Transcripts For CSPAN2 Executive 20240705

Ank you so much. In the last the world has persevered through a deadly pandemic that has claimed nearly 7 million lives across now, as we reflect on the International Response to this Public Health crisis 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 the time to emphasize now that in our work to prevent and prepare for future pandemics, is not in conflict with enhancing international cooperation. Are strengthened and fortified by it. In our last hearing on agreed that threats to the American Peoples health, do not end at our borders. , 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 another country, aiming for global influence. No, now is the time to reinforce the United States Global Health leadership with ingful 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 reengagingthe 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 and fill to use Public Health diplomacy as a geopolitical dominance. S 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, capabilities for Public Health emergencies of International Concern. Exactly what we are working on, strengthen. So, these reforms would not only institute positive changes at the world health ganizationt , bu pandemic preparedness on a global scale, and therefore reinforce u. S. Influence in international to institutions and norms. Ys Global Health is the cornerstone of our st continue to find ways that enhance our role in this space on the International Stage. Th 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 proach 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 the worlds population for covid19 within a oneyear period. With the u. S. , making go to key regions of the world, where we compete with the prc for influence. Additionally, the Biden Administration mented 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 fromyou today about how the bureau has integrated Global Health security in our National Security and informed iorities and 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. Fort to enhance Global Pandemic preparedness as well as forward looking policiesthat 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. He is a cher, 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 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 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 sothat 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 to give an opening statement. Good afternoon, chairman ranking me ruiz, and members of the subcommittee. Thank you for ensuring that we identify these the covid19 pandemic to enhance our Public Preparedness and National Security. 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 profby the cod19 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 we also know that it is only a matter of time before the world faces another serious Public Health threat. Rns nearly every Global Health challenge over the past 75 years, combating and curing some of the planets most deadly diseases. Currently, 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 wellbeing, supporting the safety and sovereignty of america. Frankly, if w. H. O. Didnt exist, we would have to that said, pandemic also revealed ma 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 nationat that table, hhs is leading efforts to update the International Health onre 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 e working alongside state Department Colleagues to negotiate a global agreement that seeks to improve and collaboration on pandemic prepar rough 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 lutions that break the cycle of pandemic crisis and complacency. The u. S. Is also pushing 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 closing i would like to highlight two of the greatest Health Achievements of the 20th and 21st centuries. The elimination of smallpox, are the direct results of pa zs. 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 you can be assured that the Bidenharris Administration is committed to building on this legacy. Service to the American People, which is our north star. Thank you, again, for the opportunity to testify on these important issues. Annow recognize ambassador nkengasong to give an opening statement. 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 we engage internationally at all levels, bilaterally, regionally, and multilaterally. Further w. H. O. , World Health Organization. I come before you today to presentthe u. S. Health security and diplomacy, which was launched on august 1st of this year, by i would like to thank members of the congress 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 globallyd 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 ha an economic crisis, and it is a National Security crisis. Without the combined leadership of the United States partners including w. H. O. And others, the world might not yet have successfully made it out the covid19 pandemic. The coordinated global efforts required major demonstration of this lesson. A coalition of countries, including the United States 3bthe w. H. O. To support the covid19 vaccines, the Global Access initiative. Nership with kovacs, and bilaterally, has administrated close to 7 million safe vaccines to over 117 countries around the world. Whereas, simultaneously, Regional Vaccine manufacturing. Supporting workers, and strengthening our capacity to prevent, detect, and respondto covid19 and future Health Threats. Under secretary blinkens leadntrtntinues to play a Critical Role in eliminating Global Health and security, as a majorplayer in security and diplomacy is focused on collaborating across the u. S. Interagency community, and to do all that we can to mitigate future threats. Unfortunately, it is not a question of ifemerge, it is a matter of when. The worl collaboration, and communication. A major priority continues to be ending the hiv a. I. D. S. Threatthe future i look forward to working with you, in a strong passion pass a clean five years through authorization. These are part of the challenges w. H. O. Has faced and continues to face advancing Global Health security priorities. By coordinating laws and responding to emergencies and promoting the w. H. O. s leadership in developing these guines and policies for combating hiv a. I. D. S. Has been criticalfor enhancing diplomatic efforts when working with to advance their respective hiv a. I. D. S. Responses. Un continued continue to a in ensuring the w. H. O. Is reformed to effectively address current and future Global Health challenges. Engaged with the task force involved in these efforts, and we continue to exercise these in this space. Thank you, ch and Ranking Member ruiz to testify on this topic, and i look forward to yo 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 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 the systems required to secure our collective protection from international Health Threats. Usaids Health Investments focus on the global burden of mortality and di Global Health threats abroad. We work daily to prevent and respond to emerging threats, while also pursuingterm 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 fundin h. O. Levacation Eradication Initiative is one example. W. H. O. Demonstrates its unique convening power and technical Capacity Activities worldwide. Usaid has supported w. H. O. s polio eradication 35 years and now we have only 12 wild type cases documented ar, in a small region along the afghanistanpakistan border. Last week, w. H. O. s quiet,n to finally allow house to house vaccination , p priorities is strengthening Global Health security. The capacity to prevent, detect, and respond to infectious threats that can ld our partnership with w. H. O. Is cric Global Network and Technical Expertise to help countries everywhere prepare for and manage dangerous outbreaks. For example, in february, an outbreak of mabo occurred in Central Africa and uatorial 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. Suppended up delivering diagnostic capacity proper screening, isolation, and emergency trt t usaid w. H. O. Emergency stockpile for front line wor. Thoutbreak before it spread anywhere else. There is simply no entity in Global Health other than w. H. O. That has an eqndate 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, there are systems for safety vi, 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 curity 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, have killed thousands, bu outbreaks of ebola that have occurred since i have started, we have seen the response get faster and better. I was especially concernet in april 2022, an Ebola Outbreak in a city of 1 Million People in the democr pu in 2018, a similar outbreak in that region killed more than 2000 people, and required a two , effort to stop it from getting across the world. Since then, usaid, cdc, and w. H. O. Came together withhe response capacity. So in 2022, when a man with a high fever arrived at a clinic inprovince and died that day, the Health Worker had the training to recognize, this could be ebola. 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 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. Is excellent testimony from all of you. It is greatly appreciated. I now recognize myself for questions. You have really touched on some thingsappreciate greatly. I have been in vietnam twice in the last year. And i dont know that was involved, but more our own cdc. And i think the work that we did vietnamese government during covid was a tremendous plus. Not only for the lives of the our diplomacy. And so, there is great opportunity. Was involved with that, but the importance of the w. H. O. Being trusted comes into play with the example you just gave, re they came in and said trust the americans on this. Let them work with you. And if that conduit, then they certainly need to be the trusted institution that we want them to be, and th have been. Make sure that everyone agrees with that. And i suspect everyone here would agree that politics getting involved 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,in your opinion, china forthcoming, transparent, regarding covid19 . Put together a group to study this, and go to china, the only american in the group was dr. Of the pico health alliance, and he maybe should have been somebody who recused himself because he was a collaborator with the lan institute of neurology, and china was deciding who got to go. So, these were things that raised peops concerns. Secretary blinken said, we have real concerns about the methodology and process that went into your 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 th, 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, able to visit the work of cdc and our partnership with w. H. O. There. With regard 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. Thank you, ch we full with your remarks about the trust, the trust that 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 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 pand i think i fully agree with you that we need to have a trusting relationship, in order to respond in a very timely i will add only that i 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 befo 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 gettg vaccint 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 wevery slow u. S. Pressure ended up creating driving the creation of a jbie massively improved response on the ground in many subsequent outbreaks. Similarly, after covid, u. S. St, successfully, for the creation of a Standing Committee on Health Emergencies prevention preparedness, and response. That others more realtime oversight of handling in the case of potential of phenc, public gencies 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 . So, my question would be, do we say, wellh. 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 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,ed everyone to be good actors around the table. One of the things that we do, as Board Members of w. H. O. , is at least track that very level of accountability, and really understand together to support the work of the organization. As it turns out, we are Board Members alongside the Chinese Government, as well as other ac so, it is one of the reasons y to be a voice in that room, and ensure that voice is rooted in science, and the important wo of w. H. O. Really serving not only see. Chairman, i agree with we have to be at the table all the time and exercise our leadership because bybeing at the table,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 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 , 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 set that rule. Now, the burden is on all of us the burden ofcontinuing to put w. H. O. Reform so it can be more agile, more forceful, and more needed so that countries can be more transparent. I will only add a comy 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. Challenges herethat we are protective of our own sovereignty and therefore do not want to have those tools potentially challenge us or other the second point about possibly, well, could we force out a china that does not adhere . We want china under the te once a country pulls out, they become a blind spot in our National Security. Currently, china does participate in a network of 129 at 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 throina continue to be a joint actor in this work. So that leaves us in a space where it is diplomac 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 ared 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 deconcern. 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 so 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 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 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 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 cod,k, is that in crisis, u. S. Leadership is dispensable. First, we are often the first in and we bring others a case in point is the u. S. Providing 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 capacity for 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 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 k 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. 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 uple 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 t bu 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 if and when they choose to be transparent with us. In the event they are le 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, th 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 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 ns . Thank you, the state department is working very closely with our colleagues from the department to support our negotiating team in geneva. It is very clear, as you said, that we nethis 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 knowthatof pandemics. So, we are actually looking at ways we couldwork with several countries, more than 190 countries, around the table, negotiating this is not a fast process. 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, shof arises and share with us medical countermeasures. I think that is central to outo 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 lei co e adshs,d, that was not firstco cleared through their state run media. The wall street journal article states the u. S. Intelligence discovered that the ccp covered up and about the extent of the outbreak. According to the cia in january 21 threatened to seek participation in all International Covid 19 efforts if the wh are declared a Public Health emergency of International Concern. Well guess what . Whr delayed declaring covid 19 a Public Health emergency of International Concern. By the time the wh undeclared covid 19 a Public Health emergency of International Concern on january 30, 2020, the decent at the disease infected almost 10,000 killed 1019 in different countries. Despite declaring covid 19 and injured us a concert and extensive evidence of transmission through travel the who insisted otherr trade with china. In fact the wh never recommended restricting travel. The who routinely praised the communist Chinese Communistt partys efforts to let the spread oiple reportso. That the engage in a massive Disinformation Campaign for the u. S. Intelligence community severely underreported the total number of cases and deaths caused by covid 19. My question ambassador to believe the who relies too much on false information from the Chinese Communist party . Thank you congresswoman for that important question very clear and i agree with you entirely. That the cdc did not act in this crisis in a way that was responsible in terms of the threat that had emerged. It wasnt transparent and thecdc didnt act in a timely fashion and that is clear. The pho has since become announcement is the pandemic it provided the right access. We need to continue to her on the ccp to have the right information. The reforms that are underway by so i think he said something about it but what other reforms are needed before the u. S. Invest more money in the w because alternately isnt that the United States leverage is not to invest money until they done the reforms . Reforms that wh show is currently leading and we are at the table pushing that. Thats what happens in countries because we know the threat anywhere in world can affect the United States. So theres a whole set of reforms that were put on the table and we are pressing who and the items 29 of them will be acted on by the end of 2025 and we will keep an eye on that to change and reform. Please continue to press them to reform because theres a lot of money that we are investing and i dont want them to be controlled by the back. I now recognize ms. Ross from south carolina. Thank you mr. Chair and i think you for your leadership. I want to appreciate first all of the witnesses acknowledging the problems with the who and the Chinese Communist party during the coronavirus pandemic. Mr. Raskin is not with us today so i also want to remind the committee that tmp administration was crazy 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 problems and thanks to thehe good work of many of you we have ral partner. It does not mean that the who should be exonerated for not cracking down on the Chinese Communist party but the who was not alone in believing the Chinese Communistt the beginning of the pandemic to the detriment of the entire world into this country. I do want to talk about how we should work with the who Going Forward in the values of all of leadership and any contributions that we make Going Forward. So with our guidance and their leadership the who has worked on outcomes around the world standing up localized responses to Public Health emergencies and defenses against deadly diseases and will talk about some of them that were raised. Inse fac every dollar we invest in the who, the who generates a minimum return o benefits. Assistant administrator gawande how benefit of the world. Benefited Public Health here at home . Co an especially important question. There are multiple roles that who help billions around the world including americans in their three central worlds. One is that they lead collective action to the eradication of smallpox and we talked about polio but there are many other examples and one that we rely on here at home is who is essential for our annual flu shot to the global tracking system is a network of c report on flu upticks share specimens and data and thats the way wee up with an annual effective flu shot here and its important we participate with who. The second example is wh coordinates withpo health cuts wereries where u. S. Agencies are places that they are not thanco they do that through the global Outbreak Response Network and i can attestar to an experience on a weekly basis responding to outbreaks across the world whether ebola or unknown causes and this information is vital for our early action and relating other sources when you dont necessarily trust the source and make sure we understand whats happening so we can move quickly to stop the spread and address issues for the Economic Security of all americans in third affiliate show brings together global experts for norms and standards for treatment andec prevention of virtually every medical condition we weekend based on the results o that benefit us in the friday of different ways. One example is that we create the International Classification in that system where we all call the base of the same thing needs or Electronic Medical Companies Market for their medical record, systems and we are the biggest supplier and seller of those record systems because of that common framework that are negotiated and there are many examples of i see my time is about to expire. Im going to submit a couple more questions for the record pepfar. Could you briefly talk about how important it is that congress continue to fund the pepfar . Congresswoman its in ourp view humanity and solidarity to the world. It prevented hiv infections from occurring to 5 million children in the world. To focus on the devastatin the world is frightening. Without pepfar the country would have been extinct by now. Fowe are proud of what we have done in the values we have shown in the values of oure solidarity and that we care for the rest of the having today. Its also provided a huge platform for countries to dictate and respond to a disease. As i mentioned the pepfar platform is instrumental in leveraging to rule out coded and in other where ebola and cholera outbreaks have occurred it enables this to be taken early because before becomes a threat in our own country. Its not just countries to like africa but the rest of the world so im really counting on working with you all in a bipartisan way for the next five years so we get the job done. Our goal is to bring in six short years. Th thank you or your in cultsand tonight you back. I now recognize mr. Cloud for five minutes. Mr. Chairmen and Ranking Member thank you for being here today for this very important topi conversation. I wanted to start with the leadup to covids and what was happening before then. In 2018 and 2019 at bleep u. S. Submitted 839 million the rotary club had more investment in the who then china. Does the rotary club have a seat on the board . No. Chinacl does . No . Okay thank you. Tems that the resources were being used for in september of 2019 the who published a paper on addressing the harmful masculinity is to improve and reproductive health. February 2020 right after saying there is no transmission and working to correct up the who was busy addressing important healthts issues by pulling a conference on safety. What now they are still working on groundbreaking research. On the Health Benefits of t arts. There are resources being to shift negative on abortion and conscientious objection. No matter your thoughts on abortion if youre working to change peoples minds on the thats not providing scientific medical service. Im prolife and i disagree with abortion but but this is Political Action not medical action. Selfdetermined gender identity and the provision of gender affirming care means the who is invested. This is not protecting countries against the by far the largest leader in the wh of 10 times the amount of china leading to the would seem china had 10 times the influence duringg the pandemic and having their issues protected and address. I appreciat e ambassador acknowledging the list that ms. Lesko presented but you shifted to china which was appropriate but also her point was back to the missteps the who had them protecting it. What i wonder at this p fullthroated response to bringing china to account and why is china still on the board and why did they get get t bode . With the Biden Administration stand up to china and have them removed from the board . Why do they get to vote Going Forward on any of could speak to that. Certainly mr. Congressman thank you for the question because it is important to understand workings of who. And how it is directed and working in service to i Member States. The way that board elections work or selections work is each region puts fo someone from amongst their member countries to serve on the board. There had been times when 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 in what america says to put the u. S. On the board as many times as we have so wed do in the World Health Assembly object as we did when belarus was nominated because for the reasons im sure you and your colleague agree there are issues with their engagement however whatt we do. We are not seeing those bold fullthroated acknowledgments. E vote held in the Board Meeting to discipline china tick count wrap your input to whats going on. After youve killed a couple Million People you should not be able to get a vote on theth board. And from our perspective w go back to my initial list which we had a number of other items to and Climate Change at all these different things. And your your involvement in the issue that remotely affects the health of the individual seems like a whole lot of mission and a whole lot of power that the who is asking for that you are asking us to be the primaryer of with only a 134th influence on the board so how did the people funding this on the backs of the American People address those concerns and there seems to be a lot of mission that goes beyond protecting pandemics. If i may try to respond mr. Congressman thank you again for that question. Of work they do work across the spectrum of Public Health importantly when it comes back to who its applicable justifies their engagement with them whether its diabetes or cancer or other issues that we face here in our country. The vast majority is volunteer in my understanding of that comes with their ability to earmark it and we have great concerns theres a lot of opacity in what we are earmarking and what its being on so the need for transparency in what we are earmarking for we cant find the creation of that so it be great if you could help us with that. But then youd earmark these bigcategories so many of the items i have read are under the vague broad category on the wh a web thing i dont think American People feel like they should be funding and happy to work with polio an of things. Thank you and i yield back. Thank you chairman. Thoughtful strategy to make us healthier. As their witnesses have shared today if not at the table someone else will take her place in her place at the accountability we bought when he china operating. Republicans have gutted Global Health programs including the outbreaks of emerging diseases and bioterrorism will not keep americans safe. Trumps resolution of the National Security council Global Health unit which is monitoring cases of the deadly flu strain of trying an outbreak of fever in ingoglia prior to the pandemic does not keep americans safe and one of the most Global Health decisions donald trump halted and u. S. Withdraw from a school for their physician are ors that the United States is willing to abdicate our global readership. Ambassador you serve at the world health how do Donald Trumps decision to cut funding for the debate show by the organization in might it elevate us in the influence of the organizatn . Thank you congresswoman for that statement and a question. I want totate clearly we always had to have a seat at the table. Thema only way we can talk about the issues and protect o interests. Similarly to protect her interests. We are not at the table because is we to be generals that but we truly want to protect their interests. When the United States isnt at the table 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 th for covid when nominated for this position. We should always have a seat at the table and use that sea the interest into a dancer interest. Thank you for that clarification about it or end i ard a lot today on the elevated influence within the w joe nye would arguehat would probably happen as a result of the estates vacating its position on the w chose so again we should have that seat at the table. At least someone else take it for us. We are thankful that President Biden has reversed the administrations harmful decision even if the assistant secretary of senior official regular engagement with the page out what your assessment of our country is recovering on the International Stage from the harmful decisions to cut u. S. Funding of about withdraw from the w joe . Thank you met him congresswoman for this very important question because 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 their proposals to amend the International Health regulations i think to this day we feel theres quitete a bit of skepticism with regard to whether or not the u entering those conversations honestly. Our intentions and importance of improving those existing regulations but there are still questions about our intentions and our stayingower if you will. An important aspect of those regulations as well includes building or rebuilding the capacity of countries around the world to implement them and adhere to them. And so one important question that we continue to have is whether the u. S. Will continue to be a part of that Technical Assistance even beyond funding the enduring relationships that we have had and that myave described are essential so we have triednt to ensure the Member States that we are here in service to america and but also in a way that hopefully will benefit the world. Thank you for much and i know we have a lot ofre work to do to rebuild that trust and that presence on the global stage and no doubt attempting to cut the funding is not helping. Same power for accountability overall for americans across the globe so thank you very much mr. Tierney about my time. I now recognize the chairman of the full committee mr. Comer. W. H. O. Did not step up to the plate. Aligned itself with the Chinese Communist party. On december 31 1908 show warned about a potential outbreak particularly humantohuman transmission. On january 14in at 2020 ignoring this warning that the pho based on information from china claimed there was no evidence there was even transmission. This week contradicted even the w acho. W. Fr h. Starting with ms. Pacing going down the line do you agree that the20 state senate were not accurate . Thank you for the question missed mrnd we are here to learn a lesson to covet 191 of the things we have talked about wasrtance of ensuring that we get to the bottom of its origins. Ambassador. I fully agree with my colleague. We should continue to reform and strengthen the future he can play a role that they have played in the past in protecting us. Doctor. I would agree with your calling out the Chinese Government wh an and was not transparent and was behaving irresponsible he. Situation where it was too credulous may called out chinese behavior and they were willing to call out publicly that china was not being particular case they did not. Now there was more they did better. The who pressed chinas transparency even while they were silencing journalists and whistleblowers are going missing. You think china was forthcoming in sharing data abouta the pandemic . No sir absoly not. Ambassador . No. The flaws of thedo w chill permeated in itsrigins reported in 2021. A report with an investigation that had only one american who was funding the lab being investigated. He was the only american. It was restricted by the Chinese Party and the Chinese Communist party head final editing privileges of the report. Its no wonder the report was bogus. Dr. Fauci said he had considerable concerns about the report and secretary blinken said we have concerns about the methodology in the process in that report including the fact the government in beijing wrote the report. You believe the Chinese Government improperly influence the outcome of the report . Ms. Page it is our understanding that the u. S. Put forward some named to be part of that investigation and chinams rejected them. Is that your understanding as well . Thank you for the questioned mr. Chair. I do know that the has worked to not just put forward names for that particular investigation but for multiple investigations and missions that the w joe is seeking to have. To china rejects those names . I am not aware of why those recommendations were not accepted. At their understanding that china rejected china was calling the shots. The w joes word time and time again. Its important to note that the who presents facts and not just with the chinese come is pretty telling them. Its important to get to the bottom of this. Multiple missions that who that we know about theis we have a problem with china calling the shots on it and i dont think it turned out well with covid 19. T question for each of you and you can answer yes or no to the second time to believe the Chinese Government ought to be held accountable for the lack of coop the pandemic . Thank you sir. We think the International Health regulations and improving those will. Should china be held accountable . We believe all countries should be held accountable. Do not think china is a little special in this situation since it came from china and theynot truthful with the World Population about the outbreak of covid 19 and to say they had veto power over rejected reportsrl that we now know could have been helpful tax. I share your frustration with chinas lack of cooperation. Th but should we hold china accountable . Thats something we are trying to do with the National Health regulations in ensuring that violations cant happen. Ambassador should we hold china congressman transparency and accountability are important and if they attend at the ihl for reforms and an economic agreement for more accountability toll any country in any country in the future. Doctor . China should be called to account in the office of the director of National Intelligence has indicated that we are still in a world where there is no definitive answers to viable theories about the origins of covid at and in order to, in order to resolve those issues the peoples republic of china would need to be forthcoming about data that can resolve these issues which they havent mr. Chair in my time has expired and i yield back. I now recognize mr. Garcia from california. I want to thank the witnesses for making the time to be here and for your service to help not just here at home but across the world. We know the World Health Organization plays a Critical Role in globale response which impacts everything that happens in the west. In the pandemic especially we know the World Health Organization was a critical partner to everything going on globally across the board in his own countrys response to the pandemic was imperfect and we learned as we went along it was also the case for the pho everyone across the globe struggle to address it as it happened and we lost millions of lives g, not just here at home but across the world and we should bebe very clear theres a difference between a conversation about ways to improve the World Health Organization and proposals to slash the World Health Organization including critical funding or withdrawal from the World Health Organization completely. I left during the subcommittee were heard about the importanceaw of biosafety for medical research and we had a great discussion for additional funding and oversor globaurity. There was wide agreement on this. If im not mistaken the w. H. O. Plays a bio security in our laboratories is that correct . Yes its important. Thank if my colleagues are serious about International Biosafety standards it seems cosponsoring a that withdraw the United States from the constitution of the World Health Organization or another bill titled the no taxpayer funding for the World Health Organization act it would appear that bills like this would hurt Global Healthhems here in the United States grade would youd agree that would be the case mr. Secretary . Thank you congressman. We dont want anything to hinder w. H. O. s ability. And mr. Secretary its not justco members of this committee because numerous members of the committee cosponsor these bills that are on the subcommittee. The formerme president now trying to be present again donald trump tried to destroy the World Health Organization to separate the United States from other health want to responsibilities. Its a threat to all mckenzie was role will be diminished and shortsighted than and unequivocally dangerous. He is talking about the worlds leading Health Collaborative that brings countries together to bring down pandemics and i believe hes also responsible in largepandemic that led to the death of over a million americans. Would y also agree that supporting the World Health Organization is critical to the success of American Health assistant secretary . Yes congressman i agree its critical. The w. H. O. Has done much over the past 75 americans in the world. By me want to add its unfortunate that theres so much vaccine misinformation happening across the country and across theye world and last week we had a colleague that was openly encouraging the refusal of childhoodical science here today and that information is dangerous in costing american lives. Cases are declining to dangerously low levels and some of the same diseases in our communities because of climbing vaccination rates. We are having these hearings on the broader pandemic the truth and battling pandemics and trendy key people say them with that i yield back. Tired now recognize dr. Joyce. Thank you two are witnesses for your time in your testimony. Covid 19 is the most devastating Public Health emergency since the inception of the World Health Organization. They are fragrant flagrant of information is theere must be reformed and why we are holding this hearing. The subcommittee was established in response to the misguid the mishandling and guidance that arose amid the was controlled by the w. H. O. Who aremi and they ultimately placed cpp ahead of their international duties. The ccp steered clear steered the dialogue. The ccp skew the statistics and they said the w. H. O. Information that would ultimately effectively shield the Chinese Government from blame. Now its almost four years later in the same organization is calling on member nations to enter a pandemic treaty. Entering the treaty with an organization that refuses to hold bad actors accountable to the antithesis of what the w. H. O. s mission and the antithesis of the principals of all americans. The americanerican peoplea deserve answers from this community and they deserve to know that we intend to safeguardes a nation and protect our citizens from the next global Public Health emergency. Am nkengasong article ii clause to the United States constitution clearly states the powers of the executive office as pertains to the making or enteringcl a treaty nowhere does it grant the World Health Assembly that authority. Do you believe the World Health Assembly willas attempt to act unilaterally and circumvent congressional approval and entered the u. S. Into an agreement like the pandemic prevention response treaty . Thank you congressman for your statement and let me repeat what i said before herrived. If you look at section 2 countries have the right of the people. As the treaty accord is not necessarily a treaty. So absolutely we are at the table and allow any language in the accord. You would never occ foras standing with you call it a treaty or in accord he would not occur without congressional approval is that we just stated sir . Im stating we are still early in the negotiations and we dont know what look like. The citizens of the United States expect the treaty would only occur with congressional approval by the senate. The w. H. O. Did this a bulwark apologist for the ccp. If you examples include the ccps failed efforts to combat the pandemic despite the globally recognized coverup. W. H. O. Denied humantohuman spread of covid 19 based solely on cpp propaganda. Covid 19 of is a Public Health emergency because china claimed that the spread was under control. The w. H. O. Delayed implementing pandemics stalling measures to prevent trade with and to china. With that in mind how can we ever restore public trust in the w. H. O. . All through the just stated you acknowledged and chairmanom comer asked if china waser forthcoming with covid 19 and you all said no but when chairman all through the stated that the peoples republic of china should be held accountable isnt that trust fractured with a Firm Reliance of the Chinese Communist party . Thank you for this sir mr. Congressman. It is as i mentioned earlier frustratin unfortunate that china in particular did not cooperate at this critical time. Its one of the reasons we are working through these International Health regulations to make it so that we are not all didnt that fracture your ability to come forth is what you should be doing by your Mission Statement . Isnt that culpability because of the undue and over influence on the w. H. O. . Its one of the reasons we areme frustrated because we did not receive the information that we needed f trying to do is unlike that information in the event Something Like that ever happens again. My final question is how would you prepare your organizations in the next pandemic both in house in conjunct knowing what you just stated that makes it incredibly difficult . Thank you for this question because its so important that we rebuild that very trust so we can be the most than that effective and mitigating a future pandemic. One of the things that we are doing in Lessons Learned a strengtheningul Lateral Partnership with their original partnerships and ensuring we are working with networks particularly the world to understand these trends. This is building on decades of relationships and partnerships over time. Really looking to not rely on a single after to say this something we have taken away. Spirit my time is closing and that like to really drive home aid not save as the single action of the Chinese Communist party destroyed so many human lives and that culpability and the ability to on as ave charge in this committee. Mr. Chairmen thank you and i think the witness for being present here today and i yield. I now recognize the ms. Greene from georgia. Thank you mk you to thee. Witnesses that areth here today but but this is an important conversation and due to the covid 19 Pandemic Response governmentockdown forced vaccinations, school soldiers Many Americans have lost trust not only in our government but als the w. H. O. The w. H. O. Concluded the Chinese Communist party january of 2027 w. Joe repeated propaganda by saying there was no humantohuman transmission of covid. E to declare covid 19 a Public Health emergency and china insisted they had the situation under control the w. H. O. Did not impose any travel restrictions and mike President Trump stop the spread of covid 19 because china did 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 cpps fake claims about the origins of virus. Our own intelligence a have told us the race for the International Health regulations the ihrs the treaty of w. H. O. Meant to usher in a new erat requires all Member States to cooperate to make the world more secure. The ihr requires only a simple thereve been over 300 amendments imposed in Member States will not be able to see these amendments before they are scheduled. The working group compiling the amendment World Health Assembly was told that they do not to produce documents before the meeting. Some of the amendments include expanding the ability of the w. H. O. Director director general to declare a Public Health emergency to include regional declarations as well as intermediate threats allowing director general to act on information in the Public Domain without verification from Member States and a creation of the Compliance Committee to enforce their rules and ian c the w. H. O. And any rules on their own personal decisions regarding their health. A certain ihr amendments are adopted in sovereign countries including the United States would be obligated to it here to the treaty. The Biden Administration led the charge for amendments or theen ihr including the science committee. The treaty would create a separate in the United Nations for help in implementing the treaty. There is talk of that conference as the party reemerged together with the i spotify demonstrations once more Globalist Organization to imperil the health and safety of american citizens President Trump withdrew the u. S. From the w. H. O. Completely wisely anticipating t ones being proposed. Its reliant upon surveillance which relies on data. China thats what they did to their citizens and still do put the treaty called for more sharing of Persona Health data in the name of safety and outbreak prevention. The next step is to create a the world at the w. H. O. Skip inviting power to you and was since we have the power to restrict any American Movement access to Health Care Medicine etc. I can assure you right now the American People will never comply with anything like this from a Globalist Organization regarding their personal Health Decisions in this matter that anyway they try to conduct their lies. I thin dangerous. Ive questioned ms. Pace. The working group for the ihr were told recently that did not have t final draft of proposed amendments to the ihr for the World Health Assembly and tell me of 2r any member state have any meaningful way to evaluate or consider the proposed amendment before tht to it both . Thank you very much for the question madam congresswoman. This is a really important issue for us especially considering our leadership on the International Health regulations not only in this administration. Going back to the previous administration. A couple of things in response. One i want to be certain to ensure everyone here echo what the ambassador said earlier about the pandemic agreement that applies to the International Health regulations in the negotiations there. Going to accept anything that would undermine our National Sovereignty and in fact the w. H. O. Does not have that authority over our u. S. Health policies. I wanted to be sure to reiterate that. I think addition one of the things that i also wanted to asse you excus. Is very much at the table with these negotiations and so we do have visibility into the various amendments being proposed and the opportunity or the ability to push back and out of respect for ow sovereignty or other National Policy and thats something we are absolutely. Finally with regards to our own amendments we did feel it was important to revisit the alert system as we described earlier so that we are not in a position to scramble and outbreak but have an alert whereby we can mobilize resources. Also one of the reasons we touched on verification of Public Information is the ccp or the pic not providing that. So we wanted to provide a sort of alternate pathway again to protect america and the world in the countries were forthcoming. Thank you ms. Pace. I can also assure you in a future Trump Administration 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 mr. Chairmen and i yield back. Ognize doctor karmic. Doctor karmic. Thank you mr. Chair. Zation the United Nations the World Health Organization trying to gain more authority to pandemic prevention response and coordinion. This worries me greatly. Let me be clear the United States should never specifically the World Health Organizations to be our sovereignty. When you design the World Health Organization and informative nations aroundntuorld typical of providing interchange of information from Different Health care organizationsadministration must ensure the w. H. O. Authorities limited to setting Public Healthin standards countries to Exchange Information but not to be given Greater Authority to infringe on our nations sovereignty and i know we have this debate with world organizations that want to overreach. Support when we talk about u. S. An National Interest to advance with these upcoming negotiations real important for the pandemic preparedness response accord which both of you are correct . Can you bow commit to complete transparency during ou commit to making the proposed treaty public to any proposed public to offer commentary . Have done so. And you will continue to do so. Absolutely. One of the things im about is we have obviously been compromised in the past and we have had information which you have pointed out where we propagate chinese misinformation if you will weather it be not embedding the process are not thinking it through. We just took one country in propagated data Data Networks many f get the trust back and more partly what have we done to hold china accountable or is there a way because im telling you if you look at w organization where china was defeated in court we have yet to hold themw do we keep countries like china and other bad actors from using the system and giving us the inappr information and how do we hold them accountable because i dont feel like theyve been held accountable at all. To this question mr. Congressman and its an an important one. As ambassador said we are quite clearilateral settings including china and even in our bilateral engagements we have been able to reiterate. With all due respect ms. Pace saying i expect to do Something Holding someone accountable is like saying i expect my kids not to eat cookies and doing nothing when they steal them. What have we done to keep them accountable . Ambassador . Thank you. I think you congressman forun that question and i appreciate your comments without china conducted itself and continue to do so. There that we are working on. There are instruments of accoun ihl and let me be very clear there is no room in the pandemic effort that would allow w. H. O. To have influence or make any determination absolutely none. As the principle as we have said repeatedly during his this hearing it clearly defines whattries have affirmed in the leading role of each country. I appreciate your answer the question you previously answered which is their sovereignty which is great but the question it was never answered and the reason we are he to hold accountable the question is what are we doing to hold them accountable which was not answered. I think we answered. Instruments we are working on which are instr useful in accountability. I amount of time so i yield back. Thank you. At i. T. Yield to member dr. Ruiz for closing statement if youd like to make one. Thank you mr. Chairmen to use roundtable National Roundtable on health care with the congressional spending caucus and i came back as soonysngz neezg