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Mr. Chairman, I would just like to point out that we in the United States have nearly a million people suffering with HIV/AIDS at the mome nt. We spend something over $10 billion every single year on this issue, and that averages out to well over $10,000 per person in what we do here in this country in relation to AIDS. In Africa, the amendm ent that is being offered by the gentlewoman from California (Ms. LEE), the amendment by itself would involve $2 per person of the roughly 25 million people now suffering from HIV/AIDS, 20 percent in a country like South Africa, as high as 35 percent of the population in Botswana.
It is a very small, a very small pittance for us to contribute to dealing with the AIDS pandemic ar ound this world. We should adopt the amendment by the gentlewoman from California (Ms. Lee).
Ms. LEE. Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, I want to first thank the gentlewoman from California (Ms. PELOSI) for her extraordinary leadership on this issue and also for her support consistently and constantly on helping us really raise the level of awareness on the HIV/AIDS crisis here in the United States Congress, and also to the gentlewoman from California (Ms. WATERS), to the gentlewoman from the Virgin Islands (Ms. CHRISTENSEN), to all of the Members who spoke here tonight.
I want to pay a special recognition and tribute to my former boss and predecessor Congressman Ron Dellums who often has been the lone voice in the wilderness speaking about this pandemic in Africa.
Finally, I believe we are breaking the silence here in the United States Congress. I want to thank all of my colleagues for engaging in the debate tonight. I believe many of you read the incredible series of articles that was in The Washington Post last week. These articles demonstrated and documented the fact that we knew as early in the 1990s that the potential for this pandemic in Africa was going t o be so great, we chose to put our heads in the sand on this issue.
Mr. Chairman, it is chilling to think that we have not done much of anything in the last 10 years, so tonight we are just asking for a mere $42 million, that is it. We heard the arguments for that. I implore and plead with the other side to please join us in a bipartisan effort and restore $42 million to the budget.
Mr. Chairman, I yield back the balance of my time.
The CHAIRMAN. Does the gentleman from Alabama (Mr. CALLAHAN) wish to be heard on his point of order?
Mr. CALLAHAN. Mr. Chairman, I withdraw the point of order.
The CHAIRMAN. The point of order is withdrawn.
Mr. CALLAHAN. Mr. Chairman, I yield myself such time as I may consume and simply want to say that I think that the committee has been most understanding. In response to many requests that I received from many of those that spoke tonight, we have increased this year's assistance to HIV/AIDS problems fr om $175 million to $212 million, an 18 percent increase.
Mr. Chairman, I just do not want my colleagues to think that I have ignored their plights and their pleas when they came to me hearing the message. In addition to that, I spent last week in Africa talking to some of the political leaders there, and I recognize fully especially in Africa the tremend ous problem with HIV/AIDS. And if, in deed, we reach a stage in this process of the conference committee, as I have told the gentlewoman from California (Ms. WATERS) with respect to the HIPC problem, if we reach a stage where additional allocations are given to us, certainly we would request this, but to take it out of the FMF program we think is not proper.
Mr. Chairman, I do not want to go through that debate again, but I might remind my colleagues that now we are, if we adopt the Waters amendment and we adopt the gentlewoman's amendment, then we will be into the Middle East portion of the FMF, but I hope that we do not do that. I hope that it is better resolved to your satisfaction at some other point in the process. Mr. Chairman, I ask for a no vote.
Mr. CALLAHAN. Mr. Chairman, I yield back the balance of my time.
The CHAIRMAN. The question is on the amendment offered by the gentlewoman from California (Ms. LEE).
The question was taken; and the Chairman announced that the ayes appeared to have it.
Mr. CALLAHAN. Mr. Chairman, I demand a recorded vote.
The CHAIRMAN. Pursuant to House Resolution 546, further proceedings on the amendment offered by the gentlewoman from California (Ms. LEE) will be postponed.
Are there further amendments to this section of the bill?
AMENDMENT OFFERED BY MR. BROWN OF OHIO
Mr. BROWN of Ohio. Mr. Chairman, I offer an amendment.
The CHAIRMAN. The Clerk will designate the amendment.
The text of the amendment is as follows:
Amendment offered by Mr. BROWN of Ohio:
In title II of the bill under the heading ``BILATERAL ECONOMIC ASSISTANCE-FUNDS APPROPRIATED TO THE PRESIDENT-AGENCY FOR INTERNATIONAL DEVELOPMENT CHILD SURVIVAL AND DISEASE PROGRAM FUND'', after the first dollar amount insert ``(increased by $40,000,000)'' and in the fifth proviso after the fourth dollar amount (relating to other infectious diseases) insert ``(increased by $40,000,000)''.
In title IV of the bill under the heading ``MULTILATERAL ECONOMIC ASSISTANCE-FUNDS APPROPRIATED TO THE PRESIDENT-CONTRIBUTION TO THE ASIAN DEVELOPMENT FUND'', after the dollar amount insert ``(decreased by $40,000,000)''.
The CHAIRMAN. Pursuant to the order of the House of earlier today, the gentleman from Ohio (Mr. BROWN) will be recognized for 5 minutes and a Member opposed will be recognized for 5 minutes.
Mr. CALLAHAN. Mr. Chairman, I reserve a point of order on the amendment of the gentleman from Ohio (Mr. Brown).
The CHAIRMAN. The gentleman from Alabama (Mr. CALLAHAN) reserves a point of order.
The gentleman from Ohio (Mr. BROWN) is recognized for 5 minutes on his amendment.
Mr. BROWN of Ohio. Mr. Chairman, I yield myself 2 minutes.
Mr. Chairman, the threat of tuberculosis is spreading rapidly through the developing world. TB is the greatest infectious killer of adults worldwide. It is the biggest killer of young women. It kills 2 million people per year. Over more than 1,000 people in India die everyday. TB hit an all time high in 1999 with 8 million new cases, 95 percent in developing countries.
Mr. Chairman, I would first like to thank the gentleman from Alabama (Mr. CALLAHAN) and the gentlewoman from California (Ms. PELOSI) for their good work in increasing the appropriations to tuberculosis in the last 3 years up to $60 million.
Our amendment asks for an additional $40 million added to the other infectious diseases component of the Child Survival and Diseases Program. This increase is meant specifically for TB control efforts. This level of spending for health is much lower than any other multilateral development bank despite the fact that the majority of deaths globally from TB and childhood infectious diseases occur in Asia, that is why we are taking dollars from the Asia Development Bank, which does not meet its mission to save the poor, in order to fund a program that will absolutely save millions of lives and preserve communities in the best interests of Asia, in the best interests of Africa, and in the best interests of Latin America, and only in the best interests of the United States where TB is becoming a more and more serious problem.
[Page: H5940] GPO's PDF
Gro Bruntland, the director general of the World Health Organization has said that tuberculosis is not a medical issue, it is a political issue. Getting Americans engaged in an international medical issue like tuberculosis, even when addressing that issue serves our best interests as a Nation is an uphill battle.
Mr. Chairman, we have an opportunity to save millions of lives now and prevent millions of needless deaths in the future. We are asking for $40 million from the Asia Development Bank, a bank that has not done well at serving the poor, and we can clearly save thousands and thousands of lives by upping our contribution to the world TB effort, according to the requests of the World Health Organization of $100 million.
Mr. Chairman, I reserve the balance of my time.
Mr. CALLAHAN. Mr. Chairman, I do not seek time at this point, but I rise in opposition to the amendment and reserve the balance of my time.
Mr. BROWN of Ohio. Mr. Chairman, I yield 1 minute to the gentlewoman from Maryland (Mrs. MORELLA), who was the cosponsor and the cowriter of this amendment last year when the chairman helped us increase tuberculosis spending $5 million more.
Mrs. MORELLA. Mr. Chairman, I thank the gentleman from Ohio (Mr. BROWN) for yielding me the time and thank the gentleman for his leadership on this very important issue.
Mr. Chairman, I also want to extend my thanks to the gentleman from Alabama (Mr. CALLAHAN), the chairman of the committee, the gentlewoman from California (Ms. PELOSI) for the work they have done in raising the amount for tuberculosis. This is really very important.
Mr. Chairman, TB kills more women than any single cause of maternal mortality, and it is the biggest killer of people with AIDS which was j ust recently discussed. It accounts for 40 percent or more of all AIDS deaths in A frica and in Asia . I could go on and on with what is happening in the developing world in terms of attacking its victims in their most productive years, medical costs rising, families that are dissipated, children that are put to work, lack of educational opportunities.
According to the WHO, recent studies in India found that 100,000 women are rejected by their family because of TB every year.
[Time: 23:40]
Because there is no way to stop TB at national borders, the only way to eliminate it here in the United States is to control it worldwide, especially in nations with the greatest burden. It is not a matter of doing just what is right; it is a matter of doing what is smart. A single case of drug-resistant TB can cost hundreds of thousands of dollars to treat in the United States. Let us ratchet the amount up.
Mr. Chairman, I rise today in support of this amendment to increase funding for global TB control because, although we have a cheap, effective treatment for TB, the tragic fact is TB will kill more people this year than any year in history--someone every 15 seconds.
TB is the biggest infectious killer of young women in the world. In fact, TB kills more women than any single cause of maternal mortality. TB is the biggest killer of people with AIDS--accounting for 40 percent or more of all AIDS deaths in A frica and Asia. < p> In the developing world, tuberculosis also destroys girls' and women's futures. TB tends to attack its victims in their most productive years, often killing or sickening the primary breadwinner of a family. In order to pay for medical costs and generate income, families frequently take their young girls out of school and put them to work. TB means the loss of educational opportunity for girls. It means dire poverty for families.
In some parts of the world there is a great stigma attached to contracting TB. This leads to increased isolation, abandonment and divorce of women. According to WHO, recent studies on India found that 100,000 women are rejected by their families because of TB every year. In Nepal, there are numerous stories of young widows with no income and no prospects for another marriage turning to prostitution in order to support their families. Currently an estimated one third of the world's population including some 10-15 million people in the United States are infected with the TB bacteria. Because there is no way to stop TB at national borders, the only way to eliminate TB here in the U.S. is to control it worldwide, especially in nations with the greatest TB burden.
The real tragedy is that effective TB treatment--with drugs costing as little as $10 for a full 6 month course--is only reaching 20 percent of those ill with TB.
It is crucial that we act aggressively now to expand access to this cost-effective treatment and thereby control the spread of TB worldwide. There is only a small window of opportunity available to us to do so. If we fail to act now, resistant strains of TB will continue to develop which will be incredibly costly and possibly even impossible to treat.
I want to acknowledge and thank the Foreign Operations Subcommittee, especially Chairman CALLAHAN and Ranking Member PELOSI, for their efforts this year and over the past several years to give TB greater priority. I stand here today because I believe we need to ratchet up that effort even more, to go even further. $100 million is needed to help jumpstart effective control programs globally.
This is not just a matter of doing what is right, it is a matter of doing what is smart--a single case of drug resistant TB can cost hundreds of thousands of dollars to treat in the U.S. We must invest now in preventing and treating TB worldwide or we will pay the price later in lives and dollars if we fail to do so.
I urge support of this amendment.
Mr. BROWN of Ohio. Mr. Chairman, I yield 2 minutes to the gentlewoman from New Mexico (Mrs. WILSON), who is the co-author of this amendment; and I thank her for the good work that she has done.
Mrs. WILSON. Mr. Chairman, I wanted to thank the gentleman from Ohio (Mr. BROWN) for his leadership on this public health issue and also the chairman of the committee for increasing the investment in TB in this bill over the last 4 years from really nothing to $60 million.
Tuberculosis is back with a vengeance, and it is back with drug-resistant strains that are affecting parts of the world where it was thought to be under control.
In March of this year, there was an outbreak of resistant tuberculosis in Toronto, Canada; in Germany; in Denmark; in Mexico; in Italy; in Puerto Rico. Drug-resistant TB is on the rise, and we are not immune to it here in the United States.
I am one of those who believes it is better to play offense than defense when it comes to public health issues, if one has got a good offense to play. We have a very limited window of opportunity to attack TB with a proven public health strategy abroad where resistant TB is growing.
The reason the resistant TB is growing is because of inconsistent and inadequate treatment. But a treatment does exist. It is called DOTSC. That means Directly Observed Treatment Short Course. If we invest in it now, we can treat TB when it first shows up so that those resistant strains do not have an opportunity to grow. We will not be faced with a huge and very expensive epidemic worldwide and in the United States.
It costs between $11 and $20 to treat a case of TB that is not resistant. It costs about $250,000 to treat drug-resistant TB. In the early 1990s, there was an outbreak in New York City that cost $1 billion to suppress it, and half of the people affected with it died.
Let us do the right thing from a public health point of view. Let us invest in this while the window of opportunity was there and reduce the cost over the long term.
The CHAIRMAN. Does the gentleman from Alabama (Mr. CALLAHAN) insist on his point of order?
Mr. CALLAHAN. No, I do not insist on the point of order, but I rise in opposition to the amendment.
The CHAIRMAN. The gentleman from Alabama withdraws the point of order.
The Chair recognizes the gentleman from Alabama (Mr. CALLAHAN) for 5 minutes.
Mr. CALLAHAN. Mr. Chairman, I yield myself such time as I may consume.
Mr. Chairman, I am almost surprised at the fact that the gentleman brought this amendment to the House. In response to his request and to the request of many of my colleagues, we have increased this fund from $12 million to $55 million, a fourfold increase in response to the recognition of the problem.
While I know that they have serious concerns about tuberculosis; we all do. The very fact that we have quadrupled the aid in just 2 years is amazing to me that they still insist upon bringing an amendment to reconstruct our bill.
[Page: H5941] GPO's PDF
We have constructed this bill to the best of our ability, providing as much as we can afford to provide to every need that has been presented to this committee. So I would respectfully request that the gentleman withdraw his amendment; and if he does that, I will agree to work in conference to conceivably get it increased if we receive a higher allocation. I offered him that, and yet he seems to reject that offer. So if he wants me to remove that offer, I will be happy to do it. But I would respectfully request that he withdraw his amendment.
Mr. BROWN of Ohio. Mr. Chairman, will the gentleman yield?
Mr. CALLAHAN. I am happy to yield briefly to the gentleman from Ohio.
Mr. BROWN of Ohio. Mr. Chairman, before withdrawing the amendment, if I could, I would like to ask, and I will do that and appreciate the good words and the good work already that the gentleman from Alabama (Mr. CALLAHAN) has done in the last 3 years. I would like to ask the gentleman from Alabama (Chairman Callahan) if he would yield 30 seconds to the gentleman from Texas (Mr. GREEN), who was in his office and hurried over and would like to say a few words on this issue if he could get some time from the gentleman from Alabama (Mr. CALLAHAN). I unfortunately used my time, but I will withdraw the amendment after that if that is possible.
Mr. CALLAHAN. Mr. Chairman, I yield 30 seconds to the gentleman from Texas (Mr. GREEN).
(Mr. GREEN of Texas asked and was given permission to revise and extend his remarks.)
Mr. GREEN of Texas. Mr. Chairman, I join my colleagues, and I appreciate the work of the Subcommittee on Foreign Operations, Export Financing and Related Programs. This is money well spent, because if we do not deal with tuberculosis nationwide, literally in Texas, we are seeing it cross our border. So I thank the subcommittee for their work.
Mr. Chairman, I rise in strong support of this amendment, which I am pleased to have cosponsored along with SHERROD BROWN and Representatives HEATHER WILSON and CONNIE MORELLA.
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