MALE SPEAKER 1: Tommy Thompson, the U.S. Secretary of Health and Human Services, spoke to the International AIDS Conference about the Bush administration’s commitment to fight the global AIDS pandemic. As he began, protestors interrupted.
TOMMY THOMPSON: (MS?) generations of families have been ravaged by the tragedy, that indescribable pain, was brought home to me in April, when I led a delegation of our nation’s elected officials, scientists...
MALE SPEAKER 1: Later, the Secretary held a news conference.
TOMMY THOMPSON: In the mother to child transmission is going to be sending antiretroviral drugs in to take care of mothers as well as children. And those countries that don’t have the medical infrastructure yet to handle that, we’re going to give nevirapine to those mothers and to those children. And, hopefully, with our (MS?) proposal, we’ll be able to educate more people and be able to get more medical personnel and more hospitals and clinics from the United States there to build that infrastructure, that medical infrastructure, so we can grow from nevirapine and upscale it to a full regimen of antiretroviral medicine. We want to be able to treat many more thousands and millions of people. That’s our objective. But in order to get there we have to start on a solid ground. The worst thing for us is to put money into programs that will not be replaced. The worst thing would be to put money into programs that fail, and then people will lose the conviction and the intestinal fortitude to put more money into it. I want the funds to be effective; I want the Mother to Child Transmission – that’s why I’m so much involved in this Mother-Child with (MS?) and NIH and CDC, because we know how to make that effective, and we can show the Congressmen and Senators and the activists, and the people in Africa and the Caribbean, that this is a program that works. And once it works, we can build upon that, expand into other countries, be able to treat more women and children, and that is the beauty of what we’re trying to do. We’ve got to be able to get it started in steps so that we can move to a degree of success that we will do something that we can show to the world that this is a successful program, therefore it warrants more money, therefore it needs to be expanded.
We are very ambitious, much more ambitious than anybody ever previously thought possible. Much more ambitious than any other country in the world. Much more ambitious than any previous administration. Why? Because I’m personally committed to it, and so is the President. So is Secretary Colin Powell and Secretary O’Neil. Have you ever seen a cabinet where three cabinet officials have already gone to Africa on the AIDS question, in less than 18 months? Have you ever seen an administration that has committed the resources and new programming on this fight than this current one? That tells the story. People won’t listen; people don’t see all the things we’re doing. And I can’t force them to do that, but I can come here and I can tell you what we’re doing, and it’s the right thing to do. I happen to be passionate about this. This is a charitable fight, and it’s going to require all of us. And I would think that the activists out there, their time would be better spent convincing other health ministers in some of the other countries to start doing just part of what the United States is doing.
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TOMMY THOMPSON: My reaction is, I wanted to give a message here that the United States is passionate, it’s committed to this international fight, that we are right now contributing over 43% of all of the resources on this international fight. That we are the largest contributor to the Global Fund, contributing 25% of all the money. And the second nation, the only nation that is committed to second place. No other nation has done that. We also have initiated a Mother to Child Transmission Initiative, that was started in my department, that is going to treat six million individuals over the course of the next five years, and have the most dramatic impact on being able to prevent the transmission of infection of HIV from mother to child. We hope to be able to accomplish this so that we will be able to reduce the incidence of that infection by 40%.
I understand that people are passionate about this, and I understand that they want to blame the United States. But the United States, under President Bush, in the last 18 months has doubled the amount of resources to the Global Fund, has been able to double the amount of money in the international AIDS fight, and we’re going to continue to do that. And I understand that people want to yell and scream. They would serve their cause much better if they would try and get other countries to contribute to the Global Fund, like the United States does. If they would help other countries see the light to give as much as the United States is. And if they would do things like the United States is doing: trying to train individuals, trying to develop opportunities for clinics and hospitals and medical personnel to train in Africa and help Africans, as well as the Caribbeans, be able to find ways in which they can be educated and get the training necessary to do this. That is what needs to be done, and they can shout, but that doesn’t deter me or the President one bit. We’re here because we have a very positive, strong message, one that far exceeds any contribution by any other country or any other block of countries. And we’re going to continue to do that, in spite of the jeers, in spite of the shouts and the insults. America is committed to this fight for the long haul, and we will continue to increase our resources and our commitment for as long as I am Secretary of Health and Human Services. I am passionate about this, and one of the number one causes that I have started in the department is this Mother to Child. I have to be very strong about that, and we’re going to make sure that this is a very worthwhile, very workable program. And last night I met with 12 health ministers from Africa and the Caribbean. And every one of those individuals told me, to a person, thank you. Thank you for your passion, thank you for setting up this program, and thank the United States and President Bush for going ahead with this.
So when I see that kind of response from the health ministers, and when I visited the African countries in April and found out the tremendous need, I am not going to be deterred by a few individuals who want to be able to shout and scream – and I don’t blame them if they want to do that, that’s their perogative. But I only say that if they would look at our record, see what we’re doing, and see how committed we are, that they could accomplish a lot more by working with us than by shouting me down in the form which it consisted today.
FEMALE SPEAKER 1: (MS?) What do you think is common ground?
TOMMY THOMPSON: The common ground is, I’m going to lay out once again, all the things that the Bush Administration and my department are doing. I’m very positive about it, or I wouldn’t be here. I have a very positive message. And we are committed, in this administration, to make that happen. We are committed. And that’s why I came here. I knew it was going to be rough, but I came here because I wanted everybody in this world to know that the United States under President Bush and under the Department of Health and Human Services are committed to this fight over the long haul. And we’re going to lead that fight, in spite of what a few individual protestors are going to say or do. We are going to lead that fight. We are in there, and we’re rolling up our sleeves, and we will be committing more resources in the future, just as we have in the past, and we will be initiating new programs, such as the Mother to Child Transmission, over the course of the years that I’m secretary of the department. So I’m going to tell the militants this afternoon: Here is my agenda. You can either work with me or you can work against me, but I’m proceeding with or without you. And I would much rather have you with us, and I would much rather have you use your talents and your vocal chords to encourage other countries, the private sector, and the NGOs to contribute money like the United States is. If we’re ever going to get to ten billion dollars, other countries have got to step up besides the United States of America. We are already contributing 25% of the total amount of money in the Global Fund, 43% of the total amount of money for all of the international fight, and the United States doesn’t have 40% or 25% of the GDP. And, therefore, we are committed, but other countries have got to do it; the United States cannot do it alone. If we’re going to win this war – and I intend to be a very valiant partner in this fight – we need the help of NGOs, of the private sector, and of other countries to be with the United States of America, who is leading the way to accomplish that.
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MALE SPEAKER 2: (MS?) exactly how do you plan to treat the mothers with antiretrovirals, all of the mothers (MS?)
DR. PAUL GENTFORD (MS?): Dr. Paul Gentford. This is an answer to Mark’s question, but also, is Anne still here? Anne asked the question, why don’t you clarify. The ultimate the goal of Secretary Thompson and the administration is what everybody is talking about: treatment and prevention. And there’s a lot of confusion about whether the Mother to Child Transmission Initiative is a substitute for that principle. No. Is it going to be pushing aside that principle? No. Is this going to be pushing aside the commitment to the Global Fund? No. Ultimately, you’re going to want to treat comprehensively. The reason that the Mother to Child Transmission program was initiated was as a result of the Secretary’s trip to Africa, when it became very clear when we spoke to the people in the trenches, is that if you can’t get something comprehensive now – and, from an infrastructure standpoint you can’t – what can you do right now? If you had been with us, you would have seen the actual pleading. Given the fact that we are in a state where we might not be able to absorb a comprehensive program, would you at least do the Mother to Child Transmission? So it wasn’t something that we just went back and decided, this is what I’m going to do because I want to do something limited. If you look at the Mother to Child Transmission program that the President (MS?), there are a couple of components that don’t get fully appreciated. One is an infrastructure-building component on it. And in fact, if you look at a bar graph, and you look at in the first couple of years it’s very front-loaded with voluntary counseling and testing and infrastructure building, partnering with NGOs, and twinning. That concern has the (MS?) to the comprehensive treatment programs that Anne asked about and that Mark asked about. But, understandably, that gets kind of lost then, because we all agree that just treating a mother to prevent transmission to the baby really misses something, in principle, that is very important. That principle has not esceped the Secretary. That’s the reason why an important, though necessarily small component, of the program is one that gets bigger and bigger over the years, is that as the infrastructure starts to get into place, that you can then amplify the comprehensive approach.
Another thing I want to make very, very clear, is that it isn’t that anybody’s saying that we have to see a result first before we’re going to be giving money. Because we all know that if you wait for a result it might not be for years, and then a lot of people are going to die. What the Secretary is saying and the President is saying is that we really want there to be a plan, a plan where there is some definable endpoint. You don’t have to give me the endpoint now, but what’s the plan? Which is the reason why, when the President was presented by the Secretary this plan for Mother to Child Transmission, he looked very favorably upon it. And if you go back to the record and look at the announcement in the Rose Garden, the President, right from the first sentence, said “this is not a substitute for a more comprehensive program or for a global trust fund.” And I know a lot of you have asked that question. This is the beginning of something that, by its very nature, can grow and expand into the kind of comprehensive programs that we all think are important for the North and for the South.
FEMALE SPEAKER 2: You’re saying that you’re not going to be looking for results, but you’re also saying, Mr. Secretary, that you need to have a successful program.
DR. PAUL GENTFORD: The successful program is the launching of it. Already we have (MS?) ....who are already on the ground doing it, who are already enthusiastic about working with us on that. So that is a result. The program is going to be up and running. That’s what we’re talking about results. We’re not talking about x number of babies saved. The program is ongoing. And, again, to reemphasize, this is going to serve as the nidus or the matrix for the more comprehensive programs that will be evolving.
FEMALE SPEAKER 3: (MS?)
DR. PAUL GENTFORD: I’ll answer quickly, and then I’ll give it to the Secretary. The answer to your question is that the Secretary was out there, here in Barcelona, knowing there was going to be protests, stood up there, took it, and was willing to continue to talk. We don’t want to let the perfect get in the way of the good. You can’t just, by logistics alone, get everything done. That is not an excuse for pushing things off; that is an explanation for why you have to start with something and build on it. So I think the answer to your question, Anne, is that right here, the Secretary is here, in Barcelona, having protestors storm the stage, and he just kept on saying the message. I think that speaks for itself.
TOMMY THOMPSON: Also, Anne, this here, the program we’re dealing with, the Mother to Child Transmission, is something that is so badly needed. Actually, based on the research that Tony’s done and the wonderful (MS?), we know that it works. And we know that this program is going to have definable, positive results. That’s why we wan to do it. It’s needed. I saw it, I want to do it, Tony wants to do it, and we’re going to have positive results and we’re going to serve the poor people who really need it. And we’re going to redouble our efforts to make sure that this works. And we’re going to continue to expand upon it, and, if it works, into other countries and other regions.
MALE SPEAKER 3: Mr. Secretary, just to clarify (MS?). I’d just like to ask you because I’m a little uncertain. Will this administration [interruption] Is the administration willing to reconsider this as an option for preventing the transmission of HIV among drug users, because as you know it’s spreading rapidly.
TOMMY THOMPSON: You have the expert right here, who has gone through the studies in the previous administration, and ongoing studies. You should really direct that question to (MS?).
MALE SPEAKER 4 [DR. PAUL GENTFORD ?]: You know, I have found the administration to be really quite flexible about considering a number of things. You all know the history of this – and I see people around us who know the history – the history was that during the second term of the Clinton administration, a group of us were – myself, Jeff Copeland, David Satcher (MS?), and a number of other people, Alan Leshener (MS?) who was at that time the Director of the National Institutes of Drug Abuse – were asked to examine all the existing data, to try and answer two questions. A, does needle exchange promote drug use? And B, does the needle exchange help prevent HIV infection? We went over, on a weekend, literally hours and hours and piles and piles, and we came to the conclusion that, from a scientific standpoint, the answer to those questions is that it does prevent the spread of HIV infection and it does not contribute to drug abuse. We made the recommendation to Secretary Shalala at the time, that she embraced, but for a variety of reasons that are very complicated, including, for example, members of the African-American community in Congress and out of Congress who were uncomfortable with that program, because it looked like one was essentially giving up on the predominantly African-American and Latino communities that comprises much of the injection drug users. So the scientific data we gathered and we made a recommendation, I think there was some confusion the other day, is that I was part of the scientific group that said we should definitely consider seriously, if not implement, a needle exchange program. But at the time, when the recommendation was made to the President, because of so many conflicting issues, the ultimate decision was not to implement it. Not to block it – we were allowed, and I can clearly remember the instructions we got from Secretary Shalala, that we were allowed to interact with programs that had needle exchange programs associated with them, but there would not be federal dollars that were directly appropriated and directly assigned to that. So there were a lot of programs that we were involved with that also had issues in which individuals were on programs that were needle exchanges, at the same time that they were doing that. The point that I made when the Secretary asked me, when the question was thrown upon us, was that had not been a major issues under briefing items, was that, in fact, the policy has not changed. I can’t address anything beyond that, but I can just explain what the history is of how that came about.
FEMALE SPEAKER 4: (MS?)
TOMMY THOMPSON: I think we’ve already expanded beyond the 2.5 billion dollars, it would depend on what money you are counting.
FEMALE SPEAKER 4: (MS?)
TOMMY THOMPSON: Well, we just put in an additional 500 million dollars – and I don’t think we were here when I just mentioned – we put in 500 million dollars into Mother and Child Transmission to prevent the spread of HIV virus to children from the breast milk of the mothers. And, under the original (MS?) of the Global Fund, that money is counted. It should be counted. When you add that to the money that we’re giving right now, and you add that to other monies that we’re going to be starting new programs, you more than likely will get to 2.5 billion dollars in that year. I can’t tell you that it’s going to be exact, but I can certainly tell you that we’re spending 16 billion total dollars right now, an additional 2 billion dollars from fiscal year 2002 to fiscal year 2003, and we’ll be putting more money into it next year. So when you count those kinds of dollars, we will meet the objectives of the protesters. It just will not be in the same way that they would like.
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TOMMY THOMPSON: (MS?) our resources to fund the project, but I can’t at this point in time commit the administration to a percentage. But it certainly is a valid assumption that you can make that if the other countries would do their share and come in at 75%, America more than likely will do its share as well.
FEMALE SPEAKER 5: The last secretary that faced a similar demonstration was Secretary Pelleton (MS?). And, at that time, the protesters’ agenda was entirely domestic. One obvious shift that has occurred, among the protesters, is that now they’re advocating – whether they’re from Philadelphia or Paris – on behalf of people who live in Abijan and Johannesburg. How do you – you must get a global view on the part of the activists a global change, not something you’ve experienced before.
TOMMY THOMPSON: That’s very true, and I just think, you know, as you have studied it, Laura, you know how committed this President and I am to this subject and to this fight. I only wish, you know, that the militants, well, would work with us, would see, you know, what we’re doing, and what we’re intent to do, instead of shouting before they even know it. They’re criticizing before they even know what the details are of the program. I’m willing to work with them; in fact, I’d like to work with them, and I would like to have them turn their anger and their efforts toward getting other countries to contribute. The United States cannot do it alone. We just don’t have the resources to do it. But we will certainly do the leadership role, which we have all along. In the last 18 months, this administration has gone light years ahead of where it was before, and I think it shows the commitment. I think that’s about all, isn’t it? Thank you all.