WASHINGTON – U.S. Senator Bob Menendez (D-N.J.), Chairman of the Senate Foreign Relations Committee, today delivered the following opening statement at this morning’s full Committee hearing entitled “PEPFAR at 20: Achieving and Sustaining Epidemic Control.” Testifying before the Committee were the Honorable John N. Nkengasong Ph.D., U.S. Global AIDS Coordinator, U.S. Special Representative for Global Health Diplomacy; Sir Elton John, Founder of the Elton John AIDS Foundation; and the Honorable Mark Dybul M.D., Professor of Medicine and Chief Strategy Officer, Georgetown University Medical Center for Global Health Practice and Impact.
“When the President’s Emergency Plan for AIDS Relief was established in 2003, for most people around the world, an HIV/AIDS diagnosis was a death sentence. But twenty years later—through the generosity of the American people and one of the most successful foreign assistance programs in history—we have changed the course of human history. We have given millions of people access to lifesaving treatment, and today’s hearing comes at a critical time as we prepare to reauthorize the President’s Emergency Plan for AIDS Relief—or PEPFAR as it is known,” Chairman Menendez said, affirming his intention to work to secure PEPFAR’s reauthorization. “The next five years will determine whether we meet the goal of ending the global HIV/AIDS epidemic by 2030. We must not take our foot off the accelerator if we hope to be successful.”
Find a copy of the Chairman’s remarks as delivered below.
“This hearing of the Senate Foreign Relations Committee will come to order.
To speak about ending the scourge of HIV/AIDS is to speak of a miracle.
When the President’s Emergency Plan for AIDS Relief was established in 2003, for most people around the world, an HIV/AIDS diagnosis was a death sentence. But twenty years later—through the generosity of the American people and one of the most successful foreign assistance programs in history—we have changed the course of human history. We have given millions of people access to lifesaving treatment, and today’s hearing comes at a critical time as we prepare to reauthorize the President’s Emergency Plan for AIDS Relief—or PEPFAR as it is known. The next five years will determine whether we meet the goal of ending the global HIV/AIDS epidemic by 2030. We must not take our foot off the accelerator if we hope to be successful.
So I’d like to thank our witnesses Dr. John Nkengasong, Sir Elton John, and Professor Mark Dybul for appearing before us today. I look forward to your frank assessment of the state of the HIV/AIDS epidemic and your thoughts on what the United States—and our partners in the international community—can do to achieve the goal of ending this epidemic by 2030 because, as you know, major challenges still remain.
It’s not just that COVID-19 slowed access to HIV services. New infections are not declining as fast as we’d like. There are more and more cases among Africa’s surging young populations—with young women and adolescent girls twice as likely to be infected as young men. And children—the most vulnerable population—continue to be at the highest risk. According to UNAIDS, at the end of 2021, 76 percent of adults living with HIV were accessing treatment, compared to only 52 percent of children.
We’re also seeing a disturbing trend towards criminalizing key, high-risk populations, like Uganda’s recently-approved Anti-Homosexuality Act of 2023. These laws drive vulnerable communities underground, keeping them from accessing testing, prevention technologies, and essential medicines, all of which increases the number of infections, and undermines years of investment.
We cannot eradicate this epidemic if we leave communities behind. Nor can we sustain the progress that has already been made unless our partners fulfill their commitments. During the Abuja Summit in 2001, African leaders pledged 15 percent their budgets for health. Today only three countries are honoring that commitment.
Of course, while we cannot achieve our goals without support from heads of state in PEPFAR countries, the United States must continue to show leadership at this crucial time. Our country has not overcome our greatest challenges by taking them on half-heartedly. So when it comes to defeating one of the most devastating epidemics we’ve ever seen, we need to make sure our investments in PEPFAR have the greatest impact possible. That means ensuring that PEPFAR activities strategically strengthen health systems to improve overall health security—including at the community level. It means doubling down on building secure supply chains, on training health workers, on building lab capacity, and on the ability of partner countries to prevent, detect, and respond to infectious diseases—especially those with pandemic potential.
It also means tailoring our investments to reflect partner nations’ priorities. If we do this right, we’ll not only lower costs and improve efficiencies in health systems across the board, we can end the AIDS epidemic as a public health threat by 2030. The gains we’ve already seen speak for themselves: 25 million lives have been saved, 5.5 million babies have been born HIV free in over 50 countries, and more than 20 million people are on antiretroviral treatment. Since 2004, we’ve reduced the number of people being infected with HIV/AIDS across PEPFAR countries by 52 percent.
PEPFAR has achieved far more beyond the disease itself than any of us could have envisioned. We’ve seen declines in mortality, improvements in maternal and child health, more girls and boys staying in school, and more than 2 percent GDP gains in PEPFAR-supported countries. The initiative is a testament to what the Congress and the Executive branch can do when we agree to lead collective action to address global challenges.
Today, as we stand on the brink of an even greater achievement—the end of the epidemic—we cannot, and should not turn back. Success is within our grasp. So, I look forward to hearing from our witnesses about how we cross the finish line. It is the Chair’s intention to get this legislation reauthorized. We look forward to working with the Ranking Member on this.
And with that we turn to the Ranking Member for his opening statement.”
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