Today, this Subcommittee will address an issue that is unequalled in its complexity and its urgency. It is the issue of the global HIV / AIDS epidemic and the role of the United States in combating this terrible affliction. This growing problem is both a trade issue, a health issue and certainly a humanitarian issue that we cannot ignore.

Our Subcommittee, recently reconstituted and vested with oversight of health and trade issues, is committed to understanding the nature and magnitude of this epidemic, and to ensuring a proper role by the United States in combating the disease. Recently, we held a hearing on another terrible infectious disease - Hepatitis B - and the importance of vaccines and properly designed vaccination policies in combating infections and meeting the health needs of our citizens. Today, and in the future, this Subcommittee will perform its oversight responsibility of examining health-related programs and practices that are promising and that will save lives.

As we will hear today, the AIDS epidemic is global and horrific, and it continues to spread across the world unabated. We will learn that no area of the world has been hit harder than the continent of Africa, particularly sub-Saharan Africa, where two-thirds of the worlds' infected population resides. Other continents and regions also are at risk. Witnesses will tell us first-hand of the devastating impacts of the epidemic in Africa, including economic, health and humanitarian consequences. They will reveal some of the terrible consequences to themselves and their loved ones.

We will hear about recent developments in vaccine research and its hopefully not-so-distant potential for preventing the spread and transmission of HIV / AIDS. Recent studies show that women are now being infected at a greater rate than men. I am encouraged by recent press accounts that a new, more affordable drug is being developed which may significantly reduce the incidence of AIDS transmission from an infected mother to her unborn child. But a question still remains: What are we doing to make sure these new drugs get to the developing countries that need them? Tragically there are nearly 600,000 new infections each year among African babies. Nine of every 10 infants infected with HIV at birth or through breastfeeding live in sub-Saharan Africa.

This hearing also will focus on the critical and complicated issue of drug treatment for HIV /AIDS. How can we treat such a large and growing population?

The World Health Organization and affiliated organizations recently announced that AIDS kills more people worldwide than any infectious disease. Imagine, in less than two decades, AIDS has become the leading killer of all infectious diseases.

As you can see on the chart we have prepared, more than 33.4 million adults and children are estimated to be infected with HIV / AIDS. This disease has already killed 14 million people, approximately 12 million in Africa. Today, more than 22.5 million Africans are living with HIV/AIDS. Reportedly, 95% of Africans with AIDS have not been tested, and 90% are unaware that they have the disease.

The tragedy resulting from this killer disease in Africa is almost inconceivable. Zambia, for instance, has one of Africa's largest orphan populations. In 1990, it was home to approximately 20,000 orphans. By next year, the number will reach an estimated 500,000.

Zimbabwe, a nation of 12 million citizens, reports 600,000 orphans, with most being supported by grandparents or other relatives.

Uganda, with a population of 20 million and a population that is 10% HIV positive, also reports 600,000 children having lost at least one parent, and about 250,000 children having lost both parents.

Today, we will hear the testimony of a mother from the African nation of Malawi, where reportedly 20% of the population is HIV positive and life expectancy has dropped below 40 years of age.

These numbers are staggering and the personal tragedies are unimaginable. AIDS now infects 6 million people annually around the world, and the number continues to climb.

This nation, which leads the world in science and technology, as well as world trade, must address two important questions: (1) What are we doing about this global epidemic? (2) What should we do about it?

First, what actions are we now taking to combat the international spread of this disease? From all appearances, not nearly enough. The administration's AIDS czar has acknowledged that the epidemic has been met with indifference by Americans and their government. We cannot afford to let this indifference continue. I am heartened to learn that some in the administration are now speaking out on the issue, even though our trade policies to date have been unclear and contradictory.

Should we, through the Office of the U.S. Trade Representative, apply economic pressures or withhold assistance to nations such as South Africa, when that nation attempts to engage in self-help to combat its national health emergency? Can we identify better approaches to expanding HIV / AIDS prevention and treatment in developing nations, than imposing rigid licensing and import practices? Is it necessary for AIDS stricken developing nations to rely upon periodic pronouncements of intentions to provide limited foreign aid from the United States?

Can nations in need and the pharmaceutical industry negotiate a solution that meets the growing health and humanitarian needs, while ensuring that a reasonable profit to support future drug development?

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Again, these are the pressing questions that this nation must address as the world's foremost economic power and a world leader in science and technology.

The second question is what should we do about this global epidemic? In answering this question, let me share with you one description of the crisis and possible response that was highlighted recently on a national television news segment. [Show ABC News video tape; July 8, 1999]

While I admit that this news video is short and perhaps superficial, it does illustrate the tragedy of the epidemic and presents a possible health dilemma: does drug treatment delivery in developing countries pose significant risks of new strains of AIDS? I hope that we will learn more about this issue today. I am not convinced that we do nothing to help these nations, and that there is no recourse but to watch millions of people die without treatment.

Here in the United States, while AIDS continues to spread, our AIDS deaths recently dropped by 47%, primarily due to new drug treatments that prolong lives and allow people to remain productive. I hope that we can do more for other nations and our trading partners in need. It is clear that many developing nations cannot progress economically until solutions to this crisis are found.

In a recent survey of American citizens, almost 90% of those surveyed nationwide say that it is safest and cheapest to fight infectious diseases at their source, which is most often in the developing world. In fact, today we will hear from a witness who is in this country because she cannot acquire the drug treatment she needs in her native Africa. The survey also found that more than 80% of Americans see AIDS as a bigger problem today than 10 years ago, despite treatment advances.

The United States plays a vital role in the global economy, and we remain a nation at risk. Recent data indicates that the infection rate among American women is increasing more rapidly than among males, and that African-Americans are at least six times more likely to contract HIV / AIDS than others.

These are some of the reasons that the solution to combating the global HIV/AIDS epidemic is complex and will not be achieved as quickly as we all hope. Yet I am convinced that, through a better understanding of this international health crisis, we can improve our treatment and prevention efforts both domestically and internationally.

It is imperative that vaccine research proceeds expeditiously. We also should assist, not hinder, developing nations and trading partners in their treatment efforts. I cannot fathom that we simply wait while the epidemic reaches multiples of the 14 million AIDS casualties who already have died. The millions of infected babies, the millions of orphaned children, the millions of new infections each year, and the millions of deaths that will occur internationally without treatment, are simply unacceptable. This crisis demands immediate attention by our government, and more than a "Band-Aid" approach.

Today, it is my hope that as we learn more about this crisis, we can begin to formulate a more effective response. It confounds me that we dedicate substantial government resources to learn whether global warming exists, while tens of millions are facing certain death from an immediate and growing crisis where real science and can save lives.

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I look forward to the testimony of our witnesses on the greatest health threat facing the world in many centuries, and the role this nation should assume in combating it. I wish to thank my colleagues in Congress for sharing their ideas with this Subcommittee on this topic. I also want to commend those witnesses with this disease who have the courage to discuss publicly this most sensitive and pressing health issue.

Finally, I believe we have a moral and humanitarian responsibility to publicly air this incredible human tragedy and our response both as Congress and a civilized nation.

Years from now and millions of deaths later we must not be accused of turning our backs on this great holocaust of disease.

Mr. MICA. I am pleased at this time to yield to our distinguished ranking member, the gentlewoman from Hawaii, Mrs. Mink.

Mrs. MINK. Thank you, Mr. Chairman. I do not have an opening statement, but I do want to join you in your remarks, and certainly lend my support to this inquiry, and to join you in expressing hope that as a result of the hearings and the testimony today, we can be guided to a policy for this country that can adequately meet this terrible need.

I want to particularly extend a welcome to our distinguished witnesses today, and look forward to their comments. Thank you, Mr. Chairman.

Mr. MICA. Thank you.

I am also pleased that we are joined by the gentleman from California, Mr. Lantos, who is not a member of the subcommittee, but the full committee. We are so pleased to have him join us for the subcommittee hearing this morning.

Mr. LANTOS. Thank you very much, Mr. Chairman. Let me first commend you for holding this extremely important hearing.

The other committee on which I serve, the House Committee on International Relations, held a hearing on the spread of AIDS in the developing world on September 18, 1998, and I would be grateful if my formal statement before that committee could be entered in the record.

Mr. MICA. Without objection, so ordered.

Mr. LANTOS. Mr. Chairman, the word "historic" is often overused, but it certainly is not overused in this instance.

I remember I was a young schoolboy studying European history when I was first introduced to the concept of the bubonic plague. The bubonic plague took place 652 years ago, in the year 1347 in Europe, and it killed about 20 million innocent human beings. I recall as a boy the concept of 20 million people being killed by a disease was mind-boggling and incomprehensible.

More recently, in 1917, another 20 million innocent human beings lost their lives because of the influenza epidemic, and today we are facing the nightmarish impact of AIDS.

I truly believe that if there is any issue before the Congress that deserves full bipartisan support, funding, and cooperation, it is the AIDS epidemic. I want to commend the Clinton-Gore administration for proposing an additional $100 million to deal with this issue.

I also want to commend the First Lady for convening a donors conference earlier in September involving international organizations and other governments capable of making major contributions in dealing with this issue.

The recently released report entitled "Report on the Presidential Mission on Children Orphaned by AIDS in Sub-Saharan Africa," is one of the most sobering pieces of literature issued by any government agency in a long, long time.

We are dealing with millions and soon tens of millions of children in desperately poor countries in Africa who will be orphaned because their parents died of AIDS. I could think of no nobler effort on the part of the wealthy nations of this world than to combine forces to try to mitigate the unspeakable human horror that will be inflicted upon vast numbers of people.