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Document 14 of 32.

March 30, 2000, Thursday

SECTION: PREPARED TESTIMONY

LENGTH: 1673 words

HEADLINE: PREPARED TESTIMONY OF DYANN WIRTH, PH.D. DEPARTMENT OF IMMUNOLOGY AND INFECTIOUS DISEASE HARVARD SCHOOL OF PUBLIC HEALTH HARVARD UNIVERSITY ON BEHALF OF THE AMERICAN SOCIETY OF TROPICAL MEDICINE AND HYGIENE

BEFORE THE HOUSE APPROPRIATIONS COMMITTEE FOREIGN OPERATIONS, EXPORT FINANCING AND RELATIONS SUBCOMMITTEE

BODY:
Mr. Chairman and members of the Subcommittee, thank you for the opportunity to testify today. My name is Dyann Wirth. I am a Professor at the Harvard University School of Public Health Department of Immunology and Infectious Disease. I am here today on behalf of the American Society of Tropical Medicine and Hygiene, as the immediate past President. The Society appreciates the opportunity to present its views on programs under the Subcommittee's jurisdiction.

ASTMH is a professional society of 3,500 researchers and practitioners dedicated to the prevention and treatment of infectious and tropical infectious diseases. The collective expertise of our members is in the areas of basic molecular science, medicine, vector control, epidemiology, and public health.

The Society thanks the members of this Subcommittee for their previous commitment and support for the programs administered by the U.S. Agency for International Development (USAID) targeted to combating the global burden of tropical and infectious disease. Your support for these important programs has resulted in tremendous progress in combating disease. World health experts estimate that USAID's child survival programs have helped drop infant mortality rates in the developing world to their lowest levels ever, and since 1985, have saved 25 million children's lives. Despite this progress, I am sure every member of the Subcommittee would agree that the global burden of tropical and infectious diseases remains staggering and poses a tremendous threat to us all. According to the World Health Organization, infectious diseases account for more than 13 million deaths a year. Over the course of an hour, the WHO reports that 1,500 people will die from an infectious disease - over half of them children under five.

The WHO has identified the seven infectious diseases that caused the highest number of deaths in 1998. HIV/AIDS, TB, malaria, and hepatitis B and C are either spreading or becoming more drug resistant, while lower respiratory infections, diarrheal diseases, and measles appear to have at least temporarily peaked. Malaria alone is estimated 'to cause up to 500 million clinical cases and up to 2.7 million deaths each year, representing 4 percent to 5 percent of all fatalities. Tragically, every 30 seconds a child in the world dies of malaria.

Most of these deaths occur in developing countries where there is extreme poverty and lack of access to basic health care and essential drugs. However, with the enormous volume of travel and trade today and the interconnection of the world economies, infectious diseases do not respect borders.

In June 1996, President Clinton issued a Presidential Decision Directive calling for a more focused U.S. policy on infectious disease. The State Department's Strategic Plan for International Affairs lists protecting human health and reducing the spread of infectious diseases as one of the U.S. strategic goals, and Secretary Albright in December 1999 announced the second of two major U.S. initiatives to combat HIV/AIDS. The unprecedented UN Security Council session devoted exclusively to the threat to Africa from HIV/AIDS in January 2000 is measure of the international community's concern about the infectious disease threat.

A January, 2000, unclassified report from the CIA's National Intelligence Council entitled "The Global Infectious Disease Threat and Its Implications for the United States," suggests that infectious diseases are likely to account for more military hospital admissions than battlefield injuries. The report assesses the global threat of infectious disease, stating "New and reemerging infectious diseases will pose a rising global health threat and will complicate US and global security over the next 20 years. These diseases will endanger US citizens at home and abroad, threaten US armed forces deployed overseas, and exacerbate social and political instability in key countries and regions in which the United States has significant interests."

USAID programs targeted to the prevention, treatment and control of tropical and infectious disease are now more important than ever to the nation's foreign policy objectives and U.S. strategic interests.

USAID Child Survival and Disease Fund

The ASTMH strongly supports USAID's Child Survival and Disease Programs which have long been at the forefront of international efforts to alleviate morbidity and mortality among the world's most vulnerable populations - children under five years of age. These programs include critical activities in developing nation's to prevent and treat infectious diseases, such as vector control strategies, improving the capacity of the public health infrastructure through training programs and technical assistance, providing immunizations, oral rehydration therapy, vitamin A supplementation, and HIV/AIDS prevention and treatment activities.

The Society is pleased that the President has recognized the importance of these programs by requesting a slight increase for the Child Survival and Disease Fund, resulting in a total budget of $659 million in Fiscal Year 2001. Within this account we also support the President's call for increasing funding for HIV/AIDS health activities by $54 million above the Fiscal Year 2000 level, resulting in an allocation of $244 million for HIV/AIDS activities in Fiscal Year 2001.

The ASTMH urges the Subcommittee to at least support the President's request and respectfully urges the Subcommittee to do better. The ASTMH has endorsed H.R. 3826, The Global Health Act of 2000, that calls for an additional $1 billion above Fiscal Year 2000 levels for federal programs that support activities targeted to child survival, the health and nutrition of pregnant mothers, and combating infectious diseases including HIV/AIDS and malaria. This legislation specifically calls for an additional $475 million targeted to prevent, control and combat infectious diseases including HIV/AIDS and malaria, and would authorize an additional $325 million to help child and family survival through nutrition and health advice for pregnant women and mothers,along with programs for child survival and infant care, such as immunizations.

We believe an increase of this magnitude for these important activities is a cost-effective, sound investment towards improving global health and protecting the health and well-being of Americans at home and abroad, given the enormous human and economic costs we face as a nation with the spread of emerging and re-emerging infectious diseases and the burden of disease on developing countries.

We urge the Subcommittee to provide the highest possible funding level for the USAID Child Survival and Disease Fund programs to help achieve this goal.

Millennium Vaccine Initiative

The ASTMH also asks the Subcommittee to work with your colleagues and the Administration in supporting efforts to encourage research and development on vaccines and drugs to combat malaria, tuberculosis, HIV/AIDS and other infectious diseases causing more than 1 million deaths annually and to ensure that these products are accessible to populations in developing countries most impacted by these diseases. These efforts, that are embodied in the President's Millennium Vaccine Initiative and in legislation pending before Congress, foster partnerships with federal agencies, industry, non-profit organizations, the World Bank, and other international organizations to combat the scourge of infectious diseases.

Specific initiatives proposed to provide incentives to accelerate the research, development and production of vaccines and drugs include enhanced R&D tax credits and new tax credits for sales of vaccines, contributions to international organizations such as the Global Alliance for Vaccines and Immunizations (GAVI) for the purchase and distribution of vaccines and drug therapies in developing countries, and measures that will improve the public health infrastructure in developing countries in order to expand immunizations, prevent and treat infectious diseases, and build effective delivery systems for basic health services.

The Society would specifically like to thank Congresswoman Pelosi for advancing many of these important objectives through the introduction of H.R. 3812, and we wish to thank the members of this Subcommittee who have been strong and tireless advocates for efforts to improve access to vaccines and drug therapies in the developing world.

The Society believes that through this Subcommittee's support, USAID will play an important leadership role in these critical multi-lateral efforts. These initiatives represent a necessary first step to marshal the collective will and resources of government, industry, foundations, international organizations, and individuals to make the kind of commitment necessary to bring these deadly diseases under control until we have them totally conquered. The Society urges your strong support for this unique and important opportunity.

I know you understand the need for greater resources to be directed to tropical and infectious disease programs, and I understand that you face many difficult decisions as you develop the funding priorities that will be reflected in your Fiscal Year 2001 bill.As we begin the 21st century we find ourselves with many opportunities to expand our efforts at controlling and preventing tropical and infectious diseases. Control of global infectious disease threats is not just a development issue, it is also a national security issue for the United States and a health concern for every American. Investments in global infectious disease programs are clearly a win-win for the country - by helping others we are also launching the best defense to protect the health of our nation. We hope you will seriously consider these requests.

Thank you for the opportunity to present the views of the American Society of Tropical Medicine and Hygiene. I would be happy to answer your questions.

END

LOAD-DATE: April 19, 2000

Document 14 of 32.


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