Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008

TOM LANTOS AND HENRY J. HYDE UNITED STATES GLOBAL LEADERSHIP AGAINST HIV/AIDS, TUBERCULOSIS, AND MALARIA REAUTHORIZATION ACT OF 2008 -- (House of Representatives - July 24, 2008)

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Mr. SMITH of New Jersey. I want to thank my good friend for yielding, and thank her for her great work on this legislation, as well as Chairman Berman and my good friend, Don Payne, and so many others who have made this day possible in this launching of a new initiative, building on the old.

Mr. Speaker, H.R. 5501, as amended, will literally mean the difference between life or death to millions, especially in Sub-Saharan Africa. As Members know, close to 70 percent of the estimated 33 million people with HIV live in Sub-Saharan Africa. Of the 2.5 million children afflicted with this dreaded disease, 90 percent of them live in Africa as well.

When combined with opportunistic infections like tuberculosis--the number one killer of individuals with HIV--and malaria, which kills at least one million people a year--again, mostly in Africa--the HIV/AIDS pandemic compares among humanity's worst.

Our distinguished late chairman, Henry Hyde, prime sponsor of the original PEPFAR program, frequently compared the sickness to the bubonic plague--the black death--an epidemic that claimed the lives of over 25 million during the mid-1300s.

So with that much at stake, I want to remind my colleagues how important it is that we get this right. And I think, after a lot of hard work, we have managed to come to a consensus, first in the House, and now also in the Senate, and I hope it will be a sustainable consensus.

I want to note that Congress has unequivocally rejected the attempts of abortion-promoting organizations who wanted to hijack the Global AIDS program and link their abortion agenda to the compassionate effort to prevent this illness or to relieve the deleterious effects of HIV/AIDS.

Look at the progression of this bill. The congressional intent is clear with respect to diverting HIV funding to reproductive health/family planning programming: It was rejected. In the first House drafts, there were numerous provisions mandating not only ``integration'' and ``linkages'' between HIV programming and reproductive health and family planning services, but even explicit authorization to fund those services. This priority is wrong. We are trying to prevent HIV/AIDS, not children.

I know some Members are likely to wince at the cost of the bill, $48 billion over 5 years. But that sum of money will likely provide treatment for millions suffering from the disease, prevent some 12 million new HIV infections worldwide, support care for 12 million individuals with HIV/AIDS, including five million orphans and vulnerable children, and will help train and deploy at least 140,000 new health care professionals and workers for HIV/AIDS prevention, treatment and care.

On the prevention side, the legislation requires that the Global AIDS Coordinator provide balanced funding for sexual transmission prevention activities that promote abstinence, delay of sexual debut, monogamy, fidelity, and partner reduction. If less than 50 percent of sexual transmission prevention monies are spent on the abstinence and be faithful part of the ABC model, the coordinator must provide a written justification.

Five years after PEPFAR first began, the efficacy and importance of promoting abstinence and be faithful initiatives has been demonstrated beyond any reasonable doubt.

The legislation before us also retains the antiprostitution/sex trafficking pledge, an amendment I sponsored in 2003 designed to ensure that pimps and brothel owners don't become, via an NGO that supports such exploitation, U.S. Government partners.

Current law ensures that the U.S. Government is not in the position of ``promoting or advocating the legalization of prostitution or sex trafficking.'' Prostitution and sex trafficking exploit and degrade women and children and exacerbate the HIV/AIDS pandemic.

Finally, we have come a long way since 2003 when significant opposition materialized against an amendment that I offered to include faith-based providers with conscience clause protection. The conscience clause in H.R. 5501, as amended, restates, improves, and expands conscience protection in a way that ensures that organizations like Catholic Relief Services, which has a remarkable record of HIV/AIDS prevention, treatment, and care, are not discriminated against or in any way precluded from receiving public funds.

This legislation is clearly a great legacy and a great honor to our former Members Tom Lantos and Henry Hyde and certainly to President Bush, who led so ably and so nobly on this initiative.

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Mr. Speaker, I rise today to submit several items of clarification for the RECORD concerning a provision in HR 5501, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008. One of the major differences in this bill today from when we voted on it in April, is an amendment that adds Title VI--an Emergency Plan for Indian Safety and Health. Because it is a new addition and because there has been some confusion about how this Title should be read and how it would be implemented, I wanted to make the intent of Congress clear with these submissions to the RECORD.

First, I have been told by the Congressional Budget Office that this amendment is an authorization of appropriations and consequently has a score of 0 since there is ``no direct spending or revenues implications.'' Since there has been some confusion on this point, I want to restate that Title VI of HR 5501 is exclusively an authorization of appropriations and a further act of Congress would be necessary before any money could be provided to this Emergency Fund.

Second, I also want to clarify that according to the author of this amendment, Senator JOHN THUNE of South Dakota, the Emergency Fund, including all health-related contracts or compacts, programs, or other services authorized in this amendment will be conducted exclusively as programs of the Indian Health Service, subject to all regulations and restrictions that ordinarily apply to the Indian Health Service. This is what the amendment language means and I want that to be clear, so I'm including the letter I received from Senator THUNE which clarified this point.

Last, I would also like this letter from the Department of Health and Human Services to be included in the RECORD. This letter makes it clear that the Administration and the relevant Department also understand that this amendment does not appropriate funds and that all health-related programs that will later receive appropriations will be administered through the Indian Health Service. They go on to explain that this Emergency Fund is, by legislative requirement, subject to the provisions of the Hyde Amendment, which are currently set forth in section 507 of the FY08 L/HHS/ED appropriations act as referenced by 25 U.S.C. Section 1676.

U.S. SENATE,

Washington, DC, July 23, 2008.
Hon. CHRIS SMITH,
Rayburn House Office Building,
Washington, DC.

DEAR CONGRESSMAN SMITH: Thank you for your interest in my Amendment # 5076 to S. 2731, the Tom Lantos and Henry J. Hyde United States Global Leadership Against HIV/AIDS, Tuberculosis, and Malaria Reauthorization Act of 2008. As you may know, my amendment, which was accepted by voice vote, authorizes $2 billion in appropriations over the next five years to tribal public safety, health, and water projects.

My amendment requires that the Attorney General, the Secretary of Interior, and the Secretary of Health and Human Services establish an emergency plan to address the law enforcement, health, and safe drinking water needs of Native Americans across the nation. Specifically, the amendment provides an authorization totaling $750 million, to be used by the Attorney General and Secretary of Interior, to address tribal law enforcement, court, and detention facility needs.

Additionally, the Amendment established $250 million in authorization to be used by the Secretary of Health and Human Services, acting through the Director of the Indian Health Service (IHS), to provide IHS contract care, health facility construction and rehabilitation, and sanitation facilities. Finally, $1 billion in authorization is to be used to implement Indian drinking water projects that have been approved by Congress.

Again, thank you for your interest in my amendment. Once enacted, I am hopeful that this modest authorization will begin to meet the critical public safety, health, and water needs that many of our nation's reservations face subject to future appropriations by Congress.

Sincerely.

JOHN THUNE,
United States Senate.

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DEPARTMENT OF HEALTH

AND HUMAN SERVICES,

Washington, DC, July 22, 2008.
Hon. CHRIS SMITH,
Rayburn House Office Building,
Washington, DC.

DEAR MR. SMITH: We understand that concerns have been raised regarding whether the Hyde Amendment will attach to funds used for Indian Health purposes under Section 601 of H.R. 5501, the Senate bill that seeks to reauthorize the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act of 2003. The Department's position is that the Hyde Amendment will attach to funds appropriated for Indian Health purposes.

Section 601 of H.R. 5501 would establish in the Treasury an Emergency Fund for Indian Safety and Health (the ``Fund''). Under Section 601(t)(3), the Secretary of Health and Human Services shall use 12.5 percent of the Fund to provide health services and improve health and sanitation facilities for members of Indian tribes. The Secretary must act ``through the Director of the Indian Health Service,'' thus, such activities will be conducted as programs of the Indian Health Service. Although Section 601 authorizes the establishment of the Fund, it does not actually appropriate money to the Fund. Subsequent legislation is necessary to appropriate money to the Indian Health Service for Indian Health purposes as authorized by the Fund.

The Hyde Amendment, which is currently set forth in section 507 of the FY08 L/HHS/Ed appropriations act, will attach to money appropriated to the Fund for Indian Health purposes under section 601(f)(3). If the L/HHS/Ed appropriations act contains the Hyde Amendment, and Congress appropriates money to the Fund in another act, then the money used for the Indian Health Service will be subject to the Hyde Amendment because 25 U.S.C. §1676 will apply. 25 U.S.C. §1676 states that ``[a]ny limitation on the use of funds contained in an Act providing appropriations for the Department of Health and Human Services for a period with respect to the performance of abortions shall apply for that period with respect to the performance of abortions using funds contained in an Act providing appropriations for the Indian Health Service.'' Because an act that appropriates money to the Fund would ``provid[e] appropriations for the Indian Health Service,'' the Hyde Amendment contained in the L/HHS/Ed appropriations act would be applicable to money used for Indian health purposes under section 601(f)(3).

Sincerely,

CHARLES E. JOHNSON,
Assistant Secretary for Resources and Technology.

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