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Federal Document Clearing House
Congressional Testimony
March 08, 2000
SECTION: CAPITOL HILL HEARING TESTIMONY
LENGTH: 4800 words
HEADLINE:
TESTIMONY March 08, 2000 MARY FISHER SENATE BANKING AND
FINANCIAL SERVICES AFRICAN AIDS CRISES
BODY:
"What
Do I Say to My Sister?" Mary Fisher Testimony Committee on Banking and Financial
Services United States House of Representatives March 8, 2000 Chairman Leach,
Esteemed Members of the Committee: If I was honored by your invitation to
testify - and I surely was - I was also uncertain what motivated it. My recent
trip to Africa did not qualify me as an expert. Your former colleague, Steve
Gunderson, has now been my colleague at the Family AIDS Network for three years
- perhaps, I thought, this was an invitation based on Steve's work. My father,
of course, believes you invited me to hear a "Republican voice" on the issue at
hand. And beneath it all, I've imaged that some of you imagine I know something
about the stigma attached to AIDS, especially to women with AIDS. Perhaps each
of these factors played a role. What's important is that I tell you, truly, how
deeply I appreciate your invitation and how grateful I am that you have shown
the courage to hold a hearing which may discomfort some of us. AIDS has not gone
away in America, it has gone underground. From the White House to the New York
Times to the campaign hustings, we want to pretend that the crisis has ended.
Despite 40,000 new infections of HIV each year in America, funding for AIDS
prevention appears to be "yesterday's" concern. A word-search through campaign
speeches and literature of our party's presumptive presidential nominee,
Governor George W. Bush, cannot turn up the word "AIDS." The Congress is unable
to reauthorize even the foundation Ryan White Act. Contributions from the
philanthropic and corporate communities have moved on to other
diseases-of-the-moment. There are no more headlines to chronicle the dying, just
quiet obituaries. While AIDS scorches the earth, it makes nary a ripple in the
evening news. Globally, at least 33 million people are now infected. Given
routes and rates of transmission, that number skyrockets daily. In the United
States, AIDS has gone underground in communities of poverty and color,
communities of youth and women. It's gone exactly the same place globally: to
those people who have the least social standing and the fewest economic
resources - typically, the young and always the women. When American young
people who are most at risk - African Americans, women, drug users - are asked
about AIDS, they respond in overwhelming numbers with the conviction that "Magic
Johnson is cured and there is no risk." That ignorance is going to kill them.
And as for our recognition of global realities, when NEWSWEEK ran a poll earlier
this year, more than half of U.S. adults said they hadn't seen anything on an
AIDS crisis in Africa. In January I visited four African nations with National
AIDS Policy Director Sandy Thurman, and others. We went places where life
expectancy has dropped 15 years since 1990 because of AIDS. I stood with a
grandmother raising her orphaned grandchildren. Where once she had a garden next
to her home, now she has a graveyard - grave after grave, she lined them up as
she buried her children one-by-one as they fell to AIDS. In Rwanda, the genocide
of 1994 left a legacy of AIDS. A full sixty percent of those who survived
torture and rape were left HIV-positive. When the killing was over, 100 doctors
were left to care for the nation's seven million people. But what dominates the
African landscape is orphans. Acres of orphans - orphans raising orphans,
because there is no one else left to do it. Tough children take to the streets.
Weak children die of starvation. Many just sit, docile and sick, a vast, human
ocean of orphans, mostly infected and doomed. Seeing the orphans, thinking of my
sons Max and Zachary, I barely heard the local government leader. I said, "I'm
sorry, what did you say?" And he said again: "I would like your advice, Ms.
Fisher. "If we should somehow get the money, do we put the orphans through
school, or do we feed them?" It was my stunning inability to respond that fueled
my desire to be with you today. I've labored for nearly a decade with the label,
"The lady who told the 1992 Republican convention she had AIDS." They remember
it because they were surprised; most of them didn't believe women could get AIDS
- and some of them didn't believe Republicans could! It's no sillier, really,
than the commonplace belief today that AIDS in Africa or Asia can be kept out of
the United States. Every new strain of virus can and apparently does find its
way across our borders within days, if not hours. With regard to AIDS, we live
in a Flat-Earth society denying that the world is round, and the virus is
prolific. Sometimes I fear that our racism traps us into indifference. I want
not to believe it, but the evidence is hard to deny. Walking Rwanda, stepping in
the trail of torture and blood that crisscrossed that country, I couldn't help
but wonder why, knowing what we knew, we did so little. How do we escape the
fear that because they were dominantly Black, and we are dominantly White, we
simply did not care? And what do we say to ten million orphans that we did not
say to five million a few years ago, or that we will not say to 20 million in
five years? Is it because my children are White and American that I receive so
many letters of concern for them, and because Rwanda's children are Black and
African that we can say, "They are not our children?" I want not to be harsh.
But I must tell you that I cannot risk being too sweet or too mild, or I risk
going to my own grave with an unquenchable guilt. You are my nation's leaders.
And I am a person with AIDS. I've witnessed, and I bear in my body, the
consequences of discrimination against America's gay community. I've experienced
life as a woman who came from the most privileged position and now carry the
most despised disease. I've listened as people have explained that the epidemic
is over, knowing that I'd need to tell my children that the prognosis for their
mother is unchanged. If anything that follows seems harsh, please forgive me;
that's not my intent. If the purpose of this legislation, or this hearing, is
simply to justify a claim of openness or a show of compassion, you must stop
this. Such theater simply raises false hope among those who are most hungry for
hope. There is no reason to taunt the AIDS community - in America or in Africa -
with false hope. But if, as I believe, it is your goal to heighten American
awareness of the global crisis, and to leverage your power within the American
government to marshal desperately needed resources for this fight - then I am,
of all people, most grateful. One piece of legislation will not be enough, but
it can be a critical beginning. If it is approved, and if it is then followed by
full implementation and funding, it is truly worthy. If it fails, either in its
adoption or its implementation, it will hand the African continent one
experience of betrayal at the American door. The most significant impact of this
legislation might be the message it sends. It would signal our recognition that
AIDS is devastating not only populations but whole economies. What we spend on
AIDS in America is only a fraction of what AIDS costs us in this nation, and is
even less on a world scale. Reckon with the lost productivity and earnings;
count the impact on our health care costs. Now multiply those numbers by what -
a hundred times? A thousand times? -- to feel the impact of AIDS on the world
economy. This is why your committee and the World Bank are appropriate arenas to
be discussing AIDS today. Merely appropriating additional monies to the
international fight against AIDS will not be enough. Merely directing the
Secretary of the Treasury to enter into negotiations with the, World Bank won't
be enough. But if this is the launch of a comprehensive and sustained commitment
by the Congress, the Administration, and the international community - it is
just the right thing to do. If I may, I would like to make just these few
additional observations regard a comprehensive address to the global epidemic.
We need a coordinated response at home and around the world. My hope is for
negotiations between the Congress, the Administration, and the world AIDS
community to develop a comprehensive program for the United States and for the
world. It would recognize that the AIDS virus doesn't carry a passport, doesn't
recognize borders, and asks only one question of those it infects: "Are you
human?" Therefore, I worry that if Congressman Porter's Committee funds AIDS
research at NIH; and if Congressman Bliley's Committee re-authorizes the
Ryan White Care Act; and if Congressman Gilman's Committee
authorizes increased authority for USAID; and if you authorize funding for the
World Bank - that we risk spending vast amounts of money, here and abroad, with
little impact. Trust me: I want you to act. Lives are depending on it. But it's
precisely because lives are depending on you that we need a comprehensive
strategy, not a piecemeal program. We must build an infrastructure. Second, we
must be devoted to creating an infrastructure for fighting AIDS - because it
doesn't exist today, not in Africa and, in some respects, not even in the United
States. In both settings, the early responses to the epidemics have risen from
community-based organizations. Here in the U.S., as the epidemic moved into
communities of color and youth and women, those organizations did not rise as
they had in America's gay community. As a consequence, much of the response must
now come from government. And therein lies the problem. Here in the U.S., many
of those already infected with AIDS will not be tested because, among other
factors, they do not trust the government that would test them. And in Africa,
for different reasons, governments are equally ill- equipped to respond to AIDS.
Some governments have outlawed birth control which is our only hope for AIDS
reduction. In Zimbabwe, homosexuality is illegal. Such governments do not
possess the infrastructure to fight, let alone prevent, AIDS. I am not
suggesting that we ignore the governments of nations. But I am reminding all of
us that in developing nations, and even here at home, we need to adopt
strategies that actually work - not that merely pass the political test of sound
bites. This will be slow, frustrating work. When I talk infrastructure, I don't
just mean doctors and hospitals. I mean everything from roads to clinical care
facilities, from clean water to medical supplies. But if we do not engage in
this effort, the cost in human life is so staggering we cannot find enough words
or examples to explain it. Perhaps it's my Republican leanings; perhaps it's
what I experienced in Africa. But for my tax money, we would be wiser to invest
$1 million in the private work of one Dr. Bobbie McGuffy than $10 million in
government programs that will never prevent a case of AIDS or give care to a
single orphan. Privatizing Education and Prevention. Governments cannot achieve
adequate education or prevention. Here in the U.S., we are prohibited by law
from the frank classroom instruction needed to teach children how to save their
own lives. Some call this moral; I call it immoral. But it doesn't matter. The
government cannot always do what must be done. And if this is true in America,
it is doubly true in Africa. What's needed there are immediate peer-support and
peer-education programs. Those with AIDS must talk to those who do not, yet,
have AIDS. They don't want to hear from Mary Fisher, frankly, and they certainly
don't need to hear from World Bank officials. Young mothers need to talk with
young mothers. Young people need to talk with young people. And adult males need
to talk to adult males. I think USAID understands this. I believe they intend to
reach the right populations with an appropriate program. But, truly, against the
tidal wave of AIDS, their financial resources are a thimble full. It need not
always be complicated. Let me share just one example: "The Memory Book Project,"
the approximate equivalent of our AIDS Quilt here in America. In Africa, the
Memory Book Project was started by one HIV-positive mother to help other
mothers, and grandmothers, prepare their families for their own deaths. The
program results in both education and support. In countries like Uganda, what
they need most of all is paper - paper, so they can make a book of memories of
those who are facing death. Myths of treatment and care. The myth of the
so-called "AIDS cocktail" - the myth that it's a cure, that it works for all -
is alive and well in Africa. Every single person with AIDS I met during my time
there asked how to get the "cocktail." When I told them that the drug did not
work for me or for many others, they - like most Americans - didn't believe it.
In Africa, they believe the rich Western world is keeping a cure from them
intentionally. If we cannot save lives, we can improve them. People begging me
for skin creams to treat the sores on their body; we could provide massive doses
of comfort for the dying at a cost of about $4 per year. Simple antibiotics,
clean water, nutrition - here is where we must begin, not with an expensive and
nonexistent cure. We cannot impose American culture on Africa. And, in some
African societies, if a woman does not breastfeed her baby, the community
concludes she has AIDS and shuns her. As a result, many HIV- positive women
breast feed and, in the process, transmit the disease from Mother to child. If
we could simply direct sufficient funding towards universal access to infant
formula, we could improve the health of most infants, one form of HIV
transmission and counter the silent stigma that helps spread the disease.
Americans hate death, our own and those of others. We like to deny it. And if we
can't defeat death, we often retreat to saying, "There's nothing we can do." If
we want to help fight AIDS in Africa, we may hate our best option. Because some
of our best options will be helping people die with greater comfort. Given
science, it's the best we can do; given morality, it's the least. Conclusion.
This is one of the final speeches I will give on behalf of the Family AIDS
Network, the organization I founded in 1992. We are closing our doors at the end
of this month, based on our recognition that we are failing at AIDS awareness
and education. We have lost that fight here, in the U.S. The silence, the myths
and the denial have won. But I can assure you I am not giving up the fight.
Which is why, on April 1, 2000, we will open the Mary Fisher CARE Fund - "CARE,"
for Clinical AIDS Research and Education -- at the University of Alabama in
Birmingham, one of the nation's largest and most effective AIDS research and
clinical facilities. We've learned that speeches without research save no lives;
that occasional awareness about AIDS does not matter without sustained, accurate
information; and that our only hope is a partnership of research, education, and
public policy. Therefore, such is the mission of the CARE Fund. Our focus will
be on long-term, outcomes-based research into AIDS treatments. We will partner
with every clinical AIDS center that will join us. We will use this new
knowledge to help impact public policy and private sector insurance and medical
policies on the treatment and care of persons living with HIV/AIDS. And, yes,
Steve Gunderson will continue to be our key colleague in Washington, DC. In the
rush to believe that we already have a cure, Americans have been duped into
thinking we are safe. We aren't. And in the call for a vaccine - for which every
one of us prays, no one more fervently than I - we look toward the distant
future. But in the meantime, in the day you and I have, today, now, we have 33
million lives that will be lost without effective treatment. Unless there is a
discovery none of us imagine in the coming moments, we are going to face 50
million, 75 million, 100 million or more deaths to AIDS. This is unimaginable,
and currently unavoidable. So Dr. Michael Saag and others at the University will
increase their pioneering efforts to keep alive those already infected. And I
will do what I can to support them. I will also do what I can to support my
brothers and sisters with AIDS. I hope to return to Africa in June. If I can
make the trip, I'll tell other crowds of women and children that, no matter what
their culture says, they are worthy of the God who created them. I will ask
religious and political leaders to replace judgment and indifference with
compassion and love. I will point out to economic leaders the need to invest in
saving lives before their investments in capital have no value. And I hope to
share with local activists, ways to launch community-based organizations to
offer education, prevention, and care for those with HIV/AIDS. I came home in
January with photographs of the women I'd visited. But I do not wake in the
night to my photo album. I wake to the sound of a Rwandan woman whom I met. Like
me, she is a mother. Like me, she has AIDS. We embraced and told each other the
truth: We are sisters. Her final words to me were, "What shall I hope for,
Mary?" I did not know what to tell her. If you would act with courage and
compassion, I could answer her question. I could become your messenger to women
in Africa, your ambassador of compassion. And I could tell my own children that
the virus is powerful, that illness and death haunt us all, but that those with
the power are doing all in their power to give us life and hope. In all your
wrestling with these issues, and all your considerations, I assure you of my
appreciation. I pray that you are sustained to do that which the Judge of us all
would have us to. To that end, "Grace to you, and peace."
LOAD-DATE: March 13, 2000 
