terrorism. I think this is an appropriate and proportional response to the problem identified by my friend from Arizona, and I urge all of my colleagues to support this second degree amendment.
Chairman HYDE. The Chair recognizes Mr. Leach.
Mr. LEACH. Well, this is an issue that has caught me by surprise, but I will say that I think it appears that Mr. Lantos' amendment is preferable to the underlying amendment. I would urge the support of Mr. Lantos' amendment, but the defeat of both. The reason is self-evident. If you take each of these individual countries, and let's take Iran, for instance, Iran is a country that I don't think there are any Americans that support its state-sponsored terrorism against Israel. It is repugnant.
On the other hand, we are dealing with an issue that is about life and death for individuals contracting a disease. If the Congress wants to go on record saying that a given type of people should not get sympathetic support—and there is no substitute here, I want to make it clear. The United States is unlikely to be giving direct assistance to Iran if the Global Fund cannot give assistance to Iran. So the underlying amendment, as well as the substitute, has this dilemma.
I think there are some issues in international affairs that are government to government, and some are people to people. This bill is profoundly a people-to-people issue, despite the governments that might be terrifyingly irrational and terrifying in policies such as terrorism.
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So, I would urge that the Lantos amendment be accepted over the underlying amendment simply because it is less draconian, but both amendments be defeated.
Mr. FLAKE. Would the gentleman yield?
Mr. LEACH. I would be happy to yield, yes.
Mr. FLAKE. I tried to draw the distinction here. This does not prohibit, although it may be unlikely, that we would enter into agreement, although it is not that unlikely that we would work with an NGO in Iran. It doesn't prohibit that. It doesn't even reduce the amount of money that would be available for that.
The difficulty with the Global Fund is that it works government to government—it works through governments, and what we are saying here is if our own State Department has identified these governments as state sponsors of terrorism, it is probably not the best idea to spend taxpayer dollars giving it to those governments directly.
Mr. LEACH. You have a point, although I am not 100 percent of the premise; that is, I am not sure the Global Fund doesn't also work in both directions. I don't think it is exclusively government to government. I may be in error on that. Even if I am in error, I don't find this a compelling approach, although the issue the gentleman has raised is certainly profound. As a general thing, anything we can do that undercuts the precept of terrorism we should do.
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On the other hand, this is people to people. I don't see any sense that it will assist us in causing a government to change its policies, and I see lots of reasons why money sent to peoples of countries with irrational policies when confronted with this type of decision will be more likely to support an irrational government, rather than less likely. So I would assert the precept of people-to-people sympathy over any other consideration at this time.
Chairman HYDE. Mr. Berman.
Mr. BERMAN. Mr. Chairman, first I would ask the author of the substitute if he would accept, and perhaps by unanimous consent, an amendment to his second degree amendment that would indicate an amount equal to the amount expended by the fund to the government of each such country.
The reason I just insert the words ''to the government of each such country'' is because contrary to what my friend from Arizona has said, there are Global Fund programs with NGOs in these countries that I don't think he would argue or anyone would argue should be discontinued. Therefore, in the context of this substitute, I think we should reduce the dollar amount to the extent they are giving to the governments.
Mr. LANTOS. If my friend will yield?
Mr. BERMAN. I yield.
Mr. LANTOS. I am more than happy to accept my friend's suggestion. In his typical fashion he improves on the product, and I think with his modification, the substitute is far more to my liking.
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Chairman HYDE. Would the gentleman from California Mr. Berman yield?
Mr. BERMAN. Yes, I would, Mr. Chairman.
Chairman HYDE. Taking Mr. Lantos' amendment and looking at the last line, you want to take the word ''for'' and strike it and put ''to the government of.''
Mr. BERMAN. That is exactly what I would like to do, Mr. Chairman. I ask unanimous consent that that amendment be included in the substitute.
Chairman HYDE. Any further discussion? If not——
Mr. FLAKE. I am prepared to accept the Lantos amendment with the amendment.
Chairman HYDE. Very well. Mr. Flake accepts it, and without objection, the modification is agreed to.
[The perfected amendment offered by Mr. Berman follows:]
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Mr. BERMAN. Mr. Chairman, I haven't finished my time, if I might.
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Chairman HYDE. Surely. Your time.
Mr. BERMAN. I just want to ask my friend from Arizona, do you find it at all incongruous that you, as the proponent and really eloquent supporter of striking down travel bans and economic embargoes to one of the countries on the terrorist list, now seek to prohibit AIDS funding to any country on the terrorist list, selling food, selling machinery, but don't let the Global Fund donate money? In other words, I guess the ultimate point is we have come to a point where even those of us who believe in the use of economic sanctions and economic embargoes accept that food and medicine should be excluded from them. This is simply about the Global Fund's ability to carry on AIDS prevention and AIDS treatment in these countries, and I was so surprised to see this amendment come from you, a person who is articulate, I thought some very interesting principles generally about trade, and particularly to one of the countries on the terrorist list.
Mr. FLAKE. If the gentleman would yield, I am glad you raised that point. I was hoping somebody would so I wouldn't have to. I am a big proponent of normalizing trade relations with Cuba, one of those countries on that list, for precisely that reason. I think that our policy over the years has aided and abetted the dictator in that country for far too long, and that people-to-people contact is what we need.
I would not suggest that we give money directly in any form to the Government of Cuba. That is exactly what we are trying to avoid here with the other countries listed.
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Chairman HYDE. The question occurs on the Lantos substitute——
Mr. BROWN. Mr. Chairman, to your left?
Chairman HYDE. Mr. Brown.
Mr. BROWN. Mr. Chairman, thank you.
I have one question concerning this, if the gentleman would be able to answer this question. My understanding is your amendment, coupled with the Lantos amendment and the Berman refining of that amendment, deals with government money, government-to-government money, in those cases where the Global Fund provides money to an NGO in one of those countries. Does your amendment speak to that?
Mr. BERMAN. Will the gentleman yield?
Mr. BROWN. I yield to Mr. Berman.
Mr. BERMAN. The purpose of the amendment to Mr. Lantos' amendment was to exclude Global Fund contributions to NGOs or any nongovernmental organizations providing help on AIDS in countries that are on the terrorist list.
Mr. BROWN. Taking back my time, in other words, if an NGO is operating in a country that is on that list, the Global Fund provides money for them, that will not be affected by the Flake-Lantos-Berman perfected amendment.
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Mr. FLAKE. If the gentleman will yield, that is my understanding as well. I mentioned in the introduction that we have already bilateral programs with NGOs in state-sponsored terrorism countries. We simply should not direct that money through governments.
Mr. BROWN. Thank you.
I support the amendment and yield back my time.
Chairman HYDE. I would like to ask the clerk, have we adopted the Berman amendment, changing ''for'' to ''the government of''?
Ms. RUSH. You did a unanimous consent on that.
Chairman HYDE. The question occurs on the Lantos substitute for the Flake amendment as modified. All those in favor, say aye.
Those opposed, nay.
The ayes have it. The amendment is agreed to.
The question now occurs on the Flake amendment as amended. All those in favor, say aye.
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Those opposed, nay.
The ayes have it. The amendment is agreed to.
Are there further amendments?
Chairman HYDE. Ms. McCollum.
Ms. MCCOLLUM. I have amendment 1 at the desk, please.
Chairman HYDE. The clerk will designate amendment 1.
Ms. RUSH. Amendment offered by Ms. McCollum, page 56, line 11. After ''nurse'' insert ''physician's assistants''.
[The amendment offered by Ms. McCollum follows:]
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Chairman HYDE. The gentlewoman is recognized for 5 minutes in support of her amendment.
Ms. MCCOLLUM. It is very simple, a few words. By adding this amendment, many of my colleagues familiar with the physician's assistant program realize they are critical providers of health care here at home and will be an invaluable asset to our overseas pilot program.
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Chairman HYDE. The Chair is prepared to accept the gentlewoman's very useful amendment. Is there any further discussion?
If not, the question occurs on the McCollum amendment. All those in favor, say aye.
Opposed, nay.
The ayes have it. The amendment is agreed to.
The gentlelady is recognized for her second amendment.
Ms. MCCOLLUM. I have amendment 2 at the desk.
Chairman HYDE. The clerk will designate the amendment.
Ms. RUSH. In section (1)(f)(2)(B)(ii)(VII)——
Chairman HYDE. Without objection, further reading is dispensed with, and the gentlewoman is recognized for 5 minutes.
[The amendment offered by Ms. McCollum follows:]
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Ms. MCCOLLUM. Mr. Chairman, I have an amendment that I will be withdrawing, but I would like an opportunity to spend a minute or two talking about it.
Along with the amendment I have provided the clerk with a map. This amendment would add the country of Malawi.
Mr. Chair, the President has designated 12 African countries to target relief. While it is clear that each one of these countries has a tremendous need for resources to prevent HIV/AIDS, as well as caring for people with AIDS and orphans with AIDS, there are many nations who will not receive this. I bring this forward because there are 850,000 Malawians who are currently living with HIV and dying of AIDS.
Mr. Chairman, Malawi shares borders with Tanzania, Mozambique and Zimbabwe. We are creating an island of infection by not having this country included. I would urge as we move forward with this bill to work with the President and other interested people to look at considering this country for AIDS funding.
Mr. Chair, with that, thank you very much for your time, the hard work you and Mr. Lantos have put into this bill, and I withdraw the amendment.
Chairman HYDE. I thank the gentlelady.
There is a vote pending on the Floor, so we will stand in recess until after the vote, at which point I would entreat you to return so we can finish this monumental legislation today.
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We stand in recess.
[Recess.]
Chairman HYDE. The Committee will come to order. I have been informed that there is a closed briefing for Members only at 4 o'clock in the House Chamber. In the interest of time, I ask unanimous consent that the very meritorious amendments to be offered by Mrs. Harris dealing with abstinence in a noncontroversial context, and the amendment to be offered by Mrs. Davis dealing with human papilloma virus or cervical cancer, be considered en bloc and be considered adopted. They are noncontroversial. They have been reviewed by everybody. So we can get that out of the way.
[The amendments offered en bloc by Mrs. Harris and Mrs. Davis follow:]
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Mr. LANTOS. Mr. Chairman?
Chairman HYDE. Mr. Lantos.
Mr. LANTOS. Mr. Chairman, we are pleased to accept both of these amendments.
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Chairman HYDE. The authors of both amendments by unanimous consent may put statements in the record at the appropriate place.
Without objection, the two amendments are adopted.
It is the intention of the Chair to do everything possible to complete the consideration of amendments to this bill and move to a vote on final passage prior to the closed briefing at 4 o'clock. It is my fond hope that Members will bear in mind the exigencies of time.
Mr. Pitts is not here, so he waives his opportunity to offer an amendment—oh, Mr. Pitts.
Mr. PITTS. I was just getting the amendment.
Chairman HYDE. Are you ready to proceed?
Mr. PITTS. Yes. I have an amendment at the desk.
Chairman HYDE. The clerk will designate the amendment.
Ms. RUSH. Amendment offered by Mr. Pitts. Page 47, strike line 13 and all that follows——
Chairman HYDE. Without objection, further reading of the amendment is dispensed with, and Mr. Pitts is recognized for 5 minutes in support of his amendment.
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[The amendment offered by Mr. Pitts follows:]
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Mr. PITTS. Thank you, Mr. Chairman.
This is a conscience clause amendment. Rightly or wrongly, some groups believe that providing condoms encourages promiscuity or wrongdoing. The Catholic Church, which may have a conscientious objection to distributing condoms, cares for one in four AIDS patients around the world. To deny them funding would be to ignore a crucial partner in the fight against AIDS.
This amendment acknowledges that faith-based organizations are most often the most effective in preventing the spread of HIV. It would provide protections for faith-based groups, like the Catholic Church, who apply for Federal funds, but who object to distributing condoms as a form of HIV prevention.
This amendment is necessary because of discrimination experienced by faith-based organizations in their quest for Federal funding in the past. In 2001, the Boston Globe reported that USAID had begun a multimillion-dollar project in African mosques and churches partly in the hopes of overcoming religious obstacles to condom use.
USAID in Benin stated that ''certain religious organizations present formidable obstacles to effective AIDS prevention activities. Catholicism, Islam and traditional religions all encourage behaviors that are in effect risky for HIV transmission.''
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So, despite their effectiveness in caring for millions with the disease and working to prevent the spread of it, USAID and other relief organizations continue to disregard the right of faith-based organizations to object to condom distribution. Rather than trying to work with religious organizations that are part of the culture, the public health community has chosen to circumvent them and, as a result, have put people's lives at risk.
This discrimination is unacceptable here at home. Why would we fund it with our money simply because it goes on overseas? The success in Uganda demonstrates the key role that faith-based organizations can play in HIV/AIDS prevention. Mission hospitals were among the first to develop AIDS care and support programs in Uganda. The Protestant Church of Uganda also organized a workshop for bishops and other religious leaders in 1991 and implemented an extensive AIDS education project in many dioceses.
Mainstream faith-based organizations wield enormous influence in Africa. Early and significant mobilization of Ugandan religious leaders and organizations resulted in their active participation in AIDS education and prevention activities. We should at least offer faith-based groups a level playing field when applying for Federal funds. To refuse to do so would ignore an effective part of the battle to save lives and defeat this disease.
So I urge this Committee to adopt this amendment.
Mr. ACKERMAN. If the gentleman would yield, I didn't understand something that Mr. Pitts said. Who did you say encouraged high-risk behavior? At the beginning of your statement, after citing Catholic Relief Services, you cited some groups or some entities as encouraging high-risk behavior. I wanted to know who it was you cited.
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Mr. PITTS. I said in Benin, Catholicism, Islam and traditional religions, this is a quote by USAID in Benin, encourage behaviors that are in effect risky for HIV transmission. That is a close quote.
Mr. ACKERMAN. I am not sure that is accurate.
Mr. PITTS. That is a USAID in Benin statement.
Chairman HYDE. Mr. Lantos.
Mr. LANTOS. Thank you very much, Mr. Chairman.
I am opposed to the amendment offered by my friend from Pennsylvania.
Mr. Chairman, I stand in awe of the very valuable work done by the Catholic Church and its various organizations, both in my own congressional district, throughout the country and throughout the globe, and I am very sympathetic to some of the concerns raised by Mr. Pitts related to matters of conscience. But I would like to note at the outset that I am deeply offended that the Pitts amendment only grants freedom of conscience to faith-based organizations, apparently on the assumption that representatives of other NGOs have no conscience or principles.
I believe it is critical that we acknowledge the conscience of all recipients of U.S. HIV/AIDS money. We must also ensure that the scarce resources are spent effectively and wisely.
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I fully agree with Mr. Pitts that organizations should not be required to violate their principles or beliefs as they relate to HIV/AIDS in order to be eligible for U.S. funds. For instance, if a faith-based organization wants U.S. funds to carry out an abstinence only program, they should be eligible. Similarly, if an American NGO wants to use funds to carry out a condoms only program, that, too, should be allowed.
But I am very concerned that some groups will use the conscience clause offered by Mr. Pitts to implement programs which assertively undermine other approaches to HIV/AIDS prevention and treatment. I am also concerned that groups utilizing one approach to HIV/AIDS prevention and treatment will refuse to refer someone to another organization which offers a different method of HIV/AIDS prevention.
Mr. Chairman, it is critically important that organizations which receive HIV/AIDS funds from the United States work closely together and support each other's work. Abstinence only groups should not use U.S. funds to tell men and women in Ghana that condoms don't work and are morally wrong, and condoms only groups should not use U.S. funds to deny abstinence.
Recipients of U.S. HIV/AIDS money should not undermine approaches to HIV/AIDS that they do not utilize or do not endorse. Recipients must establish a mechanism by which individuals receiving services or information are made aware of other prevention strategies.
Mr. Chairman, we must ensure that organizations support each other's important work overseas in preventing HIV/AIDS transmission and that their respective clients understand all of the options available to them. We cannot afford to fund programs in the same country which tear each other down.
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I strongly urge my colleagues to oppose the Pitts amendment.
Chairman HYDE. Mr. Leach.
Mr. LEACH. Mr. Chairman, I am very sympathetic both to the amendment and to what Mr. Lantos has just said, and I would only suggest that perhaps there is a little bit of a middle ground. I sense the amendment is something that will be very desirable in getting national consensus for this bill, and I don't think that should be underestimated.
I also believe that Mr. Lantos has very fair points. Perhaps a compromise would be to allow the amendment to go forward, and at the same time have report language which very clearly outlines some of the concerns that Mr. Lantos has raised, and to make it clear that there is a desire of the Congress that we not set up dichotomous programs, but we are trying to protect individuals and how they approach this issue.
But my strong sense is from hearing from a number of people that are very desirous of this bill going forward, who believe that unless we incorporate something like this, we might shatter some of the consensus that does exist in communities that might not otherwise be as supportive.
I think the points raised by my distinguished friend have a terrific degree of validity, but the underlying amendment also has some profoundness that the Committee cannot or should not ignore.
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Mr. LANTOS. Will my friend yield?
Mr. LEACH. Of course.
Mr. LANTOS. As always, I deeply appreciate Congressman Leach's comments. I think we occasionally need to face the fact that some items are just not compromisable. I think this is one of those items.
On our part, we are more than prepared to give full authority to faith-based organizations to carry on their work which is effective and respected and admired in their own way, but we simply cannot assume that non-faith-based NGOs somehow are of a lower order of organization, of principle effectiveness. I am afraid Mr. Pitts' amendment, as much as I would like to see compromise, falls into that category.
I also agree with you there is a political issue to be considered here. I am very conscience of it, and I would like to accommodate it. But I would like to ask my good friend from Iowa what specific compromise he is offering, other than expressing his preference for a compromise solution?
Mr. LEACH. Well, my sense is, first of all, that, of course, you are right, that everybody working in this field are probably not only people of principle, of all the people in the world of enormous dedication and fashion and principle, and I don't think the author of the amendment, I am not he, but I think would never assert anything but that.
The compromise that I was suggesting is that we could put in report language a series of concerns about whether or not any recipient organization should preclude someone from going someplace else and to be very open and suggesting options that they might not personally wish to participate in, but to be open and honest in terms of referencing other options that might exist.
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But I think that if we go in the direction of offending the conscience, for example, of a church that represents a quarter of the American people and an extraordinary number of people around the world, I think we are errant. I think if we allow the issue of conscience to be asserted in this kind of framework, which is, I believe in my own mind, extremely well-intended, and I don't think this is anything but a well-intended amendment, we probably would be assisting in getting this bill with the support of virtually all of the body and virtually all of the American communities of interest. To me that is a worthy goal.
Chairman HYDE. The gentlewoman from California, Ms. Lee.
Ms. LEE. Thank you, Mr. Chairman.
First let me say straight up that I oppose this amendment by Mr. Pitts, and I want to associate myself with the remarks of the gentleman from California, Mr. Lantos.
During the negotiations with regard to this bill—and I think, Mr. Leach, what we see now on page 47 in terms of the language that is in the base bill, this is the language that was negotiated by both sides. This is the consensus agreement. I hate to see us now, after discussing this for many weeks, begin to unravel what was agreed upon previously.
Specifically, the language as it is written is very clear in terms of the fact that discrimination cannot occur against any group, and it says also any organization that is eligible to receive this assistance shall not be required as a condition of receiving the assistance to endorse or utilize a multisector approach to combatting HIV/AIDS.
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It is very clear the Catholic Church or any organization, an NGO who has or which has, we believe, a matter of conscience just as the Catholic Church does, would be able to do their work in the proper way that they so see fit.
So, after negotiating this and coming to this compromise, which everyone agreed upon, to me it is very disingenuous to begin to try to unravel these issues and this very delicate negotiation that has taken place, and I urge all Members to consider that as we move forward with this bill.
Chairman HYDE. The gentleman from Indiana, Mr. Pence.
Mr. PENCE. Mr. Chairman, I would be pleased to yield to the gentlewoman from Virginia for a moment or two.
Mrs. DAVIS. Mr. Chairman, I just had a question of Ms. Lee.
The way the language is written on page 47, are you saying the faith-based groups would be allowed to accept the money and not have to be forced to give out the condoms?
Ms. LEE. Absolutely. The way the language is written, the faith-based group could accept the money and provide the type of intervention that they so desire. That is why it says that this bill is not seen as a condition, and the way it is written, of receiving the assistance, and that we don't require them to endorse or utilize a multisectorial approach. It is very clear. That is why we wrote the bill the way we did, to take care of the concerns.
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Mrs. DAVIS. I thank the gentlewoman.
Mr. PENCE. Reclaiming my time, I will be very brief, Mr. Chairman, in the interest of time.
I want to strongly support the Pitts amendment that would provide for this safe harbor. I think we have illustrated today during this markup, Mr. Chairman, that there is a bit of uncertainty about what the language, the agreed-upon language—and I don't remember being invited to that markup, but I understand how the process works—but the agreed-upon language from some prior meeting has arrived at.
But there is obviously confusion. I take the gentlewoman from California at her word, being the person of integrity that she is, that her intention here is to allow for organizations to participate under the act without having to compromise their conscience, and with particular reference to the Catholic Church.
While we sit on Capitol Hill, they are currently caring for one out of every four AIDS patients around the world. While we talk, they do, and making sure they continue to have the ability to do that in a way consistent with their values I think is extremely important.
In closing, I would reflect, Mr. Chairman, on much of the dialogue that we had earlier today about another measure that was offered by the gentleman, Mr. Pitts, and we were told again and again that we are not to impose our values from the United States on people around the world. I think that this conscience clause is all about ensuring that we do not impose a view of or a value system on organizations that are deeply dedicated to helping the infirm.
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With that, I yield back my time.
Chairman HYDE. Is there further discussion?
If not, the question occurs on the amendment offered by Mr. Pitts. The clerk will call the roll.
Ms. RUSH. Mr. Leach.
[No response.]
Ms. RUSH. Mr. Bereuter.
[No response.]
Ms. RUSH. Mr. Smith of New Jersey.
Mr. LEACH. Madam Clerk, did you hear me? I said aye.
Ms. RUSH. I am sorry. Mr. Leach votes yes.
Mr. Smith of New Jersey.
Mr. SMITH OF NEW JERSEY. Yes.
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Ms. RUSH. Mr. Smith votes yes.
Mr. Burton.
[No response.]
Ms. RUSH. Mr. Gallegly.
[No response.]
Ms. RUSH. Ms. Ros-Lehtinen.
[No response.]
Ms. RUSH. Mr. Ballenger.
Mr. BALLENGER. Yes.
Ms. RUSH. Mr. Ballenger votes yes.
Mr. Rohrabacher.
[No response.]
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Ms. RUSH. Mr. Royce.
Mr. ROYCE. Yes.
Ms. RUSH. Mr. Royce votes yes.
Mr. King.
Mr. KING. Yes.
Ms. RUSH. Mr. King votes yes.
Mr. Chabot.
Mr. CHABOT. Yes.
Ms. RUSH. Mr. Chabot votes yes.
Mr. Houghton.
Mr. HOUGHTON. No.
Ms. RUSH. Mr. Houghton votes no.
Mr. McHugh.
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[No response.]
Ms. RUSH. Mr. Tancredo.
Mr. TANCREDO. Yes.
Ms. RUSH. Mr. Tancredo votes yes.
Mr. Paul.
Mr. PAUL. Yes.
Ms. RUSH. Mr. Paul votes yes.
Mr. Smith from Michigan.
[No response.]
Ms. RUSH. Mr. Pitts.
Mr. PITTS. Yes.
Ms. RUSH. Mr. Pitts votes yes.
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Mr. Flake.
Mr. FLAKE. Yes.
Ms. RUSH. Mr. Flake votes yes.
Mrs. Davis.
Mrs. DAVIS. Yes.
Ms. RUSH. Mrs. Davis votes yes.
Mr. Green.
Mr. GREEN. Yes.
Ms. RUSH. Mr. Green votes yes.
Mr. Weller.
Mr. WELLER. Yes.
Ms. RUSH. Mr. Weller votes yes.
Mr. Pence.
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Mr. PENCE. Yes.
Ms. RUSH. Mr. Pence votes yes.
Mr. McCotter.
Mr. MCCOTTER. Yes.
Ms. RUSH. Mr. McCotter votes yes.
Mr. Janklow.
Mr. JANKLOW. Yes.
Ms. RUSH. Mr. Janklow votes yes.
Mrs. Harris.
Mrs. HARRIS. Yes.
Ms. RUSH. Mrs. Harris votes yes.
Ms. RUSH. Mr. Lantos.
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Mr. LANTOS. No.
Ms. RUSH. Mr. Lantos votes no.
Mr. Berman.
Mr. BERMAN. No.
Ms. RUSH. Mr. Berman votes no.
Mr. Ackerman.
Mr. ACKERMAN. No.
Ms. RUSH. Mr. Ackerman votes no.
Mr. Faleomavaega.
[No response.]
Ms. RUSH. Mr. Payne.
Mr. PAYNE. No.
Ms. RUSH. Mr. Payne votes no.
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Mr. Menendez.
Mr. MENENDEZ. No.
Ms. RUSH. Mr. Menendez votes no.
Mr. Brown.
Mr. BROWN. No.
Ms. RUSH. Mr. Brown votes no.
Mr. Sherman.
[No response.]
Ms. RUSH. Mr. Wexler.
Mr. WEXLER. No.
Ms. RUSH. Mr. Wexler votes no.
Mr. Engel.
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Mr. ENGEL. No.
Ms. RUSH. Mr. Engel votes no.
Mr. Delahunt.
[No response.]
Ms. RUSH. Mr. Meeks.
Mr. MEEKS. No.
Ms. RUSH. Mr. Meeks votes no.
Ms. Lee.
Ms. LEE. No.
Ms. RUSH. Ms. Lee votes no.
Mr. Crowley.
Mr. CROWLEY. No.
Ms. RUSH. Mr. Crowley votes no.
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Mr. Hoeffel.
Mr. HOEFFEL. No.
Ms. RUSH. Mr. Hoeffel votes no.
Mr. Blumenauer.
Mr. BLUMENAUER. No.
Ms. RUSH. Mr. Blumenauer votes no.
Ms. Berkley.
Ms. BERKLEY. No.
Ms. RUSH. Ms. Berkley votes no.
Mrs. Napolitano.
Mrs. NAPOLITANO. No.
Ms. RUSH. Mrs. Napolitano votes no.
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Mr. Schiff.
Mr. SCHIFF. No.
Ms. RUSH. Mr. Schiff votes no.
Ms. Watson.
Ms. WATSON. No.
Ms. RUSH. Ms. Watson votes no.
Mr. Smith of Washington.
Mr. SMITH OF WASHINGTON. No.
Ms. RUSH. Mr. Smith of Washington votes no.
Ms. McCollum.
Ms. MCCOLLUM. No.
Ms. RUSH. Ms. McCollum votes no.
Mr. Bell.
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Mr. BELL. No.
Ms. RUSH. Mr. Bell votes no.
Chairman Hyde.
Chairman HYDE. Aye.
Ms. RUSH. Chairman Hyde votes yes.
Chairman HYDE. Mr. Sherman of California.
Mr. SHERMAN. I vote no.
Ms. RUSH. Mr. Sherman votes no.
Chairman HYDE. Mr. Rohrabacher.
Mr. ROHRABACHER. Votes yes.
Chairman HYDE. Mr. Nick Smith.
Mr. SMITH OF MICHIGAN. Yes.
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Ms. RUSH. Mr. Rohrabacher votes yes.
Mr. Smith from Michigan votes yes.
Chairman HYDE. Mr. Bereuter.
Mr. BEREUTER. Mr. Chairman, I am voting yes.
Ms. RUSH. Mr. Bereuter votes yes.
Chairman HYDE. Have all voted who wish?
Mr. BERMAN. Mr. Chairman, am I recorded?
Chairman HYDE. Mr. Berman?
Ms. RUSH. You are recorded as voting no.
Mr. LANTOS. Mr. Chairman, how am I recorded?
Ms. RUSH. Mr. Lantos is recorded as voting no.
Mr. ACKERMAN. Mr. Chairman, how am I recorded?
Chairman HYDE. Was that Mr. Ackerman?
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Mr. ACKERMAN. Yes.
Chairman HYDE. Mr. Delahunt.
Mr. DELAHUNT. How am I recorded, Mr. Chairman?
Chairman HYDE. I don't think you are recorded.
Mr. DELAHUNT. You are so perceptive. I would like to be recorded, Mr. Chairman.
Chairman HYDE. Very well. How would you like to be recorded?
Mr. DELAHUNT. I would like to be recorded in the negative.
Chairman HYDE. In the negative. If we have such a space on the paper.
Ms. RUSH. Mr. Delahunt votes no.
Mr. DELAHUNT. I will vote no, too.
Chairman HYDE. Have all voted who wish?
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If so, the clerk will report.
Ms. RUSH. On this vote, there were 21 ayes and 23 noes.
Chairman HYDE. And the amendment is not agreed to.
The Chair recognizes for what is the final amendment, and so with great gusto I recognize Mr. Chris Smith.
Mr. SMITH OF NEW JERSEY. Thank you very much, Mr. Chairman. I will be brief, but I do think this is a very, very important amendment. It addresses two of the most heinous practices——
Chairman HYDE. If the gentleman withholds, the clerk will designate the amendment.
Ms. RUSH. Amendment offered by Mr. Smith of New Jersey. Page 47, after line 20——
Chairman HYDE. Without objection, further reading is dispensed with. The gentleman is recognized for 5 minutes in support of his amendment.
[The amendment offered by Mr. Smith of New Jersey follows:]
86302p.eps
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Mr. SMITH OF NEW JERSEY. Thank you very much, Mr. Chairman.
This amendment recognizes two despicable practices, human trafficking and prostitution. Both practices that involve the severe degradation and exploitation of women, the literal rape of countless women around the globe.
The horrors of trafficking, Mr. Chairman, a form of modern-day slavery and prostitution, cannot be understated. I am very saddened to say that as many as 4 million people, mostly women, are bought and sold as forced prostitutes in our world, and millions more suffer in prostitution, usually with an MO in their own lifestyle and own life that is also a tragedy indeed. In addition to being demeaned and forcibly violated, many of these victims suffer from AIDS.
Unfortunately, reports show that human trafficking is on the rise in many African nations, and with this comes the spread of HIV and AIDS. We also know that the fear of HIV and AIDS has caused traffickers to seek younger and younger victims, since young girls are less likely to be infected with this dreaded disease. I was shocked and outraged to learn that in India, some of the trafficking victims are as young as 8 and 9 years old. Last summer I think Members of this Committee who were here for the hearing on the human trafficking report saw the video of dozens of these little girls in India being rescued from prison-like basement dwellings, and were outraged.
Although this comes as a shock to most Americans, in other parts of the world many officials in both government and the private sector who work on these issues feel that legalizing prostitution and focusing primarily on safe sex for victims of trafficking who are being raped every day is a solution. Some actually look at prostitution as a workers' rights issue, and believe it is a legitimate form of employment. Those who advocate these approaches are doing, I would respectfully submit, a grave disservice to women, and it saddens me greatly that the value of women could be so demeaned.
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As the prime sponsor of the Trafficking Victims Protection Act that was signed into law in 2000 by President Clinton, I believe that the United States should do everything within its power to combat and eliminate human trafficking and prostitution. By doing so, we will most certainly, as a direct consequence, mitigate the spread of HIV/AIDS.
My amendment, Mr. Chairman, is clear and simple. It states that no funds made available under this act may be used to provide assistance to any group or organization that does not have a policy explicitly opposing prostitution and sex trafficking.
It does not state that prostitutes and trafficked women should not be treated for AIDS. As a matter of fact, the underlying language in the bill on page 47—and I know there is a perfecting amendment, and it in fact does not perfect, it is a gutting amendment that may be offered momentarily—points out that nothing in this act shall be construed to preclude the provision to individuals of palliative treatment or postexposure pharmaceuticals, including the distribution of condoms, and it goes on, in brothels and places of that sort.
The issue that is before us today is whether or not we will provide money to organizations that seek the legalization of prostitution and also enable the traffickers, and stand side by side with the traffickers and, regrettably, enable them to enslave these women, whether or not we will provide the money to them.
If indeed there are going to be condom distributions in a brothel, which should be seen only as a short-term endeavor, those distributions should not be carried out by a group that is also comprised of the very slavers that have these women and will not let them go. That is an unseemly partnership.
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The perfecting amendment that will be offered in a moment will do just that, completely gut this amendment, and I frankly find it outrageous that we would want to give money to an organization that does that kind of thing. We should find those, like the Red Cross, who are there to help and assist the victimized women who are enslaved by these traffickers, instead of standing toe to toe with the oppressor against the oppressed.
I yield back the balance of my time.
Mr. LANTOS. Mr. Chairman?
Chairman HYDE. Mr. Lantos.
Mr. LANTOS. Mr. Chairman, it pains me to no end to oppose an amendment of my dear friend from New Jersey. He and I respectively at various times as Chairman and Ranking Member of the Human Rights Subcommittee and as active members of the Human Rights Caucus have stood together against trafficking in women, and many of the issues my good friend has mentioned.
But I do not believe his amendment achieves the goal he seeks, and I have an amendment to the gentleman's amendment, and I ask for its immediate consideration.
Chairman HYDE. The clerk will designate the amendment.
Ms. RUSH. Amendment offered by Mr. Lantos to the amendment offered by Mr. Smith of New Jersey. Page 1, line 5——
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Mr. LANTOS. I ask that the amendment be considered as read.
Chairman HYDE. Without objection, so ordered.
[The amendment to the amendment offered by Mr. Lantos follows:]
86302q.eps
Chairman HYDE. The gentleman is recognized for 5 minutes in support of his amendment.
Mr. LANTOS. Mr. Chairman, let me first say that none of us support prostitution as a choice for any person, and all of us strongly oppose sex trafficking. As my good friend from New Jersey knows, I have been a tireless opponent of trafficking in women and children, and we joined together during the last Congress to support the significant increase in U.S. antitrafficking programs.
My problem here is that the gentleman's amendment is overly broad and will lead to unintended consequences, and it upsets the careful balance in the Hyde en bloc amendments that we adopted earlier today.
The vast majority of organizations that will receive funding under this act have nothing to do with prostitution or sex trafficking. They provide HIV/AIDS assistance to rural villages and do not provide services to prostitutes or victims of sex trafficking. Asking them to adopt such a policy is nonsensical.
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Moreover, some of these groups may have bylaws that prohibit them from adopting positions on specific policy matters. Many groups, particularly nations without freedom of speech, deliberately seek to stay out of political fights. The gentleman's amendment will cut off funding to such groups.
Finally, groups that work with prostitutes may have no policy one way or the other regarding the legalization of prostitution and may believe that explicitly adopting one may decrease their access to these vulnerable populations.
This amendment may consign victims of prostitution and sex trafficking to contracting HIV/AIDS and eventual death, and I truly believe that such language is singularly unhelpful.
I agree with my friend from New Jersey that we need to support programs to get them out of prostitution, that we need to prevent trafficking in women and children, we need to punish those elements of organized crime who perpetrate heinous abuses against women and children. In the meantime, however, we must try to prevent individuals from the life-threatening effects of HIV/AIDS. My good friend's amendment is likely to cut off groups that could save countless lives, countless lives among this extremely vulnerable population.
My substitute amendment provides that groups can still provide the necessary services to these extremely vulnerable populations. This language is identical to language already adopted unanimously by the Committee, and I hope that the author can accept this.
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Thank you, Mr. Chairman.
Chairman HYDE. Is there further discussion?
Mr. SMITH OF NEW JERSEY. If I could just respond briefly?
Chairman HYDE. The gentleman from New Jersey.
Mr. SMITH OF NEW JERSEY. This language is not identical because it is gutting the language that is pending before this Committee, and the key different is that the language offered by Mr. Hyde was adopted as a manager's amendment. You said that we are talking about individuals. Your amendment doesn't say groups or organizations in the way that our language does. So there is a difference.
Let me say to my colleagues, I hope this doesn't break down to a partisan vote if we are serious about ending the enabling collaboration and promotion of human trafficking and prostitution. Many organizations do believe that sex trafficking and especially prostitution are legitimate deals, and in many of the places, including the Netherlands, where mostly out-of-country women create about 5 percent of the GDP from this kind of activity, 80 percent of the women trafficked, and they are called legitimate prostitutes by the Dutch Government, are coming from other countries. They are not coming in there saying, I want to sign up for this. Many of them, we don't know the exact number, have been forcibly trafficked into this. There are groups that believe that prostitution ought to be legalized. In some countries like the Netherlands it is. We ought to be liberating these women, not legalizing their continued degradation.
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I would just say to my colleague that when it comes to the amount of money that we want to provide, we are in solidarity. We need to get this money out through an effective means to help all people at risk of AIDS. But helping a group that stands side by side with the traffickers and those who run the brothels is a grave mistake, and it will only continue under this perfecting amendment.
Mr. LANTOS. Will my friend yield?
Mr. SMITH OF NEW JERSEY. I will yield.
Mr. LANTOS. In a few minutes we will have a briefing on the Floor of the House. I think all of us have made up our minds on this issue. Let me just make one observation.
This is not a Democratic or Republican issue. Neither side nor any Member of this Committee has a higher moral ground than any other Member of this Committee. I think it is important we deal with this issue in a spirit of mutual respect for our various positions.
I ask for a vote, Mr. Chairman.
Chairman HYDE. The Chair would like to honor your request, if Ms. Lee will defer.
Would you defer?
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Ms. LEE. I will defer if we are going to have a vote.
Chairman HYDE. Thank you very much.
The question occurs on the Lantos perfecting amendment to the Smith amendment. The clerk will call the roll.
Ms. RUSH. Mr. Leach.
Mr. LEACH. Yes.
Ms. RUSH. Mr. Leach votes yes.
Mr. Bereuter.
Mr. BEREUTER. No.
Ms. RUSH. Mr. Bereuter votes no.
Mr. Smith of New Jersey.
Mr. SMITH OF NEW JERSEY. No.
Ms. RUSH. Mr. Smith of New Jersey votes no.
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Mr. Burton.
Mr. BURTON. No.
Ms. RUSH. Mr. Burton votes no.
Mr. Gallegly.
Mr. GALLEGLY. No.
Ms. RUSH. Mr. Gallegly votes no.
Ms. Ros-Lehtinen.
[No response.]
Ms. RUSH. Mr. Ballenger.
Mr. BALLENGER. No.
Ms. RUSH. Mr. Ballenger votes no.
Mr. Rohrabacher.
Mr. ROHRABACHER. No.
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Ms. RUSH. Mr. Rohrabacher votes no.
Mr. Royce.
Mr. ROYCE. No.
Ms. RUSH. Mr. Royce votes no.
Mr. King.
Mr. KING. No.
Ms. RUSH. Mr. King votes no.
Mr. Chabot.
Mr. CHABOT. No.
Ms. RUSH. Mr. Chabot votes no.
Mr. Houghton.
Mr. HOUGHTON. No.
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Ms. RUSH. Mr. Houghton votes no.
Mr. McHugh.
[No response.]
Ms. RUSH. Mr. Tancredo.
Mr. TANCREDO. No.
Ms. RUSH. Mr. Tancredo votes no.
Mr. Paul.
Mr. PAUL. No.
Ms. RUSH. Mr. Paul votes no.
Mr. Smith of Michigan.
[No response.]
Ms. RUSH. Mr. Pitts.
Mr. PITTS. No.
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Ms. RUSH. Mr. Pitts votes no.
Mr. Flake.
Mr. FLAKE. No.
Ms. RUSH. Mr. Flake votes no.
Mrs. Davis.
Mrs. DAVIS. No.
Ms. RUSH. Mrs. Davis votes no.
Mr. Green.
Mr. GREEN. No.
Ms. RUSH. Mr. Green votes no.
Mr. Weller.
Mr. WELLER. No.
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Ms. RUSH. Mr. Weller votes no.
Mr. Pence.
Mr. PENCE. No.
Ms. RUSH. Mr. Pence votes no.
Mr. McCotter.
Mr. MCCOTTER. No.
Ms. RUSH. Mr. McCotter votes no.
Mr. Janklow.
[No response.]
Ms. RUSH. Mrs. Harris.
Mrs. HARRIS. No.
Ms. RUSH. Mrs. Harris votes no.
Mr. Lantos.
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Mr. LANTOS. Yes.
Ms. RUSH. Mr. Lantos votes yes.
Mr. Berman.
Mr. BERMAN. Yes.
Ms. RUSH. Mr. Berman votes yes.
Mr. Ackerman.
Mr. ACKERMAN. Yes.
Ms. RUSH. Mr. Ackerman votes yes.
Mr. Faleomavaega.
[No response.]
Ms. RUSH. Mr. Payne.
Mr. PAYNE. Yes.
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Ms. RUSH. Mr. Payne votes yes.
Mr. Menendez.
Mr. MENENDEZ. Yes.
Ms. RUSH. Mr. Menendez votes yes.
Mr. Brown.
Mr. BROWN. Yes.
Ms. RUSH. Mr. Brown votes yes.
Mr. Sherman.
[No response.]
Ms. RUSH. Mr. Wexler.
Mr. WEXLER. Yes.
Ms. RUSH. Mr. Wexler votes yes.
Mr. Engel.
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Mr. ENGEL. Yes.
Ms. RUSH. Mr. Engel votes yes.
Mr. Delahunt.
Mr. DELAHUNT. Yes.
Ms. RUSH. Mr. Delahunt votes yes.
Mr. Meeks.
Mr. MEEKS. Yes.
Ms. RUSH. Mr. Meeks votes yes.
Ms. Lee.
Ms. LEE. Yes.
Ms. RUSH. Ms. Lee votes yes.
Mr. Crowley.
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Mr. CROWLEY. Yes.
Ms. RUSH. Mr. Crowley votes yes.
Mr. Hoeffel.
Mr. HOEFFEL. Yes.
Ms. RUSH. Mr. Hoeffel votes yes.
Mr. Blumenauer.
Mr. BLUMENAUER. Yes.
Ms. RUSH. Mr. Blumenauer votes yes.
Ms. Berkley.
Ms. BERKLEY. Yes.
Ms. RUSH. Ms. Berkley votes yes.
Mrs. Napolitano.
Mrs. NAPOLITANO. Yes.
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Ms. RUSH. Mrs. Napolitano votes yes.
Mr. Schiff.
Mr. SCHIFF. Yes.
Ms. RUSH. Mr. Schiff votes yes.
Ms. Watson.
Ms. WATSON. Yes.
Ms. RUSH. Ms. Watson votes yes.
Mr. Smith of Washington.
Mr. SMITH OF WASHINGTON. Yes.
Ms. RUSH. Mr. Smith of Washington votes yes.
Ms. McCollum.
Ms. MCCOLLUM. Yes.
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Ms. RUSH. Ms. McCollum votes yes.
Mr. Bell.
[No response.]
Ms. RUSH. Chairman Hyde.
Chairman HYDE. No.
Ms. RUSH. Chairman Hyde votes no.
Mr. Janklow.
Mr. JANKLOW. No.
Ms. RUSH. Mr. Janklow votes no.
Chairman HYDE. Have all voted who wish?
Mr. LANTOS. Mr. Chairman, how am I recorded?
Ms. RUSH. Mr. Lantos is recorded as voting yes.
Chairman HYDE. Mr. Chabot.
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Mr. CHABOT. I have already voted. I voted no.
Chairman HYDE. He has voted no.
Mr. BERMAN. Mr. Chairman, I was wondering if I could inquire how I am recorded.
Chairman HYDE. How is the gentleman recorded?
Ms. RUSH. Mr. Berman is recorded as voting yes.
Ms. LEE. Mr. Chairman?
Chairman HYDE. The gentlewoman from California.
Ms. LEE. Mr. Chairman, how am I recorded?
Ms. RUSH. Ms. Lee is recorded as voting yes.
Mr. PAYNE. Mr. Chairman, how am I recorded?
Ms. RUSH. Mr. Payne is recorded as voting yes.
Mr. SMITH OF NEW JERSEY. Mr. Chairman, it is obvious they are delaying. I would ask that the Chairman call the vote.
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Chairman HYDE. Well, I would prefer to think they just have a collective memory lapse, but the clerk will report.
Mr. MENENDEZ. Mr. Chairman?
Chairman HYDE. The clerk will report.
Who is seeking recognition? I can't recognize the voice.
Mr. ACKERMAN. We are all part of that collective then.
Chairman HYDE. I recognize the flower.
Mr. ACKERMAN. Mr. Chairman, am I recorded?
Chairman HYDE. I haven't the foggiest idea, but it is too late now.
Could we have the count, please?
Mr. ACKERMAN. I think I would like an answer to the question, Mr. Chairman.
Chairman HYDE. Probably. You are probably recorded.
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Mr. ACKERMAN. Could I ask how I am recorded?
Ms. RUSH. We are checking how he is recorded.
Mr. ACKERMAN. Mr. Chairman, how am I recorded?
Chairman HYDE. We are trying to find out.
Mr. ACKERMAN. I think they are trying to do something else, Mr. Chairman.
Ms. RUSH. You are recorded as voting yes.
Mr. ACKERMAN. Thank you. I appreciate that.
Chairman HYDE. Did you wish to change your vote?
Mr. ACKERMAN. Well, maybe we can discuss it for a while.
Chairman HYDE. The clerk will report.
Ms. RUSH. The vote on this vote, there are 21 ayes and 22 noes.
Chairman HYDE. And the Lantos perfecting amendment is not agreed to.
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The question occurs on the Smith amendment. All those in favor——
Mr. BERMAN. Mr. Chairman, on the Smith amendment, could I ask a question of the author of the amendment?
Chairman HYDE. Surely.
Mr. BERMAN. I wonder if the author could tell me, is this an amendment that is in any way designed to restrict or limit the ability of an organization to provide AIDS treatment to someone who had been engaged in prostitution?
Mr. SMITH OF NEW JERSEY. The purpose of this is,—and the language that immediately preceded my amendment makes it clear—that the money provided in the bill would help women who perhaps are in a brothel, through condom distribution within that venue. But we are asking that organizations that seek to provide that kind of assistance make it clear that they are not trying to legalize prostitution or legalize sex trafficking, which is obviously a heinous practice.
Mr. BERMAN. But in no way would it limit the assistance because they were trying to provide assistance to people, to women, in that situation.
Mr. SMITH OF NEW JERSEY. As I just stated, that is what it would do.
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Mr. BERMAN. There is no restriction—there may be a restriction on who can get the money, but there is no restriction on who can get the assistance?
Mr. SMITH OF NEW JERSEY. The organizations are the ones that would be precluded funding under this bill pursuant to this language.
Mr. BERMAN. Not because——
Chairman HYDE. The Chair has indulged this.
Mr. BERMAN. Let me just, I really——
Chairman HYDE. Go ahead.
Mr. BERMAN. I am just trying to understand. It is not a limitation on the organization receiving money because they are trying to provide assistance to this group of people. It is about what their policy is.
Mr. SMITH OF NEW JERSEY. Exactly.
Chairman HYDE. The question occurs on the Smith amendment. All those in favor, say aye.
Opposed, nay.
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Well, in the opinion of the Chair, ayes have it.
Mr. LANTOS. I request a recorded vote.
Chairman HYDE. The clerk will call the roll.
Ms. RUSH. Mr. Leach.
Mr. LEACH. Yes.
Ms. RUSH. Mr. Leach votes yes.
Mr. Bereuter.
Mr. BEREUTER. Yes.
Ms. RUSH. Mr. Bereuter votes yes.
Mr. Smith of New Jersey.
Mr. SMITH OF NEW JERSEY. Yes.
Ms. RUSH. Mr. Smith of New Jersey votes yes.
Mr. Burton.
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Mr. BURTON. Yes.
Ms. RUSH. Mr. Burton votes yes.
Mr. Gallegly.
Mr. GALLEGLY. Yes.
Ms. RUSH. Mr. Gallegly votes yes.
Ms. Ros-Lehtinen.
[No response.]
Ms. RUSH. Mr. Ballenger.
Mr. BALLENGER. Yes.
Ms. RUSH. Mr. Ballenger votes yes.
Mr. Rohrabacher.
Mr. ROHRABACHER. Yes.
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Ms. RUSH. Mr. Rohrabacher votes yes.
Mr. Royce.
Mr. ROYCE. Yes.
Ms. RUSH. Mr. Royce votes yes.
Mr. King.
Mr. KING. Yes.
Ms. RUSH. Mr. King votes yes.
Mr. Chabot.
Mr. CHABOT. Yes.
Ms. RUSH. Mr. Chabot votes yes.
Mr. Houghton.
Mr. HOUGHTON. Yes.
Ms. RUSH. Mr. Houghton votes yes.
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Mr. McHugh.
[No response.]
Ms. RUSH. Mr. Tancredo.
Mr. TANCREDO. Yes.
Ms. RUSH. Mr. Tancredo votes yes.
Mr. Paul.
Mr. PAUL. Yes.
Ms. RUSH. Mr. Paul votes yes.
Mr. Smith of Michigan.
Mr. SMITH OF MICHIGAN. Yes.
Ms. RUSH. Mr. Smith of Michigan votes yes.
Mr. Pitts.
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Mr. PITTS. Yes.
Ms. RUSH. Mr. Pitts votes yes.
Mr. Flake.
Mr. FLAKE. Yes.
Ms. RUSH. Mr. Flake votes yes.
Mrs. Davis.
Mrs. DAVIS. Yes.
Ms. RUSH. Mrs. Davis votes yes.
Mr. Green.
Mr. GREEN. Yes.
Ms. RUSH. Mr. Green votes yes.
Mr. Weller.
Mr. WELLER. Yes.
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Ms. RUSH. Mr. Weller votes yes.
Mr. Pence.
Mr. PENCE. Yes.
Ms. RUSH. Mr. Pence votes yes.
Mr. McCotter.
Mr. MCCOTTER. Yes.
Ms. RUSH. Mr. McCotter votes yes.
Mr. Janklow.
Mr. JANKLOW. Yes.
Ms. RUSH. Mr. Janklow votes yes.
Mrs. Harris.
Mrs. HARRIS. Yes.
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Ms. RUSH. Mrs. Harris votes yes.
Mr. Lantos.
Mr. LANTOS. I pass.
Ms. RUSH. Mr. Lantos passes.
Mr. Berman.
Mr. BERMAN. No.
Ms. RUSH. Mr. Berman votes no.
Mr. Ackerman.
Mr. ACKERMAN. I believe I am going to pass for now and think this over for a while.
Ms. RUSH. Mr. Ackerman passes.
Mr. Faleomavaega.
[No response.]
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Ms. RUSH. Mr. Payne?
Mr. PAYNE. Following the gentleman from New York, I will think it over and pass.
Ms. RUSH. Mr. Payne passes.
Mr. Menendez?
Mr. MENENDEZ. Pass.
Ms. RUSH. Mr. Menendez passes.
Mr. Brown?
[No response.]
Ms. RUSH. Mr. Sherman.
[No response.]
Ms. RUSH. Mr. Wexler.
Mr. WEXLER. No.
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Ms. RUSH. Mr. Wexler votes no.
Mr. Engel.
[No response.]
Ms. RUSH. Mr. Delahunt.
Mr. DELAHUNT. Pass.
Ms. RUSH. Mr. Delahunt passes.
Mr. Meeks.
Mr. MEEKS. Pass.
Ms. RUSH. Mr. Meeks passes.
Ms. Lee?
Ms. LEE. Pass.
Ms. RUSH. Ms. Lee passes.
Mr. Crowley.
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Mr. CROWLEY. Pass.
Ms. RUSH. Mr. Crowley passes.
Mr. Hoeffel.
Mr. HOEFFEL. Pass.
Ms. RUSH. Mr. Hoeffel passes.
Mr. Blumenauer.
Mr. BLUMENAUER. No.
Ms. RUSH. Mr. Blumenauer votes no.
Ms. Berkley.
[No response.]
Ms. RUSH. Mrs. Napolitano.
Mrs. NAPOLITANO. Pass.
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Ms. RUSH. Mrs. Napolitano passes.
Mr. Schiff.
Mr. SCHIFF. Pass.
Ms. RUSH. Mr. Schiff passes.
Ms. Watson.
Ms. WATSON. No.
Ms. RUSH. Ms. Watson passes.
Mr. Smith of Washington.
Mr. SMITH OF WASHINGTON. No.
Ms. RUSH. Mr. Smith of Washington votes no.
Ms. McCollum.
Ms. MCCOLLUM. No.
Ms. RUSH. Ms. McCollum votes no.
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Mr. Bell.
Mr. BELL. No.
Ms. RUSH. Mr. Bell votes no.
Chairman Hyde.
Chairman HYDE. Yes.
Ms. RUSH. Chairman Hyde votes yes.
Chairman HYDE. Have all voted who wish?
Mr. MENENDEZ. Mr. Chairman, how am I recorded?
Mr. SHERMAN. I wish to vote.
Chairman HYDE. Who wishes to vote?
Mr. Engel?
Mr. ENGEL. Thank you, Mr. Chairman. I vote no.
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Ms. RUSH. Mr. Engel votes no.
Chairman HYDE. Mr. Crowley.
Mr. CROWLEY. No.
Ms. RUSH. Mr. Crowley votes no.
Chairman HYDE. Ms. Lee.
Ms. LEE. No.
Ms. RUSH. Ms. Lee votes no.
Chairman HYDE. Mr. Meeks.
Mr. MEEKS. No.
Ms. RUSH. Mr. Meeks votes no.
Chairman HYDE. Mr. Delahunt.
Mr. DELAHUNT. No.
Ms. RUSH. Mr. Delahunt votes no.
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Chairman HYDE. Mr. Hoeffel.
Mr. HOEFFEL. No.
Ms. RUSH. Mr. Hoeffel votes no.
Chairman HYDE. Mr. Brown.
Mr. BROWN. Could you tell me how I am recorded?
Ms. RUSH. Mr. Brown is not recorded.
Mr. BROWN. I vote no.
Ms. RUSH. Mr. Brown votes no.
Chairman HYDE. Mr. Lantos.
Mr. LANTOS. I also vote no, Mr. Chairman.
Ms. RUSH. Mr. Lantos votes no.
Chairman HYDE. Mr. Payne.
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Mr. PAYNE. No.
Ms. RUSH. Mr. Payne votes no.
Chairman HYDE. I see an arm. Mr. Menendez.
Mr. MENENDEZ. No.
Ms. RUSH. Mr. Menendez votes no.
Chairman HYDE. Ms. Berkley.
Ms. BERKLEY. No.
Ms. RUSH. Ms. Berkley votes no.
Chairman HYDE. Mr. Sherman.
Mr. SHERMAN. No.
Ms. RUSH. Mr. Sherman votes no.
Chairman HYDE. Mr. Schiff.
Mr. SCHIFF. No.
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Ms. RUSH. Mr. Schiff votes no.
Chairman HYDE. Mrs. Napolitano.
Mrs. NAPOLITANO. No.
Ms. RUSH. Mrs. Napolitano votes no.
Chairman HYDE. Mr. Ackerman.
Mr. ACKERMAN. No.
Ms. RUSH. Mr. Ackerman votes no.
Chairman HYDE. The clerk will report.
Ms. RUSH. On this vote there are 24 ayes and 22 noes.
Chairman HYDE. And the amendment is agreed to.
The question occurs on the motion to report the bill H.R. 1298 favorably as amended. All in favor, say aye.
Opposed, nay.
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The ayes have it, and the motion to report favorably is adopted. Without objection——
Mr. LEACH. Mr. Chairman, I request a recorded vote.
Chairman HYDE. A recorded vote has been requested. The clerk will call the roll.
Ms. RUSH. Mr. Leach.
Mr. LEACH. Yes.
Ms. RUSH. Mr. Leach votes yes.
Mr. Bereuter.
Mr. BEREUTER. Yes.
Ms. RUSH. Mr. Bereuter votes yes.
Mr. Smith of New Jersey.
Mr. SMITH OF NEW JERSEY. Yes.
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Ms. RUSH. Mr. Smith of New Jersey votes yes.
Mr. Burton.
Mr. BURTON. Yes.
Ms. RUSH. Mr. Burton votes yes.
Mr. Gallegly.
Mr. GALLEGLY. Yes.
Ms. RUSH. Mr. Gallegly votes yes.
Ms. Ros-Lehtinen.
[No response.]
Ms. RUSH. Mr. Ballenger.
Mr. BALLENGER. Yes.
Ms. RUSH. Mr. Ballenger votes yes.
Mr. Rohrabacher.
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[No response.]
Ms. RUSH. Mr. Royce.
Mr. ROYCE. Yes.
Ms. RUSH. Mr. Royce votes yes.
Mr. King.
Mr. KING. Yes.
Ms. RUSH. Mr. King votes yes.
Mr. Chabot.
Mr. CHABOT. Pass.
Ms. RUSH. Mr. Chabot passes.
Mr. Houghton.
Mr. HOUGHTON. Yes.
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Ms. RUSH. Mr. Houghton votes yes.
Mr. McHugh.
[No response.]
Ms. RUSH. Mr. Tancredo.
Mr. TANCREDO. Pass.
Ms. RUSH. Mr. Tancredo passes.
Mr. Paul.
Mr. PAUL. No.
Ms. RUSH. Mr. Paul votes no.
Mr. Smith of Michigan.
Mr. SMITH OF MICHIGAN. No.
Ms. RUSH. Mr. Smith of Michigan votes no.
Mr. Pitts.
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Mr. PITTS. No.
Ms. RUSH. Mr. Pitts votes no.
Mr. Flake.
Mr. FLAKE. No.
Ms. RUSH. Mr. Flake votes no.
Mrs. Davis.
Mrs. DAVIS. No.
Ms. RUSH. Mrs. Davis votes no.
Mr. Green.
Mr. GREEN. Yes.
Ms. RUSH. Mr. Green votes yes.
Mr. Weller.
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Mr. WELLER. Yes.
Ms. RUSH. Mr. Weller votes yes.
Mr. Pence.
Mr. PENCE. No.
Ms. RUSH. Mr. Pence votes no.
Mr. McCotter.
Mr. MCCOTTER. Yes.
Ms. RUSH. Mr. McCotter votes yes.
Mr. Janklow.
Mr. JANKLOW. Yes.
Ms. RUSH. Mr. Janklow votes yes.
Mrs. Harris.
Mrs. HARRIS. Yes.
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Ms. RUSH. Mrs. Harris votes yes.
Mr. Lantos.
Mr. LANTOS. Yes.
Ms. RUSH. Mr. Lantos votes yes.
Mr. Berman.
Mr. BERMAN. Yes.
Ms. RUSH. Mr. Berman votes yes.
Mr. Ackerman.
Mr. ACKERMAN. Yes.
Ms. RUSH. Mr. Ackerman votes yes.
Mr. Faleomavaega.
[No response.]
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Ms. RUSH. Mr. Payne.
Mr. PAYNE. Yes.
Ms. RUSH. Mr. Payne votes yes.
Mr. Menendez.
Mr. MENENDEZ. Yes.
Ms. RUSH. Mr. Menendez votes yes.
Mr. Brown.
Mr. BROWN. Yes.
Ms. RUSH. Mr. Brown votes yes.
Mr. Sherman.
Mr. SHERMAN. Yes.
Ms. RUSH. Mr. Sherman votes yes.
Mr. Wexler.
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Mr. WEXLER. Yes.
Ms. RUSH. Mr. Wexler votes yes.
Mr. Engel.
Mr. ENGEL. Yes.
Ms. RUSH. Mr. Engel votes yes.
Mr. Delahunt.
Mr. DELAHUNT. Yes.
Ms. RUSH. Mr. Delahunt votes yes.
Mr. Meeks.
Mr. MEEKS. Yes.
Ms. RUSH. Mr. Meeks votes yes.
Ms. Lee.
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Ms. LEE. Yes.
Ms. RUSH. Ms. Lee votes yes.
Mr. Crowley.
Mr. CROWLEY. Yes.
Ms. RUSH. Mr. Crowley votes yes.
Mr. Hoeffel.
Mr. HOEFFEL. Yes.
Ms. RUSH. Mr. Hoeffel votes yes.
Mr. Blumenauer.
[No response.]
Ms. RUSH. Ms. Berkley.
Ms. BERKLEY. Yes.
Ms. RUSH. Ms. Berkley votes yes.
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Mrs. Napolitano.
Mrs. NAPOLITANO. Yes.
Ms. RUSH. Mrs. Napolitano votes yes.
Mr. Schiff.
Mr. SCHIFF. Yes.
Ms. RUSH. Mr. Schiff votes yes.
Ms. Watson.
Ms. WATSON. Yes.
Ms. RUSH. Ms. Watson votes yes.
Mr. Smith of Washington.
Mr. SMITH OF WASHINGTON. Yes.
Ms. RUSH. Mr. Smith of Washington votes yes.
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Ms. McCollum.
Ms. MCCOLLUM. Yes.
Ms. RUSH. Ms. McCollum votes yes.
Mr. Bell.
Mr. BELL. Yes.
Ms. RUSH. Mr. Bell votes yes.
Chairman Hyde.
Chairman HYDE. Yes.
Ms. RUSH. Chairman Hyde votes yes.
Chairman HYDE. Mr. Chabot.
Mr. CHABOT. No.
Ms. RUSH. Mr. Chabot votes no.
Chairman HYDE. Does anyone else wish to be recorded?
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Mr. TANCREDO. I vote no.
Ms. RUSH. Mr. Tancredo votes no.
Chairman HYDE. The clerk will report.
Mr. Rohrabacher would like to be recorded.
Mr. ROHRABACHER. Aye.
Ms. RUSH. Mr. Rohrabacher votes yes.
Chairman HYDE. Now the clerk will report.
Ms. RUSH. On this vote there are 37 ayes and 8 noes.
Chairman HYDE. The motion to report favorably is adopted, and, without objection, the Chairman is authorized to move to go to conference pursuant to House rule XXII. Without objection, the staff is directed to make any technical and conforming changes. And without objection, the bill will be reported favorably to the House in the form of a single amendment in the nature of a substitute incorporating the amendments adopted here today.
I thank you very much for a very good day's work. The Committee stands adjourned.
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[Whereupon, at 4:08 p.m., the Committee was adjourned.]
A P P E N D I X
Material Submitted for the Hearing Record
PREPARED STATEMENT OF THE HONORABLE JOSEPH R. PITTS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF PENNSYLVANIA
Mr. Chairman, thank you for the opportunity to address this most urgent matter.
President Bush outlined his vision to meet the AIDS pandemic head on. I am pleased that we have acted quickly to develop a plan for combating this global health crisis. I am concerned however about the way this bill goes about fighting AIDS. As it stands, this bill will not make progress against this epidemic.
While it provides the full $15 billion of the President's request, it does not stick to the President's priorities for this funding. It does not provide adequate oversight of taxpayer funds. And it does not give support to organizations and groups that are most effective in battling this disease. It seems to me that we should use this $15 billion of taxpayer money to fund programs that actually work and save lives.
It is of vital importance, Mr. Chairman, that we take a clear stand on the behavior that encourages the spread of AIDS. This bill must make sure that taxpayer money is not made available to any group that supports, legitimizes, or facilitates prostitution, sex trafficking, or needle exchange programs. Groups that promote these ideas don't help—they only make the behavior that spreads this disease more common. They must be stopped.
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Mr. Chairman, instead of funding these failed schemes of the past, H.R. 1298 should contain a provision giving priority for funding to abstinence programs. This is what has worked and will continue to work better than the social marketing of condoms. In Uganda this strategy has worked. Look at the facts. In the 1980s, Uganda instituted what we know as the ABC program—abstinence before marriage, being faithful to one partner, and then condoms only if A and B are not practiced.
As you can see from my chart, the Uganda model has produced remarkable results. HIV infection rates have plunged from 21 percent to 6 percent since 1991. The success caused Dr. Edward Green, a senior research scientist at Harvard University, to remark on the program that, ''Many of us in the AIDS and public health communities didn't believe that abstinence or delay, and faithfulness, were realistic goals. It now seems we were wrong.''
By contrast, in Kenya, a country that has not adopted the ABC approach to the disease, the HIV infection rate has risen dramatically. As you can see, Uganda's strategy works, while Kenya's commitment to the failed policy of condom distribution continues to cause AIDS deaths.
The countries in Africa which have the highest levels of condom availability relative to male population like South Africa and Kenya have some of the highest HIV prevalence rates in the world. A 2003 USAID review of condom effectiveness concluded that, ''There are no definite examples yet of generalized epidemics that have been turned back by prevention programs based primarily on condom promotion.'' The success of the Uganda program prompted the USAID administrator, Andrew Natsios, to declare the priorities of the ABC program official United States policy on December 24, 2002. Adoption of this legal requirement would change the prevention paradigm in a way that reflects science, the President's priorities, and the success of the ABC program in Uganda and elsewhere. This is what works, Mr. Chairman.
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Uganda's program captures much of what faith-based organizations on the front line of the war against AIDS have said for years. The Catholic Church alone, for example, cares for 1 in 4 AIDS patients worldwide. But many of these organizations do not believe condom distribution will reduce HIV infection rates. AIDS funding should not discriminate against these groups. H.R. 1298 mentions conscience objections but does not explicitly protect organizations against discrimination for federal AIDS funding because of their beliefs.
In addition to providing conscience protection for faith-based groups we must set clear priorities for where this money needs to go. Prioritization of funding will accomplish this goal. Binding percentages—55% for treatment, 15% for palliative care, and 20% for prevention—will help us maintain oversight of this funding and get money to those who need it most. These binding percentages will guard against tampering by groups who wish to exploit this program and steer funding from life-saving strategies that work to the deadly schemes of the past.
Mr. Chairman, I am also particularly concerned about the funding this bill provides for The Global Fund. The Fund has no accountability to American taxpayers or to the American government. And I am concerned about what practices this money goes to support in rogue regimes like North Korea and Sudan.
The bill mandates that the United States can fund up to 33% of The Fund's budget, or up to $1 billion, and allows the President to waive this percentage as he sees fit. Until the Fund can adequately account for its use of taxpayer funds, we should not consider funding more than 25% of the Fund's budget or as the President suggested—$200 million.
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In conclusion, Mr. Chairman, I'd like to urge the committee to adopt a strategy for fighting this global health crisis that works, sticks to the President's priorities, and ensures that taxpayer money gets to where it needs to go.
PREPARED STATEMENT OF THE HONORABLE BARBARA LEE, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF CALIFORNIA
Thank you very much Mr. Chairman. Let me just congratulate you personally for the dedication that you have demonstrated in pushing this bill to markup today, and for making it one of your top priorities in this Congress. It has been a pleasure working with you, and Ranking Member Lantos, and Congressman Leach on this extremely important issue over the last several years, and I want to thank the staff on both sides of the aisle for their diligent work.
Together we have forged a collective effort, building upon the work that began back in 1998 when my friend and colleague, former Congressman Ron Dellums and AIDS activists approached us with an idea about how best to address the emerging Global AIDS pandemic. Introduced as legislation in 1999, the AIDS Marshall Plan for Africa represented the first major Congressional effort to deal with this horrendous disease on a global scale.
This initial plan was refined with the leadership of my good friend, Congressman Jim Leach, into the World Bank AIDS Trust Fund, which provided a framework for the creation of an international trust fund with the important ability to leverage funding from a variety of sources to combat the AIDS crisis. This language was embodied in the Global AIDS and Tuberculosis Relief Act of 2000, which was signed into law by President Clinton in July of 2000.
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Our bill laid out the rationale and the framework for a Global Fund, dedicated to fighting the AIDS pandemic. This framework was taken up by Secretary General Kofi Annan in 2001, when he formally called for the establishment of the Global Fund to Fight AIDS Tuberculosis and Malaria. This was a major achievement, and a turning point for the international community in our battle against this horrendous pandemic.
As you all know, last year we came very close to passing a comprehensive AIDS bill into law. And while we were ultimately unsuccessful, we learned a lot from last year's experience. I am very glad that this year we picked up from where we left off, with the same kind of dedication to crafting a bi-partisan piece of legislation that everyone in the AIDS community could support.
The bill that we are marking up today does just that, and will go a long way not only towards preventing the growth and spread of the AIDS, Tuberculosis and Malaria pandemics, but also to help the millions of people who are already suffering and dying, and who currently have little to no hope for the future. This bill provides a multi-faceted approach to dealing with these epidemics, from prevention, to treatment, to palliative care, to vaccine research, to a variety of worthwhile pilot programs.
Perhaps most importantly, it also provides support for multilateral institutions like the Global Fund to Fight AIDS, TB and Malaria, so that we can leverage the commitment that we have made to defeating these diseases with funding from other donor nations and the private sector. And now with the recent election of Health and Human Services Secretary Tommy Thompson as the Chairman of the Executive Board of the Global Fund, it makes even more sense for us to provide a significant contribution this year.
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I know that Secretary Thompson understands the depth and breadth of this horrible disease because we traveled together to Southern Africa in 2001, where we witnessed the devastation to families and communities that AIDS has caused.
Even armed with this experience, Secretary Thompson can only be effective if he has the proper support from the Congress and the Administration. As the chief fundraiser for the Global Fund, Secretary Thompson cannot go around challenging other countries to donate more money when we fail to provide our own fair share.
We all know the statistics, and we are all aware of the devastation that AIDS has caused and the dire projections of the potential devastation the world will face, if we ignore this pandemic. The fact of the matter is that there is no other single issue which has the power and reach to affect every single person in our world more so than HIV/AIDS.
Mr. Chairman I commend you again for your work, and I encourage my colleagues to vote for this bill and to push for its speedy consideration on the House floor so that we can finally begin to provide the kind of resources that are necessary to defeating this truly global pandemic.
PREPARED STATEMENT OF THE HONORABLE JOSEPH CROWLEY, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW YORK
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Thank you Mr. Chairman and Ranking Member Lantos for holding this important markup.
I would like to voice my strong support of the United States Leadership Against HIV/AIDS, Malaria and Tuberculosis Act of 2003. Make no mistake this bill is a big step in the right direction.
This bill means more help for those infected with HIV and AIDS. It means more hope for those whose children are dying from malaria. It means that fewer families will live in fear of tuberculosis.
This bill is a true victory. But we must take steps to insure that what the bill stands for—protecting the health of individuals around the world—is also protected. And that is why we must see that this bill is not the end to the debate, but, rather, a step in the right direction.
The prevention and treatment of these diseases requires funding. But, of course, it requires even more. It requires accurate information, cultural sensitivity, rapid response. It requires real dedication.
We need to know how this funding will be spent and where; just giving drugs to those infected will not help anyone. We need to look into the areas hardest hit as well as infrastructure, political, and educational deficiencies in those cultures affected.
This is not an attack on the Sub-Saharan Africa. In fact, in the United States during the past 20 years, we have undergone a societal introspection among the most infected, especially among those who were the earliest victims. We also had an educational and political transformation in our country. A transformation that is still ongoing.
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But even as I express my support for the legislation, unfortunately, the recent past has shown us that the intent of this bill is being threatened by many who profess to support it. This bill is finally a step in the right direction for an Administration that has removed information from government web sites providing accurate information about condom effectiveness and opposed language in international documents promoting ''consistent condom use'' as a method to prevent the spread of HIV/AIDS.
This bill is a step in the right direction for an Administration that refused to released $34 million in UNFPA funding even after the President's own blue ribbon team found no justification to hold up this money.
This is an Administration that has sought to apply the Global Gag Rule to HIV/AIDS, Malaria and Tuberculosis assistance. This is an Administration that fought for the Global Gag Rule for Family Planning Assistance. This is an Administration that must be watched closely.
Thus, while President Bush has supported the authorization of $15 billion over five years, I am sadly skeptical that he will support the full appropriation of this funding. I fear that this funding will come directly from the existing Global Fund to Fight AIDS, Tuberculosis, and Malaria, funded at $725 million in 2003—meaning little new real money.
Nonetheless, I am pleased that this important piece of legislation is being marked up. If this bill survives, it will mean real hope for countless people around the world. I only hope that what this bill stands for survives as well. Thank you.
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PREPARED STATEMENT OF THE HONORABLE EARL BLUMENAUER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF OREGON
Passage of H.R. 1298, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003, is a commendable achievement. Passage of this bill is proof of the important work that can be accomplished when we work together in a bipartisan manner. The administration should also be praised for putting forth a proposal to address the HIV/AIDS epidemic.
Addressing the AIDS epidemic and these other diseases will play a critical role not just in improving health around the world, but will boost economies and stabilize communities and regions that are being devastated. This will likely help us as we attempt to alleviate global issues of health, safety, and security that affect us here at home.
PREPARED STATEMENT OF THE HONORABLE ADAM B. SCHIFF, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF CALIFORNIA
Mr. Chairman, thank you for the opportunity to mark up this important legislation that will enable us to effectively combat the global scourges of HIV/AIDS, tuberculosis, and malaria. I am grateful for the leadership of the Chairman in authoring this bill, as well as for the leadership of my colleagues Mr. Lantos, Mr. Weldon, Ms. Lee, and Mr. Leach as the original cosponsors.
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This legislation enables the United States to take a strong leadership role to ameliorate, and, we hope, ultimately to eradicate one of the most devastating diseases that man has ever encountered. We count the victims of HIV/AIDS in the tens and hundreds of millions, worldwide. It is a disease that affects men and women, adults and children. Its impact is most devastating on the poorest, those with the least capacity to deal with the ravages of this disease or to act effectively to prevent its spread. By affecting so many millions across societal cross-sections, this disease presents a humanitarian crisis of unprecedented magnitude. Furthermore, the HIV/AIDS pandemic is a potentially destabilizing force that presents a grave threat to international security.
The African nations have been especially hard hit by the epidemic of HIV/AIDS and other diseases. Together, HIV/AIDS, tuberculosis, malaria, and related diseases are undermining agricultural production throughout Africa—aggravating disease with hunger.
This bill will address these global problems by authorizing $15 billion to combat HIV/AIDS, tuberculosis, and malaria, through a comprehensive five-year integrated strategy. This legislation will use these funds effectively by promoting inter-agency coordination, supporting the expansions of public/private partnerships, and using targeted programs that will especially benefit children and families affected by HIV/AIDS.
Of course we must continue to work aggressively to combat the spread of this disease here in the United States and to continue our efforts to research a cure and to aid our own countrymen afflicted with this terrible illness.
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I am proud to be a co-sponsor of this vital legislation to attack one of the most significant threats to global health and I urge my colleagues to support this bill.