00:00Mr. Lora, the full committee, ranking member, I don't know what your time constraints are.
00:05Do we go, I want to, you're okay to go back and forth or do, because I can recognize you
00:12now if you'd like.
00:13Do you want to have something?
00:14Go ahead.
00:15Go ahead.
00:16Go ahead.
00:17All right.
00:18I just want to make sure that I know that your time is, I know that you've got a lot
00:19of other subcommittees that you'd like to attend.
00:22All right.
00:23To the vice chairman of the subcommittee, you're recognized, sir.
00:26Thank you, Mr. Chair.
00:28To both of you, thanks for being with us this morning.
00:33One of the allegations that I've heard over the PEPFAR program is that taxpayer dollars
00:38had been somehow used to fund abortions, and I can't help but think, how can this committee
00:49appropriate funds for such a worthy cause, it appears, and yet they, those funds be so
00:58egregiously misused.
01:03How does that happen, and how does this committee ensure that with any other decision that we
01:08make, the funds are actually used for the sole purpose that they're intended?
01:17Mr. Vice Chairman, you raise a hugely important question, and let me just say from the outset,
01:23and I think anyone implementing would agree, it is completely unacceptable when the U.S. law
01:30is violated in any way, but in particular on the Helms Amendment because that's such an important
01:35part and has been a benchmark of foreign development, and particularly HIV programs.
01:42There was in Mozambique, as the ranking member mentioned, a group of nurses that were not trained
01:51in the Helms Amendment and were active in abortion care.
01:56Their salary was paid for by PEPFAR, which you could say then funded the abortion, but
02:02it doesn't matter.
02:03I mean, I think we're getting into details.
02:05It never should have happened.
02:06The, what has been put in the, excuse me, with all due respect, we need to get into
02:11the details here.
02:12Yeah.
02:13We need to understand how the United States sends money someplace else, and then it gets
02:18used for a purpose totally different than what it was intended.
02:22I'm okay to hear the details.
02:23Yeah.
02:24So, as I understand the details, nurse funding went to the government for nurses to provide
02:31care, including HIV care, but they do other things as well because, and that's an important
02:36piece of what happens is it, what PEPFAR has done is funded a health system which allows
02:42for pandemic response and many other things.
02:45So those nurses were being funded in order to provide HIV care, but then they also performed
02:51abortions.
02:53And that is unacceptable because no one funded by the U.S. government should engage in those
02:58types of activity.
03:00And as was mentioned by the ranking member, they had not been trained in the Helms Amendment
03:05and weren't aware of it.
03:07And so now, and these have to be put in place, and this is a problem with cutting money too quickly
03:12is it's difficult to have oversight then, especially if you don't have the systems to do it, is training
03:19of everyone who receives any money from the U.S. government in the Helms Amendment and in the U.S.
03:24government policies and practices so that they understand what they are, that they actually sign
03:30and attest to that they are aware of those policies and practices, and that very importantly,
03:36that there be reviews, systematic reviews, and as the ranking member mentioned, this did happen,
03:41but it didn't happen until after, that there be regular reviews, and everyone be aware that
03:48those reviews are happening to deter any action against.
03:52Right.
03:53The law.
03:54That is helpful.
03:57One of the key screens for this committee now is to make sure any funds that we spend abroad
04:05are in the best interest of our national security.
04:10Can you tell me how funds for PEPFAR and preventing AIDS abroad is in the United States national security
04:20interests?
04:21Perhaps I can speak to that as a former ambassador and level of assistant secretary of state.
04:30I can tell you, let me give you an example.
04:35When I first went to Namibia, I met with the president.
04:39This was early in the days of PEPFAR.
04:41And the president said to me, you know, we hate the United States because you were on the
04:44wrong side of apartheid.
04:46But now we love the United States because you're the only one here supporting us in something
04:50that's going to destroy our country.
04:52So the soft power the ranking member mentioned is hugely important because the United States
05:00actually, if you go back, it's hard to do a negative.
05:05But what we expected to happen, what the U.S. intelligence community expected to happen,
05:10was literally Africa falling apart.
05:13Because there were countries where a third, more than a third of the adult population was
05:18infected.
05:19A district in Botswana I visited, 75% of pregnant women were infected with HIV.
05:24They were all going to die.
05:25Their kids were all going to die.
05:27There were entire villages run by orphans.
05:30The African continent could not put a peacekeeping force together because their soldiers were all
05:36infected with HIV.
05:38And because HIV hit people in their reproductive age and productive age, it was factory workers
05:45and machine workers.
05:47Ford Motor Company in South Africa was among the first providing antiretroviral therapy because
05:51it was going to destroy their ability to produce cars.
05:55So on a diplomatic front, on a stability front, and on a soft power front, it is in our interest.
06:04The other way it's in our interest, and this has been shown, is Africa is the fastest growing.
06:10By the 2030s, Africa will have more people than India or China.
06:16And it is a young population.
06:18It is also among the fastest growing economies in the world.
06:22And it is the economy of the future.
06:25Virtually everyone predicts that.
06:27The CEO of Walmart told me that.
06:30Africa is our trading partner for the future.
06:33It's where we will make money, where our companies can make money and invest.
06:37There is a company sitting right behind us that produces new technologies that could end
06:42the AIDS epidemic.
06:43So on a diplomatic dividend front, on a future economic growth and development front, and
06:52economic opportunity, and on a national security front, both on the diplomatic and economic and
06:58stability side, this is in our national interest, which is why we did it.
07:04The first time the UN Security Council held a meeting on an infectious disease was HIV for
07:11all the reasons I mentioned.
07:14What was averted, a negative is hard to measure.
07:17This is in our national security.
07:18I can also be very clear because I spend a lot of time in Africa.
07:22We are losing ground rapidly because of recent events and because of the fact that China and
07:29Russia are all over Africa right now, all over Africa.
07:35And we have lost our status as the number one trading partner in Africa.
07:39And there are a lot of resources and minerals and that future economic opportunity.
07:44And if we see that field to our adversaries, it will not be a pretty picture because it's
07:50a big part of the world.
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