Ted Kennedy

Mr. KENNEDY

Mr. KENNEDY. I suggest the absence of a quorum.

Mr. KENNEDY. Mr. President, I, first of all, again want to commend the Senate leadership for moving to consideration of the nomination of Dr. Satcher. It is long past time for the Senate to vote on his nomination to be Surgeon General. It is long past time for the country to have a Surgeon General and have an Assistant Secretary for Health. And it is important that we make a judgment, which we will do tomorrow. I believe there will be strong bipartisan support, as there should be, for this really extraordinary, outstanding nominee. I listened with interest and read a good part of the debate. Mr. President, the discussion thus far is a very brief sketch of Dr. Satcher's extraordinary achievements. He rose from poverty, obtained his doctorate and medical degree. He has been published in many of the scientific publications. He has been recognized with honorary degrees and various awards over the course of his lifetime. He has been endorsed by an overwhelming number of groups and organizations. When you look through the list virtually every medical association--the American Medical Association, the Academy of Pediatrics, the Public Health Physicians--and the list goes on and on; virtually all of the nursing associations; the hospitals; the principal pharmaceutical companies; the major academic centers; the Association of American Medical Colleges; virtually all the children's groups, such as the Children's Defense Fund, the Children's Health Fund; virtually all of the allied health groups, the Cancer Society, the Lung Association, the Public Health Association, the Association for Maternal and Child Health Programs, the National Mental Health Association; all of the disability groups, the March of Dimes, National Multiple Sclerosis--again the list goes on--women's groups, such as the Women's Legal Defense Fund, the Breast Cancer Coalition, the National Black Women's Health Project, the National Asian Women's Health Organization; virtually all the senior groups, the National Council of Senior Citizens; and very strong support from the various religious groups; virtually all of the civil rights groups, law enforcement societies, the other groups; family, violence prevention, and a number of extraordinary individuals. I do not agree with all of these organizations on all of their various matters, but the breadth of the type of support that we have here, virtual uniformity, the men and women who have judged him on the basis of his professional life and also about his commitment and caring, it is virtually uniform. And these are the men and women, the organizations, who over a lifetime have been associated with this really extraordinary individual. It is interesting. Are all these groups and individuals that support Dr. Satcher out of step with those that have spelled out their reservations about him? I daresay, this is about as mainstream a group of organizations as we would find in our country. Basically, it is a group of organizations that understand the extraordinary life and achievements and accomplishments of a very, very exceptional individual. Mr. President, Dr. Satcher's life story is the story of America at its best. He eminently deserves the Senate's overwhelming support and confirmation. Dr. Satcher learned his work ethic early. As a young boy in rural Alabama, he often rose before dawn to work on his family's farm before heading off to his segregated school. In addition to helping on the farm, he worked after school and on weekends in the foundry where his father worked for some 55 years. His extraordinary ability was evident early. He did so well in high school that he sometimes substituted for the school's chemistry teacher and other teachers when they were ill. Dr. Satcher rose above the poverty and racism of his youth to become a national public health leader. His early commitment to his family, his education, and his community reflect the best American values. Today, he is a respected family doctor. He is a respected researcher and educator and public health leader. He is a role model for everyone, especially those from disadvantaged backgrounds. Before becoming the director of the Centers for Disease Control and Prevention, Dr. Satcher was President of Meharry Medical College in Nashville, the Nation's largest private historically black institution for educating physicians, other health care professionals, and medical researchers. This is a nominee whose whole life has been committed to making health better for fellow citizens, as an educator, practicing physician, and as a teacher. How fortunate we are to have this nominee. Earlier in his career, before he served as president of Meharry, he served as professor and chairman of the Department of Community Medicine and Family Practice at Morehouse School of Medicine in Atlanta. He served on the faculty of UCLA School of Medicine and the King/Drew Medical Center in Los Angeles, one of the top medical teaching schools in the country. For 5 years, Dr. Satcher ably led the Centers for Disease Control and Prevention in Atlanta, the Federal agency responsible for protecting the Nation's health and preventing disease, injury and premature death. Dr. Satcher has many accomplishments as director of the CDC. In 1992, under his leadership, CDC developed and implemented the extraordinarily successful childhood immunization initiative. Before the initiative that was developed, only a little more than half of the Nation's children--55 percent--were immunized. Today, it is 78 percent. As a result, vaccine-preventable childhood diseases are now at record lows. He has borne an important responsibility. There are others that should share in those achievements, but Dr. Satcher was there and fighting and in a key position to make a very, very important difference--and he has, and he will. Dr. Satcher has also led the CDC efforts to deal more effectively with infectious diseases and food-borne illnesses. We rely heavily on CDC to provide the rapid response needed to combat outbreaks of disease and protect public safety. Under Dr. Satcher, CDC has implemented a strategy against new and re-emerging infectious disease, like tuberculosis, using better surveillance and detection. In response to recent food-poisoning incidents, Dr. Satcher has been instrumental in developing a new early warning system to deal with such illnesses. Dr. Satcher has received numerous honors and prizes, including the Watch Grassroots Award for Community Service in 1979, the Human Relations Award of the National Conference of Christians and Jews in 1985, Founders' Award of Distinction of the Sickle Cell Disease Research Foundation in 1992 and the Martin Luther King Jr. Drum Major for Justice Award in 1994. He was elected to the Institute of Medicine of the National Academy of Sciences for his leadership skills in 1986; recognized again by the National Academy of Sciences as being one of the outstanding leaders in health policy and for all of his leadership skills brought into the Academy of Sciences. We are fortunate to have this extraordinary human being as a nominee. In 1996, he received the prestigious Dr. Nathan B. Davis Award given to Presidential appointees for outstanding public service to advance the public health. More recently, he received the James D. Bruce Memorial Award for distinguished contributions in preventive medicine from the American College of physicians. And the list goes on: the John Stearns Award for Lifetime Achievement in Medicine from the New York Academy of Medicine, and the Surgeon General's Medallion for significant and noteworthy contributions to the health of the Nation. Dr. Satcher's broad range of skills and experience and his strong commitment to improving public health make him well qualified to be the country's principal official on health care and policy issue--America's doctors. Today, the public is constantly bombarded with reports about new diseases from other parts of the world--from the Ebola virus to dengue fever to Hong Kong flu to mad cow disease. Yet there is no Surgeon General in office to educate the public about these threats and to dispel the widespread concern and fear about them. The public also continues to be confused about rapid changes in the health care system, especially on issues such as access and quality and cost and managed care. We need a Surgeon General who can address these challenges. For more than three decades, the Surgeon General has been effective in educating the public about the dangers of smoking. Now we know there are those that don't like that message and take it out on the messenger, and we understand that. At his hearing in the Senate Labor Committee, Dr. Satcher said with typical eloquence that he would like to ``take the best science in the world and place it firmly within the grasp of all Americans.'' That challenge is a big part of the job of the Surgeon General--to translate scientific research into plain talk that the public can use to improve their health. Dr. Satcher's nomination has received broad bipartisan support and is endorsed by a large numbers of organizations, including medical societies and all of the various groups I mentioned earlier. Clearly, he has the credentials, the commitment and integrity to serve brilliantly as Surgeon General and as the Assistant Secretary for health. Mr. President, some of the critics have raised questions about some of the particular issues, and I will respond to some of those. Some critics of Dr. Satcher have argued that he and CDC want to fund needle exchange programs that will increase the use of illegal drugs in the name of AIDS prevention. It is preposterous to suggest that Dr. Satcher would do anything to advocate the use of illegal drugs. Use of illegal drugs is wrong and is a major public health problem and a major law enforcement problem. The needle exchange is a strategy for preventing the spread of infectious diseases by providing clean needles in exchange for old ones. One to two million Americans inject illegal drugs. Sharing of needles is a leading cause of AIDS transmission. Approximately a third of all AIDS cases are linked to drug use. For women, 66 percent of all AIDS cases are caused by drug use or sex with partners who inject drugs. More than half of the children with AIDS contracted the disease from mothers who are drug users or their sexual partners. A report to Congress from Secretary Shalala in February of 1997 concluded that needle exchange can be an effective part of a strategy to prevent HIV and other blood-borne diseases. The GAO, National Academy of Science, National Commission on AIDS, and the Congressional Office of Technology Assessment have all concluded that needle exchange is an effective strategy. Despite the scientific and public support for such programs, a congressional ban on Federal funding of the program is in effect unless the Secretary of HHS determines that certain conditions are met. These include a finding that the program is effective in reducing AIDS transmission, and it has not encouraged illegal drug use. Dr. Satcher is an eminent scientist. He has recommended to Congress we allow scientific studies to answer the key questions involved with this issue. Dr. Satcher supports Federal funding for research and evaluation of State and local needle exchange programs to assess the effort. That is the extent of his position, to find out what the best in terms of science is going to provide, whether it does make a difference. That sounds to me to be a very reasonable and responsible position to have on that question. Some critics have alleged Dr. Satcher, as head of CDC, has been promoting a pro-gun-control agenda. In reality, Dr. Satcher, through CDC's National Center for Injury Prevention and Control, is simply carrying out a congressional mandate to collect data relating to all types of injuries that occur outside the workplace, including those caused by motor vehicle accidents, fires, and firearms. President Bush established the National Center for Injury Prevention and Control in the hope that just as the Federal highway fatality reporting system helps to reduce unintended death from automobile accidents, better information about other injuries would lead to better education and prevention programs. Recent public service campaigns have focused on such injury prevention strategies, especially children's safety, bicycle safety, seatbelt use, watercraft safety. Preventing violence is a public health issue and a criminal justice issue. Thirty-eight thousand Americans were killed with firearms in 1994; 17,800 were homicides, 18,700 were suicides, and 1,300 were caused by unintentional discharge of a firearm. Approximately 100,000 citizens are treated in hospital emergency rooms each year for nonfatal firearm injuries. The budget of the Center for Injury Prevention and Control amounts to $49 million a year or 2 percent of the overall CDC budget of $2.5 billion. Of the $49 million, only $7.5 million is spent on research concerning youth violence, and less than 11 percent of that deals with firearm-related violence. Even that is enough, listening to the speeches in opposition to Dr. Satcher--a center set up by a Republican President, that has these broad responsibilities, and people are flyspecking that there will be less than $1 million and, therefore, somehow he is going to violate second amendment rights. Injuries resulting from violence are preventable. CDC's purpose is to save lives. Firearm injuries have a huge impact on public health. We cannot ignore the issue. Instead of criticizing Dr. Satcher's efforts as a public health leader to address this serious problem, we should condemn the attempts by the National Rifle Association to shut down this important aspect of research into the causes and the prevention of injury. Now, critics have also charged that Dr. Satcher, as CDC director, conducted HIV studies on newborns and allowed them to be sent home without informing parents of the HIV status of their children. This survey was part of the Nation's effort to obtain more information on the spread of HIV in various populations. The survey was implemented through State and local health departments with support from CDC. In fact, the survey, which was initiated under President Bush, was implemented in 45 States, including the State of Missouri, when Senator Ashcroft was Governor of that State. He signed the papers. And as I understand it, the effort was made to continue at the time when they were going to halt this study.

Mr. KENNEDY. I think the Senator from South Dakota indicated 6 or 7 minutes; 5 minutes?

Mr. KENNEDY. So I will yield myself such time as I might use on behalf of those who are supporting Dr. Satcher.

Mr. KENNEDY. Mr. President, I understand that we are under a time control. Am I correct?

Mr. KENNEDY. Briefly.

Mr. KENNEDY. The subject of that transmittal was a University of California needle exchange study, commissioned in 1992 by the Bush Administration. The goal was to provide a scientific evaluation of local needle exchange programs. Senator Ashcroft has requested and received a review of the University of California study prepared by CDC scientific staff. The CDC review was conducted by career CDC scientists and the bulk of the review was done before Dr. David Satcher joined CDC. The CDC staff analysis was not intended to reflect scientific consensus within the Department of Health and Human Services, which must include the National Institutes of Health, the Substance Abuse and Mental Health Services Administration, the Health Resources and Services Administration and the Food and Drug Administration. While scientific review of needle exchange issues continues, HHS has not yet concluded that the conditions set forth by Congress on federal funding of needle exchange programs have been met. Dr. Satcher has never advocated taxpayer funded needle exchange programs for drug abusers. He also believes strongly that we should never do anything to advocate the use of illegal drugs. The intravenous use of illegal drugs is wrong. It is a major public health problem as well as a law enforcement concern. Dr. Satcher does believe that to realize our goals of effective HIV prevention, it is vital that we identify and evaluate sound public health strategies to address the epidemic of HIV and substance abuse. Dr. Satcher, like Secretary Shalala, has recommended to Congress that we allow scientific studies to answer the key questions involved with this issue. Dr. Satcher supports the Administration's position as summarized in Secretary Shalala's February 1997 report to Congress that concluded that needle exchange programs ``can be an effective component of a comprehensive strategy to prevent HIV and other blood borne infectious diseases in communities that choose to include them.'' But, the Department has not yet concluded that the conditions set forth by Congress on federal funding of needle exchange program have been met. Specifically, it has not yet been concluded that needle exchange programs do not encourage drug use, one of the key standards set by Congress. The Department continues to look at the science on this issue. The federal government continues to fund the research and evaluation of state and locally funded needle exchange programs in order to increase scientific knowledge concerning their impact, if any, on drug use. But at present, this is, and should be, a local decision. Under current law and policy, local communities remain free to use non- federal funds to support such programs if they choose. Madam President, earlier today, the Senator from Missouri and I had a colloquy about surveys of child-bearing women for HIV. The surveys began in 1988 and the State of Missouri requested to participate in them from the beginning, including while Senator Ashcroft was Governor, the director of the division of administration signed on behalf of Missouri. I ask unanimous consent that two applications on behalf of the State of Missouri be printed in the Record at this point.

Mr. KENNEDY. Madam President, the Senator from Missouri asserted that the CDC funded an Illinois needle exchange conference ``Getting the Point.'' The H.H.S. informs us that the CDC did not cosponsor that conference. The Center's for Disease Control do not fund ``needle exchange conferences.'' CDC does make a number of small grants to local organizations to support HIV-AIDS prevention conferences, and awarded approximately $600,000 to 65 projects last year. The conferences can include such topics as community planning; HIV testing; counseling; referral and partnership notification; health education and risk reduction; public information programs; and training and quality insurance programs. The content of the conferences is determined locally, according to the needs of the community. However, CDC reserves the right to review the conference agenda. The only documents CDC located that were determined to be at all responsive to Senator Ashcroft's request on needle exchanges were documents related to an HIV conference in Denver, Colorado. After reviewing the agenda, which focused on the transmission of HIV through drug use and included sessions on needle exchange, CDC found it inappropriate for funding. CDC withdrew its award of $4,719 to the conference in October 1997. In March of 1996, CDC was incorrectly listed as a cosponsor of a conference held in Atlanta which included sessions on needle exchange. CDC did not fund the conference, which was held at the Rollins School of Public Health at Emory University, and Dr. Satcher did not participate in it. A CDC scientist participated in the conference to discuss the HIV epidemic among intravenous drug abusers. The scientist was unaware that Dr. Satcher had declined to participate in or sponsor the conference. Following the conference, one of the participating organizations released information listing CDC as a cosponsor. When the error was discovered the organization withdrew the materials. Dr. Satcher is opposed to illegal drug use, and would never do anything to encourage the use of illegal drugs. He agrees with the Administration's position. While the studies summarized in Secretary Shalala's February, 1997 report showed that needle exchange programs can be an effective HIV prevention strategy, the Administration has not yet found a similar degree of evidence on the question of whether such programs encourage drug use. Therefore, both tests--as mandated by Congress--have not been met. Senator Ashcroft has charged that HHS inappropriately withheld a copy of an intra-departmental transmittal memo when it supplied Senator Ashcroft with information concerning CDC's staff review of a University of California Needle Exchange study. The truth is that Senator Ashcroft received everything he requested from HHS less than 24 hours after his request was first sent to HHS by Majority Leader Lott's staff. Senator Ashcroft's request included ``The CDC's 1993 and 1994 written reviews of the California Study'', which he received with all the other materials. The transmittal memo in question, which was prepared subsequent to the CDC staff review as a cover note to a non-CDC official, was supplied to Senator Ashcroft several hours later when HHS realized that his staff was interested in additional material beyond his original request. The charge that this transmittal memo was inappropriately withheld is untrue. The memo is an innocuous six sentence cover note to the Deputy Assistant Secretary for Health that summarizes the subject of the CDC needle exchange staff review and indicates that it was reviewed for scientific comment by staff of other HHS health agencies. If anything, the memo indicates how little Dr. Satcher and other top HHS public health officials were involved in the CDC staff review of the needle exchange study. In the memo, Dr. Satcher states that ``Directors of these [public health] agencies have not been asked for final concurrence on the review.'' It is also important to remember that the CDC review of the University of California needle exchange study was a scientific evaluation prepared by CDC career staff. Most of the work was completed before Dr. Satcher joined CDC on November 15, 1993. And as Dr. Satcher's cover note indicates, it was not intended to represent the views of the leaders of the HHS public health agencies. I ask unanimous consent that the full text of the transmittal letter be printed in the Record.

Mr. KENNEDY. Mr. President, I yield to the Senator from Georgia.

Mr. KENNEDY. I yield 5 minutes to the Senator from Ohio.

Mr. KENNEDY. Mr. President, this assurance has been enough to persuade many of our Republican colleagues to put this issue aside and support Dr. Satcher's nomination. I see others who want to address the Senate. I yield the floor. Mr. DeWINE addressed the Chair.

Mr. KENNEDY. Mr. President, in addition, Dr. Satcher emphatically stated on October 28, 1997, in a letter to Senator Frist, chairman of the Subcommittee on Public Health and Safety, ``I have no intention of using the positions of Assistant Secretary for Health and Surgeon General to promote issues related to abortion.'' I ask unanimous consent that this letter from Dr. Satcher to Senator Frist may be printed in the Record.

Mr. KENNEDY. Yes, I yield such time as the Senator requires, and then could I ask consent that the Senator from South Dakota be recognized after the Senator from Utah, for whatever time he requires?

Mr. KENNEDY. Dr. Sullivan goes through the studies and regimens and deals with those in a very responsible way--I would say we could call it an unbiased way. He has been the head of the whole department, HHS, under a Republican administration. He has known this man for a lifetime, and he has heard all of the charges we have heard last week. He discusses them and provides strong support for Dr. Satcher. It is a very, very powerful letter. I won't take the time of the Senate now to go through the letter. It is a very important letter, which I hope our colleagues will consider. Now, Mr. President, there are other issues. I would like to briefly address the AZT trials. Some of our colleagues have questioned Dr. Satcher's support for clinical trials of the drug AZT in foreign countries as part of the international public health effort to stop the epidemic of mother-to-infant transmission of the AIDS virus. Every day, more than 1,000 babies in developing countries are born infected with HIV. Clinical trials in the United States in 1994 showed that it is possible to reduce mother-to-infant transmission of HIV by administering AZT during pregnancy, labor and delivery. It was obvious, however, that such treatment would not be feasible in developing countries. It is too expensive and requires ongoing therapy, including intravenous administration of AZT, which is not possible in remote areas. It also prohibits breastfeeding, which the various populations that were the most at risk were following. Thus, the standard treatment in the United States termed the ``076 Regimen,'' was not a feasible option for the developing countries. Dr. Satcher could have washed his hands of the whole matter, but he didn't. He felt he could help. A group of international experts convened by the World Health Organization in June 1994 recommended research to develop a simpler, less costly treatment. Responding to the urgent need, the Centers for Disease Control and Prevention, the National Institutes of Health, the World Health Organization, and other international experts worked closely with scientists from developing countries to find treatment that is feasible for use in these countries and that can reduce the devastating toll of HIV on their children. In cooperation with experts and leaders from countries where the studies were to be conducted and with careful input from ethical committees, it was recommended that placebo-controlled trials offer the best option for a rapid and scientifically valid assessment of alternative treatments to prevent mother-to-infant transmission of HIV. The decision to go forward with the trials was carefully made by the countries themselves and by the international medical research community. They did so because it was the only approach that could be expected to produce a sufficiently clear response, in a reasonable time period, to the questions that had to be answered about safety and effectiveness of an alternative treatment in the developing world. The point is made that they might have followed a different experimental design or a different regimen and could have gotten the outcomes, perhaps not quite as accurate, but fairly accurate, but it would have taken a good deal longer to receive the outcomes if they had not used a placebo. Dr. Satcher has acted entirely ethically and responsibly on this issue. The World Health Organization and the developing countries had urgently requested help from CDC and NIH in designing and conducting these trials. Before patients were enrolled in the clinical trials, they were specifically informed of their AIDS status. They were specifically counseled about the risks and benefits of participation, including the fact that they might be in a study group that received a placebo instead of an experimental AZT antivirus drug. I think that is an enormously important responsibility, that full information is available and that those who are participating in these various regimens have a full understanding of the risks. There is no indication that they did not. The best we have heard from those opposed to Dr. Satcher is anecdotal kinds of information. But we never heard that prior to the time that we had this opposition on the floor of the Senate to his nomination. As a practical matter, the only AZT treatment available to any women in these developing countries is the treatment provided to participants in the study. Ethics Committees in both the United States and developing countries conducted continuous, rigorous ethical reviews of the trials. The committees are made up of medical scientists, ethicists, social scientists, members of the clergy, and people with HIV. The role of these committees guaranteed that the trials conform to strict ethical guidelines for biomedical research, including the Declaration of Helsinki and the International Ethical Guidelines for Biomedical Research involving human subjects. Even those within the scientific community who have raised the concerns about these trials, such as Dr. Sidney Wolfe, director of Public Citizen's Health Research Group, have expressed their support for Dr. Satcher's nomination. Dr. Wolfe has said that he thinks Dr. Satcher will ``make an excellent Surgeon General.'' Dr. George Annas and Dr. Michael Grodin of Boston University's School of Public Health have stated, ``While it is true that we have expressed concern regarding the U.S.-sponsored trials in Africa, it is also true we strongly support Dr. Satcher's nomination as Surgeon General.'' These judgments that are made on these ethical issues are complex, and it is very difficult to get virtual uniformity on some of them, particularly when they are at the cutting edge of various kinds of research. We understand that is part of the debate on these issues. But to those who have expressed a differing opinion regarding the various studies, even though every effort was made to go through the various regimens to make sure they adhere to ethical standards--and I believe, having gone through this in great detail myself that it certainly meets all of those standards--but the ones that have expressed some reservation by and large are enthusiastic about Dr. Satcher. It isn't that they reached a different conclusion with regard to this but they also respected the process Dr. Satcher followed. Again, this was not an issue during the confirmation hearings, not that we should be restricted from talking about it. But it is something that we welcome the opportunity to try to respond to. Some colleagues have also questioned Dr. Satcher's views with regard to abortion. Again, this was an issue during Dr. Satcher's confirmation hearing. But some Senators appear eager to use the controversial and unconstitutional Partial-Birth Abortion Ban Act to attach his credibility. Dr. Satcher believes--as do most Americans--that abortions should be safe, legal and rare. His position reflects 25 years of medical experience and is entirely consistent with Supreme Court decisions. In fact, Dr. Satcher supports a ban on most late-term abortions. He believes that ``if there are risks for severe health consequences for the mother, then the decision [to have an abortion] should not be made by the government, but by the woman in conjunction with her family and physician.'' Dr. Satcher's position on this issue is shared by the American College of Obstetricians and Gynecologists, the American Medical Women's Association, the American Nurses Association, and the American Public Health Association. Some of our Republican colleagues have raised this issue in an attempt to defeat a supremely qualified nominee. They point out that Dr. Satcher's position on this issue is at odds with the position of the American Medical Association--but what our Republican colleagues don't point out is that the AMA has unequivocally endorsed Dr. Satcher's nomination. I ask unanimous consent that the letter of endorsement from the AMA may be printed in the Record.

Mr. KENNEDY. Dr. Wolfe raised some questions about ethical issues about the studies in Africa, and then we find Members of the Senate using his kind of statements and representations and saying, isn't this horrible, shouldn't we oppose it? And Dr. Wolfe is supporting Dr. Satcher. Then we have these studies and hear Dr. Ammann quoted here about how Dr. Ammann himself was very much involved in interacting with Dr. Satcher. He indicated his full and complete support for the nominee despite his concerns about these surveys. He stated, ``I support the nominee.'' We have heard it said considerable times over the past few days that these issues were never raised in the committee hearings. Dr. Satcher has the credentials, integrity, and commitment to be Surgeon General and Assistant Secretary for Health, and he really is outstanding. I mentioned the other day, Mr. President, we have the extraordinary letter of support from Dr. Sullivan, who was the Secretary of HEW, a Republican under the previous administration, who is familiar with these various kinds of issues that are being raised and considered here on the floor of the Senate. He goes into analyzing just about all of them. I urge my colleagues who are having any questions about it, take the time, and I will include it in the Record. I ask unanimous consent that Dr. Sullivan's letter be printed in the Record.

Mr. KENNEDY. I am familiar that he came with others on that. I think it is an open question whether he was lobbying for the continuation or not. Mr. President, this survey went on, as I mentioned, in 45 States. It began at a time when little was known about the impact of HIV on women and their children. Studies were carried on to check for the presence of antibodies to HIV in newborns. The presence of such antibodies could indicate that a mother has the HIV virus and the child has been exposed to the virus. Approximately 25 percent of the children exposed to HIV by mothers developed HIV infection, too. They were carried out by using blood samples left over from other procedures, which otherwise would have been discarded. The samples could not be identified as coming from specific individuals because the identifying information had been removed to protect confidentiality. At the time, because AIDS was so poorly understood, CDC decided to survey newborns as a group to learn more about the level of AIDS in particular communities at the time. Science offered no treatment for the newborns. The goal was to obtain information as quickly as possible about the prevalence of HIV in each population so that the resources could be targeted quickly and effectively. The survey adhered to the ethical principles, was approved by the Office of Protection From Research and Risk at NIH, the Institute of Medicine. The Academy of Sciences also agreed with using this well-established approach. No infants known to be HIV positive were sent home without parental notification. The information in the surveys was used by communities for education screening and treatment. In 1995, the survey ended when a combination of treatment options for infants with HIV and better ways to monitor HIV trends in women of childbearing age became available in September of 1997. Dr. Satcher recommended that the study be formally terminated, and HHS agreed. Some in the scientific community have questioned the surveys. Dr. Satcher's opponents cite the opposition of Dr. Arthur Ammann, the Professor of Pediatrics of the University of California Medical Center in San Francisco. These clinical trials are support for their opposition. They ignore the fact that Dr. Ammann has endorsed Dr. Satcher. I ask unanimous consent that a letter to Senator Lott from Dr. Ammann be printed in the Record.

Mr. KENNEDY. Could I ask how much time remains?

Mr. KENNEDY. Well, I certainly agree with the Senator that at the time when you have this kind of progress made for alternative remedies, there has to be full notification. The point that I also mention is that Dr. Satcher halted the studies.

Mr. KENNEDY. Fine. I will make every effort to provide them this afternoon. Are you questioning whether you did OK it for the State of Missouri, or not, just so I have an understanding?

Mr. KENNEDY. Senator, you will be able to explain it when we put it into the Record. This study was stopped by Dr. Satcher for some of the reasons that you are just mentioning at the present time. The point I was making here is that I listened to your very eloquent statement and criticism of this kind of a study last week, and then in the preparation for this debate found out, to my surprise, when it was initially proposed that your Administration signed on for it for the State of Missouri. Now, I am sure there are other changes, perhaps, that were brought about while you were Governor. That is fine. Whatever explanation you have on it--and maybe you were critical of it at the time that you received it. My information from the DHHS is that your Administration signed it and that you never expressed any criticism of it at the time that you were Governor, and that Dr. Satcher eventually halted it. I may be wrong in that series of time line, but that, at least, is my understanding.

Mr. KENNEDY. I don't believe just from personal knowledge that it was, but I will provide the papers during the course of the debate with regard to this particular program which the Senator is familiar with because he has criticized it quite extensively. But it has been represented to me by the Department that this program was put in place while you were Governor. If you tell me it was not, I am willing to accept that, but I have been informed it was. I was not aware that you had been critical of it prior to the time that we had Dr. Satcher's nomination--or were critical of it at the time it was in place in Missouri, but all I am saying is you or your Administration signed the paper for these studies which you have been critical of and I want them in the Record. I think you obviously will make whatever comment you want in interpreting it.

Mr. KENNEDY

Mr. KENNEDY. I suggest the absence of a quorum, with the time to be charged equally.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, I recently received an impressive letter from Boston Police Commissioner Paul Evans on Boston's current successful experience in reducing crime in the city, especially juvenile crime. Firearms homicides have plummeted, and the overall crime rate has dropped significantly. As Commissioner Evans states, ``The keys to our effort in Boston have been prevention, intervention and enforcement.'' The city's comprehensive approach includes not only law enforcement agencies, but the entire criminal justice system and community and social service agencies as well. As more and more cities become aware of this successful, anti-crime strategy, Boston is becoming a model for the nation on this vital issue. His letter goes on to say, ``Our strategy relies on focused intervention, with smarter, tougher enforcement targeted at the very small group of hard-core offenders. We work closely with state and federal agencies to disrupt the flow of illegal firearms by mounting coordinated investigations and prosecutions of gun traffickers.'' As Commissioner Evans emphasizes, the progress in Boston was made ``without measures such as housing juvenile detainees and convicts in adult jails and prisons. The focus of policy and dollars should be intervention and prevention at the front end, and not incarceration in adult facilities at the back end.'' As the Senate prepares to take up legislation to combat juvenile crime, I urge my colleagues to heed the words of Commissioner Evans, and I ask unanimous consent that his letter be printed in the Record.

Mr. KENNEDY

Mr. KENNEDY. Mr. President, as the scientific and medical community learns more about this legislation, almost universal opposition is developing. The American Association of Medical Colleges has circulated a letter to other scientific and medical organizations asking that this legislation not go forward. The letter states, The current opportunities in biomedical research are unparalleled in our nation's history. To ensure that these continue, the scientific and organized medicine communities urge you to oppose legislation that would prohibit the use of somatic cell nuclear transfer due to the grave implications it may have for future advances in biomedical research in human healing. They go on to compare S. 1601's attempts to ban not just cloning of human beings but use of the technique itself to the ill-considered attempts to ban recombinant DNA techniques in the '70's. They state, Like the recombinant DNA debate, the scientific techniques involved in cloning research hold great promise for our ability to treat and manage myriad diseases and disorders-- from cancer and heart disease, to Parkinson's and Alzheimer's, to infertility and HIV/AIDS. As of this morning, the letter had been signed by 71 distinguished organizations, from the American Academy of Allergy, Asthma, and Immunology, to the Association of American Cancer Institutes to the Parkinson's Action Network--and the list continues to grow. A letter from Dr. Gerald R. Fink, the Director of the Whitehead Institute of the American Cancer Society--one of the pre-eminent cancer research institutes in the country--explains very clearly what is at stake. Dr. Fink says, ``I am very concerned about efforts to bring the Bond bill to an immediate vote. While I agree that there should be a national ban on human cloning, it is essential that any such law protects areas of critical research that can benefit human health. The Bond bill's generic ban on the use of `human somatic cell transfer technology,' would in fact be quite damaging to medical research progress in the United States. ``The Bond bill would seriously limit our ability to develop new cell-based strategies to fight cancer, diabetes, and Alzheimer's disease. It would also prevent vital research on the repair of spinal cord injuries and severe burns. ``I urge you to convey to your colleagues that the Bond bill would cause us to lose ground in the battle against deadly and disabling human diseases.'' Is this really what the Senate or the American people want, Mr. President? To lose ground in the battle against deadly and disabling human diseases? I don't believe so. More than 120 scientific and medical organizations have expressed opposition to the Lott-Bond bill or concerns about prohibition on legitimate cloning research as the result of ill-conceived or over- broad legislation. So you have this immense array of scientific and medical societies and patient groups opposing S. 1601 and urging us to use caution and not to rush ahead without adequate consideration. Our friends who are supporting this bill say that it won't impede necessary research. If this true, where is their support from people who know. I ask them to cite even a handful of mainstream scientific or medical organizations supporting rushing their legislation through without committee hearings, adequate definitions, or even a semblance of careful consideration. They can't do it. They can't do it, because the scientific and medical and patients' communities know that what they are doing is wrong. As objectionable as the substance of this bill is the procedure by which it is being considered. To grant cloture to this bill tomorrow would be a travesty of the Senate's role as a deliberative body. This is one of the most important scientific and ethical issues of the 21st century. It was introduced on Tuesday of last week. It was put on the calendar on Wednesday. The Majority Leader tried to bring it to the floor on Thursday and filed an immediate cloture petition when he was unsuccessful. The Senate was not in session Friday--and few of our colleagues are present today. This legislation has not received one day of committee hearings. It has not received one minute of committee discussion and markup. The telephones in my office are ringing off the hook from scientists and physicians and patients from all over the country who are deeply concerned about the impact of this legislation. But they have had no opportunity to have their voices heard. Mr. President, this is an important issue. It warrants Senate consideration. But it does not warrant consideration under this accelerated and indefensible procedure. The authors of this legislation know that it cannot stand up to public scrutiny. That is the reason for their extraordinary attempt to rush this legislation through. The Lott-Bond bill does not just ban cloning of human beings, it bans vital medical research related to cloning--research which has the potential to find new cures for cancer, diabetes, birth defects and genetic diseases of all kinds, blindness, Parkinson's disease, Alzheimer's disease, paralysis due to spinal cord injury, arthritis, liver disease, life-threatening burns, and many other illnesses and injuries. Here is what the bill says--Page 2, line 13, paragraph 301 is entitled, ``Prohibition on cloning.'' It is the heart of the bill. It states, ``It shall be unlawful for any person or entity, public or private, in or affecting interstate commerce, to use human somatic cell nuclear transfer technology.'' That is the end of the statement. It does not just ban the technology for use in human cloning. It bans it for any purpose at all. That means scientists can't use the technology to try to grow cells to aid men and women dying of leukemia. They can't use it to grow new eye tissue to help those going blind from certain types of cell degeneration. They can't use it to grow new pancreas cells to cure diabetes. They can't use it to regenerate brain tissue to help those with Parkinson's disease or Alzheimer's disease. They can't use it to regrow spinal cord tissue to cure those who have been paralyzed in accidents or by war wounds. Congress should ban the production of human beings by cloning. But we should not slam on the brakes and stop scientific research that has so much potential to bring help and hope to millions of citizens. As J. Benjamin Younger, Executive Director of the American Society for Reproductive Medicine, has said: We must work together to ensure that in our effort to make human cloning illegal, we do not sentence millions of people to needless suffering because research and progress into their illness cannot proceed. Let us work together. Let us stop this know-nothing and unnecessarily destructive bill. Let us vote against cloture tomorrow and send this bill to Committee where it can receive the careful consideration it deserves. Together, we can develop legislation that will ban the cloning of human beings, without banning needed medical research that can bring the blessings of good health to so many millions of our fellow citizens.

Mr. KENNEDY. Mr. President, tomorrow the Senate will cast one of the most important votes of this Congress, and perhaps of this decade. That vote will determine whether one of the most promising avenues of research against a host of dread diseases will continue, or whether the Congress will act to ban it--and condemn millions of Americans to unnecessary death and disability in the process. The vote that will occur is on a cloture motion to take up S. 1601. The authors of S. 1601 say that it is a bill to ban the production of human beings by cloning--an attempt to stop Dr. Seed and other unscrupulous scientists in their tracks. But that claim cannot pass the truth in advertising test. S. 1601 isn't a bill to ban a brave new world of mass production of cloned human beings. It is not legislation to stop wealthy individuals from reproducing themselves at will in an unscrupulous and unethical attempt to achieve a kind of immortality. Instead, this legislation bans the actual technology used in human cloning research--the technology that could be used to create cures for cancer, diabetes, spinal cord injuries, arthritis-damaged joints, birth defects, and a host of terrible neurological diseases like Alzheimer's disease, Parkinson's disease, Lou Gehrig's Disease, and multiple sclerosis. Every scientist in America understands the threat this legislation poses to critical medical research. Every American should understand it, too. A vote against cloture is a vote for medical research. It is a vote for millions of Americans suffering from dread diseases for whom the technology of cloning offers hope of new and miraculous cures. But it is certainly not a vote in favor of cloning human beings. Congress can and should act to ban cloning of human beings during this session. But it should not act in haste, and it should not pass legislation that goes far beyond what the American people want or what the scientific and medical community understands is necessary and appropriate. Senator Feinstein and I understand the importance of a ban on creating human beings by cloning. This is an ethical judgment I believe our society is ready to make. We have introduced legislation of our own that will accomplish this goal. We hope that it can be reviewed through the normal committee process of hearings and mark-up. I have no doubt that responsible legislation to ban the production of human beings by cloning can come through committee and mark-up and be passed into law during this session of Congress. But S. 1601 is not that responsible ban on cloning. It is an attempt to capitalize on public concern to rush through a sweeping and inappropriate ban on critical medical research. I have just received the Administration's statement of position on S. 1601. The President has taken the lead in directing a prompt response to the ethical and moral dilemmas created by human cloning. He called for a ban on creation of a human being by cloning in the State of the Union message. If S. 1601 were simply a ban on creation of a human being by cloning, it would receive his wholehearted support. But that is not what S. 1601 does, and that is why the Administration says in its letter, ``On June 9, 1997, the President transmitted to Congress legislation making it illegal for anyone to create a human being through cloning. The President believes that using somatic cell nuclear transfer cloning techniques to create a human being is untested, unsafe, and morally unacceptable. The Administration, however, believes S. 1601, as introduced, is too far-reaching because it would prohibit important biomedical research aimed at preventing and treating serious and life-threatening diseases. Therefore, the Administration does not support passage of the bill in its current form.'' I ask unanimous consent that the entire text of the Administration statement of position be printed in the Record.