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The United States' War on Aids Hearing Committee On THE UNITED STATES’ WAR ON AIDS HEARING BEFORE THE COMMITTEE ON INTERNATIONAL RELATIONS HOUSE OF REPRESENTATIVES ONE HUNDRED SEVENTH CONGRESS FIRST SESSION JUNE 7, 2001 Serial No. 107–17 Printed for the use of the Committee on International Relations ( Available via the World Wide Web: http://www.house.gov/international—relations U.S. GOVERNMENT PRINTING OFFICE 72–978PS WASHINGTON : 2001 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: (202) 512–1800 Fax: (202) 512–2250 Mail: Stop SSOP, Washington, DC 20402–0001 VerDate 11-MAY-2000 13:00 Aug 07, 2001 Jkt 072978 PO 00000 Frm 00001 Fmt 5011 Sfmt 5011 F:\WORK\FULL\060701\72978 HINTREL1 PsN: HINTREL1 COMMITTEE ON INTERNATIONAL RELATIONS HENRY J. HYDE, Illinois, Chairman BENJAMIN A. GILMAN, New York TOM LANTOS, California JAMES A. LEACH, Iowa HOWARD L. BERMAN, California DOUG BEREUTER, Nebraska GARY L. ACKERMAN, New York CHRISTOPHER H. SMITH, New Jersey ENI F.H. FALEOMAVAEGA, American DAN BURTON, Indiana Samoa ELTON GALLEGLY, California DONALD M. PAYNE, New Jersey ILEANA ROS-LEHTINEN, Florida ROBERT MENENDEZ, New Jersey CASS BALLENGER, North Carolina SHERROD BROWN, Ohio DANA ROHRABACHER, California CYNTHIA A. MCKINNEY, Georgia EDWARD R. ROYCE, California ALCEE L. HASTINGS, Florida PETER T. KING, New York EARL F. HILLIARD, Alabama STEVE CHABOT, Ohio BRAD SHERMAN, California AMO HOUGHTON, New York ROBERT WEXLER, Florida JOHN M. MCHUGH, New York JIM DAVIS, Florida RICHARD BURR, North Carolina ELIOT L. ENGEL, New York JOHN COOKSEY, Louisiana WILLIAM D. DELAHUNT, Massachusetts THOMAS G. TANCREDO, Colorado GREGORY W. MEEKS, New York RON PAUL, Texas BARBARA LEE, California NICK SMITH, Michigan JOSEPH CROWLEY, New York JOSEPH R. PITTS, Pennsylvania JOSEPH M. HOEFFEL, Pennsylvania DARRELL E. ISSA, California EARL BLUMENAUER, Oregon ERIC CANTOR, Virginia SHELLEY BERKLEY, Nevada JEFF FLAKE, Arizona GRACE NAPOLITANO, California BRIAN D. KERNS, Indiana ADAM B. SCHIFF, California JO ANN DAVIS, Virginia THOMAS E. MOONEY, SR., Staff Director/General Counsel ROBERT R. KING, Democratic Staff Director ADOLFO FRANCO, Counsel LIBERTY DUNN, Staff Associate (II) VerDate 11-MAY-2000 13:00 Aug 07, 2001 Jkt 072978 PO 00000 Frm 00002 Fmt 5904 Sfmt 5904 F:\WORK\FULL\060701\72978 HINTREL1 PsN: HINTREL1 C O N T E N T S Page WITNESSES The Honorable Andrew Natsios, Administrator, U.S. Agency for International Development ......................................................................................................... 13 His Excellency Mamadou Mansour Seck, Ambassador E&P, Republic of Sen- egal ........................................................................................................................ 31 Stephen Hayes, President, Corporate Council on Africa ...................................... 36 Rupert Scofield, Executive Director, Foundation for International Community Assistance ............................................................................................................. 39 Charles Dokmo, President and CEO, Opportunity International ....................... 45 Dr. Paul Zeitz, Co-Director, Global AIDS Alliance ............................................... 50 LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING The Honorable Henry J. Hyde, a Representative in Congress from the State of Illinois, and Chairman, Committee on International Relations: Prepared statement .............................................................................................................. 3 The Honorable Andrew Natsios: Prepared statement .......................................... 17 His Excellency Mamadou Mansour Seck: Prepared statement ........................... 34 Stephen Hayes: Prepared statement ...................................................................... 38 Rupert Scofield: Prepared statement ..................................................................... 41 Charles Dokmo: Prepared statement ..................................................................... 47 Dr. Paul Zeitz: Prepared statement ....................................................................... 53 APPENDIX The Honorable Andrew Natsios: Supplemental Statement .................................. 81 The Honorable Barbara Lee, a Representative in Congress from the State of California: Prepared statement ...................................................................... 83 (III) VerDate 11-MAY-2000 13:00 Aug 07, 2001 Jkt 072978 PO 00000 Frm 00003 Fmt 5904 Sfmt 5904 F:\WORK\FULL\060701\72978 HINTREL1 PsN: HINTREL1 THE UNITED STATES’ WAR ON AIDS THURSDAY, JUNE 7, 2001 HOUSE OF REPRESENTATIVES, COMMITTEE ON INTERNATIONAL RELATIONS, Washington, DC. The Committee met, pursuant to call, at 11:10 a.m. in Room 2127, Rayburn House Office Building, Hon. Henry J. Hyde (Chair- man of the Committee) presiding. Chairman HYDE. The Committee will come to order. While the modern world has made great progress in medicine over recent decades, there is one horrific new killer that is stalking the globe, and particularly an entire, defenseless continent, Africa. Many of us believed that such a horrible epidemic, which cuts down people in the prime of their lives, was a thing of the past, but we now know that despite all of the wonderful medical progress of the 20th century, new killers can emerge. The statistics speak for themselves. Twenty-two million people have died of AIDS worldwide, including more than 3 million last year. That is over 8,000 per day—or nearly six deaths every minute. Tragically, the number is growing. By the year 2010, 80 million persons could be dead of AIDS. That is more deaths than all the military and civilian forces suffered during World War II. For someone who lived through that horrific period in war, this is a mind boggling statistic. In Africa, where 70 percent of the AIDS cases are, the virus has been particularly devastating. Let me recite just a few of the alarming statistics. I am sure that our witnesses today will expand on the devastation and the challenges confronting the African con- tinent and the rest of the developing world. Life expectancy has been reduced by nearly half in many coun- tries of Sub-Saharan Africa, including Botswana, Swaziland, and South Africa. The death of parents with HIV/AIDS will result in 40 million orphans this decade alone. In some southern Africa coun- tries, 20 percent or more of the adult population is infected with HIV. The HIV infection rate has reached 35 percent in Botswana. In Swaziland, the statistic is estimated to be nearly the same. National economies are being devastated, as trained personnel in key sectors die, these include teachers, health care personnel, and law enforcement personnel. To date, eastern and southern Africa have been far more affected than west Africa, but infection rates in West Africa are climbing. The infection rate exceeds 10 percent in the Ivory Coast, and is in- creasing in Nigeria. An estimated 600,000 African children became (1) VerDate 11-MAY-2000 13:00 Aug 07, 2001 Jkt 072978 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 F:\WORK\FULL\060701\72978 HINTREL1 PsN: HINTREL1 2 infected with the AIDS virus each year through mother-to-child transmission, either at birth or through breast feeding. These chil- dren have a short life expectancy, and the number of HIV-infected children in the region is currently estimated at 1 million. Sub-Saharan Africa is the only region in the world where HIV/ AIDS infection rates for women exceed the AIDS virus infection rate for men. The United States Government has already made major con- tributions to the fight against the AIDS virus. Currently, the United States is contributing 300 million through the Agency for International Development to fight the scourge of HIV/AIDS in the developing world. The Center for Disease Control, Department of Labor, and Department of Defense have all also brought their ex- pertise to bear on the pandemic. Government funding is helping to create a powerful coalition of Government, foundations, United Na- tions organizations, pharmaceutical companies, academic institu- tions, and scientific institutions to combat the HIV/AIDS pandemic. The focus of our government’s bilateral efforts are, of course, channeled through the Agency for International Development. To that end, this Committee will consider legislation to authorize AID funding for Fiscal Year 2002 at the highest level to date, $469 mil- lion in prevention and health infrastructure, and $50 million for a pilot treatment program for those who already suffer from HIV/ AIDS. Our first priority for Agency for International Development pro- grams is prevention through education. Until medical research pro- duces an effective vaccine, prevention through changes in behavior will remain the best and only truly effective means of overcoming the AIDS threat. At the same time, recent initiatives by the pharmaceutical com- panies point the way toward less expensive medication aimed at treating those with AIDS. With sufficient resources, it is now pos- sible to improve treatment options—provided that the health sys- tems are able to deliver and monitor the medications. That is why we are eager to authorize funding for a pilot treatment program, including the purchase of medicines to help the poorest of the poor. I am confident that in administering these programs, USAID will continue to rely on the fine work performed by community-based organizations, both religious and secular, to ensure the success of delivering not just medicine, but the health
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