Alzheimer’s Accountability and Investment Act

Mr. President, I rise today to introduce the Expanding America's Pacific Diplomatic Presence Act, a bipartisan piece of legislation that seeks to deepen our diplomatic relations with Pacific Island countries and territories. I am thankful to Senator Cotton, Senator Markey, and Senator Hagerty for joining me in introducing this legislation.

The United States enjoys strong historical ties, economic relationships, and cultural links with many Pacific Island nations. During World War II, these islands became the frontlines of some of our hardest fought battles of the Pacific campaign. Now, Pacific Island nations and territories are at the frontlines of climate change. Our friendships with Pacific Island nations are deepened by generations of Pacific Islanders whose presence in the United States and contributions have enriched communities throughout our country. We also recognize the strategic importance of Pacific Island nations, as demonstrated by the Compacts of Free Association we have with the Republic of the Marshall Islands, Federated States of Micronesia, and Palau. Unfortunately, while our diplomatic presence in the region has waned in the last decade, the diplomatic and economic presence of the People's Republic of China, PRC, has increased as it seeks to forge closer ties with Pacific Island nations. What happens in the Pacific Islands matters to the United States and we must take steps to demonstrate the strength of our commitment to the region.

Diplomatic engagement in the region is critical for understanding how we can better support our Pacific Island partners. President Biden has worked to elevate the U.S.'s diplomatic engagement by being the first U.S. President to participate in a gathering of the Pacific Island Forum leaders. The President also signaled his commitment to the Freely Associated States by appointing Special Presidential Envoy Ambassador Joseph Yun to lead negotiations over the Compacts of Free Association. Several high-ranking administration officials, including the Secretary of State Antony Blinken, have visited the region to pledge U.S. support for efforts related to COVID-19 response, climate change adaptation, maritime security, infrastructure development, trade, and economic investment. I applaud this level of meaningful diplomatic engagement in the region and would like to see this sustained in the future.

Establishing new U.S. diplomatic posts would support our efforts to build lasting relationships with Pacific Island nations and territories. The United States currently has eight Embassies among Pacific Island nations, with plans to reopen an Embassy in the Solomon Islands. These Embassies play an important role in forging relations with host nations and serve as important symbols of the U.S.'s long term commitment to the region. Opening new embassies, consulate generals, or other diplomatic posts would allow U.S. diplomats to have more regular interactions with the governments of the Pacific Islands and learn more about the challenges and opportunities facing each nation. The year-round presence of more U.S. diplomats would improve our ability to compete with the PRC's growing presence in the region and would enhance our coordination with Australia, New Zealand, and Japan on economic development assistance and humanitarian aid. An expanded diplomatic presence in the region would also improve oversight of U.S. Government-funded programs in the region.

The legislation I am introducing would direct the Government Accountability Office, GAO, to conduct a feasibility study on establishing new diplomatic posts in Pacific Island countries and territories that currently do not have a U.S. Embassy or other U.S. diplomatic post. This legislation recognizes and seeks to understand what potential benefits and challenges may exist for establishing new U.S. diplomatic posts in the region. I hope that the results of an independent study conducted by GAO will inform future decisions by Congress and the executive branch to establish and appropriately fund new diplomatic posts in the region.

I urge my colleagues to pass the Expanding America's Pacific Diplomatic Presence Act to demonstrate our support for greater diplomatic engagement with our partners in the region and reaffirm our commitment to building a shared future with the people of the Pacific Islands.

Mr. President, I rise today to introduce two bills aimed at continuing the important progress we have made so far to prevent and effectively treat Alzheimer's disease. I know how devastating this disease is. My father, grandfather, and two uncles all died from Alzheimer's. I am committed to this effort both as a person whose beloved family members have suffered from this disease as well as a Senator concerned about the impact on our families and our healthcare budgets.

When I founded the Congressional Alzheimer's Task Force in the Senate in 1999, there was virtually no focus on Alzheimer's in Washington. Twelve years ago, I coauthored the bipartisan National Alzheimer's Project Act with my colleague Senator Evan Bayh. Before we passed that legislation, there was no coordinated, strategic national plan to focus our efforts to defeat Alzheimer's and ensure that our resources are maximized and leveraged. NAPA

fixed this by convening a panel of experts to create a coordinated strategic national plan to prevent and effectively treat Alzheimer's disease by 2025. The expert council updates the plan annually.

We have made some progress in our efforts to find a treatment, means of prevention, or cure, but Alzheimer's still costs our Nation an astonishing $321 billion per year, including $206 billion in costs to Medicare and Medicaid. If we continue along this trajectory, Alzheimer's is projected to claim the minds of 12.7 million seniors and nearly surpass $1 trillion in annual costs by 2050. It takes a tremendous toll on families, too. In 2021, family caregivers provided 16 billion hours of unpaid care for loved ones with dementia. That job is often 24/7 and often harms the health of the caregiver.

The National Alzheimer's Project Act is set to expire in 2025, so we need to reauthorize this critical legislation to make sure that our research investments remain coordinated, and we can maximize their impact.

The first bill that I will introduce today with my colleagues Senators Warner, Capito, Markey, Moran, and Menendez, is the NAPA Reauthorization Act. It would reauthorize NAPA through 2035 and modernize the legislation to reflect strides we have made understanding the disease, like including a new focus on promoting healthy aging and reducing risk factors.

The second bill that I will introduce, with my colleagues Senators Markey, Capito, Warner, Moran, and Menendez, is the Alzheimer's Accountability and Investment Act. That bill would continue through 2035 a requirement that the Director of the National Institutes of Health submit an annual budget to Congress estimating the funding necessary for NIH to fully implement NAPA's research goals. Only two other areas of biomedical research--cancer and HIV/AIDs--have been the subject of special budget development aimed at speeding discovery, and this ``bypass budget,'' as it is known, helps us to understand the additional funding needed to find better treatments, a means of prevention, and ultimately a cure for Alzheimer's disease.

Nearly half of baby boomers reaching age 85 will either be afflicted with Alzheimer's or caring for someone who has it. In many ways, Alzheimer's is the defining disease of this generation. We have made tremendous progress in recent years to boost funding for Alzheimer's research, which holds great promise to ending this disease that has had a devastating effect on millions of Americans and their families. The two bills I introduce today will maintain our momentum and make sure that we do not take our foot off the pedal just as our investments in basic research is beginning to translate into potential new treatments. We must not let Alzheimer's define our children's generation as it has ours.

Mr. President, Senator Capito and I are introducing legislation today to reauthorize appropriations for the National Wildlife Refuge System's volunteer and partnerships program. I want to share with our colleagues some information about the Keep America's Refuges Operational Act and ask for their support.

The Keep America's Refuges Operational Act reauthorizes the volunteer and partnerships program, with no increase, at $2 million per year. The U.S. Fish and Wildlife Service uses the modest Federal funding it receives for this program to leverage volunteer contributions by providing uniforms, training, equipment, and necessary travel.

Our National Wildlife Refuge System is an exceptional network of more than 850 acres of public lands and waters dedicated to fish and wildlife conservation. Tens of millions of people visit our refuges each year to explore, fish, hunt, and view and study wildlife. This ecotourism strongly supports local economies. During the pandemic in particular, our national lands, including refuges, were safe outdoor spaces for recreation.

Volunteers are critical to refuge operations. They assist with fish and wildlife surveys, restoring habitat, and supporting refuge office functions. Without volunteers and partner groups, refuges would likely have to cut back on public programs and reduce hours of operation.

In my home State of Delaware, we have two beautiful refuges--the Prime Hook National Wildlife Refuge and the Bombay Hook National Wildlife Refuge. Both refuges are highly dependent upon volunteers.

Each year, people come to our refuges to observe the federally threatened red knot shorebird, which stops along the Delaware Bay to refuel on horseshoe crab eggs along its migration journey. Volunteers make sure these visitors have memorable experiences.

When people can see these pristine habitats and the many species that call them home, they are inspired to be good stewards of our planet for the enjoyment and benefit of future generations.

I want to ensure that these opportunities opportunities abound in Delaware and around the country. A small annual investment in the refuge system volunteer and partnerships program goes a long way. Every $1 appropriated to coordinate these volunteers translates to approximately $10 worth of volunteer services.

These appropriations also help cut government costs. In fiscal year 2021, more than 11,000 volunteers donated 68,879 hours, with donated time equaling that of 318 full-time employees. The value of this time contribution is about $18.5 million.

I want to thank Senator Capito for cosponsoring this commonsense legislation. I look forward to working with her and our colleagues in the House to pass the Keep America's Refuges Operational Act and enact it into law.