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Last Updated:10/05/01
Speech by Rep. Sheila Jackson-Lee (D-Texas), July 24, 2001
Mr. 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 federal budget.

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.

Global immunization 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.

Unfortunately, immunization 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 years.

Reducing maternal 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.

Ninety-nine percent 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 upon implementation.

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.

Similarly, tuberculosis (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.

Infectious diseases 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 countries.

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, nor stable.''

I urge my colleagues to support this amendment.

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