Mr. Chairman, I thank the gentleman for yielding. Mr. Chairman, I want to commend Chairwoman Lowey for working diligently on this bill. She has produced a fairly good product here, and I want to commend her more for working with Mr. Wolf…
Mr. Chairman, I thank the gentleman for yielding.
Mr. Chairman, I want to commend Chairwoman Lowey for working diligently on this bill. She has produced a fairly good product here, and I want to commend her more for working with Mr. Wolf and myself to address many of our concerns.
She has produced a bill that is good in many respects. I appreciate the efforts as well of the staff that have worked very hard on this bill. A great example of working together is what my colleague from New York, Mr. Israel, was talking about in dealing with Darfur. I want to commend Mr. Wolf for his passion on that issue and his passion for the issue of human rights throughout the globe. I also want to commend Ranking Member Wolf and Chairwoman Lowey for their work on Colombia, and I am very pleased with the final product that they have there.
I am also very pleased that we have included language dealing with better accountability for the Global Fund to provide greater transparency. I commend Chairwoman Lowey for including the language that I introduced, the amendment, to get a better understanding of why the participation of faith-based organizations in the Global Fund appears to be significantly underrepresented. Numerous faith-based groups have been on the ground providing health care in many of those these countries for decades. In recent decades they have been on the frontlines in fighting against the spread of AIDS.
I saw the critical role that many of those faith-based groups provided firsthand when I visited Africa twice in recent years. I can tell you what part of the problem is, and it is really spelled out very nicely, and I will include for the Record this brief 3-page article from Catholic News Services, ``African Churches Find Global Fund Money Fairly Inaccessible.''
Basically, what I feel is going on here with those faith-based groups is relatively simple. They are small. They are out there. They are going into these villages on foot and on mopeds. They don't have the ability to apply for grants with multi-billion dollar organizations in Geneva. It is going to require the Global Fund to reach into these countries, identify the groups, the church groups, the faith-based groups, that are doing the work. Frequently, they are on the pointy end of the spear. So I commend the gentlewoman for that language.
I know there are a few issues that we disagree on. The Mexico City policy language, we will have amendments to address that. Certainly, I understand that the gentlewoman has tried to reach out on this issue.
For me personally, the issue is an organization that is not only maybe providing abortion but as well is actually actively lobbying to overturn pro-life laws in many of those countries. We should not be supporting them even indirectly.
Finally, let me just close on the PEPFAR language. I played a role in getting the President's plan through the Congress, the authorizing language and the appropriations language. To me one of the most important things was the requirement that a portion, actually a small portion, I think it is 20, 25 percent of the preventive dollars go to abstinence education and abstinence training.
I want to make it very clear to my colleagues the reason why I felt so strongly about that and why I feel that we should continue the requirement that abstinence education be included in the preventive dollars is my experience in going into Uganda. Uganda lowered its AIDS incidence from 18 percent to 6 percent, a two-thirds reduction in AIDS.
The Global Fund didn't exist. PEPFAR did not exist when they did this. They did not do this through distributing condoms and comprehensive sex education. They did it through what they called ABC, abstinence before marriage, be faithful in marriage. We all know, you can't expect everybody to comply. But what is amazing to me is when you educate people on this thousands of people comply.
I just want to share with my colleagues that I had a meeting just 2 weeks ago with a Parliamentarian from Uganda who was an epidemiologist and a physician who was there from the ground up, and he verified just what I said, that people responded to the message.
Let me just finish up on that. Last July, southern African AIDS experts met and they officially listed ``reducing multiple and concurrent partnerships'' as their number one priority for the prevention of spreading HIV. It was not distributing condoms and comprehensive sex education, it was reducing concurrent and multiple partnerships. That is what this is really all about.
Let me just close and again commend the gentlewoman for a bill that has a lot of good in it. I am focusing on some of the things I disagree with. But for everything I disagree with, there are 10 to 20 different things that are good in it.
The spending level, I am very concerned that the President may veto this bill. I know there are a lot of worthwhile programs covered in the spending. I certainly would like to see us get a bill enacted into law. I think that would be to the credit of the chairwoman and the ranking member, the good gentleman from Virginia.
[From the Catholic News Service]
African Churches Find Global Fund Money Fairly Inaccessible
(By Michael Swan)
Nairobi, Kenya (CNS)--In Kenya churches provide about 40
percent of all health care in remote and impoverished areas
with no government services, but for their AIDS programs,
churches receive no money from The Global Fund to Fight AIDS,
Tuberculosis and Malaria.
``Since the inception of the Global Fund, the Kenyan
bishops' conference has not accessed any direct funding from
the Global Fund, even after applying to all the rounds,''
said Titus Munene, an HIV/AIDS program coordinator for the
Kenyan bishops' conference.
``It isn't rocket science to say if 40 percent of the
health care is in the church system in Kenya, you would think
a good portion of (Global Fund money) is going to go to our
operational system. But unfortunately, it isn't that way,''
said Maryknoll Father Ed Phillips, who runs seven community-
based health care clinics.
The Geneva-based Global Fund, established in 2002, is a
partnership among governments, civil society, the private
sector and affected communities.
The Catholic Church alone provides more than 25 percent of
all AIDS care in the world, according to Caritas
Internationalis, the Catholic aid network. All faith-based
organizations combined have received just 6 percent of the
Global Fund's money since the first disbursements in 2002.
The Southern African Catholic Bishops' Conference, which
represents South Africa, Botswana and Swaziland, has almost
stopped applying for Global Fund money.
More than 18 percent of adult South Africans are HIV-
positive, and the church is the largest health care provider
after the government. But church bodies have been unable to
access Global Fund money either directly or through the South
African National AIDS Council, which coordinates South
African applications to the Global Fund.
``I have sat on SANAC, the South African National AIDS
Council, which is also the CCM (country coordinating
mechanism) for the Global Fund. It has not been a helpful
process,'' Dominican Sister Alison Munro said in an e-mail
from Pretoria, South Africa.
``The Global Fund process is too large and too cumbersome
for the churches,'' said Sister Alison. ``If they (the
churches) could apply directly to the Global Fund, some
would. They can't because of the procedures. . . . The work
involved is too much for any church group other than a
national structure or a group with lots of capacity.''
While many nongovernmental organizations employ grant
application experts, church-based agencies have tended to
regard such functions as wasteful of donor money.
Munene said when the churches do not get Global Fund money
it weakens the fight against AIDS among some of the poorest
Africans. A lack of international and Kenyan-government
funding has forced mission hospitals, clinics and
dispensaries to charge some of the poorest people in Kenya
for AIDS treatment and services, while relatively well-off
people in the cities are accessing free services.
Munene said when church agencies charge for health care it
``means some of the poor cannot access services, since there
are no government facilities in those rural areas.''
The 6 percent of Global Fund money going to faith-based
organizations translates into $325 million spread over five
years in dozens of countries. The Global Fund recognizes the
number is too low, said spokesman Oliver Sabot.
``Given the essential role that they play in health care in
many countries, particularly in Africa, we would like to see
the amount of funding to FBOs (faith-based organizations)
increase,'' Sabot said.
Part of the problem has been that churches have not done
enough to fulfill conditions that might be expected from
major international funders, such as making detailed
applications for funding and monitoring expenditures to the
satisfaction of donors, said Father Robert Vitillo of Caritas
Internationalis, the Vatican's most prominent adviser on HIV/
AIDS policy.
``Each of these funding mechanisms comes with its own set
of challenges for (faith-based organizations), which are more
expert in providing support, care, treatment and prevention
education than in completing such complicated funding
applications and then in monitoring and reporting on the
funds received,'' said Father Vitillo.
Even if it is a lot of red tape, church organizations have
to be willing to fight through it in order to continue
delivering effective AIDS prevention and care, said Father
Phillips. But the Global Fund also has a responsibility to
help churches through the red tape, he said.
``The churches have to get more proactive,'' said Father
Phillips. Sabot said the Global Fund has taken steps to
ensure that faith-based organizations are able to apply for
money. But by relying on countries' coordinating agencies or
mechanisms, the Global Fund has become subject to the
politics of Africa.
``This hands-off approach does mean that bias at the
country level is sometimes reflected,'' said Sabot. He said
sometimes faith-based groups are excluded from country
proposals ``either because of deliberate efforts by the
government or other groups, or simply because they are less
experienced with applying for international aid funding, and
not enough outreach and support was provided to them'' by
country coordinating agencies.
``We have taken steps to help correct both these problems,
but there is still more to be done,'' Sabot said.
Father Phillips said more than bureaucratic bias is
involved in shutting churches out of national applications to
the Global Fund.
``The church was considered in some of these countries to
be the opposition to the government,'' he said. ``Naturally,
if they are considered to be opposition, well, they're
(government mechanisms) going to make sure they're not going
to target a lot of money'' for the church.
Father Phillips said African bishops must get tough and
vocal about demanding that they be represented fairly in
national applications to the Global Fund, but Munene said the
churches may be talking to a brick wall when they demand fair
representation.
``The Kenyan bishops have made frantic efforts to meet the
minister of health on several occasions, and even his
excellency, the president. And promises were given, but to
date the pledges have not been fulfilled,'' Munene said.