Mario Diaz-Balart Presses Public Health Expert On How To Shift PEPFAR Funding To Private Sector

2 days ago

During Tuesday’s House Appropriations Committee hearing, Rep. Mario Diaz-Balart (R-FL) questioned Mark Dybul from the Center for Global Health Practice and Impact and Georgetown University Medical Center, about next steps in potentially transitioning the responsibilities of the President's Emergency Plan For AIDS Relief to the private sector.

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Transcript

00:00Thank you very much.

00:03Let me start with a couple questions.

00:06I'm going to be pretty flexible on the time, but I'd ask everybody, as always, to try to keep an eye on the clock.

00:12We know the statistics.

00:14They are, you know, frankly, very impressive.

00:17I'm not going to repeat those, but we've heard from you all, and all of us know that.

00:21And this subcommittee on both sides of the aisle has supported PEPFAR for many, many years.

00:26But as I mentioned in my opening statement, I think we all need to agree that we have to look at what are the next steps.

00:35Are we going to fund this forever in perpetuity?

00:37Is there going to be no ending?

00:39And, you know, how can we hand these programs back to the countries and to the private sector and other donors if necessary?

00:48And while we talk about, and I think rightfully so, the really impressive accomplishments, historic accomplishments,

00:56let me mention the price tag for that investment.

01:00So far, it's about $110 billion since 2003.

01:05That's a heck of a lot of money.

01:07Even for federal standards, that's a lot of money.

01:11And we all have talked about, and you heard it again this morning, about, well, how this also helps us with partnerships around the world

01:17and it helps countries, you know, be closer to us.

01:20But I think the American taxpayer looks at, for example, South Africa.

01:25Let me just throw one example out there.

01:28This is a country that obviously, you know, we have a strong presence.

01:34PEPFAR has a strong presence.

01:35But look what the government is doing.

01:37They're doing joint naval exercises with Russia.

01:40They're prosecuting Israel at the International Court of Justice

01:43and a number of other actions that are working against U.S. national security interests.

01:49So I think it's fair to ask these questions, which is, is it working?

01:55Can we do better?

01:56And, again, as I mentioned before, for how long?

01:59That's not being heartless or callous.

02:01That is standing up for the American taxpayer.

02:03And I would argue for the national security interests of the United States as well.

02:07So I'll start with you, Mr. Ambassador.

02:09You mentioned this in your opening statements, but what are some recommendations for next steps?

02:16Could you please expand on your opening remarks in terms of shifting responsibilities

02:21back to some of these governments and the private sector?

02:26And what's the best way, potentially, to go about that while keeping our gains

02:31but also securing the national security interests of the United States

02:35and not continue to do this forever?

02:37So I'll yield to you.

02:39Thank you, Mr. Chairman.

02:42And I actually fully agree with all of your comments.

02:45And as I mentioned in my open statement, and I'm really focused on it,

02:51it is very possible to begin a transition process.

02:54And South Africa is one of them.

02:56I mean, South Africa actually probably within a year or 18 months with planning could fully transition

03:02without losing any lives, but also bringing our private sector in.

03:06And there are actually some private sector people here who would be very active there.

03:10You asked the best way to do it.

03:12And the best way to do it is to work with tangible, with accountable benchmarks for transition in countries based on where they are from a socioeconomic standpoint

03:27and report to you on that transition, with reductions on an annual basis in the amount of money, eventually getting down to nothing.

03:35But at the same time, work closely with the private sector.

03:38And here, as I mentioned, we do not do this well.

03:41We have organs of the U.S. government, the Development Finance Corporation, the USDTA, the Millennium Challenge Corporation, but they're off to the side.

03:50If we bring them all together and work with our private sector and with the private sector in countries,

03:57and I can tell you in South Africa, for example, I work with high net worth individuals who invest in the health sector.

04:03They will come in and work with us and are hungry to work with us.

04:08So, we can transition.

04:11We can have plans.

04:12We can get, within two years, the majority of, the vast majority of countries transitioning in a clear way, in a, in a sustainable way,

04:24without an abrupt, chaotic decline that will maintain the gains, increase the benefits,

04:31and also give us the diplomatic, maintain the diplomatic and economic opportunity.

04:36The alternative is, is chaotic, chaos, retreat, and loss of all the benefits that have been gained.

04:45So, it's not, I completely agree with you.

04:47It's a matter of time.

04:48It is a matter of time planning and benchmarks, and those plans have to be presented to you with clear, sustainable approaches to transition.

Mario Diaz-Balart Presses Public Health Expert On How To Shift PEPFAR Funding To Private Sector

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