*EPF418 02/14/2002
Text: Global Fight Against Disease High Administration Priority
(Under Secretary of State Dobriansky testifies before Senate Committee) (2050)

The global fight against HIV/AIDS, tuberculosis and malaria remains one of the highest priorities of the Bush administration, says a top State Department official.

Under Secretary of State for Global Affairs Paula Dobriansky, testifying before the Senate Foreign Relations Committee February 13, pointed to the $500 million the administration is spending or has proposed as the U.S. contribution to the newly created Global Fund to fight these diseases, saying that this is the largest single source of support for that effort.

Dobriansky noted that the Global Fund recently issued its first invitation for proposals on how to use the money in the Fund. Grant proposals will come from partnerships of governments, non-governmental organizations and the private sector, she said, or from NGOs alone, where partnerships are not possible.

HIV/AIDS, tuberculosis and malaria are worldwide diseases, and thus the grant awards will not be confined to one region at the expense of others, nor will the Fund focus on just one disease, she said. The United States supports maximum Fund flexibility in responding to proposals from around the world, Dobriansky said.

Following is the text of Under Secretary Dobriansky's prepared testimony to the committee:

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STATEMENT OF THE HONORABLE PAULA DOBRIANSKY
UNDER SECRETARY OF STATE FOR GLOBAL AFFAIRS
U.S. DEPARTMENT OF STATE
BEFORE THE COMMITTEE ON FOREIGN RELATIONS
U.S. SENATE
FEBRUARY 13, 2002

Mr. Chairman, members of the Committee, on behalf of Secretary of State Colin Powell, who is testifying elsewhere on the Hill today on the State Department's budget, I am pleased to appear before you to discuss one of the Bush Administration's highest priorities -- the global fight against HIV/AIDS, tuberculosis, and malaria.

The spread of HIV/AIDS continues unabated, with some 8000 deaths per day and 5 million new infections last year alone. There are 40 million people living with HIV/AIDS worldwide, nearly 3 million of whom are children under 15 years of age. We simply have no choice but to confront this pandemic.

Mr. Chairman, our battle against the HIV/AIDS, TB, and malaria pandemics is made easier by the steadfast support we have received from you and your colleagues, on both sides of the aisle and in both houses of Congress. Simply holding this hearing, Mr. Chairman, is critical in raising awareness and manifests how both branches of government can and must work together if we hope to staunch the spread of these diseases, treat their victims, and find cures.

Two of your Committee colleagues, Senators Frist and Kerry, deserve special mention for their involvement with the work done by the Center for Strategic and International Studies on HIV/AIDS, work in which my colleagues and I have participated and from which we have benefited. Many of your colleagues in Congress, including those on this Committee, have played vital roles in backing the bilateral programs implemented by USAID and the vital work done by HHS and its agencies, as well as in facilitating the start-up of the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Administration's Commitment

Mr. Chairman, I want to underscore this Administration's commitment to this battle. Under the leadership of President Bush, the U.S. government continues to be the global leader in the fight against HIV/AIDS. President Bush made the first pledge to the Global Fund by any government, and his request of an additional $200 million for the Fund in FY03 would, if approved by Congress, continue to set an example for other governments and potential donors. The half billion dollars this Administration has committed to the Global Fund constitute the world's single biggest source of support.

Last fall, the President came to the State Department for the Forum on the Africa Growth and Opportunity Act and talked to the participants about AIDS in Africa. He included the fight against AIDS in his speech to the UN General Assembly. He also established a Cabinet Task Force on HIV/AIDS, co-chaired by Secretaries Powell and Thompson, to coordinate this Administration's efforts and to signify its high level of engagement. Like Secretary Thompson and Administrator Natsios, Secretary Powell has invested vast amounts of time and energy to this cause, having, for instance, toured Africa last May where he saw firsthand the devastation these diseases have caused there.

Last fall, to bolster and coordinate our fight against infectious diseases, Secretary Powell created a new Deputy Assistant Secretary position for International Health and Science in the Bureau of Oceans, Science and Environment, a post filled by Dr. Jack Chow, who is here with me this morning. Dr. Chow was our chief representative at negotiating sessions last fall of the Transitional Working Group, the precursor to the Global Fund, with a delegation that included representatives from HHS, USAID and the Department of the Treasury.

Dr. Chow spearheads an interagency working group that meets frequently to ensure that the U.S. approach is fully coordinated. This working group got started last fall in connection with work on the Global Fund and will continue to meet on the Fund as well as on bilateral programs. Indeed, the State Department works closely with other government agencies and Departments, including USAID, HHS, CDC, and others, which contribute their own widely sought technical support, expertise, and experience.

Creation of the Global Fund

The Bush Administration views the creation of the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria, which held its first Board meeting last month, as one of the most promising steps in this two-decade-old battle. The Global Fund, established as an independent foundation under Swiss law and based in Geneva, was created in record time by an unprecedented public-private partnership and thanks to the tireless efforts of a number of people here in this room today.

In approaching the establishment of the Global Fund, the President outlined a vision for what was needed for it to be most effective. All of the parameters we set forth during the negotiations on the Fund were agreed to, including:

-- That the Fund be based on a public-private partnership

-- That the Fund scale up the international response to these diseases with an approach that would complement, not compete with, existing international and bilateral programs

-- That it promote an integrated approach, emphasizing prevention in a continuum of treatment, care, and research

-- That it operate according to principles of proven scientific and medical accountability

-- That it focus on best practices proven to work in the field

-- That it involve developing countries in the design and operation of the Fund to ensure ownership

-- That it ensure respect for intellectual property rights as a spur to research and development.

We are also pleased that the preparations leading to creation of the Fund as well as the operations of the Fund itself have been conducted in an open and transparent manner, with a strong emphasis on attaining financial and program accountability.

Along with governments, NGOs, foundations and the private sector were represented in the Transitional Working Group that met three times last fall to establish the principles and operating mechanisms for the Fund. Some of those participants continue to serve on the Fund's Board. The Fund's Board has 18 voting members, made up of seven donor countries, seven developing country representatives, two NGO representatives, one foundation representative and one for-profit private sector representative. In addition, UNAIDS, the World Health Organization, and the World Bank (the Fund's fiduciary agent), as well as a third NGO serve as non-voting members.

Proposals

I'm delighted to announce that the Fund's Board issued a call for proposals just last week and hopes to announce the first grant awards at its next meeting in April, which will be held in New York City. The Board will have final decision making authority on proposals. It will benefit from a technical review panel, composed of experts in a variety of disciplines and serving in their independent capacities, that will review all proposals to ensure that submissions are based on best practices and are technically sound.

Proposals will come from partnerships of government, NGOs and the private sector through what is called a Country Coordinating Mechanism. Significantly, where such partnerships are not possible, NGOs will have the right to submit proposals directly to the Fund. Proposals from those countries and regions with the highest burden of disease and the least ability to bring financial resources to bear will receive highest priority. Proposals from countries and regions with a high potential for risk will also receive strong consideration.

Because HIV/AIDS, TB, and malaria know no boundaries, the fight against them, to be successful, must be waged on a worldwide scale. Accordingly, recipients of Fund grants will not be confined to one region of the world at the expense of other regions. Nor will the Fund focus on just one disease. As the name of the Fund itself reveals, it targets HIV/AIDS, tuberculosis, and malaria. There are no set limits on how much of the Fund's resources will go toward either a particular region or toward one of the three diseases. The U.S. approach has been to afford the Fund's Board maximum flexibility in responding to proposals that come in from around the world.

The Global Fund is to complement significant bilateral programs of the United States, as well as the bilateral programs of other countries and the efforts of the UN agencies and the World Bank. It is not a substitute for these efforts that are already underway. It will dispense the money it provides as grants, not loans. While the Fund will be fully independent of the UN, it will benefit from and work with the UN agencies charged with improving global health, such as the World Health Organization and UNAIDS.

Pledges

Of the $1.9 billion that has been pledged to date, some over several years, we expect $700 million to be available this year for disbursal. President Bush was the first to announce a contribution to the Fund from a government, a move that jump-started and leveraged other contributions. Our contribution totals $300 million so far ($100 million from FY01 and another $200 million from FY02), and President Bush's budget proposes adding another $200 million for next year.

The President announced the initial U.S. pledge last May in a Rose Garden ceremony with Secretary General Kofi Annan, to whom we all owe a debt of gratitude for his tireless work, as we do to Dr. Peter Piot, who will be testifying next. At that ceremony, the President stated: "The devastation across the globe left by AIDS, malaria, tuberculosis, the sheer number of those infected and dying is almost beyond comprehension. Only through sustained and focused international cooperation can we address problems so grave and suffering so great." In sum, that is why the Fund is so important.

Conclusion

Mr. Chairman, there is, of course, a great deal of work still to be done, and the best indicators of our success will be the decline in deaths from and spread of HIV/AIDS, TB, and malaria. We cannot afford to take a deliberate approach for one simple reason: the fight against these diseases cannot wait.

AIDS alone has left at least 11 million orphans in sub-Saharan Africa, and in several African countries, as many as half of today's 15 year-olds could die of AIDS. By 2010, the Asia/Pacific region could surpass Africa in the number of HIV infections. The fastest rate of HIV infection in the world is in Central and Eastern Europe and Central Asia. The disease is also spreading in regions close to home, particularly Central America and the Caribbean. Tuberculosis claims almost half a million people a year in India alone. Malaria, long thought to kill a million people a year, mostly young children, may actually kill up to 2.7 million people each year.

Time is not on our side, and we must resolve to move as expeditiously as possible. Human lives depend on our ability to get the Fund under way in an effective and successful fashion. Congress's role in this endeavor is critical, and that is why this hearing is so timely and iportant.

Thank you, Mr. Chairman.

(end State Department text)

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(Distributed by the Office of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)

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