Tom Harkin

Mr. HARKIN

Mr. HARKIN. Mr. President, this is the first time I have seen this amendment. This is setting up a congressional commission on expanding social service delivery options. I have no problem with that. But the way it is spelled out and everything, I would ask the Senator from Pennsylvania, the author of the amendment, has this been brought up before the authorizing committee? Has there been any hearing on this? Has there ever been a hearing on this, or has the authorizing committee acted on this at all? This is authorization on an appropriations bill.

Mr. HARKIN. I have no objection.

Mr. HARKIN. Mr. President, I ask unanimous consent that the Byrd amendment be temporarily set aside. I have an amendment I send to the desk and ask for its consideration.

Mr. HARKIN. I have no objection.

Mr. HARKIN. Mr. President, I join my chairman and support his views on this amendment. He correctly stated a lot of the history of how this has come about. Between the two of us, as we have alternated as chairmen of this subcommittee, it has been a strong bipartisan effort, not just between the two of us but on both sides of the aisle for a long time, to bring the Centers for Disease Control and Prevention in Atlanta's facilities up to the 21st century. I remember having gone down in the 1990s. I had seen this movie ``Outbreak'' starring Dustin Hoffman. It supposedly had taken place at the Centers for Disease Control and Prevention in Atlanta. I was quite taken by all of the containment facilities and how modern it was in this movie, and I wanted to go down and see all this. Imagine my surprise when I went down to the Centers for Disease Control and Prevention and I asked to see these wonderful facilities that were in this movie and I was told the movie producers had come down to film the movie there, saw the facilities, and said no one would ever believe these ramshackle buildings are our Centers for Disease Control, so they went out and built their own movie set to make the movie. I went around and looked at their buildings, some predating World War II, in which the most virulent specimens of viruses and other things were being dealt with. There was a tremendous concern about safety. We perhaps didn't think about it in terms we are thinking about it now, but in terms of terrorist activity, about someone being able to abscond with some of those very lethal strains, plus the environment for scientists to be able to work down there. After looking at this and consulting with one another, and others, and with probably three administrations, Republican and Democratic, it was decided we needed to bring these buildings up to the 21st century. We embarked on that and we are about through bringing them up. They are state of the art, as they should be. We have always prided ourselves in America of being on the leading edge--not on the edge, being way out in front of everyone in our medical research, but also in terms of the Centers for Disease Control. I don't know that there is any institution in America dealing with health and safety that is called upon more around the globe to do something than the Centers for Disease Control and Prevention. Whether it was SARS a few years ago--think about it. We prevented SARS from coming to America. We did. The Centers for Disease Control and Prevention did. They are called upon all over the globe, whether it is for Ebola, swine flu, of course now the avian flu, a pandemic that may be confronting us shortly. These buildings need to be finished. We have the plan. We have gone through. We have had our oversight hearings and we found they came through on time and under budget, so I think we ought to finish it. I would say the AIDS Drug Assistance Program the Senator is talking about is a good program. I have no problems putting money into those programs if they are good programs. But to take it from the Centers for Disease Control for that is--talk about robbing Peter to pay Paul, you are invading one entity that goes to control and prevent diseases and illnesses in America and putting it into another one. It doesn't make much sense. I think we ought to finish our projects, be proud of the buildings that are built there, be proud of the Centers for Disease Control and Prevention and what they do for America and for the world. I am opposed to this amendment. We ought to finish the job we started on. I don't know about Japanese gardens. I don't know that much about gardens and stuff such as that. But, you know, if I might make a minor observation, I remember traveling through the Soviet Union years ago and looking at all the government buildings built in Moscow and places such as that, East Germany. They were stark, sterile, concrete block buildings. Who would ever want to work there? They were ugly; depressing. Is that what we want to build here? As I said, I don't know much about Japanese gardens, but this is the premier facility in the world regarding health and disease prevention. I understand that the building in question where this garden is--in fact, I went down and saw it. It is designed to emphasize healthy living. The stairs are located on exterior walls to increase daylight and to encourage daily physical activity. We talked about that with Dr. Gerberding. The green space around the building includes a stream fed by water runoff collected from the building to make the area inviting for exercise. I remember seeing that. I didn't think it was a Japanese garden; I thought it was a green space. But it is to get people out, exercise, walk more. As far as I am concerned, the more green space and the more daylight and the more exercise people get there, the better off we are. That is what they are preaching, right? They are preaching to us to do more exercise to stay healthy. I guess they are going to start doing that more on their own at the Centers for Disease Control and Prevention. I understand what the Senator from Oklahoma wants to do here. If he wants to increase money for the AIDS Drug Assistance Program, that is all well and good, but not at the expense of taking it away from the Centers for Disease Control and Prevention.

Mr. HARKIN. It is my intention now that I would speak for 15 minutes, at which time I ask unanimous consent that I be able to yield the floor and Senator Kennedy be recognized for 15 minutes.

Mr. HARKIN. I further ask unanimous consent that no second-degree amendments be in order on the Dodd amendment prior to the vote.

Mr. HARKIN. Mr. President, I concur with my chairman in that regard. The only other observation I make, we are not encouraging a lot of amendments. We are just saying if you have amendments come over and do them this morning or this afternoon so we can finish up the bill, hopefully, by tomorrow. I know there are some important amendments-- Senator Byrd certainly has one coming up on title I--that we need to address in this bill. Again, I am hopeful, if people do have amendments, that they will come over. And, again, Members need to know amendments have to be filed by 1 p.m. today to be considered under the cloture motion. Mr. President, I understand that the Senator from Rhode Island, Mr. Reed, needs to make a modification to his amendment, and I know, also, the Senator from Washington, Mrs. Murray, wants to offer an amendment before we begin Senator Byrd's amendment. Senator Byrd has been kind enough to yield to them a few minutes so we can get that done before he proceeds on his amendment.

Mr. HARKIN. Mr. President, as always, it is a joy and interesting to listen to my friend and colleague, my chairman, talk about the past and what we have done together. He is right, we have worked together closely. I followed his lead on a lot of things, such as when Arlen Specter, back in the mid-1990s, wanted to do double funding for NIH. He took the lead on that. I did what I could to help. And we got the job done under his great leadership. So we have worked together on a lot of different things. And where we have had differences, we have had differences, but we have always been, I think, upfront and open about those differences. While I love Arlen Specter dearly, and respect him greatly, he is not my twin, he is not my clone, so we do have different ways of approaching things once in a while. And that is the way it ought to be around here. There should not be, as he said, this big gulf between us, but there ought to be an honest airing of differences of views on how we ought to approach things. Take the Byrd amendment, for example. I stated earlier, when we first brought the bill to the floor, that Senator Specter had done a superb job, and he was always open with my staff and me in crafting and putting together this bill. I said when you are dealt a bad hand, you have to do the best you can. And Senator Specter did. So in terms of the bill itself and how it is crafted, I do not have problems. What I have problems with is our allocation. That is where I have problems. Since I did not support the budget, I said at the time we laid the bill down the other day: Look, if people are going to come here with amendments that offset and jiggle things around in the bill, I will not support it because we worked very hard, Senator Specter worked very hard, to craft a bill that was fair in terms of what we had to deal with. So I would not support amendments which jiggle things around. But if someone has an amendment they want to offer which would not jiggle things around, but add money--which I understand takes 60 votes to waive the Budget Act--I am going to be for that because I don't agree with the Budget Act. I don't agree with what the budget calls for.

Mr. HARKIN. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. HARKIN. Mr. President, I move to reconsider the vote, and I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 2244

Mr. HARKIN. Mr. President, I ask unanimous consent on behalf of Senator Kennedy to send a modification to the amendment to the desk. It changes the date, it looks like, from August to June.

Mr. HARKIN. Mr. President, I now call up an amendment by the Senator from Massachusetts, Senator Kennedy, on women's employment data. I ask unanimous consent that the pending amendments be set aside.

Mr. HARKIN. I move to lay that motion on the table. The motion to lay on the table was agreed to. Amendment No. 2228

Mr. HARKIN. So I will support the Byrd amendment because he is not trying to take money from one pot and move it to another; he is saying the budget was wrong. We ought to waive it and put the money in. Now, with all due respect, again, to my friend from Pennsylvania, in going back over the history of this, I wish to point out that the Byrd amendment only closes 50 percent of the gap between the authorization level and what is in the Senate bill. I have here a chart that shows the authorization and the appropriations levels going back to fiscal year 2002. Senator Specter made mention there was an interim period there when our party was in charge for about a year, so we were in charge of the budget and the appropriations at that time. I point out that at that point our appropriations were a little over 70 percent, maybe about 75 percent of the authorization level. Today, we are less than 40 percent of the authorization level. So what Senator Byrd has said is the authorization level is going up, our appropriations are staying flat. We now have this huge gap. We are trying to close this gap. It is not 100 percent. It is about 50 percent of closing that gap, and that would tend to bring us back to about where we were 3 or 4 years ago, in terms of the difference between the authorization level and the appropriations level. Now, there is one other thing that happened during this period of time. The Congress passed something called No Child Left Behind, a new mandate on the States, a new mandate that States had to do in education. Now, I am on the authorizing committee for education. At that time, Senator Kennedy was our chairman. I can remember sitting at the White House, and I can remember sitting up here in meetings discussing No Child Left Behind, I say to my friend from West Virginia, and about what it was going to cost. The White House, through their representatives, agreed on what level we would fund No Child Left Behind. Now, that was only authorization because it was an authorization bill. But we were told by the White House that they would meet these authorization levels. One of the reasons I voted for the bill, not that I was enamored with it, but I felt the White House had made a commitment they would fund No Child Left Behind at the levels we agreed to. We agreed with the White House: These levels? OK, yes, we agree at these levels. Here they are. This level, right here, $22.75 billion for fiscal year 2006. That is what we agreed upon. Yet our appropriation for this year is $12.8 billion. That is why I said it is about--well, I said 40 percent. I made a mistake. It is a little over 50 percent. But in fiscal year 2002, we were at about 75 percent of funding, and that was at the beginning of No Child Left Behind. So what Senator Byrd is trying to do is make us live up to what we had agreed to do, with both the White House and the States. I dare say, any Senator here who goes home and talks to their State government, talks to their school districts--go out and talk to your school districts and find out what they are saying about No Child Left Behind. They are saying: Wait a minute. You put all of these mandates on us. You said you were going to fund it. Now you are not, and now we are being penalized because we can't meet the goals of No Child Left Behind. We have put them in kind of what they call a catch-22 situation: Darned if you do; darned if you don't. Either way, you lose. So that is why I am supporting Senator Byrd's amendment. The budget needs to be waived. We need to meet our commitments on this.

Mr. HARKIN. I move to reconsider the vote, and I move to lay that motion on the table. The motion to lay on the table was agreed to.

Mr. HARKIN. Mr. President, I ask unanimous consent that the amendment now be laid aside.

Mr. HARKIN. Mr. President, earlier today, on behalf of myself, Senators Kennedy, Reid, Durbin, Obama, Bayh, Kohl, Mikulski, Clinton, Johnson, Dayton, and Byrd, I laid down an amendment dealing with preparing this country for an avian flu pandemic. The amendment that we laid down today and that we will be voting on tomorrow will allow the United States to dramatically step up preparation for an avian flu pandemic. Last month, I offered and the Senate approved an amendment to the Defense appropriations bill that provided $3.9 billion for preparation for such a pandemic. At that time, there was some discussion as to why we were putting it on the Defense bill; it should go on the Labor- Health and Human Services bill. At that time, we didn't even know if we would have this bill up. Well, the bill is in the Chamber, and this amendment appropriately belongs on this legislative vehicle in our jurisdiction. So the amendment that was laid down that I offered earlier today is essentially a more robust version of that earlier amendment again based on more and better information we have obtained since that time. There is a broad consensus in the scientific community as to the steps we need to take to get ready for a potential pandemic. Reflecting that scientific consensus, the amendment we have laid down will do four broad things. First, as our first line of defense, it will dramatically step up international surveillance of avian flu outbreaks overseas. Second, it will ramp up our vaccine production infrastructure here in the United States. Third, it will give us the resources to build up stockpiles of vaccines that are currently believed to be effective against the flu as well as building up stockpiles of antiviral medications. Fourth, it will strengthen our public health infrastructure at the Federal, State, and local level, which today is simply not equipped to cope with a major pandemic. Some have suggested that we be patient, that we wait for the administration to put forward a plan to fight avian flu, but we have already waited too long as a nation. We have been warned now for almost 8 years to get ready. We had been warned about a lot of other things. We were warned for years that the levees in New Orleans would fail in the case of a major hurricane. Yet the Federal Government did not do anything. And the Federal Government has not come forward with any action plan now regarding the avian flu pandemic possibility. Even within the last year, as the threat of this pandemic becomes more urgent and immediate, there still is no plan. So today, with the alarm bells ringing at full volume, we in Congress cannot in good conscience wait any longer. We need to act. If the administration offers a plan at a later date, that is fine. We will almost certainly include the basic elements encompassed here. We are all talking to the same people, whether it is the Centers for Disease Control and Prevention or NIH or the major drug companies. We know what we have to do. So if we take action now in this appropriations bill with the amendment we have offered, then we will have already passed an appropriation, we will not have lost any time, and we will be able to go forward as rapidly as possible. There is no question the United States right now is woefully unprepared for a major outbreak of human-to-human transmitted avian flu. We have already had two disasters. We had 9/11, we had Katrina, we were unprepared for both despite clear warnings that we had. Similarly, we have been warned in no uncertain terms about avian flu, but our preparations are inadequate. As many of my colleagues know, avian flu, or H5N1 as it is called in the scientific community, has passed from bird to bird. What started in a small area of Southeast Asia has now extended we know to as far away as Greece, Turkey, and Romania. Recently, one bird in Great Britain died and was examined and found to have H5N1. We know that the avian flu has been detected in Indonesia and in Japan and in the Philippines, in China, in Russia. It is only a matter of time before these migratory birds cross paths and the avian flu is now in Canada and the United States and South and Central America. This is a virulent form of flu. One hundred percent of the birds, the chickens and the birds that have gotten this have died, 100 percent. Fifty percent of the humans who have come down with avian flu have died. Now, thus far we only know of one case, one certified case where the flu virus has gone from a human to a human. Only one case. But that has warned us that it is capable of doing so. Now, it is not sustained, it is not widespread, but scientists tell us it is only a matter of time. And we do not know how much time we have. We know as we say it has killed 50 percent of the individuals it infected. A nightmare scenario, a kind of 21st century Black Death is not difficult to picture. Indeed, most experts say it is not a matter of if but when. So we have to ask some tough questions now: Where do our preparedness efforts stand? Can we do better? First, look at global surveillance. The Centers for Disease Control is doing a great job working in concert with the World Health Organization and governments in affected regions to detect the disease and help stop its spread. This is our first line of defense-- surveillance and quarantine in the area in which it occurs. The sooner we can identify it and quarantine it, the better off we will be. To put it in other terms, better to find H5N1 over there than home. The good news is we have experience. The Centers for Disease Control and Prevention kept SARS from coming to the United States with this procedure. But we do not have adequate personnel, we do not have the resources in place in other countries to make sure that we detect as rapidly as possible an outbreak of avian flu. We can and we must do better to protect our people. Second, the status of our capacity to produce vaccines in the United States, unfortunately, is all bad news. It is astonishing when we tell people we only have one plant in America capable of producing flu vaccines. And that plant uses an egg-based technology. Right now, in the event of a worldwide pandemic, the United States would have to rely on imported vaccines, vaccines that other countries might not be willing to send to us. After all, the first responsibility of any government is to protect its own people, and if this pandemic starts, every government is going to want to protect its own people first. So we are vulnerable. We are playing catchup ball. We need to help private industry develop more vaccine manufacturing capacity, and we need to do it in a way in which we can produce enough vaccine rapidly to deal with a major outbreak. Some say it would take many years to produce a non-egg-based, cell- based production capacity. I don't accept that. This is a matter of incredible urgency. We have to do better, and we can do better. Our goal should be to have research and production capacity to isolate a virus, convert it to a vaccine, produce enough vaccine for nearly 300 million Americans, and do it within 6 to 9 months. Right now we are a long way from reaching that goal. This amendment we have offered will put the money forward to get that process moving rapidly to develop cell-based technology for the production--the rapid production--of vaccines in this country. Third, as I mentioned, we need an aggressive program of purchasing and stockpiling vaccines and antivirals. Unfortunately, the United States is way behind. I am indebted to Senator Kennedy for producing this chart. I want to show it here. The World Health Organization a few years ago suggested that countries stockpile at least 25 percent antivirals to cover their population. Look what some other countries did: Australia, 20 percent; Britain, 25 percent; France, 25 percent; Japan, 17 percent; the United States, 1 percent. We only have enough antivirals to cover 1 percent of our people. It is unconscionable. So we need to play catchup ball here also. We need to stockpile--and that is what this amendment will do--to provide the funds to begin to ramp up the production of these antivirals. Roche is a drug company. I met with them. They publicly announced-- they hold the patent; they produce most of it overseas--they are willing now to let other generic companies produce this under license to them. We need to get the money out there right now to buy them from those companies so they can start producing the antivirals now. Not next year; now. That is what this amendment provides. Fourth, and last, public health infrastructure. Right now our public health infrastructure is simply not capable of dealing with either a bird flu pandemic or even an act of bioterrorism. Even if we had an adequate stock of vaccines or antivirals, what good does it do if we don't have the public health infrastructure to identify, isolate, and deliver the antivirals and the vaccines? Again, the President's budget this year cut $120 million from State public health agencies. This amendment does not just restore that. We need to do a lot more than that. We need to make major new investments. We need to hire more public health professionals--epidemiologists, physicians, lab technicians, and others. We also need to dramatically increase the surge capacity of hospitals. As Dr. Rick Blum, the president of the American College of Emergency Room Physicians, recently said: We've pumped billions of dollars into preparedness since 9/ 11, but virtually none of that has gone to the one place where we know 80 percent of patients go first. The emergency room--if we have an avian flu pandemic, that is where people will go. And most victims of avian flu might need ventilators to help them breathe. Right now there are only 105,000 ventilators in the entire United States, and three-quarters of them are in use on any given day. We have our work cut out for us. We face enormous technical and logistical challenges, and there is no time to waste. The time for planning and planning and planning and planning is over. It is now time to act. This amendment would provide, as I said, nearly $8 billion for a comprehensive national effort to prepare our people for an avian flu pandemic. I know that sounds like a lot of money, but keep in mind, it is less than 2 months of our expenditures on the war in Iraq. When this avian flu pandemic--I don't say if; when. Scientists tell us it is not a question of if, it is a question of when. When it hits, we have to be ready to protect our people. That is what this amendment does. Again, I hope as we move forward we can get this amendment adopted and get the money out there. It does not have to be spent now. It is at the Secretary's discretion, but at least it is there and they can move on it rapidly to do what we all know is necessary to protect our people in this country. I have used my 15 minutes. I want to reserve 15 minutes for Senator Kennedy.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that Jacob Cilek of my staff be granted the privilege of the floor for the duration of today's session.

Mr. HARKIN. I ask unanimous consent that Matt Ryno of my staff be granted the privilege of the floor for the duration of today's session.

Mr. HARKIN

Mr. HARKIN. Mr. President, I rise today to recognize National Breast Cancer Awareness Month, and call for quick passage of the Breast Cancer Environmental Research Act. Breast Cancer is a disease that has impacted virtually every American's life, including my own. My two sisters both had breast cancer and died of the disease. Sadly, they contracted breast cancer at a time when regular mammograms and improved treatment methods were not widely available. More than 3 million women are currently living with breast cancer, and each year, tens of thousands of women die from this disease. In 1992, I offered an amendment to dedicate $210 million in the Defense Department budget to begin the Breast Cancer Research Program, a partnership between the military, medical, and breast cancer survivor communities to develop and implement innovative research towards the goal of curing and eliminating breast cancer. This funding was in addition to the funding for breast cancer research conducted at the National Institutes of Health. My amendment passed and overnight it doubled Federal funding for breast cancer. Since then, funding for breast cancer research has been included in the Defense Department budget every year. Almost a decade ago, when I looked into the issue of breast cancer research, I discovered that barely $90 million was spent on breast cancer research. Today, I am proud to say that between the Department of Defense, the National Institutes of Health and the Centers for Disease Control and Prevention, nearly a billion dollars annually is being spent on finding a cure for breast cancer. Scientific researchers are making exciting discoveries about the causes of breast cancer and its prevention, detection, diagnosis, treatment and control, leading to real progress in our war against this devastating disease. We know better than ever before how a healthy cell can become cancerous, how breast cancer spreads, why some tumors are more aggressive than others and why some women suffer more severely and are more likely to die of the disease. However, our work is not done. While important advances have been made, we still do not know what causes this disease, or how to prevent it. Today, I call upon my Senate colleagues to cosponsor the Breast Cancer Environmental Research Act, legislation modeled after the Defense Department's Breast Cancer Research Program. The Breast Cancer Environmental Research Act would establish eight centers to conduct research on environmental factors that may contribute to breast cancer and, importantly, would require collaboration with community organizations in the areas where the centers are established. I strongly believe any breast cancer research must include the perspectives of breast cancer survivors, and this legislation does so by including consumer advocates in the peer review and programmatic review process. In addition, the legislation is structured to ensure the kind of efficiency and public accountability that has made an overwhelming number of Senate colleagues, as well as scientists and consumers, so supportive of the Department of Defense Breast Cancer Research Program. I urge my colleagues to support the Breast Cancer Environmental Research Act.

Mr. HARKIN

Mr. HARKIN. Mr. President, I ask unanimous consent that William Viner be granted the privilege of the floor during the duration of today's session.

Mr. HARKIN

Mr. HARKIN. If the distinguished chairman would yield, I am sorry I was off the floor momentarily, but did the Senator from Pennsylvania do anything about the amendment that is pending?

Mr. HARKIN

Mr. HARKIN. Yes.

Mr. HARKIN. Someone told me there was a vote on a couple of judges at 5:30. I think after that we have to take a look and see how many amendments there are, if I am not mistaken. I thought the chairman was going to offer a cloture motion tomorrow. If we have third reading, the chairman can't file a cloture motion.