Congressional Budget for the UNited States Government for the Fiscal Year 2006

CONGRESSIONAL BUDGET FOR THE UNITED STATES GOVERNMENT FOR THE FISCAL YEAR 2006

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Mr. DeWINE. Mr. President, amendment No. 153 is a sense of the Senate expressing the importance of providing treatment to children infected with HIV/AIDS. I encourage all of my colleagues to read the amendment and ask that they join as cosponsors to show support for pediatric treatment of HIV/AIDS. This Congress must not overlook children who are infected with HIV/AIDS.

Fortunately, Congress has realized that the transmission of HIV/AIDS is preventable and avoidable. We have supported funding for mother-to-child transmission, which, when effectively implemented in the United States, has resulted in the near elimination, less than 2 percent transmission, of mother-to-child HIV/AIDS transmission. By contrast, in resource-poor settings, less than 10 percent of pregnant women living with HIV have access to services to prevent mother-to-child transmission of HIV. It is inexcusable for us to not do something to continue to reduce the rate of transmission between mother and child. With the President's Emergency AIDS Initiative, we have certainly made some progress, but there is always more to do.

But, we cannot stop at preventing the transmission. We have to ensure that there is treatment available for children when necessary.

Approximately 2.2 million children under the age of 15 are infected with the HIV virus, and 1,900 children worldwide are infected with HIV each day. To date, more than 4 million children worldwide are estimated to have died from AIDS. We must ensure that HIV-positive children and children with AIDS are no longer overlooked and that they begin receiving the treatment and care that they deserve.

Few programs specifically target the treatment of children with HIV/AIDS in resource-poor countries due to significant challenges in diagnosing and treating infants and young children with HIV. Such challenges include: difficulty in diagnosing HIV in infants less than 18 months of age; lack of appropriate and affordable pediatric HIV/AIDS medicines; and lack of trained health care providers. When I went to Guyana two years ago, only one child--one child in the whole country--was receiving antiretroviral treatment medicine. I know that more are receiving treatment now, but not many. We have to do more to change that. We need to ensure that physicians and clinicians are trained in pediatric care and that safe and effective medicines are available to infected children who need them to survive.

Ultimately, pediatric treatment cannot be anecdotal. It must be routine. And we should demand that it be routine. This sense-of-the-Senate amendment is a step in that direction. It forces us to look at the facts, and it compels us to do something about it.

Mr. President, today I also join my friend and colleague, Senator LEAHY, in amendment No. 161 that would increase the funding level for the Child Survival and Maternal Health Program to $660 million. That would be a $334 million increase over the budgeted level of $326 million.

This is an appropriate and necessary step. And, it is, simply, the right thing to do.

With regard to today's child survival crises, we know the facts: 130 million children entered the 21st Century unable to read or write; 2,000 children younger that 15 each day are infected with AIDS; 650 million children live in extreme poverty; and over 10 million children die each year, most from preventable causes and almost all in poor countries.

According to UNICEF, out of every 100 children born, 30 will most likely suffer from malnutrition in their first 5 years of life; 26 will not be immunized against the most basic of childhood diseases; 19 will lack access to clean, safe drinking water; and 17 will never--ever--go to school.

How have we responded to this world of ours? How have we responded to the developing world? We have seemingly come to expect, and indeed, accept poverty, instability, and epidemic disease as a way of life in the developing world. The real tragedy is that all of it is avoidable.

We can do something about it. We can do simple things to save millions of children's lives. Our amendment would help save lives.

I would like to take a few minutes to share some more statistics about child and maternal mortality. I am often hesitant to recite statistics here on the floor of the U.S. Senate because when we hear them repeatedly, it is all too easy to become numb to them--to forget the human realities that they do, in fact, represent. It is important, though, for my colleagues and for the American people to listen to some of these statistics because they are so unbelievable and so tragic and represent so many lives that could be saved--lives that could be saved if we would make the appropriate amount of resources available to the developing countries in such dire need.

Of those 10 million children who die each year worldwide, 3.9 million occur in the first 28 days of life. These babies don't even have a shot at living their lives. Yet, two-thirds of these deaths could be prevented if available and affordable interventions had reached the children and mothers who needed them.

Malnutrition contributes to 54 percent of all childhood deaths. And, as many as 3 million children die annually as a result of Vitamin A deficiency and an estimated 400,000 cases of childhood blindness are reported each year.

According to World Health Organization estimates, at least 30 million infants still do not have access to basic immunization services, and over 4.4 million children died from vaccine preventable diseases in 2001--diseases such as hepatitis, polio, and tetanus. Of all the vaccine-preventable diseases, measles remains the leading childhood killer, claiming the lives of 745,000 children--more than half of them in Africa. Yet, vaccine-preventable deaths could actually be cut in half by 2005 if these children were receiving proper vaccinations.

Recently, the Lancet, which ran a series of articles last year about child survival, has launched a series of articles about neonatal death. Here is what the first few articles reveal: Of the 130 million babies born every year, about 4 million die in the first 4 weeks of life--the neonatal period. In poor communities, many babies who die are unnamed and unrecorded, indicating the perceived inevitability of their death. [Also], 450 newborn children die every hour, mainly from preventable causes.

This is unconscionable, and it is an emergency situation. There really isn't any other way to describe it. Over 10 million children dying each year from preventable and treatable illnesses is an emergency.

But this emergency cannot be resolved through short-term, temporary, piecemeal assistance. If we are to make any real headway in improving the health of women and children in the long-term, we need to take some bold and radical steps and be committed to supporting maternal and child health programs not just now, but next year and the year after and the year after that. Our funding simply cannot be administered in a single-dose.

Our amendment would allocate additional money to help avert maternal and neonatal death and improve maternal health, including the prevention of obstetric fistulas and other types of injuries and disabilities resulting from childbirth in unsafe circumstances. The fact is that all pregnant women are at risk for injuries and childbirth complications, which is why it is so important to have skilled attendants--midwives, doctors, or nurses--present at birth. Yet, only about half of the world's women give birth with a skilled attendant available.

Child survival and maternal health funding provides resources so that USAID can provide training and technical assistance in infection prevention and quality of care, as well as needed equipment and supplies to bring health facilities up to a level where they can provide safe and effective emergency pre- and post-natal care. Child survival interventions work, and they are the most cost-effective tools we have in the struggle for better global health. We can and should invest in these programs as they increase developing countries' access to basic health services--services like vaccinations, immunizations, micronutrient programs, and vitamin supplements.

If we make this investment and work toward equal access to health care, we help ensure that mothers receive proper prenatal care, that children and families receive nutrition counseling and vitamin supplements, and that children receive the necessary immunizations and vaccinations to live healthy lives. But tragically, if we fail to make a sufficient and sustained investment in the development of public health systems that provide primary care, mothers will continue to die prematurely during childbirth, children will continue to die from preventable disease and causes, and life expectancies in these developing nations will stagnate or perhaps even decrease. That is not an acceptable future for any of us.

I ask my colleagues to join us in supporting this amendment.

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