Committee Statement of Senator Lugar Opening Statement for Hearing on Global Health Wednesday, March 10, 2010 U.S. Senate Foreign Relations Committee Ranking Member Dick Lugar made the following statement at today’s hearing on global health with former President Bill Clinton and Gates Foundation Co-Chair Bill Gates.   I join Chairman Kerry in welcoming our esteemed panelists. I appreciate the efforts they have made to change their schedules to be with us today.   In numerous locations around the world, the Bill and Melinda Gates Foundation and the William J. Clinton Foundation rival our government as visible representatives of the United States. Even as these foundations focus on helping individuals, they are playing an increasing role in the public sector and rendering policy assistance to governments. Their actions have set global precedents that have influenced public opinion and catalyzed international action. Most notably, they have been vital partners with the United States Government in the fight against HIV/AIDS, malaria, and tuberculosis, and they share in the successes that our country has achieved in this area.   According to the Office of the Global AIDS Coordinator, the President’s Emergency Plan for AIDS Relief is directly supporting life-saving antiretroviral treatment for more than 2.4 million men, women, and children. They represent more than half of the estimated four million individuals in low and middle-income countries on treatment. Before the program began in 2003, only 50,000 people in all of sub-Saharan Africa were receiving life-saving anti-retroviral drugs. Today, ten times that many are being treated in South Africa alone.   The success of prevention programs is harder to measure, but no less critical. Vaccine research, development, and distribution should remain at the forefront of our prevention efforts for HIV, malaria, tuberculosis, and many other preventable diseases that plague the developing world. I commend the Gates Foundation for its $10 billion pledge to provide funding for vaccine research and to distribute vaccines to the poorest countries.   Both of our witnesses today have spent a great deal of time thinking critically about how to maximize the funds available for global health. Their organizations are deeply attuned to both the strengths and deficiencies of the global health effort, and they have acted independently to implement good ideas. For example, the Clinton Foundation has devoted intense efforts to negotiating lower prices for HIV/AIDS drugs, thereby increasing their availability, especially in Africa. Among its many endeavors, the Gates Foundation has worked hard to promote innovative funding mechanisms that would encourage research on vaccines applicable to specific circumstances in the developing world, despite the limited potential for profit from such vaccines.   I am especially interested to hear the assessments of our witnesses concerning how the global community can more effectively work together to make progress against catastrophic diseases. Do you feel that contributions from our friends and allies are adequate? Can global efforts, including both public and private programs, be more efficiently coordinated with one another? Currently, do you believe there is a rational division of global health contributions between treatment and prevention?   Meanwhile, the U.S. government must do more to ensure that its own global health dollars are being spent effectively. Although PEPFAR has been an unqualified success, we need to continue to seek greater efficiencies in this program and other global health efforts. In particular, we should improve coordination among agencies working on international health programs. The State Department, USAID, NIH, CDC, and the Defense Department all have critical expertise and capabilities that are being applied to global health. We need to ensure that these agencies are talking to one another, adopting best practices throughout our government, and avoiding duplication in activities. Two achievable steps that could improve performance are ensuring co-location of health care agencies in embassies wherever possible and reducing unnecessary or overlapping reporting requirements by U.S. personnel in the field. Conversations with the Administration indicate that they are aware of these issues and are working on improvements. I look forward to the results of these reviews in the near future.   As efforts on global health move forward, it is vital that they be accompanied by effective assistance to improve agricultural productivity and food security. The connection between under-nourishment and health has long been established. The World Food Program reports that 25,000 people die each day from malnutrition-related causes. Prolonged malnutrition in children results in stunting and cognitive difficulties that last a lifetime. Health experts advise us that a diverse and secure food supply has major health benefits, including improved cognitive and physical development of children and stronger immune system function. I am especially appreciative of the creativity and resources that the Gates Foundation has applied to encouraging agricultural research and productivity in the developing world.   When Secretary of State Clinton testified before us last month, we noted the strong convergence between her Global Hunger and Food Security Initiative and the Lugar-Casey Global Food Security Act, which has been passed by this Committee. I believe we have an opportunity in the coming months to achieve something close to a consensus and pass a global food bill that would have major benefits for international health and stability, as well as for U.S. foreign policy.   Again, I welcome you both to the Committee and look forward to hearing your statements.   ###