During Tuesday’s House Appropriations Committee hearing, Rep. Rosa DeLauro (D-CT) questioned Catherine Connor, Vice President of Public Policy and Advocacy at the Elizabeth Glaser Pediatric AIDS Foundation, about those who use the President's Emergency Plan For AIDS Relief’s resources.
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NewsTranscript
00:00Thank you. Ranking member of the full committee, thank you.
00:05Thank you very, very much. And thank you, Ambassador Dybul, for really answering the question about national security.
00:12Thank God for George Bush, who understood the need and the fact that this was really in the best interest of the United States to be engaged in the PEPFAR program.
00:26And we have, and after him, countless others, Democrats and Republicans, have understood the need and the necessity for not,
00:38because if you can't understand the humanity of all of this, then understand what it means in terms of our national security
00:46and the stability of these economies in order for us to be able to participate in a world economy,
00:53though that may be under a threat as well these days.
00:58Let me just, PEPFAR works, yes?
01:05PEPFAR works, okay?
01:0920 years, you have one incident, not pushing it under the rug.
01:14But you've talked about it, you explained it.
01:18The other issue is here, it's my understanding, that these nurses were not trained with the Helms Amendment, et cetera.
01:27And there was a revision of the plan in order to be able to do that, but now we've got nothing but chaos.
01:32So whether or not people are being trained or not trained, et cetera, it's up for grabs.
01:39I think I want to ask my question, but I also want to just say this.
01:43I believe we're looking at a pattern here, because the domestic HIV programs are under attack.
01:55I spent a lot of years on the Appropriations Committee with the domestic HIV program with the epidemic of trying to rid us of that,
02:07and very close to doing it, except that money has been snatched back.
02:13So this is part of a pattern, which I quite frankly don't understand how it comes out in terms of the mission of saving lives, yes,
02:28and of dealing with U.S. national security.
02:32As of September 2024, PEPFAR was supporting the antiretroviral therapy art for more than 20 million people in 55 countries,
02:44that including 566 children living with HIV.
02:48As a result, the use of ART led to 95%, 89% of children being virally suppressed.
02:56As a result of the funding cuts, UNAID has warned that this will lead to more than 6 million excess deaths
03:04and an additional 2,000 new HIV infections each day, or 730,000 a year, over the next four years.
03:14ART suppresses the viral load to a level that makes HIV undetectable, prevents transmission.
03:21What is happening and will happen to more than the 20 million if they have to stop using ART?
03:29What do you expect to happen to transmission rates?
03:35I'll jump in here. Thank you, Ranking Member.
03:37You know, I appreciate your comments, and I think it bears repeating that.
03:41I think in some ways our progress has masked the root of the problem,
03:44which is that HIV is an uncurable, infectious, and fatal disease.
03:49And because we've done such a good job in trying to control it,
03:52we forget the devastation that it can bring.
03:54And I think both the subcommittee members as well as Ambassador Deibel
03:58have done a good job talking about that.
03:59And the disruptions we are seeing have the potential for to see some resurgence.
04:04You mentioned all the people that are on treatment.
04:06Right now the ARV stocks are low.
04:08There was a really good market analysis done by CHI that really looked at the supplies that are coming in.
04:12And right now there may be no ARV stock outs, but our own organization has looked,
04:17and there's not a single country we work in that has more than two to three months supplies of pediatric ARVs right now.
04:22And children that experience treatment disruption die much faster than adults who have treatment disruption.
04:28So I do think we can expect to see increased mortality, increased infection rates,
04:32and a lot of despair if things aren't corrected.
04:35And just a couple of other things here.
04:37So if the administration fails to continue investing in a comprehensive program,
04:46do we then figure that we have squandered the billions we have provided over the last, you know, 20 years?
04:56Have we thrown that money away given what you have just said about what happens for the future?
05:03Just an adjunct question to this if I might.
05:07I find that we've, PEPFAR works with other agencies.
05:14You were looking at USAID, CDC, and that in essence helps to make it work.
05:23So now if you're focused on maybe not investing in PEPFAR and then you are decimating or dismantling USAID
05:36and you are decimating CDC at the moment, which we are watching in real time here,
05:42how does that all play into what your mission is?
05:47And again, the squandering of billions of dollars.
05:50As I say, if you can't get people on the humanity of it, think about the money that we have spent here, you know?
05:58I choose humanity, but also efficiency.
06:02But let's talk about efficiency and the use of dollars and what those dollars have created
06:07and what happens when these agencies that you rely on crash and burn, and where do you go from there?
06:14And I'm going to ask you to try to get—it's an important question, but try to get to it concisely.
06:20That was a question, Mr. Chairman, and I'm sorry for the—
06:23And it's an interesting compliment to what Ambassador Dybal was talking about,
06:26about planning and looking at capacities and how we transition work.
06:30You know, right now we've talked a lot already in this hearing about the disruptions we've seen at the country level.
06:35We've talked a lot about where countries can lean in and do more, where private sector can do more.
06:39But we're not just disrupting the technical capacity that's in the field.
06:43We are disrupting the technical capacity at PEPFAR and the ability for these agencies and PEPFAR leadership to create a strategy, to make a plan.
06:51You know, again, I keep focusing on the area of my organization.
06:54You know, we've heard over and over again from the Trump administration officials that they want the focus of PEPFAR to be on eliminating mother-to-child transmission of HIV.
07:02But we're seeing the services in country being disrupted, and we're seeing the technical expertise that could help us create a strategy to do just that be diminished as well.
07:11So this is why I think it's going to be very important for this committee and its oversight function, but as well as conversations with the administration to look at this capacity.
07:19Where have we diminished our capacity so much that we really have to rethink we need to lean back in?
07:25Because right now it is hard to see a way forward, and the thing that, as Ambassador Diable mentioned, the confusion about where we're supposed to go, what are we supposed to do, how are we supposed to do this work if we don't have the structure at the top to help direct our work,
07:38if we don't have the structure at the country level to do the work and do it in a way that we can transition and sustain it over a long period of time.
07:45Thank you and thank the Ranking Member.
07:48Thank you very much.