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REMARKS BY:
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TOMMY G. THOMPSON, SECRETARY OF HEALTH AND HUMAN SERVICES
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PLACE:
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American Enterprise Institute Conference, Washington, D.C.
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DATE:
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February 5, 2004
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Address of Tommy G. Thompson Secretary of Health and Human Services to the American Enterprise Institute Conference on The Global Pandemic: AIDS in Africa, China and Russia
Thank you, Jim. And good afternoon, everyone. I’m
pleased that you’ve heard from my friends Randall Tobias and
Jim Glassman, as well as so many other experts on AIDS and foreign
policy.
And I’m pleased to see so many of you take an interest in
fighting the spread of AIDS around the world.
As most of you know, AIDS kills more than three million people a
year. To put that in terms we can relate to, AIDS kills
almost three times as many people every day as the terrorists
killed on September 11.
And every day, in addition to killing 8500 people, HIV also infects
another 14,000. That’s the population of the Washington
metro area every six weeks.
Here at home, AIDS has killed more than 475,000 Americans since the
epidemic began in 1981. We estimate that about 40,000 more people
acquire the virus every year. About 850,000 to 950,000 Americans
are currently living with HIV and a quarter of these don’t
even know they are infected.
The Bush Administration has made an unprecedented and growing
commitment to fighting the disease at home and abroad. On Monday,
the President requested almost $20 billion to address HIV and AIDS
in 2005, a 28 percent increase over 2001. No government has ever
committed the time, energy, and resources to fighting AIDS as the
United States under President Bush.
We would spend $17 billion of these dollars to fight AIDS here in
America.
Our scientists at the National Institutes of Health are working to
develop and test an effective vaccine, to evaluate potential
therapies and microbicides, and to develop better strategies to
prevent mother-to-child transmission, sexual transmission, and
needle-sharing.
Our prevention and education campaigns encourage people to avoid
risky behaviors and develop healthy habits. We keep the blood
supply safe. And we offer an AIDS hotline and medical
services to people with AIDS.
A year ago, we augmented prevention and treatment efforts by giving
rapid FDA approval to a new, speedier HIV test that can be used
outside laboratory settings. We expect to approve another such test
soon.
Our achievements build on earlier progress. By the early
1990s, as people began to change their behavior, infections in the
United States fell from roughly 150,000 a year to about 40,000 a
year. In the mid 1990s, as effective combination drug therapies
became available AIDS-related deaths began to decline as
well. Also, mother-to-child transmission has fallen sharply
from 2,500 infections in 1992 to an estimated 300 to 400 infections
annually.
We’re making special efforts to target treatment and
prevention activities to racial and ethnic minorities. In
fact, as part of $6.5 billion in minority health spending to
eliminate health disparities, we’ve doubled our spending to
reduce the incidence of the AIDS virus among minority populations.
The AIDS problem is slightly different everywhere you look because
different cultural habits encourage different forms of risky
behavior. But what we’ve learned about AIDS in
America—how it is spread, what behaviors put people at risk,
how to diagnose it, and how to treat it—has made it easier
for us to help people in Africa, China, India, and Russia.
I believe that the spread of AIDS can be reversed, not just in
America, but around the world. That’s why President
Bush dedicated $15 billion over five years to fighting AIDS and
caring for the afflicted in 14 focus countries in Africa and the
Caribbean and more than 60 others where we have prevention,
treatment, and research programs. Of the 42 million people
with AIDS, almost 70% live in sub-Saharan Africa.
I’d like to talk about a number of ways that Americans are
taking the hard-won lessons of AIDS in America and using them to
save lives elsewhere.
Our fellow Americans are contributing as investors, as donors, as
taxpayers, as missionaries, as doctors, as nurses, and as
researchers.
Let me give you a few examples from Africa.
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Merck started a program with the Bill and Melinda Gates
Foundation to provide anti-retroviral drugs in Botswana.
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Abbott Laboratories is selling two of its AIDS drugs, Norvir and
Kaletra, and a rapid HIV test kit to Africans at cost.
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Pfizer provides an antifungal drug, Diflucan, free of charge to
treat Africans with AIDS. Diflucan treats candida and
cryptococcal infections, which frequently attack people with
AIDS. In a program sponsored by my Department, workers on
Suzuki motorcycles deliver Diflucan as well as anti-retroviral
drugs to remote villages in Uganda.
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Living Water, a faith-based group in Houston, drills village
wells in many blighted areas of Africa, a crucial, life-saving
message of hope.
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The Wheelchair Foundation donates wheelchairs to Africans
previously trapped by their disabilities who have now gained
their freedom.
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And, of course, private investors in the United States spend $32
billion every year on health care research, and American
taxpayers spend another $32 billion. Their research yields
new and better drugs. And while they may have American
consumers in mind, the drugs and devices they develop improve
health around the world.
Two years ago, I visited Botswana, Mozambique, South Africa, and
the Ivory Coast and saw the damage with my own eyes. I held
innocent babies who had contracted the virus from their mothers
during birth. Many are orphans.
When I came home, I asked my Department to come up with a program
to help HIV mothers have healthy babies and live to raise
them. This initiative to prevent the transmission of HIV
during childbirth became the core of the President’s
Emergency Plan for AIDS Relief.
In November, I returned to Africa as Chairman of the Global Fund to
Fight AIDS, Tuberculosis, and Malaria along with Ambassador Tobias,
Jim Glassman, and the largest public-private delegation ever to
visit that continent. Again I saw the devastation, but this
time I also saw a great deal of hope. The treatment and
prevention programs we’re supporting are starting to work and
show results.
Ugandan President Musavene and his wife, Janet, go on the radio to
remind people to practice abstinence before marriage and
faithfulness thereafter.
Ugandans have responded to their message, and have successfully cut
their infection rate from 21% to 6%. They demonstrated that
encouraging and motivating people to take responsibility for their
lives, avoiding risky behavior, and embracing changes in their
lifestyles can keep them safe from AIDS.
That is why President Bush’s Emergency Plan for AIDS builds
on Uganda’s “ABC” model of placing a priority of
encouraging abstinence until marriage and being faithful to
one’s spouse. As President Musavene says, "When a lion
comes into your village, you must raise the alarm loudly."
A couple of years ago, I met with African health ministers in
Geneva. Their sense of despair was palpable. But when I
visited African countries that are practicing better habits,
including Uganda, the health ministers this time were filled with
hope.
And so was I.
Many Ugandans with AIDS live in villages so remote only rutted dirt
roads reach them. So my Department delivers anti-retroviral
medications on the Suzuki motorcycles I mentioned. I went
along on one delivery and met a woman named Rosemary.
Her husband and brother both died of AIDS, leaving her to care for
seven children and her elderly mother, who live in mud huts.
She feeds them with the crops she grows on 2 acres of her
brother-in-law’s land, which bring in about $70 a year.
And she has AIDS.
You might expect Rosemary to be bitter. And not that long ago
she was close to dying from AIDS. But when she started taking
anti-retroviral drugs, her health improved, and she’s back to
feeding her family. And she’s one of the most
optimistic people I’ve ever met.
I also met a carpenter named Samson. AIDS killed his wife, and he
has it, too. He goes down to the swamp every day to gather
wood. After the wood dries, he makes tables and chairs, which
he sells for $1.50 each. He supports three children on $5-7 a
week. And his wife’s grave is right there in the yard,
a constant reminder that he uses to warn his children to avoid
risky behaviors so they never get the virus.
Like Rosemary, Samson is an optimist. And when he met me, he
eagerly asked me to thank Americans and President Bush for sending
the anti-retroviral medicines that keep him healthy. I will
never forget his gratitude.
AIDS has cut down millions of Africans. Its swath is very
broad—ten to twenty percent of adults in many countries are
infected, and, in the worst case, more than 35 percent of adults in
Botswana have the virus. By contrast, only a small fraction
of the populations of China, Russia, and India are
infected—less than a percent in India’s case.
But, in a country with a billion people, even a small increase in
the percentage of the population affected could strike down
hundreds of millions of our fellow men, women, and children.
We have focused the majority of our efforts at fighting AIDS on
Africa and the Caribbean, since they are the hardest-hit. But
we have been helping many people in other countries confront AIDS
as well.
Almost three years ago, in May of 2001, President Bush and Kofi
Annan announced the creation of the Global Fund to Fight AIDS,
Tuberculosis, and Malaria. He also announced the first U.S.
Government contribution to the fund. The Fund encompasses
public-private partnerships and mobilizes resources to fight the
spread of disease around the world. The Fund today has over
$5 billion. It has already approved 224 grant programs in 121
countries totaling more than $2 billion. I am proud to serve
as Chairman of the Fund, and proud of the work that the
Administration has been doing through the Global Fund as well as
through bilateral agreements.
The United States government has productive bilateral relationships
with the governments of India and the People’s Republic of
China to fight AIDS, and we are working to develop a similar
arrangement with the government of Russia. And Americans are
doing much to fight AIDS in all three places.
For example, we are working with Indian scientists on AIDS vaccine
research. The Global Fund has also approved grants to India
to expand government and free market interventions in HIV, TB, and
malaria treatment and prevention efforts. And we are
evaluating the effectiveness of anti-retroviral drugs and
microbicides in Pune.
China, too, has received support from the Global Fund.
Through their China CARES program, they are fighting AIDS through
community-based HIV treatment, care, and prevention efforts in
communities in central China that have been devastated by the
spread of the virus through networks of people who sold blood and
plasma.
We have been working with community leaders in Russia to reduce
risky behaviors among intravenous drug users. We are also
working with research organizations that used to be involved in the
development of hazardous biological agents, but are now working on
developing an HIV vaccine.
Of course, disease prevention only works when people understand
it. Many people live in parts of the world with few doctors,
and few people who can read.
So we developed an idea to bring basic medical information to them
directly. Soon we hope to provide it to communities in Africa
and even the United States, but the first place to receive it will
be Afghanistan.
For every 1,000 Afghan babies that survive birth, another 145 die
at birth or soon after. And mothers die in childbirth at a
rate of 1600 mothers per 100,000 live births. But ninety
percent of maternal deaths can be prevented with basic health
care. And we are starting to provide basic health care and
information.
We are hoping to provide 20,000 interactive talking books to women
in Afghanistan over the next year to promote health and disease
prevention. These talking books can help women regardless of
whether they can read.
They provide good, appropriate basic information in both Dari and
Pashto on nutrition, sanitation, hygiene, preventive health, safe
childbirth, and immunizations. We beta tested demonstration models
in Afghanistan and they have been a big success. The women
have said they felt empowered.
Someone in this room may know an investor or a philanthropist who
wants to distribute a book like this on AIDS prevention in Africa,
or the Caribbean, or China or India, and to every area where
literacy and basic medical knowledge are in short supply.
I want to encourage every one of you: let’s use the
technology that we have to help not only Americans, but people
around the world. When it comes to life-saving information,
there’s no time to waste.
And there are more reasons to help than we might think.
Saving lives is not the only thing we are achieving when we help
others. We are also spreading respect and love for Americans
and for our way of life.
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I saw it in Samson's eyes
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I heard it in Rosemary's voice
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I felt it in the relief among the women in Kabul
You’ve heard of “dollar diplomacy?” Well I
advocate doctor diplomacy. It works.
You don’t have to share a man’s faith to help save his
life. You don’t have to speak a woman’s language
to cure her illnesses. You don’t have to understand a
town’s culture to bring it fresh water. But you do have
to understand your place in the world and your responsibility to
love your neighbors, whether they live down the street or across
the ocean.
They say that good fences make good neighbors, and maybe they
do. But what I’ve learned is that good medicine makes
good neighbors, and it makes good foreign policy, too.
Thank you.
Last Revised: February 8, 2004
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