00:00Thank you, and I think this has been a very helpful hearing.
00:03Let me, again, first go to, because people have to move on in other meetings.
00:10And I think everybody's been very good.
00:11I think the witnesses have been extraordinary.
00:13Let me recognize the ranking member for if you have any further questions or closing.
00:17If you can just do your closing as well, there you go.
00:20Let me do my closing with a question, closing with a question.
00:23First of all, I want to thank our witnesses again.
00:25You are so obviously so competent and professional.
00:29It's just been an absolute pleasure to have you here today.
00:35And I want to thank, Mr. Chair, for bringing this hearing and bringing these witnesses, exceptional.
00:43And I just, you know, I don't mean to, I don't like to exaggerate or be trite, but I do think
00:49that what we listen to today is earth shattering.
00:54It really is, because there are millions of people whose lives are at stake.
01:01We have, we're on the, you know, the real possibility of losing opportunities with Africa, the fastest-growing,
01:10the fastest-growing population in the world, opportunities in regards to security and trade.
01:18But we also heard that we are on the brink of finding a way to keep people from ever having
01:29their HIV come back with a simple injection every few months.
01:36So these are, I mean, that's just absolutely amazing.
01:41But here's what you both said.
01:44I think, and that's why I want to end with the, oh, listen, before I end with the question,
01:48I have to take one more pot shot, okay?
01:51Just one more.
01:52He understands me well.
01:54Listen, I just want to say this, a violation of the Helms Amendment, which affects 21, affected
02:0221 patients, I'm not going to minimize your shock.
02:05I wouldn't bring smelling salts with me in the future, but it doesn't, it's not an excuse
02:12to put 20 million lives in jeopardy right now, it's not an excuse.
02:18We're going to move on, and we're going to try to do this the right way.
02:24But I think what both of you have said, as I've heard you, is this, and you can correct
02:28me, let's not shatter, let's not lose what we have had with PETFAR.
02:36Let's find a way to transition to where other health systems and other countries can take
02:43over where this can be a sustainable program, which will mean, really, the United States
02:52being our taxpayers to be able to use their money in different ways.
02:55But maybe what we're going to be in other ways to stop other calamities.
03:01This is my last question that I want to make sure that I can, from both of you.
03:07Do you both agree that it is very important that we do not let Humpty Dumpty on the ground
03:16all shattered before we try to make this transition, that we have to make sure there's prevention,
03:21that the whole comprehensive PETFAR piece is looked at before we're able to even transition.
03:32And I think that I'm trying to say that as diplomatically as I can.
03:37And that does mean that other agencies, that we have to make sure that CDC, USAID, well,
03:44we don't have USAID, but the pieces of USAID, the Defense Department, the Global Fund, that
03:49those pieces are working too.
03:52Did I make my question clear here?
03:55In my...
03:56I think so.
03:57I'm happy to go first.
03:58I would hope, Ranking Member Frankel, that your taxpayers and your constituents were proud
04:03of PETFAR.
04:04You know, I would hope that they would see the work that's been done and really consider
04:07it an American success story, not just an African success story.
04:12You know, it has been very personal, I think, to many Americans who are knowledgeable about
04:16the program that we've been able to save so many millions of lives.
04:18And one of the things I've reflected on is sort of, you know, in the polling that's done
04:22that shows that Americans really like this, you know, I think it resonates because it's some
04:26of the values that they see in their own communities, that we don't let families suffer unnecessarily,
04:31that Americans are uniquely built to tackle big problems, and this is a big problem that
04:35Americans have tackled.
04:36And I think they should be really proud of that.
04:38So as we look ahead, we shouldn't forget those values and why that's so important.
04:41And again, I think Ambassador Deibel and I are aligned in many ways that, you know, we do
04:45need to think of a transition and sustainability plan.
04:48But first we have to look at the capacities that are there, you know, and really reassess what
04:53are those capacities we have, what are the strengths of American ingenuity and American companies
04:57that we really want to bring to bear.
04:59I think we have to look at sort of the goals we still want to achieve.
05:04PEPFAR's mission has been very clear.
05:05It has been meant to save lives, reduce infections, put people on treatment, and stop people from
05:10dying, especially children dying of AIDS.
05:13Are those still the goals?
05:14And then you can look at a sustainability plan on a country-by-country basis and say, here's
05:19where we can move, here are the roles and responsibilities we're going to share.
05:23Here are the roles and responsibilities that have moved on to you.
05:25Here's where private sector can leverage this work and really help us bring those innovations
05:29like digital health, like AI, like those new prevention technologies to bear.
05:34It's a longer conversation.
05:35I don't think it's just a U.S. policy talking to the national government's discussion.
05:41I do think you need all the partners at the table to really go through it and assign those
05:45roles and really think to the future.
05:47Because I don't think we want to arbitrarily pick a timeline.
05:50And as you said, sort of waste all the infrastructure, waste all the work we've done, because we
05:54decided that we wanted to be out by a certain day.
05:58And all those reasons we were doing this work no longer mattered.
06:01Mr. Dybul.
06:04Thank you to this subcommittee and to the chair and ranking member and to the whole committee
06:09for holding this hearing, first of all, because there are so many other things to do.
06:14And for your constant bipartisan support, I do think you framed it exactly right.
06:19We have the opportunity to have not only the legacy of the last 20 years, but a tremendous
06:26diplomatic national security and economic success.
06:30So we do want to transition from financing over time.
06:33But we want to transition to stronger economic national security diplomatic partners.
06:41And that we can do, it will be different country by country.
06:45There are some countries that will require long-term support because of their socioeconomic status.
06:50Others can move more rapidly.
06:52And I would like to emphasize again that if we move too quickly, the groups most likely to be impacted
06:58are faith and community-based organizations because governments don't actually have mechanisms to fund them.
07:05But we know because we've done it in the past, we can create, we can support them to create those mechanisms.
07:10So we have an opportunity before us, similar to 25 years ago when PEPFAR was started.
07:17We have an opportunity to have a massive win for the United States on all levels by having successful transitions,
07:24by working with the countries.
07:25And I can guarantee you that the countries want that transition, but it has to be done in a staged, structured way,
07:34rather than a chaotic, rapid retreat.
07:38And I just, I might ask another question, but I'm just waiting for the, again, thank you both.
07:49Mr. Chair, I just have a, a request of, I don't know what to call this, from this committee.
07:58This is, you know, a lot of people, I mean, I think what we heard today is so important.
08:03I hope that we can find some consensus to deliver a message.
08:08I'm not talking, I'm not a political message.
08:11We have got to keep PEPFAR stabilized, keep the component parts together now,
08:18so that we can do this transition, because you cannot transition from nothing or from a mess.
08:24It'll cost a lot more money, so I hope that we can find some way to deliver this message
08:33that I think I've gotten from these two witnesses today in a very non-political way,
08:41and then move towards the transition that we've heard about.
08:45And I, with that, I yield back.
08:47Thank you very much.
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