by Rep. Sheila Jackson-Lee (D-Texas), July 24, 2001
Chairman, I rise today to join my colleagues in offering an amendment to
this bill that will permit the United States Agency for International Development
to provide valuable support for global child and maternal health programs
and to combat global infectious diseases.
This amendment will
provide $50 million additional funding for Child and maternal health programs
and $50 million additional funding for the USAID's valuable infectious
disease program. We are not asking for new funding, but merely funds from
the State Department's Andean Counterdrug initiative.
We know firsthand
that the health and survival of a child is directly linked to the health
of his or her mother. Infectious diseases continue to take a toll on the
developing world. Ten million children will die before their fifth birthday
this year due to preventable diseases, such as diarrhea, pneumonia and
measles. In addition, infectious diseases, such as tuberculosis and malaria,
take the lives of millions of people living with HIV/AIDS. All of these
deaths are preventable and by strengthening the basic health and nutrition
services in developing countries, we can make a difference.
We must recognize
that the U.S. federal budget allocation to foreign aid has hit a record
low, and is now less as a proportion of our national income than in any
other industrialized nation. Foreign aid is not only one percent of our
In September, we
will mark the ten-year anniversary of the 1990 World Summit for Children.
At that summit, the U.S. joined with over 70 other nations in committing
to the reduction of child and maternal deaths. Substantial progress has
been made since 1990, but many goals have not yet been met. We need to
redouble our efforts to expand programs that can sharply reduce the millions
of preventable deaths.
Despite the good
work of many organizations and individuals worldwide, each year more than
ten million children die before reaching their fifth birthday due to preventable
infectious diseases, such as pneumonia, measles, and diarrhea. This is
equivalent to every child living in the eastern half of the United States.
While diarrhea remains one of the leading causes of death in the developing
world, at present one million childhood deaths are averted every year
due to diarrheal prevention and appropriate treatment programs.
Clean water and sanitation
prevent infections, and oral rehydration therapy (a simple salt sugar
mixture taken by mouth, which costs only pennies and was developed through
U.S. research efforts overseas) has been proven to be among the most effective
public health interventions ever developed.
coverage has soared from less than 10 percent of the world's children
in the 1970s to almost 75 percent today. Annually, immunizations avert
two million childhood deaths from measles, neonatal tetanus, and whooping
cough. The success of these programs in the world's poorest regions is
even more striking when one considers that the vaccination rate in the
United States only reached 78 percent in 1998.
rates are not improving everywhere. Coverage in sub-Saharan Africa has
decreased. 30 percent of children still do not receive their routine vaccinations--30
million infants. Measles immunization rates have improved in the past
ten years but there are still 30 million cases of measles every year.
If a child is not
killed by measles, it may cause blindness, malnutrition, deafness or pneumonia.
It is possible to save millions of children per year just by increasing
immunization rates from 75 percent to 90 percent, and by assuring access
to essential nutrients such as Vitamin A, which increases resistance to
disease and infection. Vitamin A supplementation is protective and will
protect a child from the most serious consequences of measles, such as
blindness and death, and costs only four cents per year per child. Deficiencies
of both iron and iodine are among the most harmful types of malnutrition
with regard to cognition. Iodine deficiency disorder is the leading preventable
cause of mental retardation in children and it renders children listless,
inattentive and uninterested in learning.
We must reduce hunger
and malnutrition, which contribute to over one-half of childhood deaths
around the world. We can do so through these Child and Maternal Health
programs. As estimated 150 million children are malnourished, which puts
them at even greater risk for infections. Protecting children from disease
and malnutrition increases their ability to learn and thrive. The issue
of hunger and nutrition was so important to my predecessor, Mickey Leland,
that along with Congressmen TONY HALL and BEN GILMAN, he founded the House
Select Committee on Hunger in 1983. The bi-partisan non-profit Congressional
Hunger Center grew out of this effort in 1993 and fights national and
global hunger. It is important that we in Congress continue these efforts.
According to the
United Nations, approximately 828 million people are chronically undernourished
in the world today. Approximately 300 million are children. UNICEF reports
that 32 percent of the worlds' children under five years of age, about
193 million, have stunted growth, which is the key indicator for undernutrition.
Weak health and poor
nutrition among school age children diminish their cognitive development
either through physiological changes or by reducing their ability to participate
in the learning experience, or both. The extra demand on school age children
to perform chores, for example, or walk long distances to school, creates
a need for energy that is much greater than that of younger children.
Available data indicate high levels of protein energy malnutrition and
short-term hunger among school age children, and deficiencies of critical
nutrients are pervasive.
Poor nutrition and
health among school children contribute to the inefficiency of the educational
system. Children with diminished cognitive abilities and sensory impairments
perform less well and are more likely to repeat grades or drop out of
school. The irregular school attendance of malnourished and unhealthy
children is one of the key factors in poor performance. Even temporary
hunger, common in children who are not being fed before going to school,
can have an adverse effect on learning.
For those of you
who worry that their home districts will not support such additional aid,
I offer that polls consistently show that Americans support putting a
high priority on addressing world hunger and poverty. In a recent survey
by the Program on International Policy Attitudes at the University of
Maryland, 87 percent polled support foreign food and medical assistance.
Only 20 percent surveyed supports cuts in efforts to reduce hunger. 62
percent said that combating world hunger should be a very important goal
for the United States. 76 percent positively rated giving child survival
programs more money. Only about one fourth positively viewed giving military
aid to countries friendly to the United States.
U.S. food aid alleviates
poverty and promotes economic growth in recipient countries. As incomes
in developing countries rise, consumption patterns change, and food and
other imports of US goods and services can increase. Hence, supporting
child nutrition programs is an effort that we can and must all support.
This amendment will
benefit families in many other important ways. Nearly 500,000 women die
of pregnancy-related causes each year. Every minute, around the world,
380 women become pregnant, 110 women experience pregnancy-related complications,
1 woman dies. Each year, an additional 15 million women suffer pregnancy-related
health problems that can be permanently debilitating, and over 4 million
newborns die from poorly managed pregnancies and deliveries.
Ninety five percent
of maternal deaths occur in the developing world. In some sub-Saharan
African countries, the risk jumps still further: one in every 14 girls
entering adolescence will die from maternal causes before completing her
child-bearing years--compared to 1 in 1,800 girls in developing countries.
According to the
World Health Organization, maternal health is the largest disparity between
the developed and developing countries. While infant mortality (death
to infants less than one year), for example, is almost 7 times higher
in the developing world than in the developed, maternal mortality is on
average 18 times higher. Beyond the consequences for women, the health
of their children is also put at risk. Children are much more likely to
die within two years of a maternal death. The chances of death are 10
times greater for the newborn and 3 times greater for children 1 to 5
deaths is to be an effective investment in healthy families--and therefore
in sustainable development--around the world. These deaths can be averted
through services that include skilled attendants at birth with necessary
equipment and supplies, community education on safe motherhood, improvement
of rural and urban health care facilities. Most of these interventions
are low-tech and low cost.
Maternal deaths affect
women in their most productive years, and as a result the impact reverberates
through their families, their communities, and the societies in which
they live. The diminished potential productivity of the women who die
is $7.5 billion annually and $8 billion for the newborns who do not survive.
of maternal deaths can be prevented with improved pregnancy care, nutrition,
immediate postnatal care as well as appropriate treatment for the complications
of incomplete abortions. The WHO Mother-Baby program has identified a
package of health interventions that, for a cost of $1-3 per mother, can
save the lives of countless women and will begin to do so immediately
U.S. funding for
maternal health programs has remained level at $50 million for the past
3 years. While other global health and development programs have received
increased attention, women continue to die needlessly of preventable causes.
Through this amendment,
we also seek additional funding to prevent infectious diseases. Almost
2 million people die each year from tuberculosis (TB). It is estimated
that one-third of the world's population is infected with tuberculosis,
although it lies dormant in most people. Deadlier and more resistant forms
of TB have emerged and have spread to Europe and the U.S., re-introducing
the possibility of TB becoming a global killer. Moreover, since HIV/AIDS
reduces one's resistance to infectious diseases, TB is easily transmitted
to an infected individual. It is regarded as the most common HIV-related
opportunistic infection in developing countries.
Many advances have
been made to reduce the prevalence of these diseases by the USAID, in
collaboration with other international agencies. For example, the World
Health Organization's Roll Back Malaria campaign had decreased the death
rate from malaria by 97 percent in some countries. WHO has also started
a ``directly observed treatment strategy,'' or DOTS, to fight tuberculosis.
Under this strategy, patients are given second-line drugs when they become
resistant to first-line drugs.
(TB) has re-emerged on the world stage in deadlier and more resistant
forms. With the appearance of multi-drug resistant TB, and its spread
to Europe and the U.S., we face the possibility that this could again
become a leading killer of the rich as well as the poor.
account for 8 percent of all deaths in the richest 20 percent of the world
and 56 percent in the poorest 20 percent. This poorest fifth of the world's
population is seven times more likely to die as a result of infectious
diseases, accounting for 56 percent of deaths within this population segment.
Children are particularly susceptible to infectious diseases, which tend
to be exacerbated by malnutrition, and all-too common condition in developing
Finally, this amendment
does not seek to cut any economic assistance for the Andean region, assistance
for Peru or Bolivia, or funding for the Colombian National Police. It
only seeks to cut some military aid to Colombia, aid that does not help
the Colombian people, as will these valuable heath programs.
The human rights
situation in Colombia has deteriorated since Congress approved last year's
aid package. The Colombian military continues to collaborate with right-wing
paramilitaries that commit over 70 percent of human rights abuses, such
as the paramilitary massacres of civilians that have nearly doubled in
2001 compared to last year.
The U.S. is engaged
in a costly military endeavor with no clear exit strategy. The high level
of military aid threatens to draw the U.S. further into Colombia's civil
war. The amendment leaves intact $152 million in police aid, and estimated
$80 million in the Defense Appropriations bill, $30 million in expected
drawdowns and IMET, and $158 million in military aid in the pipeline from
FY 2001. Security assistance accounts for 71 percent of expected U.S.
aid to Colombia this year.
Military aid escalates
the conflict and weakens the fragile peace process by emboldening those
who hope to solve the conflict on the battlefield and undermining government
and civilian leaders seeking a peaceful resolution to the conflict.
President Bush himself
said this Tuesday that ``A world where some live in comfort and plenty,
while half of the human race lives on less than $2 a day, is neither just,
I urge my colleagues
to support this amendment.
As of October 3, 2001,
this document was also available online at http://thomas.loc.gov/cgi-bin/query/B?r107:@FIELD(FLD003+h)+@FIELD(DDATE+20010724)