Senate Committee on Foreign Relations regarding the Administration’s Global Health Initiative

March 10th, 2010

Building on success: new directions in global health

Wednesday March 10, 2010

Highlights

Both The Honorable Bill Clinton and Bill Gates strongly support the Global Health Initiative Bill as the next logical step following PEPFAR.
A strong global public health system is not merely a favor we do for other countries. It is the right thing to do morally and strategically, and it protects our own citizens. – Senator Kerry
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. – Senator Lugar
The Clinton Foundation just succeeded in getting an agreement with Pfizer to improve access through a 60 percent price decrease to $1 per dose on drug to treat TB in patients taking second-line HIV/AIDS medications.
Pfizer hasn’t received enough credit yet for undertaking this initiative.
Key points raised by the Honorable William Clinton included:
- GHI is an opportunity to send a clear signal that we’re moving away from a dependency to an empowerment model.
- Vaccinations work and they’re cheap.
- There is more we can do to reduce costs of drugs, lab testing and other health interventions. The non-commodity cost of health care systems can also be improved.
- UNITAID is a new source of funding. ‘Massive Good’ has just been introduced to allow voluntary contributions from other countries on airline ticket purchase to help purchase medicines for developing countries.
I wish Americans better understood the impact of global health spending. – Bill Gates
“I can honestly say that no NGO leader in the history of America has ever consulted as much as I do with the Secretary of State.” – The Honorable William Clinton

STATEMENTS

Senator John Kerry

The Global Health Initiative has identified several core principles that should guide our thinking:

Health systems are more than the sum of their parts;
Focus on the women and girls who are at the center of each family’s health. This includes taking on maternal mortality, which robs families of half a million young mothers every year.
We must recognize country priorities and the importance of building local capacity.

We can’t afford not to invest in these programs. A strong global public health system is not merely a favor we do for other countries. It is the right thing to do morally and strategically, and it protects our own citizens.

To make each tax dollar go further, we must also leverage our government’s contribution into greater cooperation from the private sector.

Senator Richard Lugar

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.

Foundations are playing an increasing role in the public sector and rendering policy assistance to governments.

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.

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 U.S. government must do more to ensure that its own global health dollars are being spent effectively.

We should improve coordination among agencies working on international health programs. We need to ensure that these agencies are talking to one another, adopting best practices throughout our government, and avoiding duplication in activities.

The Honorable William J. Clinton, William J. Clinton Foundation

Senator Kerry, thanks for reiterating that global health is a foreign policy priority.

The Gates Foundation has done more to encourage innovation and improve access than anyone could have expected.

The Clinton Foundation just succeeded in getting an agreement with Pfizer to improve access through a 60 percent price decrease to $1 per dose on drug to treat TB in patients taking second-line HIV/AIDS medications.

Pfizer hasn’t received enough credit yet for undertaking this initiative.

The biggest problem in developing countries is that they don’t have the basics that we take for granted.

I strongly support the Global Health Initiative Bill. It is well conceived and is the next logical step following PEPFAR.

If we don’t get the countries we’re working with to a point where they can stand on their own two feet, we’re not doing right by them.

Everyone with AIDS medicine is living longer. The longer you live, the more likely you are to need a second line therapy. The challenge is that the demand for second line therapies is going up more than the costs are going down.

There is more we can do to reduce costs of drugs, lab testing and other health interventions.

UNITAID is a new source of funding. ‘Massive Good’ has just been introduced to allow voluntary contributions from other countries on airline ticket purchase to help purchase medicines for developing countries.

The non-commodity cost of health care systems can be improved.

GHI is an opportunity to send a clear signal that we’re moving away from a dependency to an empowerment model.

Prevention is still key.

Vaccinations work and they’re cheap.

We ought to do more to provide clean water.

We need a higher percentage of our health dollar spent in country. We also need to examine the constraints imposed by oversight committees as many reports are never read as they’re not consistent with the country’s health priorities and systems.

We should be able to do something to change food aid. We need to support agricultural self-sufficiency.

Bill Gates, Bill and Melinda Gates Foundation

I wish Americans better understood the impact of global health spending.

In 1960, more than 20 million children died before their fifth birthday; last year, it was fewer than 9 million. During this time, the number of births rose by about 25 percent. This means that we have reduced the number of deaths by a factor of more than two even as more children were born. I think this is one of the greatest accomplishments of the last hundred years, and it was achieved through increased resources and the availability of vaccines.

The U.S.A. is the biggest funder of global health, but accounts for only 0.19 percent of its GDP.

I strongly support the Global Health Initiative proposal. It builds on the success of PEPFAR, focuses on target countries and aims to provide better vaccination coverage and maternal health programs.

I wish congress could increase spending on two elements: vaccine allocation and funding for the Global Fund.

Discussion

Senator Lugar – Do your foundations consult with USAID and other agencies and how does your foundations work affect the perception of the U.S.A.?

The Honorable Bill Clinton

“I can honestly say that no NGO leader in the history of America has ever consulted as much as I do with the Secretary of State.”

The work that foundations do is intrinsically good for the perception of the U.S.A.

We try not to go into any country that would create a foreign policy conflict.

Bill Gates

“If you’re rich enough, there will be some resentment no matter what.”

Senator Feingold – Global health assistance plays an important role not only in saving lives, but also in improving security. How can NGO’s prevent ‘brain drain’

The Honorable Bill Clinton

You can’t totally prevent ‘brain drain’, but improving health systems will encourage people to work in their own countries.

Funding more in-country education and training would help.

Senator Casey – If we had another 1-2 billion to spend on maternal and child health, how would you spend it?

The Honorable Bill Clinton

Capacity building. Make sure every pregnant mother can get access to care.

Improving water quality.

Bill Gates

Vaccines. Increase vaccination rates and access to medicines.

Integrated approach of nutrition, vaccination and education.

ONLINE RESOURCES

Hearing site – http://foreign.senate.gov/hearings/hearing/20100310_2/