you can watch all of public affairs programming on television, online or listen on our free radio app, and be part of the national conversation through c-span's daily washington journal program or through your social media feeds. c-span, created by america's cable television companies as a public service, and brought to you today by your television provider. >> the senate foreign relations committee last week held a hearing on the u.s. and international responses to the coronavirus pandemic. we'll hear from witnesses with the u.s. agency for international development, the state department's office of foreign assistance, and the health and human services department.

>> the committee will come to order. good morning, everyone. i want to thank all of you who are attending this important hearing, and today we are going to discuss the international response to the covid-19 pandemic and the future pandemic preparedness, prevention and response. the hearing will focus on senate bill 3829, which senator murphy and i have introduced, the global health security and diplomacy act. it's written on paper, not on stone, which we'll talk about a little bit in the future here. this is an important endeavor that this committee is going to take up, indeed probably one of the weightiest matters that we'll deal with as they attempt to create a new shield to prevent a covid virus type

attack from happening again. the covid-19 global pandemic has reaffirmed what we've long known, and that is infectious diseases, particularly those of viral nature, do not respecta tt threat everywhere. we've been right here to focus on our domestic response to the pandemic, but we ignore the spread overseas at our own peril for obvious reasons. it is essential that we respond now to help our partners who are not yet experiencing significant spread to get testing, tracing and quarantine procedures in order to prevent a worst-case scenario. we also need to focus on protecting access to food, livelihood, water, sanitation and hygiene.

protecting existing investments in immunization, maternal and child diseases, and other infectious diseases are important at this time. also we need to work with partner countries and organizations to ensure that our aid reaches those who need it most. without aiding and abetting corruption human rights violations and democratic black sliding which we know happens when we start focusing on something else. we need throat had to get ahead of the next global pandemic, indeed that is the focus of this hearing. again, the vehicle that we're talking about is senate bill 3829, but for discussion purpose, we look for every possible improvement to that bill that we can make. this hearing is one of a number that i'm going to undertake as we construct senate bill 3829 to go forward. the purpose of it to, as i said,

constructed shield is better than the one that we have. i've repeatedly said that what we need is a fire station and a fire department to be able to put out a fire before it burns the entire world. over the years we've come to expect that the world health organization would play a role. the world health organization has done great work in many respects. it plays a key role as the guardian of international health regulations, and is the clearinghouse of global health data and best practices. it has done a remarkable work in combatting polio and eradicating smallpox, but its response to fast-moving emergencies such as ebola and covid 19 has exposed significant weaknesses that the world health organization has. we however are not here to

demean or criticize or condemn the world health organization. rather what we're here to do is have a fear analysis of what the response was, and how their structure is constructed, that to cause the weaknesses that we have. doctor tedros and his management team were very kind to spend some time with me early on, and they explain to me what their objectives were, and how they were attempting to do so. they meet some very fear points, and it is truly obvious that they did things that could have been done differently, and they will be the first to admit that. in addition to reaffirming world war three organization that --

world health organization, we should reform in the kindest way possible to make it work better. we need an international financing mechanism that will re-energize action understand the global health security agenda to help countries with high commitment but look pass it improve their pandemic preparedness and response. we need a long term thanks to the coronation problems that have long play the u.s. and country teams operating overseas. this accountable entity would not, i repeat not replace the efforts of the nsc.

we put these ideas forward in the bipartisan bill, and have invited all those who wish to participate to do so. this has to be a bipartisan effort. it's not too late to get back on track and restore the long-standing tradition of bipartisanship that has characteristic, characterized every successful u.s. global health program of the past 20 years. it's not too late to focus our efforts on addressing the current covid-19 pandemic overseas in a manner that saving lives and protects the united states from future waves of infection. there is no doubt that this will happen again. we've been told that the bat population particularly in wuhan area in china contains about doesn't viruses. this, of course, the pandemic was caused by one of these

viruses jumping from one species to another, from a back to a human being. what happened after has been greatly debated, but we know the result, we know it wasn't good, we know there were failures along the line and we know we can do better. there's no other group more qualified than this committee of the united states senate foreign relations committee to undertake this proposition. this is something that we owe america, we owe the world, and we can do this. i'm committed to do that. i would hope that every member on the committee focus on this as one of the most important things that we do. it will be a legacy that will be incredibly important for future generations, and we know that the world cannot withstand much more of what we've seen, that we got from the covid-19

infection. it went through the world. with that, i hope that we as a committee do what we tried to do and that is focus with civility, kindness, understanding, and tolerance. we are going to hear different ideas. there's a lot of ideas that people have strong feelings on. i hope that people listen to what others have to say, and listen to defenses that people make about what has happened, but more importantly listen to what people tell us they have learned that will help us in the future. in the bipartisan fashion that is done with kindness and civility, i have every confidence that we can develop a bill that can pass this

congress, be signed by the president, become law, and really be a tremendous benefit to our fellow human beings as we go forward. with that i will turn to senator mendes. >> i'm happy that we are having this their hearing. let me start by speaking to the larger concerns of the democratic minority. we must have serious and sustained focused on u.s. foreign policy and serious oversight over our agenda. we want to make that happen. we need to tackle some of the major challenges. afghanistan, venezuela, north korea. we need to ensure that the secretary of state testifies before this committee.

we should all be shocked and frankly offended that the secretary is refusing to appear, refusing to defend the administration's foreign affairs budget and we should all be insisting on his appearance. this could be the first time in over 20 years that a secretary of state has not testified before this committee to explain administration priorities. i guess after ambassador bolton's book will probably never see him again. this lack of engagement fundamentally undermines our work, not only does the secretary of state feel comfortable in refusing to come before us, that refusal apparently extends to other senate officials. we've heard from only one in this entire year, the administration has issued oversight inquiries, many of them bipartisan. we don't need to rehash the

contentious vote on michael pack, but we should all be concerned over what we've seen in the last 2010 days and 24 hours at the u.s. agency for global media. mr. pack has gone on a wholesale firing spree, removing the heads of networks, dissolving their corporate boards to replace them with unqualified political people. it's now obvious why the white house wanted pack so badly, so they can transform the agency into their own personal mouthpiece. this is a blow from which it may never recover. once the credibility is gone, no one will ever trust a report from radio free europe, radio team, nor trust the tools of the open technology fund. i would urge you mister chairman, to respond to the letter that we sent you in the spirit in which it was offered. on behalf of myself and all the

democratic members of the committee and tell you that we want to work with you and want to find common ground, we want to be successful and we want the committee to take on serious and meaningful work that will make an impact on the national and global stage. let's work together to make that happen. it is disappointing that the white house would not sent a member of the coronavirus task force or any of the senate confirmed individuals from the state department, health and human services, or the united states agency for international development responsible for administration's response. the american people deserve to hear from members of the presidents handpicked team to understand what is happening to address the worst pandemic the world has faced in hundred years. more than 8 million cases worldwide, more than 115,000 american lives lost. in my own home state of new

jersey, the second largest state in the nation in terms of covid deaths, i'm vividly reminded of this consequence. the tragedy was a wake up call to those who question whether we should engage with and invest in, i would like to use this hearing to understand how we got here, what we knew about the virus and when, and how we are leveraging our diplomatic relationships in leadership to best respond to protect the american people. we should examine the world health organization's response, i wish we had someone from the state department's borough of international organizations to do exactly that. we also know that the u.s. was regularly communicating with and receiving information from the world health organization. including government employees embedded at the world health organization. rather than seriously consider how to best leverage our leadership and contributions,

the president abruptly announced the u.s. would pull out of the organization, threatening not just our ability to confront covid-19, but risking decades of progress on other global health initiatives including combatting polio and ebola. yes china has a lot to answer for, but the administration's use of racially stigmatizing language to describe covid-19 in direct contradiction has been hurtful to americans at home and utterly counterproductive in leading an international response. the secretary of state's insistence ppppppppppppppppppppx language has prevented us from reaching consists this at the g7 and security council. while the white house is engaging in divisive rhetoric, the rest of the world is stepping up without us. when chinese president using

beijing addressed the world health organization in may he pledged two billion dollars to combat covid-19. eight billion dollars was raised. the white house declined the invitation to participate for reasons that are beyond. me is this what the administration means by america first? well if this eu consumption comes up with the vaccine before we do, it will meet america is last. this approach is not only short shots, short sighted and foolish then jean jurors american lives. as old saying goes, an ounce of prevention is worth a print and of here. i'm all for ensuring the u.s. government is better organized and able to detect and respond to future pandemics both here

and abroad, but some of the proposals coming out of the administration are eerily similar to those coming from some members of congress. i look forward to the first of what i hope for many throw discussions. thank you. >> thank you very much. now we will proceed to do exactly but i said we are going to do, which is examined this with an eye toward constructing a shield for the future. of course that require some discussion about what happened and how we got here. nonetheless, i'm hoping we will continue this discussion, senator murphy and my bill has done, sent bill 2839 has moved forward. we have a distinguished panel today. people with access -- outstanding knowledge in this area, who can help us understand the task at hand, and how we can accomplish that

task. first of all we have mr. james richardson who served as the director at the office of foreign assistance recordings 35 billion dollars of foreign assistance across the department of state. yes 20 years of government experience and hold the battle and science and government, a masters and science and strategic studies, and is a graduate of the united states air force and command. mr. richardson, thank you so much. give us the benefit of your wisdom. >> thank you chairman. ranking members, members of this committee. thank you for inviting me to testify on the international response to the pandemic. as a former staff and member of the committee i look forward to

having an opportunity to have a dialog and answer your questions. first i need to acknowledge the leadership of president trump, vice president pence, secretary pompeo, and everyone around the world that stayed in usaidãto combat the pandemic. that we coordinate assistance on half of the secretary. as the chairman mentioned prior to that i was at usaid looking for ways to strengthen the power of development and improve the institution. as such, i believe deeply in the power of the development and diplomacy. together i think they can be unstoppable. the united states is the world's undisputed leader in foreign assistance. we've invested 500 billion dollars over the past 20 years. 140 of that in the united

states alone. the united states has built and sustained health systems around the world, trained millions of health care workers and saved millions of lives. we have a huge challenge here. impacting both high income and developing countries alike. the numbers speak for themselves. the state department has received nearly 1000 requests from almost every country in the world. in the face of covid, the generosity of the american people has been on full display, with more than 12 billion in financial, humanitarian, scientific and technical support to combat the crisis. this first, thank you for that, this money is being well spent. we've

billion of that, and our assistance has gone to 123 countries. we've obligated over 500 million of that this. we've provided much needed ventilators in el salvador, we've trained workers in india, we've put out public service announcements about how to fight the virus. the coronation hasn't slowed a step down, it's insured alliance and effectiveness of our resources. when people's lives are at stake we need to make sure we get this right. while the covid-19 pandemic is certainly not over, i firmly believe that we need to start thinking about today what systems the u.s. and the world needs to lessen the likelihood of another outbreak becoming a global pandemic. when looking across this

pandemic, and pandemics of the past, i think we can pull some important lessons learned. moving forward i hope we can all agree that more data, more coordination, and more response functions are necessary to respond to future outbreaks and prevent pandemics. so the first lesson learned is that pandemics aren't just a development challenge or confined to the developing world. for instance, of the countries with the highest percentage of covid related deaths, almost none of them have u.s. government bilateral global health programs. as such, u.s. leadership needs to not just focus on the development piece which is critically important, but also have a broader scope, focusing on mobilizing countries own

resources, maroon and sharing with like minded donors and building true accountability into the global system. the second lesson is that the u.s. government and global system must be prepared to respond internationally. as i often say true coronation is key. we need maximum impact. that's true coronation is not about control, it is about empowerment. we have to unleash the power of our diplomacy, of our development, of our public health efforts in order to maximize our impact. we also need to ensure that the global structures can effectively prevent and contain outbreaks from becoming epidemic and pandemic's. also we need really warning systems and data tracking. we need to be flexible, we

understand that the challenges we face time in many different forms, and our response will ultimately be multi faceted. we need to start planning for all of those inevitability. us in the age of globalization, i face, i worry that outbreaks will look more like this one at than other epidemics we've had in the past. we need to ensure that pandemics are prevented to the greatest extent possible. we need to fill in the gaps while coordinating and leveraging the unique strengths of each aspect of the u.s. government. time and time again when there is a global challenge we lead. we are the greatest humanitarians the world has seen. i'm committed to working with all of you to strengthen this fact. thank you for having me today,

and i look for to your questions and important conversation. >> thank you so much, great comments, mr. mulligan serves as the senior development adviser for the first diplomatic, review senior deputy for police and learning, he has a bachelors degree from george town school, masters degree from john hopkins. distinguished graduate of national war college. thank you for coming, we'd like to hear what you have to say. >> thank you chairman, ranking member, it's an honormamamamamau for my -- your generosity, which has allowed for a quick response to the pandemic. i've been a foreign service

officer for usaid for several months, that i have been a foreign service officer at that usaid for 30 years and currently served as a counselor. i have seen how the united states saves lives. how we sit support our partner countries and how we stand with them when disaster strikes. the scale of covid-19 is unprecedented, but the core american values are constant. in the past ten years usaid has been on the front line to fight emergencies including ebola, zika, and the played in madagascar, i know it very well. we are fighting ebola, and we are in it for the long term,

that is what we do and it's who we are as americans. through these experiences, that usaid has developed deep technical expertise to respond quickly, and appropriately to public health crises. the government is strongest one we are well coordinated, particularly at the country level. i know from my own experience that out of control pandemics are a symptom of complex causes, this can require broader development assistance. to address the deeper root causes of instability and court governance, controlling academics requires more than a stand-alone effort. we've seen that when we don't address poor governance, we lose out on basic public

services. that usaid prevent these issues that and addresses them. were hampered, they specially when the republic of china don't disclose that information, that imprison medical personnel at silence journalists. in stark contrast usaid we build capacity, and democratic institutions to enable countries themselves to respond better to global health crises. we appreciate your support this for allowing us to make these investments ourselves based on data and the best available evidence. today faced with covid-19, the united states again is demonstrating clear and decisive leadership.

usaid is donating two billion dollars to finance health care, humanitarian assistance, stabilization efforts worldwide. this funding is saving lives, it's also improving public health education and protecting health workers. supporting disease surveillance, and boosting capacity in over 100 countries around the world. we are leveraging our programming, because we recognize that covid-19 will have extensive secondary and tertiary order impacts. isolating the issue won't improve things, we must empower our health experts to do what they do best in their field. respond to infectious diseases. we need to act proactively and address the issues, the crisis

has threatened development outcomes. we are very concerned about the tertiary incomes, were concerned about the people that are going to need food assistance with the 20% increase. we are seeing it trend of rolling back of backsliding. they were investing not only in food security, but also combatting the democratic backsliding. they will respond to the pandemic contribute to the united states remaining a trusted and preferred partnering countries around the world. no other country can match our unparalleled lq long term commitment to help during this self reliance, that's why i appreciate the ability to testify today in

this committee. >> thank you. good information. mr. garrett is the director of global affairs at the development of health and you know, human services. previously the director for conflict and human therrien assistance. 1ssistance. the senate foreign relations committee, with that, they were anxious what you have to say about our relationship with the world health organization and moving forward. >> chairman, ranking member, members of the committee, it's an honor to be with you to discuss the world health organization and the agenda. last month secretary easier addressed the world health organization's governing body,

expressing concerns to the covid-19 outbreak. the committee is aware of the president statements in a letter expressing his concerns in a me 29th statement that the united states is terminating its relationship with the world health organization. with the respect to the world health organization allow me to go back even before the first reporting in wuhan in china, and highlight the concerns, and then i will address the gsa. after the pandemic that originated in china, the international health regulations revised in 2005 to improve transparency and reinforce allegations of countries to provide accurate, timely, and complete information about outbreaks. after the 2014 west africa ebola crisis, the world health organization's emergency program was created, it's had

some success on the ground respond to conflicts emergencies, but it hasn't met the global challenge of covid-19. 14 years after sars, china failed again to provide accurate, timely, and complete information to the world health organization about covid-19 a break. in fact, withheld information that could have helped countries take actions earlier to protect public health. the world health organization didn't call out chinese government, which we believe exacerbated that pandemic. earlier statement from world health organization praised the chinese government while criticizing others. when missteps of china and world health organization became apparent, our team compiled information to identify gaps in the world health organization's toolkit. the sparked conversations of reform in the world health

organization. the director general of the south emergency program must be insulated from malign political pressure. improvements to the process for declaring a public health emergency of international concern are overdue. linking travel and freed restrictions together must be reexamined so countries can take proactive measures like the u.s. did to protect our citizens without criticism or retaliation. enacting these reforms regardless of the united states relationship with the world health organization would be good for the world. that will only live up to its mandate with increased transparency and accountability of all member states. switching to the global health security agenda 18 months into phase two called that ghsa 2014,

the need for a multi sector approach to preparedness is greater now than ever. ghsa that was created in the midst of the 2014 west africa ebola crisis to help countries comply with the that ihrs. it's a group of 67 countries international organizations, ngos, and companies working together to prepare for infectious disease. under the ghsa them, a merica made commitments to respond to infectious diseases as a national priority. members provide support for implementation through advocacy, collaboration, information, and

technical advice. the u.s. is a leading voice on the ghsa 2024. as a chair of the accountability result task force ensuring the focus on addressing gaps and challenges in the countries. the target is to have more than 100 companies with improved passage by 2024. we also collaborate with partners to mobilize resources for preparedness. this works with many hhs countries to improve health security, this includes developing a joint evaluation, developing action plans, and mobilizing resources. as ghsa this core capacities are based on the international health regulations, both efforts i discussed leading ghsa 2024 and forging ahead on

reforms focus on strengthening the ihrs are mutually enforcing and will help bring about a safer world. >> thank you. it looks like we have the right panel here to give us the right information going forward. let me say how thankful i am that you are reminding us of how critical this time is. also our generosity, our 330 million people have contributed a incredibly high percentage of the aid given to less fortunate people. you made one statement that i'd like to focus on a little bit. i'm going to follow up on this with that mr. garrett grigsby

there. you said that you feared future pandemics are going to look like this, versus ones you seen in the past. >> what do you mean by that? >> i appreciate the question senator. i think when we start looking at the real differences between this pandemic and whether it is ebola or sars, both of those were fairly localized in scope. the challenges that they presented were probably overwhelmingly focused on the developing world. this pandemic, and i think given the globalization realities that we find, the fact that we can easily travel around the world and that's continuing to accelerate, i fear that the mobility will drive epidemics for outbreaks somewhere, to be more easily

spread through the developed world, in addition to the developing world. >> let me stop you there. as i look at these things, a bullet compared to covid. the transmission mechanism is very different it seems to me. the contagious miss of the disease attempts to be different, with this doesn't viruses kicking around there, you're probably going to have idiosyncrasies. >> that when you look at the challenge we are presented, with the likelihood of transmission, the globalization of this world, and ability for viruses to quickly move outside of containment area, that is a game changer.

and again, given the fact that it's been able to impact the high income countries the way it has it makes us want to rethink how we approach this. >> i think your identification there is important. in a minute i'm going to ask garrett grigsby more about that, because of the system that needs to be put in place. it seems to me, covid-19 because of the way it is transmitted, and the rapidity with which it's transmitted, it's so different from what we've had in the past. in defense of the systems trying to respond to this, they weren't ready for that. they expected it to behave like sars or ebola, or something like that. what we found out is that it behaved very differently, and

required a very different response, and that didn't happen. is that a correct characterization? >> absolutely. there we are not really sure what the next outbreak or next virus will look like or what it will do. i'll leave it to the scientists to talk about its transmission or how it can move easily, but i think our systems are not built for this type of outbreak. this clearly it didn't work. it didn't stop the ability for this to become a global pandemic. we have to think about the flexible mechanisms, that we can put into place now that allows us to be able to respond at an outbreak and pandemic level that's able to say

regardless of what the virus is or regardless of where the outbreak starts, and where it goes we need to have an ability to respond. and this sort of idea of a worldwide ability to respond is an incredibly critical. >> that's what senator murphy and i are focused on, trying to develop the system, thank you for being part of it. in my conversations with that team, profit they were defensive cough in one respects they said they didn't have enough power. regardless of our criticism of them we do have to realize that they are not a sovereign entity. they can't tell a sovereign entity what to do. they can encourage them, try to press them to do the right thing, but it struck me along this conversation that i was having with mr. richardson,

that they as much as the rest of the world were taken aback by how covid-19 reacted compared to their dealings with polio or aids or ebola. is that a fair assessment of where they were as far as being taken aback by what happened? >> thank you mister chairman, it is fair to say that covid-19 was a novel virus. one that had not been seen in human beings before. there is still a lot that we are learning about it. and we would be happy to come brief you and your staff, not myself, but leading scientists in the world and they could answer some of these questions for you. they are so learning about this. that is a fair comment. it is true that it is a challenge, that the world health organization does not have a police force or standing

army to go in and it boris international health obligations. that is only one of two treaties that are in the w.h.o. that countries have signed up to and are obliged to comply with. but i think that what we know, rather than calling china out, what was really going on was that the leadership of w.h.o. is praising china. this has happened before. we have been in this movie before. if you go back to sars in the early 2000s, the leadership of the w.h.o. was more involved when it was confronting china and they did call china out. there were significant problems that happens, that lead as i mentioned, to the revision of the international health regulations of 2005. but there is only so much that

they can do. but it didn't even see the minimum that it could've done, as and calling out what was really going on. the information that it needed, especially that it was not receiving. it didn't happen at all. >> thank you. i'm going to end here and go to senator mendes. we focused quite a bit on what did not happen and why did not. what i would like to hear when we come back, i want your thoughts as what a system would look play if we were designing it now. which we are now hopefully. for the next pandemic, that has the transmission as rapid and easy as covid-19. as we now all three, this is entirely different than what we have dealt with in the past. we want your thoughts on that, how should we go forward.

>> thank you mister chairman. one comment. i agree that we need to continue workinghthththththththt managers package. i along with all the other committee, response and recovery costs, and i hope you can find a common ground and productive path forward. mr. crazy, i want to have off your last set of comments. that china did not share sufficient information. you just said that the w.h.o.'s words were praise for;;;;;;;;;;d they exacerbated the pandemic because it did not pressure china to be more transparent. but try president trump incel praised china's response multiple times.

quite explicitly in one tweet he wrote, china has been working very hard to contain coronavirus, the united states greatly appreciates their efforts and transparency. it will all work out well, in particular on behalf of the american people i want to think president xi. on february six the w.h.o. executive meeting, ambassador who represented the u.s. was also effusive, quote, we deeply appreciate all that china is doing on behalf of its own people and the world. we look forward to continuing to work together as we move ahead in response to coronavirus. those are just some of the quotes. was the w.h.o.'s praise the fatal flaw which necessitate it they u.s. withdraw from the w.h.o., and if so why did the u.s. speak similar statements for the praise to china if this

was detrimental to the global pandemic response? >> thank you, the comments she made are absolutely correct. early on the information that we are receiving was that china was being proper though we are getting those reports from the world health organization, i'm ever having conversations at my level, and members of the w.h.o. telling me how unbelievably transparent china was being. especially compared to the sars problem in the early 2000s. what happened was is that we receive more information later, as we all have. and more information will continue to come out. as that information changed, the tone changed, that is a fair comment. blast month, the world health assembly approved a resolution, pro sponsored by --

they had one item and that was resolution cosponsored by 140 countries, expressing concern and also demanding that there be an independent review of what happened, including about the origins of the disease and its path to transmission to humans. a lot of countries are saying bad things about china's response early on, but as more information comes out there will be more information coming. out >> i believe it is important, but the president's praise continued even after the ones i mentioned. the list of several reforms that the administration would like to see the w.h.o., including better compliance for international help regulations.

but the director general is not the person who decides on those reforms. it is the w.h.o. who is september organization, member countries make those decisions. how does the united states expecting influence those members to achieve reform in the w.h.o. if it has relinquished its? >> senator, that is a good question. i appreciate it the fact of the matter is that the united states is part of the w.h.o., the president has announced that relationship is being terminated. >> if i said i'm terminating my relationship with you, why should i listen to heal? please explain that to me. if i am terminating their relationship, -- >> why don't i tell you what we

are actually doing? >> why don't you answer my question? >> i'm doing that. as you know the united states has the presidency of the g7 this year, that provides nnnnnnp ministries and since early on in the pandemic once a week talk, as the situation with covid-19 more apparent, there was a focus on reform with the w.h.o. and as those conversations continue, some of those countries have asked us the same question, it is in the interest of the u.s. to be a member of the w.h.o.. >> i appreciate your lengthy answer, it is a non answer as far as i understand.

you have not made it clear of how you are going to effect change the w.h.o.. if we create a new global trust fund at the world bank, as i understand reading different bills that's what it would do, would we just be going it alone? the rest of the world would be seeking change with the w.h.o., or behind the w.h.o.. help me understand why other countries would support a new mechanism at the world bank. when this just create a parallel mechanism to the w.h.o.? >> senator, we just received a copy of the bill a couple of days ago. our team is looking at that. i don't know if that would be the case. in terms of hiv and aides, there are multiple organizations that have been created, and they have complemented each other, i assume that proposal would be in the same spirit.

>> i look forward to your further analysis of the bill. let me close, mr. richardson, i know that you have talked about the generosity of the u.s., i would just say that if i look at the presidents proposals for global health for 2020, which is more than a big win cut, and the cut of state, and similarly the proposal for 2021 a 34% reduction to the state department and usa global health funding, and the budgets of the president, had they been enacted, the u.s. would have by some accounts seven billion dollars left to spend in humanitarian assistance. to that extent that the american people have been generous, is the congress has

put forward these funds, i have serious concerns as it relates to the actual delays and obligation of critical humanitarian aid. we have heard from many partners, up to ten weeks in delay, i don't think there is a good reason for that they look forward to exploring it with you. >> thank you, chairman. this is a crisis that is really being driven by and defined by certain data point, certain metrics. moving forward, if we're going to respond properly, there are some measures that we have to keep in on. i want to ask questions about that. if you look at recent and past viruses, h1n1, i'm not a doctor but it is the flu, the numbers i've seen is that 60 million americans were affected by that.

but it wasn't particularly deadly. i think with a bullet it was less than 50,000 people affected, i think mers was 2500 people, 32% fatality rate, sars was less than 10,000 people and less than 10% fatality rate. is it safe to say that early on he december when this first surfaced in china, that's who was looking at this, was doctor fauci looking at this? we were hoping that this type of new virus would be something similar tumors or sars where it might be deadly and it wouldn't spread that much. how quickly can we retain

transmission rates on a new virus? >> you hit on a major problem. i wish dr. fauci was here. the point is, it was a novel coronavirus. 8i coronaviruses that were dealt with, sars is an example. that is the only thing that you can go back to look at. covid-19 is not sars, it behaves differently. but you don't know that until you get into it. and they are still learning, the scientists are still learning. and they will be four years, i am sure. that makes it difficult to respond to. ebola is a scary thing, the fatality rate is high. it is difficult to deal with. but at this point there has been a lot of experience in dealing with it. there are new tools that have been created like a vaccine

that is effective. there are therapeutics that are effective. early on that was not the case. cs that are once you deal with these things you become better about it, learn more about it. that is the process. >> we have seen economic devastation caused by global and national shutdowns, i think we have to take that into effect. i think we are only now starting to understand the devastating human toll of what has happened to our economy. early on these models, i read the reports, the one that drove so many of the shutdowns, in the first report the introductory summary said seven billion people would contract the coronavirus. isn't that an impossibility? >> tips i confessed to you,

that i am not an expert on those models. we had people the cdc and other places that are who could be happy to answer those questions to your stuff. there is a whole industry that deals with these models. >> i guess my point being, what models are we relying on to drive policy. we need to take a serious look at that and a serious look at what drove so much economic devastation. eventually we will find out that infection and fatality rate is. according to the oxford they are saying it's going to be between 0.1 and point for 1%. a bad seasonal flu is about 0.1 eight. we really need to, as far as moving forward, we need to identify these metrics, to drive the type of policy and address the health situation.

and understand what is happening with our economy as we employ the shutdowns. >> you are right, senator. i would go back to the fact that this is a novel coronavirus. something that has not been seen in humans before. some of it is educated guesswork. no doubt about it. >> thank you. >> if i may, i think your point is exactly right. i want to reemphasize that this idea of having an early warning tracking system, we have those four others, it is phenomenal, what we don't have is an effective warning systems for pandemics, for outbreaks going into a pandemic. this is a huge vulnerability and gap in our system. it is not a gap filled by the w.h.o. or any other system out there. it is something we need to look at. >> i will take note of that.

thank you for bringing this into that area of economics. it is something that needs to be considered as we move forward with the bill, and also the metrics that need to be looked at. senator cain? >> thank you to the witnesses, i want to follow up on senator johnson and ask you some questions about data. on january 21st the u.s. and south korea both had their first reported case of coronavirus. on that day, the unemployment rate in both nations was fairly similar, 4%. on march 3rd we had a hearing in this room, and there was a health committee hearing, with a number of political appointees dealing with coronavirus. on on that day south korea had

28 deaths, and u.s. had nine deaths. the unemployment was still similar. today south korea has lost 280 people to coronavirus, and the u.s. has lost more than 119,000. the south korean unemployment rate has risen to 4.8% while the u.s. unemployment rate has risen to 13.3%. south korea has won six of the population of the u.s., their gdp is won 12 of the u.s.. south korea and per capita income is less than two thirds of the u.s.. south korea is every bit as much effected by missteps of the w.h.o., and maybe even more affected by chinese missteps because of their close proximity to china and the frequency of travel. even with vastly greater resources, the u.s. still has a

covid-19 death rate of per 100, 000, that is 80 times higher than that of south korea. i know for people that have died of coronavirus. and our economy has been devastated in a way that south korea has not. in a hearing on international response, it is important to look at other nations and ask, what did they get right? especially that we got so wrong. i would like to ask our panel, how can america and entire world replicate the more successful strategy that south korea or other nations, japan, canada, germany, australia, new zealand, vietnam, utilize going forward to prepare for the next pandemic. >> i am happy to start out.

i think that a lot, many years are going to be spent at lessons learned. the w.h.o. just approved a resolution to take the first steps to do the first one. >> is that a good thing? do you support that? >> yes we did. we negotiated ships, the eu sponsored and we work closely with them. and we make sure that language was in there. i have no doubt that in our own country there will be countless studies looking at this. and there will be lots -- of >> can i ask you, are you guys looking at this? are you analyzing this periods

of nations where death tolls are dramatically less than the u.s. and asking yourself where do we have to do better right now? what we need to do better right now? and what do we need to do better to prepare for the likelihood of a future pandemic? >> yes, we have folks at the cdc who do just that. as you mentioned, south korea is a very different country than the u.s.. in fact even their laws allow the government to -- >> but they are also similar to the united states. they are an alley, messy multi party democracy, densely urban but also rural. every place is different than the u.s., but south korea has a lot of similarities including a very close working relationship. >> i think all of us are going to have a lot to learn from the successes and failures of many

countries. including what we have done in the united states. that is going to be happening for years on something like this, this massive of an impact. >> my time is closely aunt, but i think a hearing on best practices on this committee or a combined hearing would make a lot of sense. there are things that we have done that we can teach others, but there are awful lot of things that other nations have done that we should learn. we are having this hearing to prepare for future epidemics. we should be trying to learn those lessons. i couldn't agree with you more. >> it seems to me, up that the answer to the question is relatively straightforward. how tough does the government want to be as far as locking people up so they can't spread the disease?

that is a debate that is going to be quite heeded. up the culture and where you come from. it needs to be explored, no question about it. the question is, do you want to go ahead as senator johnson said,& a result of that. what are we willing to do in a pandemic like this? that is a very fair discussion. >> just to respond, south korea is not china or vietnam. it is a democracy. yes, the government did some things early testing, people were sick, contact tracing, isolate and treat those who are sick. by doing that, they didn't have to shut down the economy. that's why the unemployment rate went from 4% to 4.8%,

while our swing from 3% to 30%. so tougher testing and contact tracing, meant they had to do less for shutting down the economy. and we have done things, especially our research institutions, that we can share with others. it makes me, it makes my skin crawl to think that the first case was on the same day. similar types of deaths in march, and now 280 deaths in south korea and over 190,000 in the u.s.. i know we can do better. this committee, with a global health subcommittee, is the place that we should be hashing it out. >> fair points across the board. a person pointed out that it was very important to wear a mask in social interaction.

this person also pointed out that culturally around the world, there are people that are very comfortable wearing a mask. in some countries, people wear a mask if they have a cold or cough. you never see that in our western civilization. in other countries it is the case. these things to meet further look at. doctor? >> thank you. mr. grisby, i believe the w.h.o. fill the people, fill the world, refused to call out china for its disinformation campaign, lack of transparency, the cover-up from the start. i believe the w.h.o. blindly

accept a w.h.o. -- they repeatedly praised china for transparency. they said there is no evidence of human to human transmission, despite evidence to the contrary. just last week the w.h.o. announced that asymptomatic spread of a coronavirus was rare and then that made the national news for a day, and then the next day they walked back and claims that they had to change things. lots of in consistencies. this isn't the first instance of the w.h.o. to prevent, detector respond to a severe infectious receives. i always thought the w.h.o. was mismanaged and their mismanagement of ebola. i called them out publicly, back in 2014. due to the leadership failures,

repeated mistakes, i think it is time to reconsider the role that the w.h.o. and its leadership. has reforms are needed, up. the question is how do you do this? if you say you want the funding, you want us to come back and reengage, give us the type of credibility and engagement that is necessary. fundamentally, what do you see as the problem with the w.h.o.? is it a lack of political commitment? capacity or capabilities? why are they continuing to fail and implement needed reforms? >> thank, you senator. let me talk a little bit about the reforms that we are discussing with other countries. it goes beyond g7 health

ministers. but also, as i mentioned before, this is not the first time that we have experience this. in fact, i made mention the sars earlier, when there were problems again also in the creation of the emergency program at the w.h.o.. the obama administration had to re-direct funding away from w.h.o. because they could not get their act together to accept the money. so that went for good work that was going on in those countries. this sort of thing, is not new. there is a big difference between covid-19 pandemic and how that has impacted the world

and the west africa ebola crisis. but we have had many encouraging conversations with other countries regarding the need for reform. i mentioned a few of those in my statements. you answered this question better than i did, the fact remains that if the w.h.o. can get its act together and could make the reforms, and can prove that it has independence from china, i am sure there is every possibility that the relationship with the united states is going to be changed. but the balls in their court. there are a number of reforms that they need. we have remarkable amount of agreement and common ground with other house ministers that

we are dealing with on the need for reform, notwithstanding our relationship with the w.h.o.. that is beside the point. so the ball is in their court. we hope that they will embrace these reforms. >> can i ask about the development of a vaccine? can you discuss the steps that the administration is taking to engage with our global partners to ensure that the vaccine can be developed and distributed as quickly as possible? >> yes. we have our own projects that are going on at work speed. we are investing a lot of resources in that. there are a lot of efforts globally. we have collaboration's and conversations and share our lessons learned and technical assistance to all of these efforts. we are rooting for all of these. we are going to be more than one vaccine, more than one company. we are really going to need

vaccinations for everyone on earth and easy access to that. there are a lot of different things that play. we have folks that their job is to work on these. i'm happy to bring up some technical experts and scientists who can speak to you in your stuff, we can do that at any time. but there are a number of issues going on. our departments and the white house, there are discussions, i'm assuming with all of them. >> thank you. >> thank you, senator booker. >> it goes without saying, this pandemic has had the u.s. pretty significantly within the context. my state of new jersey has seen the worst of this pandemic. the lives lost, the families who faced ever stayed in grief, the struggles that we have seen

have been legion. i'm grateful that this committee and we have a series of problems at a time that people were calling into question china secrecy. and we had a president that was praising china, at a time that people were demanding transparency from china. this president was caught like them and encouraging them in numerous public statements. it numerous tweets. and we were failing, as people in new jersey were dying, we failed to hold him to account. and so i continue to be concerned about our poll cities regarding china, especially that goes beyond tough talk and goes to get results. some china peers during this crisis to have nationalized control of domestic production and international distribution of critical personal protective

equipment, and early 2020 in response to this crisis, including u.s. companies, such as 3 am, trying to required factories that make masks on behalf of american companies in china that produce masks for so on domestic use. china is currently exporting more masks, and these exports relate to political calculations with the u.s. receiving less priority than other markets. china's basque of diplomacy, and medical equipment is incurring favor and has been widely reported. i would like to know, how is china, in your day's perspective how are they prioritizing their exports of

ppe and how is the u.s. in your view benefiting this? and really the entire world. and how are all these people working without ppe while we wait air waiting for china to release these, what have we learned as a nation? what happens if we have another surge of the coronavirus, i am concerned that this chinese policy is still working in a detriment, a significant that rim trim into the u.s.. i would like a response was if possible. >> thank you. your comments are spot on. i don't know that there are many silver linings to this crisis. one of them is going to be, i assure you, reexamination of the supply chains.

i believe that everything you mentioned is true in terms of that. there are, i assure you, it is not my office that does this, but there are a lot of people across our government working very hard specifically on supply chain issue. it is a big issue. >> thank you, senator. i totally agree with you. i agree with him. when you look at china, don't look at it just in the context of covid, but their approach to foreign assistance, they have a really mercantilist ache, very strategic approach to what they do. they are looking at strategic ports, bribing officials in order to get their companies access to things. that is really the chinese

approach to foreign assistance. i think it sets up a really great dichotomy between if you want to go with china and except that type of assistance, you are going to go backsliding on your government and transparency and it is not ultimately going to be the most successful for any of our partners. what the u.s. offers with our partners, donor partners, is a different solution. transparency, no strings attached assistance, and those types of things. it is a critical. issue >> i am grateful, i don't think we are sounding the alarm enough. we see the authoritarian regime working against our country from currency manipulation to corporate espionage, stealing secrets, we have seen this behavior consistently and how they deal with foreign relations. now the nature of a pandemic is chilling to see that their

actions and what they are doing is putting lives in our country at risk in the past, right now, and within the coming months or the second wave. i'm grateful you are echoing what i am saying. small business committee, the supply chain issues are national security issues. we need to be acting bolder, and with far greater action to protect our nation from this menace that seems to be the chinese attention to undermine our safety and well-being. i want to ask quickly, about wet markets? i have great partnerships across the aisle. china cdc said it found covid-19 samples in a wet market in wuhan china in january. there is a new outbreak in beijing, but china yet again,

in this outbreak we see that it is still leaking a lot of wet markets. and that is linked to the 2003 sars outbreak. scientists studying these diseases, that jump from animals to humans, have pointed to the close proximity to shoppers and vendors in these markets, in these prime locations for this spread of these pathogens. we know from stars, ebola,óeóeóo humans. it is clear that wildlife markets that sell these for human consumption need to be shut down. we sent a letter to the heads of international organizations to shut these markets down. , i would love to ask this

question, how should the u.s. work through these organizations to increase see awareness of this risk, and really he get to take real measures to shut down and ban wildlife markets so that we do not see this challenge again. i'm grateful to be working with senators, but to me this has to be an international priority. can i get your thoughts on that? >> path, -- we have a fairly broad reach, although a lot of the countries who are great defenders like china, we don't have a lot of those programs in those countries. we do need to expand, not just in the development but on the

diplomatic side. we have to deal one two punch here. working together could make real progress. >> thank, you i think what this shows is that this is all interrelated. you can't so look at just a simple help focus. we have a tremendous opportunity to build more commitment behind preventing wildlife trafficking. and by talking to many of the countries that enable this to happen about the consequences and the effects. this is a tremendous opportunity. going back to the sanitation issue, we are prioritizing many of our investments in water sanitation and hygiene. so that we can prevent the spread of these diseases. your point is well taken, these issues are interrelated. but we have an important

ability to message strongly and show these connections which can help have a broader impact on these places. >> thank you. >> thank you, senator booker for raising the supply chain issue. it is critical. this ties a little bit into what cain was saying, one of the things that south korea did, it had a very government approach to this. they supplied -- they hung on to everything they had. they shut down their supply chain. what happened is that there has been a real underscoring of the weaknesses that we have as a result of a lot of our manufacturing being overseas. manufacturing that's national security and that is a national security issue. i have no doubt we will be looking at that moving forward.

thank you for that. senator murphy? >> thank you. in response to a question about global vaccine efforts, they said we are rooting for these efforts. why should be we be rooting for these global vaccine efforts? in fact we could be part of these global vaccine efforts. in particular, there is one that is the most promising the coalition for epidemic preparing us innovations, all our out lies are part of it, frankly doing work as we speak with u.s. companies. the legislation that senator rich and i have is authorizing the u.s. to become a partner with them and put money behind that effort. what is the administration specific position on the wisdom

of joining this particular global vaccine effort? it just seems to be smarter to be at the table, so if they are the one at the table producing a vaccine, we have something to say about who gets it first. >> i appreciate that. up it plays an important role, when there are many that play in essential role. the administration just made the largest pledge ever for thee international effort for vaccines is pretty strong. i would say that if you look at what we have done, a lot of this is on the hhs them, a lot of the money that we have invested, we have allocated 350

million dollars for vaccine efforts, 1.8 billion for rapid acceleration of diagnostics, there is a lot of work that has already been happening in the u.s.. am i going to say that we shouldn't coordinate more closely with partners and allies around the world? of course we should. that is a great common sense approach. i don't know if your question was dealing with the eu conference, but the u.s. has invested private sector and public dollars over 12 billion so far into vaccine development. >> i don't didn't know that we are spending a lot of money on vaccines. i just wonder if we are better off hedging our bets and making sure that we are not only doing that domestically but joining these international efforts. i hope that administration would be open to a bipartisan legislation pushing us towards joining this group.

up i did want to turn back this question of the w.h.o., i think it is pretty stunning to hear from the administration that the problem early on that the w.h.o. was giving cover for china to withhold information about vaccine. so we don't need to belabor the point but it was not that the president was simply saying nice things about china early on, on 40 different occasions, up to including april, the president of the united states was the primary global cheerleader for the chinese response to covid. he went out of his way over and over again. here he is on february seven, this is far after we all recognize that china was

withholding information, are you concerned that china is covering up to the full extent of covid? he has an opportunity right here to say, yes i am concerned. his answer is, no. china is working very hard. i have 20 pages of this from the president. it just belies reality to suggest that the problem was the w.h.o. covering up china's response. the president is not more powerful than the president of the u.s., we all need to acknowledge that. my question to you is, the idea that we are going to try and effectively have me reform through the g7, let's stipulate for the time being, that it is harder to the u.s. to impact reform in the w.h.o. if we are not a part of it?

rather than a part of it? it might just be good for us to stipulate that, whether you're going to try to pursue reform for the g7 are not, let's stipulate that it is more difficult for us to get the w.h.o. to reform if we have withdrawn from it? >> w.h.o. is a member state institution, our relationship with the g7 is important because it is the most influential donors to the w.h.o.. i would say that if the w.h.o. and other countries do not want to see the united states leave the w.h.o., there is no doubt about that. it is important for the w.h.o. to embrace these reforms. and that the appropriate government bodies meet and

approve them. >> there is one country that is desperate for the u.s. to leave the w.h.o., that is china. they are going to fill this vacuum and put in the money that we have withdrawn and even if we try to rejoin in 2021, it will be under different terms because china will be more influential because of our temporary absence. any other construction of reality is putting the u.s. in a very dangerous position. >> i would say to that, the u.s. has been the most generous donor to the w.h.o. since the beginning. it has been remarkable, the increase and china's influence over the w.h.o. is over a long period of time. the president made a bold decision, there is no doubt about that, personally i hope that it will get the attention

of the leadership of the w.h.o. and that this narrow you described will not come about. that is my hope. >> we were continuing to fund the w.h.o., but we left the seat on the board vacant. doesn't take a lot of imagination to figure out why china could get more influence if we were sending money but nobody to sit on the governing board. we invited -- look, i'm not defending that the w.h.o. has got closer to china, but we have to step in. we were not sitting on that governing board. >> i would like this respond to that, i am the alternate board member. i don't do nearly as good as a job as a confirmed person. that seat was not vacant. there are always people to fill that seat. this is since secretary of

health was nominated in 2017, and he was nominated a long time ago, and we wish we could have had him confirmed sooner, he was just confirmed a couple of weeks ago. he was nominated last year and had to be re-dominated again this year. >> i won't get into an argument over whether it is more effective to have senate of confirmed positions, i would argue that it is. i'm well over my time. >> thank you senator murphy. mr. grisby, i have contacts with the w.h.o., and your suggestion that our top of withdrawing and withdrawing funds might get their attention, i can assure you it has gotten their attention. it is probably been your experience to. in any event, we want to look forward and serve backward. before we do that, next.

>> i hope i am looking forward. thank you for holding this hearing. i think all the witnesses for their service to the country. on global challenges, u.s. leadership is indispensable. if we are going to have the type of outcome that is in the interest of the u.s. and our security interests, this committee knows that best. that's why i was very pleased to see that we are holding this hearing. it is three u.s. leadership to have a safer world, a more democratic world, and healthier world. many of us are very concerned as to how the u.s. responded to this global pandemic. we have seen in consistent information coming out from the white house. that is being kind to the president on a lot of the things that he has done in regards to this pandemic. we have not seen the type of

preparation or response to the pandemic that would be used as a model for the world. i think senator cain pointed that out clearly in his question. this is not an isolated example, enough regards to global affairs with trump. i could point the immigration policy and i was very proud that the supreme court ruled that the president's actions in trying to and the dock program, was arbitrary and capricious. we also have to talk about the presidents trade agenda that put us at odds with our trading partners rather than trying to isolate china. where the united states pointing out and removing themselves from the climate agreement, we are the only country in the world to pull away from that. and now the pandemic. my question starts off with,

the effectiveness of u.s. global leadership on this pandemic, when other countries look at what has been done in the u.s., how much influence do we really have in the behavior of other countries? they look at what is happening in the u.s. and they see that the president is holding a political rally, bringing lots of people together against the advice of the public health officials. how can we complain about what is going on in other countries, my question will deal specifically with some of our largest countries in our hemisphere. countries who who covid are very much under reported. and that they have not taken the steps that public health officials believe or necessary in order to contain the spread of covid-19. this is our hemisphere and we

know this is a global pandemic. how much influence do we really have? how much are we concerned with what is happening in our own hemisphere and countries that are under reporting covid-19 and have not taken the steps that health officials think are necessary to contain this virus? >> i appreciate that question. we are truly committed to the western hemisphere. we just announced another 250 million dollars to be turned on for the northern triangle companies. our commitment to columbia is unprecedented, mexico. >> i'm trying to limit this to covid-19. you might want to also point out that congress appropriated almost two billion dollars of aid to deal with covid-19, can you tell me how much of that money is actually been spent

and where it has been spent? >> we can go and look exactly what our obligations are. >> how much has been spent? >> can you give me a range of that two billion dollars, how is it been spent? >> we have committed about 1.3 billion of that we have committed to almost 200 million for the western hemisphere. >> when you say committed, it has been spent? >> we have identified which projects. >> how much of that has been actually spent. >> it gets down to the obligation rates. usda has their own obligations. in general, we have obligated almost 500 -- >> i don't care. how much has been spent?

this is a global emergency. the timing is critical. how much has been actually spent? >> obligation equal spending. it is when we actually handover the money to the partner to do the work. that is the big picture. maybe chris has more details, what the obligation rate is. i will say, each individual bureau and agency handles their own obligation rate. i can speak for the state department. they are obligated every dollar that we have identified that we want to spend on covid. that is happening. aid has a different mechanism, a different approach to this. i will let crystal lab rate. let me just do that. >> the easy answer is that

there is over a billion dollars put into the hands of people overseas to respond to covid-19, that includes a supplemental that we continue putting in other people's hands. of the portion -- >> why hasn't all of it been given? >> we have been allocating, the virus moved very quickly. what we needed to do is see where the virus was going and then prepare and learn as we go. >> so you will be requesting more money? >> we are busy obligating the money that we have. we are very thankful for the generosity of congress. we are not through this pandemic. one of the things i'm most concerned about, that is the secondary and tertiary impact. we are seeing a big rise in security, democratic

backsliding, children out of school, we are alarmed about gender based violence. there is a whole set of secondary in tertiary impacts that we have to consider. >> can you keep our committee informed as to whether the money is spent? and the request for additional funds as you see the need. >> absolutely. to pick up on what he mentioned, we have 35 billion dollars that is being spent every year on foreign assistance. much of it goes to the western hemisphere. we want to make sure that every dollar is spent in the covid sensitive way. how do we make sure that our gender based violence program, or education program, takes into effect what is happening with the virus right there right then. it is an important conversation. it is not just the supplemental, we are trying to bear all of

our foreign assistance to help other countries. >> let me follow up, on the 50% of the supplemental money that has been put out, how has it been spent? on the primary effects of covid or mostly on the secondary and tertiary effects that you quite properly considered. >> it is mix. congress has appropriated a certain amount of money for economic support funds, it is really looking at that tertiary and secondary impact, primarily most of our resources are coming in the forms of humanitarian, which focuses more on the virus and providing critical medical supplies. >> thank you mister chairman.

thank you to our panelists. i would like to go back to china. there is put a lot of discussion and their role in the hearing today. we have seen a concerted effort from china to counter any negative narrative that may develop at the international media. i would say that given the discussion today that they have been pretty successful. they demonstrated a willingness to use their resources, to realign nationals said tense in countries that may be inclined to criticize china. they found that china is gaining ground on political influence and fire -- so, i have two questions for you.

one is, how does the lack of leadership on the pandemic response creative vacuum to create china to did better develop that narrative where they are the provider and helping countries with needed resources and expertise? secondly, how does the pandemic contribute to this dynamic in southeast asia that has a negative impact on the u.s. and our role? >> i can start and then passed it on. i totally agree with your premise. the reality is, china has used this pandemic to advance their strategic interests around the world. it does need to be seen in the context of the larger efforts. we have a lot of work to do, especially in the public diplomacy side, to counter misinformation and our global

impeachment center does a good job of that. >> i'm sorry to interrupt, let me ask, why do you think that is? why have we been slow? has it been some of the statements that were read from the president that suggest we have been slow to recognize what was happening in china? >> no. i think what you are seeing is that the u.s. has outspent china time and time again. both in its every day foreign assistance. china spends about 400 million, and we are at 35 billion. they are not a significant player when it comes to what we consider to be effective foreign assistance. they spent all the resources up building up strategic ports and engage in bribery and other aspects. i think it is an asymmetrical challenge from a development perspective. we need to develop asymmetrical

responses accordingly. congress was smarts in the last years, they establish what is called the counter china incentive fun. we will spend 300 million dollars, trying to develop best practices across the world to say how could we effectively counter china in djibouti, in malawi, and el salvador. this is not a southeast asia problem. china's influence has dramatically shifted and the next battlefield is africa. we want to position ourselves in order to be the winners and the partner of choice. and to remind people of the everyday commitment we have been making to countries over the last 40 years. we have been there. we have stood witht@t@t@t@t@t@t. we have invested 500 billion dollars over the past 20 years.

>> i agree with that. but that 500 billion has not been all humanitarian. is it? when you are counting that 500 billion are you not counting military aid? >> about 25% >> -- the way that our budgets work, 25% goes to foreign assistance, that is not just military, but log force meant. 75% is global health, 25% is humanitarian, and 25 persons everything else. >> given that, why do you think that we have not been more successful and china has been? >> we have seen the quick increase in chinese influence. but we are also saying that china is not as successful. there is a lot of buyer's remorse. there is more understanding in

chinese investments that they come with strings attached. the supplemental's we are implementing has a very important public diplomacy side. it shows american leadership. countries are turning to us in our embassies for leadership on this issue. >> i'm sorry to interrupt again, but i-20 get an answer, what has the pandemic done to allow china to increase its influence as opposed to our reaction which does not seem to have produced a similar response to american aid? aid? >> yeah, that's a tough question, we would have to go country by country to determine, every country is unique. and how they think of chinese existence, most countries are willing to accept face masks

from china, but as to this point they often go to us and say hey, is this financing deal from china any good? we are the trusted partner and choice even though we have seen china accelerate. if you look at their investments, even covid versus what the u.s. has invested, it pales in comparison. i think they are just focused on getting those headlines. >> let me point out, the state of new hampshire could get ppe from china when we couldn't get it from the u.s. or fema. i think we need to examine what is happening there and what we could be doing better in order to address fallout from the pandemic. thank you mister chairman. >> -- thank you. now, tough questions, if you guys were sitting here one at a time, what would you do to

construct a system for the future? would have the two real they'll take the w.h.o., reform the w.h.o.? create a duty vision? to restructure its management? would it be to create a new international agency? were you something like the new cdc? i think the last thing anybody wants to do is to create more bureaucracy as a effective nimble response to this in the future. give me your thoughts. we will go down the line. for >> thank you. whenever you deal with these challenges, i want to make sure what we are thinking about what problem we are trying to solve.

and what results we want. the solution and the specifics will naturally come, that is through the legislative process. administration has yet to finalize its own proposal on this. but let me say that a couple things matter. first and foremost, having a clear weight of functioning is essential. coordination does not mean control, it means empowerment. we should not be doing global health programming. that would be a terrible duplication of effort. it takes away from what the cdc does. the state department also has global reach, embassies and nearly every country in the world, has a natural coordination function that is essential. the otherccccccccccc|t both domestic and international, his data tracking, built in

accountability. how do we create true accountability to international systems? to hold countries accountable forgot meeting minimum standards? how do we make sure that we are encouraging countries to use their own resources in a systematic way that allows us to better share data. to create early warning systems. how do we bring the very best? our private sector and the u.s. government and make them work together. those are a couple of thoughts. >> those were all good points but not much of an answer. weijia fire alarm goes off, who response? >> the state department is the functional lead for the united states. >> for the world? >> for the world. the cdc is responsible for ct see the health outbreaks, complex health crisis.

each one has her natural roles and responsibilities. i would encourage us to pool all of our expertise together in order to solve the problem. >> so the criticism has been made them, that the w.h.o. fell down on the job, and it was obvious that there was a development. should they be the ones to undertake this in a fast pandemic like this? or should it be different agency? who should do that? >> the w.h.o. has failed the world on multiple occasions. the last administration saw the same thing with ebola. we have seen this with covid now. when this problem has been brought to us, this is not the first time we had to think about can the w.h.o. do hiv, aids response. the world said no.

it does what it does. but it will not be nimble, dynamic, bring in private sector actors and able to respond appropriately, so last time the u.s. created the global fund in order to do something on the hiv side. i think that looking at, where are the strategic gaps at the multilateral space? and how can the lead with our friends and partners and folks around the world in order to fill those gaps? that would be the central part of the conversation. when >> the global fund is a tremendous model. i think there are a lot of things to be learned from lots of different options out there. i think the real key here is having worldwide reach, focusing on burden sharing. the u.s. 40% of the world's

global public health work them. as we take on this new challenge, we really need to search in both privates and other donors. both global funding has been a tremendous model. >> what i think about the future, i think about how do we respond to the next pandemic, how do we prevent the next pandemic? and then how do we structure ourselves to engage in that effort? we know to respond we have to maintain a humble and effective means to do so. we can't have overarching bureaucracy engaging in that. >> we have learned that the hard way. >> we need to empower our people in the fields because

that is where the true coordination and expertise comes through. >> do you agree that the vehicle are the global fund and gaby. >> that depends, a model for? what i don't mean to be cheeky. >> fair enough. >> preventing is very different than responding. very different skill sets. what i consider preventing, we know that a pandemic is not really a health crisis. it is governance crisis. we know where we have epidemics today, we have that because of state fragility. where is a bullet today? congo. why does polio still exist. it exists in fragile states like parts of pakistan and sudan. an epidemic is really a governance crisis masquerading as a health crisis. we need ankokokokokokokokokokoky

there is a level of coordination that needs to take place. we can't have a stove pipe alone approach that creates another layer of bureaucracy. it has to be something that brings everything together. when we look at the response side, you have to retain and ability to engage in international effort. c@ would you recommend in that regard? who is the fire department? >> the global fund is responding to slow-moving epidemics. >> is there no model that exists to call the fire department? >> the only model that we have is suggesting needs to be reformed. when there is a humanitarian

crisis, i have light many of them, we work with the un cluster system. the un sits and organizes an international part together. it works well. but now, we don't have a model for the pandemic stage. we have principles to incorporate. communication, coronation, integrated reproach. >> mr. grisby, think you i think they have stated it quite well, i want to think the colleagues, we have worked very closely and the development of these ideas. we appreciate that. we do support what a coordinated concept.

why would just point out, most of what we talk about as just foreign assistance related. the cdc which would be the agency with the hhs, they would have the much to do with this area. it operates differently and in different places. it has 50 or 60 offices in developing countries. but it operates in every country on earth, rich or poor countries. it has all sorts of collaboration's. >> are you suggesting that the cdc is the model for the fire department? >> not necessarily. depends on what type of fire. the cdc is on point when it comes to pandemics and disease

outbreaks. it often time works closely with international development, particularly in certain cases. where there is a disease outbreak and it is happening in a part of the world where there is a war going on and many other problems and by definition a complex emergency. they work hand in glove in those situations. i don't know that there is a one size fits all answer, it is kind of case by case. >> thank you, i was hoping to get a clear answer to the question, who is the fire department. because that is what we are trying to do here. i get all the moving parts. i understand that. but it seems to me that if there is a telephone number that somebody could call and say come and put out the fire, we want that agency. right now, what you are

suggesting is that we have a list of phone members to call and i'm not sure if that is good. >> i just want to be very clear, there is a number that countries call when they have a problem. and that is where our worldwide reaches essential. our ambassadors and chiefs around the world lean on the technical expertise depending on the challenge. i think, as we start to think about how what the next pandemic looks like, is fast moving? is it slow-moving? does it hit the developing world? does a hit high income countries? how does that work? what is the response is that we need to do? we just don't know. making sure that we have true coordination that can pull the right levers at the right time in order to get to results, that is essential. i wouldn't want to move away

wl worldwide reach today. people know who to call. that is our chief mission at the state department. we want to strike -- >> if i can add briefly to that. our ambassadors and mayors and firemen are there for disaster assistance. we are currently responding to complex emergencies. our u.s. point of view, we have firemen, and i think your question was, should there be and will there be an international fire person? >> that is what we are looking for. >> senator keen, any good for the order? >> to follow up on your comments, i will put myself firmly in the camp on this is that i think we should stay in the w.h.o. and use our leverage

to push reforms. an enormously frustrating organization, the u.s. chose, the senate chose to not put the u.s. into the league of nations when president wilson urged -- it was more ineffective because the u.s. wasn't involved. in the 19 thirties, long before world war ii, they saw the league of nations collapse coming. they said it was speed and effective. and they start planning for a un. those plans were delayed by world war ii, but roofs of else carried on with it. recognizing the frustrations, the u.s. pulled out of the you'd council, a history of bias, and a broad history of hypocrisy of member nations that were going on about human rights and doing bad things. but what has happened is a

result of us pulling out? has gotten betty forever's israel? no. -- fighting against discrimination, if it weren't for the united states that would've been on the agenda. those are sort of dormant. i think these organizations are enormously frustrating, but it always goes worst for the world if the u.s. is not involved. it goes generally worse for us as well. i like the president, whether it is the w.h.o. or nato, we have more accountability, more strings have to be attached, it just goes worse for the world if we are not there. we are so confident that the u.s. has such value to add to any organization, that when we back away from it, they lose their expertise that we have,

and worst actors elevate their profile. here is the question. it follows up on a conversation you are having with senator carter. there is new york times piece last week about on the ground agencies feeling frustrated about the slow pace of delivery of march cares act. this 1.6 billion out into the field. you have given us basically a lot of it has been committed, a big chunk has been obligated, i just want to understand, obligation means you put it in the hands of the organization. that the u.s. is writing a check? is that the same thing as getting it to the field? might some of the complaints of these ground level services, save the children, rolled vision, might their complaints be that the u.s. has written a check to somebody but there is a middleman problem that it is

not getting down to the ground? because this was a recent piece in the new york times. what is the source of their frustration? how can we solve it? they want to act as quickly as we want them to act. >> without getting bureaucratic, or different accounts have different abilities to spend money. here are these concerns from ngos and important partners. with a humanitarian assistance funding that we have, as soon as it is available, they can begin spending it. we don't have to have a contract. we contractor actually with then we don't go through middlemen. as soon as it is available, so unique ability. 535 million dollars in assistance funding, they can currently spend 267 million,

and then by july they can spend all of it, that is in addition to the overall funding that we made available which is a billion dollars. it is in their hands to do work now. we are looking at ways to actually streamline the process. i have to tell you, these are extraordinary times. previous to the pandemic, we were riding very large assistance efforts in very difficult places like yemen, iraq, so sudan and syria. the global pandemic has affected our own workforce as well. we are adapting and streamlining. and we will meet the challenge. >> i appreciate that. >> our witnesses, thank you so much. you've been very patient with us. this is part of the puzzle that

we are trying to solve. we appreciate your thoughts on it. we hope to hold a number of these hearings to gets as much input as we can, and as a committee sit down and try to construct something that will move us forward. if this happens again. i think we are all under the belief that it will happen again. hopefully later rather than sooner. but let's be ready for it. hopefully will have some legislation for that. with that, thank you again for your service and this hearing. the meeting is adjourned. adjourned.