Speaking today at the Bill and Melinda Gates sponsored “Grand Challenges” meeting, Secretary of State Rex Tillerson outlines the Trump administration position on U.S. aid and humanitarian relief.
“We must view foreign aid as a means to an end, not an end unto itself. A country’s prosperity and security is best sustained from within, not through foreign aid. There can be no greater measure of success than witnessing a country able to stand on its own two feet.” ~ Secretary Tillerson
[Transcript] SECRETARY TILLERSON: Good afternoon. And thank you so much, Harry, for that very kind introduction.
The work and commitment of the Bill and Melinda – of Bill and Melinda Gates and the Gates Foundation that they have undertaken across a range of humanitarian initiatives have had an extraordinary impact on eradicating diseases and improving health outcomes for people the world over. And I offer my thanks once again, as I have thanked them in the past, to Bill and Melinda both for this life-long passion and commitment – much of which I have seen up close and personal. And I certainly am thankful for what they have done to help so many.
I also want to recognize USAID Administrator Mark Green. Under Mark’s leadership USAID will continue to be a leader in global health and development issues, and I hope that individuals and organizations in this room who share Mark Green’s passion for helping people will continue to partner with USAID.
As those of you who have dedicated yourselves professionally to global health and other fields of international development know, the challenges we have all committed to solve require a clear vision, a plan of action, dedicated individuals, and a constancy of purpose to complete the mission. While victory is not tomorrow, probably not next month or next year, or maybe not even the year after that, we all arise every day with the belief that “one day” – “one day” is coming.
Long-term solutions to daunting global challenges demand patience and perseverance. In our society, of course we often want results immediately, and when we witness the human cost, having that sense of urgency is okay. It is hard for human beings to exercise patience in the first place. But it is important, I think, to measure our success and celebrate progress even if it is incremental.
An incremental approach may not be as satisfying or generate as big a headline or publicity. But if we’re truly mission-driven, then we need to keep putting one foot in front of the other and, without wavering from our goal, every day get up and take another step. I know that the patience and dedication in this room will pay off.
The President’s Emergency Plan for AIDS Relief, better known as PEPFAR, of course, is one of the sterling examples of what I’m talking about.
When PEPFAR began, the prevalence of AIDS in Africa seemed an insurmountable problem. At the time, only 50,000 people in Sub-Saharan Africa were receiving HIV treatment. In many countries, an HIV diagnosis was a death sentence. In the hardest part of – hardest hit regions of Africa, infant mortality had doubled, child mortality had tripled, and life expectancy had dropped by 20 years. More than 14 million children had lost one or both of their parents to AIDS.
Now, 14 years after PEPFAR’s creation, we have not only saved millions of lives, but we’re getting ever closer to ending this pandemic by supporting HIV treatment and prevention services using data and analytics to improve performance, find efficiencies, and increase the impact.
President George W. Bush and other originators of the PEPFAR program took the long view to solving this challenge. The problem, they knew, wasn’t going to be resolved overnight.
But again, look how far we’ve come today:
With focused investments and data-driven approach, the United States continues to reach more people.
In the past three and a half years alone, under Ambassador Deborah Birx’s leadership, the number of those receiving life-saving treatments has increased by 60 percent. Today, more than 12 million people around the world receive treatment made possible by PEPFAR.
The number of babies born HIV-free to pregnant women living with the disease has been steadily increasing too – almost twice as many in 2013. That’s more than two million babies who now begin life free of HIV.
Through PEPFAR and more than – more than 6 million orphans and vulnerable children grappling with the physical, emotional, and economic impact of HIV and AIDS are receiving critical care to survive and succeed, including receiving educational support and counseling care.
And as a result of PEPFAR’s DREAMS public-private partnerships, over 1 million adolescent girls and young women have been reached with comprehensive HIV prevention services to ensure they grow up and thrive without HIV.
PEPFAR has empowered people around the world to take their lives and their countries back.
Since its inception in 2003, PEPFAR – together with UNAIDS, the Global Fund, and many countries and partners represented here today – has transformed the global response to HIV/AIDS.
The Trump administration is committed to building on the progress we have already made by accelerating our approach that focuses on the hardest-hit populations.
Recently we unveiled PEPFAR’s new Strategy for Accelerating HIV/AIDS Epidemic Control. This is one of our Grand Challenges. We believe that is it possible to control this pandemic, and in partnership with countries who share our vision, we are creating a road map to that control.
Through this strategy, PEPFAR will invest its resources to decrease the number of new HIV infections through data-driven programming and a focus on the highest-burden populations and locations.
Our data is better; our data is more nuanced than ever before, allowing us to measure progress and concentrate our efforts based on sex, age, and geography. We are committed to taking full advantage of this data by using it to improve our programming and hold ourselves and our partners accountable for the results.
Our strategy includes investing in more than 50 countries, with several concrete goals in mind.
First, we will maintain life-saving treatment for those we currently support, while making essential services like testing and treatment more accessible for all populations. In these countries, PEPFAR will continue to expand both HIV prevention and treatment services through increased performance, efficiency gains, and shared responsibilities with all of our partners.
Second, the strategy will provide even more HIV services for orphans and vulnerable children – those who are immediately, permanently affected when a parent or caretaker is lost to this disease. It will also ensure that the most vulnerable and key populations have access to essential services to prevent and to treat HIV.
Third, the strategy will accelerate implementation in a subset of 13 high-burden countries that have the potential to achieve epidemic control by the year 2020, working in collaboration with host governments; the Global Fund to Fight AIDS, Tuberculosis and Malaria; UNAIDS; and other partners. Through this international effort, we expect not only to control the epidemic, but also to reduce the future costs required to sustain the HIV/AIDS response.
PEPFAR will continue to illustrate that our effective whole-of-government approach, coupled with high accountability measures and mutual respect for our partners, can and will change the future for the better. To those engaged in these challenges, please know you have the support of the U.S. Government as we work together with partner governments, the private sector, and faith-based and civil society organizations to control this pandemic once and for all.
But HIV/AIDS is not the only pandemic we are committed to stopping. The President’s Malaria Initiative is credited with saving millions of lives. Ambassador Green just announced the expansion of the initiative to four additional countries in West Africa, which will extend preventative and treatment interventions to 90 million additional persons.
The Global Health Security Agenda is one of the most useful frameworks for halting the spread of infectious disease. Such outbreaks, even in the most remote parts of the world, do not respect boundaries between countries or sometimes even between species. With more than 70 percent of emerging diseases originating in animals and jumping to humans, integration of animal health into the broader health security effort is imperative.
Containing the spread of deadly disease in the countries of origin is a vital U.S. national security interest. However, many countries remain ill-prepared to prevent, detect, and respond to infectious disease outbreaks within their borders, which poses a threat to all of us.
The Global Health Security Agenda remains one of the most vital initiatives for building global capacity to prevent, detect, and respond to infectious disease threats.
Under GHSA, the United States continues to assist 31 countries and the Caribbean Community to strengthen global health security, including through $1 billion in investments to strengthen global health security in 17 specific at-risk countries. These investments have yielded outstanding results.
For example, with U.S. support, more than 3,700 disease detectives have investigated more than 650 outbreaks. When the Democratic Republic of Congo identified a cluster of suspected Ebola cases in May of this year, a group of U.S.-trained disease detectives deployed immediately to trace the disease and provide technical support. Their fast and coordinated action contained the potentially-devastating outbreak to only eight cases of Ebola, only four deaths, and no spread outside of the DRC.
GHSA has also encouraged countries to conduct a Joint External Evaluation, a rigorous, peer-review evaluation led by the World Health Organization to assess a country’s health security capacities and map out a path to achieving compliance with International Health Regulations. To date, 56 countries have completed their JEE with 25 additional countries in the pipeline.
Our global partners have also stepped up to the plate. Australia, Canada, Japan, the Republic of Korea, the United Kingdom, and others have committed substantial resources to build health security throughout the world, and dozens of developing countries have increased domestic financing to build capacity to combat infectious diseases.
While we’ve made tremendous progress since GHSA was launched in 2014, considerable work remains. That is why the United States advocates extending the Global Health Security Agenda until the year 2024.
We must keep up the momentum to ensure that donors continue to commit resources and follow through on prior commitments, while also encouraging developing countries to make health security financing a permanent item in their budgets. Health security is a necessary foundation for countries to make strides in other areas. As President Trump told African leaders at the UN, “We cannot have prosperity if we’re not healthy.”
We must continue to empower global health security leadership, including by supporting the important efforts of the Republic of Korea, Finland, the Netherlands, Indonesia, Italy, and others, while also developing and encouraging new leaders.
We also need to ensure the commitment and interest of non-governmental stakeholders, including the private sector, by making the business case for investments in health security.
The global health security landscape has changed, but the United States commitment to working in multi-sectoral partnerships to counter infectious diseases through the Global Health Security Agenda will remain constant.
Our approach to development must continually evolve to meet the changing global landscape. Around the time baby-boomers like Bill Gates and I were entering elementary school, governments accounted for over 70 percent of financial flows into the developing world. Today, that number has fallen to below 10 percent.
The involvement of non-governmental entities in international development is commonplace today, but the emergence – their emergence in this field was at one time a groundbreaking innovation in its own right. We must continue to adopt a spirit of innovation common to Grand Challenges in order to build on what we’ve already accomplished. As Isaac Newton once said, I have seen further – “If I have seen further, it is by standing on the shoulder of giants.” Newton knew he was deeply indebted to those who had produced the knowledge that served as the foundation for his own work.
That same attitude should exist among us: innovation begets further innovation that improves old processes and moves us closer to achieving our goals. I know there’s been a host of innovative products developed by Grand Challenges, whether to help end Ebola, or Zika, or Dengue Fever, or other diseases. I commend all of those who have dedicated themselves to finding these new solutions. And for those of you who are still hard at the task, feeling discouraged, I encourage you to press forward. Don’t give up.
Thomas Edison made 1,000 unsuccessful attempts at inventing the light bulb. When a reporter asked, “How did it feel to fail 1,000 times?” Edison replied, “I didn’t fail 1,000 times. The light bulb was an invention with 1,000 steps.”
Last but not least, I want to emphasize that generosity is at the core of who we are as Americans. The United States is the global leader in providing lifesaving assistance in times of humanitarian crisis. And we will remain to take on that task.
The U.S. approach to Grand Challenges reflects our overall approach to global development. We must view foreign aid as a means to an end, not an end unto itself. A country’s prosperity and security is best sustained from within, not through foreign aid.
There can be no greater measure of success than witnessing a country able to stand on its own two feet. Our goal for U.S. development assistance is that it will serve as a bridge to the day that recipients can rise economically and achieve sustainable prosperity for themselves.
Today, many one-time recipients of foreign aid under the Marshall Plan are leading U.S. trading partners. It shows that foreign aid can create the conditions for a burgeoning middle class that makes for an inviting market for American goods and services. Even more importantly, it can put a country’s own people on a path to sustainable growth and prosperity.
Finally, accountability is a necessary complement to generosity. Those of us in government must ensure that the taxpayer dollars we spend are used efficiently and effectively. Accountability is essential in the non-profit sector as well: Individuals who have contributed to philanthropic organizations are trusting you with their money. And the same need for accountability goes for the private sector as well. We must continue to be good stewards of our finite resources and work with reliable and transparent public, private, and non-profit partners.
The United States and its partners have and will continue to make smart and targeted investments that put countries on the way to success. The road to progress will be uneven, and the emergence of global development challenges will continue to present themselves. But I know that when we put our shoulder to the wheel day in and day out, as all of you in this room do – every day you get up with your mind on the mission – we remain open to innovative ideas, we embrace accountability in what we’re doing, we can and will be successful. And most importantly, we’re going to do a lot of good for a lot of people.
Thank all of you very much. (Applause.)