alleviation and yet we continue to spend fourteen million dollars every hour in iraq while more americans are looking for work millions of americans are on the verge of losing their homes and gas prices have hit an all time high mr speaker there is no question that when we spend fourteen million dollars an hour in iraq we are neglecting real needs here in the united states but we are also hurting our economy because we aren't able to properly invest in america this war has diverted nearly one trillion dollars away from american schools roads research and other areas that would have stimulated the economy in the short term and produce stronger economic growth in the long run it's time to stop spending our money in iraq and start focusing on helping there was a gentleman from texas right now the gentleman is recognized for one minute thank you mr baker you know a recent report shows social security sliding into the red we need to protect our younger generation and i think it's up to the congress to take serious action now the trustees annual report on social security released a couple of weeks ago paints a gloomy picture social security will begin paying out more money than it takes in from payroll taxes in two thousand and seventeen in but twenty forty one the social security trust funds are going to be exhausted these dismal dates come as surprise to us each day that ebbs but we're left with fewer options on how to address this growing problem as ranking member on the social security subcommittee stand ready to work with my colleagues on both sides of the  the speaker during my time this job i met with many utah families teachers and health professionals about their struggle with autism i visited the special education classrooms where dedicated teachers work with youngsters who have been diagnosed as autistic as well as met with families desperately searching out medical options for their children i have learned from this that more data more research and more public education are imperative in order to help these families create a future for their children in utah one in every one hundred thirty three kids has autism that's the third highest rate among fourteen states according to a two thousand and seven c d c study nationally sixty seven children are diagnosed with autism every single day which costs our country ninety billion dollars a year i am humbled to represent the utah family that has the highest number of autism in a single family in the entire united states six children as a member of the autism caucus and as a co sponsor of the resolution declaring april national autism month i've been a strong advocate for increased research dollars to help us  answers about this disorder and the hardship it inflicts on families awareness is only a first step but every step forward brings us closer i hope to improve diagnosis and treatment of autism up as a gentleman from illinois the gentleman is recognized for one minute thank you met mr speaker i rise to urge the speaker this house to bring forward for a vote in this house the u s colombia trade promotion agreement we know colombia not only is the most longstanding democracy in all of latin america but our most trusted in the pen double partner and connor narcotics connor terrorism we also know president you're e bay the democratically elected president of colombia is a good friend the united states but someone who's brought security and success weapons to eliminate the fark narco trafficking terrorist organization in colombia and as a result today he's made tremendous progress in reducing violence in that country and bringing security throughout the entire country u s colombia trade agreement is good for illinois my home state my district is dependent on exports construction equipment that is made in my district and eight thousand union workers make construction equipment suffers fifteen percent tariffs when export it to colombia under this trade agreement there are eliminated on day one the farm community will tell you the u s colombia trade agreement is the best ever when it comes to access for el noir and u s farm products to the colombian market bottom line is the u s colombia trade promotion agreement is a win win for the united states it's a win win for colombia madam speaker we need to bring it to the floor colombia is our friend it deserves a vote thank you neil back up of a gentleman from kentucky writes this in the us now one minute gentleman is recognized for one minute mr speaker how much longer do the american people have to bear the financial burden of the war in iraq between two thousand and one and two thousand and eight congress has appropriated nearly seven hundred billion dollars for the global war on terrorism most of that money going to fight the war in iraq investing in iraq rather than our own country has contributed to our nation's economic downturn according to columbia university professor joseph stiglitz and harvard university professor linda blinds quote the iraq adventure has seriously weakened the u s economy whose woes go far beyond loose mortgage lending you can't spend three trillion dollars yes three trillion on a failed war abroad not feel the pain at home and americans are definitely feeling the pain mr speaker during the minute that i've been speaking the bush administration has spent two hundred  thirty five thousand one hundred sixty eight dollars on the war in iraq it is time that we once again invest in america our forces now should be helping those americans who face work losers who can't pay their gas and heating bills and they continue to watch their financial security are rude well funding the war grows every minute of the purpose of gentleman from colorado writes a mission to address how for one minute gentleman is recognized for one minute morning mr speaker it's nice to see a coloradan in the chair mr speaker for seven years now the bush administration has done the bidding of big corporate interests the administration has never supported regulation of big business and in fact they've eliminated important oversight that is necessary to protect the american consumer in other instances agencies have simply turned a blind eye and for a time this benefited big business but we are now seeing how devastating the failure to enforce the law or regulations can be for both the american people and the american economy last month the bush administration bailed out bear stearns out of fear that if the wall street giant filed for bankruptcy many more suppose a giants would follow what the administration refuses to admit is that had it enforced the law and properly regulated bear stearns and the other giants for the last seven years they never would have been in this predicament in the first place mr speaker the administration should be commended for finally recognizing the need to enforce the law and regulations that are on the books unfortunately it should not have taken a huge economic and house economic and housing crisis for them to recognize the importance of government oversight that is after all part of their job and i yield back what purposes gentlemen who california gentleman is recognized for one minute speak to members of the house next week the administration is poised to give us the american people a rosy assessment of the situation in iraq they're going to suggest that in fact there has been no escalation in iraq and there everything is just fine well everything isn't just fine and there is in fact an escalation going on in the violence all over iraq what the president's policy is is a bait and switch policy the american troops were sent to iraq to fight al qaida to fight terrorists now we see american troops inserted into combat coming under fire dying and being wounded for the sake of one shia political party that is afraid that it might lose an election in october what are the american troops doing fighting for  of one shia party over another recently the pentagon suggested that this was all a sign of success of the surge i think we should watch those words closely you may miss something is a ministration earlier told the people that the was for the purposes of decreasing the violence and create an environment of political reconciliation the people who are supposed to create political reconciliation are now shooting that one another because they think they might lose an election in october mr speaker all across america and wisconsin people are demanding lower gas prices and affordable health care not more debt in recent weeks our nation has experienced a dramatic decline in home values and when our home values decline and disappear so does the tax revenue in every town in every county in every state of the union our very way of life is now at risk due to this administration's continued economic policy of borrow and spend it and last week in the administration forced us to swallow a minimal with worms by nationalizing the debt of financial institutions guaranteeing their debts will be paid by american tax there's whose side are they on taxpayers invested in their own homes not in insider wall street deals this administration is in bed with big banks they can surance and big oil and businesses who are shipping our jobs overseas if this administration was adoption of this resolution the speaker may pursue it a clause to be of rule a to declare the house resolved into the committee of the whole house on the state of the union for consideration of the bill h r fifty five one to authorize appropriations for fiscal years two thousand and nine through two thousand and thirteen to provide assistance to foreign countries to combat tuberculosis and malaria and for other purposes the first reading of the bill should be dispensed with all points of order against a separation of the builder waived except those arising under clause nine or ten of rule twenty one general debate should be confined to the bill shall not exceed two hours equiv divided and controlled by the chairman and ranking minority member of the committee on foreign affairs after general debate the bill should be considered for amendment under the five minute rule the bill should be considered as read all points of order against provisions of the bill or wa standing clause eleven of rule eighteen no amendment to the bill shall be in order except those printed in the report of the committee on rules accompanying this resolution each such be offered only in the order printed in the report may be offer subject to a demand for division of the question in the house or the committee of the whole all points of order against such amendments are waived except those arising under clause nine or ten of rule twenty one at the conclusion of consideration of the bill for amendment the committee shall rise or report a bill to the house with such amendments that may have been adopted the previous question show because that is ordered on the bill and amendments there to the final passes without intervening motion except one motion to recommit with or without instructions section two during his that aeration in the house of h r fifty five will one pursuant to this resolution now we stand in the operation of the previous question the chair may postpone further consideration of the bill to such time as may be designated by the speaker and general to match students and recognize for one hour mr speaker for the purposes of debate only i yield the customary thirty minutes to the ten sixty five that objection as a speaker house resolution ten sixty five provides for the consideration of h r five five zero one the tom lantos and henry j hyde united states global leadership against hiv aids tuberculosis and malaria reauthorization act of two thousand and eight a structural the role provides for two hours of general debate and makes an order three amendments each of which is debatable for ten  mr speaker all members of this house should be very proud of the bipartisan collaboration and careful compromises that have resulted in the underlying bill before us today h r five five zero one the tom lan and henry j high united states global leadership against hiv aids tuberculosis and malaria reauthorization act i wish to express my appreciation to the work of the gentleman from new jersey congressman donald payne the chairman of the subcommittee on africa and global health and subcommittee ranking member chris smith as well as the house foreign affairs committee chairman howard berman and ranking member ileana ross lightman and like all of my house colleagues on both sides of the aisle i am grateful that the committee named this bill after the great leaders of the foreign affairs committee chairman tom lantos and henry hyde who guided the original two thousand and three act into law may the collegial spirit of these two great champions for global health guide us all during today's debate mr speaker h r five five zero zero one what authorize fifty billion dollars over the next five years for us global programs that address the prevention care and treatment of hiv aids tuberculosis and malaria it strengthens sustains and expands a program that is universally recognized as one of the shining a complement accomplishments of the bush administration the challenge for this reauthorization is to move our hiv aids programs beyond the emergency phase first call for end of the president's emergency program for aids relief or pepfar and make them sustainable over the long term over the past five years we have literally gone from watching people die from aids hiv aids to watching people live and return to productive life in their communities the two thousand and three act provided fifteen below in dollars over five years h r five five zero one provides fifty billion dollars a direct response to the needs identified over the past five years for lifesaving medicines and well trained effective national health care systems the two thousand and three law relied upon the health care workforce in infrastructure already in place and of and developing countries and a far sighted move mr speaker today's bill invest in strengthening hiv related health care systems and building the capacity of the health care workforce in these nations under this legislation funds will be used to train some one hundred forty four thousand new health care workers over the next five years to care for people infected this is just the start easing the severe shortage of health care workers and develop in the developing world and it is our hope that other donor nations will follow our lead if there is ever to be a hope that these programs can become self sustaining health care capacity must be significantly strengthened in countries hard hit by hiv aids the two thousand and three bill focus on creating new programs to tackle hiv the hiv aids crisis this reauthorization build stronger linkages between our global hiv aids initiatives and existing programs designed to alleviate hunger improve health care bolster education and increase income security and stable livelihoods and approach endorsed by the president's global aids coordinator in february in his annual report to congress these changes ensure that our hiv aids programs no longer operate in isolation from our other development priorities and that the expertise and benefits from these other programs are provided in an effective manner to hiv aids affected individuals families and communities and addition the building creases us contributions to the global fund for hiv aids tuberculosis and malaria and provides benchmarks to improve the transparency and accountability of the global fund and while the majority of the funding authoriz five zero one is focused on the prevention care and treatment of hiv aids affected people and communities i would like to emphasize that the bill specifically authorizes four billion dollars over five years for a comprehensive strategy to combat tuberculosis and five billion dollars for the prevention treatment control and elimination of malaria in addition better integrates are hiv aids programs with a diagnosis testing counseling treatment prevention care and health care training needed in the fight against tb and malaria mr speaker h r five five zero one also removes a requirement that one third of all funds for a hiv aids prevention be dedicated to abstinence only programs over the past five years this restriction has proven to hamper the effectiveness of our health care efforts in the field as documented by two recent independent reports produced by the government accountability office g a o and president bush's own office of personnel management this reauthorization now requires the executive to promote a balanced prevention program that includes every element of abstinence being  this will ensure that many more women of reproductive age receive vital information related to their hiv status as well as a hiv aids education mr speaker we all need to recall the twenty million men women and children have perished from hiv aids forty million people around the world are hiv positive and each and every day another six thousand people are infected with hiv it is a moral imperative that we actually wrong really decisively and continue to address this crisis in a forward looking manner five years ago president bush acted to meet a perceived emergency as the aids epidemic spread out of control during that period the united states has provided drug treatment to nearly one point five million people we have given supportive care to another six point six million including two point seven million orphans and vulnerable children and our programs have prevented an estimated one hundred fifty thousand infant infections during this first five year phase of programming u s bilateral programs to combat hiv aids tuberculosis and malaria were expanded to  hundred fourteen countries today the u s now supports programs in one hundred thirty six countries including programs funded by the united states and administered to the global fund we can all be proud of this record of accomplishment but there is so much more left to do now we must work on making these initial gains sustainable our programs even more effective and expanding them to reach an even greater number of hiv aids fact and communities specifically over the next five year period h r five five zero one aims to prevent twelve million new with new infections provide antiretroviral treatment for three million people including four hundred fifty thousand children provide medical and other care for twelve million people including five million orphans and trained over one hundred forty thousand health care workers in the developing world there's a speaker addressing global aids hiv aids is one of the moral imperatives of our time and while history will no doubt judge our response it's more important that each of us recognizes that we can truly make a difference in the lives of millions of people right here and right now h r five five zero one represents a genuine confront and combat the scourge of aids hiv aids tuberculosis and malaria congress followed through and passed the u s leadership against hiv aids tuberculosis and malaria act known as the president's emergency plan for aids relief pepfar authorizing fifteen billion dollars in assistance to combat these diseases for fiscal year two thousand and four through two thousand and eight that was the largest commitment ever by any nation for an international health initiative fighting a single disease since its an accident in two thousand and three the programs created by this landmark legislation have made admirable progress in combating those horrible diseases so far more than one point four million people have received life preserving anti retroviral treatment over two point seven million eight hiv aids affected orphans have received care and many millions more have received instruction on how to protect themselves from infection tens of millions of people have received malaria and tuberculosis prevention or treatment services even though this program has achieved remarkable successes there is more that we can do to burkill osis still kills an estimated two million people each year and is the leading cause of death for people with aids one million people die from malaria each year a this is the world's fourth leading cause of  dating consequences of these diseases are plaguing sub saharan africa over twenty two and a half million people are living with hiv and approximately one point seven million additional sub saharan africans were infected with h r u v last year just last year this horrible aids epidemic claimed the lives of an estimated one point six million people in that region more than eleven million children have been orphaned by aids many families are losing their income earners health services are overburdened life expectancy in sub saharan africa is now forty seven years henry hyde united states global leadership against aids hiv aids tuberculosis and malaria reauthorization act of two thousand and eight will dramatically augment our commitment to fight these horrible diseases with an increase of approximately thirty five billion in funding to a total of fifty billion over five years but speaker some of my constituents are immigrants from haiti and have family and friends in their land of origin and i often hear about the disastrous effects that hiv aids is having on that country as a two thousand and seven haiti had and hiv rate of almost four percent thankfully since congress passed that far we have invested over three hundred three hundred million dollars to help haiti combat the aids pandemic by building on existing clinic and community based health resources expanding a network of satellite connections to the centers of excellence to permit instant review of difficult cases training staff members of health care facilities to provide prenatal going to logical and maternity care and provision of prevention of mother to child hiv transmission and enhancing the lab network for clinical sites to support the diagnosis and treatment of hiv and other associated infections i am pleased the legislation will also now cover several other countries that were previously not part not part of that far as i said yesterday in the rules committee when we look upon our work in congress many years from now i can think of nothing that we or anyone else will be able to point to that is of more importance than this admirable effort by the great and generous american people this massive effort proposed by president bush here in the united states house of representatives during his state of the union marvelous bipartisan very hard work on this important issue i also wish to thank them for naming this landmark program for two ultimately respected colleagues of ours who have recently left us henry hyde and tom lantos this is truly a fitting tribute to two remarkable human beings and public servants are reserved about some of them of this time the gentleman from the tom lantos and henry hyde united states global leadership against hiv aids tuberculosis and malaria reauthorization act of two thousand and eight this is an important measure which will ensure that our efforts to save the lives of so many people afflicted with the scourge of aids tuberculosis and malaria continue in a rigorous holistic way the continued success of program was brought to life five years ago by our late colleague henry hyde and tom lantos is a matter of vital importance to us here in the united states as president bush said in his recent trip to africa i quote i want the american people to understand that when it comes to saving lives it is in our national interest it is in our security interests to help alleviate areas of the world from hopelessness it's in our moral interest to say the lives of others so mr speaker that is precisely what the bill before us is about the program that we are authorizing today commonly known as pepfar is now recognizes perhaps the most successful foreign assistance program of the united states of america since the marshall plan just as the marshall plan protected american lives then by helping to stabilize a continent ravaged by war pepfar is protecting american lives today by helping to stabilize a continent ravaged by disease pepfar does more than just express america's compassion it supports american security mr speaker as an illustration of this important point i would like to quote from a letter that i received from our former house colleague from wisconsin the honorable mark green who is now serving as the united states ambassador to the united republic of tanzania embassador green said the following we are approaching the tenth anniversary of the terrorist bombings of embassy dar es sal nairobi and i can't help but note that general wald wald the former deputy commander of the u s european command has called hiv aids the third greatest threat to u national security yes this bill is less than perfect in some aspects all compromises are mr speaker but it is a good bill one that will save millions of lives around the world and help to maintain stability in a key region as chairman hyde said during the markup of the original leadership back in two thousand and three and i quote congress is so equally balanced that it is very difficult on controversial matters on expensive matters on matters that have different blocs who have different points of view to reach an agreement in a situation like this compromise is the heart and soul of the process he added we cannot please the left and the right and the center we can't please the libertarians and the arch can services and the republicans and the democrats with legislation that would have done all of these magic properties but we can do our best and we have done our best in two thousand and three mr speaker we did do our best and created a program that demonstrated compassion to so many since it's meant today the house has an opportunity to do its best again today for the sake of the fathers the mothers and the children who are victims of hiv aids as well as tuberculosis and malaria today we can follow in the steps of henry hyde and tom lantos demonstrating that american compassion that this thing wishes our nation and our people above all others all others mr speaker i believe that this is a balance bill i believe that this is a bill that will save many lives and protect american security and with that i thank the gentleman for  on this bill and for the record there is bipartisan appreciation for her strong and passionate commitment to ending the scourge of aids hiv aids tuberculosis and malaria i reserve my time gentleman reserves the gentleman from florida speakers by a privilege to yield three minutes to this thing which gentleman from georgia a physician who does so much on issues of health damion day out throughout the united states and as in this instance throughout the world dr gingrey the gentleman georgia is recognized for three minutes because i thank my colleagues for yielding and at the risk of being labeled the skunk at the annual fragrances picnic i do rise today in opposition to the structured rule i know compromises have been made to improve the underlying legislation but i think there's plenty of room for additional improvement just because we have a good program to increases spending from fifteen billion to fifty  billion i wonder if there's justification for that but here we are again mr speaker considering a rule that restricts debate on another republican created program which a democratic majority is now proposing a massive expansion we already have more than our share of entitlement programs right here in the united states and to me it now appears the majority is on the verge of using taxpayer dollars to create global entitlement program remember mr speaker pepfar the president's emergency plan for aids relief was created back in two thousand and three to provide emergency relief for aids  will certainly say as a physician that i of course am encouraged by the increases are in the bill to also help fight against tuberculosis and malaria however misspeak or we should not devise a plan to treat these diseases without fanning how to actually buy sufficient medications to provide the necessary care the majority states that treatment floor was not included in this bill as it was in the original legislation that is because the cost of medications have decreased that may be true yet while had it is more than triple the price tag for the pepfar expansion as i said in this bill it's not triple the number of people it plans to reach with medication so if the cost of medications have gone down at think they have the majority states they have shouldn't the massive increase in the cost of this program be matched by a proportionate increase in the people that we target through the program so mr speaker i was at the rules committee yesterday offered an amendment to just simply say keep that floor of fifty five percent of the money going to treat the patient in the rules committee unfortunately did not make that  order since the majority is not allow an adequate adequate input on this legislation particularly from the minority i would urge my fellow members vote against this rule give us a chance to go back and make some of the needed changes in an otherwise good bill that mr speaker i'll you back the balance of my time and you'll be back the gentleman from massachusetts preserve my time as speaker and one reserves gentleman florida speaker is my privilege to yield four minutes to the distinguished gentleman from the outset that i used to take care of aids patients before i came to this congress back in one thousand nine hundred four i was one of only two physicians in a county of four hundred thousand people that was seeing aids aids patients and i have announced my retirement my intent to leave the house of representatives at the conclusion of this congress and i will most likely go back to seeing patients in january and i may indeed be seeing aids patients again and let me additionally say  that i'm very concerned about the situation in africa indeed i have gone to africa twice in my in my term of service here in the congress specifically to look at the issue of helping in africa with the issues of aids and malaria and tb and so i think i have credibility to be able to say i care i'm concerned but this underlying bill and this rule that restricts any cutting amendments in my opinion is just excessive the president's plan and years ago when the president originally came up with pepfar he came to me and asked me to help him with his plan and i did and i actually thought his plan was very very generous three billion dollars a year and when he gave his state of the union message just a few months ago indicating that he wanted to double the size of this from three billion to six billion dollars a year i personally thought that was excessive when you look at all the problems we have with health care access for americans the problems that we have with transfer per transportation infrastructure the problems that we have in fighting the war in iraq afghanistan the homeland security issues i thought to take this program from three billion dollars a year to six billion dollars a year was excessive and over the top but now we have before us today an underlying bill to not increase it by one hundred percent which is what the president was asking for but to increase it by over two hundred percent and that's the underlying bill and the leadership of the house the democrat leadership of the house under the democratic rules committee is saying with no we don't want any cutting amendments now let me tell you a little bit of why i am so passionately upset about this yesterday nasa announced that with the retirement of the space shuttle they are going to be laying off over six thousand five hundred people in the central florida my congressional district that is a huge amount of people it has a huge economic impact on the state of florida and for us to be putting our astronauts on russian rockets we're going to have to sign a contract with the russians for the construction of these rockets we're sensually going to be laying off people in florida and hiring people in russia with u s taxpayers now this congress under this democratic leadership is saying that we have no choice we cannot afford to continue to fly the shuttle in two thousand and eleven two thousand and twelve two thousand and thirteen we cannot afford to bring the new rocket system on line any sooner than two thousand and five or two thousand  six we don't have the money while we have all this money to send fifty billion dollars to africa for aids now again let me just say i understand this is a terrible problem i don't even mind increasing the africa aids account but to be increasing and i and what to me is is installed on top of injury my staff has informed me that they have one billion dollars in this account and spent that they are they are working to try to spend so they can't even spend all the money that we're sending them over there and we want to send them a a two hundred forty percent increase now i know every member of this house can get up and give a speech like this they have water projects in their district they have health care clinics in their district they can address can i get thirty more seconds usual thirty dollars recognize thirty more seconds in my particular case it's pretty it's pretty significant we got six over six thousand people who are going to get a pink slip so for us to say we can't fly the shuttle beyond two thousand and ten because we can't afford it but that we can somehow find fifty billion dollars to send africa to me is just it's way over the top i can't justify that back home opposing this rule i'm going to vote against the underlying bill and i thank the gentleman for yielding the time i appreciated gentleman from massachusetts you know thank you mr speaker i just want to remind my colleagues that the underlying debate is not about the space program it's about whether we're going to end the terrible scourge of aids hiv aids malaria and tuberculosis that has cost the lives of countless individuals across this planet this is a moral imperative and i am proud of the bipartisan work done by democrats and republicans working together to accomplish this bill at this time i feel three manage the gentleman for the virgin islands via bridge christianson generally from the virgin islands is recognized for three minutes thank you for yielding to the speaker i rise today in full support of the rule and of h r fifty five zero one a bipartisan bill to reauthorize and expand the president's emergency plan for aids relief i want to particularly applaud the increase in funding from fifteen to fifty billion over clued in the increased funding and whose work with congresswoman barbara lee ensure that these provisions were included as well as chairman rangle who began the caribbean effort four years ago the expansion to include all caribbean nations as focus countries was greatly aided by the hard work of caribbean health ministers whose collective entire list efforts raise awareness about the impact of hiv aids in the caribbean i also want to thank the pan caribbean partnership against hiv and cap not only for their support of this bill but for the important leadership role that they have and continue to take to address hiv and aids in the caribbean region over the past five years pepfar has literally saved the lives of more than one million people and has had a significant positive impact on those most affected by and most at risk for a hiv infection women and girls congresswoman lee and i had the opportunity to visit several pepfar site and partners in south africa late last year and saw the great work that they are doing it was also clearly evident though that more was needed to digital funding will help to expand the number of focus countries under pepfar it will help to ensure that the innovative and effective it's that have been launched not only continue but help other hard hit nations get access to the resources they desperately need to address hiv and aids within their borders while two caribbean nations haiti and guyana are as one of the leading causes of death in the fifteen to forty four age group many caribbean nations that are currently receiving pepfar assistance absorb millions of dollars in debt every year leaders in the caribbean maintain that high  prevalence rates can overwhelm the region's health care capacity destabilize economies and compromised caribbean nations socio political infrastructure in fact assistant secretary general of the organization of american states the honorable albert rand and stated in january of last year that and i'm quoting hiv aids if not effectively and urgently tackled poses a clear threat to the sustainable development social stability and human security of the caribbean and of quote making all caribbean countries eligible is clearly the right thing to do with the bible one while it includes the region lays the foundation to have the fourteen caribbean nations specifically listed in the bill that will be sent to the president for his signature i urge all of my colleagues to support the rule and to support h r fifty five zero one rightly named to honor the service of chairman hyde and chairman lank trigger for minutes for the distinguished gentleman from texas was recalled recently along texas recognize foreman thank you mr speaker there is no more noble endeavor that we can engage in than to cure human diseases we all of us in congress i think have an obligation to be sure that we are for example double the investment we make in the national institutes of health in the national science foundation and the research work that they're doing to identify and cure human diseases at the earliest stages i represent the texas medical center proud to do so those institutions the greatest in the world the m d anderson hospital cancer center the texas children's hospital of baylor university of texas house science center is doing research today particularly at the nano research where we have the potential within the next ten to fifteen years of being able to identify in a child before she's born genetic predisposition to certain diseases for example like lou gehrig's disease or or diabetes or  fluid the child within take up those nano sponges and we can cure diseases in children before they are born we have the potential if we will just invest in the national institutes of health and their competitive peer reviewed grant process if we will just invest the money that's needed right here in america for the national science foundation we have the ability to detect cancer when it's only a few hundred cells in the body using nanotechnology and gold nano shells and that will attach to the cancer cells and destroy them before they turn into a tumor we have not adequately invested in our own scientific and medical infrastructure the united states first and foremost before you even begin to talk about curing disease globally we have not secured our border the southern borders essentially wide open and unprotected in areas other than tucson and other excuse me other than del rio and righto what are we doing to make sure that we've that we've that we've done all that we can do here at home first and foremost for our own folks but then finally and most importantly the reason i'm so spun up about this this is the fact that this democrat film on low we congress the obama hillary pelosi democrat congress is managing this economy of the united states like a and louise driving right off the cliff i urge you to go to geo dot gov go to geo dot gov and look at the fiscal wake up tour that david walker's put up on the web site that contra the united states has notified us formally that we spending money so irresponsibly so rapidly that the standard and poor's and moody's has already formally notified the treasury that they are beginning the process of downgrading u s treasury bonds the comptroller's told us that by the year two thousand and twenty in twelve years young people who are eighteen if you're listening by the time you turn thirty medicare is bankrupt treasury bills will be great it is junk let me repeat that treasury bills are on a path to the great it is junk bonds if we don't stop spending money and focus on the bare essentials every american already owes hundred twenty five thousand dollars a person this bill creates a worldwide entitlement to anyone in the world that has a germ alarie or tuberculosis at u s taxpayer expense it's an affordable it's unacceptable as it is one of it is utterly irresponsible at a time of record national debt record deficits record federal spending that we need to rein in otherwise america's going to become argentina the dollars rapidly becoming the peso it's time for this family and louise democrat congress to quit spending money on things that are not absolutely essential to this nation's survival let us focus on protecting the united states of america and quit spending my daughter's money that she does not have and driving our kids and our grandchildren deeper into debt it is irresponsible it's it is frankly criminal in my opinion to drive up the national debt and the deficit to record levels it is a noble good thing to try to cure disease in africa let me focus on clean drinking water for ample if you had a want to disease in africa quit spending my children's money that they don't pay out the chair will remind members to restrict their forced to inherit i will remind my colleagues that when bill clinton left office we had a surplus after the leadership after the out of the leadership of george bush and the republican congresses we are now in historic record debt our kids have have not have inherited a debt tax i am all for investing more in medical research i would much rather do that quite frankly than invest in tax cuts for donald trump or more subsidies to big oil companies or more tax giveaways to big corporations that are gouging the american taxpayer but what we have here mr speaker is a bill to save lives this is a moral imperative it is a product of bipartisan collaboration this is something that we can be proud of this is something the american people i think support overwhelmingly and so we don't need any lectures about the mess this economy is in this president and the republican congress is have driven this economy into a ditch and we're trying to get us out of that ditch so i would urge my colleagues to focus on what is being debated here today which is a bill to save lives to end the scourge of hiv aids malaria and tuberculosis this is a worthy goal this is something that we should be committed to and i think that the bipartisan collaboration that has produced this recognized for one minute thank you want to thank mr mcgovern first off a response and point out that over the last sixty years the democrats have been in control of the congress the republicans excuse me been a control the congress for i think about fourteen of that we were in control about twelve years and then i think there were two to maybe four years under eisenhower that the republicans were in control so democrats controlled the congress for the overwhelming majority the last sixty years and over the last eight i got here in two thousand and one and i can tell you mr mcgovern and you're a thoughtful good man i enjoy working with you that i personally on behalf of my constituents have voted against every major spending initiative that the white house has pushed on us because of four i recognize this problem the comptroller has put out before us voted against the farm bill a vote against a medicare prescription drug bill i voted against the no child left behind act i voted against aids in africa bill the last it came up because we cannot continue to spend money that our children cannot afford to pay we are piling the money we spend today will be paid by our kids and our grandchildren and that's the fundamental message here mr mcgovern i would encourage the everyone in this congress and i know you're a thoughtful guy why don't we focus on providing clean drinking water let's convert existing foreign aid in africa to clean drinking water which have led the effort to provide to convert five hundred million dollars focus on clean drinking water and research here in america and fire jennifer massachusetts businesspeople images you my so twenty seconds i appreciate the gentleman's response i would just remind the gentleman again and everybody that this is a bill about saving lives and this is a bill that is supported by the head of the republican party the president of states and so i am proud to join in support of this bipartisan collaboration i reserve my time jemma reserves on the florida speaker jemiah privilege to yield three minutes to the distinguished gentleman from puerto rico compromises that gave life to this light giving program i want to highlight an aspect of h r fifty one fifty five a one that has not received much attention and favorite zero seven i introduced h r a forty eight which call for the additional fourteen caribbean nations commend them for their work we are we were heartened when the language of h r eight forty eight was included in h r fifty five zero one fifty five zero zero one reflects a bipartisan agreement fortune through deliberations among democrats and republicans on the for the first c they white house on the state department's office of the global aids coordinator each of these groups recognize that the united states can do more to help the people of the caribbean fighting the aids pandemic that is ravaging raging their communities regional approach to fighting aids in the caribbean as h r fifty five zero one does is the right thing and the smart thing to do there are currently fifteen focused countries targeted for increase assistance on their part far only to haiti and we are in the caribbean caribbean is not sufficient to address a problem setting aside funding to haiti and biljana u s assistance to the caribbean has remained stagnant and in fact even decreased slightly thirty seconds  emphasize this point by adding this caribbean nations congress does not seek to substitute its judgment for the judgment of the experts of the state department needs or in determining how pepfar money will be allocated this fact intensive decision will and should ultimately be made by  mr speaker i just came from a meeting with local doctors from my district they told me that there is a severe shortage of funds necessary to care for america's seniors citizens we are having trouble finding the money to even take care of of our returning veterans millions of americans are facing foreclosure on their homes and now with all of these challenges that we're facing at home we are being asked to spend fifty billion dollars to fight aids in africa this is a absurd and as irresponsible as it gets where are we going to get the fifty billion dollars for africa well we can lower spending for our own people we can raise taxes which would likely throw us into a recession and have us even less money for our people at home or of course we can borrow it yes if we borrow it it will probably come from communist china and make ourselves even more vulnerable to their pressure we have exported our manufacturing base to china already and now we want to borrow even more from these dictators so we can give that money away to others it is terrible that millions of africans are suffering aids but we cannot afford such totally ear reaction irrational generosity this is benevolence gone wild we can't afford to short change our own people to raise taxes are to borrow and yet we expect the american people to absorb another fifty billion dollar hit for someone else we can't take care of our own veterans when they come home from the war we can't take your elderly we have people who can't take care of their own health needs and our risk of losing their homes and we are going to spend fifty billion dollars an hour for mr speaker we have big hearts but we need to use our brains we cannot afford this type of fifty billion dollar generosity it's going to cost that this will cost the american people their way of life it will cost them their health care their education for their children it will cost our vets our economy is facing a catastrophic set bending and taxing policies of the federal government and now we're going to exacerbate that problem by making believe that we can still afford to save the world by funding every worthwhile cause out there i'm not in any way suggesting that helping people with aids in africa is not a worthwhile endeavor but the fact is we've got to use our heads are we will have serious negative comps consequences on our own people fifty billion dollars is way out of line is way out of line it would be wonderful to help the people of africa through this age crisis by transferring tons of cash into african accounts but i suggest to you that as experience shows just sending that much money will not cure aids in africa and will have serious repercussions on our standard of living and the quality of life of our own people i ask my colleagues to vote problem supporting a three trillion dollar war in iraq that resulted in four thousand american soldiers dead tens of thousands wounded and on top of all of that not even paying for the war just putting it on the credit card voted for budgets to cut veterans health and to cut money for health care in general and what we have been trying to do is to make up for the indifference of so many years you know the general presents a false choice i mean you know what we're trying to do here is actually respond to a humanitarian crisis in a bipartisan way i mean i don't often stay with the prez united states but i do on this he's right we can't ignore  the hiv aids crisis or the crisis with regard to malaria and tuberculosis around the world this is a moral imperative and i will tell you in addition to being a moral imperative it makes sense for the united states states to take a leadership role and encourage the rest of the world to step up and to provide the resources to combat these scourges is the right thing to do and i'm proud of this bipartisan collaboration of this bill and i hope all my colleagues will support it i want to yield one minute to the gentleman from florida my colleague on the rules committee mr hastings i think nationally one minute i think my esteemed colleague on the rules god committed for yielding one minute i regret very much my colleague all of who is my friend from california all i had to be about his business because i wanted to respond directly to him dealing specifically with his comment as if this legislation is directed only to africa this legislation was the really expand of to the caribbean basin and urged yesterday in the rules committee that people understand that american tourists visit these places and in many instances it is in our best interest to make sure that these kinds of humanitarian concerns are taken care of haiti is that involved in this legislation and i doubt seriously if they then about it it doesn't believe that we should be about the business of all trying to help haiti my colleague from massachusetts mr mcgovern just set that it is the right thing to do it is the humanitarian thing to do it is the right thing to do and lest we ignore the extraordinary no vote on the previous question so we can amend the rule and allow the house to consider a change the rules the house to restore accountability and for civility to the earmark rule under the earmark the current rule so long as a chairman or sponsor of a bill joy a resolution conference report or manage that memo includes either a available in the rules a question of consideration because a democratic rules committee specifically exempted earmarks from the waiver of all points of order they deprive members of the ability to raise the question of earmarks on the rule is a member will restore the accountability enforceability the earmark rule to where it was at the end of the hundred ninth congress to provide members with an opportunity to bring the question of earmarks before the house for a vote last year the distinguished new speaker said that if she were to become speaker of the house she would require all earmarks to be publicly disclose and would quote put it in writing and quote however as we to the gentleman from massachusetts mr speaker five five zero one is one of the most important foreign policy global health bills of this congress will pass this year we have literally gone from five years ago from standing helplessly by and watching people die of hiv aids to watching people live and take up productive lives in their communities the impact is far reaching for example mr speaker let me highlight just one sector of development that has broad bipartisan support in this congress basic education we all know that education is key to lifting countries out of poverty and hiv aids creates barriers to education teacher deaths in absenteeism due to hiv aids compound compound problems of quality and access and education systems that are already face teacher shortages children are often pulled out of school to care for a family member with hiv aids i want to parent dies they are forced to take care of younger siblings rather than attend school hiv aids affected children who are able to attend school often face discrimination and are sometimes segregated from other children or denied admission entirely by teachers or school administrators young people with little or no education are more than twice as likely to contract hiv be as those who have completed primary education but under this bill and as we continue to better integrate our age hiv aids programs with our other development priorities schools can become hubs of care and support for our orphans and vulnerable children by providing psychological support nutrition and basic health care and support to obesity caregivers in a thirty two country demographic and health survey women with post primary education were four times more likely than illiterate women to know the basic facts about hiv aids and three times more likely to know that hiv can be transmitted from mother child oxfam estimates that of all children completed primary education seven hundred thousand new cases of aids hiv aids in young people could be prevented each year totaling seven million cases in one decade  speaker for these and so many other reasons this bipartisan bill deserves our support i urge my colleagues to support this rule and to support the underlying bill h r five five zero one i yield back the balance of my time  move the previous question on the resolution question and on ordering the previous question those in favor say aye those opposed no the eyes have it the a's unaids are requested those cause nine and cause nine of rule twenty this is a fifteen minute vote on the rule of the journal this will be followed by a five minute vote on ordering the previous question on h r as ten sixty five and adoption of a president sixty five the house here their first recorded vote of the day on they approving the journal the previous efficient written record of the previous day's activities likely a series of three votes here they have been debating over the initial debate anyway a bill that authorizes money for programs designed aid foreign countries in combating aids hiv aids malaria and tuberculosis fifteen minute vote here in the house for a preview of some of the debate ahead on this bill we talked a short while ago to a capitol hill reporter we're joined by adam graham silverman of congressional quarterly what's behind this bipartisan compromise agreement that's allowing this global a jig bill to come to the house floor well the initial version that democrats had proposed back in late january had a temper of asians in it that threatened to make this a very ugly fight to get the bill through congress including language strengthening family planning programs ties to  what's going to be a large pool fifty billion dollars well not quite fifty billion for the money and the conservatives have said this is going to open the door to funding for abortion overseas through these family planning groups  now they ended up leaving that those ties out of the house bill and agreeing on a fifty billion dollar amount this was helped out by president bush's trip to africa in which he saw firsthand the benefits this program is reaping and really wanted to get it done while he was still in office and have the kind of support behind it that it's had all along since it came along five years ago that fifty billion dollars level how much of an increase is is it from the current level of a first for the first five years from two thousand three to zero eight fifteen billion was authorized and congress ended up providing close to around eighteen billion so this is a very large increase and there's some question about whether there's the capacity for countries and for programs on the ground to absorb it the program say they're capable and are looking looking forward to getting this money expanding treatment and antiretroviral drugs and hiv prevention  throughout developing countries particularly in sub saharan africa you write about this by particularly partisan compromise that supported it's a fairly disparate group supporting them who are they well everyone from some pretty liberal house members who it's not surprising to hear our behind care an outreach program like this to some pretty strong fiscal conservatives such as mike pence who's the former chairman of the republican study committee which is a conservative group within the house republican conference they are often very fiscally conservative but also morally  quite quite strong about following up on their strong moral beliefs which is what led pence to support this increase in money saying that you know this is really a humanitarian crisis that needs to be addressed what's the family to strike just one little phrase in the bill that only planning groups say is going to restrict their access to some of the money in the bill and condemn it was ruled out of order basically the house leaders have decided to put off these fights or restrict the fights in order to keep the comedy in the consensus around the bill hence the conservative had said that he warned that if this kind of amendment was let in it would open the floodgates for a lot of nasty debate so if they decided to put this to the side we'll probably hear some voices saying that they wish that there was more for family planning groups on the ground in the bill and as to other complaints about some of the social policy restrictions but most people are expected to line up behind it when all of a sudden done well the white house support this bill yes they've been released a statement yesterday in support of the bill so that you have concerns about the cost but they were at the table when this compromise was hammered out so they're very much on board that i'm graham silberman of congressional quarterly covering the debate today on the global aids hiv aids bill thank you for joining us thank you california right mr speaker i asked him in a consent that all members may have five legislative days to revise and extend their remarks and include extraneous material on h r fifty five zero one the house will be in order for members to move the conversation from the floor the house is in the committee of the whole house on state of the union for consideration of h r five five zero one which the clerk will report by title a bill to authorize appropriations for fiscal years two thousand nine the gentleman from california mr berman and the gentlewoman from florida ms ross legg mason each will control one hour of the chair recognizes the gentleman from california please take your yield myself such time as i may consume madam chair on the president's request five years ago congress launched a global campaign to stop the spread of hiv aids and to treat and care for those who are already afflicted the united states leaders act ship against hiv aids tuberculosis and malaria act was a bipartisan bill from its inception today the foreign affairs committee again brings a bipartisan global aids hiv aids bill to the floor and again this important reauthorization bill enjoys strong support from the white house the negotiations that brought this compromise bill were conducted in the same bipartisan spirit that guided the two thousand and three act into law a spirit made possible by close cooperation between two former chairman of the foreign affairs committee hiv aids overseas as a direct result of the extraordinarily successful law we passed five years ago the united states has provided lifesaving drugs to nearly one and a half million men women and children supported care for nearly seven million people including two point seven million orphans and vulnerable children and prevented an estimated one hundred fifty thousand infant infections around the world the two thousand and three legislation firmly established the united states as the leading provider in the world of hiv aids assistance for prevention treatment and care it is reminded the global community that americans are a compassionate and generous people and so as help to repair our nation's badly damaged image overseas in many ways that legislation has had great healing power most importantly with this initiative we have ensured that hiv aids is no longer the certain death sentence it was just five short years ago hospital corridors that were jammed with aids patients waiting to die now bring with hope as lifesaving drugs are dispensed the reauthorization bill before the house today reaffirms our commitment to the programs and policies established five years ago the two thousand and three legislation worked well as an emergency intervention but it must now be modified to reflect the constantly changing nature of the hiv aids crisis we also have five years of experience under our belt we know what works and what does not the law we passed in two thousand and three was designed to deal with the emergency phase of the global aids hiv aids crisis the lantos hyde bill will move our programs towards long term sustainability that will keep the benefits of us global hiv aids programs flowing to those in need with this reauthorization act host governments will also gain the ability to plan direct and manage prevention treatment and care programs that have been established with the u s assistance to do thousand three legislation authorized fifteen billion dollars over five years in response to the desperate need for lifesaving medicine and a greater number of trained health care workers in nations hard hit by a hiv aids the bill before us authorizes fifty billion over five years for these three pandemics the two thousand and three law relied upon the health care workforce already in place in the developing world yet many of the hardest hit areas of the world there are simply not enough doctors and other health care workers to meet the challenges of this pandemic the lantos hyde legislation invests new funds in training new professionals and paraprofessionals as well as building existing capacity the two thousand and three law focused on creating new programs to tackle the hiv aids crisis the reauthorization bill increases the number of individuals receiving prevention treatment and care services it also builds stronger linkages between the global aids hiv aids initiative and existing programs designed to alleviate hunger improve health care and bolster a jig occasions goals and approach indorsed by the president's global aids coordinator in a report issued just a few weeks ago the two thousand and three law gave in adequate attention to the need to the needs of women and girls the new legislation remedies the situation by strengthening prevention and treatment programs aimed at this especially vulnerable population the reauthorization legislation also eliminates the one third abstinence only earmark but requires a balanced approach to hiv aids sexual transmission prevention programs and a report regarding this approach in countries where the epidemic has become generalized the bill before you today is a compromise in the best sense of the word and it is in the true spirit of the great leaders of this committee who guided the two thousand and three act into law chairman lantos and high this a result of more than a year of for apparent ori work and weeks of discussions concluding with a bipartisan agreement with the white house president bush has indicated his support and his intention to sign it into law as soon as congress  for all its strengths the bill before the house today is not perfect no cause from eyes ever is no one got everything they wanted in this compromise legislation but with this agreement we have maintained a strong bipartisan coalition behind the  global aids initiative which has been critical to winning rapidly increasing funding levels for this important initiative madam chair twenty million innocent men women and children have perished from a hiv aids and forty million around the globe are eight hiv positive each and every day another six thousand people become infected with hiv we have a moral imperative to act and to act decisively i will speak more  compromise a number of members on her side from the committee were active don payne a gentleman from new jersey the chairman of the africa subcommittee was critically involved as was congresswoman barbara le from california who played such a key role in the two thousand and three law as well and a number of other people congressman carnahan and i can't get into everyone who was involved but this was truly a collaborative effort that started long before i became  chair of the committee with great work by chairman lantos last year and with the staff of the committee and with that i reserve the balance of my time gentleman has reserved this time the gentleman from florida is recognized by the us madam chairman i thank you so much and i thank my at my good friend the new chairman of our foreign affairs that committee howard berman he's got a tough act to follow because we all loved tom lantos and the gentleman from california mr berman had a hard act to follow but boy did he fill those big shoes very well so thank you mr chairman this has been your your first the trial by fire and you came out looking us so well because you accommodated the concerns and the anxieties and the and the the worries that so many of our members had i want to thank in a bipartisan level the all of the members of the foreign affairs committee from the most conservative to the most liberal we were able to forge a compromise that reached a broad consensus on this vital and complex legislation and we couldn't have done it without the leadership of chairman berman but also has a very able staff and the staff on our republican side of the  foundation of this bill as chairman berman has pointed out is the two thousand and three leadership backed which was the first comprehensive u s emergency response to the h r of the aids pandemic and which stands as  noble legacy of our two former chairman henry hyde and tom lantos they understood as do all of us that millions of lives around the world depend on our country's willingness to battle this pandemic together it does honor to our country that five years ago we undertook this true mission of mercy we are fortunate to have the opportunity to reaffirm that commitment by our vote here today since the passage of the original leadership back to two thousand and three extensive emergency treatment and prevention programs have begun to slow the advance of hiv aids tuberculosis and malaria the success of these programs as well document documented according to the office of the global aids coordinator and like to cite some specifics more than one point four million people infected with the h virus are now being treated with the necessary drugs to fight this disease pepfar has supported hiv testing and counseling for thirty million people cared for nearly six point seven million and as the chairman pointed out including almost three million orphans and vulnerable children we are on our way to achieving the five year goal of preventing the infection of seven million people pepfar has supplied medicines for approximately eight hundred thousand expectant mothers preventing an estimated one hundred fifty seven thousand infant hiv infections what a successful program the legislation before us keep faith with the core principles of the hyde lantos act we have modified the original blueprint by adding or adjusting a number of provisions based on five years of real world regarding what works and what doesn't in addition to medicines and sophisticated methods of treatment the two thousand and three act mandated that a more comprehensive approach be used that took account into account local values indigenous cultures and the act before us does that with respect to this balanced approach the wife of the president of the m b s said it best recently when she said there are several ways in which we can reach the young people one of the effective ways is abstinence it brings back dignity and self responsibility to young people because they know their bodies are not supposed to be abused and they learn to say no the compromise bill before us removes the specific directive in current law so that implementation as the chairman has pointed out can be a refined to reflect the varying circumstances in host countries nevertheless the bill before us continues this comprehensive approach by requiring that the aids coordinator provides a balanced approach for prevention activities for sexual transmission of hiv aids and to ensure that abstinence and faithfulness programs are implemented and funded in a meaningful and equitable way the argument that we have the agreement that we have is carefully crafted designed in the area of reproductive health and family planning to ensure that the funding for prevention is not misused to promote programs beyond the scope of this bill we can do that if you wish in other bills but the bill ensures also that those working to fight these diseases are not required to choose between their conscience and receiving the assistance they need to carry out their work also we worked a lot on the prostitution and the sex trafficking pledge the bipartisan agreement maintains the existing certification requirement that any group or organization receiving pepfar funds explicitly oppose prostitution and sex trafficking the u s agency for international development has implemented this prohibition by requiring that any group that receives funding sign a pledge affirming its opposition to these practices let me be clear neither current law law nor the pledge itself prevents organizations from working with prostitutes or other high risk groups but it does mandate that the assistance to that sissons to their to these individuals not be mistaken for approval or support of the activities that take their terrible toll on their bodies and that can only be described as destructive to human dignity had issues with accountability and national security you know and although this bill is absolutely motivated by the altruism of the american people i believe that this legislation ensures that our interests are protected as well for example u s contributions to the global fund will be subject to more stringent oversight than is currently provided by calling for the fund to meet even higher benchmarks of transparency and accountability the legislation also includes a prohibition on taxation of our assistance by foreign governments to ensure that assistance intended to the afflicted not be siphoned off by unaccountable bureaucrats the bill also strengthens our national security the hiv pandemic is first and foremost a health issue but it also is one of the most significant global economic and security threats of our generation general charles wald the former deputy commander of the u s european command has called hiv aids the third greatest threat to our national security together aids tuberculosis and malaria kill millions of people during their most productive years between the ages of sixteen and fifty and in the hardest hit countries the aids epidemic alone is killing a generation of parents of teachers of health care workers breadwinners peacekeepers shattering the economic and the social life of villages communities and indeed nations losses on this scale have staggered the economies of the hardest hit countries without further prevention societies and undermining the security of entire regions are former house colleague from wisconsin mark green who now serves as the united states ambassador to tanzania wrote to me following the committee passage of this bill highlighting this security aspect he said in tearing apart the social fabric and leaving a generation of war friends the scourge of hiv aids could spread and create a long term breeding ground of radicalism pepfar programs in turn help to counter these precursor conditions as general wald has said in addition to the obvious humanitarian efforts of pepfar the program is one of our nation's development activities that can help strengthen the social structure that keep communities and nations secure the threat is not just in faraway lands but in our own backyard many countries in the caribbean have been particularly hard hit this bill places a new emphasis on assistance to this region it adds fourteen caribbean countries to the existing list of nations in which global aids coordinator is given explicit statutory authority over the aids programs and let me add that although all of us share their goal  reducing the further spread of this pandemic this is also a personal issue for me both professionally and morally south florida which falls within my congressional district ranks first in the state of florida in the number of aids cases roughly nineteen percent of the state toll for those living with hiv reside in my district so i am all too familiar with the human cost of this disease and hope for the day when it's ra are safely confined to the past although all them don all members while fully agree with every aspect of this complex compromise it does contain the bipartisan approach that we have maintained throughout the years of work on hiv aids in our committee we have an opportunity indeed a responsibility to continue the lifesaving work that began five years ago the legislation is the means by which that can happen but the dry text of the legislation nor the posters behind me cannot adequately capture the human drama from which we are trying to write the exit strategy the the posters behind me show where pepfar has worldwide activities the number of countries where it has positively had an impact the second shows the number of adults and children estimated to be living with hiv just this last year and the third poster shows some of the faces of the children this legislation has saved let me read to be to conclude from a washington post op ed authored by our chairman henry hyde five years ago and mr hyde wrote not sensible bionic plagues swept across the world in the last millennium has our world confronted such a horrible curse as we are now witnessing with the growing hiv aids pandemic this pandemic is more than a humanitarian crisis to those who suggest that the united states has no stake in this pandemic let me observe that the specter of failed states across the world is certainly our concern the aids virus is a mortal challenge to our civilization is my hope that each of us will be animated by the compassion and yes the vision that has always defined what it means to be an american madam speaker endless numbers of children have already been orphaned and deprived of the of the protection and the love of their parents we cannot make their world whole again but there is much that we can do to come to comfort and care for them and to brevet others from suffering the same fate i asked my colleagues to join us in supporting this bill in a strong bipartisan manner and thereby allow our country to commit to continue our mission our asked for time for the purpose of the general eighty for missouri and i entering into a colloquy with the chairman on the importance of integrating food and nutrition programs with the prevention care and treatment of hiv aids affected individuals families and communities last year i traveled to africa and had the opportunity to see firsthand many of our programs related to food security in ethiopia and kenya i visited hiv aids programs to look at how food and nutrition was included at that time i heard from local communities o partners and our embassy staff how restrictive guidance from global aids hiv aids assistance often hindered their ability to design and carry out affective food and nutrition programs targeted at hiv aids affected individuals please and communities the lack of resources available for food and nutrition programs within the global hiv aids assistance and from other sources also pose a significant barrier i very much appreciate support the work of the committee in ensuring that this bill addresses these concerns throughout the throughout and especially in the section entitled food security and nutrition support the bill recognizes that strengthening the linkages and hansing coordination among a hiv aids programs and vital development programs like food and nutrition programs will significantly increase our effectiveness in the fight against hiv aids while we advance other essential u s development priorities i remain concerned however that the bill is less clear on where or ho such funding will be provided for these purposes it is not clear on how much funding will come from the global aids hiv aids program first as other sources of funding i am concerned that without adequate resources to the global aids hiv aids program or necessary increases for current food and nutrition services to programs like food for peace that usa i d will be faced with the possibility of having to divert funding from programs that address long term chronic congar and food insecurity to meet the enhanced mandates of h r five five zero one i know the chairman will agree that we want to avoid the scenario of robbing peter to pay paul so that we do not end up shortchanging other communities suffering from hunger malnutrition food insecurity i want to yield to the  you i thank the gentleman from massachusetts mr chairman i'm also concerned that the situation will become even worse because the cost of food commodities and transportation as skyrocketing just last month on february twelfth usa i d s office of food for peace and that the cost of wheat and other food the united states donates to poor countries jumped forty one percent forty one percent in the first half of this will year two thousand and eight according to usa id this means one hundred twenty million dollars in food assistance will not be available for people who are malnourished or food insecure or i would ask the chairman to work on strengthening the language in the bill as it moves through second i'd ask the chairman to work on strengthening the language in the bill as it moves through the legislative process and into conference negotiations to clarify how the necessary level of funding for food security and nutrition will be provided especially in light of rising food and transportation costs so that funds won't be diverted from us programs addressing chronic hunger and emergency operations i yield back the gentleman from massachusetts  the gentleman gentleman time has expired madam chair before i respond with my views i'd like to yield one minute to the gentleman from new jersey mr payne two is expressed his views on the matter that's the subject of this coll gentleman from new jersey is recognized the one minute mr chairman as you know the provision on food nutrition security in the bill currently on the consideration is drawn directly from a bill i introduced in december h r forty nine one for the global h i v a split security and nutrition support act of two thousand and seven i had to do is to build after chairing a hearing in the subcommittee on africa and global health to determine whether the global  aids program was adequately addressing the nutritional needs of its beneficiaries the herion purab aerated that what i had already heard in the field on numerous visits to africa over the past five years  pepfar as falling short in this critical area i share the concerns of the gentleman from massachusetts senate gentle lady from azhari about the increase in cost of food a day just last week the world food program had to issue an appeal for an additional five hundred million to offset the increased cost of food and fuel without the extra funds seventy three million people who rely gentleman's time has expired you know the gentleman i use a gentleman an additional thirty seconds to an additional thirty seconds thirty seconds without the extra seventy three million people will who rely on w f p where their daily substances substance this may have their rations cut this is truly alarming situation and it is not my intent but the provision of this bill to exacerbated the language on a consideration very clearly states that these activities are to be funded from amounts authorized on a section for all one of this bill i use this language deliberately as i strongly believe that the food assistance and nutritional support we are providing on a global a program must be on top of the food aid we are already providing with that idea back gentlemen stand by madam chair i yield myself one minute to one and a half minutes to respond to the rator and the global aids coordinator to address the food and nutrition needs of individuals with hiv aids and other affected individuals including orphans and vulnerable children to fully integrate food and nutrition subordinate h aids prevention treatment in care programs carried out under this act i'd like to emphasize it to committee ny personally share our colleagues concerns about the negative effect rising costs are having on our long term and emergency food aid programs this is a matter that has our most serious attention because it affects a wide array of our food aid and development programs including the effectiveness and success of this program i want to reassure my colleagues that i will be working over the coming weeks to strengthen clarify in the bill that food security and nutrition programs especially those are furred to as wraparound services are not to be funded with monies diverted from other standing commitments to address food insecurity elsewhere in the world or in these countries and i yield thirty seconds additional time to the gentleman from massachusetts thank you gentlemen recognize a thirty second i want to thank the chairman for that assurance i know that many members of congress on both sides of the aisle stand ready to support him in these efforts now you back my time madam chair i reserve my time generated from florida is recognized thank you madam chairman i yield three minutes to the gentleman from california mr royce who is the ranking member of the subcommittee on terrorism nonproliferation and trade someone from california as recognizable of three minutes thank you and thank you madam speaker many have described the crisis tuberculosis malaria these take countless lives lives every day especially on the continent of africa and these these diseases their devastated families they they devastate communities and nations this bill is titled the leadership back and its title that way because it on or to former foreign affairs committee chairman who indeed did show leadership in forging this legislation five years ago and with this act the united states will continue to lead in tackling these killer diseases as others have said this legislation did not come together easily and the reason it is difficult is because many people have strong views on how best to fight these diseases this bill is a compromise it would have been far easier to hold on to positions probably but that would have gotten no bill but instead those working on it did the hard work to craft a policy that most everyone could support frankly at the end that not been a done it would have been a sharp rebuke to the work chairman hyde and lantos did five years ago tens of millions of people around the world would have lost and america would have lost that we're in this position now to continue these two men's legacy is due to the dedication of chairman berman and ranking member ross layton and i particularly appreciate their inclusion of a provision i had recommended prohibiting foreign countries foreign governments from taxing our aid and i thank them for that provision while endorsing the policy of the bill's authorization level is a great concern as others have expressed have conferred with enough people working in the field and been in enough african countries to doubt the ability to productively absorb this very large funding level which is well over the administration's request and while these are devastating diseases these countries face many other public challenges some deadly which may be short changed our country has many public health needs too and that leads me to believe that this would be a better bill if it conforms more closely at the level the administration which has gotten real results thinks it could best spend and i believe this bill's authorization level will be addressed in chairman berman of the committee for bringing forth this tremendous important legislation and for the support and this bipartisan effort from ranking member elena ross leighton for her support of this very important legislation and i rise in strong support of the legislation currently under consideration and i'm very pleased to appropriately named because it was under the leadership of the late henry hyde then chair of the foreign affairs committee that the pepfar legislation was originally authorized and under the leadership of  tom lantos reauthorization began and both of these tireless giants who have left us should be remembered by this legislation and i might also note that on their leadership of the original authorization congresswoman barbara lee and the congressional black caucus were very strong advocates to push the leadership of the house and the president to consider this very important  legislation in the five years there has certainly been a pandemic that the world is facing and there has not been a pandemic similar to this sense the plague during medieval days in europe and so i am pleased that we are finally dealing with this pandemic in the way that it should be in a five years since congress passed the original legislation authorizing the president some urgency plan for aids relief or pepfar as it is well known it has become a historic program in my opinion this will be remembered as the single most significant achievement of president bush's two terms in office and with my recent conversations with the president i know that he has worked very hard at this rea uthorization and it's with the support of the white house and the staff they helped us craft this bipartisan legislation prior to pepfar the united states did very little in supporting aids treatment programs abroad in fact we may recall a high ranking usa idea official said that treatment was not feasible in africa the most heavily aids affect that region of the world because africans could not tell time and therefore would be unable to take the required medication properly as we know it was foolish to said at the time and as we've seen the results it has proven once again to have been a foolish statement these officials advocated limiting our activities only to education and prevention the spread of this disease a position which would have in fact say in effect sentenced millions of that men women and children to die if it were only that program and so i'm so pleased that we expanded it to where it is today fortunately the president and the congress did not agree with that position and that only education and prevention would work and because we were willing to find a way to provide treatment for over eight hundred thousand people today are receiving and try and tire of medication to prevent pepfar in the fifteen focus countries twelve of which are in sub saharan africa were also please that we're increasing the number of countries to the fourteen caribbean countr chair of the bipartisan congressional caribbean caucus and under the leadership of representative donna kristen christmas and add a meeting that she convenes in her district we had health ministers to admit that the caribbean also needed substantial help however our progress while significant is not enough only twenty eight percent of africans needing answered anti retroviral as are receiving shockingly over eighty five percent of african children who need a r v's are going without them a mere eleven percent of h i v positive women who need drugs to prevent mother to child transmission of h i v during childbirth are getting them in light of these i'm may i ask for one additional minute yield the gentleman additional minute gentlemen is to heal that one additional minute in a lot of these troubling facts we have taken steps in this legislation to transform pepfar from an emergency response to a social stansell program by expanding the program beyond a series of medical interventions for example the committee incorporated the provision that i was discussed earlier about food security into the legislation in order to address the nutritional needs of h i v patients their families and communities have the affected by the disease lack of food and nutrition support has up to now been a major impediment to the adherence of h i v aids treatment regimens h r fifty five all one also contains provisions to build and strengthen health systems in developing countries the committee has given the office of global aids coordinating the flexibility to do prevention care and treatment programs tailored to the characteristics of the epidemic in the country and which they are operating by eliminating cumbersome earmarks that the g o s said were in effect the finally the bill authorizes significant funds fifty billion over the next five years in order to accomplish the three goals of the dolls of our bill donating time a million people i urge the chairman and i urge our house to pass this legislation thank you i yield back the balance of my time the gentlewoman from florida is recognized thank you madam chair i'm proud to yield seven minutes to the gentleman from new jersey mr united states global leadership against h p v aids tuberculosis and malaria reauthorization act of two thousand and eight and admittedly long but appropriate title for a bill that is long on substance meaningful intervention tangible compassion and of the giants of this institution who helped shepherd president george w bush pepfar initiative through the congress in two thousand and three h u r fifty five zero one will literally mean the difference between life and death to millions especially in sub saharan africa the bill before us today is consensus legislation a delicate balance that is kept intact and only if kept intact will be signed into law so i wan chairman berman and ranking member of slayton and other members and staff for helping to forge today's pepfar consensus our new especially sanctuary record mary noon in order to frederick's elim pub let peter yarrow pearl alice dr king kristin wells and david abramowitz for their extraordinary work in drafting this legislation better speaker as members know close to seventy percent of the estimated thirty three million people with hiv live in africa of the two point five million children afflicted with this dreaded disease ninety percent live in africa as well when combined with opportunistic infections like tuberculosis the number one killer of individuals with hiv and malaria which alone kills one million each year again mostly in africa they hiv aids pandemic compares among humanity's worst former chairman hyde frequently compared t sickness to the vanished plague the black death an epidemic that claimed the lives of over twenty five million people in europe during the mid thirteen hundred s i know some members are likely to wince at the cost of the bill fifty billion dollars over five years for pepfar tb malaria and the global fund but that some of money will be used to prevent twelve million new hiv infections worldwide and support treatment for three million people including estimated four hundred fifty thousand children that sum of money will provide care to twelve million individuals with hiv aids including five million orphans and vulnerable children and will help train and deploy at least one hundred forty thousand new health care professionals the workers for a hiv aids prevention treatment and care on the prevention side the legislation requires that the global aids coordinator provide balance funding for sexual transmission prevention including abstinence delay of sexual debut monogamy for the elderly and partner reduction if less than fifty percent of the sexual transmission prevention monies are spent on  greater transparency and accountability five years madam speaker after pepfar first began the efficacy and importance of promoting abstinence and be faithful initiatives have been demonstrated beyond any reasonable doubt and the evidence is compelling according to a joint comments by the u s department of state usa id and h h s on pepfar i quote congressional directors have helped focus u s government prevention strategies to be evidence based because of the data a b c is now recognised as the most effective strategy to prevent hiv and generalized epidemics the original legislation's emphasis of a b activities has been an important factor in the fundamental and needed shift in u s government prevention strategies from a primarily see approach prior to pepfar to a balanced a b c strategy the emergency plan developed a more holistic and equitable strategy one that reflects the growing body of data that validate a b c behavioral change the u s government workers on the say the recent data from zimbabwe in kenya mirrors the earlier successes of uganda's a b c approach to preventing hiv these three countries with well is known as generalized epidemics have demonstrated reductions and hiv prevalence and in each country the data point to significant a b abstinence be faithful behavioral change and modest but important changes to see so i want to thank mr pitts for writing the original a b earmark into the original law because it has instructed and has had tremendously positive consequences i would note to my colleagues at this past september the foreign affairs committee heard from a world renowned expert dr norman hurst who said that five years ago he had been commissioned by un aids to conduct a technical review of how well condoms had worked for aids prevention in the developing world and he said and i quote in part my associates and i collected melton's of data and here's what we found when we look for evidence of public health impact for condoms and generalized epidemics to our surprise we couldn't find any no generalize age of the epidemic has ever been rolled back by prevention strategy primarily based on condoms instead of few successes in turning around generalize  epidemics such as uganda were achieved not through condoms but by getting people to change their sexual behavior because on the say that these are not just our conclusions are racist consensus statement in the lan endorsed by a hundred fifty aids experts including nobel laureates the president of uganda and officials of the most prominent and into international aids organizations and it said the priority for adults should be be limiting one's partners the priority for young people should be a not starting sexual activity too soon and this contrast with other funders that often officially endorse a b c but in practice continue to put their money and the same old strategies that have been  unsuccessful in africa for the past fifteen years a washington post article by craig timberg noted that many women abbas want to continue to contract a heavy faster than almost anywhere else on earth research is increasingly attributed their resilience of hiv botswana and in southern africa generally to the high incidence of multiple sexual relationships researchers increasingly agree and please i ask my colleagues to take note of this that curbing behavior is key to slowing the spread of aids in africa and the july report southern african aids experts said that reducing multiple and concurrent partnerships was their first priority for s leaves intact the anti prostitution sex trafficking pledge a policy designed to ensure that pimps and brothel owners don't become via an ngo that supports such exploitation u s government partners last february the us government court of appeals for the disc of columbia upheld the prostitution pledge and said in part in part in this case the government's objective is to eradicate age of aids one of the means of accomplishing this objective is for the us to speak out against legalizing prostitution in other countries the court of appeals because on the say and i quote it would make little sense for the government provide billions of dollars to encourage the reduction of hiv aids behavioral risks including prostitution and sex trafficking  engage as partners in this effort organizations that are neutral towards or even actively promote the same practices sought to be eradicated finally we've come a long way madam speaker since two thousand and three when significant opposition materialize against an amendment that i offered to ensure that faith based providers and others are not excluded from participation worldwide but especially in africa faith based organizations are absolutely critical  the fight against aids so we welcome and are grateful deeply grateful their support and their work the conscience clause in h r fifty five zero one restates improves and expands conscious protection in a way that ensures that organizations like the catholic relief services which with its two hundred fifty plus projects in fifty two countries which has had a remarkable record of hiv aids prevention treatment and care are not discriminated against or in any way precluded from receiving public funds that figure this is a good bill carefully crafted and again i want to thank my colleagues on both sides of dial for the enormous amount of work has been poured into its creation yield back the balance the gentleman has yielded back is time western hemisphere and remember this is a bill about h i v age malaria and tuberculosis he played a major role in this tuberculosis section of bill the gentleman from new york mr ingle for three minutes gentleman from new york is recognized with the minutes i thank god distinguished chairman for yielding to me and madam speaker i am proud to be an original co sponsor of h r five five zero won the tom lantos and henry j hyde united states global leadership against hiv aids tuberculosis and malaria reauthorization act of two thousand and eight named after our daily departed to great house foreign affairs committee chairman that i had the pleasure of serving under tom lantos and henry hyde the hiv aids pandemic continues to pose a major threat to the health of the global community from the most severely affected regions of sub saharan africa and the caribbean as as the chairman mentioned i'm the chairman of the subcommittee of western hemisphere to the emerging epidemics of eastern europe central asia south and southeast asia and latin america i also want to take this time to pay tribute to to our colleague who is in the chamber the gentlewoman from mostly while most widely recognized for reviewing our commitment to global aids relief h r fifty five zero one reauthorizes provisions on hiv aids malaria and tuberculosis all deadly the diseases of poverty the lentulus hyde act is a decisive step forward for global health particularly for efforts to control tuberculosis i want to take a moment to specifically address the tuberculosis provisions included as the chairman mentioned as my bill  r one five six seven the stop tb now act which passed the floor earlier this year was largely incorporated into this bill and i'm delighted about that the world health organization reports that one and a half million people died of tuberculosis in two thousand and six with another two hundred thousand dying from hiv associated tuberculosis the emergence of multi drug resistant and x extensively drug resistant tb known as m poses a grave risk to global health a contagious airborne disease tb knows no barriers or borders and can only be successfully controlled in the united states by controlling it overseas this lantos hyde act declares tb control a major objective of u s foreign assistance programs in support of w h o targets the bill prioritizes having tb deaths and disease cutting them in half and achieving a seventy percent detection rate and an eighty the legislation supports key t b a of the activities such as providing aids patients with tb screening and treatment and providing tb patients with proper counseling testing and treatment for hiv aids finally the legislation authorizes assistant the systems for the development of new vaccines for tb the current tb vaccine is more than eighty five years old and is unreliable against pulmonary t v which accounts for most of the worldwide disease burden nuti the vaccines have the potential to save millions of lives and would lead to a substantial cost savings studies modeling the ten year economic benefits of a vaccine that is seventy five percent effective have estimated worldwide savings in medical costs of twenty five billion or more i strongly urge my colleagues to support this bill this is a very very important bill and i yield back the balance of my time the gentleman yield back the balance of his time gentlewoman from florida is recognized thank you so much madam chair before to my distinguished a colleague from illinois i'd like to recognize the efforts of your lamp i'm glad our staff director on the g o p side mark gage joan condon sarah kiko and our committee that they've all been working so hard in our detail ia valuable addition to our pepfar team ben snyder thank you to everyone who's work so hard madam chair i'd like to yield three minutes to the gentleman from illinois mr weller and his team member of the committee on ways and means to commend the current leadership of the committee the bipartisan leadership mr berman and miss ross leighton for their leadership in moving this legislation to the florida bipartisan way and it's most appropriate that it be named after  henry hyde two distinguished chairman of the international and foreign relations committees of change names one thing that was in common between tom lantos and henry hyde as they always work to ensure that foreign policy should be a bipartisan product and a team effort and so it's so appropriate that they be recognized by name in this legislation after them which reauthorized as president bush's emergency plans for aids relief as noted by a number of my colleagues almost thirty three million citizens of this pla today suffer from the consequences of hiv aids we have a moral responsibility and it's important the united states exhibit and demonstrate moral leadership and addressing this crisis which now is a health issue but it's a security issue for this globe i think we all watched the reception of president bush when he traveled recently to africa and the appreciation that was shown by the leadership in africa for the president's initiative and the bipartisan support that we've seen in the effort against aids and they help those who are victims of aids in africa and we often think of africa as when we talk about global wades but of the thirty three million there's also many living and latin american the caribbean who suffer from a hiv aids as well latin america today there are one million six hundred thousand people living with hiv aids that's up from one point three million in two thousand and one and fifty eight thousand citizens of latin america lost their lives to hiv aids in the caribbean two hundred thirty thousand adults and children are currently known to be infected with hiv aids that's up from one hundred ninety thousand in two thousand and one in the caribbean eleven thousand citizens of caribbean have lost their lives and i've know we've made some progress as a result of the president's initiative and for aids relief and haiti alone large recipient of aid as a result of this initiative almost four percent of the population of haiti is infected with hiv aids think about that one hundred ninety thousand people and sent two thousand and four thanks this initiative the number of people receiving care and support has grown from thirty thousand two hundred twenty five thousand then to supported one hundred fifty thousand people will be reached this year because it's in haiti received almost eighty five million dollars from this program the past year to address this crisis which affects many in the caribbean point is that pepfar as we know it as a lot of streets almost every person in haiti struggling with hiv aids and for example the continued supports necessary to make sure we reach every person struggling with hiv aids in the world and that's why this extension is so important so noted earlier hiv aids is vassar additional two minutes madam chair i'd like to yield an additional two minutes to the gentleman from illinois and jennings recognized one additional two men also like to share a couple other examples of the success of this initiative and how this funding is helping regular people and making a difference in latin america bolivia a large nation the size of texas with nine million people thanks to the pepfar initiative or using data to combat hiv aids in fact real time data is helping bolivian health officials carry out more h i v aids prevention education including h i b counseling and testing services and according to the joint night a nation's program and hiv aids for valence rates in bolivia's general population has remained at one tenth of one percent which is remarkable success compared to some of its neighbors and central america and the republicans on douras beginning in february two thousand and five the united states seven thousand at risk individuals with behavioral change models as part of the hiv prevention efforts group began offering h i b counseling and testing and counseling testing programs for the first and under to be offered by those trained in accordance with working with the ministry of health standards as part of a larger national prevention effort this collaboration between the government on terrorists usa id indigenous organizations the ministry of health has set the standard the expanding of expanding access to testing in the nation of andras the bottom line is this program is making a difference in combating what is clearly a terrible crisis around the world currently impacting thirty three million citizens of this planet we have a moral obligation and support the united states continue to exert the leadership and demonstrate the leadership we have over the last two years to address  california someone who has been heavily invested in in getting our attention on this issue and passing the legislation putting in fashioning and passing the legislation in subcommittee and all who have helped to make this legislation an amazing piece of legislation and i know that chairman lantos and chairman hyde wanted thank us and are here with us honoring their legacy because they would want to see this move forward as it is today as one of the five a original co authors of both the initial legislation established in pepfar and of this new bill reauthoriz cooperation that we have have moved forward with in the past there's no other piece of legislation that we will consider in congress this year that will have the greatest impact on the lives of people around the world like many i have witnessed firsthand many times the dramatic and positive impact of our aids programs on individuals and communities throughout the world especially in sub saharan africa but it wasn't always this way not ten years ago actually when i first came to congress i think it was ten years ago in april the world really had not recognized the devastating toll that hiv and aids was beginning to take on families and communities throughout africa since that time however we have worked together in a bipartisan basis on a number of very important legislative initiatives that have put the united states on the right side of history when it comes to this global pandemic first in two thousand we passed in president clinton signed into law h r thirty five nineteen the global aids of tuberculosis really fact now this important bill was a vision inspired by an idea by our former colleague and my friend former congressman now mayor ron dellums of oakland california to establish an aids marshall plan in africa for africa funded through the world bank aids trust fund with the help and leadership of our former colleague congressman jim leach of iowa we turn this idea into legislation which provided the founding contributed in and the framework for what we know today as the global fund to fight aids tuberculosis and malaria in two thousand and one working with both former chairman hyde and la mr berman mr paine mrs ross layton mr smith we drafted h r two o six mine which was called the global access to hiv aids prevention awareness education and treatment act this was the first bill that dared to provide large scale antiretroviral therapy to people living in the developing world although we made progress in advance in this legislation through congress in two thousand and one in two thousand and two we weren't able to reach a conference agreement with the senate before the one hundred seventh congress thankfully however our discussions would lay the foundation for quick action in the next congress so at the end of two thousand and two the congressional black caucus along with practically every advocacy group in the united states senate letter to president bush urging him to set up and create a presidential an initiative on aids especially for subsaharan africa in january of two thousand and three the president took up our cause understanding the growing sense of urgency that had been building for years his promise of fifteen billion dollars during his state of the union address provided the impetus that we needed to pass h r twelve ninety eight the united states leadership against hiv aids tuberculosis and malaria act of two thousand and three which created pepfar in two thousand and five we took yet another step forward when we recognize that our foreign assistance programs did not adequately address the needs of children orphaned or made vulnerable by aids so working again with former chairman hyde and chairman lantos we passed on the president's find h r fourteen zero nine the assistance for orphans and vulnerable children in developing countries act so manicure i lay out out some of the history of our work on this important issue because it speaks volumes about what is possible when we come together in the spirit of bipartisan compromise as we honor the great legacy of both chairman lantos and chairman hyde through this legislation chairman lantos i know very much wanted to reach a bipartisan compromise on this bill as to chairman hyde i'm saddened that both of them are not with us to witness this moment but i know that they are very pleased with what we have put together today let me especially take a moment to man hav only the additional two minutes two minutes thank you mr chairman i don't really know what i could nice for two minutes thank you as a former member of the staff here on capitol hill for eleven years i have to their work deserves really to be applauded because this was not just work as a professional on the hill this is part of their life's work and i have to thank them again for their diligence and their competence this is a by prior some compromise so there were things that we had to give up and things that our colleagues on the other side of the aisle had to give up but that's what compromise is all about let me just mention a few of the items that were included in this bill of course it included language taken from my bill h r seventeen thirteen the pathway act to strike the thirty three percent abstinence until marriage and provide a comprehensive mention strategy to address the needs of women and children it also includes language taken from a bill thirty eight twelve the african health capacity and investment act of build health capacity by recruiting training and retaining health professionals and strengthen health systems now of course there are still some issues i think need to be addressed which aren't in this bill i think we should eliminate the prostitution probably pledge which violates the first amendment and poses an unnecessary barrier to organizations that work with sex workers i think we need to recognize the public health benefits of linking our h i b in aids programs with family planning services by a lemonade and ideological restrictions imposed by the global gag rule i think we need to end the un just in discriminatory travellin immigration ban on people living with eight b n aides who wish the enter and to the united states so these are not impossible goals but  addition we should fully fund the recruitment training and retention programmes for health professionals with the focus on training doctors and nurses to build health capacity and strengthen the healthcare system so i hope that we can  chairman for his leadership in addressing the greatest humanitarian national security and public health crisis of our time general woman the general the general woman's time has expired and the gentlewoman from florida is recognized thank you madam chair and i'd like to yield five minutes to the gentleman from indiana congressman pence the ranking member on the subcommittee on middle east and south asia who spoke so eloquently doing the committee markup on the need for this bill five minutes madam chair gentleman is recognized for five minutes i thank the ranking member for yielding i rise in support of the tom lantos and henry hyde united states global leadership against hiv aids tells us to whom much is given much is expected and i believe the united states has a moral obligation to lead the world in confronting the  dimensions of this crisis a truly staggering hiv aids pandemic has infected more than sixty million people worldwide it has killed more than twenty five million a number which grows grievously every day by more than eight thousand five hundred hiv aids is orphaned some fourteen million children and today seventy percent of the people in the world with hiv aids reside in africa within that continent there are entire countries where more than one third of the adult population is infected or startling of current infection rates continue new epicenters for the disease are likely to arise out of india china eastern europe with numbers that could surpass africa in a few short years and the threat of this pandemic poses to our security is also real left unaddressed this plague will continue to undermine the stability of nations throughout the two thirds world leaving behind collapsing economies and tragedy and desperation a breeding ground for extremist violence this is truly a global crisis and because the united states can render timely assistance i believe we must originally titled the president's emergency plan for aids relief pepfar put the world on notice that america will not ignore despair desperation and disease i'm proud that supported the original passage of pepfar in two thousand and three and i'm proud to support it today you know every so often in this place we have the opportunity to do something for human andy and serve the american people and this is such a time i thank chairman berman and ranking member ross leighton for their strong leadership i commend my colleague chris smith in particular for his yeoman's work on care on carefully preserving the delicate balance of this legislation and i also like to publicly acknowledge the work of our president george w bush mr president because of your moral leadership and compassion africa will never be the same and history will record your work this global aids bill seeks to address the crisis not by providing medicine and health care to those in need but also by providing resources for evidence based programs that have been successful in preventing infection it's imperative i believe that we not only send our resources but we also send them in a manner that is consistent with our values we cannot send billions of dollars to africa without sending value based safeguards and techniques that work to fight the spread of hiv aids by changing behavior currently within the global aids bill these pivotal provisions exist in the form of a requirement to quote provide balance funding for prevention activities and to ensure that abstinence and faithfulness program programs are quote implemented in funded in a meaningful and equitable way it was essential that we preserve these prevention methods that focus on behavioral change that we work with faith based and non governmental organizations at the local level particular through the a b c model that has produced such undeniable results also it was absolutely critical that with that we administer this foreign aid under the historic pro life guidelines that prevent our foreign aid from going in a direction that's antithetical to the values of millions of americans i'm pleased to say the lantos high global aids bill preserves all of these vital pro family provisions as we tend to the suffering though we always have to figure out how we're going to pay for it the federal budget i believe is packed with waste and bloated programs which could supply more than enough opportunities to cover the cost of the lantos heide global aids bill and this summer madam speaker when it comes time to fund this program during the appropriations process i believe congress should make the hard choices necessary to ensure that this global health crisis does not become a crisis of debt for our children and grandchildren i believe it is possible to be responsible to our fiscal constraints while being obedient to our moral calling the greatest of all human rights is the right to live america is a nation of great wealth wealth of resources but more importantly a wealth of compassion history the world is filled with telling moments regarding the character of a people sometimes where witness to mankind's great inhumanities other times we marvel at the beauty of mankind selfless acts of compassion when we rise above politics and raise up those in dire need let this be such a day germans tyrants my colleagues to support the lantos hyde global aids bill and it carefully crafted bipartisan compromise gentleman from california to recognize when one liberal minute to the the majority leader the gentleman from maryland mr hoyer the majority leaders recognize but one minute much thank you very much madam speaker and thank you mr chairman congratulations to the chairman of the committee he is an extraordinary individual whom i've known for four decades he'll want to associate myself generally with the remarks of the previous speaker and i think it is a emblematic of the partnership that we have no way with the administration but on both sides of the aisle as it relates to this moral as well as health issue and i thank the gentleman for his comments madam speaker five years ago the united states made an unprecedented commitment to the people of the world who suffer from a and aids turkey tuberculosis and other diseases we pledged fifteen billion dollars and with that funding we have provided lifesaving drugs to almost a million and a half people facilitated care for over two million orphans and vulnerable children and provided mother to child transmission prevention services during more than six million pregnancies we have played a very real role in helping to transform h i v from a death sentence to a manageable disease and madam speaker as i said five years ago when we first passed this legislation we must recognize that our  nation and each one of us has a moral obligation and a national security interest as has been spoken of in combating the h i b aids pandemic as well as malaria and tuberculosis today with this legislation the tom lantos and henry j on global leadership against hiv aids tuberculosis and malaria reauthorization that we build on and increase our commitment to stop the spread hiv aids through this legislation we make a fifty billion dollars contribution to the fight to eradicate hiv aids malaria and tuberculosis yes in addition to expanding our prior efforts this carefully negotiated legislation will strengthen h i b related health care delivery systems and increased health workforce capacities to foster stronger relationships between a hiv aids initiative and other support programs including those that promote better nutrition and education allows a hiv aids testing and counseling to be provided in the united states bilateral family planning  finances prevention and treatment programs targeting women and girls this bill madam speaker also eliminates an ineffective requirement that one third of pepfar prevention funds be spent on ab instead we have directed the administration create a balanced approach requiring behavioral change programs to receive fifty percent of the funds devoted to the prevention of sexual transmission of hiv and in addition we require the administration to report to congress in programs nations where the epidemic has become generalized do not adhere to this balanced approach this legislation represents both commitment and compromise it will not make everyone happy but it does signal to the international community that the united states recognizes and excepts our moral obligation to act last year alone two and a half million people contracted h i b roughly sixty eight hundred people per day last year alone two point one me one million people died of aids the global aids is a problem too large to fall prey to political support my very good friend the late chairman lantos noted five years ago that this health care crisis ruins families communities and indeed whole nations fueling violence and bloodshed across borders and thus it is a global challenge that demands a global humanitarian response with the united states in the lead man a speaker this is a very good bill it builds on proven outcomes and it deserves the sport of members on both sides of the aisle and again i congratulate chairman berman and ranking member russ leighton on their leadership on this effort and you to balance my time the job the gentleman has yielded his time and the gentlewoman from florida is recognized thank you so much madam chair i would like to yield such time as he may consume to the gentleman from new jersey mr smith for the purpose of engaging in a colloquy with our chairman mr behrman of california i'd like to engage in a colloquy with my friend and colleague the chairman of the foreign affairs committee is to berman i would know that there are two versions of the committee report for each r five five zero one designated as part one and part two i wish to clarify that the definitive version that applies for purposes of the legislative history of this bill is part two is that the understanding of the chairman i appreciate the gentleman yielding and the gentleman is absolutely correct part of the report is the definitive report on the legislation being considered by the house today i thank the chair for the clarification yield two minutes to my colleague from california the distinguished generally ms was named chairman of the education and labor subcommittee on workforce protections and a member of the foreign affairs committee health care subcommittee for writing a bill that clearly reaffirms congress commitment to healthy communities this time with a focus overseas as a member of the subcommittee i'm especially pleased that this bill supports maternal health orphans and vulnerable children today in africa and throughout the world children are losing their parents to the aids epidemic these same kids  up too soon they will be forced to become caregivers to their own siblings leaving school joining the under age workforce praying that they are not the next in line for the graveyard in a world of prost as prosperous as our own madam chairwoman it is absolutely unacceptable that this could be happening anywhere but this bill actually continues our promise to rid the planet of this plague this bill offers real hope we invest in treatment but most importantly it works towards prevention like many of my colleagues i'm disappointed that the conservative forces pushed to reduce the reproductive health initiatives but the overall result will actually be remarkable and most importantly it will be lifesaving  encourage all of my colleagues both for h r five high vol one make this a better place to live than world wide and i yell back joe woman has yielded her time the gentleman from new jersey is recognized yes i recognize the gentleman from missouri mister carnahan for two minutes there gentleman from missouri is recognized for two minutes thank you miss beaker i am proud to rise in support of h r fifty five zero one properly named after our former chairman lantos and hyde both of whom i had the honor to serve under on the foreign affairs committee i also want to thank president bush for reaffirming his commitment to africa in his state of the union but also to being open to improvements in how we deliver our support in africa i want to also add my thanks to chairman bair berman and ranking member oscillating and for their leadership in bringing this to the  floor but especially to chairman berman for his great instincts to reach out in craft an achievable and better bill in this congress in this way today we have an opportunity to improve the way the u s february i had the opportunity to travel to ethiopia and study and investigate the effectiveness of many of these programs the positive effect that pepfar has had over the last several years is quite obvious plus lives have been saved and numerous infections have been prevented visited health clinics in rural ethiopia including p m t c t family planning and government supported clinics this bill makes him port steps to not just increase funding that had a more balanced approach to integrate prevention programs well i would have liked to have seen even greater integration in these programs with family printing and prevention programs i'm pleased with the steps that bill does take stand the steps that are being taking in a bipartisan way that can help this be done sooner jealous time has expired thank you madam speaker  of more than one hundred fifty thousand infant infections in a supportive lifesaving treatment for almost one point five million men women and children in the focus countries over sixty percent of those receiving treatment are women and girls it is my on  say that i have supported this program when it was first introduced before this body and i worked to ensure the puff arc was as effective and as efficient as possible an example of this bipartisan effort was the inclusion of language which i champion to emphasize education on gender equality and respect for women and girls the authorization act strengthens these provisions by calling for the empowerment of women and youth and by promoting changes in male behavior and attitudes that respect human rights of women and youth and that support and force to gender equity however let me be equally clear this bill could do so much more and could prevent many more infections if it improved a critical partnership with these programs in the field that have served in the field that have served women and their families for over ten foot over four decades complement with the global gag rule be eligible to receive pepfar funds to provide education counseling and testing i believe that this would be a new restriction though such weak crime existing current law policy and i believe was serious about avenging the most new infections we need to put aside political differences on the merits of the global gag rule and ensure that the very best in the field have the support of the u s to do what they need mcdermott from the state of washington gentlemen for our three minutes the gentleman from the state of washington is recognized for three minutes so ordered against hiv aids hiv aids and tb and malaria from an emergency to sustainability in so doing we declare that hiv is no longer the death sentence that it was only five short years ago we can hope and strive for a generation free of hiv and aids i want to thank the chairman and the subcommittee chairman for including provisions in the legislation that in representative granger and i introduced which strengthens the prevention of mother to child transmission of hiv we must ensure that women and children have access to early screening and lifesaving drugs therapies we can do this by providing greater training and education on effective prevention we also must ensure that they integrate these services with other maternal health efforts every day more than one thousand children around the world are infected with hiv an estimated ninety percent of those infections occur in africa but a single dose of anti retroviral drugs given once to the mother at the onset of labor and once to the newborn during the first three days of life reduces transmission by fifty percent fewer than ten percent of pregnant women with h resource poor countries have access to these prevention services but i'm proud that this bill includes prevention provisions to strengthen our commitment to prevention and save lives in the process perhaps the most important provisions are those that recognize the importance of expanding access to screening and treatment of women and children h r fifty five zero one also provides my provisions to establish two five year targets that will bring us closer to a generation free of hiv aids the first goal is to increase the percentage of children receiving treatment under pepfar from nine to fifteen percent treatment allows the greatest hope for giving a child infected with hiv the chance a free of the disease the second goal is for eighty percent of pregnant women in the most affected countries to receive a j v counseling and testing and where necessary anti retroviral treatment to prevent mother to child transmission the biggest limitation on reaching these goals is the availability of trained personnel this bill sets a goal of fifty percent of one hundred forty thousand people to be trained by two thousand and fifteen in south africa where my wife is working on the ground in this epidemic they are closing pediatric hospitals because there's no pediatrician to run them now the eighty percent goal is a down payment on our hope of achieving a hundred percent by the time this authorization expires we have a chance today to send a message america cares enough to lead the world in fighting these deadly diseases members i rise today in strong support of the tom lantos and henry j hyde global leadership against hiv aids tuberculosis and malaria reauthorization act this legislation represents the best in bipartisan compromise and it demonstrates that despite what divides us from time to time as republicans and democrats we can and do come together to tackle issues that matter most and the global hiv aids crisis matters deeply to all of us some forty million people around the world are living with this disease we have a moral imperative to act and to act decisively just five years ago and hiv diagnosis for a poor village or an africa was a death sentence thanks to lifesaving drugs provided by the american people this is no longer the case the global aids program works and it works because it is an initiative of one not of one political party or another it is truly a compassionate statement by the american people and i'm very proud to support it throughout there is a sion and urge my colleagues to do the same thank you madam chair and we'll back my time gentleman the remainder of this time the gentleman from new jersey is recognized i recognize the vice chair president of the subcommittee on africa member of course the foreign affairs committee representative diane watson from california with gentlewoman from california is recognized for how much time two minutes two minutes for two minutes thank you madam speaker i just returned from south africa and i did a single codell visiting the various clinics and hospices that are receiving pet for funds and i happily report that the small donations they do receive are stretched beyond imagination they are finally realizing that the in geos have really made great strides about four years ago when we went offering them assistance and so on most of our help was rejected but i want you to know that one clinic which is a hospice gets seventy thousand a year and what they do is reach that he was going to reduce the amount of donation by fifty million and i cautioned him because that would be the wrong message to sin for this small successes they have add and that what we can do is say to the government there that we will cap it at a certain amount and then you need to also kick in so i want to report to our committee and to mr payne the chair that the funds are working they're improving our image and they're helping to save lives in south africa thank you so much mr payne and mr speaker madam speaker gentlewoman texas a member of the foreign affairs subcommittee on africa subcommittee foreign affairs committee in africa subcommittee michel jackson lee for three minutes as a general the gentlewoman from texas is recognized for three minutes there's a terminology that we use to describe joyous occasion sometimes it describes freedom fifth thing is in tennessee were called the jubilee singers and it was because they are going to eyes around slavery and after slavery and the ability to be free was jubilation and therefore they were called the jubilee singers i think today is a day of jubilation and it certainly is a time to express the jubilation that we feel with the passage of the intended passage of this legislation let me thank the ranking the chairman of the subcommittee mr paine for persistence and determination and wisdom let me also acknowledge his ranking member smith and of course our chair chairman mr berman and the ranking member the region high that is a jubilation it is something to express great excitement about because these are two distinct figures in many instances with common views but many instances different views came together around this life saving legislation global leadership begins h r the aids tuberculosis and malaria and it is particularly important because we have added malaria and tuberculosis as an element that is a not a partner but results thereof and or stands alone but all of them kill and i'm reminded of the first mission to them zambia and to south africa where we went on a presidential mission three members of congress to look closely at the devastation and so this legislation is crucial and it is particularly crucial because it recognizes the devastation of all of them it is likewise crucial because we have not won the war the jubilation is that the bill is on the floor but we have not won this war and i might also say that we have not won the war in education the ability to prevent all of these diseases and so the fifty billion dollars that is authorized support this legislation and i yield back my time gentlewoman from florida is recognized thank you so much and madam chair at this time i'm pleased to yield one minute to my colleague my friend from california dana rohrbacher who is the ranking fifty billion dollars taken from the american people to africa to fight aids when it comes to the situation with aids in africa obviously we have some people in crisis who are very deserving people but where does that fifty million dollars come from are we going to be helping people overseas at the expense of the well being of our own people is only three ways of getting the money we can take it from domestic programs take it from those programs to help our own elderly in the health care for our own people our own veterans or we can raise taxes which would knock the legs out from under our economy and make our deficit even higher or we can borrow the money and if we borrow the money we end up spending hundreds of  millions dollars of your on interest we're going to borrow fifty billion dollars in order to help people overseas and then to the paying interest on it for the next i'm teen years this is a benevolence gone wild yes we would like to help everybody in the world but very much thus what we have to decide today is are we going these are private our own people our seniors i just came from a meeting with doctors from my district we can't afford to provide health care for our seniors for our veterans we can't for afford all the educational things we want to do how can we possibly then take fifty billion dollars and send it to africa even though it's a worthy cause we should not be doing this it is not in the interest of our american of the american people and i would call on my colleagues to oppose this total waste all expenditure of money and time has expired gentlemen from new jersey is recognized as my pleasure to recognize the that relate to the eradication of poverty and the alleviation of poverty eradication of disease which really our national security interest for our country about the health and well being the respect we command throughout the world i want to commend congress a chairman berman and it hurts but i think this is from the first piece of legislation to come out of the committee under your leadership as chairman and congresswoman ileana russ layton the ranking member of the committee for their leadership in bringing a bipartisan strong and initiative to the floor this initiative is a continuation of the worth it president bush has as a priority in the eradication of aids malaria and tuberculosis for those of us who have been involved in these issues chair from that chair all of you all of us know that and let it for our country to be healthy for the eradication of these diseases to take place we must have a global approach to it  disease knows no by borders and boundaries and and so again while it is the compassionate thing to do it is in our self interest to do as well the distinguished chair congresswoman eleanor holmes norton and i and others just had the opportunity to visit a pepfar site in india at the south at the salvation army where they were distributing these drugs through a regimen an organized regimen relate to hygiene and and the rest to people with hiv and aids and we can sit tell you from firsthand experience i've visited these sites in south africa this trip was to india that we're every going there's great appreciation for what our country is doing and the president president bush's leadership on this subject i'm so pleased that the bill is named for congressman chairman lantos our friend who left us earlier this year and congressman hyde  before that because they were the original authors of the first to start president's emergency plan for aids relief legislation in two thousand and three that one mark that landmark they authorize fifteen billion dollars for five years working together with the bush administration and the appropriations committee we succeeded in providing lifesaving and anti retroviral treatment to almost one point five million people supporting care for nearly six point seven million people including more than two point seven or five million orphans and vulnerable children and supporting prevention of more than one hundred fifty thousand infected and since we're talking about aids malaria and tuberculosis now we must take the next step in fighting aids in the poorest countries of the world the legislation before us will move us from the emergency phase to the  sustainability phase in fighting aids tuberculosis and malaria my colleagues have presented the provisions of the bill to you so i'll just submit mine for the record amounts here and just say in closing that the leadership against aids is our contact with developing nations across the globe it says that america stands with them in this fight that our commitment will not waiver and shows america's true face of compassion since the aids epidemic  million men women and children have died from the disease twenty million forty million around the globe are hiv positive that's what we know we don't even know of those who have not come forth to be tested each and every day another six thousand people become infected with hiv in addition the number of orphans vulnerable children who are sick parents and adolescents at risk with hiv continues to grow but an estimated nineteen million needing assistance by twenty ten there is a moral imperative to combat this act of epidemic if we have these drugs distributed in the manner in which they are under the president's  pepfar then people will come forward to be tested then we will have better success with our prevention anisha tips and if so it's all related care causes people to say there's a check and there's a reason to be tested and knowing the consequences of the disease is contributes to the prevention efforts feel crises have called out for more sustained constructive american leadership this this legislation before us makes that commitment colleagues to support it once again i salute you mr payne for your leadership in so many ways that relate to eradication of disease in the lead the nation of poverty and the strength of america related to that and how we are viewed in the world and how that all contributes to a healthier america all of these if we don't we will have a of despair that springs from a lack of hope in the world that contributes to violence and again takes us back to this security of our country so for that security and out of compassion i urge my colleagues to support this initiative which is president bush's initiative named for our colleagues mr lantos and mr hyde put forth by the chair mr berman and congresswoman russ layton in a strong bipartisan way and we salute that and advocate like myself such time as i as i may consume madam chair sometimes when we are negotiating legislative text or debating the merits of an important bill such as the one before us today we can lose sight of the extent of the impact that our our decisions here can have on the lives of so many and i would like to quote from some of the african leaders whose people and societies have been rescued from certain death by our pepfar programs the president of tanzania had said the following there would have been so many orphans to date had it not been for pepfar the care and treatment so many parents now who would have been infected can now live and some of them can live as many years as possible so can you imagine if this program is this continued or disrupted there would be so many people who would lose hope and certainly there would be death you create more orphans so my passionate appeal is for pepfar to continue or listen to the words of the president of botswana when he said pepfar is now a critical partner in the historic and heroic battle to save lives pepfar has turned despair into hope pepfar has galvanized donor countries and agencies alike to act in concert in the interest of humanity if the fund is not renewed and if it is not replenished the momentum generated by pepfar thus far will no doubt be lost and the hope rekindled by the generosity of the american people will be is extinguished i say this to you said the president of botswana and that's what i said to the congressional committees recently so madam chair these and so many other statements that reflect the human contribution of this critical united states program but they also demonstrate that pepfar programs are helping to win hearts and minds throughout the world they are building and strengthening the bonds between the governments and the people of these countries and the united states of america they are building goodwill toward our nation and toward the american people madam chair after the deplorable attacks on our nation on that fateful day almost seven years ago we and in this chamber committed ourselves to using the range of u s foreign policy tools including soft power to counter the conditions that breed hatred intolerance and radicalism radicalism that targets the united states our interests and our allies and seeks to undermined our freedom and democracy everywhere the bill before us is a vital tool in that effort again as our former colleague our ambassador to tanzania has said i want you to know that pep bar is crucial to my current mission as ambassador to the united republic of tanzania it is a tremendous public diplomacy tool that shows america at her best a compassionate partner who is committed to helping tanzania meet its enormous hiv aids challenges i was asked to present remarks to the national consult of meeting continues of islamic leaders and scholars  hiv aids here in dar es salaam continues the ambassador this was a historic gathering as it was the first time that the most the steamed muslim leaders of tanzania had gathered together to discuss their role in the fight against hiv aids they invited me to speak along the president because of their concerned about hiv aids and their awareness of america's historic contribution to hiv prevention treatment and care programs why because of pepfar so as we help to save lives and restore hope the ambassador and we are leaving a lasting impression on the people of this country madam chair i hope that our colleagues will see the great merit of this program and that we will continue to build upon it to save many more lives and with that i reserve the balance of my time pleased and proud to be here today to commend not only chairman berman but the late tom lantos and hindery high for their wisdom and therefore side in putting together this most important legislation ladies and gentlemen i just returned from south africa and i'm pleased to announce that while i was there i was recognized and given the order of the companions of oliver tambo award for my work to have dismantle apartheid in south africa and basically for been a friend of south africa's and i was very proud but as i sat there you know talking with president mbeki and others i was reminded that south africa there's an estimated five point five million people living with h and aids that is more than any other country in the world over eighteen percent of the adult population of south africans infected by hiv infected persons including thousands of well educated professionals such as doctors nurses civil servants and teaches in recognizing that we've done a great job in helping to promote democracy and get rid of apartheid they enemy now is a child the end aids and tuberculosis they are losing all of their professionals they don't have the personnel to carry out the plan that they have put together to continue to move south africa to where south africa needs to be i was very proud that they had built two point three million new houses over the last ten years but again tuberculosis is a child the end aids is destroying this population this legislation will help this country and other countries babies are our friends th love us and a lot of us for haven't been and bob in the struggle to help save them babies are countries that we will be able to town on in the world because we have come to their aid and let me also recognize that there were many california has nine minutes remaining the general gentlewoman from florida has eighteen minutes remaining thank you madam speaker ma'am chair we have no further requests for time i'd like to yield back the balance of my time the gentlewoman from florida has yielded back the balance of her time the gentleman from california is recognized madam chair we have no further requests for time i'd like to make a few closing comments and you myself managing this bill today and it is the first bill seeking not on the suspension calendar that's come out of the committee since i've become chair but the fact is the work on this legislation began a very long time before i became the chair and they've been mentioned before but there are so many new initiatives and so much thoughtful logic underlying this legislation that i thought it would pay to once again mention a group of staff people who are working under the leadership of our staff director dr bob king spend a huge amount of time working for chairman lan heather flynn from chairman payne's africa subcommittee christos centers from congresswoman barbara lee staff ny only seller and jessica boyer from the government oversight committee staff all played important roles on our side in working on this legislation million public the minority staff or made major contributions and and the result is a bipartisan product where where in a way we have internalized on our side the logic of efforts to change behavior and recognize the validity of abstinence programs in the context of a comprehensive approach to this problem and accepted the value of faith based organizations and in the minority has exempted the logic that this is a fundamental moral and humanitarian  concern that that we should address and be willing to put a lot of value because we know it works we know there's a direct relationship between the resources we put into this program and the lives save the the people who can avoid and and prevent it and that has implications beyond just the moral and humanitarian dimension as speaker pelosi and congresswoman ross layton said in terms of security and economic welfare and economic growth and so many parts of the world which ultimately all in order to our benefit and our national interest so once again i'm very pleased to be part of this process with my partner the ranking member and yield back the balance of my time at all times the general debate has expired so and to the rule the bills shall be considered read for amendment under the five minute rule no amendment to the bill is in order except those printed in house report one ten days five sixty two each amendment may be offered only in the water printed in the report by members designated in the report shall be considered read shall be debatable by the time specified in the report equally divided  controlled by the proponent and an opponent of the amendment shall not be subject to amendment and shall not be subject to demand for division of the question and so now in order to consider amendment number one printed in house report one ten five sixty two madam chair for what purpose does the gentleman from oregon writes i have an amendment made an order to the rule and ask that contains an important section to address barriers that might limit the start of an adherence to treatment services the section also encourages direct linkages between the efforts to treat hiv aids in nutrition and in security programs i applaud the chairman and ranking member for the work they've had bringing this together and the recognition that dealing with hiv aids must be done in a holistic fashion that treats the entire person and their environment not just the disease i have a very personal connection to this legislation now that was not present when i first started working on issues of water for the poor now that i have a daughter working in mozambique in the peace corps who dealing with these problems on a day to day basis this direct amendment would add safe drinking water to nutrition income security on the list of programs for which direct linkages are encouraged this is an important tribute  include safe drinking water and legislation through which we honor their memories is a small testament to their lasting legacies including safe drinking water is critical because we cannot treat hiv aids without safe drinking water usa ideas recognized in its guidance for missions carrying out these programs that people with hiv aids are at increased risk for diarrheal diseases and far more likely to suffer severe and chronic complications if infected there's terrible irony in providing patients with advanced anti viral agents and then asking them to use the water in a glass that may infect them with a life threatening illness to wash down the life one of the complications of diarrheal illness is hiv infected patients have a reduced ability to absorb and through viral and other medications from the gut this poor absorption can contribute to development of h range that are resistant in the decision to the negative impact of on life expectancy and quality of life they also add significantly to the burdens on caird rivers in clinics and at home and put them in other family members at risk for infection we are all a part of this in the global community this legislation is important to tie these challenges together not deal with it piecemeal and to help with advancing the overall objective of this legislation and i would reserve the balance of the time manager who rises in opposition thank you madam chair i ask unanimous consent to claim time in opposition to the amendment for purposes of debate without objection gentlewoman is recognized thank you madam chair i support mr bloom an hours amendment which would add safe drinking water to nutrition and income security on the list of programs for which direct linkages are encouraged for patients whose immune systems have been compromised by aids the availability of safe clean drinking water is vitally important this is especially true for a hiv positive women with young infants who use infant formula to avoid transmitting the virus to their babies during feeding if the water used in the formula is not clean their babies are at high risk for water borne know but one was that about one point two billion people globally lack safe water to consume in the in the least developed countries and up to ninety percent of aids patients ninety percent suffer and frequently die from the chronic diarrheal diseases the gentleman discussed these diseases are caused by the use of unsafe water this is a compelling amendment i join the gentle easy in supporting it and i yield back thank you poor act of two thousand and five has been a strong advocate on this issue for years and he was kind enough to testify about the challenge of clean water in africa at a hearing of the subcommittee on global health i chaired in may of two thousand and seven during the course of that hearing it became clear that in africa the region hardest hit by the aids pandemic the problem of safe water is particularly acute the total number of people without access to p water in the region has actually increased by sixty million in the past half decade that is why mr blome howard i along with other members of congress successfully secured three hundred million dollars for save drinking water and sanitation projects where fiscal year zero eight we all know that h i v comprise compromises the immune system those infected with the disease are far more likely to succumb to the allness caused by on save drinking water especially if they are children and there is no way that people can take a r v's if they do not have access to clean drinking water i strongly support most of them house amendment and thank him for his co sponsorship of h rez three one eight supporting the goals of the united nations international year of sanitation his resolution encourages international community's to achieve the target of having the proportion of people without access to safe drinking water and basic sanitation i i appreciate the ranking member yielding time to him i was prepared to do so but she got was able to give him more time and that's important congressman payne your laser like focus on this with the subcommittee your long term advocacy your work on the continent is something that i find inspirational look forward to working with you partnering on these issues as we move forward to the chair and ranking member your willingness to include this is important and our work together to be able to focus not on the whole person and be able to deal with water borne disease the number one preventable cause of death and disease around the world half the people who are sick today anywhere in the world are sick needlessly from water borne disease adding this critical amendment to your important legislation is important step forward i hope it is just one step that we can work on together to bring people to around the world to support this critical priority and as i say i can think of no more fitting tribute to our your previous your predecessor as chair of the committee congressman hyde and congressman lantos who worked so hard to advance this cause i urge adoption of this amendment and you'll back the balance of my time jim as time has expired it is now in order to consider member number two printed in house report one ten five sixty two for what purpose does the gentleman from nebraska  foreign affairs committee and the subcommittee on africa and global health i have been involved extensively on the issues before us today and i really do appreciate the bipartisan cooperation that has guided this process particularly by chairman berman and our ranking member miss ross leighton and thank thank you this bill is appropriately named for two giants of this institution tom lantos and henry hyde my m m addresses the issue of transparency and accountability in the global fund the global fund is a unique non governmental multilateral organization headquartered in switzerland and focused on combat in a aids tuberculosis and malaria throughout the developing world the s government is the single largest provider of resources and technical assistance to the global fund and since two thousand and one congress has appropriated nearly four billion dollars to the fun the lantos hyde bill before us today authorizes additional funds that will total in the billions the bill currently and appropriately calls for systematic assessments of performance data of principal recipients and sub recipients of funds as recommended by the by the government accountability office the g a o this tech technical amendment simply clarifies that audits by the fun's inspector general should also in compas principal principal recipients and sub recipients the entities that actually receive programatic funding medicare i believe that this amendment strengthens the spirit of accountability that is present in the underlying bill according to a june two thousand and five report by the g a o the global fund possessed a limited ability to monitor and evaluate grants concerns have also been raised that the volume of funding provided through the global fund may exceed the capacity of the recipients in the field to actually utilize it since we are considering a definition of contribution that may total in the billions of us packed taxpayer dollars to the global fund over the life of this reauthorization i believe that it would be beneficial for ourselves as well as for the fund as well as for other donors to have additional clarity on how these funds are being used in the field for those most in need of our assistance madam chair i intend to support the overall bill take the time in opposition without objection so order madam chair the gentleman's amendment which i and i've spoken to him about it encourages the global fund inspector general use of hiv aids assistance provided through the global fund is critically important for all the reasons that he stated the global fund in all fairness i do want to point out has shown i believe its commitment to that transparency and accountable accountability it has new inspector general and has instituted in the hands counties system that focuses on improving accountability among several sub recipients but the but the principle of this amendment makes sense while there are some technical issues i want to talk to about as we move through the legislative process i look forward to working with them on it and i certainly urge the adoption of the amendment and i would like to yield first minute to the gentle lady from florida i'm the ranking member thank you so much i think the gentleman for yielding and i also support mr fortenberry amendment which would ensure that audits by the global fund inspector general include information on sub contractors the u s government is the largest contributor to the global fund to fight hiv aids tuberculosis and malaria since the fund was created the u s has appropriated and pledged three point five billion dollars for contributions to the global fund representing the really one third of the total budget of the global fund it's an important component to the world's response to these three disease has and has made progress on issues of transparency accountability in recent years as the bill makes clear continued support to the global fund should be based on the funds ability to meet certain transparency and accountability benchmarks this amendment builds on and clarif the underlying ticks in order to ensure that the odd is conducted by the global funds office of inspector general cover both primary symbionts of grant funding and sub recipients who perform smaller pieces of the grants these audits are i'm from california is recognized madam chair i yield a minute to the chairman of the africa subcommittee the gentleman from new jersey mr payne gentleman from new jersey is recognized for one minute thank you madam chair and i been doing an adequate job however we do not oppose this amendment the office has approved over ten billion for programs in one hundred thirty six countries around the world so far wh h mouse the twenty one percent of all donor h i b n eight spending and two thirds of all the donors spending on malaria and tuberculosis out through the global fund one point four million people have been treated with lifesaving anti virals three point three million cases tb has been treated and a new area of forty six million bed nets have been distributed to protect children against malaria and i'm pleased to say that ray chambers from new jersey my congressional district has been an appointed ambassador for the u n to combat malaria and so we do not oppose this amendment and we look forward to the bill's pass brasses recognize madam chair i would go back shortly but i just want to thank the chairman of the foreign affairs committee for support of this i understand the concerns he addressed and i understand his comments as well as the chairman of the subcommittee i look for the eyes have it the amendment is adopted it is now in order to consider amendment number three printed in the house report one ten five sixty two for what purpose does a gentlewoman from minnesota rise manchuria have an amendment made an order under the roll and two to the list of countries that will be in part of the focus countries in the reauthorized in this global hiv aids legislation in two thousand and three the original pepfar legislation designated fourteen focus countries these countries were prioritized for intensive investment of resources and technical expertise as provided through pepfar the bill on the floor today adds focus countries by designating vietnam and fourteen caribbean basic focused status unfortunately these three three countries in southern africa each confronting devastation as a result of hiv aids have not been granted priority status in pepfar the crisis hiv aids confronting malawi was the land and they sued to is real and in some cases worse than the existing focus countries malawi is a country of thirteen million people with nine hundred thousand children orphaned by aids and nearly one million of its adults living with hiv a fourteen percent infection rate swaziland with a population of only one point one million people has over two hundred thousand adults living with h one in three adults or a thirty three percent in adult infection rate playsuit two has a population of two million people and hiv infection rate among its adults of twenty three percent these three countries are not only confronting hiv and aids but they're also among the poorest countries on the planet which makes their challenge so much greater malawi for example is one hundred sixty fourth out of one hundred and seventy seven countries on the united nations human development index also each country is geographically surrounded by countries that were designated focus countries in the original pepfar legislation south africa mozambique zambia tanzania which are presently receiving massive investments to confront  to are working bilaterally with the united states but by not being granted pepfar as focus country status the gap that they face between your needs and the available resources means that too many people will continue to be infected unanimous consent to insert in the record a letter supporting the three governments quest to be covered by general leave these countries believe as i do that the severity of the epidemic in their countries should make their fight against aids a priority for this congress and for the american people finally i want to thank the chairman and the ranking member for their commitment for fighting hiv aids and for their hard work in bringing h r fifty five all want to the floor i also had the honor of serving on the international relations committee under the leadership of mr hyde and mr lantos when we passed the original pepfar legislation they were both extraordinary men and wonderful mentors to me their compassion they were compassionate leaders in this house and it is fitting that we pay tribute to their lives and their contributions to this country by passing a bill that will save lives in improved life all around the world i urge my colleagues to support this amendment to be included in the bill and also to support a passage of this important bill and i reserve the balance of my time who rises in opposition to the amendments general the generally the gentlewoman from florida is ranking man and madam chair i ask unanimous consent to the claim time in opposition to the amendment for purposes of debate so ordered thank you madam chair i actually support the mccollum jackson amendment which would add malawi swaziland and less to two to the list of countries in which the global aids coordinator is given explicit statutory authority malawi swazi land and left to do all face major hiv aids epidemic and have received significant resources through pepfar in the first five years of implementation by given the global aids coordinator explicit authority over the u s government's h aids programs in these countries the congress is signaling that it believes the u s government should continue to come alongside these nations governments and their citizens to support them in the fight against hiv aids payne of new jersey first the gentleman from new jersey is recognized thank you very much and i may thank the gentleman eighty for the yielding i rise in strong support of the amendment offered by the gentle lady from wisconsin southern africa has the highest rate of h i v and eight in the entire world in the salto we've heard a country with an h i v age prevalence rate of thirty eight percent among pregnant women only nineteen percent of those in need of treatment for the disease have access to it even more troubling the fact is that only five percent of a positive mothers get drugs to prevent the transmission of the virus to their children during childbirth life expectancy for women is forty four years for men a marathoner d nine m allowed a situation is a little better men are expected to live forty one years women forty two the health care worker shortage in the country remains a major obstacle country list all three of the southern african countries suffer from both a high h i v aids prevalence rates and high poverty rates with devastating effects statistics in all three countries regarding a distinguished chair of the subcommittee on africa and global health mr payne for their kind words and urge all my colleagues to support the amendment i yield back the questions on the amendment offered by the gentlewoman from minnesota those in favor please say it is now in order to consider amendment number four printed in house report one ten five sixty two for what purpose as the gentleman from indiana arise resolution ten sixty five the gentleman from indiana mr carson and a member of post each will control five minutes the chair recognizes the gentleman from indiana madam chair i rise today in support of the h r fifty five zero one tom lantos and henry hyde united states global leadership against hiv aids tuberculosis and malaria reauthorization act of two thousand and eight and to offer my amendment which i believe will enhance the base bill i want to thank chairman berman and ranking member roll slayton for their hard work in bringing this legislation to the floor madam chair i find it a coincidence the timing of our consideration of this legislation for it is juxtapose between two pivotal historic moments in time the deaths of renown african american medical doctors dr charles drew on april first one nine hundred fifty and the celebrated human rights leader dr martin luther king april fourth one hundred sixty eight both dr drew dr king were products of the american educational system and particularly historically black colleges and universities madam chair i cannot think of any better way to explain the importance of this amendment and its use for the effort to address states government activities to that h i b aids globally and the administrator of the united states agency for international development to expand their plan for strengthening health systems of host countries by allowing for african post secondary education institutions to collaborate with united states post secondary educational institutions and specifically historically black colleges and universities to develop such human and institutional capacity madam chair the goal  minutes to allow our nation's finest post secondary education institutions to be directly involved in the training of health care workers that will enhance the effectiveness and advocacy of the efforts put forth in h r fifty five zero one chair i can think of no better way for the citizens of indiana the great hoosier state to contribute in the fight against this pan epidemic than to train the best and brightest and to commit to countries whose health care system suffer woefully from the lack of trained health professionals after all who are we to block the opportunity to these children to be successful madam chair before i close i want to acknowledge and salute the two men this speech this piece of legislation is named after congressman tom lanto and henry hyde i didn't get a chance to work with them in this body and i cannot think of a better way to honor their service and this great institution finally i want to thank the wonderful staff of the foreign relations committee and the rules committee for helping me craft this great claims time in opposition madam chair the gentleman the gentlewoman from florida is recognized thank you i ask unanimous consent to claim time in opposition to the amendment for purposes of debate without objection sort of thank you first of all i'd like to thank mr carson for his well thought out an important amendment we all had the honor of serving with his grandmother a julia carson for many years in this body and i know that congresswoman carson is looking down at her grandson and saying she is mighty proud so thank you so much for your amendment and thank you for carrying on in her great legacy  by presenting wonderful luck topics and themes for us to discuss on the floor and i fully support the carson amendment madam chair because it focuses on building human and institutional capacity in pe far host countries it directs global aids coordinator and the usa idea administrator to expand their plan to by strengthening health systems of host countries by encouraging post secondary educational institutions particularly those in the african continent to collaborate with post secondary educational institutions here in the united states including historically black colleges and universities in training health care workers as other provisions of this bill make clear madam chair an important component of the fight against hiv aids tuberculosis and malaria a strengthening of the educational capacity to host countries to train health care workers the carson amendment does exactly that i congratulate him for it he is a welcome addition to our chamber and i today to support this amendment to commend the gentleman from indiana i understand this is a first amendment and it shows that he has hit the ground running and today i am reminded of  former colleague his grandmother our beloved congresswoman julia carson i know that she is smiling today and is very proud of you and your efforts thank you historically black colleges and universities have trained some of our finest and dedicated doctors nurses and health care workers these college and universities go way beyond the call of duty they have a deep cultural and historical understanding and connection to the continent of africa they are attacking a hiv and aids here on the home front where h i b an aids disproportionately affecting the african american community as well by developing human an institutional capacity in africa and in the caribbean we are bringing to bear and a comprehensive manner methodism to maximize our effectiveness in combat in a hiv and aids malaria and tuberculosis so i want to salute and thank the gentleman from indiana once again for his leadership and for helping to strengthen this bill thank you thank you madam chair the gentleman from recognized as a gentleman yield to the gentleman from yes we claiming my time in opposition to the amendment i would like to yield to the time as you may consume to mr payne of new jersey the gentleman from new jersey is recognize through collaboration between us colleges and universities to those in the developing world i too am very pleased to see this piece of legislation by mr carson we all know julia carson she came to my district to deal with health disparities in new jersey and traveled to africa with me on a trip and was dealing at that time with problems and so this is very appropriate and let me commend you again in may of two thousand and seven doctors without borders released a report that found that in southern africa a shortage of trained health care workers was a main barrier to increasing access to anti retroviral treatment the report found that in mozambique people had to wait up to two months to start a r v s because there were not enough doctors and nurses to manage it and one helped district in the cell told nearly half of the nursing posts were vacant malawi has only two doctors per one hundred thousand people the minimum standard according to the w h o is twenty doctors per one hundred thousand people i am pleased to say that the bill under consideration seeks to address those problems calls on the united states to train  hundred forty thousand new health care workers and start professional so that people can start on life saving therapy university partnerships are logical an affective means through which to support this gulden so i once again commend mr carson for his amendment urge my colleagues to support it i appreciate the time yield by my colleague and i yield back the balance of my sentiments on has expired gentleman from indiana is particularly in africa there's a member the status of the crop or the framework in which aids research is in africa can collaborate with american medical experts including researchers at historical black colleges and universities on the best ways to treat and prevent the spread of this devastating infectious disease akam in and thank the gentleman from indiana for offering this worthwhile a minute i curse my colleagues to support this chair i just want to thank the members for listening and considering this amendment i think it's a great opportunity for us and thank you for the support thank you germans time has expired questions on the amendment offered by the gentleman from indiana those in favor say  those opposed now in the opinion of the chair of the eyes have it i request a recorded vote and pending that i make a point of order their core mr president the chair will count for a quorum corded vote is requested those in favor of taking this vote by a recorded vote will rise sufficient number having arisen a recorded vote is ordered members will record their vote by a that tronic devi