tv US Senate CSPAN November 29, 2016 2:15pm-8:01pm EST
own, a member of the senate, to be the nation's top lawr enforcement officer. our friend the junior senator from alabama, senator sessions from is undoubtedly qualified and prepared for this role as attorney general. because of a long career he spent protecting and defending our constitution and the rule of law. speared john cornyn yesterday. we will leave this at this point as the senate has traveled and for more legislative work. h commentary on the senate floor? the presiding officer: we're in morning business with 10-minute grants. mr. nelson: may i be recognized? the presiding officer: the senator from florida is recognized. mr. nelson: mr. president, i want to talk about something that we all hear about and generally support, but the national institute of health needs help. the national institutes of health need help.
it was founded in 1887. its work and investment and the work of others have led to countless discoveries, including alzheimer's disease, cancer, and so many other chronic illnesses. i visited this 300-acre campus in bethesda, and it is jam pammed -- jam-packed with these buildings that are teaming with scientists and physicians, and yet that's just the tip of the iceberg because the research is really being done all over the country, all over, indeed, the world by the medical research grants that are given by n.i.h. this funded research has led to
many discoveries and treatments which not only are allowing us to live healthier lives but also contribute to our knowledge and understanding of how diseases and the human body work. so take, for example, the brain initiative. n.i.h. seeks to unravel the mysteries of the vastly complex human brain, which would allow us to understand an array of conditions affecting the brain. when i visited yesterday, met with dr. francis collins, the head of n.i.h. and a plethora of his brilliant scientists that are working on newer row degenerative -- neur neurodegenerative diseases, diseases such as concussions, diseases such as a.l.s. diseases such as parkinson's,
and all the many, many complicated things that come from this complicated o organ called the brain. well, they're on the verge of some real breakthroughs, but that comes at a cost. dr. collins stressed the need for consistent, robust funding for n.i.h. in 2003 when we had passed the stimulus bill, n.i.h. -- a correction on the stimulus bill. in 2003, n.i.h. peeked and then it has since failed to keep up with inflation. then in 2009 we came along with a stimulus bill, and that
increased n.i.h. for only the two years of the stimulus bill approximately $4 billion or $5 billion a year over its base funding of $24 billion to $25 billion a year. i'll never forget dr. collins had shared with us after the effect of that second year of the stimulus bill that he had to cease 700 medical research grants sent out to the medical schools and research institutions all across the country. because he simply did not have the money that they had planned for and thus the call for consistent and robust funding. dr. collins mentioned that the agency's biggest concern was a
loss of young researchers as the next generation of researchers are facing increasingly being denied research grants, they're leaving the research field. i don't think that's what this nation wants. we need to ensure that n.i.h. maintains a strong pipeline of researchers so that the critical work towards scientific discovery can continue. this is not a partisan issue. health, disease research is a bipartisan issue and so we need to come together to support this consistent and robust funding. even now n.i.h. is engaged in developing a prevention tool
against what was the dominant conversation last summer, the zika virus. they're going into their first trials on a vaccine. zika has affected more than a thousand people in my state of florida alone, and more than 30,000 people in puerto rico. we need a vaccine. but the process of f.d.a. trials takes time. now, just to show you it's not confined to puerto rico and florida, just yesterday the state of texas reported the first case of locally transmitted zika virus now making it the second state to officially have local transmission after the state of florida. the head of the centers for disease control and prevention,
dr. frieden said that zika can become endemic within our united states border making it more important now than ever to have a zika vaccine. that's just one other little example of what has been going on at n.i.h. we're just about to consider a cures bill. it has some more robust funding. it was the whole impetus for the cures bill was n.i.h. funding. a lot of other things have been attached. there is some controversy. but it would begin to authorize funding that would be stable over a ten-year period. i think in we are going to do what the united states is looked
to as the leader of medical research around the world, we're going to have to provide for the funds for this great institution, and then just within our lifetimes all of which we have already seen major breakthroughs, we're going to see some incredible ones accomplished. you've heard of the moonshot for cancer research. look at the existing victories that have been had in cancer research already. now we're just on the cusp. what about diseases that we don't know the cure, such as a.l.s., am trovic lateral scher row sis. i'm making this speech for my friend evan in jacksonville.
he's afflicted with this disease that debilitates the body's motor nerves. there's something that happens in the brain that does not send the signals all the way through the neurons, all the way through the neurological system to the motor nerves. we saw that first identified in a famous baseball player, lou glare rick. 20,000 to 30,000 people in the country are afflicted with this disease. we still don't know the reason for it nor the cure, but yesterday i talked to three different physician scientists who have very promising leads of identifying a gene that has a direct connection to what happens in the brain on als and
then a determination could we go in and clear out that gene so that our progeny would not have this concern. we've seen what happened in alzheimer's. did you see the 60 minutes -- "60 minutes" segment last sunday in which there's this incredible space in colombia within a hundred miles diameter where so many families get the onset of alzheimer's during their 40's which is quite unusual. now they have identified in the brain a protein that if you now know the gene that causes that protein you could go ahead and
alert the people, even though the effects of alzheimer's have not come on. you could start a therapy that would work against that protein in the brain. this is what we are right on the cusp of, these kind of exciting discoveries that can help us to live healthier, longer lives. i implore my colleagues in the senate not to short sheet the n.i.h. and the funding that is so desperately needed. mr. president, i yield the floor.
a senator: mr. president? the presiding officer: the senator from california. mrs. boxer: thank you very much. mr. president, i rise today to discuss legislation i introduced to eliminate the electoral college and ensure that the candidate who wins the most votes will be elected president. now, clearly this has nothing to do with this past election. there are recounts going on. we'll see where that goes. but the bottom line is, this looks to the future. and i want to say something. the presidency is the only office in america where the candidate who wins the most votes can still lose the election. there isn't any elected office in the nation, be it county level, city level, state level, national level, where this is true. a person gets more votes, one
person one vote, majority wins. not true in the presidential. you know, i realized how little sense this made many years ago, but when i tried to explain it to my grandkids after this election, they said grandma, who won? well, i told them donald trump. well, wait a minute, didn't mrs. clinton get more votes? yes. you know, what if we did that in sport? i'm a big basketball fan, major basketball fan. what if the team that got the most votes -- most votes -- the most points didn't win. what if that happened? what would people think? well, why not? well, because not everybody on the team touched the ball. so, therefore, even though they won by 40 points, they don't win. this doesn't make sense. this is an outdated system that
does not reflect dem moc -- democracy and it violates the principle of one person, one vote. every single american regardless of what state they live in should be guaranteed that their individual vote matters. now, throughout our great history, and we've had now this is the 45th presidential president, we've had five elections where the winner of the general election did not win the popular vote. but in our lifetime it has happened twice, two in the last 16 years and so it really needs to be addressed. this is more than an anomaly now. it looks like it could happen one way or the other. we don't know if a republican gets seated or a democrat gets seated. right now hillary clinton's lead in the popular vote is 2.3
million votes. it is expected that she'll win probably by more than 2.7 million votes. now, that would be more than the votes cast in alaska, delaware, washington, d.c., hawaii, vermont and dakotas combined. we're not talking about a few votes. we're talking about 2.7 million votes. more votes cast, more than the votes cast in alaska, delaware, washington, d.c., hawaii, vermont and the dakotas combined. and clinton will have won the popular vote by a wider margin than not only al gore in 2000 but also richard nixon in 1968 and john kennedy in 1960. now, donald trump himself said in 2012, and i quote exactly -- "the electoral college is a disaster for democracy."
unquote. i couldn't agree more, and i don't agree with too much of what donald trump says, but i sure agree with that. he said the electoral college is a disaster for a democracy. then right after the election, he said his views did not change. he still says, you know, i'm not going to change my mind just because i won. i'd rather see it where you went with simple votes. these are all quotes of his. you know you get 100 million votes and somebody else gets 90 million votes and you win. now, after he said that, i think his advisors went a little nuts because the next morning he tweeted -- "the electoral college system was actually genius." but then he also tweeted this, which is very interesting. "if the election were based on the total popular vote, i would have campaigned in new york, florida, california and won even bigger and more easily." okay. maybe it's true.
maybe it's true. his point is well taken. presidents -- presidential candidates should campaign in every single state. actually, if you got rid of the electoral college, candidates would campaign in every state because the vote of every american matters regardless of where they live because if you get all the popular vote in one state, you will add to your popular vote at the end. now, according to -- quote -- nationalpopularvote.com, 94% of campaigning by the presidential candidates in 2016 took place in 12 states. 12 states. that was it. and two-thirds of these general election campaign events took place in six states, just six states. now, scott walker of wisconsin
said in 2015 -- quote -- "the nation as a whole is not going to elect the next president. 12 states are." 12 states are. just think about that. the nation as a whole is not going to elect the next president. he was right when he said that in 2015. he was right. so, so what message does this send to the people who live in the populous states like my state, 39 million americans live there? what does it send as a message to the 27 million americans who live in texas? what message does it send to the smaller states like north dakota, rhode island, where the candidates don't even bother to campaign for the votes because they're either blue or red? they're not purple, so they don't matter. no wonder voter turnout was just 58% in this election. too many americans don't believe their vote matters because they're told oh, you live in a
red state. it's going for trump. even if you're for trump, just stay home. it's ridiculous. maybe that person really, you know, wanted to vote, but they're convinced if they live in, say, a bright red state like alabama, i don't have to vote because it's going for trump. and if they're for hillary clinton and they live in a reliably blue state, well, you know what, i'm not interested. why should i bother? my state's blue. what's the difference? so you get a 58% voter turnout. it's ridiculous altogether. you know, political science experts agree that too many americans feel their vote doesn't count. it just doesn't count. listen to doug mcadam, professor of sociology at stanford university who asked --
quote -- what about all those citizens who reside in noncompetitive states? he makes my point. consider the loyal republican who lives in california. he's told what's the difference? hillary's going to win by so much. don't worry about it. but if we were using the popular vote, believe me, every republican in california would get out and every democrat would get out and every independent would get out because their vote would count. every four years, a lot of people in different states feel that their vote doesn't matter. they feel powerless. when it comes to the presidential race. the only race in the country where the winner doesn't win, maybe. the winner doesn't win. it's crazy. i looked all over to find out another example where this is true. it's not true. northeastern university, william
crottie, professor of emeritus science said -- quote -- the electoral science has never worked well. the fact is it's a terrible system. it has no place in an age where democracy is ascendant. it has little to do with democracy. well, everybody knows i didn't run for the senate. i have a fabulous replacement coming. but i did drop this bill on the electoral college to do away with it because i'm still a senator, i'm here, and i will be darned if i'm going to let this thing pass. listen to a professor of law at fordham university, john furyk. quote -- "not only have reasons for the electoral college long since vanished, but the institution has not fulfilled the design of the framers. today it represents little more than archaic and undemocratic counting device. there is no reason for retaining such a formula for electing the
president of the united states. well, i also saw a poll that shows 62% of the people in this country, regardless of party, think we should do away with it and go to a system where the winner wins. how unique. the winner wins. and the loser loses. that's the way it should be in the greatest democracy in the country. try explaining this to your kids and grandkids. i'm telling you, if they are about 11 or 12. explain what happens. i know changing the system won't be easy. i have been around a long time. i've spent more than half of my life in politics and elected life. so we understand that the legislation would need to be enacted by congress and would only take effect after being ratified by 3/4 of the states within seven years after its
passage. this is very difficult. this is a constitutional amendment. so i am not naive, and i understand what we are talking about, but there is another way to address this. it's called the national popular vote plan, which would guarantee that the presidential candidate who wins the most votes would win the election and be the president, whether it's donald trump getting the most votes or hillary clinton getting the most votes, et cetera. all it required is for enough states to act. it's an interstate compact where the states would agree to award their electoral votes to the presidential candidate who wins the popular vote, so that if in california where we have a number of electoral votes, if donald trump wins, they go to donald trump, regardless of how our state voted. in other words, the votes are counted, and then the states give their electoral votes to
the winner of the popular vote. pretty simple. so you still have the electoral college, but the result is the votes are given to the person who wins the national popular vote. the agreement takes effect only when the participating states together hold a majority of electoral votes. that is, 270 out of 538. now, so far the national popular vote bill has been enacted into law by ten states and the district of columbia, adding up to 165 electoral votes, and the legislation has been introduced in every state of the country, and it has support on both sides of the aisle because electing a person who wins is the democratic way. trump supporter newt gingrich wrote a letter in 2014 endorsing
the idea. he wrote -- quote -- "no one should become president of the united states without speaking to the needs and hopes of americans in all 50 states. america would be better served with a presidential election process that treated citizens across the country equally." and former republican congressman bob barr said -- quote -- "only when the election process is given back to all of the people of all the states will we be able to choose a president based on what's best for all 50 states and not just a select few." now, i want to make a point here. i don't agree with newt gingrich on pretty much anything except this. this is rare. i mean, newt gingrich said medicare should wither on the vine. he called democrats traitors. i mean, believe me, i served with him, i know. and his ethical standards don't meet what i think the standards
should be. but set it aside. here we are on the same side. no one should become president of the united states without speaking to the needs and hopes of americans in all 50 states. america would be better served with a presidential election process that treats citizens across the country equally. so i urge my colleagues to take a close look at the legislation i've introduced, and i urge state legislators and governors around the country to take a close look at the national popular vote bill. again, i'm going to be honest with you. it is really hard to pass a constitutional amendment. i'm not naive about it. but to pass a law in various states isn't that hard. that should be done. and the american people can help. i would ask them to call their senators and members of congress about our bill. there's world cup in the house by charlie rangel, to do away with the electoral college. very simple, and just let the
popular vote stand. ask them to sign onto this bill. but don't stop there. write and call your representatives in the state house and push for your state to sign onto the interstate compact. you know, a lot of people came up to me after this election and said, you know, i don't feel my voice is heard, period, and this is one of the reasons. well, make your voice heard on either getting rid of the electoral college or the state compact where a state would give its votes to the winner of the national popular vote. voting's the cornerstone of democracy. we've had many women through the decades die for that right to vote. generations of americans of every gender, race, religion and ideology have marched and struggled and died to secure this fundamental freedom, and yet we have a system where the winner can lose, where the winner can lose. we owe it to the american people
who have given so much for the right to vote to make sure that every vote matters and every vote counts. we owe it to them to ensure that the vote of the citizen in my state is worth the same as a vote of someone in a swing state. we owe it to every republican voter and every democratic voter and every independent voter, every green party voter. whatever the party, to have that vote count. to have that vote count. one person, one vote. that's the cornerstone of democracy. so by making this critical change where the winner of the popular vote wins and every citizen's vote counts regardless of who they are, where they live, whether they are republican, democrat or green or
whatever the party they choose. we will then be engaging voters in every single state. we will lift voter turn scrowt. we will ensure that every presidential candidate speaks to the needs of americans in every state and every region. we will ensure equal representation for all. you know, sometimes i come down here and i talk about issues that are very controversial. i must tell you. i must tell you if you ask anyone on the street do you think the winner of the popular vote should win the presidency, i say a very strong majority would say of course. and if you say to them do you know of any office in the land, whether it's governor, mayor, supervisor, city council, sewer board, sanitation district, you name it where the winner doesn't
win, they'll say no, i can't think of any. you know what? there are none. so why not do the simple thing and the right thing and the just thing and make sure that the winner of the popular vote is sworn in as our president. and i think this will be a huge boon for every single vote near this greatest of all countries. with that i would yield the floor. a senator: mr. president? the presiding officer: the senator from maryland. mr. cardin: thank you, mr. president. i notice the majority leader has given us all notice that he intends to bring up the iran sanctions act after consultation with the democratic leader, h.r. 6297. i point out this legislation passed the house of representatives by a vote of 419-1. its legislation that would
extend the iran sanctions act that was passed by this congress that is set to expire at the end of this year. let me repeat that. the iran sanctions act that was enacted originally in 1996, if no action is taken before the end of december, that sanction -- authorization legislation would expire. so, mr. president, this is our last opportunity to extend the iran sanctions act before it is scheduled to expire at the end of december. it was passed in 1996 by a unanimous vote of this body. its goal is to deny iran the ability to be able to have financial support for its nuclear proliferation. congress had passed several bills that provided sanction opportunities by the administration to impose sanctions in order to get iran to change its behavior, its
illegal activities in pursuing a nuclear weapon which was against the united states security interest, destieblizing for the entire region, threatened israel, threatened the neighbors states and i think it was the unanimous view of our body that we take whatever steps were possible to prevent iran from becoming a nuclear weapon power. the legislation we passed, including the iran sanctions act, allowed the obama administration to move forward with sanctions against iran and they rigorously enforced the sanctions they imposed. i want to acknowledge the work done by the obama administration in enforcing those sanctions that we gave our authorization to impose. but the obama administration went further than that. they then garnered international support to also impose and support the sanctions that we had imposed in the united states which was strong enough to get iran to recognize that they had
to come to the negotiating table. the sanctions clearly were the motivating factor that allowed for the negotiations of the nuclear agreement that was greed to two years ago. so this legislation is pretty simple. it extends for ten years the iran sanctions act that was used by the administration and in which we have a temporary -- we have relief granted under that law as long as iran is in compliance with the nuclear agreement. the nuclear agreement, jcpoa, specifically provides for snapback of sanctions in the event iran violates the provisions of the agreement. in order to have snapbacks, you have to have the sanctions regime in place. therefore, it's incumbent upon us to extend the sanctions authorization. this does not impose any new
sanctions on iran. it just allows us to have the effective enforcement to make sure iran complies with their testimony. mr. president, i just want to underscore that point. during the senate foreign relations committee hearing, i had a chance to ask the administration's witness secretary lew that specific question. i asked him the iran sanctions act expires at the end of 2016. this question was asked july 23, 2015. and i said to the witness, the iran sanctions act expires at the end of 2016. will we still be -- we will still be in the jcpoa a period of time where snapback of sanctions is a viable hedge against iran's cheating. congress may well want to extend that law so that power is available immediately if iran were to violate the agreement. is that permitted under the j jcpoa?
the answer from secretary lew, i think if it is on expiration, it's one thing. if it's well in advance, it's another. i think the idea of coming out of the box right now is very different from what you would do when it expires. well, we're doing exactly what the administration asked us to do. we've held off for over -- now it's been over 15 months, 16 months we've held off before we've taken action to extend the iran sanctions act. if we don't take action now, the authority given by congress in the 1996 act which would be part of the snapbacks if needed would not be available. so it is timely for us to act and it's totally consistent with the jcpoa and is not at all inconsistent with our responsibilities under that legislation. mr. president, i think that we should have a little bit of discussion as to what we do moving forward. i should point out that the iran sanctions act, h.r. 6297 is identical to legislation i file
with 19 of my colleagues earlier this year, s. 3281. so i think this enjoys strong bipartisan support and i would urge my colleagues to support it. now, looking forward, i cannot support the jcpoa. i do not support that agreement for various reasons. but it went into effect. i must tell my colleagues i think it would be tragic if the united states unilaterally walked away from the iran nuclear agreement. what that would do is give the ability of iran to pursue a nuclear weapons program without inspectors on the ground to let us know what they are doing. they would be able to pursue that knowing full well that the international community would not be unified in regards to sanctions against iran. yes, we would impose sanctions, but our allies around the world
would no longer be obligated to follow that since it was the united states pulling out of the agreement. many of these countries already have arrangements and it would be very difficult to see that they would follow the u.s. leadership. in fact, one of the, i think, adverse impacts of the united states walking away from the iran agreement would be that we would lose our standing as an international leader bringing the international community together to isolate iran. instead we would be isolating the united states. that's not in our national security interest. so what should we do? well, as i said earlier, first step let's pass h.r. 6297 so that we have all the tools in place. secondly, let us all join together to rigorously enforce the iran agreement, the jcpoa. we need to do that. we need to make sure that every part of that agreement is adhered to, including making sure iran never becomes a nuclear weapons state. we need to continue the use of
sanctions on iran's nonnuclear nefarious activities. they are still a sponsor of terrorism. we all know that. i was recently in the middle east. i had a chance to talk to a lot of our strategic partners. they tell me about ie rang's activity -- iran's activities in their region, how they're supporting efforts to destabilize other sovereign states in the middle east. they are supporting terrorism. we also know that they have expanded their ballistic missile program. that's in contravention to their international obligations. we can impose sanctions, continue and strengthen sanctions against iran in regards to those activities. they are violating the human rights of the citizens of their own country. we can take actions there. so there are areas where we can continue to work with the international community to deal with iran's nefarious activities, and we should do that. i just would call to my
colleagues' attention that several -- well, actually in october of 2015 i introduced s. 2119 along with several of my colleagues so that we would be in a better position, that congress would be in a better position to carry out the rigorous enforcement of the jcpoa and to take on iran working with our partners in regards to their other activities. it provides more information to the congress on how the sanction relief resources are being used by iran so that we can track the money. if they use it to supporter rich against the united states or they use it against our interests, we would be able to know about that and take action. it provides for expedited considerations. if iran commits these types of violations. and it makes it very clear that we will continue to work on a regional security strategy so that our partners in the region know that the united states will
continue to be on their side against the aggression that we've seen from the iran regime. to me that is the responsible action for us to take in order to carry out what should be u.s. leadership in isolating iran, getting it to change its behavior, recognizing that it's been a major problem for the security of the united states and the region, and we must continue to be actively engaged. with that, mr. president, i would suggest the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
mr. alexander: mr. president? the presiding officer: the senator tennessee. mr. alexander: i ask unanimous consent to vitiate the quorum call. fer sphe withou-- the presiding officer: without objection. mr. alexander: i ask consent to speak for as much time as i may require. officer without objection. mr. alexander: thank you, mr. president. mr. president, tomorrow the united states house of representatives will vote on a piece of legislation that many in this body on both sides of the aisle have worked on and that the majority leader of the senate has described as the single most important piece of legislation that will pass this year. we call it 21st century cures. and it will be amended to add three mental health reform acts, the most significant reforms in mental health programs in ten
years. i ask consent to place into the record following my remarks the organizations supporting the 21st century cures legislation, more than 200 different organizations from all across the country. the presiding officer: without objection. mr. alexander: now, why would -- why would the majority leader say that it's the most important legislation the senate might act on, because we do a lot of important stuff around here, whether it's defense authorization, whether it's cybersecurity, whether it's the bill to fix no child left behind that we passed in a bipartisan way last december. i think it's because that this legislation will affect virtually every american family because we're entering the most exciting period of medical research in our country. that's the first part of it. and the second part, the part that has to do with mental health, affects so many families
because we know that about one out of every five adult americans suffers from some form of mental illness. and this concentrates the large amount of money we actually spend on mental health every year from the federal government and spends it in a more effective way to actually help people. now, in the next few minutes what i would like to do is to acquaint the senate again with how we've gone about this and remind senators of how many of you, how many of us have had a hand in this legislation, because it's a really remarkable two years of work. it's involved many, many, many hearings, dozens of meetings, and then has been done in a large committee of 22 senators of very different points of view in a largely bipartisan way.
so let me begin to summarize. the first thing i would mention, the legislation includes $6.3 million of funding. $1 billion of it is for state opioids grants. now, whether it's senator whitehouse of rhode island or whether it's senator ayotte and senator portman, probably most senators in this body have seen on the front pages of their newspapers -- i know that's true in tennessee -- the tragedies of opioid abuse. this bill helps that in two ways. the most immediate way is it provides state grants, federal dollars to go to states over the next two years to help states fight opioid abuse. the other way that it helps when we get to the part of 21st
century cures is that dr. frances collins, who is the head of the national institutes of health, dr. collins calls it "the national institutes of hope," says that one of the groundbreaking discoveries that we expect to happen in this country in the next ten years is a nonaddictive pain medicine. the problem with opioids is it's addictive. now, people need it, if you have a back surgery or if you have terrible pain. opioids can help people. we know that. but it's addictive, and it's causing normal problems. what if we had nonaddictive pain medicine? so that bill helps that in two ways. there's other funding in this legislation. $4.8 billion for the national institutes of health. now let's see -- let me see what's next. the first -- $4.8 million. this is for biomedical research. the first $1.8 million is for
cancer moonshot. this is vice president biden's initiative. he is motivated for many reasons by it. his son died of cancer. many of us have family members or friends with cancer. there are startling discoveries going on in cancer today, and this is $1.8 billion in support of vice president's cancer moonshot. then there's $1.4 billion in precision medicine. this is one of president obama's most important initiatives. i know that he has said very realistically that hes it to -- that he expects it to happen any way. this helps move it along. if the senator and i each have a disease, the medicine we might get for that disease should be different. if we know the genetic difference between the two of us, the doctor can prescribe it. that's called precision
medicine. then there is a $1.6 billion for the brain initiative. this includes groundbreaking research in alzheimer's, for example. i'vi have talked to one -- i've talked to one drug manufacturer who's spent more than $1 billion -- several more than $1 billion -- trying to develop a medicine that will help identify the symptoms of alzheimer's -- to identify alzheimer's before it shows symptoms and then another medicine that will retard the progression of alzheimer's. now, imagine what could happen in our country if the tens of millions of americans who are going to suffer from alzheimer's, if we can find that out before they actually have the symptoms and then we can slow down the projetion of -- the progression of alzheimer's. think of the suffering that that would help avoid. think of the billions of dollars it would save. this is for that kind of research. dr. collins says that during
this next ten years, he expects us to have on the market medicines that identify alzheimer's before we know the symptoms -- see the symptoms and medicines that will stop the progression of alzheimer's. now, it also includes $500 million for the food and drug administration to help pay for the extra -- extra work that we're giving the f.d.a. now, one senator was on the floor talking about this bill and suggested that this isn't enough money. let's take this down just a minute. let's talk about money just a minute. the united states spends more on research and development, biomedical research and development than europe, japan, and china put together, almost as much as those three countries
put together. there is been an credit need for -- an increased need for funding for the things i just mentioned. imu the way we do things here +s we have authorization bill, which this is, where we decide what our policies and our programs are going to be. and some of us are on those committees, like the committee i chair and senator murray of washington is the ranking democrat, the health committee. then we have appropriations committees that decide how much we can afford to spend on that. we do that separately. last year this congress, it was a republican congress, i would point out -- republican majority, but senator blunt, who is chairman of the appropriations committee for the senate, would quickly give senator murray, who is the ranking democrat, full credit, added $2 billion to the national institutes of health budget for one year. that means $20 billion new dollars over ten years. this year the same republican
congress, with the cooperation of the democratic members, added another $2 billion to the national institutes of health budget. that's another $20 billion over ten years. and the cures legislation that i've just described is another $5 billion. so that's $20 billion, $20 billion, and 5 billion. add that up to $45 billion new dollars approved. now, the first $20 billion is law. the second $20 billion has just been approved i the appropriations -- approved by the appropriations committee. hopefully that'll be approved. and the second $5 billion comes here. now that's money -- that's real money. and it's unusual to find an appropriations bill stuck on an authorization bill. but we've done it this time. this is an unusual tunes. we've done in a way that speaker ryan in the house of representatives believes is fiscally responsible.
that means it doesn't add any new mandatory spending. that kind of spending has got the budget going through the roof, so it doesn't do that. it means that it's paid for. that means we've reduced other spending to pay for it. so when you look at the entire budget, it doesn't add a penny to the entire budget. we call it the discretionary plus the mandatory part -- because it's paid for by reducing other spending. so we've set priorities. we've done our job, and the aeption pros committee has done -- and the appropriations committee has done its job in consecutive years approving $20 million more o.e.f. over ten years -- over ten years for the n.i.h. and we'll add another $5 billion for the national institutes of health. now let's talk about the bipartisan nature of this bill. i'm going to go through this fairly quukly, but for -- quickly, but for those watching, i think it is important for you to see this, because sometimes
when bills are popular -- and i think this one will be popular -- everyone says, well, that's easy. that didn't take a lot of work. tomorrow the house of representatives will vote on the 21st century cures bill. it will add the mental health bill that i will describe in a minute by amendment. i think it will be by extension, which means i expect a big vote over there. i expect the big vote over here. i don't think there are senators who want to vote against opioid funding in their states. i don't think there will be a lot of senators who want to vote "no" on more known fight cancer and to help the vice president with the cancer moonshot. i suspect there will be a lot of senators who will want to vote "yes" to help the president advance his precision medicine legacy. i imagine we'll get a big vote here when it comes up next
monday and tuesday after the house passes it tomorrow. there was plenty of controversy and conflict as we put this bill together but virtually everything weighs did was bipartisan. the money i just described is certainly bipartisan. the president's initiative, the vice president's initiative -- those are -- the opioids initiative, that's bipartisan. but look at the bills we're talking about. here is one called the advanced targeted therapies. it allows researchers to use their own data from previously approved therapies to help find a faster treatment for serious genetic diseases. senator bennet, democrat, senator warren, democrat, senator burr, republican, senator hatch, republican -- and it passed by a voice vote. that means unanimous. in fact, mr. president, i'm going to go through very quickly 19 different bills that are the core of the 21st century cure legislation. they came out of our committee, which has 22 members, and the largest number of recorded votes
against any one of those 19 amendments was two because every single one of these amendments had a democratic sponsor and a republican sponsor, except for one, and that was senator murray's bill, and she is the ranking democrat on our committee. so don't let anyone suggest to you that a bill that has $6.3 billion of appropriations that include democratic priorities and bipartisan priorities and the core of it is 19 bills of f.d.a. reform that tha has a democratic sponsor for every single bill and that was approved by a 22-member committee and only had two recorded votes against -- was the most that was against it. don't let anybody say tower that this is not a -- don't let anybody say to you that this is not a bipartisan bill. anyone who says that simply
hasn't spent the time to be involved in the process. so let's go to the next one. now, burr and franken, l. -- republican and democrat -- f.d.a. device accountability. it will bring innovative devices like artificial knees and insulin pumps to patients more quickly by et getting rid of unnecessary regulations. one of the major things we need to do -- and we do it in this bill -- is to bring cures and discoveries through the regulatory process more quickly and at less cost. all of us are concerned about the high price of medicine, the high cost of drugs. one reason is because it takes $1 billion and 13 or 15 years to bring it through the process. we'd like to short thafnl that. it is safe. the next one srt next generation researchers act. it improves opportunities for our young researchers passed by
voice vote. that means there was no objection. the next one is called the enhancing rehabilitation research at the national institutes of health. kirk -- republican. bennett democrat. hatch republican. murkowski republican. republicans isakson and collins passed by voice vote. neurological research. here we have isakson and murphy. the next has to do with the super bugs and protecting patients. you know about these. the bugs, the diseases you get. and you take a medicine for the disease and the medicine doesn't work because the bugs are super bugs, and they will clarify that the f.d.a. requires cleaning and validation data for reusable medical devices. in other words, this will make it less likely that that will be a problem. that's senator murray's bill.
improving health i.t. this is electronic health care records. the government has spent a huge amount of money on that, maybe $30 billion including hospitals and doctors to do it, to adopt electronic medical records. it's very important to precision medicine, personalized medicine because if you can't use this data the doctor isn't going to prescribe something for the senator from ohio that is different from the senator from tennessee. we found the electronic system was a mess. the obama administration can do some things to fix it and we can do some things to fix it. i say to secretary burwell in the obama administration, i thank her for the efforts they have made to do what they can do and andy slavin. senator murray was involved, senator cassidy, white house, hatch and bennett, a bipartisan effort to reduce the system to
make it more interoperable and get this system moving again. advancing break through medical devices. this is one of the great successes we've had in legislation, has been a few years ago. senator bennet and senator burr, among others, introduced a bill and made it law that brought breakthrough medicines through the food and drug administration more rapidly. more than 100 have been approved in about four or five years. so we're applying that same breakthrough strategy to medical devices. and of course we have bipartisan support for that. there's advancing hope act. if you're a parent of a child with a rare disease like brain cancer, this increases the opportunity that the drug will help. medical electronic data technology, there we had senator bennet democrat, senator hatch republican. medical count measures invaiftion act. this is very important.
senators burr and casey have been real leaders in dealing with medical countermeasures. this is in case there's a bioterror attack. anthrax, some kind of problem like that, are we ready to deal with that? this helps to do that. just a few more, and some will say why are you going on so long? because i would like for people to know when it happens that this senate is capable of taking a great big complex subject and democrats and republicans are capable of working together to produce the result that deserves a big vote. a combination of products and innovation act, this helps to bring to the market combination products of medical devices and medicines at the same time. then there is a bill by wicker, bennet, collins, franken on patient focused impact assessment. there is one on, to modernize the f.d.a. workforce.
dr. caleb told us his biggest problem at the f.d.a. is that he can't hire all the people he needs to deal with all the exciting things going on. this gives him new authority to do that. everybody thinks that would be an important thing to do. it was approved by voice vote. and then advancing precision medicine. this is legislation that i introduced and supported the president's precision medicine initiative that i've talked about before. and then there's other legislation that went through. but the point of all this is 19 different bills are the core of this twenty first century act. there are only the most number of recorded votes against these bill was two -- was two. and every single one was sponsored by a democrat as well as a republican except for one which was senator murray's bill. and she's the ranking democrat on the committee. now in conclusion, we're fortunate to be able to add to
the bill the mental health act. actually it's three mental health acts, and together they make up the most significant reform of mental health programs that we've had in more than a decade. i want to give particular credit to senator murphy -- democrat -- and to senator cassidy, a republican, for working together through some real land mines to get this to a place where it could pass the house almost unanimously and where it will be a part of the bill that we'll vote on next year. i want to thank the majority whip, senator cornyn, who also added an important judicial part to this legislation and helped us navigate some difficult things. in other words, these senators show that they know how to legislature. -- how to legislate. they could have stood up and made a speech or insisted on doing things their way but they said look for an area where we
agree on 70% or 80% of the policy and let's agree with that. so, mr. president, this is one of those bills, look at the number of republicans and democrats who have passed that. then here's the second, i guess, mental health bill that we're talking about, and you can see the number of senators. so i've taken some time to go through the legislation that will be coming to the senate early next week that will be voted on tomorrow in the house of representatives. i do think it represents likely, as the majority leader has suggested, the most important piece of legislation that we could act on this year. because it affects virtually every american family, forbes magazine reported that 78% of the american people favor the congress taking action on medical innovation because they have had heard people like dr. francis collins, the head of the national institutes of health, talk about within the
next ten years a zika vaccine, an hiv-aids vaccine, a medicine to identify alzheimer's before its symptoms and to retard its progression, an artificial pancreas for those with diabetes, a nonaddictive type of pain medicine. these are magnificent opportunities for us. we have strong leadership in the national institutes of health. and so we've put our money where our mouth is. it is true that we'll have to approve it every year. and it is true that we had to reduce other spending in order to have this spending, but that's the way we're supposed to do things. what we have done is take a bipartisan core of bills, worked hard for two years in a bipartisan way and produced a result that had very few no votes on the way and it includes democratic priorities as well as
republican priorities. it has the avid interest of the democratic president of the united states, the democratic vice president of the united states. it's a part of the agenda forward in the health care for the republican speaker of the house and the republican majority leader in the senate says it's the most important bill we're going to act on. i would think that would get a big vote tomorrow in the house and i would think it deserves a big vote in the united states senate next week. it has been might have privilege to work with senator murray and the other members of the health, education and labor committee to produce the bill. i thank the president, and i yield the floor. i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
mr. cornyn: mr. president, earlier this year, the republican leadership made a somewhat controversial decision, but when you think about it, it shouldn't have been all that controversial. it was to allow the american people by their selection for the next president of the united states to express their views about who ought to nominate to the vacancy left by the untimely death of justice antonin scalia. this is not an easy decision. but the fact remains that the supreme court considers and rules on some of the most pressing, challenging questions of our time. it does some really important things like interprets the constitution. they are the final word. and it guarantees the liberty -- it guarantees liberty by separation of powers, enforcing the bill of rights and the like. so it's no exaggeration to say that the supreme court affects the lives of every man, woman
and child in our country. and it's a truism that obviously who occupies those seats can have a very clear impact on the future direction, not only of the court but on our country, too. so we have to consider lifetime appointments carefully. as justice scalia liked to say during his lifetime, why in the world should people trust nonelected judges to make value judgments and in so doing substitute their judgment for the views of the duly elected members of congress who represent the american people, who are politically accountable? so that's why he said judges ought to take a rather limited role or view of their role under the constitution, and i agree with him. the role of the judiciary is not to say what the law should be but rather what the law actually
is, and unfortunately the supreme court of the united states we know has become such a controversial place in large part because of its tendency to substitute its value judgments for those of the american people or to read into the constitution words that nobody found in the last 200 years but somehow miraculously they sprung up with new meaning, resulting in the creation of a new constitutional right that nobody ever dreamed existed before. but it is true that the supreme court plays an essential function in our government, and there was simply too much at stake not to let the american people through their selection of the next president to have a say. well, suffice it to say, three weeks removed from election day, it's clear that we heard their voice by selection of donald
trump as the next president of the united states, the american people, i think, clearly realized that even though the supreme court wasn't on the ballot, the person who selected the next supreme court justice, perhaps the next two or three, was clearly on the ballot, and there was a clear difference between those choices. i think people realized that secretary clinton would likely appoint more judges in the -- in the tradition of people like judge ginsburg, judge sotomayor, people who have demonstrated their record of being willing to take some license with the constitution, with the laws and basically to rewrite them in their own image. so the american people knew, i think, what they were choosing between -- activist judges who essentially operated as an unaccountable, unelected legislator wearing a black robe,
or judges who believed in a more traditional role for the judiciary, judges who actually interpret the written words on the page passed by the congress and signed into law or the constitution itself. i believe that's how our founding fathers intended our separation of powers to work. the judiciary is not supposed to be a substitute for congress and for the political branches. it's supposed to represent a check and a balance to make sure the laws that are passed do not violate the constitution as written and that the laws that are passed are faithfully enforced according to the words in the statute. i for one look forward to considering president-elect trump's nominee to the supreme court in due time. since i have been in the senate, i have had the privilege of participating in the nomination and confirmation of four justices to the united states
supreme court. as a member of the judiciary committee, we are at ground zero in that process, and i know chairman grassley is already preparing, along with members of the committee, to receive the nomination of president-elect trump. we don't know who he will nominate to the court yet, but he's given the american people a pretty good idea of the type of jurist he would nominate. and i think that's one of the reasons millions of americans voted for him. they wanted an administration committed to the constitution, and they saw that commitment reflected in the list of men and women that president-elect trump circulated as potential nominees to the court. so now that we've heard from the american people, i look forward to going through the confirmation process once again. i'm sure it will be a rigorous contest of ideas. i'm sure there will be a lot of different views expressed, and
that's okay. but in the end, i'm confident that we will confirm president-elect trump's nominee to the united states supreme court. i'm optimistic that it will be somebody in the tradition of justice scalia, somebody who believes in upholding the rule of law in this country. having myself been a member of the state judiciary for 13 years, i have some pretty strong views on this topic. and if people want to take on the role as a policy-maker, i believe they ought to run for congress or some legislative office, or maybe run for president. they shouldn't seek to be a judge on the federal courts on the court system because that's not primarily a policy making role. it's really the important but perhaps less exciting in some ways, or at least less visible way of interpreting the
constitution and the laws passed by congress. and that's important and straightforward enough. but it's important that the people that are nominated and confirmed understand what their important but limited role is under our constitutional government. as i said, we need a justice like the late justice scalia who believed that the words in the constitution matter. we need a justice who brings some sense of humility to the bench. that's a really important quality. i remember chief justice roberts talking about the importance of humility when it comes to the job of judging. now when you have a lifetime tenure job and you can't be removed from office except by impeachment, that gives you a lot of latitude to do things that maybe perhaps humility would dictate that you do not do. and so we need people of character, good character, people with the requisite qualifications and experience and with the right judicial philosophy, i believe.
we need a justice who will fight for the court to take its proper role as a check against executive or legislative overreach, but it ought to be constrained by the words of the constitution as written and by the words in the legislation that congress has passed. there is no justification under our constitution for a judge who simply views their position as license to do what they want or to substitute their opinion for that of the elected representatives of the people. so i'm optimistic we'll be able to move forward with president-elect trump's nominee to fill the bench and we'll soon be up to full speed of nine justices. through president obama's tenure, we saw the senate confirm two of his justices to the supreme court. as i mentioned, those are two of the four that i've had the pleasure of participating in those confirmation, that confirmation process. but president obama was able to replace two members of the court. we've heard in recent months our
friends across the aisle say how important it is to fill the vacancy left by the death of justice scalia. we know they disagree with us on our decision to leave that decision to the voters who selected the next president, but i trust they'll feel the same way now that it's important that we fill this bench without undue delay now that the people have spoken. it's the american people who i believe have made a choice in the type of judge they want confirmed to the court. they determined that what our country needs is a justice committed to the rule of law and to the constitution, not politics, not value judgments, but enforcing the law as written. and i look forward to helping the new administration deliver that for the american people. mr. president, separately today the house will take up a piece of legislation known as the justice for all reauthorization act, a bill that would help
victims as they seek to restore their lives and will better equip law enforcement to fight some of the most heinous crimes imaginable. this legislation will help put more guilty behind bars and provide key resources to forensic labs across the country while aiming to end the rape kit backlog. now the rape kit backlog in particular has been something that a wonderful woman named debbie smith has committed her, much of her life to to making sure that we provide the resources to local forensic labs who test those rape kits because of the power of d.n.a. and forensic testing. you can literally tell within almost certainty whether the evidence contained in a rape kit matches a d.n.a. sample from a suspected sexual offender. you can likewise tell that it
excludes the suspect from being the one that has provided that forensic d.n.a. samp. -- sample. you can exonerate as well as convict people as a result offing these rape kit backlogs. we've heard there are as many as 400,000 untested rape kits in america and some of them have been tested 20 years after the fact only to find out that the sexual offender didn't just commit one act of violence, sexual assault, but was a serial offender. there are many incredible stories of courage on the part of victims of sexual assault who have been willing to come forward and tell their story about the impact of this important elimination of the
rape kit backlog. and there are cities like houston who on their own, under the leadership of mayor parker, who basically said we're going to eliminate the rape kit backlog in houston on our own with perhaps maybe some federal assistance. and they were able to identify a number of unsolved crimes because they were able to tell that the d.n.a. in these rape kits matched certain hits on the f.b.i.'s codis list which is where they maintain their data bank of d.n.a. samples matched against those of suspects collected in forensic examination. suffice it to say that this legislation will contribute to ending that rape kit backlog, and that is good reason enough, i believe, to support it. it will make sure that brave people like debbie smith, who herself years ago suffered a
sexual assault, and has made this one of her causes in life, to make sure that no woman would have to endure what she had to endure, and that is where law enforcement fails to use all of the resources available to it in order to find her assailant and to bring them to justice. most importantly, this legislation will also help strengthen victims' rights and help them pursue their justice in court. we already passed it once unanimously in the senate back in june, and i'm thankful to the leadership in the house for prioritizing this bill in the waning days of the 114th congress. i look forward to the house bringing up and passing this legislation today and for us to take it up here with any amendments that the house may offer, and take it up here, i hope, by unanimous consent and pass it before we leave for the holidays. with that, mr. president, i
a senator: madam president? the presiding officer: the senator from rhode island. a senator: madam president, i ask first unanimous consent that any pending quorum call be vitiated. the presiding officer: without objection. mr. whitehouse: thank you. may i ask unanimous consent to speak for up to 25 minutes as if in morning business? the presiding officer: without objection. mr. whitehouse: thank you. madam president, i started my weekly series of speeches about the dangers of climate change back in the spring of 2012.
my trusty time to wake up sign is getting a little battered and showing some ware and -- wear and tear but i'm still trying to get us to act on climate before it's too late. the senator from new hampshire clearly knows what's going on in her state. it is long past time to wake up to the industry-controlled campaign of calculated misinformation on the dangers of carbon pollution. op poantszs of -- opponents of climate action relish operating in the dark. their slimiest work to undermine science and deny the harmful effects of carbon pollution on human health, natural systems, and the economy is done by hidden hands through front groups. if anything is to change, we first need to acknowledge peer-reviewed science. the expert assessments of our
military and national security leaders and the business case for climate action iconic american companies are making. but if anything is really going to change, we need to shine a light on the sophisticated scheme of science denial being foisted on the american people. president theodore roosevelt once said far and away the best prize that life offers is the chance to work hard at work worth doing. we in congress have the chance to do this worthy work, but big special interests don't want that to happen so congress keeps drifting toward climate catastrophe and i keep delivering my weekly remarks today for the 150th time. thankfully i'm not a lone voice. many colleagues have been speaking out, particularly our ranking member on the environmental public works committee senator boxer and one of our democratic party's
presidential contenders senator sanders. senator markey has been speaking on climate longer than i've even been in the senate. senator schumer, nelson, blumenthal, schatz, king, baldwin, brown, and coons have each joined me to speak of the effects of carbon pollution on their home states and economies. our democratic leader, senator reid, has pressed the senate to face up to this challenge. and 18 fellow democratic colleagues, including climate champs merkley, warren, markey and schumer join me in calling out the industry-controlled many tentacled apparatus deliberately polluting our american discourse with climate science denial. the climate science that deniers try to undermine dates back to the 1800's predating henry ford's first production model t, predating thomas edison's first
light bulb demonstration, and predating the first commercial oil well in the united states. it was 1824, around the time president monroe added the south portico to the white house that french scientist joseph foyer explained that earth's temperature would be much lower if the planet lacked an atmosphere providing one of the first descriptions of the greenhouse effect. in 1861, the year president lincoln took office, irish fist cyst john continuedle describes the trace components of the atmosphere that were responsible for the greenhouse effect, including carbon dioxide, methane and water vapor. in 1896, the year utah joined the union, swedish scientist vonte arenius calculated the
global warming due to the carbon die oxide of burning fossil fuels. the concentration of carbon dioxide in the earth's atmosphere at that time was 295 parts per million. today it's 400 parts per million and rising. indeed, rising at a pace not seen for 66 million years. scientific research continues to demonstrate planetary warming and the many changes that come with it. i'm from the ocean state, and we can particularly look at the oceans to see the devastating effects of climate change. of course, the great corrupt denial machine, the fossil fuel industry supports, rarely talks about oceans. but remember, that machine doesn't care about evidence. it just wants to create phony doubt.
but there's not much room for doubt in measurements of warming, rising and acidifying seas. measured with everyday thermometers, with yardsticks essentially and p.h. tests. so, faced with all that measurement, they just don't go there. but the changes happening in the oceans are real. our unfettered burning of fossil fuels has made our oceans warmer. the oceans have absorbed the vast majority of the heat trapped in our atmosphere by our carbon pollution. the heat equivalent to several hiroshima style atomic bombs being set off in the sea every second for the last 20 years. one result of all this heat is the calamity now taking place in the world's coral reefs, the incubators of the sea. australia's great barrier reef is the largest coral ecosystem on earth. severe bleaching has hit between
60 and 100% of corals on the great barrier reef according to dr. terry hughs of james cook university in queensland. research at the university of melbourne determined that the ocean warming that led to widespread and devastating coral destruction was made 175 times more likely by human-caused climate change. as one researcher put trks climate -- put it, climate change is the smoking gun. but we're not just warming the oceans. the oceans actually absorb carbon dioxide as well as heat. because it forms carbonic acid when it dissolves in sea water, the seas are acidifying at the fastest rate in 50 million years. on america's northwest coast, oyster hatcheries have already experienced significant losses when their new hatches were unable to grow their shells in
the acidified sea water. off the coast of washington, oregon and northern california, 50% of tiny sea snails called tear pods -- tarapods, 50% of them were measured to have -- quote -- severe shell damage, mostly from acidified seas. a noaa study released just last week detailed for the first time the extent to which that damage was caused by human carbon pollution. if this species collapses, the bottom falls out of the oceanic food chain. in rhode island narragansett bay's mean water temperature is up nearly 4 degrees parent height -- degrees fairn hielt. our -- fahrenheit. our rhode island fishery is collapsing and our flounder particularry is practically gone. i know the new hampshire fishery is equally stressed. rhode island's clammers,
lobstermen, fish farmers and shellfish growers are all watching with real alarm the damage acidified seas are doing. this is the cost f climate change -- cost of climate change in the oceans. madam president, we're approaching a point of no return. the u.n. environment programs emissions gap report released earlier this month warned that unless reductions in carbon pollution from the energy sector are taken swiftly, it will be nearly impossible to keep warming below 2 degrees celsius and avoid widespread catastrophe. the report says the next three years are -- quote -- likely the last chance to limit global warming to safe limits in this century. likely the last chance to make the difference. but republicans in this senate want to do nothing about it. once upon a time republicans
joined democrats in pushing for action on climate. senator mccain ran for president on a strong climate change platform and was the lead cosponsor of the climate stewardship act which would have created a market-based emissions cap and trade program to reduce carbon dioxide and other heat-trapping pollutants from the biggest u.s. sources. here's what senator mccain said at the time. while we cannot say with 100% confidence what will happen in the future, we do know the emission of greenhouse gases is not healthy for the environment. as many of the top scientists through the world have stated, the sooner we start to reduce these emission, the better off we will be in the future. of the republican -- other republicans got behind cap and trade proposals. senator carper's clean air planning act at one time or another counted senators alexander, graham and collins among its supporters. senator collins later coauthored
her own important cap and trade bill with senator cantwell. senator kirk voted for the waxman-markey cap and trade bill in the house. and senator flake then representing arizona in the hois was an original cosponsor of the wages cut act to reduce taxes for employers and employees in exchange for equal revenue from a carbon tax. so what happened? why did this steady heartbeat of republican climate action suddenly flatline in 2010? something happened right in 2010. what happened was the supreme court's disgraceful 2010 decision in citizens united veto the federal election commission where the court ruled corporations are people, money is speech, so there can be no
limit to corporate money influencing american elections. when citizens united uncorked all that big dark money and allowed it to cast its bullying shadow over congress, republicans walked back from any major climate legislation. rather than freeing up open debate, citizens united effectively ended any honest debate in congress on the climate crisis. unlimited corporate spending in politics can indeed corrupt. and not just through floods of anonymous attack advertisements. it can corrupt secretly and more dangerously through the mere threat of that spending through private threats and promises. and sometimes the fossil fuel industry threat to politicians who don't tow their line is not so subtle. the coke brothers backed
political juggernaut, americans for prosperity has openly promised to punish candidates who support curbs on carbon pollution and openly taken credit for the -- quote -- political peril to use their words, political peril that that organization created for republicans on climate change. since 2010 the fossil fuel industry strategy has been to crush republican opposition to prohibit republicans from working with democrats on climate change so that the industry can disguise what is basically old fashion special interests pleading as a partisan issue in america's culture wars. i don't know if you remember the alien in the movie "men in black" who climbed into the skin and clothing of the unfortunate farmer. that's what the fossil fuel industry has done to the
republican party since citizens united. the industry has a lot at stake. the international monetary fund has reported the american subsidy for the united states fossil fuel industry at nearly $700 billion a year. that's billion with a "b" and every year. how much trouble, i ask you, would an industry go to to protect a $700 billion per year subsidy? a growing body of scholarship is examining the science denial apparatus protecting the fossil fuel industry, how it's funded, how it communicates, and how it promulgates the denial message. that research includes work by harvard's naomi orasky, oklahoma state's riley dunlap, yale's justin ferrel, drexel's robert brulle and others.
industrial powers fighting to obscure the harms their products cause isn't new. they operate from a well worn playbook. it was used for industrial contaminants and health hazards like d.d.t. and c.f.c.'s and of course particularly tobacco. it's the ultimate special interest lobbying. president-elect campaigned on a promise of draining the swamp of big special interests controlling washington. yet leading the transition at the environmental protection agency for the trump administration is myron e. bell, the poster child of industry-backed climate denial. mr. ebell is the director at the competitive ente -- enterprise institute.
c.e.i. received millions of dollars from exxon mobile, from the koch family, from coal companies murray and massey, and from the identity laundering groups donors trust and donors capital. c.e.i. and myron ebell are the quintessential d.c. swamp creatures. "politico" reports that ebell was a veteran of the tobacco regulation wars. jeremy simons of the environmental defense fund credits ebell with taking the tobacco playbook and applying it to climate change. and on climate, jerry taylor of the libertarian center says ebell was "involved in marshaling allies building a skeptic movement and enforcing that political orthodoxy as best he could in the republican party." ebell criticizes scientists for
working outside their degreed fields, but it turns out he isn't even a scientist himself. after college he studied political theory at the london school of economics and history at cambridge. he has even criticized pope francis' encyclical on climate change, calling it scientificically uninformed, economically illiterate, intellectually incoherent and morally obtuse. that's rich, right thereto -- an outspoken climate contrarian whose organization receives fossil fuel money calling pope francis morally obtuse. well, the president-elect mocked republican politicians when they went graveling before the koch brothers at their beg-a-thon, as
the president-elect called it. but now he is busy filling his staff with koch operatives. donald trump may have won the presidency, but with operatives like myron ebell, the koch brothers are moving in to run the presidency. the new president, however, will hear from our military, he'll hear from our national labs, he'll hear from nasa, who with a rover driving around on mars right now may actually know a little science, that this is deadly serious. i encourage president-elect trump to listen to the voices of reason and expertise, not to the swamp things. don't, mr. president-elect, be taken in by industry, lobbyists, and front groups scratching and clawing to protect a $700 billion conflict of interest.
consider, mr. president-elect, listening to your children, who joined you just seven years ago in saying climate science was irrefutable and portends -- quote -- "catastrophic and irreversible consequences." that is what you and they said just seven years ago. madam president, let's assume something. let's assume that all our national labs -- let's assume that nasa and noaa, let's assume that our military leaders, let's assume that our home state universities across our 50 states, and let's assume that hundreds of major american companies and the more than 190 different nations that signed the paris climate agreement, let's assume that they are all actually not deluded about
climate change. that they're not part of a hoax. if that's so, if these trained expert scientists who don't labor under a $700 billion-per-year conflict interest of are telling the truth, then the fossil fuel industry denying operation is a fraud. as a fraud, mr. president, it is a particularly evil one because in order to achieve its goal, the industry has to drag down the government of the united states or at least the congress of the united states to its level. the fossil fuel industry maintains a science denial operation and a political influence operation dined and --
designed and intended to willfully sabotage the proper operation of a branch of the government of the united states. we ought to all have a problem when a powerful special interest is willing to damage our american experiment in democracy just to achieve its selfish ends. as a senator, john f. kennedy once said, "let us not despair but act, let us not seek the republican answer or the democratic answer but the right answer, let us not seek to fix the blame for the past. let us seek to fix the responsibility for the future. solutions to climate change need be near the republican nor democratic -. they do immediate to be based in sound science and healthy and open debate. and we will be a stronger and
more respected country if they are american solutions, if we are leading the world not tailing along behind other countries. for a country like ours that claims to stand as an example, as a city on a hill, we call it, a country that benefits from the power of our example around the world, this horrible are example of out-of-control special interest influence will have lasting consequences. madam president, we have a role to play in this world, we americans, and it's time we got about it i yield the floor, and i note the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
mr. whitehouse: madam president, may i ask unanimous consent -- first, may i ask unanimous consent the quorum call be lifted. the presiding officer: without objection. mr. whitehouse: and let me also take a moment to add to my climate remarks my appreciation to dr. gifford huang, who is here on the floor with me today, who has been helpful in my office as a trained expert scientist and has helped with many of these speeches, and who leaves us to join the astronaut training program. so i'm proud to have had him serve in my office, and i wish him wsm this is his last climate speech with me. i yield the floor and notice the absence of a quorum. the presiding officer: will
the senator withhold? mr. whitehouse: yes. the senator withholds. mr. schatz: madam president? the presiding officer: the senator from hire -- hawaii. mr. schatz: thank you. i want to commend senator whitehouse for his 150th climate speech. it is a lot of passion. it is a lot of research. it is a lot of focus to be willing to stay on one topic in the united states senate for that many consecutive speeches. being in the senate, there are lots of things that are important, and it is easy to get distracted. but senator whitehouse remains steadfast, remains focused, remains passionate, and history will show that sheldon whitehouse was right, is right. i'm proud to be his colleague. i'm here to speak on another topic actually, and that is what we are about to do with respect
to appropriations. this congress, we were told by the majority leader that the senate would return to the regular order, and i have no doubt that he expwenned to make -- intended to make good on that promise. i know that he is an appropriator, he is an institutionalist, and he really wanted to get back to the regular order. we were given assurances that keeping the government funded would be an orderly and bipartisan process. and you know it was true at the committee level, but that was then, and today we are far from that promise. today the republican leadership, led by house leadership, has refused to complete funding bills for the current fiscal year. and what is so confounding for the folks that pay attention, who believe in the appropriations process, who believe in our constitutional per roughing tirvetion our constitutional -- per roughing tirvetion our constitutional obligation to hold the purse strings and to use that authority to be a proper check
on the executive branch is that simply kicking the can down the road and passing another short-term c.r. doesn't result in anything conservative at all. many in this chamber talk passionately about the need to eliminate government waste, fraud, and abuse and yet a c.r. does exactly none of that. it does the opposite. it means that for programs that should be eliminated altogether, they'll keep getting fund, and for programs that are working well and are critical but in need of additional funding, they will remain underfunded. a c.r. puts government on autopilot, stopping us from shifting investments to the most critical areas and decreasing funding for programs that are not working or are no longer needed. for example, the c.r. does not support accelerated counter-isil operations in iraq and syria. it diverse work on the iron dome, delays protection for israel from long-range missiles,
and it underfunded the d.o.d.'s basic operations by $12 billion. it delays cybersecurity efforts led by the department of homeland security. the c.r. also delays critical funding needed to address it the opioid crisis, something that i know the presiding officer cares passionately about. and both house and senate bills provide large increases to fund drug abuse prevention. but the funding will remain flat under the c.r. we are on autopilot. we are not doing our job. we are abdicating our oversight role in the appropriations process. so there are actually two problems here. one is that things that need to be funded are not funded. things that should be eliminated or funded less are still funded. the other result in a lot of ways is more insidious from the perspective of the constitution and from the perspective of this institution, which is that to the extent and degree that members of the administration
regardless of party listen to members of the legislative branch, it's because we hold the purse strings. it's because we hold the purse strings. and every time we fail to do and authorization, every time we fail to do an appropriation, we are just shifting authority and clout to the executive. there is nothing conservative about that. there is a mistaken assumption that running up against our funding deadline will somehow pressure the congress into doing its job. and what's crazy to me is that we have now five or six or seven years of proof that that doesn't work. this idea that what we should do is take difficult decisions and have them co-en side with -- coincide with other difficult decisions and coincide with even bigger difficult decisions and then we're going to wrap all this up in a bough and do it all at once. there may have been a time in the 1970's, 1980's, or 1990's where we could create these
ominous solutions, but you know what we need to do? we need to hit a few singles. the idea that we should take the debt ceiling and expiration of the c.r. and put them together is -- it just doesn't make any sense, and it is proven wrong by the government shutdown of 16 days in the year 2013. the administration estimated up to ads 6 billion impact -- up to a $6 billion impact on the economy, n.i.h. studies were delayed, national parks were shuttered, transportation and energy projects were postponed, f.d.a.'s routine food safety inspections were pushed back. this is not fiscal conservatism. this is not any kind of conserving conservatism. the idea of being a conservative, as i understand it -- and i will the grant you, i am a progressive, so it is not totally clear to me. but as i understand it, it is the idea that what you do may have unintended consequences and
that whatever changes you make ought to be incremental and ought to respect the institutions that have gotten america this far. so this is not a conservative result. to kick the can into the next spring when we have no idea whether we're going to be able to solve multiple problems at the same time. if you want government to work, piling up all these issues and leaving it to a new administration to deal with in the spring will likely not work. we should finish the work that we were elected to do and complete the funding bills for this fiscal year. madam president, i yield the floor and notice the absence of a quorum. the presiding officer: the clerk will call the roll. quorum call:
the presiding officer: the majority leader. mr. mcconnell: i ask consent that further proceedings under the quorum call be dispensed. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the secretary of the senate be authorized to request a return of papers with respect to house concurrent resolution 122 so that the enrolling clerk may make a technical correction. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the senate proceed to the immediate consideration of calendar number 513, s. 2944. the presiding officer: the clerk will report. the clerk: calendar 513, s. 2944, a bill to require adequate reporting on the public safety
officers benefit program and for other purposes. the presiding officer: is there objection to proceeding? the presiding officer: mr. mcconnell: i ask don sent the committee reported amendments be withdrawn, the grassley subtiewt amendment be agreed to, the bill be read a third time and passed, the grassley title amendment be agreed to and the motions be considered and made on the table. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the senate proceed to the immediate consideration of calendar number 559, s. 461. the presiding officer: the clerk will report. the clerk: calendar 559, a bill to provide for alternate financing arrangements and so forth and for other purposes. the presiding officer: is there objection to proceeding? without objection. mr. mcconnell: i ask consent the committee reported substitute amendment be withdrawn, the cornyn substitute amendment be agreed to, the bill as amended be considered read a third time and passed and motions to reconsider be considered made and laid upon the table. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the senate proceed to the immediate consideration of h.r. 4419 which was received
from the house. the presiding officer: the clerk will report. the clerk: h.r. 4419, an act to update the financial disclosure requirements for judges of the district of columbia courts and so forth. the presiding officer: is there objection to proceeding? without objection. mr. mcconnell: i ask unanimous consent the bill be considered read a third time and passed, the motions to reconsider be considered made and laid upon the table. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the senate proceed to the immediate consideration of h.r. 5785 which was received from the house. the presiding officer: the clerk will report. the clerk: h.r. 5785, an act to amend title 5, united states code and so forth. the presiding officer: is there objection to proceeding? without objection. mr. mcconnell: i ask unanimous consent the bill be considered read a third time and passed, the motions to reconsider be considered made and laid upon the table. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the armed services committee be discharged if further consideration and the senate now proceed to s. res. 607. the clerk: senate resolution 607 recognizing the national geo spacial intelligence agency on
its 20th anniversary. the presiding officer: is there objection to proceeding? without objection. mr. mcconnell: i ask unanimous consent the resolution be agreed to, the preamble be agreed to, and the motions to reconsider be considered made and laid upon the table. the presiding officer: the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the armed services committee be discharged from further consideration and the senate now proceed to s. res. 611. the presiding officer: the clerk will report. the clerk: senate resolution 611 supporting the designation of october 8, 2016, as 40 years of women cadets at the united states air force academy day. the presiding officer: is there objection to proceeding? without objection. mr. mcconnell: i ask unanimous consent the resolution be agreed to, the preamble be agreed to, and the motions to reconsider be considered made and laid upon the table. the presiding officer: without objection. mr. mcconnell: now i ask unanimous consent the senate proceed to the consideration of s. res. 622 submitted earlier today. the presiding officer: the clerk will report. the clerk: senate resolution 622 expressing support for the goals of national adoption day and national adoption month and so forth. the presiding officer: is there objection to proceeding?
without objection. mr. mcconnell: i ask unanimous consent the resolution be agreed to, the preamble be agreed to, and the motions to reconsider be considered made and laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the senate proceed to consideration of s. res. 623 submitted earlier today. the presiding officer: the clerk will report. the clerk: senate resolution 623 recognizing the vital role the civil air patrol has played and continues to play in supporting the homeland security and national defense of the united states. the presiding officer: is there objection to proceeding? without objection. mr. mcconnell: i ask unanimous consent the resolution be agreed to, the preamble be agreed to, and the motions to reconsider be considered made and laid upon the table with no intervening action or debate. the presiding officer: without objection. mr. mcconnell: i ask unanimous consent the committee on veterans affairs be discharged from further consideration of s. 3438 and the senate proceed to its immediate consideration. the presiding officer: the clerk will report. the clerk: s. 3438 a bill to authority authorize the secretary of veterans affairs to carry out a major medical facility in nef. the presiding officer: without objection.
mr. mcconnell: i ask unanimous consent the hiller-feinstein amendment be grid to, the bill as amended be considered read a third time and passed and motions be considered made and laid upon the table. the presiding officer: without objection. mr. mcconnell: now, mr. president, i ask unanimous consent that when the senate completes its business today, it adjourn till 10 a.m. wednesday, november 30, following the prayer and pledge, the morning hour be deemed expired, the journal of proceedings be approved to date, and the time for the two leaders be reserved for their use later in the day. further, that following leader remarks, the senate be in a period of morning business with senators per miforted to speak -- permitted to speak therein up to ten minutes each. the presiding officer: without objection. mr. mcconnell: if there's no further business to come before the senate, i ask that it stand under the previous order. under the previous order.
>> the senate is in recess now so lawmakers can attend their weekly party meetings. senate scheduled to come back into session around 215 eastern. earlier today senators approved legislation to study expanding role healthcare programs. now it is working at a tenure sanction with iran. will have live coverage when they double back in on c-span2. >> president-elect donald trump continues to plan his transition. selecting elaine chao as transportation secretary. she served as laborers secretary under president george w. bush and is the wife of senator majority leader, mitch mcconnell. other cabinet post visited trump. senator bob corker's from a meeting and said he believed the president-elect had narrowed the list were candidates for secretary of state to a very small group. the washington times washington times writes the selection process were who will run the state department and the trump administration has been grueling including grumbling along among his allies about considering it romney for
his consideration. >> it has been an honor to have the kind of meeting that i had today. we had a very wide range of meeting, couple of meetings. and then foreign-policy his thoughts on for policy are very good. he has the greatest opportunity in modern times to really strengthen our nation and the security interest around the world and to help us economically. again, i enjoyed the opportunity to be here. it is an honor. i know he has a number of outstanding individuals he is talking with. but i was glad to be here, glad to see more fully was some of
his views about the world are. i think he's going to make a tremendous difference for a nation for the world. [inaudible] [inaudible] >> again, discussions are underway about of the things. this is a decision that he needs to make. the secretary of state role is so important to the president, he needs to choose someone he is very comfortable with, that he knows is going to be no daylight between him and then. the world needs to know that the secretary of state is someone who speaks fully for the president. again that is the decision is going to have to make. it's an honor to be here when i relish
the role i have been able to play. i think as a chairman of the foreign relations committee anybody who feels like they could further our country's national interest around the world would obviously want to talk about that and would be honored to serve in that capacity. >> we do not talk about that. he has put together a very rapid and good team, rapidly put it together. i think you make the decision when his comfortable. my sense is that he has narrowed it down to a very small group of people and again, a distinguished group of people, i will exclude myself and then certainly but he has a choice to make as who he feels most comfortable with, who he feels can best serve our nation in this capacity. i think you make a decision fairly soon.
>> sunday on book tvs in depth. we are hosting a discussion on december 1941 attack on pearl harbor on the eve of the 75th anniversary. on the program steve toomey, author of countdown to pearl harbor, author of countdown to pearl harbor, the 12 days to the attack. the author of japan, 1941 count out tiffany and craig nelson with his book, pearl harbor from infamy to greatness. followed by greatness. followed by an interview with donald stratton, pearl harbor survivor and american sailors first-hand account of pearl harbor. were taking phone calls, tweets, and questions lie and questions live from noon until 3:00 p.m. eastern. go to booktv.org for the complete we can schedule. >> the united states global aids coordinator spoke yesterday at a conference on combating hiv and aids are on the world. from the center for global development in washington, this is 90 minutes.
>> we have an all-star panel coming up, welcome to the center for global development, i'm amanda, director for the global -- the topic of today's event is challenging. we are getting closer to ending hiv, aids of a public health threat, the program has really had a bipartisan priority for the entire life, born from a bipartisan bipartisan consensus and it has been that way from the start. the u.s. partners have been essential in the response making progress and providing life-saving medication, providing care and support for 17 million people including 5 million vulnerable children. we also have to recognize that our current approach to financing the fight against hiv
and aids has not created clear support or incentive to reduce the fiscal burden of the academic or encourage partners to take a more direct responsibility for financing. what i mean? first on fiscal sustainability we point out the required epidemic control. only 56% of hiv-infected people in low income countries are on treatment. that means means if we reach the other 44% we're going to have growing number of hiv-infected people requiring treatment for the foreseeable future. my colleague has calculated there'll be a doubling of the hiv-infected population every 25 years unless we get serious about prevention. the fiscal burden will continue to grow not decline. second external funders currently shoulder an apparent
share in the partner countries. we don't know the exact share given the lack of regular spending on hiv and aids. some some analysis suggests the physical states available is limited and it insufficient. that means greater efficiency is essential. also that greater greater domestic funding should be a priority. so facing these challenges today is the new partnership between u.s. department of treasury and the program to support finance and look at the efficiency and effectiveness of the health sector. you will you have everyone's bios as you came in. we'll start with ambassador burke was heading the program, program, will follow with assistant secretary from the u.s. treasury to speak about the program and will and with the
james of the economic counselor. >> thank you amanda. we have lots of great people so i will be quick. the first slide, he probably can't see these, what we are going to be talking about today and i think it's important is very much around accountability transparency, and impact. when you talk about the fiscal stage and negotiation with ministries of finance, is the level of transparency and the clarity about where those dollars are going and the impact to expect that's really extraordinarily important. because it's getting difficult to constantly translator data many of you know we put our data online and its age and sex disaggregated. so any health manager can
quickly utilize the tools to see where the program is and the impact it has had. but as a partnership between the government communities. we felt like we needed to model what behaviors we thought all ministry should have an showing your work around transparency, accountability and impacts. and this and this worlds eight states we'll be announcing the first impact survey center been in the field this past year. that's in zambia, zimbabwe and malawi. you'll find those results exciting. we have known from another number of years from usaid's data, we've had a number of pediatric infections. we know pediatric new infections are down by 70% over the last decade. we also realize we did not have the same impact on adult new infections. we been exploring about what is at issue. when we talk about the administer of finance with
malawi about a year and half ago, in their mind what they believe the hiv aids epidemic was, was their family members and their employees dying from hiv, aids. once people were not dying anymore there is no visibility to the epidemic. also we we were not clear about our numbers. in 20,002,000 you had 80000 new infections in kenya. 80,000 new infections last year, but the makeup of those 80000 has dramatically shifted from being 50/50 pediatric adult, to 90% adult. the programming you need to expand, invest in and ensure becomes really critical. we also spent time working with government to look where the resources were. there's there's an issue between equal versus equity. we worked hard to create equity.
that means those those in need of services received the services. that's not equal because diseases are not equally represented. every health center doesn't have the same makeup of the same diseases. if you stand on the same essential medicine, and some clinics those bills will fit and in others you won't have enough. in kenya there's a geographic area that has had expanding epidemic while others have been increasing. thanks to the world bank and their accessibility of their data we have been looking at the democrat demographics in sub-saharan africa. you can see a decade since hiv is epidemic started between 1990 and 2020 there are exactly twice as many 15 to make 20 -year-olds. so that becomes an issue when you have new data out of south africa. i call your attention to the
first set of bars with a number of infections in young women in the 15 - 24 age range are particularly high. data now shows that 24-year-old men and 17-year-old young girls. that dynamic has been ongoing for the last decade. when you look at the surveys it's a composite to get you interested, in our group under 25 they don't know their status. whereas we are reaching over 80% of people over 30 know their status in these countries and i want to say that again. 80% of the adult population know their status and are getting referred to treatment. less than half under 25 another status. now you have three different epidemics going on. the pediatric epidemic as we believe is under control and continues to be decreasing, you have the over 30 epidemic where you are approaching what we would call heard immunity vaccination when you have a
significant number of that population suppressed and then you have the 15 - 24 -year-olds who have a huge demographic number ongoing transmission and a health system where there is no binding site. those are the discussions we need with ministries of finance. it's a discussion and investment of gender equity. it's a discussion about training and job opportunities for 24-year-olds. the discussion is bigger than health. that's why we are excited about the program we have in the field called dreams and i will spend time on that in light of the time. and conclude by thin that we believe there is amazing short-term opportunities with this new direction we have of the dialogue with the department of treasury. one how people talk we don't always get the words correct. we know that we bring in the heavy hitters who understand the words and how to make the business but these kind of investments in secondary
education with decreased pregnancy and hiv risk and show the value for that money invested and have the dialogue about how you create a preventive health system for 10 - 25 -year-olds which we know no matter where you are the world don't interact well with the health system. it it has to be a different kind of interaction than the traditional maternal block. these discussions is an exciting juncture to recognize the progress we have made and hone in on the areas where we have difficulties and where we need to do more together. were excited about the partnership. [applause] >> morning. inc. you for attending today's discussion and i would like to thank amanda for global development for hosting the form on this important topic and also
ambassador burke for sharing and all members of our panel for sharing their important insights. i would like to build on it ambassador brooks opening remarks and provide an update on u.s. treasuries partnership. this is a collaboration that was launched in may 2015 to support finance ministries in low and middle-income countries to improve the efficiency and effectiveness of health resources to fight hiv aids. my remarks will outline the motivations and objectives of the partnership ship and the path forward. first of let me address the issue of why this partnership. achieving an aids regeneration by 2030 will require dedicated efforts today, first to improve the coordination, efficiency, coordination, efficiency, and effectiveness of resources devoted to combating hiv aids and to strengthen the long-term
sustainability efforts. we are aware of the need for more recess resources. by some estimates annual spending will need to increase by a most 40% from $19 billion to $26 billion by 2020. donors and partner countries must do their part to fund this effort. in an abatement of plateauing donor resources partnering countries will have to take on an increased share. given realities is more important than ever to maximize the effectiveness of every dollar. the treasury collaboration is motivated by the premise that finance ministries have a key role to play in achieving the outcomes. today, finance, finance ministries have generally been less involved in decisions around hiv aids because the majority of the financing from donors has been channeled through health ministries and other nongovernmental organizations.
given the different expertise areas finance and health ministries often do not speak the same language as policy making. given the current financing environment for hiv aids effort and the key role finance ministries play in managing finance resources is in urgent they courtney more closely with their health counterpart. in doing so they will be better positioned to promote efficiency to maximize value for money in the hiv-aids response. central to the efforts will be to overcome challenges around how public financial management systems ensure hiv-aids resources, including from donors are properly tracked and integrated into the regular institutional process of government. in many cases this requires under the management system
themselves with a knife or improving the budget formulation process, achieving transparent transparent and efficient allocation of resources, developing budget execution systems. strengthen capacity and link that linking to systemwide -- and strategic programming not only in hiv-aids but in the broader healthcare cessna sector and in the broader governmental sector. governments are taking steps in this area. in zambia the finance ministry recently established a oversight group that will better coordinate track resources from the government and development partners. to help address the challenges the u.s. treasury petco partnership leverages the treasuries departments institutional relationship and policy dialogue with finance
ministry. as well as treasuries many years of experience providing technical assistance to government to improve overall resource mobilization and public financial management. treasury seeks to support these two establish three pillars of a sustainable and successful financial response to hiv-aids. first, stronger public financial management precious health resources. second, improve engagement coronation between health and finance ministries. third, effective mobilization of domestic resources over time in close collaboration with donors. since the partnerships launch 18 months ago the u.s. treasury has of ansi efforts by regularly incorporating a set of issues into policy dialogue with finance industry. in addition, the treasurer has sent technical teams on
fact-finding missions to countries to assess and diagnose the challenge facing their hiv and aids efforts. we also help discussions with teens, the global fund and other partners to discuss a how treasury can complement ongoing work. these discussions and assessment missions continue the partnership is also entering its next and most exciting phase. involving the formal establishment of technical assistance programs between the u.s. treasury and partner companies which will enable the partnership to begin building the foundation for a sustainable financial. i'm happy to announce that earlier this month uganda's ministry of finance in the u.s. treasury signed the terms of reference for the partners first technical assistance program. this partnership has multiple objectives. it aims to bolster uganda's hiv
aids response through greater coordination and improvements in public financial management system as well as supporting the government subjective to forge stronger links among the ministry of finance, the ministry of health and that countries std aids program. will optimize programming decisions and help with gaps and data ability, build a better understanding of budget support and address other gaps that prevent uganda from maximizing the impact of scarce financial resources in the fight against hiv aids. as part of this they'll be working alongside staff to support work to establish a business unit to monitor the
countries hiv-aids resources. the resident advisor will help develop methodology for oversight and review of all of these resources and recommend financial policies to ensure resources are allocated to high-impact activities, develop the ministries capacity and cost analysis and recommend ways to incorporate donor resources into the national management system. taken together we hope the collaboration will support uganda's efforts to make the most informed decision possible about the allocation and use of the countries hiv-aids resources and ultimately to save more lives. we look forward to collaborating with the finance and administrative uganda and my colleague laura from the treasury office of technical assistant can provide additional details in the upcoming panel. more broadly we have the project in uganda is just the beginning with their partner countries. i'll conclude by expressing my
appreciation for the work that you are doing to achieve the goal of an aids regeneration by 2030. as you know the global health and hiv-aids on different frontiers for the u.s. treasury and are committed to engagement with their counterparts that will inform our efforts to complement the work that all of you are doing to save lives. we look forward to continuing the partnership in our partner countries and look forward to updating you on a joint successes in the future. thank you. [applause] morning i like to thank you for inviting me to come and share with you what the ministry is
doing to them. [inaudible] the ministry put down that economic development to help human development that is a vision and productive. so issues on economic growth and financial stability we fully appreciate the need for health, the ministry of finance also knows education and other factors can affect human capital. the news to finance the effort.
[inaudible] it is clear that hiv, aids, illyria and other diseases and challenges to the health sector. further, governments at the minister of finance is deeply involved with putting itself with the implementation of program and hiv and aids financing when the government funds are provided. it is also not been acquainted with dealing with ten years of. [inaudible] in terms of financing and sector. also needs to ensure that the
voter fraud, exchanging developments on program financing and focus in overlaps and programming. to support this work and improve financing they propose to taking assistance through an advisor. so this will support and oversight group to ensure efficient use of resources. the advisor will ensure resources -- and also provide capacity development on financial analysis, it will also support and enhance on hiv and
aids extensions. will develop -- on all levels of government. will design and implement and improve financial report. we recommend to incorporate donor into country systems and books of account. provide advice and funding options and strategies. during the course there may be other areas upon which finance would like to focus, the advisor is expected to be a valuable aspect. the finance is an agreement, the work of the advisor and with
oversights with working groups and is broad enough to assist in other areas that are important for public financial management but not directed to a technical advisor. [inaudible] thank you. [applause] >> so we are going to have an invited guest for the minister of finance from south africa who will join us on video. why don't we change out our panel while we hear little bit from mark fletcher, either any key questions, maybe i can ask one question before you go.
one is that a lot of the measures that you thinking of taking with this partnership are very relevant for the hiv-aids response but would have huge implications for the rest of the health sector as well. is it the role of this treasury person to look or the advisor together with the ministry of finance to look beyond hiv-aids as well as they are competing priorities. >> i think one philosophy that animates the initiative is that these programs need to be embedded in the overall business of government. in the overall public financial management. if you you look at the terms of reference that have been developed for uganda, it's basically embedded in the broader look at the public financial management system. i think similarly another recipient countries in the most sustainable interventions are going to be ones that are
tailored to assessing the effectiveness of resource deployment in the hiv-aids area but also making sure the broader public financial management system is compatible with the objective of maximizing return on investment in public health and public education et cetera. i think these interventions will be tailored and we can talk in greater detail about this, he'll be tailored to the needs of the country, often those needs will the broader context will be very relevant. >> one question for you, when you think about one result that you want to see in a year or two time in terms of financial sustainability, what would you like to see? that we, and civil society looking at this partnership and trying to assess whether it's making a difference, which we look for?
>> i think the parallel now improve data system that link investment to outcome and. whether that is investment in education, investment in the health system itself or in the laboratory system or the human capacity, it has to be linked to outcome. if we can help generate that it will be a tremendous success. >> do you want to add any. [inaudible] the end-user should benefit. >> i think that is an excellent
issue and goes to the heart of the issue of efficiency. we don't we don't know how her spending necessarily every dollar etc. we'll. we'll look into that. thank you to our first panel. if we can get mark fletcher on screen in the second panel two,. [inaudible] [inaudible] [inaudible] >> will start off asking our panelists to respond a bit to what they've heard on the panel based on the work and maybe we will start with mike at the end
who is with treasury, you will have to mime your response. [inaudible] maybe we we won't with mike. let's start with you laura come to the treasury, you are not miked either. >> will start with you david because you are mike's. sorry to hold your stuff? >> why don't we start with you, you are working at the world bank leading the hiv-aids effort looking at financing and efficiency issues. when you hear you hear about the partnership to have thoughts or responses a with the role of the world bank sorry let's go to mark first. see mark, can you hear me? >> can you hear me? so do you want to say a few words about this partnership
between treasury and -- and how the government of south africa is thinking about these issues? >> thank you very much. good morning. [inaudible] with the new partnership in our experience were thankful to the hiv financing response and given that the with the annual budget negotiations between the health sector, the sectors in the finance ministry, will think of a partnership between the two ministries will be critical to ensuring treatments and prevention.
privatization. some have very low gdp's many countries are not putting in the necessary resources and they need the right mix of facilities to do the right thing, one of the things with understanding from elsewhere in learning from each other in negotiations of a company of large standing there's a common understanding a commitment they both have a desirable. [inaudible] national global commitments to usc. with the national health
insurance link to usc. providing additional -- for achieving the outcomes. [inaudible] certain governments have been useful and high-level negotiations with health financing. thank you. >> thank you very much mark. let's turn to the panel this time tell us about the partnership, what it it seeks to accomplish, how it will work? >> first really think we need to situate this into a wider sustainability effort. we do do have a view about how we are going to achieve epidemic control and maintain it over time. this new treasury partnership which were excited about is
really part of that wider effort. it's not that we didn't have contacts with finance and ministry before but this is just an opportunity for us to root that and give structure to that engagement with the finance ministry. again as part of the drive for sustainability. we often hear the development world that you need to talk to the finance and a ministry about it. in this arrangement allows us to do that. i'm reminded of a conversation that was part very early in this gets back to what the investor was saying about sometimes we don't talk the same language. we very quickly got to a commodity probably in this particular country. of course the health i was talking about the air become oddity's in the finance and
ministry said was talking about the copper prices and oil prices in those commodities. so just in bringing those together is something by partnering we can use their unique to p relationship that they have and leverage the goodwill of their technical assistance program to get us talking on the same thing. we know from a long-term sustainability standpoint we need finance. the vaccine transition has pointed to weaknesses and financial systems is one of the reasons the transition failed. and often even for the short term as well as we have a drive towards efficiency. that's why we look for to the partnership. >> laura to want to comment on the office of technical assistant. what role role are you playing in this effort? >> the office of technical assistance has been around for
about 25 years. were focused on working with countries that are interested in reforming their systems. what we do is we are invited by the countries to come rather than week tried to be demand driven rather than supply driven. so we are when we are invited we put together an assessment team and we assess the needs of the country and together with the country develop terms of reference that focus on their needs and how we mutually agree to address those needs. the programs we put together we tried to be very practical, very targeted, focus on the basics and at the root of it that they be sustainable. once we're done the country can actually pick up the tools that
we have transferred to them. our advisors, we select them from skilled practitioners. we like to hire finance directors, budget directors, people that have actually worked in these jobs, been responsible to their executive leadership as well as responsible to the legislative leadership and can craft practical solutions with their counterpart. once it is identified we want to make sure they are a good fit with the country so we have candidate mission so both the advisor and the counterpart have a clear understanding of what is expected on both parts. within 60 or 90 days we arrive in the country the general terms of the terms of reference or expanded into annual work plans for the counterpart in the
advisor are mutually responsible for the work at getting done. it is not the advisors work program. it is the program to implement to reform in the country. then the execution of the project is the advisor sitting side-by-side with counterparts on a day-to-day basis working through the problem. transferring knowledge with hands-on, working together some formal training but a lot is p or two. mentoring said that it is not separate from their work. they are incorporating what we're trying to achieve their work product. we realize the sustainable reform is not quick, earlier someone said what can we expect in the year. often systemic reform is a three or four your process. that is treasury's engagement. we are patient.
the counterparts we have have day to day jobs. they may not be working in the most efficient manner but for us to come in and impose changes to their activities takes them away from their work and we ultimately have to shift the work into more efficient models so treasury does have the patience to sustain these efforts. >> tell us a little bit -- involved in the sustainable financing initiative. as i mentioned even if we are very successful, the fiscal burden will increase on the most affected countries in the near term, to have any sense of tell us about sustainable financing and what is the timeframe for this? more resources are required in the immediate future, external funding will be in an ideal
world sustained, probably probably not likely to be increased, what's the outlook. what are we asking partner countries to do? the me give you a couple minutes on -- and i really want to acknowledge for believing in this. the the basic premise is that with economic growth we all know the health goes up. and so with economic transition taking place but over time what we have done this. [inaudible] as countries evolve and grow donors pulled back very quickly. and they see that out-of-pocket
spending it takes quite a time for out-of-pocket financing to catch up. our defense was that in order to leverage the economic growth of the country's one had to have engagement that focused. one was mark in really good data that can be used to go have a dialogue. the second was improving financial management system. the third was we can ask for more money without focusing on efficiency. the fourth 11 was how can we leverage the private sector to be more involved. so we did this analysis and i remember as a presenting on the modeling and all of this stuff what would be five years if you give up your opportunity you can do something different she looked at me and said that's
fantastic can you come back and tell me what you're doing and five years. [laughter] she's known for her patients and really focus in -- now we have these inside countries and i'll share with you two examples. we are very focused on results that are sustainable over the long road. it comes to mind where what we found was that hiv both highly insurable does not find its way to in insurance program. one can already observe one is the government of vietnam is already putting more money in but also the changes for insurance systems are going to lead to greater efficiencies and
value over $200 million over a ten year time. now that's interesting because eventually and you're not going to get more money. so the the analysis with it was not what is the economic cost of investing in hiv, it is what is the economic cost of not investing. so this is a very different question to answer and we were able to demonstrate significant impact in gdp growth rate, labor market and foreign growth. this is the information and data that ministries of finance like to see. so what we are observing is that the concept of shared responsibility something countries are in favor of. what they want to do what they want is more strategic and more
focused assistance to help them think through these things. i think this is where really getting the treasuries involved is fantastic from a usaid perspective. the credibility of the treasury has in working through ministries of finance is something that is important. we work closely with treasury on this and it is not a bout hiv, it's about improving systems as a whole and then talking about the investments with a clear line. >> that helps. david you want to say something about the role of the world bank? >> i would say this is extremely timely. ultimately it's a manageable challenge if we get it right. but we can afford too many mishaps.
first off it's been a great response it has been. we need to move from an emergency response to long-term development all approach. i think that is going to be why this initiative is very important. to me that greatest challenge is if we compare the share of international assistance with -- in general. and lower middle income countries it's about 20% for all of health there can be 80 to 90% for hiv. and ultimately those figures need to converge and we need to help promote that convergence. i think the most important points have been touched on in that is how we can balance things out across the international system. if we do that right we can be prepared for some -- the reality
is upper income countries -- the and that is by large happening. lower income countries need to shift change up not too hundred% but closer to the 50 and 75% and within a relatively compressed timeframe. and then you have some which you have no exit such as malawi. we need need to be frank about that. so what we need to get right? first economic growth is going to be important. economic growth for africa tonight as good as they were. the rest of africa they have to focus in and so we consider population which is approximately 4%. clearly we need to focus on the growth and it's not commodity driven. the the second point we
need to do is focus on improved efficiency and africa collects lesson spends more than any other region. this is by the treasury initiative can help. p on that we have to ensure that a great share of this is allocated to health. it it might be rational the short term to pull a but it's very hard to reallocate in the budget if international funding stalls. we have to make the argument for african countries spending at least global norms on health. to do that advocacy has to change. i think the world bank finance industries are inoculated against the argument. it's really hard to find a good argument for focusing on one disease or teaching algebra and trigonometry. it's not the type a question they're going to prioritize.
they have to put it in the context of global health spending. financement is streets tented think in terms of social sectors so we have to put it in broader context. and we have to face the issues that they touched on. in terms of budget execution, delivery and results. and the efficiency argument become central. i will close by saying i think the initiative is very important to move from emergency to sustain long-term response. we can get this right but it's complex thank you. >> so where are we on timing? we have about half an hour, maybe i will do brawn roundup here with you and then we'll will go to the audience suffer. questions.
given that we are at the cusp of a new administration and the uncertainty that involves come i wonder if you could reflect on scenarios for going further, what you would hope the global fund would be doing differently going forward as a result of any uncertainty going on. any thoughts? maybe i'll start with you mike. >> from our standpoint were really in the midst of what david is talking about, moving from the emergency to a sustained response. there's a broad agreement agreement that these are the things that we should be doing so the work that were doing here with the treasury department is part of anybody's packages, what we need to do to make that have it. and this is just part and parcel of a larger sustainability plan that we have. we talk about financial and
programmatic sustainability for emphasis but there really part of the same thing. we have created a sustainability framework, we now chart progress against that with sustainability index and the dashboard that has created, we have taken a further step to look at how we can what knowledge and how to take international dollars further. were very much looking at efficiencies of spending going forward and hoping that finance ministry can be a good partner in that effort. i think too that you touched on the global fund. it too has flattened out. the efficiency drive particularly over the short term as we develop these longer-term health finance rules is really the key to making that and
locating that within the context of finance ministry is key. but also david said it's just a piece of it. getting us to look at the totality of the response whether it's in education or the labor market, we have to look at all of those pieces together. working with the health ministries themselves to show that they are good recipients. they are a useful place to invest in overtime so again this is part of a much broader set of packages. even though were hiv specific we understand we need to get there for the long-term sustainability response.
>> here we talk more about direct financial incentives for greater domestic cofinancing. have you considered that? what is what is the role of the global fund in that effort? we'll look at the composition of the funding a lot is technical assistance and training. if we want to leverage a domestic spend on this especially in the lower middle incomes that have some capacity not to finance everything, what what strategy would you see going forward? >> let's just brainstorm. [inaudible] financing is not going to be sufficient by a long shot to meet the needs of financing of health and hiv. so there there is no option but to work with countries on a shared responsibility agenda.
the bulk of the financing has to come from domestic resources. how do you make that happen? what reality one uses what we have to do is manage for the results on results have to focus in two areas. one is more money and better use of money and measurable impact of what the money invested briggs. what we should focus on going forward whether it's global funds, usg or anyone else's on the three dimension in heaven the data and evidence to demonstrate this increasingly. unless we can demonstrate the value proposition, arguing for more money by itself is not going to get us very far. i agree there is significant
deficiency games that can be achieved. in kenya as part of their survival when you work with the ministry of finance the first question is can you ensure that the money is properly spent. so then that was provided is to ensure that that money was properly spent the next money they put $24 million. if you can demonstrate you are going to see that ministries of finance will get more response. but increasingly you will see that is going to be the countries that have to put in 50, or 75% of it. . .
we have a low growth scenario but i think we get a strong sense of responsibility that is our problem is a country and when to deal with it. i think we have a strong sense of ownership. i think this layout is sustainable and one that could be predictable. i think we are happy with the way the department of health and other apartments are performing and they support more interventions for young women and young girls so there is an incentive.
i think it does recognize their other countries that are much -- than ourselves. it's clear changes need to happen over this time period. we need to expand this. [inaudible] we will do it need to do. i think we will do our best with our partners. >> so doubling the number of people in a situation of severe fiscal constraint and i think we be we are being too polite. this is an extraordinary fiscal act from partner governments and so we will look forward to following that.
it's a very major challenge to think about what has to be. you will have some growth in your health budget and maybe not and you have to reallocate from other uses. is that the kind of thing you would do? >> a combination of things. we have to raise 25 billion additional revenue. we have to achieve station. we have a very active movement at the moment to increase associated to geisha which is obviously the age group. we have a lot of young people coming through.
so i combination of different strategies that we need to set priorities and i think we have a fair amount of --. >> the ministry of finance and treasury. >> i think that there is a lot of talk about efficiencies and how does that manifest itself. there's also talk about putting more resources into help in other areas. they can't execute the budget they have. the you look at the global funds in uganda reporting that they could only execute 46% of the available grants so i think that
is underappreciated. the systems in the countries are very fragile and unable to cope with large flows of funds so the basic underpinning needs to be supported and you know so one level of efficiency is the ability to execute their budget. that's putting more resources into the effort. if budgets are more timely in their execution inventories of drugs don't expire. they are actually processed through the system. then there is the timely fashion. supreme defenders put on costs of items because they know they won't get paid in a timely fashion. there's a very high tax to the
government. if they can start moving the money through, paying their vendors with an appropriate level of time than they can get the competition. the vendors want to pontificate and go for a high premium on their cost but under execution you have high levels of idle funds. they are just sitting there because they can't get through the system. but those are some of the underlying issues that i don't think are fully appreciated and honestly some other risks are getting the right people to take on the reforms and sustain them without a turnover of staff and also the adequacy of information management systems. there are lots of information management systems. their huge information management demands and do they
have the underpinnings systems to generate and analyze the data? there is a lot going on. the term efficiency kind of masks what the details are beneath it. >> david the last question to you, what do you see as the world bank's role in partnering with the treasury in this effort? >> i think obviously talking about trying to help the economy more broadly, the more efficient allocate a greater share and share more wisely. i will just touch on one final dimension. i draw attention to a -- of mine
that is it's pretty helpful to look at this. the u.s. is in a unique position responsible for two-thirds of financing. africa is the second-largest contributor. the other donors have the opportunity not to increase their involvement into progressively focus on the global funding and scale it out and we are seeing that. they have not been able to match the extent that the u.s. has been willing to put on for two consecutive rounds and then many recipient countries have a really clear interest in not paying more as long as again the internationally finance. i think understanding this is
important in relation to your question to one thing the bank does pretty well as offer predictability to countries that either blend ibrd eligibility and i think if you could communicate greater predictability about what countries need to do and over with period and if we could hold to it we would be closer to what we need to achieve together.
we are joined by mike lillis senior congressional reporter what the hell. the democratic house elections of 115th congress coming up on wednesday morning. mike lillis tell us by tim ryan is challenging democratic leader nancy pelosi. >> guest: i think there's several reasons. going back to 2010 when the democrats lost control of speaker's gavel and they were wiped out they said why should we return the same leaders to the same spot if they weren't able to keep us in the majority? since then every election cycle you've heard a little bit of that rumbling but it's been behind closed doors. this year is very different because of the trump victory and because the democrats were expecting significant house -- they didn't do that and what was once behind closed doors has become very public in the form of tim ryan's challenge. i think you to break it down a couple of different ways. one is generational. leader pelosi has been in charge for 14 years.
she is in her mid-70s. steny hoyer and jim clyburn have also been there for more than a decade also in their mid-70s and there has been a constant rumbling among younger members that there's no room to move up in the world of the democratic leadership. and what you have seen is a brain drain. you have seen an exodus of people like chris van hollen, like steve israel and donna edwards who are moving on to other places because of the bottleneck at the top. tim ryan is saying we need a fresh face, we need new ideas and not the guy to do it. the other is regional pretend right represents youngstown ohio very blue-collar manufacturing base and he points out that pelosi is liberal from san francisco the other leaders all from the coast. all of them are from the coast almost without exception and he says they simply don't speak to the working class whites rust
belt voters and he again is the guy to do it. >> host: who is tim ryan and what is his track record on capitol hill in the house in particular? >> guest: particular? >> guest: he has an appropriator. he is young come he's 43 so he does represent a new generation but he is not a new guy. he's been around, this is his eighth term so he was very young when he arrived. he was 29 in the youngest democrat in the house when he did arrive but he's been here entering his eighth term. he's been here exactly the same years that pelosi has been the leader. a little bit of irony there. he does represent this manufacturing district. he did go for trump and he was able to secure 60% of those of you saying we need somebody who can go into the fish fries and somebody who can talk to these
voters and broaden the democratic party. >> host: to showing our viewers the headline insurgent endorse pelosi challenger tim ryan. tell us about the supporters of the democratic caucus. >> guest: you have seen a trickle of supporters in and right now the number stands at 11 or you might see a couple more and we might not. we are not sure how may people are going to come out publicly. today you have ruben gallego just elected to a second term, a 37-year-old hispanic from arizona and seth moulton and iraq veteran. gallego is in iraq veteran to so2 veterans also from massachusetts. they have successfully delayed the leadership election. pelosi wanted it to happen two weeks ago. they said no way. we are going to take some time and have a reckoning and figure out what went wrong. they were successful. they hadn't endorse anybody until today so they were holding their fire and now they are trying to go with a little
momentum for ryan even if it's a losing effort. they are young and they will be here when pelosi is gone so it's a strategic move i think more than anything else. >> host: walk us through the timeframe and the logistics on the vote. we understand there's a secret ballot wednesday morning? >> guest: it's always a secret ballot and that is that the advantage of tim ryan. pelosi is an extremely powerful force in this caucus. she is very well respected but she also is feared to an extent. so that's why you are not seeing so many people come out public way. the last challenge in 2010 was shuler, not a senior guy. he hadn't been around very long and he got 43 votes. very few of them are public. people will vote in a secret ballot because they didn't remain anonymous and not have any political reprisal from pelosi who has in the past denied people committee
assignments are denied campaign cash, things like that or it's kind of a retribution and trying to keep people in line instead of having everyone so unified area tomorrow morning started 8:50 or 9:00 in the morning. it'll be in the basement of the capital we understand which is where the democrats meet every week for their caucus. they will have somebody nominate pelosi and they will have somebody nominate tim ryan. we don't know yet to those figures are going to be in bed you will have a couple of speakers on behalf of both of the candidates. you can expect pelosi probably will grab a female probably somebody from the chp's somebody from the black caucus. she will have a whole swath of people and tim ryan will probably try to do the same thing. he has got some diversity there. he has marcia fudge, former black caucus chairwoman from
ohio who will probably speak on his behalf and then they voted a close ballot. whether or not we know batali, the tally in the shuler vote was -- but this when we don't know if we will know if it's a tally at least not merely. >> host: we will look for your reporting on all of this mike lillis senior congressional reporter for the hill. you can. more at the hill.com. thanks for joining us. >> guest: thanks for having me. civil rights leaders held a press conference to call on president-elect trump to denounce racism. speakers included represents
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