Freedom of Conscience Act of 2003

Mr. Chairman, I yield myself such time as I may consume.

I rise in strong support of this grand humanitarian legislation, and I urge all of my colleagues to make history today by securing its passage.

Mr. Chairman, we could not have reached this day had it not been for the heroic efforts of the gentleman from Illinois (Mr. Hyde), my distinguished chairman and good friend. His leadership on this issue has been a true profile in courage, and I salute him. I also want to identify myself with his powerful and eloquent opening statement. Our colleagues on the Committee on International Relations, the gentlewoman from California (Ms. Lee) and the gentleman from Iowa (Mr. Leach) on the Republican side, have also been critically instrumental to our success thus far as have many other members of the committee. With the support of every single Democrat and most Republicans on the Committee on International Relations, we have crafted a bipartisan piece of legislation worthy of this body's support.

Mr. Chairman, the $15 billion authorized in this legislation to combat HIV/AIDS, tuberculosis and malaria worldwide is an enormous sum by any measure. It is five times the amount we considered authorizing for this cause just last year. 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 are, they are no more than the crisis demands. Every day AIDS claims the lives of thousands of innocent men, women, and, yes, children, old and young, sick and able- bodied, destitute and affluent, unemployed and professional, African, Asian, and American. This disease, Mr. Chairman, does not discriminate. It targets us all; and in doing so, it ruins families, decimates communities, and fuels the violence and bloodshed that destroys whole nations. The political, economic, social, and humanitarian impact of this scourge cannot be contained to one region or to one population. It is a

global human challenge that demands a global humanitarian response with the United States in the lead.

The tragic history of this disease has shown that there are no silver bullets. We must use every means at our disposal to defeat it. All legislation builds to a significant extent upon Uganda's success in curbing the spread of AIDS through a combination of abstinence, monogamy, and condom use. In lending his support to this bill earlier this week, President Bush endorsed this three-pronged approach. In the President's words, preventing spread of HIV/AIDS requires a strategy emphasizing abstinence, marital fidelity, as well as condoms. Each element is crucial. Uganda's success in combating HIV/AIDS required not only abstinence and marital fidelity education programs but the distribution of nearly 80 million condoms per year. Countless lives will be lost if we fail to learn this lesson and undermine the balanced approach exquisitely negotiated and embodied in this bill.

Mr. Chairman, in the his State of the Union address earlier this year, the President issued a challenge to Congress to join him in a new global campaign to combat HIV/AIDS. Today we take up the President's challenge and seek to fully fund this bold initiative. An overwhelming vote by the House of Representatives today to pass H.R. 1298 without crippling amendments will bring the President's vision, a vision most of us share, close to reality. The time for words has passed and the time for action has arrived in our struggle against HIV/AIDS. I urge my colleagues to join me today to pass this historic legislation.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I yield myself such time as I may consume.

Before yielding to our distinguished whip, let me also underscore the important contribution to the fight against HIV/AIDS of Bono who has worked with us on all aspects of this problem and whose leadership worldwide is deeply appreciated by all of us concerned with this issue.

Mr. Chairman, I yield 3 minutes to the gentleman from Maryland (Mr. Hoyer), the distinguished Democratic whip, a leader on this and all issues in this body.

Mr. Chairman, I am delighted to yield 5 minutes to my good friend, the distinguished gentlewoman from California (Ms. Lee), who has brought boundless energy and bold passion to this legislation. She has been the leader on our side on this entire matter.

Mr. Chairman, before yielding to our next speaker, I want to express my deep appreciation to several members of our staff. Pearl Alice Marsh, David Abramowitz, Peter Yeo, Bob King, and on the staff of the gentlewoman from California (Ms. Lee), Christos Tsentas. They have done an outstanding job in bringing this legislation to the floor.

Mr. Chairman, I am delighted to yield 1 minute to my good friend, the gentleman from New York (Mr. Crowley), a distinguished member of the Committee on International Relations and a leader on this issue.

Mr. Chairman, I am delighted to yield 1\1/2\ minutes to the distinguished gentleman from New Jersey (Mr. Payne), the ranking member of the Subcommittee on Africa of the Committee on International Relations, my good friend who has been one of the strongest leaders on this whole issue in the Congress.

Mr. Chairman, I am delighted to yield 1 minute to my good friend, the gentleman from Pennsylvania (Mr. Hoeffel), a distinguished member of the Committee on International Relations and a strong leader on this and on so many other issues.

Mr. Chairman, I am very pleased to yield 1 minute to my good friend and distinguished colleague, the gentlewoman from California (Mrs. Capps).

Mr. Chairman, I am delighted to yield 1\1/2\ minutes to my good friend, the gentlewoman from New York (Mrs. Lowey), the distinguished ranking member of the Subcommittee on Foreign Operations, Export Financing and Related Programs.

Mr. Chairman, I am very pleased to yield 1 minute to my good friend and distinguished colleague, the gentlewoman from Minnesota (Ms. McCollum), a member of the Committee on International Relations.

Mr. Chairman, I am delighted to yield 1 minute to my good colleague, the gentlewoman from California (Ms. Waters), a distinguished Member of this body and a leader on this issue.

Mr. Chairman, I am very pleased to yield 1\1/2\ minutes to my good friend and distinguished colleague, the gentleman from New York (Mr. Engel), a valued member of the Committee on International Relations.

Mr. Chairman, I am delighted to yield 1 minute to my good friend, the gentlewoman from New York (Mrs. Maloney), a distinguished Member of this body.

Mr. Chairman, I yield 1 minute to my good friend, the gentleman from Ohio (Mr. Brown), a distinguished member of the Committee on International Relations, our ranking member on the Subcommittee on Health.

Mr. Chairman, I yield 1 minute to my good friend, the gentleman from Massachusetts (Mr. Olver), a distinguished member of the Committee on Appropriations.

Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, this is a historic moment in dealing with global humanitarian legislation. What we were doing today on a bipartisan basis will save the lives of tens of millions of innocent people across the globe. We are doing it on a bipartisan basis with the typical generosity and humanitarian instincts of the American people.

This is legislation we must all be proud of. It should pass with an overwhelming majority. We are supportive of the legislation. We are grateful for the President's support and we fully anticipate that lives around the globe will be improved as a result of our efforts.

Mr. Chairman, I yield back the balance of our time.

Mr. Chairman, I rise to claim the time in opposition.

Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, I want to thank my good friend from Louisiana (Mr. Tauzin) and my good friend from Ohio (Mr. Brown) for their thoughtful contribution to our legislation. Their amendment includes a number of complex initiatives, many of which reflect improvements to the bill. For example, I believe that the amendment's efforts to explicitly prioritize U.S. programs authorized by this Act to countries based on the size and demographics of the HIV/AIDS populations and the needs of those populations is a wise measure.

I am concerned about several other provisions in the amendment. For example, the limitation on administrative expenditures of the Global Fund is well meaning, but when the fund may be going through a massive expansion of operations, there may be a need for some significant investments to make sure that the Global Fund can properly administer its programs.

I was pleased that the sponsors added a waiver, and I believe that the President should consider the actual operations of the fund as he applies this provision.

Finally, Mr. Chairman, I remain concerned regarding the provision requiring numerous reports to be provided to Congress within 30 days of the request. I am uncertain whether any Member could make this request or whether it must be a relevant committee or by resolution. Moreover, my experience with international organizations is that some of the documents may be considered confidential, such as unfunded proposals, and it may not be possible to get these documents within the time frame provided in the amendments. Nevertheless, Mr. Chairman, I am prepared to accept the amendment, and I look forward to working with the sponsors to clarify and further refine these provisions.

Mr. Chairman, I ask unanimous consent to yield the balance of my time to my friend, the gentleman from Ohio (Mr. Brown) for the purposes of controlling time.

Mr. Chairman, will the gentleman yield?

Mr. Chairman, I strongly support this amendment introduced by the gentleman from New York (Mr. Crowley).

There is no question that the HIV/AIDS pandemic is disproportionately affecting women and compounding the egregious inequalities poor women live with all over the world. It is absolutely necessary that we deal with both genders if we are to reduce the impact of this disease on women's life and offer them opportunities to live with respect and dignity, free from sexual violence and coercion.

The Crowley amendment requires that we include in the 5-year strategy a plan to make sure that men take responsibility for their sexual behavior and that they do respect women. It will also increase opportunities for women seeking access to employment. I urge Members to support this amendment.

Mr. Chairman, will the gentlewoman yield?

Mr. Chairman, we are in complete agreement with the gentlewoman on the value of the Global Fund and on the importance of private contributions to the fund. Contributions from the Gates Foundation and others significantly enhance the functioning of the fund, and we agree that the President should do even more to encourage private donations here.

I am not aware of any objections to the gentlewoman's amendment on this side of the aisle. We would be pleased to accept it. I commend the gentlewoman from Illinois (Mrs. Biggert) for her important initiative.

Mr. Chairman, we expect the Global Fund to recruit and hire the most competent and competitive international experts to manage this very complex organization.

I feel strongly that exorbitant executive salaries would only go to undermine the credibility of the organization. There are lots of skeptics who oppose the Global Fund and wish it to fail. These naysayers are looking for any means to discredit the work of the Global Fund. It is very important that the Global Fund salaries should be realistic and competitive and attract the most competent professionals in the world, but they should not be set at levels that would undermine the credibility of the good work that we hope to accomplish.

I urge my colleagues to support my friend's amendment.

Mr. Chairman, I yield back the balance of my time.

Mr. Chairman, I strongly support the amendment introduced by the gentleman from North Carolina (Mr. Ballance), and I want to commend him for his initiative. We think this is a significant improvement to the underlying bill. We have no objections, and we strongly support it.

Mr. Chairman, I offer an amendment as the designee of the gentlewoman from California (Ms. Millender-McDonald).

Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, the amendment offered by the gentlewoman from California (Ms. Millender-McDonald), my good friend and colleague, deals with a very important issue. The HIV/AIDS pandemic has had a frightening impact on women, particularly in Africa where 55 percent of all HIV/AIDS victims are women. Unequal inheritance rights all over the world, but particularly in Africa, favor men over women. Poor women are abandoned because of their HIV/AIDS status, widowed by the premature death of a husband, or left as orphans by the death of parents. Left with nothing but their desperation, these women and girls are exploited by sex traffickers, pimps, and abusive employers.

Mr. Chairman, it is crucial that programs funded by this emergency program include the promotion and protection of women's inheritance rights, but we should not stop there. Women's equal rights across the board are absolutely essential to overcoming the poverty that underpins the seeming hopelessness of this disease.

Mr. Chairman, I urge all of my colleagues to support this amendment.

I yield to the gentleman from Illinois.

Mr. Chairman, we have no further requests for time, and we yield back the balance of our time.

Mr. Chairman, I want to congratulate and commend my friend from Minnesota for offering this most important amendment, which dramatically improves the underlying bill. On this side we are proud and pleased to accept her amendment.

Mr. Chairman. Let me first thank our ranking member, the gentleman from California (Mr. Lantos), for those very kind and generous remarks, and let me thank the gentleman for his leadership in helping to ensure that our Democrats really saw the goal and understood our mission and helped to work to make sure that this was a bipartisan bill.

I want to thank the gentleman from Illinois (Chairman Hyde) for his leadership, and for, again, I think, setting an example that on issues of common concern and where the survival of the human family is at stake, we all can come together and agree that we should work together.

I also want to thank our staffs, especially Christos on my staff, and Pearl Alice, Peter and the entire committee staff, for their very diligent, competent and dedicated work.

Mr. Chairman, today we really do stand at the crossroads in this global battle gains HIV/AIDS. With an estimated 42 million individuals infected worldwide, the disease has already devastated the African continent, where 30 million people, 30 million, are currently living with AIDS and over 11 million children have been orphaned by this pandemic.

Throughout Africa, AIDS has had a devastating impact, not only on health, but on education, agriculture, the economy, the military, on governments, as people at all levels of society have struggled to cope with this disease.

Even now, the ongoing famine in Sub-Saharan Africa has been aggravated by the AIDS crisis. Food Insecurity and malnutrition have contributed to the spread of the virus, and both have sped up the onset of AIDS in HIV-infected individuals.

The Caribbean, which is ranked as the second most affected region behind Africa, is also facing a devastating situation because of AIDS. In Haiti, where over 90 percent of all AIDS cases in the Caribbean are, Haiti has the unfortunate distinction of being the only country outside of Africa with an adult prevalence rate of over 6.5 percent.

Despite the devastation that HIV and AIDS has caused within Africa and the Caribbean, the disease is truly a global killer. Even here at home, in my own district in Alameda County, we have been forced to declare a state of emergency to deal with the AIDS crisis. Now the disease is poised to run rampant through India, China and Russia, where a lack of information is contributing to the spread of the disease among poor and rural populations.

So without a truly global effort to halt the spread of this disease, to provide care and treatment to those who are infected and affected by HIV and AIDS, we will all face a humanitarian disaster, the likes of which the world has never seen before.

But there is hope. We have the know-how to stop the spread of HIV, and we have the drugs to prolong the lives of those infected with AIDS. The challenge is how we translate this know-how and these resources to people living in the developing world.

Yet even in a country as poor as Haiti, there are already programs on the ground that are making a difference with minimal resources, like the Zanmi Lasante Clinic, run by Dr. Paul Farmer and the dedicated people at Partners in Health.

And we also know from the indication of Uganda that when a country unites in the battle against AIDS, through the leadership, through its president, members of the government and civil society, and when everyone really engages in open dialogue about sex and AIDS, the need for abstinence, faithfulness and safe sex through the use of condoms, the HIV/AIDS rate can be reversed. In this case, it came down from 15 percent in 1991 to 5 percent 10 years later. But it took all three strategies. No preference is given to one over the other.

This bill we have before us today really recognizes these possibilities. But, more importantly, it sends a message to the world that the United States will not sit idly by and allow AIDS to wreak havoc on the human family.

By committing $3 billion a year to fighting global HIV/AIDS and the two largest opportunistic infections that feed off of AIDS, tuberculosis and malaria, we will virtually double our global AIDS budget in the next year.

Several years ago when we won a $40 million increase in global AIDS spending in 2000 under the leadership of our distinguished minority leader, the gentlewoman from California (Ms. Pelosi), we felt that that was a major victory and a major accomplishment. This legislation now puts those living with

AIDS and those at greatest risk of getting infected ahead of ideological and political differences, and that is why the Pitts amendment does such a disservice to the bill and to those who desperately need our help. This bill attempts to create a comprehensive strategy to deal with the AIDS pandemic. Comprehensive.

Finally, let me just say how important it is that this be new money. The President said that this was new money. We must make sure that this is new money. We face many challenges as this bill moves forward, but we hope that the President will receive the bill on his desk intact and sign it before Memorial Day, as he said he wanted to do.

Mr. Chairman I want to thank again the chairman of our committee and the gentleman from California (Mr. Lantos) for their leadership, and once again hope that we can pass this bill intact, as it moved out of committee.

Mr. Chairman, I thank the gentleman from Ohio (Mr. Brown) for yielding me this time and for his leadership. Also I want to thank the gentleman from Louisiana (Mr. Tauzin) for this amendment, and with the cautions which our ranking member laid out, I rise in support of this amendment.

I would like to just briefly mention the history and our debate here in Congress with regard to the background of this Global Fund. The idea for the Global Fund really started back somewhere around 1998 and 1999, when my friend and former colleague, Congressman Ron Dellums, had the vision and the foresight for an AIDS Marshall Plan in Africa. Refined under the leadership of our good friend, the gentleman from Iowa (Mr. Leach), who was then Chair of the Committee on Banking and Financial Services, we introduced the World Bank AIDS Trust Fund, and this fund became the basis for the Global Fund. This fund was signed into law in, I believe it was August of 2000, under the Global AIDS and Tuberculosis Relief Act of 2000, signed by President Bill Clinton.

I cite this history because I think it is important for us to remember how important this fund is and that we fully debated this fund, and on a bipartisan basis voted it out and it was signed into law. So I think this amendment really strengthens the fund and its accountability.

The United Nations, in I believe it was June 2001, picked up the idea of the fund, and Secretary General Kofi Annan made an impassioned plea for the creation of a Global Fund to fight AIDS, TB, and malaria, which again moved forward the World Bank AIDS Trust Fund, in terms of the foundation, the parameters and the guidelines. So this fund was established in 2002 and really has made significant strides in over just a year of operation. Not only has it created a novel approach to grant-making and approval-processing, but it has also made really a very determined commitment to maintain as lean an operation as possible in order to focus its activities on getting money out to those in need.

The current system that the fund has set up provides several layers of accountability. On a country level, the

proposals are gathered and voted upon by an advisory body that represent government, civil society, the private sector, faith-based groups, and nongovernmental organizations. Proposals that are submitted to the Global Fund then undergo a technical review from an independent body composed of leading global health experts. And now our own Secretary of Health and Human Services Tommy Thompson is leading this effort.

So I believe this amendment will help further strengthen the Global Fund system of accountability, and I encourage Members to vote for its inclusion. And also, with regard to the comments of the gentleman from California (Mr. Lantos), I hope we can move forward, as he has so eloquently outlined, and fix what he thinks needs to be fixed in it.

Mr. Chairman, I thank the gentleman from New York (Mr. Crowley) for yielding me this time, and

thank the gentleman for this amendment. It is very important to this bill. I thank the gentleman from Illinois (Chairman Hyde) for accepting the amendment.

The empowerment of women is critical in developing an AIDS strategy that is effective. In many parts of the developing world, women are still treated as second-class citizens. They lack basic protections of civil rights laws in their own country, and oftentimes are left at a disadvantage when it comes to accessing resources, owning land and in their general relationships to men.

The Crowley amendment would fix this by encouraging men to develop a healthy relationship that treats women with respect. That is so important as we address this pandemic. In addition, it supports the development of specific strategies to increase women's access to employment, land and financial resources like microfinance programs that, in many instances, have encouraged women to set up their own small businesses and avoid having to turn to a life of prostitution in order to make ends meet.

I urge Members to thank the gentleman from New York (Mr. Crowley) for his wisdom in moving forward with this amendment. I thank the gentleman from Illinois (Mr. Hyde) for accepting this very important amendment.

Mr. Chairman, will the gentlewoman yield?

Mr. Chairman, I want to thank the gentlewoman from Illinois (Mrs. Biggert) for this amendment. I think it strengthens the bill. It strengthens the fund.

One point I would like to make about the Global Fund which has been mentioned is the leveraging ability of the fund. $1 billion could leverage up to $4 to $5 billion. It has been estimated that $9 to $10 billion is needed just to begin to scratch the surface on this pandemic. The importance of the fund cannot be overstated, and I thank the gentlewoman for this amendment. Now

that Secretary Tommy Thompson is chair of the executive board, both sides should feel confident that he will move forward. And once we insist that our side put $1 billion in, at least we know that should lead to $4 to $5 billion immediately. I offer my support of the amendment.

Mr. Chairman, I yield myself such time as I may consume.

Mr. Chairman, not since the bubonic plague swept across the world in the last millennium killing more than 250 million people has our world confronted such a horrible, unspeakable curse as we are now witnessing with the growing HIV/AIDS pandemic.

In the very short time that we will spend today considering this legislation, thousands of people around the world will die of HIV/AIDS. The number of dead or dying is grotesquely high: 25 million already dead worldwide and growing at the rate of 8,500 every day, with the horror of entire villages populated only by orphans because the adults are dead or dying from AIDS.

I do not mean to demean the work of this House, but so much of what we do is really unimportant and trivial; but not today. Today we have an opportunity, the opportunity to do something significant and of lasting importance. Today we have an obligation, the obligation to do something reflecting our commitment to human solidarity. We have a privilege today, the privilege of doing something truly compassionate.

It is no exaggeration to compare the AIDS pandemic in Africa to the bubonic plague in medieval Europe. This plague took one-third of Europe's entire population, creating political chaos and set the course of civilization back for decades, perhaps centuries. AIDS in Africa is well on its way to doing something terribly similar, and similarly terrible. Tuesday's Wall Street Journal tells us 42 million people are infected with HIV/AIDS, 30 million in sub-Saharan Africa alone.

Today we need to consider H.R. 1298, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. We would not be here today with this bill, that I think is an excellent one, without the sincere and heartfelt and invaluable assistance of the gentleman from California (Mr. Lantos), which makes this a truly bipartisan effort.

This legislation authorizes the President's 5-year $15 billion emergency plan for treatment and prevention of AIDS in those countries already facing crisis. The legislation creates a more responsive, coordinated, and effective approach among the various agencies of the U.S. Government involved in this global fight. The legislation promotes an approach that provides funds for antiretroviral therapy for more than 2 million people living with HIV. It encourages a strategy that extends palliative care for people living with AIDS. It supports efforts to find vaccines for HIV/AIDS and malaria. It emphasizes the need to keep families together with particular focus on the assistance needs of children and young people with HIV. It endorses prevention programs that stress sexual abstinence and monogamy as a first line of defense against the spread of this disease and contributes to multilateral initiatives that leverage the funds of other donor nations.

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 the U.S. has no stake in this pandemic, let me observe that the specter of failed states across the world certainly is our concern.

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 build democracy and a growing economy in Nigeria and elsewhere. The spread of HIV/AIDS frustrates this important mission. 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 the 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 and for us.

The President's proposal is based on America's deep conviction about the dignity of every human life, and these proposed remedies for the AIDS crisis in Africa recognize that human dignity. In adopting this proposal, we show the world that conviction and compassion go together as we demonstrate that compassion is not a sign of weakness but of strength. America does not have to take on the African AIDS crisis alone; but as is often the case, American leadership, political or financial, is necessary if our friends around the world are to bear their fair share of the burden. That is what the President's proposal does. It sets a pattern of American leadership that others we believe will follow.

This bill is a compromise, a delicately arrived at, painstakingly negotiated compromise between various factions interested in this legislation; but it hangs together, and it works and it will advance the cause that we so desperately need to support. AIDS is a mortal challenge to our civilization. Let us today be animated by compassion and, yes, vision that always have defined what it means to be an American.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I yield 3 minutes to the distinguished gentleman from Iowa (Mr. Leach).

Mr. Chairman, I am very pleased to yield 5 minutes to the distinguished gentleman from Florida (Mr. Weldon) who, as an original cosponsor of this legislation, has made an invaluable contribution.

Mr. Chairman, I am pleased to yield 3 minutes to the learned gentleman from Wisconsin (Mr. Green).

Mr. Chairman, I am pleased to yield 3 minutes to the gentleman from Michigan (Mr. McCotter).

Mr. Chairman, I am pleased to yield 3 minutes to the distinguished gentleman from Delaware (Mr. Castle).

Mr. Chairman, I am pleased to yield 2 minutes to the gentleman from Iowa (Mr. King).

Mr. Chairman, I am pleased to yield 3 minutes to the distinguished gentleman from Arizona (Mr. Kolbe).

Mr. Chairman, I yield 1 minute to the distinguished gentleman from Indiana (Mr. Pence) for the purposes of a colloquy.

Mr. Chairman, will the gentleman yield?

The gentleman is correct. Nothing this in this legislation should suggest that it is United States' policy that abortion is a proper and appropriate method for prevention of or treatment of mother to child transmission of HIV/AIDS.

Mr. Chairman, I yield the balance of our time to the distinguished gentlewoman from Florida (Ms. Harris).

(Ms. HARRIS asked and was given permission to revise and extend her remarks.)

Mr. Chairman, I yield back the balance of my time.

Mr. Chairman, I am pleased to say we are very pleased with this amendment. We are happy to accept it. It adds to the bill, and so I will not repeat what the other people have already said in outlining its terms. But it is a good amendment, and we hope everyone accepts it.

Mr. Chairman, I claim the time in opposition; however, I do not oppose the amendment.

Mr. Chairman, I yield myself such time as I may consume.

This is a good amendment, a thoughtful amendment. It adds to the bill, so we are pleased to accept this amendment.

Mr. Chairman, I yield back the balance of my time.

Mr. Chairman, will the gentlewoman yield?

Mr. Chairman, we certainly accept the amendment. It is an excellent addition to the bill, and congratulate the gentlewoman from Illinois (Mrs. Biggert).

Mr. Chairman, we are prepared to accept the amendment.

Mr. Chairman, I am delighted to associate myself with the remarks of the distinguished gentleman from California (Mr. Lantos). This is an excellent amendment, and I urge all our colleagues to support it.

Mr. Chairman, I thank the gentleman for yielding. I am pleased to say that the majority accepts the amendment. It is an excellent addition to what I think is an excellent bill. So we are pleased to accept it.

Mr. Chairman, the children and orphans who are affected by this scourge could have no better champion than the gentlewoman from Minnesota, and we are very pleased to accept her excellent amendment.

Mr. Chairman, I move that the Committee do now rise.

Mr. Chairman, I thank the gentleman from California (Mr. Lantos) for his leadership.

The Global Fund to fight AIDS, TB and malaria represents the best tool we have to provide relief on a scale that matters. Some of my colleagues want to eliminate the U.S. commitment to the Global Fund. They will say it is effective when it only began disbursing funds in the past year. They will say it is a blow to bureaucracy, when, in fact, it is a model of efficiency in coordination. They will say that evidence shows that it does not work, and then fail to produce any evidence.

The Global Fund stresses accountability. Each proposal is reviewed by 22 physicians and health experts from a variety of nations. Forty percent only of the applications are accepted. Only the best are approved. Each proposal is for 5 years. After 2 years a major audit of the program is done. If it is not effective funding is cut off.

Both the House and the Senate supported its creation unanimously. It is transparent. The Global Funds Web site contains downloads of every single country's proposal that is approved.

Fifty million people in the last 25 years have died of malaria, tuberculosis and AIDS, 50 million people. The Global Fund will help history's worst epidemic.

Mr. Chairman, I yield myself 5 minutes.

Mr. Chairman, I rise in support of the Tauzin-Brown amendment. I thank the gentleman from Louisiana (Mr. Tauzin) for his good faith and bipartisan work in drafting this amendment, especially his staff, Patrick Ronan, for his hard work and others on his staff.

The Committee on Energy and Commerce has jurisdiction over agencies that play a pivotal role in successful efforts to reduce the spread of HIV/AIDS, TB, and malaria in our country and worldwide. Some of the world's most promising research and best treatment on these diseases are carried out by agencies within the Department of Health and Human Services. CDC provides technical and scientific support for international agencies like USAID as well as national infectious disease programs in developing countries, in addition to the work that NIH and other agencies do.

Secretary Thompson is the newly appointed chairman of the Global Fund to fight AIDS, TB, and malaria, the best tool this world has to fight three diseases that kill 6 million people every year. The success of this bipartisan Global AIDS Initiative depends on collaboration of the world's most important and best resources. One of the reasons why the Global Fund is such a critical component of the U.S. Global AIDS Initiative and a crucial part of the bill we are considering today, is it recognizes the need to fight tuberculosis, a lesser known infectious disease that has been around longer and kills 2 million people a year, including 1,100 people every day in the country of India.

TB infects one-third of the world's population. Two million people carry the TB bacteria, and it is the leading killer of young women and people with HIV worldwide.

HIV and TB form a lethal combination, each speeding the other's progress. HIV promotes rapid progression of primary TB infection to active disease. It is the most powerful known risk factor for reactivation of latent TB infection to active disease. Most HIV patients, in fact, will actually die of TB before they succumb to AIDS. The intersection of AIDS and TB is like the perfect storm.

The Global Fund is a public-private partnership which draws contributions from governments, from private corporations, from faith- based organizations and foundations. The Global Fund has shown signs that it works. Government entities, in coordination with nongovernment organizations, submit 5-year plans. Each plan is unique to each country, not a one-size-fits-all that comes from Washington or Geneva or any other country. The Global Fund recognizes cultural differences. What works in Christian Uruguay may not work the same in Muslim Bangladesh.

No overriding, international political agenda is attached to the Global Fund's assistance. No litmus test, only a judgment by the Global Fund, in collaboration with local citizens and health workers of what works best for each country. The Global Fund demands results, quantifiable results. The money supports activities, including access to health care services, purchasing of drugs, training of personnel, and training of community workers. If a country fails or an NGO fails to show results within 2 years, the money is cut off.

About 60 percent of the Global Fund's money goes to HIV/AIDS, about 20 to TB, about 20 to malaria. Fighting these diseases together, which the Global Fund does, is a cost-effective approach. For example, the infrastructure created in the treatment of TB, having health workers in place who sit with patients every day for about 6 months, has been proven, that infrastructure, to help in the treatment of HIV/AIDS, of malaria and other public health issues.

If we can fully commit to the Global Fund, and fully commit means at least $1 billion every year, 2 million patients will be treated for TB, a half million AIDS orphans will receive support, and 16 million new malaria nets will be distributed over the next few years.

Access to these lifesaving treatments means children will not be pulled out of school to work or to care for a sick parent. It means an HIV-positive father in the developing world has a few more years of life to provide for his family. It means children with TB, otherwise facing a virtual death sentence, will live.

What AIDS and TB experts know, but policymakers consistently underestimate, is that preventing and treating HIV/AIDS without preventing and treating TB is a virtual death sentence for the developing world. If HIV does not kill you, TB might or malaria might. The Global Fund is the best tool in the world to address all three of these infectious diseases together.

Our investment in the Global Fund, rather than a unilateral or bilateral U.S.-waged effort, will help leverage support from other countries. Funneling U.S. dollars through U.S. programs alone will do nothing to promote a united global front against these killers. If we put in money to the Global Fund, so will other nations and so will major philanthropists.

In a short time, the Global Fund has shown it is capable of tremendous progress. In just two rounds of grants, the fund has approved 160 proposals in 94 low- income countries. With significant U.S. funding the fund will continue to support countries committed to addressing the epidemic killing their people. Without U.S. leadership, it will be a fund in name only. AIDS, TB, and malaria would remain a virtual death sentence in the developing world.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I yield 2\1/2\ minutes to the gentlewoman from California (Ms. Lee).

Mr. Chairman, I thank the gentleman from Michigan (Mr. Upton) for his comments, and I yield the balance of my time to the gentleman from Minnesota (Mr. Gutknecht).

Mr. Chairman, will the gentleman yield?

Mr. Chairman, I appreciate the efforts of the gentleman from Louisiana (Mr. Tauzin) and appreciate his offer. And I think the work we are doing with the gentleman from Illinois (Mr. Hyde), the gentleman from Louisiana (Mr. Tauzin), the gentleman from California (Mr. Lantos), the gentlewoman from California (Ms. Lee), and the gentleman from Iowa (Mr. Leach) today is outstanding, especially because with the Global Fund and with all of these efforts we can address all of these diseases, encourage philanthropists and other governments to contribute and make a difference in people's lives.

Mr. Chairman, I offer an amendment.

Mr. Chairman, I yield myself 3 minutes.

Mr. Chairman, I rise today to urge all Members of the House to support the passage of the Tauzin-Brown amendment to H.R. 1298, the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. I want to commend my colleague from the Committee on Energy and Commerce, the gentleman from Ohio (Mr. Brown) for his assistance and support and advocacy of this amendment.

First, the Tauzin-Brown amendment strengthens H.R. 1298 by adding additional accountability measures to ensure that our fight against HIV/AIDS and TB and malaria has a greater chance of success. That is what we all want.

Our amendment establishes priorities to be followed by the global AIDS coordinator for the distribution of resources based on factors such as size and demographics of specific nations to ensure that the countries who need assistance the most receive it first.

Next, our amendment utilizes an independent third party to examine the success of strategies implemented by the global AIDS coordinator. The Institutes of Medicine, the IOM, will be responsible for examining the achievements of the programs funded by the global AIDS coordinator and then comparing the success rates of various methods that have been used by the coordinator.

Second, the Tauzin-Brown amendment also strengthens the existing authority and the accountability measures in H.R. 1298. Our amendment specifically states that if at any point administrative expenses within the Global Fund exceed 10 percent of total expenditures of the fund for any 2-year period, then the U.S. will withhold an equal amount from its contribution the following year. This is to ensure that this fund does not get gobbled up in bureaucrats and administrative expenses. We believe this is fair and, at the same time, will ensure that the Global Fund remains fiscally responsible to its purpose. That is, getting dollars in to actually combat AIDS, malaria, and tuberculosis in the world.

These two accountability measures represent provisions ensure our approach to this problem is not only morally responsible, it is fiscally responsible as well.

Finally, the amendment requires that the HIV/AIDS coordinator make available to Congress basic information on the Global Fund. Specifically, the coordinator is required to submit to Congress a detailed report outlining all financial and accounting statements, copies of the reports provided to the Global Fund by organizations contracted to audit recipients, and project proposals submitted by applicants and grantees. In the past we have had great difficulty getting this information from the Global Fund. We are confident the coordinator will do a wonderful job in delivering this information to Congress. I urge my colleagues to support the Tauzin-Brown amendment.

Mr. Chairman, I reserve the balance of my time.

Mr. Chairman, I am honored to yield 1 minute to the distinguished gentleman from Illinois (Mr. Hyde), the chairman of the Committee on International Relations.

Mr. Chairman, I yield 2 minutes to the gentleman from the great State of Michigan (Mr. Upton), the distinguished chairman of the Subcommittee on Telecommunications and the Internet.

Mr. Chairman, will the gentleman yield?

Mr. Chairman, the intent of the language is to study the question of the illegal diversion of drugs for improper purposes, that is, for resale and that sort of thing. We describe the purposes within that amendment. So the gentleman is accurate in his statement.

Mr. Chairman, I yield myself such time as I may consume.

I simply wanted to thank the gentleman from Ohio (Mr. Brown) and the members of the Committee on Energy and Commerce who worked on this amendment, as I said, to help coordinate the fine work done by the chairman and the gentleman from California (Mr. Lantos) on this underlying bill. This is an excellent piece of legislation. I hope we have improved it.

I will commit to the gentleman from California (Mr. Lantos) that we will continue to work with him to clarify the concerns he has. We do not want to create those problems. We are simply trying to add more accountability, not less; and more clarity, less confusion.

Finally, let me point out to the gentleman from Ohio (Mr. Brown) that it has obviously come to our committee's attention that a great deal of work is going on domestically by a number of pharmaceutical companies in testing, et cetera, in attempts to find some sort of vaccine to combat HIV/AIDS and some of these other diseases, particularly HIV/ AIDS. And when and if that discovery is made, as we all hope it is, we will be back on the floor with legislation to establish some sort of national framework for us to utilize that scientific breakthrough, when and if it does occur, in a way that humanely administers that kind of a hope and expectation of cure and prevention to all Americans without regard to the Americans' capabilities or financial capabilities to take advantage of it.

We will have to think that through, how do we make sure everybody gets to take advantage of those scientific breakthroughs when they occur. We have done some preliminary work on it; and I invite my colleague from Ohio, and others, to stay in touch with us as we move forward. As we see these breakthroughs coming, we will want to talk with the gentleman and others on the committee to see if we cannot advance legislation to make sure that every American has the advantage of those breakthroughs when they occur.

I yield to the gentleman from Ohio.

Mr. Chairman, I yield such time as he may consume to the gentleman from Texas (Mr. Green).

(Mr. GREEN of Texas asked and was given permission to revise and extend his remarks.)

Mr. Chairman, I yield myself such time as I may consume, and let me again offer my sincere thanks to the chairman and to the gentleman from California (Mr. Lantos) for accepting this legislation and urge adoption of it.

Mr. Chairman, I yield back the balance of my time.