During Tuesday’s House Appropriations Committee hearing, Rep. Grace Meng (D-NY) spoke of her disapproval for President Trump’s shuttering of the U.S. Agency for International Development and its effects on the President's Emergency Plan For AIDS Relief.
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NewsTranscript
00:00Ms. Meng, you're here when we started, I believe.
00:07And if not, take advantage of it.
00:09Okay, thank you.
00:10Go ahead.
00:11Pretend you were.
00:12Thank you, Mr. Chairman and Ranking Member Franco and DeLauro and to our witnesses for being here.
00:19In June 1981, five cases of a mysterious illness appeared in Los Angeles.
00:26And that moment marked the beginning of the HIV epidemic in America.
00:32Since then, over 700,000 Americans have died from this illness, including 8,000 each year.
00:39But HIV AIDS didn't start here.
00:42But we knew that protecting Americans and addressing the AIDS epidemic meant fighting the disease globally.
00:50And that's why PEPFAR is important.
00:53Since 2003, we have saved 26 million lives through PEPFAR and another 65 million through investments in worldwide HIV response programs like the Global Fund.
01:05We're actively helping to treat, you've heard the numbers, over 20 million people with life-saving medication, including pregnant women.
01:14We have prevented 7.8 million babies from being born with HIV.
01:21And as a mom, that last number means so much to me.
01:25Because of this program, millions of children have been able to grow up without worrying about treatment or passing HIV on to others.
01:33Meanwhile, PEPFAR's annual regular funding since 2009 has been flat.
01:40In fact, the cost of treating someone has dropped from $1,200 a year in 2003 to just $58 in 2023.
01:52And that sounds pretty efficient to me, Mr. Chairman.
01:56PEPFAR is a crown jewel, but this administration's illegal, unconstitutional, and chaotic attacks on USAID are public servants,
02:08and the programs they support are jeopardizing decades of progress.
02:13Ms. Connor, I'm very worried about the impacts of the stop work order on ARVs.
02:21This is, as you know, medication that 20 million people receive that helps stop the spread of HIV.
02:28And each day of the foreign aid freeze, over 220,000 people, including 7,000 of them who are children, were blocked from receiving these.
02:39As you mentioned in your testimony, a study showed that one in five HIV-positive children who experienced treatment interruptions died.
02:48Interrupting ARV treatment risks creating drug-resistant HIV trains, correct?
02:55Can you talk a little bit about that?
02:57Ms. Absolutely, and thank you for raising this question.
03:00You know, when I started working at AGPF, I had to go around to members of Congress and tell them there were 2,000 children that were acquiring HIV every day.
03:08And that number is down to 300, which is still too many by any measure.
03:12But that just kind of speaks to the success.
03:14And a lot of that is because of the ability to put pregnant women on treatment.
03:18So I just want to thank you for raising that issue.
03:20You know, drug resistance and treatment failure is a really big problem, especially in the pediatric community.
03:26A lot of children who are exposed to HIV are exposed, again, through pregnancy, labor, and delivery, and breastfeeding.
03:34And so if they do end up being HIV positive, often they are resistant to the drugs that their mother may have been taking.
03:40And so we have to be very vigilant on that.
03:42And that's why treatment disruptions in the adult and the pediatric community are so important to try to avoid.
03:48Is that we do find that when people's treatment is disrupted, not only do they get drug resistance, but their virus tends to spike, right?
03:56So not only have they stopped treatment, they are actually, they get sick very fast.
04:01And that means that they're able to infect other people and they won't even really understand or know that.
04:05So this is an area that we take really seriously.
04:07And as we're looking at sort of where the disruptions are, we are trying to make sure and work very closely with the ministries that at least where we can that ARVs are being supplied.
04:16And again, hopefully at the levels that people can adhere, but we are starting to see some rationing of medications as well, just because of the uncertainty.
04:24I want to be clear that uncertainty here is almost more dangerous than what's happening on the ground is that ministries and partners are unable to plan ahead, unable to look at what's available and sort of redistribute resources.
04:37It's just, everyone's a little bit frozen in place and that has its own damaging impacts.
04:42Thank you so much.
04:43And I'll pivot quickly to, if I still have time left, to my home state of New York.
04:48The administration's dismantling of USAID obviously will impact so many of the communities and districts that we all represent.
04:57Between 2022 and 2024, USAID contracts were responsible for over $12 billion in grants and funding to organizations
05:06and universities here in the U.S.
05:09In my home state, we received over $185 million during that period.
05:14Money that went to disease research and treatment and programs to help reduce the cost of everyday goods like coffee.
05:22And now the administration has canceled many of them.
05:25One of the impacted groups is the International AIDS Vaccine Alliance, headquartered in New York City.
05:32This was, they were developing a promising vaccine that was already in clinical trials.
05:38And the administration canceled their contract, resulting in the end of that clinical trial.
05:44You know, an American-led, taxpayer-funded HIV vaccine trial was actively underway.
05:50And if successful, could have helped prevent almost 32,000 Americans and 1.3 million people around the world from getting HIV each year.
06:03Ambassador, can you discuss the impact that an HIV vaccine and other injectables would have had on treatment costs and PEPFAR's sustainability?
06:15Yeah.
06:16Yes.
06:17Thank you for the question.
06:18I'll do it quite quickly.
06:19The vaccine was kind of, by the way, I used to be on the board of IAVI, so I want to make that clear.
06:25So I was involved in some of that planning.
06:28The new technologies that are available, there are long-acting injectable drugs that actually prevent infection.
06:38So like you would take malaria, anti-malaria drugs when you travel.
06:43This is the same.
06:44It's called pre-exposure prophylaxis.
06:46You take antiretrovirals to prevent getting infected in the same way you treat, just like you do with malaria.
06:52So a couple of companies have developed injectable products that you can have one injection every three or six months.
07:01And the six-month one should be available, we hope, soon.
07:05By American technology and American companies, one injection every three to six months could prevent new infections,
07:12which is how we get to know more infections.
07:15And then the vaccine would add on to that as well.
07:18There are a couple of countries, the United Kingdom and the Netherlands, that are very close to achieving that.
07:24And the United States was getting close.
07:26The first Trump administration actually put the end of HIV as a top priority for them domestically.
07:32And it is possible, and these new technologies will make it possible.
07:37If you can give an injection once every three to six months and prevent new infections,
07:42there's a pill that does that as well, that is being used.
07:46And it was starting to be used in Africa.
07:48So for the long term, one of the key parts of sustainability transition is get the new infections down.
07:55And the second part of that, and this is an unfortunate part, but it happens to all of us,
08:00if you do an actuarial analysis, there have been many people on therapy now for 20 years.
08:05So there have been estimates of the fact that they're going to start dying from natural causes,
08:10even if they retain their antiretroviral therapy.
08:13So if you reduce the number of new infections, you have an increase in death for natural causes,
08:18you get down to a very small number of people that will need treatment for the future.
08:23That's sustainability.
08:24But that requires planning.
08:26Countries are ready for that planning.
08:29I can't tell you, Africans want a transition.
08:32They are not looking for this to continue forever.
08:34They want a transition.
08:36But they want a transition that they can manage because it shifts responsibility to them.
08:41And they want the private sector very much at the table.
08:43They want all the things we've been talking about.
08:46So you have ready partners to go with.
08:48But these technologies are hugely important to achieve that ultimate goal.
08:54And we can actually have an AIDS regeneration because of those new technologies,
08:58including the vaccine and including the long-acting injectable products.
09:02So we have success with the lernen.
09:04And we need a жизни again.
09:05Prepared to prevent
09:24as those new new avaient-7.