Tly hearing on science, space and Technology Committee with gina mccarthy. And faithbased organizations and delivering care to countries with hiv aids. This first group looked at a report on Global Health conducted by the lancet. This is an hour. Good morning. Sorry for the few minutes delay getting started. Im the Deputy Director of the Global Health policy here at csi s. It is my pleasure to welcome you for what promises to be a new series on faithbased health care. Before we get started, thanks to anita smith. I want to say thank you to katie on my team, instrumental in pulling everything together this morning. Faith is a powerful force in the lives of individuals is and communities throughout the world. Faithbased organizations are an important provider of health care globalry and resource for Health Services and support, particularly at the Community Level and hard to reach populations in some of the poorest places in the world. As rick Warren Church noted there may not be a church in every town village but there is usually a church, mosque or other place of worship. It can be critical to meeting Global Health and development goals. We have explored issues through ava right of issues including active collaboration around the aids. As well as controversies in places like uganda where discrimination against the lgbt endanger People Living in hiv. Moving forward it will be critical to find ways to engage productively on these sensitive issues. It is essential to better understand roles and contributions of faith based providers and improve coordination between faith and health communities. We will hear more from our panelists today. Thank you and good morning. On behalf of the authors im delighted to introduce this session from the lancet on faithbased health care. This is made possible by capital for good. In addition to the book lets you have received, Additional Information is Available Online for free and full contents will be published in the weekly edition of the lancet next month. Faithbased organizations deliver substantial amount of health care around the world. How much and what benefit has not been well documented. In in which collaboration with different sectors will be crucial, this series sets out to estimate the contribution for faithbased organizations for health care. Particularly strengths and weaknesses of faithbased actions and how their expertise might be best recruited in the future. The three panelists were each lead authors from one of the reviews in the series. Going from your left to right jill olivia has worked with the world bank is is coordinator at the university of cape town, director of the International Health assets program. Jill combines these skills as the lead author of paper one. Andrew tomkins is emeritus professor of International Child health at University College london. He combines a career with extensive experience in the field to present a review about the influence of religious beliefs on behavior in the second paper controversies in faith and health. The final review toward stronger partnerships between Public Sector and faith groups for improved health was not intended as such but rather planned as a brief viewpoint. However, peer reviewers were so enthusiastic that they were asked to put the monday script in a fulllength review. Head of the partnership for faith and development and coordinator of the joint learning initiative on faith and local communities. And at your far ride nina smith will moderate todays session. Past cochair on hiv aids. Ladies and gentlemen, the panel. [ applause ]. Thank you sop for hosting this important event and to bill for the introduction. I wanted to ask one question. Probably would need to get back to the microphone. But this entire series would not be possible without all your support. And i just wanted to hear from you as we start this discussion what your goals are in terms of how you want to see the material thats being used and how you would like to see what you are supporting through this effort. Thank you. The founding of the lancet set out with two purposes. To inform and to reform. So the name lancet means both a surgical instrument and narrow window. He wanted to cut out bad practice and shine light on good practice. And i think that still collects the way we approach topics. And health is such a vast part of our lives with so many different interfaces that this is a large area of health which received disproportionate attention over the years. Its a very sensitive area. And i think that may have made it difficult for groups to explore others in the past. And i think its also a very vast area with evidence based. So its difficult to make firm conclusions in the way one might do for other expects of health care. So with this issue what we want to do, however imperfect, is so set down a marker and to say this is an important topic. Its going to actually be more important in the future. And if we are to achieve the Sustainable Development goals, we need the help of all potential actors. What im hoping is this initiates a dialogue which is then taken up by other science, sociology Health Journals that we move the influence of faithbased provision of health care from the margins of the debate and make it mainstream. So my metric of success would be for people to write in three four five yearss time this was great but it is so terribly out of date, this issue. I would like to see things move on. And as they do move on i hope that the lancet can be part of that. Thank you so much for that perspective. Which gives us a perfect foundation. I do have a few slides. This paper im presenting on behalf of my coauthors. If you are not familiar with the area it is a very diverse area with major evidence holes. I didnt say gaps. They are big black holes. We simply do not know how many faithbased Provider Services they are. Faith and individual health behaviors. So what this is thought to do is provide a synthesis based on a systemic review. A synthesis of primary search in which there was some substantial evidence that could be on afternoon faithbased Health Service providers. Theres been a lot of these quotes that have been around the last 20 years. We dont know the numbers. We dont know whats going on. These have been around a long time. We do know a little bit more now in the recent time. So what this paper is focusing on is specifically on that cluster of countries in africa where there is a particular presence of faithbased biomedical providers. Were not looking at faith healing. Were not looking at ava right of other important issues. This is really looking at the hospitals in those regions. Evidence based is biased towards africa, towards christianity, and towards english literature. Im saying that now. We did not know about islamic facilities and other facilities. We did not know about northern africa. This is a very common slide. Selfdeclare on the percentage of Health Service providers against the Public Service provider. So, for example, only count number of hospital beds or number of facilities and compare the faithbased christian Health Services against the government facilities. These figures are highly contentious. What the paper tries to impact is the numbers are very contentious contentious. There is a need to move away from this focus on the percentages of market share. The argument is basing your entire idea on whether or not they provide 20 or 25 or 30 of the Health Services is actually less important than the issues such as do they provide Quality Health care. Do they emphasize Health Coverage to people who dont otherwise get access. Do they provide a different kind of care that supports the season and make more resilient. So really the argument is moving away from those kind of figures of market share and looking at things such as utilization, satisfaction. We are trying to pull on what data there is on these other expects we consider to be more important. Ill just touch on a couple of issues. We presented some data looking at utilization, which did show slightly lower market share than we had originally assumed. However, it is comparing apples and oranges to the bid based comparison. Dont worry about that too much. We found quite a lot of evidence that in those countries a lot of patients were reporting on higher satisfaction levels. They were normally based on the idea they were getting a high quality of service in the faithbased service the public facilities. It is not just africa but it is normally in times of humane tear yann crisis. Im not going to go through this whole slide. But just to say, as i mentioned earlier, there is a push away from broad general raeugzs about service providers. I would encourage you strongly not to use the word just generically. So being specific in the evidence and the engagement is really important. And im going to stop there. Thank you very much. We will go ahead and have all the presentations and open for questions. We had a very interesting and challenging task at looking at controversies. As you can imagine from the title, we had a rich diversity of people to inquire and include in the team. And i think the key thing we wanted to emphasize in the paper was that there are many, many people who report faith in the world. In fact, it actually says more than 84 of the worlds population report having a faith. This slide shows some of the faith and methodology and looking at differents between faiths and sometimes differences within faiths. And that is a very important thing to do. The second slide i think just shows the importance of not being too simplistic in attributing anything to faith belief alone. This slide just emphasizes in the center talking about things like attitudes and beliefs and prejudices behavior choice of technologies. All the things that we think of every day. But it isnt just faith that actually influences. Sometimes its actually centuries and thousands of years of culture. Sometimes its social and economic aspects. Sometimes it is issues in relation to the laws in the country which may actually conflict with faith. Unfortunately sometimes believes and behaviors are by extremist ideological positions. When we looked at various component, we looked, as you will see in the paper a series of health damaging behaviors, which included childhood marriage. Opposition to immunization. Violence against women. And female genital mutilation. We looked at the way they had a viewpoint on this. And we looked how at notwithstanding considerable varieties, there was a lot of common gnat. There are a lot of ways in which groups groups have come together to work for the reduction of child marriage, for the increase in uptick of immunization, for the improvement of care for women, for the reduction of stigma and improvement in the provision and care in hiv aids. So this was some of the things we look at. This shows a little bit of a problem. What we found was within the fate Leadership Group there was often a limited awareness of what was going on in the world. We actually found there was a considerable problem in faith leaders remaining within their intellectual and theological faith equities. At the same time we found some working in Development Agencies were extremely unaware of what faith actually meant. And therefore there was a tendency particularly for those affected by intense is secular agendas to stay within their secular silos. And i do apologize to those who object to this. Because we saw remarkable opportunities of faith groups i probably used a word ive just been told not to. But faith groups working intensely with governments and local communities. And we provide within the paper some great examples of that. What are our recommendations . Well we would like to see that the Health Care Leaders become more faith active and the faith leaders become more health active. Im not suggesting all faith leaders join gyms or Health Leaders go to the mosque. But it is important that literacy and understanding are improved. Notwithstanding these issues, we do provide some evidence and quite a bit of Peer Reviewed evidence showing there is remarkable opportunity for faith to be integrated with a program. We can see there are opportunities for a program. So what do we seek to achieve from this paper . We would hope discussion, possibly disagreement. But we see quite likely to be an opportunity for groups to Work Together for the improvement of care. To move from compassionate, faith accepts active care especially for the hard to reach. And we do not believe the rules of Sustainable Development will be achieved, unless some of the issues that we raised in our paper are taken into action. Thank you. Good morning everyone. Thanks to csi s for helping to organize this session. Thank you bill and the lancet and my fellow authors and the working group of amazing people to bring this unprecedented series to launch at Sustainable Development held over the last several days at the world bank. Kay warren was key inspiration by her deep lived out personal experience of how religious and faithbased organizations transform stigma and save lives of People Living with hiv aids. We pick up where andrew left off. The partnership between Public Sector organizations, between governments and donors and faith groups in general. And what exists by way of partnership and what might scale up and strengthen partnerships. The time is now right in the context of developing trends and opportunities. To very substantially increase engagement with faithbased organizations. Policies and policymakers seems to be moving beyond the question of whether to engage how how to collaborate. They discussed their mutual approach to implementing a preferential option for the poor over our conference the last couple of day, a notion that was tagged in the paper themselves becoming more activists around these issues was underscored by the German Government, who have newly constituted focus within the Development Agency on this work. Next slide please. Great. Thank you. Now the next slide. On the faith side, the paper reviews how existing partnerships and mechanisms are expanding collaboration. We look at those in three groups. We look at large scale interventions, such as the significant donor to the global fund for aids tb and malaria. So very Interesting Partnership there between faith body and multilateral donor. The paper references the longstanding ongoing efforts of agency toss facility partnerships. Substantial private assets that the Faith Community brings. And a study of ngos which amounted to 16 million which was only 77 777 million. To a small chair. Next slide, please. The paper drills down on the case for partnership by looking at contributions to maternal and child deaths and impacts every woman, every child praeupling by unicef. It goes into breast feeding, immunization access to care that make a difference to those health outcomes. We offer ava right of case studies and examples from nigeria, sierra leone mozambique. Finally, the paper drills down on series of recommendations. They are clustered in five areas. Again, time doesnt commit us to go into them. But we offer them for your further krbgz. They include suggestion of new business models. Faith groups can strengthen themselves to b to be more effective in partnership mechanisms. It was interesting when this paper was conceived 18 months ago the conference that took place the last couple of days was not even intended. But to see how all the work embodied in the lancet paper was very much a grounding for the conference the last couple of days. These recommendations were evaluated very extensively. It looked to strengthen partnership between Public Sector and faithbased organizations. Thank you so much. This is just a taste of document that you have that you will definitely want to read if you arent already into it. Thank you all for your questions. Let me just is ask each of you a question. Wanted to clarify that the its hospitals you were looking at. Were you looking at clinics or just hospitals in how extensive was the data . It was looking at all health facilities. But, again, they are data holes all over the place. Most would show the Christian Health associations. They normally met a whole number of facilities. Okay. Obviously there is a lot of work to still be done to get beyond just the christian facilities. Is there work under way that youre aware of . There is work under way. A lot of health facilities. Faithbased facilities. Its not quite as clear ket. How many of those would be the partnership between government. It differs with the country. It was probably 20 or so big hospitals. Normally in areas where there is not a substantial presence of the public system yet. Okay. Great. Thank you. Andrew, what an interesting paper. And look at the controversies. How did you and your team go about deciding what you were going to look at and how did the teamWork Together to work with the outcomes in the paper . With fear trepidation, Energy Enthusiasm and an objectivity. Thats just off the top of my head. Basically as scientists we are basically looking at what is the evident. And we didnt have any particular axe to grind. And as for readers of the paper will see, there were representatives looking at all the major faiths in the issues. We came particularly from the perspective of what are the particular needs for hard to reach areas, poor countries, women and children. We looked at mortality rates. Poor nutrition rates, and Poor Development of children and adults. How we do it we basically looked at the problems and we analyzed them using traditional sacred texts. And we also looked at the ways those texts have been interpreted in different ways. And then we moved on to see how the text had inspired and driven Health Workers to provide services in very difficult situations. Thank you. Jean congratulations on already putting some legs to this effort in the conference. I know it was very successful. I think one of the questions people have why havent these partnerships been so difficult to bring about and why has it taken this long to come to this place . The event that anita is referring to this is conference on religion and Sustainable Development effective partnerships to end extreme poverty, which was held over the last couple of days at the world bank and cohosted by the u. S. Government here in the front row, the German Government the british government, world vision. And other leading faithbased organizations. In itself it represents part of the answer to the question that an extraordinary collaboration among governments faithbased organizations and the Academic Community around these issues. And anita, i think part of what we struggle with is a cultural divide. We have different approaches and methods. We have a common ground. We have clearly Common Grounds but different approaches. And i think what is so heartening the last couple of days was the spirit of collaboration. The reciprocal frame. It called for the part of the Public Sector organizations for a very strong evidence grounding. And really a challenge to step up the kinds of evidence that jill and her team have been presenting as a basis for discussion. The work head is the building of trust, the building of understanding, faith, literacy and Development Across the two communities. And i would like to just point out that the materials, all the materials for the conference are available on the website of the joint learning initiative at www. Jliflc. Com. And i commend those to you. Thank you. Now well open the florida questions. There will be people coming by with microphones. We would like you to identify yourself and your organization before the ask the question. Well take three at a time. And then well pose them to the panel. We have several hands up here. Good morning, ladies and gentlemen. I have an Organization Called hope for tomorrow. We are also based in kenya. Thank you so much for your presentation. I just wanted to mention about what you said. There has not been outreach and awareness through partnership with society government. So how do we make this happen . Because of lack of coordination collaboration. This message is very very important. How do we work with you guys . We just came up with the application for communication with people in africa. Using health care, and everything. How do we collaborate . Thank you. Im the Health Program coordinator at the Corporate Council on africa, association of businesses based in africa. This question is mostly i think for andrew. Did you find big differences between religions that do not have sacred texts or that dont have one overarching philosophy for the entire religion . Like full based. I have worked in many countries in subsaharan africa. I expected the team to look at the relationship between faithbased Health Services and government policy development. The relationship between funding agencies and faithbased institutions in countries. I give example toss give a little clarity to my question. When i work for the world bank and when missions my colleagues did not want to discuss with the baptists or the catholics or the presbyterian institutions. They are pretty unprepared for these facilities. This was never really integrated for policy Reforms Program development. When i worked for the cameroon government before i joined world bank i helped a relationship between the missionaries the government. Especially in the area of statistics. And the most complete statistics were collecting anywhere from institutions not from the government. I worked on other countries where when you visit a government that is missionary run or faithbased run, attendance is probably four times the size. The hospital is not in the capital certify. It is in some remote little town. Monies are provided by the catholics or the baptists. And so its been there i hate to see us move ahead as if things have been very sweet and nice between the god men, policy makers and the institutions, because that has not been the case. In fact, in some countries the missionaries that are Trading Health but the government got discouragement from supporting the programs. They are discouraging the use of public funds in what was classified as private enterprises. Thank you. And that has cost us a lot. Okay. Thank you for your observation. Lets take one more question. And then well go to the panel. Good morning. Im john blevins director of the inner faith at emery. My question is mainly to dr. Tomkins but wonder if others have comments on it as well. In hard to reach and vulnerable populations particularly in activities and programs that might be of a contentious nature and cultural context a lot of faithbased organizations that were aware of that do that work, that work arises intrinsically around a complicated but potentially contentious negotiation between the faithbased providers that do that work and larger religious traditions. One of our concerns is that when actors from Civil Society or the multilateral or bilateral donors are made aware of the programs, how does it change the impact of the programs in ways that may be negative . That it makes them and the staff in those organizations more suspect or the work of those organizations suspect or maybe even puts those Staff Members and the people who receive services in danger . And i wonder if you saw any evidence of that and if you have any thoughts about ways that Civil Society organizations and the large donors can be aware of how to build respectful partnerships with those organizations reaching hard to reach and vulnerable communities. Thank you. Andrew, do you want to go ahead and respond . Yeah. Those were some great questions. Thank you so much. If i could start with the core, which is coming out of the older questions about the collaboration, if we look at the political framework in which my comments are based it is that sustainable goals are going to talk about universal Health Coverage. Thats a big challenge. Its important. Its invites if we are to reduce poverty. The bank has changed its mind. It used to say you can only become healthy once you become rich. Now they are saying the bank is saying that you have to be healthy to increase your standard of living. Several things. Part of them, comments have come out of review in the paper and my objectivity and partly comments because i have lived in africa for many years and have been privileged to do so. The first thing is that when the faith groups are involved in health care delivery, it seems to me that often there is a tokenism rather than a true involvement. And one of the challenges seems to be the coming out of this that the governments and the agencies actually need to lose the nervousness that you, sir described. The anxiety. And just get real and say if we want to achieve Health Coverage, then we have to look at ways of working together with partners who are working in the poorest. Now, that actually means that literacy, as jean was saying, needs to be developed. And there are some good examples in the paper on ways in which faith leaders have actually been the leadership of the programs. Particularly in some of the health damaging practices and more recently our experience in northeastern nigeria is that faith leaders are absolutely vital in assisting the increase in development of Immunization Services which are tragically declined over the last few years. You mentioned about kenya. You gave a good example of countries where there are great opportunities for people in government and for donors and the people who work at delivering. To actually understand each others language. And i think there needs to be a greater appreciation knowledge, and respect. And at the moment i am quite blunt found that lacking in international Development Agencies. They do not want to accept that there are people who they disagree with with in their own personal lives. So i think the challenge is how do we get people to move out of their personal prejudices and work into global care which is what were talking about. Just sort of a short answer. Either of you like to comment . Im sorry. I didnt catch your name. Mark, thank you. I think theres been a bit of a change since the era that youre talking about. Ive been involved in this work for a long time, like a number of friends and colleagues have been as well. And in the beginning even 15 20 years ago every time we started a meeting or every time we started writing something, the first sentence would have to be make an argument. It would have to make a statement about the relevance before thinking about the collaboration within the community. Thats where market share figures were coming out of. That was our one piece of evidence people were using for that statement. But things have changed quite a bit. There is work. And published work on statistics on contracting. W. H. O. On the financial compensation relationship in three african countries. Universal health care studies. Im not saying they are not fault. And im not saying there is constant work to build between the providers. It is an ongoing all partnerships. But i dont think its quite the same as, no were not even going to think about it. I think theres been a change. They are lingering biases, secular biases many of you in d. C. Will be familiar with and as authors we are very familiar with. I think thats what bill was saying this is an unusual area of engagement for the lancet because of those dialogues. There is a slight more openness to think about this engaging. I think underlying your question was this you know, why have the meeting in d. C. And talk about these things here rather than in the countries. Im not sure if that was the underlying. All i can say is these partnerships are absolutely happening on the ground in countries. Several partners here. John blevins. I know they are doing lots of work on collaboration and networking in kenya with local partners. And so i think its not just here in d. C. That these conversations are happening. If that was the subtext to your comment. Jean . Just to support what my fellow authors are saying here and going to our sister from kenyas question around the challenges of partnership. What im excited about is there seems to be a Real Movement both on the policy side and faith side looking at developments and new approaches to forging those partnerships. I see deb derrick in the audience on friends of the global fought on hiv, aids, tb. Organizations like the global fund are working intentionally on the challenge of how to engage more effectively and more inclusively local faith communities and faithbased partners in country. Indeed, i was so heartened during our conference to hear christopher band from the global fund saying during the ebola situation in west africa they directed their grantees to repurpose funds for hiv, aids, to be to ebola. That was a wonderful example of the institutional flexibility obviously in a crisis but a rail, really good example of that. Going to jills point in terms of contracting and new innovative finance mechanisms and cam rargo, from cania they spoke us to and challenged faithbased Delivery Health care systems to formalize and strengthen mechanisms. And in fact he challenged them to say the mous are not worth the paper they are written on. And pushing people toward contracting. And for faithbased, it is for us to step up, to offer more robust collective organizations that bring us together in larger scale so we can deal as collective bodies not just small institutions with governments so they can achieve the scaleable objectives in terms of development. Those are some thoughts. Thank you. And andrew there was one more question for you between religious that you saw. Yes. That was an interesting question. You asked about whether there was any differences between the written theology as opposed to a more verbal one. Yeah the main face that we looked at obviously did have a written. What we didnt look at and weve actually referred to this in the paper, was the enormous richness of traditional faiths and certainly i can speak mainly in africa, but im sure the truth is in asia where the faiths have been there for years and sometimes in a sink ronnistic ray, combined with more modern faiths such as christianity and islam we didnt look at those because the diversity of those would have needed a lot more work. All we could see was a very interesting thing was that there was a considerable enthusiasm among all of the faith leaders for seeing how they could be more involved and actually there was a great opportunity expressed in the work that we did for making faith leaders more aware so that their sacred teachings the preachings about traditional values could actually have a very clear Health Content and they could be part of the action rather than just leaving everything to the health professionals. I dont know if that answers the question at all. But that is how we saw it. Thank you. Were closing in on the end of the hour unfortunately. Maybe we have time for two more questions and short answers in the panel. Any other any other questions . Okay. Well i will ask each of you on the panel youve done such amazing work and given us so much to think about. I would like to hear from you in summary what you would like to see as the next steps as a result of your work that youve been that youve put so much effort into the research and the writing, and not necessarily relating to the piece youve written, but how you would like to see this play out so jill . As someone academy and immersed in evidence, that is what im hinting at at the moment. And someone made the comment about the lancet by having these papers in here, signaling something in terms of the broader discipline and ill give you an example. We hosted a conference on the Health Systems conference in cape town and there were 2,000 people there and there were only two faithbased conferences and it is a signal to the fact that these issues come up in conferences, we have separate conversations about faith and faithbased providers but they are rarely intergrated into the broad Health PublicDevelopment Agenda and conversations and my hope would be rather than this becoming a standalone conversation, it gets more strongly integrated into the broader Public Health and development conversations. Great. Andrew. Yeah i see this series and the amazing meeting that has just been on religion and Sustainable Development being a start of a place in which things can have markers. Im just a boring academic but i do get enthusiastic from time to time and the markers should be gained in terms of donors and Health Providers in terms of how aware are you and how much are you being inclusive. Many have been exclusive. And what jill is talking about in the paper how inclusive are you of faithbased groups in policy and programs and it is possible to look at policy and International Agencies and see how well they are coping with the chal oenks that this paper puts forward. Similarly i would see that the faith groups have theyve made some wonderful responses in the last 10, 20 years, particularly in the area of hiv care. But there are many other examples. But how do the faith leaders actually become more aware of how their teachings can actually interface most profitably in association to build these partnerships up and they too i dont think theyve ever been subject to peer review and monitoring and evaluation. But the peer review process is a very interesting one with the faith leaders and the theological colleges, all of the colleges that are churning out faith leaders, it is very interesting to see if they could become more faith aware because that does give enormous potential for changing the societies which are hurting at the present time. One of our presenters at the conference yesterday, david sutherland, who is working in the philippines challenged the conference with the notion of how do you measure hope and dignity. I think that our challenge our real opportunity now is to build on the growing interest by virtue of the scale of the ambition of the goals, the develop goals the growing interest on the part of policymakers for engaging all hands in the development tact and therefore also being very open to engage in faithbased assets. Our opportunity now is to pull together the evidence frame that shows to them that our work and our contribution will help achieve and heff drive help drive development out comes and i think we need to do that in creative ways. A lot of evidence already exists and i think that we need to underscore and get much more creative at communication. And in the end of the day, i think that a lot of our work Going Forward is about building friendship and trust that will allow us to cross the cultural divides that we addressed earlier in the remarks in the paper. Thank you. Thank you, all. And again thank you to the lancet, for publishing this important series and opening the discussion, which will go on. Thank you very much. [ applause ] the center for strategic and International Studies also heard from representatives from u. S. Aid and the kaiser foundation. They discussed faithbased organizations and the current challenges in responding to pandemics and other health scares. This is just under an hour. Thank you all. In the interest of time, were going to dive right into the second panel which will give us an opportunity to look at the u. S. Angle and the u. S. Engagement with faithbased organizations and the genesis of those strategies and what impact and evolution we can see. And we are honored today to be joined by three very respected panelists, we have Sandy Thurman to my left who is the chief Strategy Officer for the office of the global aids coordination and many of you know sandy from her long work in this arena. And in the middle we have mark Frank Mueller the director of the center for faithbased initiatives at usaid and janet kates at the Kaiser Family foundation. You have their full bios in the handout so i wont go into all of the details, but you can see that we have a very a very Important Panel up here and we are eager to dive into some interesting discussion on this. I think we all know in the first panel made very clear the importance of engaging with and understanding the role of the faithbased communities in providing Global Health, in providing information, especially in reaching communities, the poorest of the poor, the hard to reach areas. Im reminded of a time not long ago when i was in it ethiopia and interviewed an orthodox priest and we were talking about Family Planning and i asked him what message he gave to his followers and he said roughly translated, Family Planning isnt a sin. Hungry children is a sin. And it is just a fascinating lense through which we can see against the importance of faith leaders and the information they can transfer to their communities in engaging them and ensuring they have the information and the capacity that is necessary to reach their communities with appropriate and accurate information. We have been engaging in some very interesting conversations on this subject. Most recently last week with some faith providers from kenya on the subject of Family Planning. So i think it is true what the first panel really emphasizes, that things are evolving and developing and this is an important moment to be exploring this further. And with this panel were eager to talk about it from the focus of the u. S. Policy perspective. And i think to begin with well turn to Sandy Thurman. Given your long involvement with hiv policy from the u. S. Government can you describe to us more about how pep far began partners with faithbased organizations and how that has evolved. Sure. Thank you. And thank you all for