Transcripts For CSPAN Executive 20240706

This subcommittee on the coronavirus pandemic will come to order. I want to welcome everyone here today. Without objection, the chair may declare a recess at any time. I now recognize myself, with the purpose of making an opening statement. Today, this subcommittee is holding a hearing to examine the future of the World Health Organization, and our relationship, as the United States, with the w. H. O. The World Health Organization is supposed to be the preeminent organization that governs just that, the worlds health. It played a key role in eradicating smallpox, and significantly reducing the cases of polio around the globe. Yet, when the world was faced with the outbreak of covid19, the pandemic, we saw that the w. H. O. Does not always serve all of its members equally. We saw it is not an organization that serves all of humankind, but instead perhaps an organization that became beholden to, or are trapped in, politics. When it was most essential that the w. H. O. Be able to step up and help everyone, it seems to have bowed to political affiliations over Global Public health. When the w. H. O. Should have been conducting independent investigations into the origins of covid19, and presenting the Global Community with verified information to help keep them safe, we instead saw that they ignored some facts and parroted back statements that came from the Chinese Communist party. We saw the w. H. O. Deny that covid19 was spread via human to human transmission, based entirely on the word of the Chinese Government. The w. H. O. Delayed naming covid19 a Public Health emergency of International Concern. A World Health Organization procedure that, amongst other things, would have allowed for the procurement and distribution of scarce supplies. All because the Chinese Communist party told them to the spread was under control. The w. H. O. Delayed serious measures to counter the global spread of covid19, because the ccp was only worried about their own bottom line. When the w. H. O. Produced a report evaluating the possible origins of covid 19, it became unquestionably evident that the entire report was nothing more than chinese propaganda. Even dr. Fauci was worried about the report stating, there were a lot of restrictions on the abilities of the people who went there, to really take a look. I have some considerable concerns about that. The ccp was so entrenched in influencing the w. H. O. s investigation into the origins of covid, that they even contacted me. With unanimous consent, i wish to submit for the record, an email sent to me by the Chinese Embassy. So, order. This email from the Chinese Embassy is another attempt to interfere with the investigations of covid. The letter stated, we express our grave concern regarding the covid19 origins hearing. We firmly oppose it. This kind of communication and action hardly expresses a clear conscience. The w. H. O. s lack of independent investigation potentially allowed the beginning of the pandemic to be worse, and spread further than it could have been. All in all, still the w. H. O. More influenced by politics and Public Health. Not necessarily their fault. There is no denying it, the w. H. O. Stumbled out of the gate. This subcommittee is as much about looking back, as it is about looking forward and preparing for the future. We must be better prepared when the next pandemic surfaces. And a scientifically focused w. H. O. Is paramount to that. It is evident the w. H. O. Is in need of some reform. So, why not take an opportunity to ask the very people who were in the trenches, how we can help them . Why not ask direct sources what we can do right now, to equip future generations . Should there be an independent body, that is able to conduct oversight . How can the ideal methods of data sharing and development be implemented across the world . What we do know, is that the w. H. O. Needs to be reestablished with raised expectations of transparency, verifiability, and accountability. Accountability amongst its members, as well. Running any public Health Organization in a political manner destroys the organizations credibility. The w. H. O. Needs to police its members and not cower behind bullies. The w. H. O. Should have been in the position to tell the world that china was lying, if they were lying. The fact that it didnt do so, until later, is very telling. Honesty is always nonnegotiable. Especially during a once in a generation Public Health emergency. The w. H. O. Is currently drafting a new pandemic accord and new International Health regulations that will apply to all its members. These changes must ensure american interests are protected. They must not violate international sovereignty, and they must hold china and others accountable. Further, any accord or treaty must be presented to congress for approval. Anything else is fully insufficient, especially in the minds of the American People. Lets use this opportunity to ensure that the w. H. O. Can actually protect the worlds Global Health, and not just the interest of a few of its members. The United States should be setting the Gold Standard in incentivizing best practices. And we should be doing everything we can to force the w. H. O. To listen to american interests. Nothing is more important than Global Public health. Properly forming the w. H. O. Is the first step to that protection. So, there are officials, and providers, can better care for citizens and establish best practices. Not only for here, but perhaps around the world. We are holding this hearing to look at the current circumstances surrounding the w. H. O. , and seeing how we can make it better, and stronger for the future. I look forward to a strong, on topic discussion today, and i would now like to recognize Ranking Member, dr. Louise, for the purpose of making an opening statement. Thank you. I believe, mr. Chairman, that this is the first time we gathered after you made your announcement, so i think it is absolutely appropriate to congratulate you on your decision regarding your retirement, to show you our full, full respect, and full appreciation for the amount of service you have given to our nation. Not just as a policymaker here in congress, but also in your service in our military, and as a physician. As a fellow physician, it will be sad to see you leave, but know you are loved, and know you are very well respected, and our nation appreciates you, 100 . And i will miss working with you, and i think we got a few bills we can get past this year. We must. We must. It has been a while, my friend. You know, and thank you to ambassador song, assistant secretary pace, for your participation today. I must say, mr. Chairman, right now, you probably cant see or feel, but inside, i am like a kid at a candy store. I am really excited to have all three of you here. All three of you have done remarkable work, have led your profession, and have been thought leaders for our nation, and many countries around the globe. So, i want to thank you, personally. I also want to give a special thank you to dr. , because when i was a thirdyear medical student doing my general surgery rotation at the brigham and womens hospital, i actually scrubbed in with dr. When he was a fellow there, and i really need to thank you for your kindness, because despite you looking like you havent slept in seven days, you were still kind, and patient in helping me maneuver around the operating room. So, thank you so much. In the last three years, the world has persevered through a deadly pandemic that has claimed nearly 7 million lives across the globe. Now, as we reflect on the International Response to this Public Health crisis and look to the future, we must do so with a commitment to advancing Global Health security. There is no International Organization as central to this work, as the World Health Organization. Which, has contributed to monumental advancements in Healthcare Access, improvements in Population Health outcomes, and the defeat of deadly diseases, even in the furthest corners of the world. The w. H. O. s continued surveillance of Global Health threats have helped prevent outbreaks of deadly diseases, such as measles from arriving on our shores. The w. H. O. s global vaccination programs have helped contribute to an overall 54 increase in global Life Expectancy in the last 70 years, and put us on track to prevent 51 Million Deaths from measles, and hepatitis b around the world. So, i want to take the time to emphasize now that in our work to prevent and prepare for future pandemics, is not in conflict with enhancing International Cooperation. Instead, our efforts are strengthened and fortified by it. In our last hearing on safety and security, we all agreed that threats to the American Peoples health, do not end at our borders. So, in order for us to ensure our nation is truly prepared for the next pandemic, we must continue to engage with the International Community on work that prevents future threats from reaching our nation. The United States has served as the preeminent leader in Global Health for decades. Now is not the time to see that role to another country, aiming for global influence. No, now is the time to reinforce the United States Global Health leadership with meaningful reforms to the w. H. O. That promote transparency and strengthen International Cooperation, in the event of future pandemics. Thankfully, after years of leadership under the previous Trump Administration, the Biden Administration has sought to correct course by reengaging not only with the World Health Organization, but our partners around the world, to advance Global Health in our interests abroad. You see, when we become an isolationist nation, we leave a void, that other countries can easily come in and fill, to use Public Health diplomacy as a way of geopolitical dominance. Taking a Lessons Learned approach from the early days of the pandemics, the Biden Administration has pursued reforms to the w. H. O. , and i think we can all get behind reforms that, one, enhance oversight of Member States compliance with International Health regulations, two, develop an Early Warning system for Public Health threats, and three, strengthen investigative capabilities for Public Health emergencies of International Concern. Exactly what we are working on, to strengthen. So, these reforms would not only institute positive changes at the World Health Organization, but they would also enhance pandemic preparedness on a global scale, and therefore reinforce u. S. Influence in international to institutions and norms. In many ways, Global Health is the cornerstone of our diplomatic efforts, and we must continue to find ways that enhance our role in this space on the International Stage. The fact of the matter is, when we leave gaps, our adversaries will fill them. So, now, more than ever, we should work to deepen cooperation with our allies and commit to a collaborative approach to Global Health security that will ultimately counter the Chinese Communist party and deter their influence. Bold investments in Global Health and pandemic prevention made through the consolidated appropriations act, and the American Rescue plan, has set the stage for this work. For example, the American Rescue plan funds bolstering the w. H. O. s covid19 Vaccination Administration efforts helped vaccinate approximately health half of the worlds population for covid19 within a oneyear period. With the u. S. , making vaccines go to key regions of the world, where we compete with the prc for influence. Additionally, the Biden Administration has complemented these investments with forwardlooking policies that advance u. S. Interests abroad. Notably, under President Bidens leadership, the state department established its bureau of Global Health security and diplomacy, with ambassador at large at the helm. Ambassador, i look forward to hearing from you today about how the bureau has integrated Global Health security in our National Security and informed policy priorities and how United States is engaging with w. H. O. To advance that effort. So, there is certainly a great deal of ground to cover in todays discussion and it is my hope that today, we can identify constructive reforms to the w. H. O. That build on the administrations effort to enhance Global Pandemic preparedness as well as forward looking policies that further cement americas leadership in Global Health security. With that, thank you, mr. Chairman, and i yield back. Well, thank you. Our Witnesses Today are ms. Loyce pace, ms. Pace as the assistant secretary of health and Human Services for global affairs. Ambassador john nkengasong, ambassador nkengasong is the u. S. Global a. I. D. S. Coordinator and Senior Bureau official for Global Health security and diplomacy for the department of state. He worked as the w. H. O. Special envoy for africa during the covid19 pandemic. And he is a surgeon, writer, and Public Health researcher, the current administrator of the u. S. Agency for International Development for Global Health, as well as board certified, in general surgery. Pursuant to the committee on oversight and accountability, real 9g, the witnesses will please stand and raise the right hands. Do you solemnly swear or affirm that the testimony you are about to give is the truth, the whole truth, and nothing but the truth, so help you god . Thank you. Let the record show that the witnesses all answered in the affirmative. This selective subcommittee certainly appreciates you all being here today. And i am sorry we had a delay in this meeting, but we are grateful you are here today, and look forward to your testimony. Let me remind the witnesses, we have read your written statements, and they will appear in full in the hearing. But, please limit your oral statements to five minutes. As a reminder, please press the button on the microphone in front of you so that it is on when you speak, and so that the members can hear you. When you begin to speak, the light in front of you will turn green. After four minutes, the light will turn yellow. When the red light comes on, your five minutes has expired, and we would ask that you please wrap up the statement. I now recognize ms. Pace to give an opening statement. Good afternoon, chairman, Ranking Member ruiz, and members of the subcommittee. Thank you for ensuring that we identify these lessons from the covid19 pandemic to enhance our Public Preparedness and National Security. My office leads u. S. Engagement with w. H. O. , and has been working since the start of the pandemic, on Institutional Reforms that improve transparency and accountability, both within the organization, and as he said, sir, across its 194 Member States. We work closely with our colleagues at the department of state and usaid as well as other agencies to build pandemic prevention, preparedness, and response capacities, worldwide. Of course, the world has been profoundly impacted by the covid19 pandemic. In the u. S. , unfortunately, we tragically lost more than 1 million lives, and nearly 7 million have died locally. We know there is no ocean large enough to protect americans from a virus that can spread rapidly. So, we also know that it is only a matter of time before the world faces another serious Public Health threat. As it turns out, w. H. O. Has been on the frontlines of nearly every Global Health challenge over the past 75 years, combating, containing, and curing some of the planets most deadly diseases. Currently, w. H. O. Is responding to dozens of serious Health Emergencies, including in gaza and in ukraine. But, it takes an effective w. H. O. To adequately guard health and wellbeing, supporting the safety and sovereignty of america. Frankly, if w. H. O. Didnt exist, we would have to create it. That said, the covid19 pandemic also revealed major gaps in our Global Health security architecture, including, and importantly, at w. H. O. Working with likeminded Member States, the u. S. Is leveraging our seat at the table to draw dialogues and solutions required today, because unfortunately, we have learned the hard way that this is in our national interest. So, at that table, hhs is leading efforts to update the International Health regulations, to make them clearer, more precise, and better fit for purpose. Among other important reforms, we are advocating for amendments that would ensure rapid and transparent information sharing, and hence w. H. O. s ability to assess Health Threats, and improved Global Implementation and compliance. Additionally, we are actively working alongside state Department Colleagues to negotiate a global agreement that seeks to improve International Accountability and collaboration on pandemic preparedness and response. Through both of these negotiations, we are advancing longstanding u. S. Priorities, to reinforce regional capacity and reduce risks posed by emerging infections. Ultimately, we are focused on finding Sustainable Solutions that break the cycle of pandemic crisis and complacency. The u. S. Is also pushing for reforms within w. H. O. Itself. With vocal u. S. Leadership, the 2023 executive Board Meeting and World Health Assembly approved a set of recommendations and plans for more stringent oversight of w. H. O. s budget and business functions. We are closely Monitoring Progress with w. H. O. Leadership, and ensuring principles of Good Governance , at all levels of the organization. In closing, i would like to highlight two of the greatest Health Achievements of the 20th and 21st centuries. The elimination of smallpox, and significant progress in eradicating polio. Both are the direct results of a partnership between the u. S. , nongovernmental organizations, countries around the world, and w. H. O. In fact, the u. S. Was 1 of 59 countries that first signed the treaty, establishing a World Health Organization. Since then, we have been party to many of its successes, and at the same time, have pushed the organization to be better over these last 75 years. You can be assured that the Bidenharris Administration is committed to building on this legacy. Through ongoing work, and service to the American People, which is our north star. Thank you, again, for the opportunity to testify on these important issues. Thank you. I now recognize ambassador nkengasong to give an opening statement. Good afternoon, chairman, Ranking Member ruiz, and members of the subcommittee. It is an honor to be with you today on behalf of the department of state, to discuss the u. S. Governments commitment to strengthening security to protect the American People. We engage internationally at all levels, bilaterally, regionally, and multilaterally. Further w. H. O. , World Health Organization. I come before you today to present the u. S. Bureau of Global Health security and diplomacy, which was launched on august 1st of this year, by secretary blinken. I would like to thank members of the congress for their support in establishing this bureau. The covid19 pandemic left a deep Lasting Impact on all of us. With over 1 million american lives lost, and at least 7 million globally, one study found that the American Economy lost more than 14 trillion, due to the pandemic, and economies estimates that global gdp contracted by three Percentage Points in 2020. The last three years have reinforced that a pandemic is not only a hard crisis, it is an economic crisis, and it is a National Security crisis. Without the combined leadership of the United States, with our partners including w. H. O. And others, the world might not yet have successfully made it out of the active phase of the covid19 pandemic. The coordinated global efforts required to deploy covid19 vaccines around the world was a major demonstration of this lesson. A coalition of countries, including the United States, came together with the w. H. O. To support the covid19 vaccines, the Global Access initiative. United states, in partnership with kovacs, and bilaterally, has administrated close to 7 million safe vaccines to over 117 countries around the world. Whereas, simultaneously, investing in Regional Vaccine manufacturing. Supporting workers, and strengthening our capacity to prevent, detect, and respond to covid19 and future Health Threats. Under secretary blinkens leadership, the state department continues to play a Critical Role in eliminating Global Health and security, as a major player in international dialogues. Security and diplomacy is focused on collaborating across the u. S. Interagency community, and with congress, to do all that we can to mitigate future threats. Unfortunately, it is not a question of if a new threat will emerge, it is a matter of when. The world needs greater cooperation, coordination, collaboration, and communication. A major priority continues to be ending the hiv a. I. D. S. Threat, and in the future, i look forward to working with you, in a strong passion to pass a clean five years through authorization. These are part of the challenges w. H. O. Has faced and continues to face in advancing Global Health security priorities. By coordinating laws and responding to emergencies and promoting the w. H. O. s leadership in developing these guidelines and policies for combating hiv a. I. D. S. Has been critical for enhancing diplomatic efforts when working with partners and countries to advance their respective hiv a. I. D. S. Responses. United states played a continued continue to play a Critical Role in ensuring the w. H. O. Is reformed to effectively address current and future Global Health challenges. We have engaged with the task force involved in these efforts, and we continue to exercise these in this space. Thank you, chairman with rob, and Ranking Member ruiz to testify on this topic, and i look forward to your questions. Thank you, ambassador. I now recognize dr. Gawande to give an opening statement. Chairman wenstrup, Ranking Member ruiz, dr. Ruiz, we are across a different table, and who knew we would be here from where we were a few years ago . Also, members of the select subcommittee, thank you for your chance to speak about u. S. Commitment to Global Security, to our partnership with the World Health Organization, and the importance of continuing reform to the systems required to secure our collective protection from International Health threats. Usaids Health Investments focus on the global burden of mortality and disease, and protecting americans from Global Health threats abroad. We work daily to prevent and respond to emerging threats, while also pursuing longterm goals, such as eradicating polio, and ending the Public Health threats of hiv, malaria, and tuberculosis, by 2030. Success requires global collaboration, collaboration for impact on health is what w. H. O. Has done for 75 years, and that is why w. H. O. Has been an essential partner and recipient of usaid funding. W. H. O. s leadership of the global polio allowed vacation Eradication Initiative is one example. W. H. O. Demonstrates its unique convening power and technical capacity in leading polio activities worldwide. Usaid has supported w. H. O. s polio eradication efforts for 35 years, and now we have only 12 wild type cases documented, worldwide, in the last year, in a small region along the afghanistanpakistan border. Last week, w. H. O. s quiet, but consistent diplomacy persuaded the taliban to finally allow house to house vaccination , reversing its long opposition. Among usaids Top Priorities is strengthening Global Health security. The capacity to prevent, detect, and respond to infectious threats that can spread worldwide. Our partnership with w. H. O. Is critical in this work, allowing us to leverage its Global Network and Technical Expertise to help countries everywhere prepare for and manage dangerous outbreaks. For example, in february, an outbreak of marlboro virus, a deadly cousin of ebola, occurred in Central Africa and equatorial guinea. Usaid and cdc supported and worked closely with w. H. O. To respond, because of their particular relationships and technical capacity there. Equatorial guinea had resisted, as often happens with countries, resisted sharing information, or permitting foreign involvement in what was happening. But, w. H. O. Persuaded the government to accept u. S. Support that ended up delivering diagnostic capacity, proper screening, isolation, and emergency treatment procedures, and ppe from the joint usaid w. H. O. Emergency stockpile for front line workers. That produced a turnaround that ended the outbreak before it spread anywhere else. There is simply no entity in Global Health other than w. H. O. That has an equivalent mandate reach, or capacity to influence the countries where usaid works, and where we dont. That influence is not, however, foolproof. It is up to countries whether they adhere to w. H. O. Recommendations, but as we saw during the covid19 pandemic, w. H. O. s role is vital. There are systems for safety review, for sharing technical information, for emergency response, made vaccines, tests, and treatments available globally, saving millions of lives. The pandemic exposed some fractures in our Global Health security systems, including at w. H. O. With our interagency partners, usaid has pushed for the Critical Reforms at w. H. O. Needed to increase effectiveness, transparency, and accountability in future emergencies and in tackling other health goals. And, we see progress in what matters, which is lives saved. For example, historically, Ebola Outbreaks have killed thousands, but in the six outbreaks of ebola that have occurred since i have started, we have seen the response get faster and better. I was especially concerned about in april 2022, an Ebola Outbreak in a city of 1 Million People in the democratic republic of congo. In 2018, a similar outbreak in that region killed more than 2000 people, and required a two year, billiondollar global effort to stop it from getting across the world. Since then, usaid, cdc, and w. H. O. Came together with others to help the country improve its response capacity. So, in 2022, when a man with a high fever arrived at a clinic in the province and died that day, the Health Worker had the training to recognize, this could be ebola. He had the protective gear he needed, he had the test equipment to make the diagnosis, he alerted contacts, and the National Health authorities who got a team on site within 48 hours. They identified the contacts, and brought newly approved vaccines. As a result, ebola claimed just five lives, compared to the 2000 lost in 2018. W. H. O. And u. S. Investment meant that the outbreak required no emergency foreign assistance, at all. I thanked the subcommittee, and i look forward to your questions. Well, thank you. That is excellent testimony from all of you. It is greatly appreciated. I now recognize myself for questions. You have really touched on some things that i appreciate greatly. I have been in vietnam twice in the last year. And i dont know that w. H. O. Was involved, but more our own cdc. And i think the work that we did with our cdc and the vietnamese government during covid was a tremendous plus. Not only for the lives of the vietnamese people, but for our diplomacy. And so, there is great opportunity. So, like i said, i dont know if w. H. O. Was involved with that, but the importance of the w. H. O. Being trusted comes into play with the example you just gave, dr. , where they came in and said, trust the americans on this. Let them work with you. And if that is what is needed for that conduit, then they certainly need to be the trusted institution that we want them to be, and that they have been. Make sure that everyone agrees with that. And i suspect everyone here would agree that politics getting involved with science can create a distrust among the public, atlarge, just as politics always does. But, with your knowledge of what we have now, in looking at covid19, i asked, was, in your opinion, china forthcoming, transparent, regarding covid19 . Because the w. H. O. Put together a group to study this, and go to china, the only american in the group was dr. Peter danzig, of the pico health alliance, and he maybe should have been somebody who recused himself because he was a collaborator with the Milan Institute of neurology, and china was deciding who got to go. So, these were things that raised peoples concerns. Secretary blinken said, we have real concerns about the methodology and process that went into your report. Including the fact that the government in beijing apparently helped to write it. That is not an independent organization. So, do you agree with the secretarys assessment, and what are your thoughts during that time, and moving forward . And im willing to go down the line. Thank you, mr. Chairman, and thank you for your reflexes on your travel to vietnam. I, too, have been able to visit the work of cdc and our partnership with w. H. O. There. With regard to your question, it is an important one, especially because we have a lot of lessons to learn, regarding covid19. Unfortunately, one of those lessons is the importance of transparency. We are quite disappointed, and share your frustration with the government of china not being as forthcoming as they should have been with w. H. O. At the time, especially because getting to the bottom of this crisis is critically important, as you said, not only for covid, but for any outbreaks moving forward. Thank you, chairman. We fully agree with your remarks about the trust, the trust that is required to do global disease trades. That comes with the ability to be fully transparent, to be accountable, to report in a timely fashion, and also to cooperate. All of these elements were lacking in chinas ability to cooperate with w. H. O. And the world. You have a fastmoving respiratory disease like covid, all of these elements are important for the Global Health security. I think the budget is still on china that for the past three years, china has not been forthcoming the way it should be in working with w. H. O. , working with us. We see that we just understand what the origin is, of the virus, so that it can better prepare us for the future. As we have all said, it is a matter of time before we face another pandemic. So, i think i fully agree with you that we need to have a trusting relationship, in order to respond in a very timely fashion. I will add only that i am in complete agreement with my colleagues. China was not forthcoming early on about human to human transmission. As we noted, a common reluctance, under sars, which happened years before, w. H. O. Pushed hard, and was public about that lack of forthcoming behavior in a way that did not occur in this particular instance. However, w. H. O. Got a lot right, that were critical to getting vaccines out to the world, getting treatments out to the world. I will say we have also seen that history has shown they are capable of improvement. After ebola, where response to emergencies were very slow, u. S. Pressure ended up creating driving the creation of a global Emergencies Program that massively improved response on the ground in many subsequent outbreaks. Similarly, after covid, u. S. Post, successfully, for the creation of a Standing Committee on Health Emergencies prevention, preparedness, and response. That is already giving u. S. And others more realtime oversight of handling in the case of potential of phenc, Public Health emergencies of emerging national concern. I guess my real concern is if a member is not participating in the way that should be expected, not only, how do we call them out in a way that might get them to behave as they should . You know, so, my question would be, do we say, well, you cant be part of the w. H. O. If you are not going to adhere to the rules . Or, is there some enforcement mechanism . I dont know where to turn on that, if it were to happen again in the same way. And i dont know if that is why i would love to hear your ideas, as you deal with the w. H. O. And the frustration that everyone had. So, i will try to respond to this question, mr. Chair. Again, it is a good one, especially because we need everyone to be good actors around the table. One of the things that we are able to do, as Board Members of w. H. O. , is at least track that very level of accountability, and really understand how we all come together to support the work of the organization. As it turns out, we are Board Members alongside the Chinese Government, as well as other actors, like syria. So, it is one of the reasons why we want to remain at the table, if nothing else, to be a voice in that room, and ensure that voice is rooted in science, and the important work of w. H. O. Really serving not only america, but the world, in ways that we want to see. Chairman, i agree with my colleague that we have to be at the table all the time, and exercise our leadership, because by being at the table, a rally of friends and allies to put pressure across the board on countries that do not want to cooperate fully, we know that when we are not at the table, we cant not take a seat at the table. We always have to be at the table and continue to put pressure. The administration has been very clear on this, that we have to work in the area of Global Security, we must work with people that we agree with, and people that we do not agree with, because there is just no way of knowing where the next one will come from. The way to do that, the platform for that is w. H. O. I cant think of any other platform that could set that rule. Now, the burden is on all of us, the burden of continuing to put pressure on w. H. O. Reform so it can be more agile, more forceful, and more accountable in putting pressure where it is needed so that countries can be more transparent. I will only add a couple of points to my colleagues. One is that we want to respect for our sovereignty. So, we also limit how much w. H. O. Can control or demand things up. That is one of the challenges here that we are protective of our own sovereignty and therefore do not want to have those tools potentially challenge us or other Member States. The second point about possibly, well, could we force out a china that does not adhere . We want china under the tent. Once a country pulls out, they become a blind spot in our National Security. Currently, china does participate in a network of 129 countries that submit flu and other illness data. It is the reason we have an effective annual flu vaccine, because we have access to information being supplied through those means. So, we want to have china continue to be a joint actor in this work. So, that leaves us in a space where it is diplomacy. Now, the additional reforms that u. S. Is advocating for under reforming the International Health regulations will make a clear tiered response. Right now, we just have a Public Health emergency of International Concern and that is the declared level and we are looking at a three level set of tears, so that there is an earlier indication that countries have a health issue developing of concern. There are clear standards about what transparency requires, and then clear requirements that w. H. O. Has to live up to for reporting public and indicating when countries are not adhering to those. So, that set of commitments are part of what we are aiming to negotiate, and produce, in strengthening International Health regulations with the pandemic accord. Well, i would also like to see something where the host nation in this case, china doesnt get to decide who the United States ascends, and doesnt restrict who we send, because frankly, i would have been very pleased if any of the three of you were there, when that occurred. With that, i yield back, and i now recognize the Ranking Member for questions. Thank you. As Ranking Member of the subcommittee, i have long called for a forwardlooking approach to preventing for and preparing for threats from lessons we learned from the covid19 pandemic. Emerging Health Threats are not bound by our borders, meaning that this objective is as important for our engagement with the International Community, as it is for domestic efforts. Reforming the World Health Organization to be insulated from political pressure and strengthen the International Communitys response to emerging Public Health threats is central to this mission. So, i would like to begin by asking each one of our witnesses, with respect to the United States Global Health engagement in reforming the w. H. O. , what is the single most important lesson, the single most important lesson that we should take away from the covid 19 pandemic . Lets start with you, assistant administrator gawande, and then we will move to the left. Thank you. Number one lesson from covid, i think, is that in crisis, u. S. Leadership is dispensable. First, we are often the first in, and we bring others along. A case in point is the u. S. Providing more covid vaccines without charge, then any other country in the world, with 700 million vaccines. But then, we also supported covax as a mechanism that then got other countries to do their share. We came in early with funding first, but the net contribution of covax was even larger in the end. There are multiple other examples in the ways we have lead on oxygen capacity and building that out in places that didnt have capacity for oxygen in the face of a respiratory virus, around antivirals being distributed. American leadership works because when we lead, we pull in partners and allies with us. We demonstrate the values of global collaboration and harnessing collective National Security. And american engagement with the w. H. O. Has been essential to our affective Global Response, as a result. Thank you, ambassador. Nkengasong . Thank you, congressman. I think number one, the lesson or, one of the lessons from the covid pandemic is that these trends anywhere in the world, immediately take track in the United States. It took nearly two months for covid to spread to 165 countries. Two months. There were just four countries in the world that had reported covid. But, by march 20th, 165 countries reported covid. So, in terms of our common connectivity, common vulnerability, and the inequalities or inequities that we have to address. In other ways, i think a lesson that follows from there is that leadership is important. Leadership in making sure that we are properly engaged, so that anyway it occurs, we squash it before it becomes a threat in the United States. Thank you. Assistant secretary pays . Thank you, Ranking Member ruiz, for this question. My colleague, assistant administrator gawande touched on the importance of the International Health regulations. When it comes to the lessons, i think we can think of it in a couple different ways. First, there are different ways that we, as hhs, are working to amend those Health Regulations. Not only through the alert system or the approval of that alert system he described, but also thinking of ways to give w. H. O. Flexibility to share the information that they see or receive, by other means. So, i believe the chair, as well, spoke to the limitations with regards to countries if and when they choose to be transparent with us. In the event they are less than transparent with w. H. O. , w. H. O. Actually has other means to understand the situation, perhaps by other sources, or other publicly available information. But, they might hesitate for fear of backlash from that country, if they get ahead of them. And then, that country essentially retracts and isnt a partner in the response, or otherwise continues to be more opaque in what they share, or less than forthcoming. And so, what we are hoping to do also through these amendments, is make it so that w. H. O. Has permission, so to speak, to notify other countries around the world if and when they give certain actors a chance to provide what they know, and those actors just dont respond. We just essentially dont want to be in the dark, and that is why it is so important to work in this way on these ihrs. Thank you. The state department and department of health and Human Services have also been representing the United States in the ongoing pandemic agreement negotiations, which are generating recommendations for Member States to promote cooperation on preventing, preparing, and responding to future pandemics. Ambassador nkengasong, what steps is the state Department Taking to advance the United States interest in Global Health leadership in the ongoing pandemic agreement negotiations . Thank you, the state department is working very closely with our colleagues from the department of health and human safety to support our negotiating team in geneva. It is very clear, as you said, that we need this instrument, of a pandemic accord, pandemic agreement, that would protect us. I mean, if you asked me to summarize that in one line, i would say, it is an accord that we will do the things we have been discussing here, which is allow us to detect early, respond early, to threats that emerge and invariably will emerge because we all know that we live in an era of pandemics. So, we are actually looking at ways we could continue to work with several countries, more than 190 countries, around the table, negotiating this is not a fast process. But, it is a necessary process. We have to be at the table and continue to sail that ship in the way that we want countries to share secrecys, share viruses when a threat of arises and share with us medical countermeasures. I think that is central to our ability to protect ourselves. Imagine if an unknown virus emerged anywhere in the world where we dont have access to it, i mean, we would rely on this kind of an accord or agreement to have access to news, specimens, sequences, so that we can develop a diagnostic test, vaccines. Assistant secretary pays, how will the frame of the pandemic agreement apply lessons we learned from the covid19 pandemic to advance International Pandemic prevention and preparedness . Well, certainly, this potential agreement, which to complement what is already in place, such as the International Health regulations, one of the shortcomings, unfortunately, of the covid19 pandemic is it did not allow for a high degree of accountability, when it came to accessing innovations, in particular. One of the things we were trying to negotiate as part of this agreement is to ensure that those innovations reach everyone, including americans, on time. As the ambassador mentioned, that involves sharing samples and data so that we can actually produce or manufacture these innovations. In other words, spare our essential r d. But then, there is the question of how these Safety Innovations reach people around the world. That isnt just a moral question , but a historic one, frankly. Because in the absence of vaccinations, for example, we have the opportunity for variants to emerge, and thus kept us in this ongoing fight against covid. So, it is our hope that this potential agreement help so, again, sort of buttress what we are able to do at a more technical level, with regards to pandemic preparedness and response. Thank you. And as negotiations for the pandemic agreement have been underway, there have been some misrepresentations of how this treaty would square with United States sovereignty. Ambassador nkengasong, could you please help us understand, correct, direct, or regard, regarding these interpretations . Thank you, congressman. Let me say up front that that has not at all been a subject of discussion, during the pandemic accords, or agreement. We were not allowed such, if ever, such a discussion was to occur during the imposition, i can assure you that we would not allow it to happen. As a matter of fact, when you look at the draft, that is separating the draft pandemic accord agreement or instrument, article three, section 2, on the principles, clearly stipulates and affirms the importance of the sovereignty of the countries, that it is the countries themselves which have the right over the people. I think that is article three, section 2 of that. So, i think the misinformation or disinformation is unfortunate. That has absolutely nothing to do with the sovereignty of our country. Thank you. Now that we have closed the chapter on the darkest days of the covid19 pandemic, we must dedicate our efforts to ensuring the United States is leading the way, as you have identified of one of the biggest Lessons Learned, in preventing and preparing for the future Public Health risk, which requires an International Response that will allow access, transparency, and data to contain an emerging virus in the host country, with full cooperation of the host country, in order to prevent it from spreading elsewhere. I think that should be our singular focus, as a Global Community, wherever this virus may arise, even if it arises in the United States, to really have International Cooperation to prevent, because that is how you are going to prevent the next pandemic. Thank you. With that, i yield back. I now recognize from new york. Thank you. I am sure you all know that the United States stands as one of the World Health Organizations top donors, contributing roughly 700 million in 2020 and 2021, with over 65 being voluntary above our membership dues. And in december 2021, the Biden Administration announced another 280 million contribution, aimed at ending covid19, bowstring healthcare systems, and providing urgent relief. As taxpayers, we want to make sure that our money is being used properly, that there are metrics in place, and that, as you say, we have a seat at the table. However, i am really concerned about what we have seen from the w. H. O. Throughout the covid19 pandemic. I mean, they denied human to human spread of covid19, based solely on ccp propaganda, it was not until january 23rd, 2020 that w. H. O. Finally recognized human to human spread was occurring. This was a month after the first warnings. The w. H. O. Delayed naming covid19 a Public Health emergency. It delayed serious measures, like travel restrictions, because the ccp told them under the w. H. O. Praised the communist chinese partys failed efforts despite a globally recognized cover up and when we pushed for an investigation into the origins, the ccp was given full veto power over inclusion of american scientists, right . The communist chinese vetoed the americans put forward by our government to be in that investigative body and the ccp was given full power to alter the final reports. And so, i am compelled to ask the question, how do you justify continuing u. S. Support for the w. H. O. Given their apparent compliance with communist chinese narratives . I agree, the World Health Organization has played a tremendous role in history and when it came to the aids epidemic in particular, you know, they have been but it seems to me they are now corrupted by the communist chinese, so what do we do and why should we continue to fund them if they take their if they continue to do what the chinese tell them to do . Thank you, madam congresswoman, for that question. Again, we really do appreciate being able to reflect on some of these very important Lessons Learned. With regards to our support of the w. H. O. , the leadership is very clear that we expect reforms with regards to the way they do business and the u. S. Has worked with w. H. O. Over time particularly in the past several years towards those types of reforms. You had the assistant administrator mention Health Emergency preparedness and response. That committee was established by the executive board in which we hold a seat and the u. S. Was supportive for the reasons you described, particularly because we felt the board needed to have oversight over the w. H. O. s response and emergencies and direct them accordingly. Even when we have a seat at the table, we are not seeing actual reforms and we have this problem with other International Organizations as well, not just the World Health Organization. Weve got egregious violators of human rights sitting on the Human Rights Council and they are allowed to get away with it. It is a much larger issue of Global Organizations infiltrated by nefarious bad actors. You know, iran sharing the u. N. Human rights council, i mean, that is disgraceful. This is another example. The way we are seeing communist china having this much influence in the World Health Organization, its a much larger question. My question to all of you, what can we do as the United States rather than send american tax dollars to these organizations . What else can we do to truly reform them . What i hear from the administration is oh, weve got to elect better actors to the committee. Thats why after President Trump removed us, this administration felt if we had a seat at the table, we could get better nations of democracies and freedom loving people on those councils, but it has not happened, so what can we do to change it . Thank you. Let me provide Additional Information on what were practically doing. Part of the members task force on strengthening w. H. O. s budget and financial governance and as you have heard, 96 actions were required and it tends to our leadership, our presence at the table. 67 have been implemented and we have five or more by the end of 2025 that must be implemented. We are putting pressure and producing a return on the investment. In terms of the actions that are required of w. H. O. And what they have actually implemented. I appreciate that. It has yet to be seen if this will amount to anything but nice words, but again, i have run out of times i will yield back but i think weve got to stop throwing good money after bad until we see changes at the international institutions. I recognize miss dingle from michigan. Thank you. I want to build on what you were talking about because we are worried about what did happen, et cetera. During covid, how we dont repeat it and how we make moves stronger. When it comes to repairing for future pandemics, whether we like it or not, our own National Security interests are linked with other countries around the world. When we live in this modern world, that is a reality. Under President Biden, the United States has reasserted its leadership by reengaging with the w. H. O. And proposing substantive reforms to strengthen the International Communitys position against countries that evade accountability. Let me start with you, assistant secretary pace, and have you elaborate more. How has the Biden Administrations reengagement with the w. H. O. Helped to solidify america s Global Health leadership in the wake of the covid pandemic, and what are you doing . You are not just talking. You are acting. Absolutely, congresswoman. Yes, we want to reassure you that our leaders at the table are directly connected to what we view as our National Security. I asked about the executive board and i will continue to because that governing body really does serve an important focus in staring and guiding the work of w. H. O. As i mentioned, china, syria, belarus are also members of that body, so what we do is we really take advantage of our seat at the table to ensure that our interests, leather whether they be in Global Health security, biosafety, bio security, or other members of Public Health are well represented. Weve had other cycles on and off of the board, even as my time as alternate board member and you can imagine during that time as we were deliberating around how we respond to ukraine , for example, and w. H. O. s work in that space and how important American Leadership was at that table. Finally, we have been very specific and deliberate with w. H. O. On what we would like to see. We need to understand for example how they are allocating their funding and ensuring that funding is going towards programs that will have a real impact. This might seem basic to us, but we have to remember w. H. O. Was a Technical Institution in its origination, its origins and over time, it has had to the, more management savvy, so we asked a u. S. Government are helping steer the organization in that direction and having it operate at its highest and best use. Mr. Ambassador, i will go to you and ask you to build on that. The Biden Administration has established a bureau of diplomacy to lead the state departments work in protecting, detecting, and responding to infectious disease. How have the Biden Administrations efforts to implement security through the bureau advanced our National Security interest . Knowing that you all Work Together, how do we make sure china doesnt lie to us the next time, which is what my colleagues on the other side are worried about . How do we not undermines peoples confidence in the w. H. O. But assure them we are working in holding those countries accountable for telling us whats going on . Thank you, commissioner, for that. There are three goals that are driving the bureau that was launched on august 1st. One is to leverage all of the assets that we have globally so we can address the challenges of Global Security as a whole. As you note, congresswoman, through the program, we have footprints in 55 countries in the world. There are assets and systems that have been used in responding to diseases, like covid. It was instrumental in africa when covid emerged and we used this for testing and ppe. Having such a footprint, we have diplomatic leverage in countries and we have access to the leadership of those countries. We have professional allies and we have the right information for such platforms. Secondly, it is to coordinate. We have highlighted the importance of coordination. One of the things it would do to advance our Foreign Policy through the lens of security is to coordinate all of the assets we have both internally and externally. Lastly, it is to elevate the security policy. During the covid19 pandemic, secretary blinken established a platform, the Foreign Ministers platform. It was very instrumental in reaching out to all of the sectors in society and in our partner countries. That platform was useful. We discussed how vaccines would be distributed and ppe made available. We want to build on those things, those existing platforms and expand so we have foreign ministries across the world to continue to promote Government Security as a Foreign Policy. Thank you, mr. Ambassador. I yield back. Mr. Chairman, i thank the witnesses for testifying before this subcommittee today. It is no secret the World Health Organization failed during the early stages of the covid pandemic. Our leading World Health Agency was manipulated by the Chinese Communist party, especially when it came to investigating the origins of the coronavirus and since the beginning of 2021 , ive stated the origins were necessary to understand because of immediate disclosure of potential pathogens and Biosafety Lab work being done in the appropriate laboratory setting, and the ethics of certain types of research such as gain of function research. As a physician and Public Health worker, i value the World Health Organization. Has done good since eradicating polio, smallpox, and reducing polio cases worldwide. However previous achievements cannot be used as a cover for costly failures during the covid pandemic, especially when United States has historically been the w. H. O. s commissioner. The w. H. O. Praised chinas leadership, delayed calling it a pandemic and acknowledging human to human transmission while many in the Public Health community were saying exactly those things. Its clear evidence the Chinese Communist party was lying to World Leaders and restricting access to its labs and information. The ccp was given access to the w. H. O. Origins report before it was published. The wall street journal reported the w. H. O. Led teams into investigative origins and had little power to conduct an investigation during that trip. China resisted International Pressure for an inquiry and proposed strict limitations and expanded its scope to encompass other countries. As the w. H. O. Seeks to alter Health Regulations, it is vital the United States and other countries not let bad actors hijack the review process. Similar to how the cdc lost public trust during the pandemic, the w. H. O. Has accomplished the same but has the chance to rebuild its reputation. Let me comment on several of the things you said. We dont want respect for our sovereignty. We demand to be respected. We demand it, especially from actors not acting in good faith. If we cannot be assured of our sovereignty, it is up to members of congress to have an accord or a treaty, have congressional approval so that our sovereignty is respected. And miss pace, we dont choose to be transparent. The 24 hour disclosure of potential pathogens is not a choice. It is a violation and that is where accountability comes into play. Oversight of the global bureaucracy is vital, as is reviewing investments the United States is making in the Global Landscape through agencies like the u. S. Agency for International Development. Miss pace, in your written testimony, you say the Biden Administration is working tirelessly to ensure w. H. O. Is essentially delivering on its mission. Do you believe limiting influence of the Chinese Communist party revision process is important to ensure the w. H. O. Is effectively delivering on its mission . Thank you for that question, madame congresswoman. Yes, its quite important for us to ensure that in these deliberations around improving Health Regulations that they evolve in a way that serves all countries and importantly to your point, ensures our highest and best level of prevention, preparedness, and response. That is one of the reasons the u. S. Took a leadership role in calling for the revisions of the International Health regulations and introduced the original 13 or a handful of amendments that now other countries have also commented tuesday, we think this is a good idea and we are willing to come to the table and have a constructive conversation on how this can be approved. While i dont support withdrawing from the w. H. O. Or not funding the w. H. O. , i do believe there are other ways to hold the Chinese Communist Party Accountable and one of those is whether or not they have a seat at the negotiating table for the pandemic reports. Dr. Nkengasong, ambassador, do you believe chinese china was transparent during the pandemic . Do you believe they should have a seat at the negotiating table . Thank you. As i said earlier, china wasnt transparent. Not as it needs to report and be accountable. It ended up costing the lives of 1 Million People here in the United States and 7 million in the world. This is the worst crisis that we have faced in terms of a pandemic, respiratory disease. It absolutely required full transparency of what happened and i dont think for the past three years we considered china has been fully cooperative and accountable. Thank you, ambassador. I have one last question in relationship to fraud within usaid and the request for additional funding, however due to my time being expired, i will submit the question and ask for it to be responded to in writing. Thank you, mr. Chair. I yield back. Maryland is recognized. Thank you, mr. Chairman. By the way, i didnt know that you are leaving us. I will associate my remarks with the Ranking Member and say to you that it is, indeed, a loss for congress and for the sense of bipartisanship, quite frankly that has really been demonstrated over and over again by this committee. I want you to know that your decision to voluntarily leave is not new. I did the same thing 27 years ago and look where it got me. That crossed my mind. You may be back. For decades and by the way, i want to agree that this is a great panel of witnesses and i appreciate the work you have done, the work you are doing, and the many things we dont know about because weve got an hour here with you or two hours there, but your reputations proceed all of you today. Mr. Chairman, the World Health Organization has helped, as we all know, to build Effective Health systems and has overseen for many, many years the expansion of Healthcare Access across the globe. In fact, 75 years. Through this work, the World Health Organization has markedly increased the number of things, not the least of which is the average Life Expectancy globally from 47 years to 72 years. It is important for countries that are part of the w. H. O. Such as the United States to give critical feedback to the w. H. O. On reforms to strengthen its mission. We all have some ideas, i think , of what we would like to see. That is why i was actually shocked when i learned the committee was not going to center this hearing around bringing witnesses from the World Health Organization to testify before us, particularly since the title of the hearing is reforming the w. H. O. It just seems like we have lost a great opportunity here and some of the things that have been raised, such as finding a way to reduce, if not eliminate chinas influence, finding ways to have greater accountability, and finding ways to make sure oversight is fixed seems to have eluded us. I strongly hope the committee will at some point in the future consider bringing in representatives from the w. H. O. So that we might in fact be able to get to the heart of some of the things that keep us up at night and trouble us when we think of what we would like to see when we think of this particular organization. Again, i appreciate the witnesses that are here today. There are a couple of things that strike me as ironic. I believe the horse just got out of the barn that some of the stuff that we are reacting to, it was really the role of this congress and the Previous Congress to get in front of and that did not happen. We are playing catchup and marked them out mopping up the floor. The real blame is in congress for not providing the proper oversight from the time the pandemic hit. I agree, it was a difficult time for all of us. We ought to be a little careful about wanting reform without being able to identify the reform that we want. This year, several members of the other side of the aisle are offering amendments that would eviscerate and to do away with quite frankly the World Health Organization. I have before me hr 1546 to prohibit the use of any and all funds to implement any obligations of the United States under the World Health Organization pandemic treaty. Hr 79, a bill directing the president to withdraw the United States from the constitution of the World Health Organization. An amendment to an appropriation that says none of the funds made available by this appropriation shall be made available to the World Health Organization. I would ask for unanimous consent may be entered into the record. Objection. So this is a very serious situation. I am going to come to the assistant secretary, miss pace in just a moment. She said something that struck me. If there were no World Health Organization, we would have to invent one. I agree with that totally, much with 1948 when countries understood there was a need to collaborate together. I would ask miss pace as assistant secretary, if you had a magic wand, since we dont have the w. H. O. Here to talk about reforms that we think and they think might be needed, what might be one or two things you would suggest for consideration of this committee . Well, thank you for the question, mr. Congressman. We do want a w. H. O. That is effective and truly in service to the world. I want to reflect on what we have offered as highlights and what the w. H. O. Has done right or well. It is not just smallpox or polio that are success stories. In fact, in Global Health security, many are seen and heard today, only they dont make headlines for that very success. Whether it is Ebola Outbreaks, we have worked with w. H. O. To address in the past, or even in longstanding programs, such as childhood immunizations or maternal care around the world, addressing mortality and issues such as aids, tb, and malaria, this is the work that helps complement longstanding programs. We cannot be everywhere as a country, nor should we be. We cannot be the World Health Organization ourselves, so we rely on this Multilateral Institution to work or partner with us and leverage resources so we can have that impact. My time has expired. Thank you, mr. Chairman. The w. H. O. And other organizations are immune from congressional testimony. That doesnt mean we cant reach out to them directly in a less official way. And we are planning that. Thank you. I now recognize miss lesko from arizona. My questions will be to the ambassador. Ambassador, on january 14th, 2020, the w. H. O. Tweeted preliminary investigations conducted by chinese authorities have found no clear evidence of human to human transmission of the novel coronavirus. A National Review article states the Chinese Communist party jailed any doctor that inseminated any information about covid19 that was not cleared through their state run media. Wall street journal article says u. S. Intelligence sources have discovered the ccp lied and covered up the extent of the outbreak. According to the cia, on january 21st, 2020, china threatened to seize participation in all international covid19 efforts if the w. H. O. Declared a Public Health emergency of International Concern. Well, guess what . W. H. O. Delayed declaring covid19 a Public Health emergency of International Concern. By the time the w. H. O. Declared a Public Health emergency of International Concern on january 30th of 2020, the disease infected almost 10,000 and killed 1000 in 19 different countries. Despite declaring covid19 an emergency of national concern, the w. H. O. Insisted other countries not restrict travel or trade to china. In fact, the w. H. O. Never recommended restricting travel. The w. H. O. Routinely praised the Chinese Communist partys efforts to combat the spread of covid19 despite multiple reports that the ccp engaged in a massive disinformation campaign, according to the u. S. Intelligence community report. The ccp underreported both its total number of cases and deaths caused by covid19. My question, ambassador, do you believe the w. H. O. Relied too much on false information from the Chinese Communist party . Thank you, congresswoman, for that very important question. It is very clear, and i agree with you entirely that the ccp did not act in this crisis in a way that was responsible in terms of fighting the threats that have emerged. It wasnt accountable. It wasnt transparent. It didnt act in a timely fashion. That is very, very clear. W. H. O. Has become more forceful. W. H. O. Has made announcements as the pandemic evolved and it has become more critical. It has provided the right access to information . I dont think so. We need to continue to press hard on ccp to have the right information. With the w. H. O. And the revisions , its all instrumental and i believe strongly that working with others is the best way for us to be at the table. A correlation of people that are likeminded can put the right pressure on any country in that fashion. Well, i think you said something about it, but what other reforms are needed before the u. S. Invest more money in the w. H. O. . Ultimately is and that the United States leverage, not to invest money until they do reforms . The reforms w. H. O. Is currently leading, we are at the table pushing areas of accountability. Country level impact happens because we know a threat anywhere in the world is immediately a threat in the United States. Government of w. H. O. , financial resources, there are a whole category of reforms we have put on the table for w. H. O. And we are progressing w. H. O. As i said earlier, of the 96 action items, 76 have been acted on and 30 will be acted on by the end of 2025 and we will keep an eye on that and continue to press them to change and reform. Thank you and continue to press them because its a lot of money we are investing and i dont want to be controlled by the Chinese Communist party. With that , i yield back. I now recognize miss ross from north carolina. Thank you, mr. Chairman, and for your leadership. You will be sorely missed in congress. So, i want to appreciate first all of the witnesses acknowledging the problems with the w. H. O. And the Chinese Communist party during the coronavirus pandemic. Mr. Rask is not with us today, so i want to remind the committee the Trump Administration was praising the Chinese Communist party at the beginning of the coronavirus pandemic and wasnt stepping up to the plate to work with our international partners. The Biden Administration came in , recognized many of these problems, and thanks to the good work of many of you, we have but, a better global partner. That does not mean the w. H. O. Should be exonerated for not cracking down on the Chinese Communist party, but the w. H. O. Was not alone in believing the Chinese Communist party at the beginning of the pandemic to the detriment of the entire world and to this country. I do want to talk about how we should work with the w. H. O. Going forward and the value of all of your leadership and any contributions that we make Going Forward. With our guidance and our leadership, the w. H. O. Has worked to improve Health Outcomes around the world standing up localized responses to Public Health emergencies and bolstering defenses against deadly diseases. We will talk about the ones ms. Pace has raised, but for every dollar we invest in the w. H. O. , the w. H. O. Generates a minimum return of 35 in Public Health benefits. Assistant administrator, how has participation in the w. H. O. Not just benefit of the world, but Public Health here at home . This is such an important question. There are multiple roles w. H. O. Plays that lead to them improving the health and lifespan of billions of people across the world including americans. One, they lead collective action to reduce common killers like the eradication of smallpox and polio, but there are many other examples. One that we rely on here at home, w. H. O. Is essential for the annual flu shot. The global tracking system has a network of 129 countries including china that report on flu upticks, shared specimens and data, and that is the way we end up with an annual effective flu shot here and it is important that we participate in w. H. O. To maintain that effectiveness. A second example, w. H. O. Coordinates action on Health Threats in countries that usa and other agencies are, and in places that are not. They do that through something called the global outbreak response network. I can attest from experience on a weekly basis responding to news of potential outbreaks across the world, whether its ebola, potentially unknown causes, that this information is vital for early action triangulating to other sources when you dont trust the country source and making sure we understand whats happening so we can move quickly to stop the spread and address issues that protect the lives and Economic Security of all americans. And third, the w. H. O. Brings together global experts for agreedupon norms and standards for treatments and prevention of virtually any medical condition human beings face. The result of that benefits us in a variety of ways. One example, they create the International Classification of diseases and that system, where we all call diseases the same thing, means our Electronic Medical Record Companies have a Global Market for their medical records systems. We are the biggest supplier and seller of those records systems because of that common framework that is negotiated. There are many examples of these in addition to that. I see my time is about to expire. I will submit a couple more questions for the record, but a couple of you have mentioned pep far. Could you choose someone to briefly talk about how important it is that congress continue to fund . It is in a collective view the greatest act of humanity in terms of solidarity to the world. Imagine what pepfar has done over the years. It has prevented hiv infection from occurring in over 5 million children in the world. Before pepfar, the devastation the disease had caused in the world was just fighting it. The former president of botswana said that without pepfar, the country would have been extinct by now. She was very proud of what we have done in the values we have shown, the values of our solidarity. We are showing the world that we care about the rest of the world and we are leaders. The discussion that we are having today on Global Security, it has provided a huge platform for countries to detect and respond to diseases. As i mentioned earlier, pepfar platforms were instrumental in testing for covid and in countries where Ebola Outbreaks have occurred, they enable the infections to be detected early before they become a threat in our own country. Its not just countries in africa and the rest of the world, but we are protecting ourselves and making sure pepfar gets reauthorized. I am counting on working with you all in a bipartisan way to get pepfar authorized for the next five years so we get the job done. Our goal is to bring hivaids to an end by 2030. Thank you, mr. Chairman. I yield back. I now recognize mr. Cloud from texas. Thank you, mr. Chair, and thank you all for being here today for this important topic of conversation. I wanted to start with the lead up to covid and what was happening before then. 2018 2019, the u. S. Contributed 839 million and china, 80 million. The rotary club actually had more investment in the w. H. O. Than china. Does the rotary club have a seat on the board . No . Okay. China does . Still . Okay. And then some of the items that the resources are being used for, and september 2019, the w. H. O. Published a paper on addressing a harmful masculinity to improve sexual and Reproductive Health rights. February of 2020, this was right after saying there is not human to human transmission and working to correct that, the w. H. O. Was busy addressing the Important Health issues by holding a conference on road safety. Right now they are still working on groundbreaking Research Series on Health Benefits of the arts. Other resources are being spent to shift negative attitudes toward abortion and prevent conscientious objection. Regardless of what you think on abortion, even if you think its right, if youre working to change peoples minds on it, thats not providing any scientific medical service. I am prolife. I disagree with abortion, but this is political action, not medical action. Legal recognition of self determined gender identity and gender affirming care, sings that the w. H. O. Is invested in. This is not protecting countries against the pandemic. We continue to be by far the largest contributor to the w. H. O. 10 times china leading into the pandemic. It would seem china had 10 times the influence during the pandemic and having their issues protected and addressed. I appreciate the ambassador acknowledging miss lesko presenting the missteps from the w. H. O. , but you have shifted the finger to china, which is appropriate, but her point was in getting back to the missteps the w. H. O. Had in protecting it. And so, what i wonder at this point, why are we not seeing full throated responds to bring china to account . Why is china on the board . Why do they get a vote . Will the Biden Administration step up to china and have them removed from the board . Why do they get the vote Going Forward on any of this . Can you speak to that, please . Certainly, mr. Congressman and thank you for that question. It is important to understand the inner workings of w. H. O. And how it is directed or working in service to its Member States. So the way that board elections work, or selections work, each region actually puts forth someone from amongst their member countries to serve on the board. There have been times the u. S. Has objected to those nominations, however not being a member of certain regions, we dont have a say in terms of who they put forward and ultimately nominate to the board, just as they dont have a say in what the americas regions does to put the u. S. On the board as many times as we have. We do in the World Health Assembly object as we did when belarus was nominated, when the prk was nominated for the reasons im sure you and your colleagues agree there are issues with their engagements. However, what we do with their what we are not seeing though is full throated acknowledgment that there could be a vote held in the Board Meeting to discipline china, to remove them, to counteract their influence and whats going on. After you have killed a couple more people, you should not be able to get a vote on the board. From our perspective, we are continuing to fund this. I will go back to my initial list. We can add a number of other items to encouraging taxing on sugar and Climate Change and all of these things. If you are involved in any issue that remotely affects the health of an individual, that seems like a whole lot of power that the w. H. O. Is asking for that you are asking us to be the primary funder of with only 1 34 influence on the board. How do we address those concerns when there is a lot of Mission Creep that goes beyond protecting against pandemics . If i may try to respond again, mr. Congressman, with regard to w. H. O. s work, they work across the spectrum of Public Health, not only in pandemics or outbreaks. When it comes back to the benefit of w. H. O. For americans, their work in noncommunicable diseases is applicable to us and justifies our engagement with them, whether it is on diabetes, cancer, other issues we face here in our country, it is an important partnership. The vast majority of our input is voluntary and i understand that comes with the ability to earmark what that is for. We have great concerns and there is a lot of capacity in us getting to what we are earmarking and what it is actually being spent on. We can talk about transparency, the need for transparency for what we are earmarking for. We can find the information on that, so it would be great if you could help us with that. It gets earmarked to these vague categories. Many of the items i have read are under these vague, broad categories on the w. H. O. Website and there are things i dont think the American People feel they should be funding. Yes, we are happy to work with polio and those types of things, but these things should not be on the backs of the American People. I yield back. Thank you, mr. Chairman. Mr. Chairman, my hollow for your leadership. I want to thank you for your service. Sadly weve heard of dangerous claims that withdrawn from the World Health Organization would somehow make the world safer for americans and holds the prc accountable. Make no mistake, a return to the Trump Administrations approach to Global Health will undoubtably put american lives at risk. Calls for accountability and cutting funding or withdrawing are not part of any legitimate effort for reform and they are not part of any thoughtful strategy about how to make us safer and healthier. As the witnesses have shared today, if we are not at the table, someone will take our place. We need china under the tent rather than operating in a blind spot. The calls to gut programs including domestic programs at the cdc, the outbreaks of emerging diseases and fighting bioterrorism will not keep americans safe. In fact, just the opposite. The dissolution of the National Security council Global Health unit which was monitoring a deadly flu strain in china and yellow fever in angola prior to the pandemic did not keep americans safe. One of the most egregious decisions of all, Donald Trumps attempts to withdraw from the World Health Organization were not only a national embarrassment, but sent a signal to the competitors that the United States is willing to advocate our global leadership. Ambassador nkengasong, you previously served at the World Health Organization , including during the pandemic. How did Donald Trumps decision to cut funding for the w. H. O. And pull us out of the organization shape the United States and in what ways may does have elevated the prcs influence within the organization . Thank you, congresswoman, for that statement and your question. I must state very clearly that we must always have a seat at the table. It is the only way we can influence the issues and protect interest. Its the only way we can influence issues and protect our interest. We are not at the table because we want to just be generals but because we want to truly protect our interest. When we, the United States, isnt at the table, others will take our place. There waiting for such an opportunity to influence the dialogue. I think we should never expect that to happen. And just for the record, congresswoman, ive never worked at the w. H. O. , so your comments are transparent. I worked in africa during the early days of covid and i was nominated for this position. No work at w. H. O. , but you are absolutely right, we should absolutely always have a seat at the table and use that seat to protect our interest and advance our interest in Global Security. Thank you for the clarification, ambassador. We have heard a lot today about the paris east elevated influence without within the w. H. O. And i would say that probably happened as a result of the United States vacating its position. We should always have a seat at the table, least someone else take it from us. We are thankful President Biden moved quickly to reverse the trumps administrations decision but the harm is already done. What is your assessment of how our country is still recovering on the International Stage from the harmful decision to cut u. S. Funding and withdraw from the w. H. O. . Thank you, madam congresswoman, for this very important question. U. S. Leadership is quite essential in this space and just turning back to the negotiations , for example, it took quite a bit for us to bring countries along with our proposal to amend the Health Regulations. I think to this day, we feel there is quite a bit of skepticism as to whether or not the u. S. Is entering conversations in good faith. We know here our intentions of improving the existing regulations, but there are questions about our intentions and our staying power, if you will. An important aspect of those regulations as well includes helping build or rebuild the capacity of countries around the world to actually implement them and adhere to them and so one important questions countries continue to have with us is whether the u. S. Will continue to be part of that technical assistance, even beyond funding, the enduring relationships that we have had and my colleagues have described are essential and we try to ensure im sure those Member States that we are here in service to americans but hopefully in ways that will benefit the world. Thank you very much. We have a lot of work to do to rebuild that trust on the global stage and no doubt attempted cuts to funding is not helping in assuring those other member countries that we have the staying power to ensure safety and security of the health and accountability overall for americans and others across the globe. Thank you, mr. Chair, and i yield my time. Thank you, mr. Chairman. During the covid pandemic, the w. H. O. Did not step up to the plate. Instead, it aligned itself with the Chinese Communist party. Tie 0. 01 an email to the w. H. O. That warned about a potential outbreak particularly human to human transmission. On january 14th, 2020, ignoring this warning, the w. H. O. , based on information from china, claimed there was no evidence of human to human transmission. This tweet contradicted the w. H. O. s own expert. In 2020, the w. H. O. Claimed there was no transmission of covid19, so this was also false. Starting with ms. Pace and going down the line, do you agree these statements are not accurate . Thank you for the question, mr. Chair. We are here to really learn the lessons of covid19 and one of the things we have talked about with w. H. O. Is the importance of ensuring that we get to the bottom of its origins. Ambassador . I fully agree with my colleague. W. H. O. Should continue to be strengthening its reform so in the future, it can actually play the role they have played in the past in protecting us. Doctor . I would agree with your calling out. The Chinese Government was not transparent and was behaving irresponsibly. This is a situation that was too credulous. They called out the chinese behavior with sars and said china was not being forthcoming. In this particular case, they did not until too late. There was more they did better, but this was important. The w. H. O. Praised chinas transparency. Even when china was silencing journalists and whistleblowers from going missing. Down the line, do you think china was forthcoming about sharing information about the pandemic . Ms. Pace . No. Ambassador . No. Doctor . No. In 2021, a report based off the information that only have one american, who was funding the lab, being investigated. He was the only american. He had access to labs restricted by the Chinese Communist party, and the Chinese Communist party had final editing privileges of the report, so it is no wonder the report was bogus. Dr. Fauci said he had considerable concerns about the report. Secretary blinken said weve got real concerns about the methodology and the process that went into that report, including the fact the government in beijing helped write the report. Ambassador, do you believe the Chinese Government improperly influenced the outcome of the report . It did. Ms. Pace , it is our understanding that the u. S. Put forward some names to be part of that investigation and china rejected them. Is that your understanding as well . Thank you for the question, mr. Chair. I do know that the u. S. Has worked to not just put forward names for that particular investigation, but for the multiple visits or investigations and missions the w. H. O. Was seeking to have. So did china reject those names . I am not aware of why those recommendations were not accepted, unfortunately. It is our understanding that china rejected those. China was calling the shots. The w. H. O. Took chinas word time and time again. Ms. Pace, how can we better ensure the w. H. O. Reports fax, not just what the Chinese Communist party is telling them . Thank you for the question, mr. Chair. It is important to get to the bottom of this. I want to take a step back and note the International Missions that w. H. O. We know about the missions. We have a problem or i have a problem with china calling the shots. I dont think it turned out well during the covid19. My last question for each of you, and you can answer yes or no for the sake of time. Do you believe the Chinese Government ought to be held accountable for the lack of cooperation in the early days of the pandemic, ms. Pace . Thank you, sir. We think the Health Regulations and improving those will make all countries should china be held accountable . We believe all country should be held accountable. Well, do you not think china is a little special in this situation, since it by all accounts came from china and they completely lied and were not truthful about the World Population and the outbreak of covid19 . They, you know, had veto power over who america put on boards and rejected reports that we now know could have been helpful . I share your frustration with chinas lack of cooperation, but should we hold china accountable . That is something were trying to do by amending the International Health regulations and ensuring those violations dont happen in the way we have previously. Ambassador, should we hold china accountable . With transparency and accountability, they were totally lacking. It is an intent of the reforms to bring more accountability to any country. Any country in the future. Doctor . Yes, china should be held to account and the office of director of National Intelligence has indicated that we are still in a world where there is no definitive answer to two viable theories about the origins of covid and in order to resolve this issue, the peoples republic of china would need to be forthcoming about data that can resolve these issues, which they have not been. Mr. Chairman, my time has expired. I yield back. We now recognize mr. Garcia from california. Thank you, mr. Chairman and to the witnesses for your help not just here at home, but across the world. We know the World Health Organization plays a Critical Role in Global Response which influences everything that happens here in the u. S. During the pandemic, the World Health Organization was a critical partner across the world. Just as our own country responds to the pandemic, we learned as we went along, as was the case for the w. H. O. Everyone across the globe struggled to address this crisis as it happened and we lost millions and millions of lives not just here at home but across the world. I am grateful for each of you to speak candidly about ways we can improve and not just strengthen our partnerships but look at Lessons Learned. I am grateful to my colleagues for the chance to have a serious discussion on how to respond to future emergencies. We should be clear, there is a difference between a good fit conversation on ways to improve the World Health Organization and proposals to the World Health Organization including critical funding or withdrawal from the World Health Organization completely. At the last hearing at the subcommittee, we heard about the importance of International Biosafety standards for international research. Everyone agreed we needed additional funding and oversight from global biosafety and bio security. There was wide agreement on this. Assistant secretary pace, if i am not mistaken, the w. H. O. Plays a huge role in biosafety in our laboratories, is that correct . Yes, that is correct. Thank you. That is what i understand as well. My colleagues are interested in biosafety standards, it seems cosponsoring bills titled withdraw the United States from the constitution from the w. H. O. , or another bill titled a no taxpayer funding for the World Health Organization act, it would appear to me that bills like this would actually hurt Global Health and hurt our Health Programs here in the United States. Would you agree that that would be the case . Thank you, mr. Congressman. We would certainly not want anything to hinder w. H. O. s ability to protect americans and the world. Its not just members of this committee. Other members have cosponsored this bill on the subcommittee. The former president , trying to be president again, donald trump , tried to destroy the World Health Organization and separate the United States from its health responsibilities. He called the bad and a threat to all americans. He called him them unequivocally dangerous. Hes talking about the worlds leading Health Collaborative that brings countries together to take on pandemics. To take on pandemics. He is also responsible for the failures of the last pandemic that led to the death of over million americans. Would you also agree that supporting the World Health Organization is critical to the success of American Health . Yes, mr. Congressman. I would agree that it is critical. We need an effective w. H. O. To do so but they have done much over the past 75 years to demonstrate their value to americans in the world. Thank you. I want to add that it is unfortunate that there is so much vaccine misinformation happening right now across this country, across the world. Just last week, we had a calling that published a post, openly encouraging parents to refuse childhood vaccinations. We know that is not advised by the Medical Center today. Antivaccination information is dangerous and it is costing lives. Diseases are declining. We are seeing a resurgence in these communities because of declining vaccination rates. While we are having these hearings on the broader pandemic, we must also rembert to be honest, focused on the truth and support organizations battling the pandemic. With that, yield back. We now recognize dr. Joyce from pennsylvania. Thank you. Covid19 was the most devastating Public Health emergency since the exception. Your fragrant lack of action was a primary concern with their blatant dereliction of responsibility is why there must be reform, while we are holding this hearing. The subcommittee was established in response to the misguided policies and mishandling and inconsistent guidance that arose amidst the pandemic. In the beginning, the covid narrative was controlled by the w. H. O. , who are corrupted by the ccp , that they ultimately place pcc political interests ahead of their international duties. The ccp steered the dialogue. The ccp skewed the statistics. They fed the w. H. O. Information that would ultimately, effectively shield the Chinese Government from blame. Now, it is almost 4 years later in the same organization is calling on member nations to enter a pandemic treaty. Entering a treaty with an organization that refuses to hold bad actors accountable is the entity cysts of what w. H. O. s mission and it is the antithesis of the principles of all americans. The American People want and deserve answers from this committee. They deserve to know that we intend to safeguard our nation and protect our citizens from the next Global Public Health Emergency. Ambassador nkengasong, article 2, section 2 , clause 2 of the United States constitution clearly states the powers of the executive office as it pertains to the making or entering of treaties. Nowhere does it grant the World Health Assembly that authority. Do you believe that the World Health Assembly will attempt to act unilaterally and circumvent congressional approval and enter the u. S. Into an agreement with the pandemic preparedness response treaty . Thank you, congressman. Let me just repeat what i understood earlier. The accord has been drafted. Article 3, section 2, talks about civility which the countries have the right over the people to make a determination as to how to manage the issues in the country. As a principle of that treaty, we still dont know how we will call it in the end but this is a word that is being used. We at the table, we would never allow any language through the accord or treaty that would remotely suggest that our civility would be taken over by the w. H. O. It would never occur, from your understanding, it would not occur without congressional approval. Is that what you just stated . We dont know what the final outcome will look like. The citizens of the United States expected that any treaty would only occur with congressional approval. The w. H. O. Acted as an apologist for the ccp. A few examples include they praised the failed efforts to combat the pandemic despite a globally pandemic cover up. W. H. O. Denied human to human spread of covid19 based solely on ccp propaganda. The w. H. O. Delayed naming covid19 is a public up emergency. China claimed they were in control. China delayed measures to protect trade with and travel to china. With that in mind, how can we ever restore trust, public trust in the w. H. O. . All three of you just stated, you acknowledged if china was forthcoming with covid19. You all said no. When the chairman continued and all three of you stated that the peoples republic of china should be held accountable. Isnt that trust permanently fractured with the w. H. O. s Firm Alliance with the Chinese Communist party . Thank you for this question. As i mentioned earlier, it is very frustrating and unfortunate that china in particular did not cooperate at such a critical time. It is one of the reasons why we are working through these International Health regulations to make the so that we are not beholden to the failure of a single actor. Wasnt that senior actor a single actor fracture your ability to come forth with what you should be doing with your Mission Statement . Is in the culpability over influence on the w. H. O. . It is one of the reasons we are frustrated. Her hands were tied because we did not receive the information that we needed from them. What we are trying to do is unlock the information in the event Something Like that happens. How would you prepare your organizations for the next pandemic both inhouse and in conjunction with the w. H. O. , knowing that it makes an incredible difficult situation. Thank you again for this question. It is so important that we do rebuild the trust so that we can be most effective in presenting preventing or mitigating a future pandemic. One of the things we are doing is strengthening not only our multilateral partnerships but our regional partnerships, ensuring that we are working with networks, particularly agents of the world to understand we have built on decades of partnerships that hhs has had globally over time and looking to not rely on a single actor to save us. It is something we have taken away my time is closing but you really drive home that a single actor did not save us. The Chinese Communist party destroyed so many human lives in the culpability and the ability to respond is what we have taken on as a charge to this committee. Mr. Chairman, thank you. I think the witnesses for being present here today and i yield the remainder of my time. Thank you to the witnesses that are here today. This is an important conversation due to the covid 19 pandemic response, government lockdowns, forest vaccinations, school closures. Many americans have lost faith not only in our government but also in the w. H. O. The w. H. O. Polluted with the Chinese Communist party. The w. H. O. Repeated Chinese Communist propaganda by saying there was no human to human transmission with covid. The w. H. O. Waited several weeks to declare covid19 a Public Health emergency because china insisted they had the situation under control. The w. H. O. Did not impose any travel restrictions, unlike President Trump, to help slow the spread of covid19 because china did not want their economy to slow down. The w. H. O. Continue to praise chinas handling of the pandemic, despite a globally recognized coverup. The w. H. O. Went along with the fake claims about the origins of the virus not being from a lab and our investigations have told us otherwise. The International Health regulation is a treaty of w. H. O. Meant to usher in a new era of Global Public health that requires all Member States cooperate to make the world more secure. Only a simple majority to amend it. There have been over 300 amendments proposed and Member States will not be able to see these amendments before they are scheduled to vote. At an october 2023 meeting, the working group compiling the amendment for the 77th World Health Assembly in may 2024 was told that they do not have to produce their document before the meeting. Some of the amendments include expanding the ability of the director general to declare Public Health emergencies to include regional declarations as well as intermediate threats , allowing director general to act on information of the Public Domain without verification from Member States and creation of a Compliant Committee to enforce their roles. The American People do not want the w. H. O. Enforcing any rules on their own decision regarding health. If certain amendments are adopted, sovereign countries including the United States would be obligated to adhere to the treaty. The Biden Administration led the charge for amendment to the ihr including a new compliance committee. The treaty would create the conference of the parties which could call on the United Nations for help in implementing the treaty. There is already talk of that conference of the party being merged together. While the Biden Administration wants to entangle the u. S. In more Global Organizations and imperil the health and safety of american citizens, President Trump withdrew the u. S. From the w. H. O. Completely, widely anticipating such mandates as the one being proposed. The move is reliant upon surveillance which relies on data. That is what china did to their citizens and still do. The treaty and the ihr call for more sharing of personal health data in the name of safety and outbreak prevention. That is an invasion of privacy. The next step is to create a digital profile of everyone in the world that the w. H. O. Is giving binding power. The you and will have the power to restrict any movement, access to healthcare medicine, et cetera. I can ensure you right now the American People will never comply with anything like this from a Global Organization regarding their personal Health Decision anyway they decide to conduct their lives. This is extremely dangerous. The working group for the ihr were told they did not have to produce the final draft of proposed amendments for the 77th World Health Assembly until the event of may 24. Can in the u. S. Or any member state have any meaningful ways to evaluate or consider the proposed amendment before they are put to a vote . Thank you for the question. This is a really important issue for us, especially considering our leadership on the International Health regulation, not only in this but going back to the previous administration. A couple of things in response. One, i want to ensure everyone here that we echo what the ambassador said earlier about the pandemic agreement. That also applies to the International Health regulation. We are not going to accept anything that would underline our national sovereignty. I wanted to be sure and reiterate that. In addition, one of the things that we are hoping the u. S. Is very much at the table for these negotiations. We do have the ability of the various elements being proposed to push back as we need to out of respect for our own sovereignty or other National Laws and poverty. Finally, with regards to our own amendment, we did feel it was important to revisit the tiered alert system as we described earlier so that we are not in a position to scramble in an outbreak but rather have done intermediate alert whereby we can mobilize resources before we are all in a panic. One of the reasons why we touched on verification of Public Information is because you had actors not providing that. We wanted to provide an alternate pathway to protect america and the world. Thank you. I can assure you, given the way the w. H. O. Conducted itself, it could be very likely that we withdraw again from the w. H. O. Thank you. Much like other International Organizations, the United Nations, World Health Organization will gain more authority through pandemic prevention, preparedness and response. This worries me greatly. Let me be clear that the United States should never, ever allow International Organizations, specifically the World Health Organization to impede our sovereignty. With that said, when you designed the World Health Organization, it was designed to be a daily gathering for nations around the world with the goal of providing the interchange of information from different healthcare positions for emergency. However, the Biden Administration must ensure the authority is limited to setting Public Health standards and providing information and given Greater Authority to infringe on our nation sovereignty. I know we had this debate that the world tribunal and other areas where we had world organizations i want to overreach. It is really important for the pandemic preparedness response accord which both of you are involved in. Correct . Can you bow commit to complete transparency during this process . Yes, sir. Thank you for the question. Can you both commit to making the proposed treaty end amendment public or any proposal public to allow for commentary . We have done so. Thank you. With that said, one of the things i am worried about is, we obviously have been compromised in the past. We have been given misinformation and then propagated that information. We propagated chinese misinformation, if you will. Whether it be not vetting the process or not thinking it through, we just took one countrys opinion and propagated that. My question is, how do we get the trust back . What have we done to hold china accountable . If you look at the world trade organization, we still dont have any feedback to hold them accountable. How do we, countries like china, and other bad actors, from giving us the inappropriate information . How do we hold them accountable . I dont feel like they have been held accountable at all. I will try to respond to the question. This has been an important one. As the ambassador said earlier, we are quite clear from what we expect from all members including china. We also have been able to reiterate our expectations. Saying i expect you to do something and holding some accountable is like saying i expect my kid not to take cookies and then doing nothing when they steal them. What have we done to keep them accountable . Mr. Ambassador . Thank you. There are two things we are working on, the i atrial and pandemic accord. Let me be very clear. There is no room in the pandemic accord that would allow the w. H. O. To have influence or make any determination. As i stated, it clearly defines what has affirmed i appreciate the question earlier. The question that was never answered we are here to hold you accountable. The question is, what are we doing to hold you accountable . There are two instruments we are working on. I am out of time. Yield. Thank you. I would like to yield to the Ranking Member for a closing statement. Thank you. Due to my absence, i was opening around table on healthcare with the Congressional Hispanic Caucus and i came back as soon as i could, right in the nick of time. Thank you again to the witnesses for your testimony. The w. H. O. Plays a Critical Role in advancing the health security. We have discussed much of the vital work, improving access to care, surveying for daily diseases, administering life saving vaccines and more. Before we conclude, i want to emphasize that our work to prevent and prepare for future pandemic is not in conflict with enhancing International Cooperation but rather our efforts are strengthened and fortified by it. In all of our conversations both today and Going Forward, i hope we continue to recognize the value our participation in the w. H. O. Brings to our nations diplomatic foreignpolicy and National Security interest. Almost everyone in the panel today said that one of the biggest Lessons Learned is that we need to lead in this effort. Right now we have the opportunity to not only enhance Global Pandemic prevention and preparedness but also cement our nations leadership in Global Health and we can do so by continuing to Foster International collaboration and advance reforms to the w. H. O. , in the International Health regulations, the pandemic accord, our very vital, real time priority instrument has the influence that we need in this space and that promote transparency improves surveillance and strengthens corporations with standards and norms. These matters are of critical importance to Global Health security and we hope we can find ways to Work Together here in congress and with our Administration Partners to pursue constructive reform that will save lives and reduce harm. I want to thank all of our witnesses. You are on the front lines. Much respect. Thank you for your hard work and your service to our nation and i want to thank the chairman and yield back. Thank you. Again, thank you all of you for your time today. It is extremely valuable. The whole situation is frustrated frustrating that this committee remains committed to a shared goal, committing to the next pandemic. Lessons learned so that the issue that the w. H. O. Has with chinese transparency, all of these, they are highly relevant to our preparedness in the United States. The more we can set the tone for what it takes to be prepared, others can as well and to make an organization like the w. H. O. Much stronger if there is cooperation. Every witness today said china was nontransparent. They were not forthcoming. I cant help but think of Ronald Reagans line, we need to trust but verify. That is what was missing, the verification. So, International Organization. We need to be there on the ground to see what the actual truth is. That is one of the Lessons Learned. Early on in the pandemic, i said to the administration, americas need to be hearing from the doctors treating covid patients. That is who they trust. That is what every patient in america can relate to, the one wearing the white coat is there to say i will take care of you the best you can. Dr. , you know that feeling. It makes a big difference. We heard some comments today. Again, trusting without verification is a problem. If the president of one country is telling the president of another country that everything is under control, weve got this, we have seen what that leads to, when you are lied to and dont know you are being lied to. Then you dont get the guidance and leadership that you should. Honesty is the lesson learned. To me, the w. H. O. Needs full access and the w. H. O. Representing all of the partners need full access to be able to do things correctly. We talked about revisions to hr. We need that to be without political influence. I thank you for your work. I heard things today that i think are really good for us to hear. We agree. The u. S. Leadership is indispensable in this process. I was pleased to hear all of you talking about the agreement that protects the United States is your priority and that is what we need to have. I also agree that we will protect the United States and we have to do everything we can around the globe when we are talking about the pandemic. It just cant be the United States. Without accurate data, without truth, we cant help. We cant help fully or quickly, which is key to a pandemic response. It became clear to me that the w. H. O. s success depends on the United States and the United States is going to have to depend on honest data through the w. H. O. We cant have a situation where one country gets to deny us from being part of the team and controlling the situation on the ground. I see a lot of opportunity here. I do have in front of me the draft. I appreciate that this is public. We need to go through it. We are here to represent the American People and taxpayer dollars. We want to know what the investment is and what it looks like. I appreciate the openness. There is a difference between an accord and a treaty and that concerns members of congress. In congress, when congress is frustrated, what is the power they have . The power of the purse. We do want to be involved. We want to be involved in this so we can honestly report with the intent is and how we are trying to make the world a better place, the help of america in particular. With that, i yield back. I want to again thank you all. Without objection, all members will have five legislative days in which to submit materials and submit additional written requests to the witnesses which will be forwarded to the witnesses for their response. Without objection, the subcommittee stands adjourned. Thank you all