To amend the State Department Basic Authorities Act of 1956 to authorize assistance to combat HIV/AIDS in certain countries of the Caribbean region.

Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 1065 and ask for its immediate consideration.

Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Florida (Mr. Diaz- Balart). All time yielded during consideration of the rule is for debate only. I yield myself such time as I may consume. I also ask unanimous consent that all Members be given 5 legislative days within which to revise and extend their remarks on House Resolution 1065.

Mr. Speaker, House Resolution 1065 provides for the consideration of H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, a structured rule. The rule provides for 2 hours of general debate and makes in order four amendments, each of which is debatable for 10 minutes.

Mr. Speaker, all Members of this House should be very proud of the bipartisan collaboration and careful compromises that have resulted in the underlying bill before us today, H.R. 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act. I wish to express my appreciation to the work of the gentleman from New Jersey, Congressman Donald Payne, the chairman of the Subcommittee on Africa and Global Health, and Subcommittee Ranking Member Chris Smith, as well as House Foreign Affairs Committee Chairman Howard Berman and Ranking Member Ileana Ros-Lehtinen. And, like all of my House colleagues on both sides of the aisle, I am grateful that the committee named this bill after the great leaders of the Foreign Affairs Committee, Chairmen Tom Lantos and Henry Hyde, who guided the original 2003 act into law. May the collegial spirit of these two great champions for global health guide us all during today's debate.

Mr. Speaker, H.R. 5501 would authorize $50 billion over the next 5 years for U.S. global programs that address the prevention, care, and treatment of HIV/AIDS, tuberculosis, and malaria. It strengthens, sustains, and expands a program that is universally recognized as one of the shining accomplishments of the Bush administration.

The challenge for this reauthorization is to move our HIV/AIDS programs beyond the emergency phase first called for under the President's Emergency Program For Aids Relief, or PEPFAR, and make them sustainable over the long term. Over the past 5 years, we have literally gone from watching people die from HIV/AIDS to watching people live and return to productive lives in their communities.

The 2003 Act provided $15 billion over 5 years; H.R. 5501 provides $50 billion, a direct response to the needs identified over the past 5 years for life-saving medicines and well-trained, effective national health care systems.

The 2003 law relied upon the health care workforce and infrastructure already in place in developing countries. In a farsighted move, Mr. Speaker, today's bill invests in strengthening HIV-related health care systems and building the capacity of the health care workforce in these nations. Under this legislation, funds will be used to train some 144,000 new health care workers over the next 5 years to care for people infected with HIV.

This is just a start on easing the severe shortage of health care workers in the developing world, and it is our hope that other donor nations will follow our lead. If there is ever to be a hope that these programs can become self-sustaining, health care capacity must be significantly strengthened in countries hard hit by HIV/AIDS.

The 2003 bill focused on creating new programs to tackle the HIV/AIDS crisis. This reauthorization builds stronger linkages between our global HIV/AIDS initiatives and existing programs designed to alleviate hunger, improve health care, bolster education, and increase income security and stable livelihoods, an approach endorsed by the President's Global AIDS Coordinator in February in his annual report to Congress. These changes ensure that our HIV/AIDS programs no longer operate in isolation from our other development priorities, and that the expertise and benefits from these other programs are provided in an effective manner to HIV/AIDS affected individuals, families, and communities.

In addition, the bill increases U.S. contributions to the Global Fund for HIV/AIDS, Tuberculosis, and Malaria, and provides benchmarks to improve the transparency and accountability of the Global Fund.

And while the majority of the funding authorized in H.R. 5501 is focused on the prevention, care, and treatment of HIV/AIDS-infected people and communities, I would like to emphasize that the bill specifically authorizes $4 billion over 5 years for a comprehensive strategy to combat tuberculosis, and $5 billion for the prevention, treatment, control, and elimination of malaria. In addition, it better integrates our HIV/AIDS programs with the diagnosis, testing, counseling, treatment, prevention, care, and health care treatment needed in the fight against TB and malaria.

Mr. Speaker, H.R. 5501 also removes the requirement that one-third of all funds for HIV/AIDS prevention be dedicated to abstinence-only programs. Over the past 5 years, this restriction has proven to hamper the effectiveness of our health care efforts in the field, as documented by two recent independent reports produced by the Government Accountability Office, GAO, and President Bush's own Office of Personnel Management. This reauthorization now requires the Executive to promote a balanced prevention program that includes every element of abstinence, being faithful, and condoms, the ABC approach toward HIV transmission prevention.

Mr. Speaker, H.R. 5501 also allows U.S.-supported family planning organizations to provide HIV/AIDS testing and counseling services. This will ensure that many more women of reproductive age receive vital information related to their HIV status, as well as HIV/AIDS education.

Mr. Speaker, we all need to recall that 20 million men, women, and children have perished from HIV/AIDS; 40 million people around the world are HIV positive; and each and every day another 6,000 people are infected with HIV. It is a moral imperative that we act strongly, decisively, and continue to address this crisis in a forward-looking manner.

Five years ago, President Bush acted to meet a perceived emergency as the AIDS epidemic spread out of control. During that period, the United States has provided drug treatment to nearly 1.5 million people. We have given supportive care to another 6.6 million, including 2.7 million orphans and vulnerable children. And, our programs have prevented an estimated 150,000 infant infections. During this first 5- year phase of programming, U.S. bilateral programs to combat HIV/AIDS, tuberculosis, and malaria were expanded to 114 countries. Today, the U.S. now supports programs in 136 countries, including programs funded by the United States and administered through the Global Fund.

We can all be proud of this record of accomplishment, but there is so much more left to do. Now we must work on making these initial gains sustainable, our programs even more effective, and expanding them to reach an even greater number of HIV/AIDS affected communities.

Specifically, over the next 5-year period, H.R. 5501 aims to:

Prevent 12 million new infections;

Provide anti-retroviral treatment for 3 million people, including 450,000 children;

Provide medical and other care for 12 million people, including 5 million orphans;

And, train over 140,000 health care workers in the developing world.

Mr. Speaker, addressing global HIV/AIDS is one of the moral imperatives of our time. And while history will no doubt judge our response, it is more important that each of us recognizes that we can truly make a difference in the lives of millions of people right here and right now.

H.R. 5501 represents a genuine bipartisan compromise. I urge my colleagues to adopt this rule and to support the underlying legislation, H.R. 5501.

I reserve the balance of my time.

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

Mr. Speaker, I yield myself 20 seconds.

Mr. Speaker, I just want to again commend the gentlewoman from Florida (Ms. Ros-Lehtinen) for her incredible work on this bill. And for the Record, there is bipartisan appreciation for her strong and passionate commitment to ending the scourge of HIV/AIDS, tuberculosis and malaria.

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

Mr. Speaker, I just want to remind my colleagues that the

underlying debate is not about the space program, it's about whether we're going to end the terrible scourge of HIV/AIDS, malaria and tuberculosis that has cost the lives of countless individuals across this planet. This is a moral imperative. And I am proud of the bipartisan work done by Democrats and Republicans working together to accomplish this bill.

At this time, I would like to yield 3 minutes to the gentlewoman from the Virgin Islands (Mrs. Christensen).

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

To be honest, Mr. Speaker, I find it stunning that a Member from the Republican Party would come up here and talk about the debt that our children have been forced to inherit. I will remind my colleagues that when Bill Clinton left office, we had a surplus. After the leadership of George Bush and the Republican Congresses, we are now in historic record debt. I now have inherited a debt tax.

I am all for investing more in medical research. I would much rather do that, quite frankly, than invest in tax cuts for Donald Trump or more subsidies to Big Oil companies or more tax giveaways to big corporations that are gouging the American taxpayer.

But what we have here, Mr. Speaker, is a bill to save lives. This is a moral imperative. It is a product of bipartisan collaboration. This is something that we can be proud of. This is something the American people, I think, support overwhelmingly.

And so, we don't need any lectures about the mess this economy is in. This President and the Republican Congresses have driven this economy into a ditch, and we're trying to get us out of that ditch.

So, I would urge my colleagues to focus on what is being debated here today, which is a bill to save lives, to end the scourge of HIV/AIDS, malaria and tuberculosis. This is a worthy goal. This is something that we should be committed to. And I think that the bipartisan collaboration that has produced this deserves to be praised and not ridiculed.

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

Mr. Speaker, let me just yield myself 20 seconds.

I appreciate the gentleman's response. I would just remind the gentleman again, and everybody, that this is a bill about saving lives. And this is a bill that is supported by the head of the Republican Party, the President of the United States. And so, I am proud to join in support of this bipartisan collaboration.

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

I reserve my time, Mr. Speaker.

Mr. Speaker, let me yield myself such time as I may consume.

Again, I find it somewhat ironic to listen to the gentleman's comments who has no problem supporting a $3 trillion war in Iraq that has resulted in 4,000 American soldiers dead, tens of thousands wounded; and on top of all that, not even paying for the war, just putting it on the credit card so our kids and our grandkids have to pay for it. Many of my friends on the other side of the aisle who have supported tax cuts for the richest of the rich and decided that it wasn't important to pay for it; instead, put it on the credit card and on the backs of our kids; who have voted for budgets to cut veterans health and to cut money for health care in general. And what we have been trying to do is to make up for the indifference of so many years.

You know, the gentleman presents a false choice. What we're trying to do here is actually respond to a humanitarian crisis in a bipartisan way. I mean, I don't often stand with the President of the United States, but I do on this. He's right. We can't ignore the HIV/AIDS crisis or the crisis with regard to malaria and tuberculosis around the world.

This is a moral imperative. And I will tell you, in addition to being a moral imperative, it makes sense for the United States to take a leadership role and encourage the rest of the world to step up and to provide the resources to combat these scourges.

This is the right thing to do. I'm proud of this bipartisan collaboration of this bill. And I hope all my colleagues will support it.

I want to yield 1 minute to the gentleman from Florida, my colleague on the Rules Committee, Mr. Hastings.

I am the final speaker on our side.

Mr. Speaker, H.R. 5501 is one of the most important foreign policy global health bills this Congress will pass this year. We have literally gone from, 5 years ago from standing helplessly by and watching people die of HIV/AIDS, to watching people live and take up productive lives in their communities. The impact is far-reaching.

For example, Mr. Speaker, let me highlight just one sector of development that has broad bipartisan support in this Congress, basic education. We all know that education is key to lifting countries out of poverty. And HIV/AIDS creates barriers to education.

Teacher deaths and absenteeism due to HIV/AIDS compound problems of quality and access in education systems that already face teacher shortages.

Children are often pulled out of school to care for a family member with HIV/AIDS or, when a parent dies, they're forced to take care of younger siblings rather than attend school.

HIV/AIDS affected children who are able to attend school often face discrimination and are sometimes segregated from other children or denied admission entirely by teachers or school administrators.

Young people with little or no education are more than twice as likely to contract HIV as those who have completed primary education.

But under this bill, and as we continue to better integrate our HIV/ AIDS programs with our other development priorities, schools can become hubs of care and support for orphans and vulnerable children by providing psychological support, nutrition and basic health care and support to OVC caregivers.

In a 32-country demographic and health survey, women with post primary education were four times more likely than illiterate women to know the basic facts about HIV/AIDS, and three times more likely to know that HIV can be transmitted from mother to child.

Oxfam estimates that if all children completed primary education, 700,000 new cases of HIV/AIDS in young people could be prevented each year, totaling 7 million cases in one decade.

Mr. Speaker, for these and so many other reasons, this bipartisan bill deserves our support. I urge my colleagues to support this rule and to support the underlying bill, H.R. 5501.

The material previously referred to by Mr. Lincoln Diaz-Balart of Florida is as follows:

Amendment to H. Res. 1065 Offered by Mr. Lincoln Diaz-Balart of Florida

At the end of the resolution, add the following:

Sec. 3. That immediately upon the adoption of this

resolution the House shall, without intervention of any point

of order, consider in the House the concurrent resolution (H.

Con. Res. 263) to establish the Joint Select Committee on

Earmark Reform, and for other purposes. The concurrent

resolution shall be considered as read. The previous question

shall be considered as ordered on the concurrent resolution

to final adoption without intervening motion or demand for

division of the question except: (1) one hour of debate

equally divided and controlled by the chairman and ranking

minority member of the Committee on Rules; and (2) one motion

to recommit.

I yield back the balance of my time, and I move the previous question on the resolution.

Thank you for yielding.

Mr. Speaker, I rise today in full support of the rule and of H.R. 5501, a bipartisan bill to reauthorize and expand the President's Emergency Plan for AIDS Relief.

I want to particularly applaud the increase in funding from $15 to $50 billion over 5 years, and the inclusion of the Caribbean countries in this reauthorization.

In this regard, I want to especially thank and applaud my colleagues, Mr. Fortuno, who introduced the Caribbean amendment, Congresswoman Yvette Clarke, who cosponsored it, as did I, Chairman Donald Payne, who included the increased funding and whose work with Congresswoman Barbara Lee ensured that these provisions were included, as well as Chairman Rangel, who began the Caribbean effort 4 years ago.

The expansion to include all Caribbean nations as focus countries was greatly aided by the hard work of Caribbean Health Ministers whose collective and tireless efforts raised awareness about the impact of HIV/AIDS in the Caribbean. I also want to thank the Pan Caribbean Partnership Against HIV/AIDS (PANCAP) not only for their support of this bill, but for the important leadership role that they have and continue to take to address HIV/AIDS in the Caribbean region.

Over the past 5 years, PEPFAR has literally saved the lives of more than one million people and has had a significant positive impact on those most affected by and most at risk for HIV infection, women and girls.

Congresswoman Lee and I had the opportunity to visit several PEPFAR sites and partners in South Africa late last year and saw the great work that they are doing. It was also clearly evident, though, that more was needed.

The additional funding will help to expand the number of focused countries under PEPFAR. It will help to ensure that the innovative and effective efforts that have been launched not only continue, but help other hard-hit nations get access to the resources they desperately need to address HIV/AIDS within their borders.

While two Caribbean nations, Haiti and Guyana, are, as they should be, currently prioritized as focus countries under PEPFAR, there are 14 other nations in this region, which is second only to sub-Saharan Africa in terms of HIV/AIDS prevalence, in need of help. In the Caribbean today, AIDS is one of the leading causes of death in the 15- 44 age group.

Many Caribbean nations not currently receiving PEPFAR assistance absorb millions of dollars in debt every year. Leaders in the Caribbean maintain that high HIV/AIDS prevalence rates can overwhelm the region's health care capacity, destabilize economies, and compromise Caribbean nations' sociopolitical infrastructure. In fact, Assistant Secretary General of the Organization of American States, the Honorable Albert Ramdin, stated in January of last year that ``HIV/AIDS, if not effectively and urgently tackled, poses a clear threat to the sustainable development, social stability and human security of the Caribbean.''

Making all Caribbean countries eligible is clearly the right thing to do. H.R. 5501, while it includes the region, lays the foundation to have the 14 Caribbean nations specifically listed in the bill that will be sent to the President for his signature.

I urge all of my colleagues to support the rule and to support H.R. 5501, rightly named to honor the service of Chairman Hyde and Chairman Lantos.

Mr. Speaker, I rise today in full support of H.R. 5501--a bill which will reauthorize the President's Emergency Plan for AIDS Relief, PEPFAR. I want to thank and applaud my colleagues, Congressman Fortuno who introduced the Caribbean amendment, Congresswoman Clarke who cosponsored it as did I, Chairman Payne and Congresswoman Lee who ushered it and many other parts of the bill through the committee.

Congresswoman Lee and I had the opportunity to travel to South Africa around World AIDS Day last year to visit PEPFAR sites and participate in and see the work they were doing first hand. There was great work being done, but the need for more was also clearly evident.

The success of PEPFAR is well documented. With the support offered through PEPFAR over the last 5 years, many of the world's hardest hit nations have been able to launch integrated HIV/AIDS prevention, treatment and care programs that have prevented new HIV infections, brought life-saving medications and other treatments and services to those living with HIV. As a direct result, PEPFAR has literally saved the lives of more than 1 million people and has had a noted and positive impact on those most affected by and most at risk for HIV infection: women and girls.

In fact, in the 15 focus countries, more than 6 in every 10 of the individuals with HIV currently on antiretroviral treatment as a result of direct PEPFAR support are women and girls.

Given the continued burden of HIV/AIDS in the world's most vulnerable nations, there is no doubt that this critically important bill not only should be reauthorized, but that it should be increased. We were pleased that the President indicated a willingness to increase it in his State of the Union message this year. And I want to especially recognize Chairman Payne for successfully increasing the fund to $50 billion over the next 5 years.

This additional funding will help to expand the number of ``focus countries'' which currently are prioritized under PEPFAR. Additionally, it will help ensure that the forward-thinking and effective HIV/AIDS- related efforts that have been launched not only continue, but that other nations that are hard hit by this pandemic will have access to the resources they desperately need to address HIV/AIDS within their borders.

Mr. Speaker, despite the many successes associated with PEPFAR, we know that there is an entire region--the Caribbean--which has been and remains in desperate need of assistance in battling against HIV/AIDS. While two Caribbean nations--Haiti and Guyana--are, as they should be, currently prioritized as focus countries under PEPFAR, there are 14 other nations in the region that together comprise the second-hardest hit region in the world; second only to sub-Saharan Africa in terms of HIV/AIDS prevalence.

Mr. Speaker, in the Caribbean today, AIDS is one of the leading causes of death among adults aged 15-44 years of age. In some countries in the region, AIDS is the leading cause of death among individuals in this age group; a disturbing reality, because AIDS is taking its ultimate toll on Caribbean residents during their most productive life years, thus compromising many Caribbean nations' economic, social and political growth and stability.

Adding to the region's challenges with HIV/AIDS is the well- documented high population mobility. We know that many Caribbean nations--whose commitment to and effectiveness in addressing HIV/AIDS is stifled not because of the absence of political will, but because of the absence of resources--offer universal access to HIV/AIDS medications, care and other services.

In fact, Mr. Speaker, many Caribbean nations, not currently receiving PEPFAR assistance, absorb millions of dollars in debt every year providing treatment and care not only to their residents with HIV, but to all individuals on their shores seeking HIV/AIDS care and treatment.

These Caribbean nations have been doing what is right not only to address HIV/AIDS head on, but to lay the groundwork to beat this pandemic. And so, I rise today to encourage all of my colleagues--on both sides of the aisle--to support this legislation, which lists these 14 Caribbean nations as ``focus nations,'' to support these nations' efforts to prevent new HIV infections and to expand access to life- saving AIDS medications to those living with HIV infection.

Mr. Speaker, because of all of the above, I want to especially single out Congressman Fortuno for his leadership on this issue and shepherding this amendment through the committee process and ensuring it became a part of the final bill. I also want to recognize Chairman Rangel who was the first to begin this process 4 years ago.

This amendment might not have been possible without the hard work of nearly a dozen Health Ministers in the Caribbean and their collective and tireless efforts to raise awareness about the impact of HIV/AIDS in the Caribbean and to include 14 Caribbean nations as ``focus countries'' in this bill. I also want to thank the Pan Caribbean Partnership against HIV and AIDS, PANCAP, not only for their support of this bill, but for the important leadership role that they have and continue to take to address HIV/AIDS in the Caribbean region.

Mr. Speaker, as the only African-American physician in Congress and as the only representative from the English-speaking Caribbean, I can tell you--firsthand--that based on the surveillance data reported in the latest UNAIDS report, we know that the entire Caribbean region without adequate and targeted support from PEPFAR, is now and will continue to experience the same devastating impact from HIV/AIDS documented throughout nations in sub-Saharan Africa. Ambassador of and Health Ministers in Caribbean countries to the United States maintain that high HIV/AIDS prevalence rates can overwhelm the region's health care capacity, destabilize economies and compromise Caribbean nations' sociopolitical infrastructure.

In fact, Assistant Secretary General of the Organization of American States Albert Ramdin stated in January 2007 that, ``HIV/AIDS, if not effectively and urgently tackled, poses a clear threat to the sustainable development, social stability, and human security of the Caribbean.''

The time to act is now; now is when we should support a bill that not only will tackle on of our most pressing international public health challenges, but that will do so in a manner that is medically, epidemiologically, regionally and fiscally responsible today. I, therefore, urge all of my colleagues to support H.R. 5501 so that it may pass in the House of Representatives and so that we may lay the path necessary to ensure that during conference, the 14 Caribbean nations listed in this bill are included in the bill that is sent to the President for enactment. It not only is the right thing to do, but it is the smart and responsible thing to do.

Mr. Speaker, I would like to thank the gentleman from Massachusetts (Mr. McGovern) for the time, and I yield myself such time as I may consume.

During his 2003 State of the Union address, President Bush outlined a bold new plan to confront and combat the scourge of HIV/AIDS, tuberculosis, and malaria. Congress followed through and passed the U.S. Leadership Against HIV/AIDS, Tuberculosis and Malaria Act, known as the President's Emergency Plan For Aids Relief, PEPFAR, authorizing $15 billion in assistance to combat these diseases for fiscal years 2004 through 2008. That was the largest commitment ever by any nation for an international health initiative fighting a single disease.

Since its enactment in 2003, the programs created by this landmark legislation have made admirable progress in combating those horrible diseases.

So far more than 1.4 million people have received life-preserving antiretroviral treatment, over 2.7 million HIV/AIDS-affected orphans have received care, and many millions more have received instruction on how to protect themselves from infection. Tens of millions of people have received malaria and tuberculosis prevention or treatment services.

Even though this program has achieved remarkable successes, there is more that we can do. Tuberculosis still kills an estimated 2 million people each year and is the leading cause of death for people with AIDS. One million people die from malaria each year. AIDS is the world's fourth leading cause of death.

The devastating consequences of these diseases are plaguing sub- Saharan Africa. Over 22.5 million people are living with HIV, and approximately 1.7 million additional sub-Saharan Africans were infected with HIV last year. Just last year this horrible AIDS epidemic claimed the lives of an estimated 1.6 million people in that region. More than 11 million children have been orphaned by AIDS. Many families are losing their income earners. Health services are overburdened. Life expectancy in sub-Saharan Africa is now 47 years. Economic activity and social progress is impeded.

We must do all we can to prevent these tragedies.

The underlying legislation, justly and appropriately named the Tom Lantos and Henry Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008, will dramatically augment our commitment to fight these horrible diseases with an increase of approximately $35 billion in funding for a total of $50 billion over 5 years.

Some of my constituents are immigrants from Haiti and have family and friends in their land of origin. I often hear about the disastrous effects that HIV/AIDS is having on that country. As of 2007, Haiti had an HIV rate of almost 4 percent. Thankfully, since Congress passed PEPFAR we have invested over $300 million to help Haiti combat the AIDS pandemic by building on existing clinic and community-based health resources; expanding a network of satellite connections to the Centers of Excellence to permit instant review of difficult cases; training staff members of health care facilities that provide prenatal, gynecological and maternity care in provision of prevention of mother- to-child HIV transmission; and enhancing the lab network for clinical sites to support the diagnosis and treatment of HIV and other associated infections. I am pleased the legislation will also now cover several other countries that were previously not part of PEPFAR.

As I said yesterday in the Rules Committee, when we look upon our work in Congress many years from now, I can think of nothing that we or anyone else will be able to point to that is of more importance than this admirable effort by the great and generous American people, this massive effort proposed by President Bush here in the United States House of Representatives during his State of the Union Address of 2003, the President's Emergency Plan for AIDS Relief.

I would like to thank Chairman Berman and Ranking Member Ros-Lehtinen and Chairman Payne and Ranking Member Smith for their marvelous bipartisan, very hard work on this important issue. I also wish to thank them for naming this landmark program for two ultimately respected colleagues of ours who have recently left us, Henry Hyde and Tom Lantos. This is truly a fitting tribute for two remarkable human beings and public servants.

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

Mr. Speaker, I yield 5 minutes to the distinguished ranking member of the Committee on Foreign Affairs who has had such an important role and hand in this legislation, the gentlewoman from Florida (Ms. Ros-Lehtinen).

Mr. Speaker, it is my privilege to yield 3 minutes to the gentleman from Georgia (Mr. Gingrey), a physician who does so much on issues of health day in and day out throughout the United States, and, as on this issue, throughout the world.

Mr. Speaker, it's my privilege to yield 4\1/2\ minutes to the distinguished gentleman from Florida, also a physician, Dr. Weldon.

Mr. Speaker, I yield 4 minutes to the distinguished gentleman from Texas (Mr. Culberson).

Mr. Speaker, I yield an additional minute to Mr. Culberson of Texas.

Mr. Speaker, it is my privilege to yield 3 minutes to the distinguished gentleman from Puerto Rico, who is a leader on issues of health and has so much contributed to this important legislation, Mr. Fortuno.

I yield the gentleman 30 additional seconds, Mr. Speaker.

I yield 3 minutes to the distinguished gentleman from California (Mr. Rohrabacher).

I would ask my friend if he has any other speakers.

Mr. Speaker, I will be asking for a ``no'' vote on the previous question so that we can amend the rule and allow the House to consider a change to the rules of the House to restore accountability and enforceability to the earmark rule.

Under the current rule, so long as the chairman or the sponsor of a bill, joint resolution, conference report, or manager's amendment includes either a list of earmarks contained in a bill or a report, or a statement that there are no earmarks, no point of order lies against the bill. This is the same as the rule in the last Congress.

However, under the rule as it functioned under the Republican majority in the 109th Congress, even if the point of order was not available on the bill, it was always available on the rule as a ``question of consideration.'' Because the Democratic Rules Committee specifically exempts earmarks from the waiver of all points of order, they deprive Members of the ability to raise the question of earmarks on the rule.

This amendment will restore the accountability and enforceability of the earmark rule to where it was at the end of the 109th Congress to provide Members with an opportunity to bring the question of earmarks before the House for a vote.

Last year the distinguished new Speaker said that if she were to become Speaker of the House, she would require all earmarks to be publicly disclosed and would ``put it in writing.'' However, as we have seen, this Congress, the majority have not fulfilled their promise.

Mr. Speaker, I ask unanimous consent to insert the text of the amendment and extraneous materials immediately prior to the vote on the previous question.

I yield back the balance of my time.

Mr. Speaker, on that I demand the yeas and nays.

Mr. Speaker, there is no more noble endeavor that we can engage in than to cure human diseases. All of us in Congress I think have an obligation to be sure that we are, for example, doubling the investment we make in the National Institutes of Health, in the National Science Foundation, in the research work that they're doing to identify and cure human diseases at the earlier stages.

I represent the Texas Medical Center, and I'm proud to do so. Those institutions, the greatest in the world, the Andy Anderson Cancer Center, Texas Children's Hospital, Baylor University of Texas Health Science Center is doing research today, particularly on nano research, where we have the potential, within the next 10 to 15 years, of being able to identify in a child before she's born genetic predisposition to certain diseases, for example, like Lou Gehrig's disease, or diabetes, or cystic fibrosis. These genetically-based diseases can be identified before a child is born using nanotechnology, reinjecting, for example, nano sponges with a protein fix back into the mother's amniotic fluid. The child would then take up those nano sponges. And we can cure diseases in children before they are born.

We have the potential, if we will just invest in the National Institutes of Health and their competitive peer reviewed grant process, if we will just invest the money that's needed right here in America for the National Science Foundation, we have the ability to detect cancer when it's only a few hundred cells in the body using nanotechnology and gold nano shells that will attach to the cancer cells and destroy them before they turn into a tumor.

We have not adequately invested in our own scientific and medical infrastructure in the United States, first and foremost, before you even begin to talk about curing disease globally. We have not secured our border. The southern border is essentially wide open and unprotected in areas other than Del Rio and Laredo. What are we doing to make sure that we've done all that we can do here at home first and foremost for our own folks?

But then finally, and most importantly, and the reason I'm so spun up about this, is the fact that this Democrat Thelma and Louise Congress, Obama-Hillary-Pelosi Democrat Congress, is managing this economy of the United States like Thelma and Louise, driving right off the cliff.

I urge you to go to gao.gov and look at the Fiscal Wake-Up Tour that David Walker has put up on the Web site. The Comptroller of the United States has notified us formally that we are spending money so irresponsibly, so rapidly that the Standard & Poor's and Moody's has already formally notified the Treasury that they are beginning the process of downgrading U.S. Treasury bonds.

The Comptroller has told us that by the year 2020, in 12 years, young people who are 18, if you're listening, by the time you turn 30, Medicare is bankrupt, Treasury bills will be graded as junk. Let me repeat that, Treasury bills are on a path to be graded as junk bonds if we don't stop spending money and focus on the bare essentials. Every American already owes $175,000 a person.

This bill creates a worldwide entitlement to anyone in the world that has AIDS or malaria or tuberculosis at U.S. taxpayer expense. It's unaffordable. It's unacceptable. It is utterly irresponsible at a time of record national debt, record deficits, record Federal spending that we need to reign in, otherwise America is going to become Argentina. The dollar is rapidly becoming the peso. It's time for this Thelma and Louise Democrat Congress to quit spending money on things that are not absolutely essential to this Nation's survival.

Let us focus on protecting the United States of America and quit spending my daughter's money that she does not have and driving our kids and our grandchildren deeper into debt. It is irresponsible. It is, frankly, criminal, in my opinion, to drive up the national debt and the deficit to record levels.

It is a noble, good thing to try to cure disease in Africa. Why don't we focus on clean drinking water, for example, if you really want to fix disease in Africa. Quit spending my children's money that they don't have.

Announcement by the Speaker Pro Tempore

I want to thank Mr. McGovern for his thoughtful response and point out that over the last 60 years, the Republicans have been in control of the Congress for I think about 14 of that. We were in control about 12 years, and then I think there were 2 or maybe 4 years under Eisenhower that the Republicans were in control. So, Democrats have controlled the Congress for the overwhelming majority of the last 60 years.

I got here in 2001. And I can tell you, Mr. McGovern, and you're a thoughtful, good man, I enjoy working with you, that I personally, on behalf of my constituents, have voted against every major spending initiative that the White House has pushed on us because I recognized this problem the comptroller has put out before us. I voted

against the farm bill. I voted against the Medicare Prescription Drug bill. I voted against the No Child Left Behind Act. I voted against the AIDS in Africa bill the last time it came up because we cannot continue to spend money that our children cannot afford to pay. The money we spend today will be paid by our kids and our grandchildren. And that's the fundamental message here, Mr. McGovern.

I would encourage everyone in this Congress, and I know you're a thoughtful guy, why don't we focus on providing clean drinking water. Let's convert existing foreign aid in Africa to clean drinking water, which I've lead the effort to provide $500 million. Focus on clean drinking water and research here in America.

I thank the gentleman for yielding. I rise in strong opposition to this rule, and very strong opposition to the underlying bill.

And let me just say from the outset that I used to take care of AIDS patients before I came to this Congress back in 1994. I was one of only two physicians in a county of 400,000 people that was seeing AIDS patients. And I have announced my retirement, my intent to leave the House of Representatives at the conclusion of this Congress, and I will most likely go back to seeing patients in January. And I may, indeed, be seeing AIDS patients again.

Let me additionally say that I'm very concerned about the situation in Africa. Indeed, I have gone to Africa twice in my term of service here in the Congress specifically to look at the issue of helping in Africa with the issues of AIDS and malaria and TB, and so I think I have credibility to be able to say I care, I'm concerned. But this underlying bill and this rule that restricts any cutting amendments, in my opinion, is just excessive.

Years ago, when the President originally came up with PEPFAR, he came to me and asked me to help him with his plan, and I did. And I actually thought his plan was very, very generous, $3 billion a year. And when he gave his State of the Union message just a few months ago indicating that he wanted to double the size of this from $3 billion to $6 billion a year, I personally thought that was excessive. When you look at all the problems we have with health care access for Americans, the problems that we have with transportation infrastructure, the problems that we have in fighting the war in Iraq, Afghanistan, the homeland security issues, I thought to take this program from $3 billion a year to $6 billion a year was excessive and over the top.

But now we have before us today an underlying bill to not increase it by 100 percent, which is what the President was asking for, but to increase it by over 200 percent. That's the underlying bill. And the Democrat leadership of the House under the Democratic Rules Committee is saying, well, no, we don't want any cutting amendments.

Now, let me tell you a little bit of why I am so passionately upset about it. Yesterday, NASA announced that, with the retirement of the space shuttle, they are going to be laying off over 6,500 people in east central Florida, my congressional district. That is a huge amount of people. It has a huge economic impact on the State of Florida. And for us to be putting our astronauts on Russian rockets, we're going to have to sign a contract with the Russians for the construction of these rockets, we're essentially going to be laying off people in Florida and hiring people in Russia with U.S. taxpayers.

Now, this Congress, under this Democratic leadership, is saying that we have no choice, we cannot afford to continue to fly the shuttle in 2011, 2012, 2013. We cannot afford to bring the new rocket system online any sooner than 2005 or 2006, we don't have the money, while we have all this money to send $50 billion to Africa for AIDS. Now, again, let me just say, I understand this is a terrible problem. I don't even mind increasing the Africa AIDS account. And what, to me, is insult on top of injury, my staff has informed me that they have $1 billion in this account unspent that they are working to try to spend. So, they can't even spend all the money that we're sending them over there, and we want to send them a 240 percent increase?

Now, I know every Member of this House can get up and give a speech like this; they have water projects in their district, they have health care clinics in their district. In my particular case, it's pretty significant. We've got over 6,000 people who are going to get a pink slip. So, for us to say we can't fly the shuttle beyond 2010 because we can't afford it, but that we can somehow find $50 billion to send to Africa, to me is just way over the top. I can't justify that back home.

I'm opposing this rule. I'm going to vote against the underlying bill. And I thank the gentleman for yielding me time. I appreciate it.