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.
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