00:00Mr. Molyneux, who also is the chairman of the Bipartisan China Task Force, so
00:04thanks for being here. Sir, you're recognized. Thank you, Mr. Chairman. Thank you to our
00:07witnesses today. And you know, Ambassador Dybal, I want to follow up with you on
00:14some of the comments you've made about, you know, China's work in Africa. You
00:21know, we know about the Chinese Belt and Road Initiative. They also have the
00:25Health Silk Road. You know, it seems that their purpose is really to expand their
00:32influence and control and expand the reach of their surveillance state and use
00:38it for both, you know, economic as well as military purposes. I wonder if you could
00:45talk a little bit about some of the efforts they're making in Africa, because
00:50I agree with you. I think the question I hear from ambassadors from African
00:57countries is, you know, where is, we'd rather do business with the United
01:01States, but where is the United States? And I think it's important that we have a
01:06strategy on that, but I wonder if you could comment on that situation.
01:09Yes, thank you very much. And thank you for the work your committee does, because I
01:14think it's hugely important. I was talking with Marion Christmas, of course, a part of
01:19that committee as well, and I hope the Senate does one as well. So China is all
01:26over Africa, and I can tell you, they have gone in and started to meet with
01:30governments to say, well, the U.S. is pulling out here, so what can we do to
01:34support you? And that is a massive risk to us for the long term. You know, the
01:42diplomatic dividend to us of PEPFAR has been enormous, because they see their lives
01:49saved. And this is down to the community level. I go back to that person in axiom,
01:52PEPFAR means the American people care about us. Shocking state. Down to villages. If we
01:58lose that, we lose a great deal. And we lose a great deal for the future, because of the
02:04mineral wealth that is there, which are essential for all the things that we're
02:08doing, as you know better than I do. But we also lose the military capacity there. And I,
02:15the Department of Defense has been a key part of PEPFAR. We forget about that. But in the
02:19beginning, the Department of Defense was as important as any other agency, because the
02:23militaries were so devastated by HIV. We spent a lot of our time supporting the
02:29militaries. And if it comes back, they're going to be the most impacted as well. But
02:34related to China, they also have grown their pharmaceutical industry. That was actually just
02:41for China. They now are trying to export their pharmaceuticals. They, they're pretty good at
02:45copying pharmaceuticals. And they're even inventing their own. They're going ahead on AI, which is a
02:51massive area for the United States, as you know, as well, who's going to win the AI war? Well, if
02:56you're, first of all, you have a lot of the materials in China, in Africa that you need to make those
03:01chips for AI. But then you also have to have places to do AI and have a genetic pool, which Africa has a
03:08massive genetic pool that is untapped. So on every level, we are at risk of ceding ground to, to China.
03:19Now, is PEPFAR and the Global Fund enough? No. But there are other parts of our government that could
03:24be. And here's where the planning for sustainability is so important. The planning for sustainability
03:29should not just be around HIV, TB, and malaria. That is hugely important because that will protect a lot
03:36of lives. It'll protect the future. It won't squander, as, as the ranking member said, our
03:41investments to date, but it has to involve a broader picture, which includes our private sector,
03:46which includes our military, which includes them. And we can do that, um, if we integrate what we,
03:52how we operate. And, and I would just like to also mention, you know, when I read PEPFOR,
03:59our president's emergency plan for AIDS relief. I think of a plan for an emergency being something
04:07that needs to be modified, updated. And as you point out, you know, looking at how some countries
04:14can transition. Uh, you mentioned South Africa. I'm sure there's other countries in that mix, but I don't
04:20know how often that plan is updated according to, you know, new conditions on the ground, new situations,
04:28because it, it appears like it's an ongoing government program, but that's very different
04:36than a plan that is strategic, updated regularly. And as you point out, benchmarks and, and evaluation.
04:43But I wonder if you could, is that something that can be redrafted in a new era?
04:50Yes. And that's exactly what needs to be done. No question about it. Um, that, that the transition
04:56needs to be, be, we are, we have done it in some places. As I mentioned, 59% of all HIV funding now
05:04comes from domestic sources. And that's really increased over time, but it's nowhere near enough.
05:09And the plan, but we don't have clear plans. And that's what I think this committee and the
05:15administration can require that they're, and PEPFAR actually has been working on one, but it has to
05:19be of the global fund because we also have sources there. Uh, but you can, you should, we do need to
05:26shift to a clear plan with compacts with every country. And there are some that I mentioned there,
05:33there are about three dozen that could transition the next couple of years, literally the next couple
05:37of years. So you could see what we need to do in that reduction in our investment, that a hundred
05:43billion could go to something very low, but if you do it in a structured, clear way with those
05:49benchmarks and you ask for that plan and the administration demand that plan and report to
05:55you regularly on that plan, it can be done and we can have a success. So instead of a rapid retreat,
06:02that will be a total failure for us on every front and threaten our national security, we can actually
06:07turn it to a success and have that transition. 30 seconds more. Uh, just one, I have to leave,
06:15uh, for another meeting, but one thing that strikes me is public, the public health community has lost
06:23trust over the years. And one of the reasons I think, you know, this issue of PEPFAR, this issue of
06:32abortion is so impactful. And, and I've heard it today, this term abortion care. When someone says that
06:43as a healthcare professional, it immediately diminishes their credibility in the minds of many
06:50Americans. Because when they hear something like that, they're interpreting it in a way that says,
06:57you're concerned about children dying of AIDS. Many others are concerned about children dying from
07:04abortion. And there's no difference in, in terms of saving an innocent human life. And so I would just
07:13say, as you speak to the PEPFAR community, to be very clear about the importance of that, because,
07:21you know, all of us should be in the business of wanting to save human lives. And, uh, and I think in
07:27the public health community, when terms are used like abortion care, it really diminishes the credibility.
07:33So with that, thank you. Thank you, Mr. Chairman.
Comments