If there political solution on the horizon . First thing we have to do and our mission here, the military mission is to defeat isil. I am not here necessarily to facilitate a broader, political solution in iraq. But for a lasting effect, there has to be political reconciliation in iraq. There are a lot of competing interests here, political interests, ethnic interests, religious interests that is the environment we live here in in iraq. As i watch it, i am hopeful that there is a broader political solution that will bring greater stability to in iraq. You could probably argue that it was the lack of that kind of political solution you are talking about that caused the rise of isis after al qaeda and iraq were defeated in 2011. Isil rose in its place. What you are alluding to was lack of a political position here. It is very important and we have achieved some sort of political solution in iraq as well where all of the people in iraq have to look at their government and make sure that it is representative of their interests. Until we get i think that is a requirement to guarantee another threat does not rise in the place of i sold after they are defeated in the place of isil after they are defeated. Host can you give us an idea of what thanksgiving was like for the troops in iraq . Guest sure. I got to see thanksgiving on all ends of the spectrum. We traveled out into the field, very close to mosul, and revisited u. S. Troops on the battlefield the day before thanksgiving. A and revisited some of our will and revisited some of our special operations folks nearby, and some troops from the airborne division. They were out there in the field, but they were getting a full, thanksgiving meal. Our military, regardless of where we are in the world, program has been a and it has been that way since making anwe had anonymous amount of progress. And enormous amount of progress. [indiscernible] we also have to recognize [indiscernible] t to i mean . First [inaudible] 56 are currently you are going to have a growing er of hivinfected a doubling of the hivinfected population every 25 years. The fiscal burden will continue to grow. Fundersxternal [indiscernible] some analysis suggests this is available and inefficient. Also greater domestic funding should give priority. I would like to announce this new partnership to support the finance ministry. You have everyones files. We will start with ambassador burke. We will end with the economic counselor out of the embassy. Counselor of the embassy. Thanks. Slide i slept too many times. What we are going to be talking is very much around accountability, transparency and impact. When we talk about the fiscal , it is that level of transparency and clarity about are those dollars are going. Because it was getting more and more difficult to translate our data, we put all of our data online. Any minister of finance can utilize to see where the program is and the impact it has. That is a partnership between the communities. We felt like we needed to model ministryiors the needed to have. So really around transparency, accountability, and impact. We will be announcing the three Impact Survey that will be in the field this year. We have known for a number of years we have had a tremendous impact. Pediatric new infections are down by 70 over the last decade. We also realize we didnt have the same impact. When we are talking about the minister of finance about a year and a half ago, there in mind what they believed the hiv epidemic lies, was family dying. There was no real visibility to the epidemic. We werent really clear about our numbers. In 2000 you had 8000 new 80,000 new infections. Obviously the programming you need to expand and invest on becomes really critical. There is this real issue between equal versus equity. We work really hard to create equity. The diseases are not equally represented. If you sign them the same essential medicine, in some clinics those will stick. You can see in kenya there is a Geographic Area that has an at expanding has an expanding epidemic. We have been looking at the demographics in subsaharan africa. In the decades since hiv started, there are exactly twice as many 15 to 20yearolds. Cap comes a new issue when you have this data out of south africa. The number of infections in the young age range are particularly high. That dynamic has been ongoing for the last decade. When you start looking at these see in theircan group they dont know their status. 80 of the Adult Population knows their status. Less than half under 25. You have three different epidemics going on. You have the over 30 epidemic where you are approaching an immunity of vaccination. Then you have the 15 through 24yearolds, who have the huge demographic numbers and ongoing transitions. Those are the kinds of discussions we need in the ministry of finance. It is the discussion of gender equity. The discussion is bigger. That is why we are excited about the program. Conclude by saying we believe there is an amazing shortterm opportunity with this new direction we have. We dont always get all the words correct. We bring in the heavy hitters who understand the words and understand that these kinds of stments and really have that dialogue about how you create a Preventive Health system. Or 10 through 25yearolds, no matter where you are in the world they dont interact. It has to be a different kind of interaction. Are aniscussions exciting juncture to recognize the progress that has been made and hone in on the area. We are excited about the new partnership. I would especially like to thank [indiscernible] burke andmbassador all members of our panel for sharing their important insight. I would like to build on ambassador burkes opening. Emarks this was a collaboration launched in may of 2015. To improve the efficiency and hivaids. Ess to fight our remarks will outline the and the partnership, our work to date. Issue. Ss this achieving an aids free debt 83 generation an aids Free Generation the strength the longterm sustainability. You are all aware of the needs for more resources. By some estimates current annual spending will meet the increased by him was 40 . In an environment of resources, partner countries will need to and mobilize more resources. Than ever important to maximize every dollar. The treasury collaboration is motivated by the finance minister having a key role to play. The finance ministry has generally been less involved. Majority because the has been channeled through Health Ministries and other organizations. Given their different expertise they often dont speak the same language or policy. Given the current financing and the key will the finance ministry is playing, it is urgent that these institutions coordinate their counterpart. They will be better print in a better position to promote efficiency. Central to these efforts will be aroundcome challenges how Public Financial Management and sure is that hivaids resources are properly tracked and integrated into the regular institutional process. The requires strengthening financial resources. With an eye toward the budget developing a robust execution system, strengthening Human Capacity and linking bae for Strategic Programming and planning areas. And indeed the broader governmental sector. Governments are taking stacks in this area. Established and oversight work ministry. To help dress these challenges u. S. Treasury department , as well asialogue treasuries and many years of experience. Firmly establishing the sustainable and successful response. Improved engagement a nations. And third effective mobilize a shins. Close collaboration with the film. Since the partnerships launch 18 months ago, regularly incorporating policy dialogue. Most recently at the Imf World Bank in october. Several partner countries that assess and diagnosis. Have also held discussions with our country teams. Global funds and other implementing partners. The partnership is entering its next end most exciting phase. They were unable to partnership and billing foundations. Ugandas ministry of finance and terms ofsury find reference to the partnership it aims to bolster uganda, hivaids and greater coordination and Public Financial Management system. Among the ministry of finance, and the full program. Optimized programming decisions and helped with cap data availability, building an understanding of the support and address other gaps to prevent uganda from maximizing the impact. The treasury resident advisor will be working alongside ugandas ministry of finance. The resident will also help resident advisor will also help develop a methodology to ensure resources are allocated to andimpact communities recommend ways in which incorporate on and off Budget Resources into the government Financial Management. Together we hope this collaboration will support ugandas effort to make the most informed decisions possible about the allocation and use of the countrys hivaids resource. We look forward to collaborating with the finance ministry. And providing Additional Details on the upcoming panel. More broadly we hope this project in uganda is just the beginning of the treasuries. Ollaboration i would like to express my appreciation for the work you are all doing. You know Global Health and hivaids are new frontiers to the u. S. Treasury we are dedicated to complement the work you do in saving lives. We look forward to updating you. Thank you very much. Quirks i would like to thank the u. S. Treasury for inviting me. I would like to thank the u. S. Treasury for inviting me. Doing inistry is i think the ministry put down that isng efficient and productive. Fullytry of finance labor. Ates the health the minister of finance also mmends fiscally impacting the ministry of finance ognizes the importance despite the treasuries efforts it is clear domestic resources other diseases and challenges in the health sector. Finance isr of involved in the implementation in hiv aids when the Government Funds are provided. It has not been acquainted with sharing accountability that are coming into the sector. It used to get up to the levels of coming through the state. There are systems for use Realtime Data on a volution and funding. Working with the usa government, came up with [indiscernible] the group is working on improving data on resources, extending development on financing, and focusing on points of overlaps. And improvehis finance involvement, the government has a Second System to a resident advisor. This advisor will support the oversight with financing and Financial Analysis. The resident advisor will recommend financial policy, ensure our resources to highimpact activities. They also provide capacity we also support we will develop and implement at the four levels of government in a timely manner. We will improve financial response. We will recommend methodologies and incorporate the owner and Budget Resources. We provide advice and supporting development. There may be other areas upon which the ministry of finance advisor expected to be valuable. To ministry of finance is in agreement. He is aligned with the vision. Public financial regimen. Fiscally these are not [indiscernible] thank you minister. We have an invited guest from who willtry of finance join us on video. Why dont we change out our panel while the hear from Mark Fletcher. Are there any questions . Maybe i can ask one question before you go. Youis a lot of the measures are thinking of taking with this partnership are really relevant for the hivaids response. Is it the role of this treasury hivaids . Ook beyond philosophy that needs to be embedded in the overall government and Financial Management, if you look at the terms of reference that have been developed for uganda, basically embedded in a broader look of Financial Management. The most sustainable intervention will be one that is tailored to assessing the inectiveness of employment the hivaids area. But also the sure the system is with maximizing return on public health. I think these interventions will be tailored in greater detail. Often those needs will be the broader context. When you think of one result andwant to see in the year financial sustainability, what would you like to see . That we can look at this partnership and the outcome and impact and whether that investment, whether thats invest investment the Health Facility itself or in the laboratory symptoms that we invest in, has to be linked to outcome and and we can help generate that together, it will ok so much well look out. Do you want to add any . I think the recipient should benefit the most from this plan higher levels. The end user should benefit from this plant. Thats a really excellent issue and it goes to the heart of the issue of efficiency. We dont no how were spending necessarily every dollar, etc. So well look into that. Thank you so much for our first panel. We can get Mark Fletcher on screen and second panel come up. [captions Copyright National cable satellite corp. 2016]] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Isit ncicap. Org] so well start off really respond r panelists to a little bit to what theyve heard on the panel based on their work. D maybe we will start with mike at the end. Maybe we wont start with mike. Lets start with you, laura. Ok. Well start with you, david. All right. Ok. So why dont we start youre to ng at the world bank hear about partnership. Have any thoughts, responses at the world bank . Lets go to mark first. Ok. Because i see you. Mark, can you hear me . Yes. Could you hear me . Yes. Perfect. So do you want to say a few words about this partnership between treasury and pepfar and how the government of south africa is thinking about these issues . Ok, thank you very much. Ood morning. Between the new treasury and pepfar, most of them have been engaged and in our experience at the domestic and planning sustainability is congressional to the financing response. The annual the budget negotiation between the health and other sectors between these two ministries is critical n ensuring budget. Indiscernible] an increasing sustainability has increasingly clear that outside of the context of world Domestic Financing for health care. So that a country that is only raising 10 to 15 of gled of National Revenue and building a spending 6 xation of health care as many countries in africa are. And theyve been working to support better domestic prioritization. While some countries like malawi are [indiscernible] in the domestic resource to help and at special services and indiscernible] that a Large Company has commitment these people from a longer term in the context of national and global commitments u. H. C. Linked to u. H. C. , incentive ased funding, providing better outcomes, several counterpart funding agreement, [indiscernible] and a greater focus in high level associations on the overall of Domestic Health financing. Tell us a little bit about the partnership, how it will work. First of all, i think we need to situate this in a wider sustainability. We really do have a comprehensive view about how we are going to achieve epidemic control and maintain it over time. So this new treasury partner, theyre excited about it. Its a wider effort. What we its not that we didnt have contact interfere, but this is just an opportunity for us to really recognize that and give structure to that engagement in this climate and its part of this drive for sustainability. We off hear in the Development World that you need to to talk the finance department about that and this new arrangement louse us to do that. Allows us to do that. Im reminded of a conversation that i was part of very early on about sometimes we dont talk the same language. But we very quickly good the concern got to the commodity problem. The health side was talking about the finance ministry side was talking about the gas and the oil prices. And just to bring you those together is something that by partnering with we can use their unique relationship what they have and we can leverage the good will of their program get us talking about the and we know from a longterm sustainability standpoint, we need finance. The transition have pointed to weaknesses in Financial Systems as is one of the reasons that it failed but we also need them for he short term as well [indiscernible] with countries that are interested in reforming their systems. What we do is we are invited by the countries to come rather than try and be demand driven rather than supply driven. So when were invited, we put together an Assessment Team and go out and assess the needs of the country and together with the country develop terms of reference that focuses on their needs and how we mutually agree address those needs. The programs that we put together, we try to be very focus l, very targeted on the basics scat the voast it that they be sustainable. Once we are done, the country tools ally pick up the that we transferred to them. Our advisors, we select them from skilled practitioners. We like to hire finance directors. Budget director, people that have actually worked in these jobs, been responsible to their executive leadership as well as be sfobble the legislative leadership and craft Practical Solutions with their counterparts. Once someone is identified, went to make sure that theyre a good fit with the country. So we have handed a missions so both the advisor and the counterparts have a clear understanding of whats expected on both parts. Within 6090 days of arrival in the country, the general terms of the terms of reference are expanded into annual work plans where the counterpart can ask the advisor are mutually responsible for the work getting done. It is not the advisors work program. It is the program to implement a reform in the country. And then the execution of the project is the advisors