September 25, 2007

Verbatim, as delivered

Opening Statement by Chairman Lantos at hearing, “PEPFAR Reauthorization: From Emergency to Sustainability”

Four short years ago, if you were to walk into the hallway of a hospital in Zambia, it would have been clogged with HIV/AIDS patients waiting to die. The lifesaving drugs which had brought so much hope to those infected with the virus in wealthy nations simply were not available to Zambia’s poor, or to those infected with HIV/AIDS throughout Africa.

Our Committee acted decisively to rectify this fundamental injustice. On a bipartisan basis, we rapidly approved the U.S. Leadership Against HIV/AIDS Act. This bill authorized 15 billion dollars – I repeat, 15 billion dollars – over five years, of which fifty-five percent was earmarked for treatment.

Four years later, as we consider legislation to reauthorize this critically important law, the hallways of hospitals and clinics in Zambia and throughout Africa are once again crowded. But not with patients at the door of death -- they are filled with hundreds of thousands of men, women and children receiving lifesaving HIV/AIDS treatment.

The legislation produced by our Committee has yielded dramatic results – particularly in the area of treatment. But the task for the next five years is not only to solidify these gains, but to re-orient the program so that our efforts to combat HIV/AIDS will be sustainable for generations to come.

To be sustainable, our HIV/AIDS program must dramatically strengthen the health care delivery systems in nations ravaged by the deadly virus. To be sustainable, our program must find new and creative ways to deliver the ABC prevention message. To be sustainable, our program – and the programs under the Global Fund – must work with NGOs and governments to battle HIV/AIDS in a cost-efficient, transparent and effective manner.

So as our Committee embarks on re-writing the U.S. Leadership Against HIV/AIDS Act, those will be our marching orders. We will increase dramatically the funding for this vitally important program, with a newfound emphasis upon sustainability at its core.

Working in the same bi-partisan manner in which the original Act was created, we will fund new efforts to encourage doctors and nurses to stay in Africa and other HIV/AIDS-ravaged nations where they are clearly most needed. We will launch new programs to train hundreds of thousands of physicians, nurses, and community health workers – and to find gainful employment for the millions of teenagers across the African continent who were orphaned by AIDS while they were very young. And we will create new efforts to bring life-saving medicine to rural areas. With just a bit of modern technology, a village health worker can immediately connect a patient with a doctor located in a major city and use a bicycle to bring life-sustaining medicine to the poor in the countryside.

Working in a bi-partisan manner, we will increase the sustainability and effectiveness of our prevention efforts. With an HIV prevalence rate of 17% in Zambia, 18% in South Africa and 24% in Botswana, we clearly have our work cut out for us. But if we stick to the ABC prevention message, and find new and creative ways to reach the most vulnerable populations, these absolutely staggering rates can and will come down.

To maintain the bipartisan consensus behind this initiative, we must recognize that each element of the ABC approach has value. For kids in elementary school, abstinence education is right on target, particularly when it empowers children to make correct choices in all aspects of their lives. For dating and married couples, awareness of one’s HIV status and faithfulness are vital to stemming increases in infection rates. And for couples who don’t know whether they have HIV, or where one partner has been tested and found free of the virus, condoms are essential. Unlike the guidance issued by the Executive Branch, I do not believe that condoms are only for prostitutes and truck drivers.

Working together, we can fine-tune our prevention programs and literally save millions of lives. Working together, we will guarantee nutrition with treatment so that patients no longer stop medicines because they have nothing to eat. Working together, we can revitalize Africa’s health care systems, and leave a real legacy for future generations. Working together, we can dramatically boost funding for our global HIV/AIDS programs, and help to ensure that millions more kids don’t lose their parents to this deadly scourge.

We have had some genuine success so far – but if we don’t help to build in the target countries the capacity and the will to sustain this struggle for the long term, than all of our good work may turn out to have been for naught.