new global health strategy aiming to tackle some of the most pressing worldwide health concerns. you'll hear remarks from the global health bureaus extended administer on how the new strategy focuses on health and child nutrition. this is an hour and ten minutes. [inaudible conversations] >> good afternoon. i'm steve morrison from usdis. happy holiday to everyone, and i'm sure you're happy to be back at work. [laughter] we're thrilled today and honored to be able to host dr. ariel

pablos-mendez, the assistant administrator from u.s. agency of international development, and he's come here today, several months now into the post, and the president nominated him back in march, and he took up duties in august, and he's been very busy since then. from the early days when ariel began, we hoped to get him here to csis at the right moment to speak to this audience here and beyond to the thinking and the direction of thinking it's been moving within us-aid on the key of global health issues before the bureau as it refines and strengths its on capacities and leadership role in moving forward u.s. interests in global health, and that's what ariel's agreed to do here today, and we're really honored and thrilled that you've done that. ariel, thank you so much, and we're very pleased at the

staff's support that we've received from aid in pulling this event together. ariel comes from a very distinguished career of almost 1 years at the rockefeller foundation where he really became the dominant personality and leader there around a broad range of issues like research, public-private partnerships, research in diseases of poverty, very instrumental in defining approaches on aids care in africa, and, of course, the foundation became a global leader in taking on the health work force issues, the joint learning initiative on human resources for health. he is an internist, professor. has been a professor for many years at columbia university, professor of clinical medicine

and een deemology, and i think that there's a point that many people have made upon his arrival at aid is we did -- the obama administration did very well in succeeding and enlisting ariel to come and take on this job at this particular moment in time, and we're all very fortunate, and so please join me in welcoming ariel pablos-mendez. [applause] >> thank you, thank you, all, and it's great to see so many friends. and all colleagues and new colleagues to be standing here before you. i'm very pleased to be here to share my perspectives in global health in the context of us aid's emerging and strategic framework. i want to start by thanking csis.

steve pointed out, we've been trying to find the time to do this, and this is a good time for hosting this forum, and i want to thank you, all, for joining in as well. earlier this month, us-aid celebrated its 50th anniversary. we were just sharing that social csis social anniversary, so happy birthday, steve. [laughter] president kennedy founded the united states agency for international development on the belief that all people deserve a decent way of life, and that peace can be fostered through development. over the past 50 years, the world, indeed, has experienced a peaceful revolution of hope and human progressment this process contributed to our own nation's peace and prosperity. dozens of new democracies came into existence. the green revolution saved millions from hunger. global poverty rates fell and global leadership grew by 60%.

the fatalities declinedded by 70% and millions of lives saved, children who otherwise would have died. and the hopelessness by the aids epidemic greatly diminished particularly in a continent where there was an implosion of hope. we look back at the period as a turning point in the history of public health. i want to say in the history of civilization us-aid's contribution to the success has created partisan, political support, engagement of multiple agencies, and the formation of civil society in the private sector. the american people can and should feel proud over the part -- of the part they played in achieving these extraordinary accomplishments. nevertheless, preventable disease and premature death continue to plague much of the

developing world, particularly affecting poor women and children. on the 7.5 million children under 5 years of age died last year, two-thirds of the deaths were easily preventable. one of every three children in the developing worlds suffers from stunting due to chronic malnutrition resulting in needless deaths. for those who do not die, condemning lives to learn and earn much less than otherwise. women in developing countries are more than 100 times more likely to die from premature pregnancy complications than in the modern world, and they have an unmet need for planning. hiv and aid related diseases kill more people in africa than any other disease, and neglected tropical diseases affect more than 1 billion people worldwide. our job is far from done, and

our budgets are not growing, but for those of you who made out we'll see change on a revolutionized scale in our lifetime, i challenge you wisdom. i believe there's indications that we are closer than ever before to narrowing the gap between our ideals and the relative of our time. today, i will introduce us-aid's frame work for global health. the next chapter and efforts in global health build on the strong foundation of prior success. the blueprint ensures we are better able to adapt to the changing realities and challenges sure to present themselves in the years ahead. our strategy is not new, but it's the direction articulated in the election to the nih scientific community this year and reflects our agency's reforms efforts called us-aid

forward. the active document is circulated among u.s. global agencies at the moment. i hope to share with you highlights and engage your views actively. i will begin the presentation by touting on the strategy developed over the last two years. we are guided by a dynamic and complex set of national policies, directives, initiatives, and other factors that interest us-aid operations into o cohesive approach to provide a more strategic global health response. secondly, our strategy feeds with the ever-changing imloabl health landscape. the world is changing. we must have an improved understanding of the forces that directly and up directly influence our ability to fulfill our mission, our chair mission. thirdly, i'll discuss priorities and the way forward. we have the foundation of

success, and make significant impacts on health. we march with the region on what is a long road to us. one maintaining progress against other diseases. to do so, we have to challenge the world and ourselves. now, we will need to adjust the way we work. u.s. air force in global health are influenced by our international commitments and con consensus around the developing goals, declaration, and agenda, and more are ding -- being discussed today. the assistance is guided by a number of national policies, initiatives, principles, and guidelines. in may 2010, president obama issue a national security strategy that recognized development as a center pill particular of our national -- pillar of our national structure capacity. last year on global development,

the president aligned high level principles and goals for our new operation in international development. further, and it's almost the first i anniversary, secretary of state, hillary clinton, issued a review, unprecedented joint review of the mandates and capabilities of the department of state and us-aid to ensure that these score elements of american civilian power working in tandem. us-aid is aligned with the goals of the global health initiatives and recently released policy framework 2011-2015, making operational u.s.-aid reforms in the agency. as remarked, us-aid is doing its part to usher in a new era. through procurement reform, talent management, better policy capacity, and a focus on

innovation and results, us-aid is undergoing a ambitious trance formation on how we do business. there's an oecd peer review. the vision is guided by the principles and goals aligned in the gsi. the goal in may of 2009, significant progress was made towards a more comprehensive global health strategy for america. after so many bumps on the road, ghi is forcing greater interagency coordination, country ownership, and more service integration while aligning previous health initiatives for greater efficiently, namely the president and initiatives and the emergency plan for aids relief. portfolio reviews have opened up our thinking to external participation. while 42 country's strategies are completed or in development and integrated in usg programs

across health for improve the cooperations and efficiencies. the prince. the principles really bring to life and are being operationized and they will be systematically implemented by u.s. government teams on the ground. on to the changing land scape -- many things are changing in our global health space. far beyond the beltway and our national borders. the rapidly evolving nature of our sector and context requires last degree of flex j -- flexibility. they are engaging and acting proactively to meet the challenges. the product of our success to date and survival of family planning is manifesting itself with a pandemic of diseases like cancer, diabetes, and heart

disease. concerns of the real safety are bound to grow. these require attention and progressive adjustments in our work even if we can want launch a whole new platform today, but there's other developments, and we will know that this is vital to better health. i'd like to take this opportunity to emphasize what i call the economic transition of health. despite the economic slow down in oecd countries, developing countries are in the midst of the an unprecedented economic expansion given by better governments, globalization of trade, and technology, and the demographic dividend. the demographic dividend itself is brought about by family planning and child survival success. for families in nations, fewer children for women of late cricket to savings and it's an expansion of the working age segment further strengthened by

empowered women joining the work force. these add one to two percentage points to the gdp growth of a country for a period of 30 years or more. we have seen this scenario in latin america and more recently asia. it is just beginning in africa and elsewhere. today, the world's economy is 500% larger than it was when us-aid started. there's more than twice the growth of the population, so gdp per capita in the world is growing unprecedented rate historically. countries once recipients are now partners as well as participants in the new emerging landscape. for many countries from india to nigeria to philippines and ewe beck stan, the cost of a package

is 10% or less of the additional per capita income growth projected between 2009 and 2012. how do these developments affect health in those countries 1234 how should we adjust to the economic growth? if experience holds true, these countries will invest proceeds from growth disproportionally in health. there's a very tight correlation between proper health benefits and gdp of countries. by the end of this decade, domestic health spending may double in many of us-aid countries, yet, the default of this growth in the sector seems to be an expansion of provision and out-of-pocket payments that now counts for 50%-80% of the top expenditure in africa and asia according to the national health accounts. default leads to access and

catastrophic expenditures across all health conditions, old and new. as noted in last year's report, every year a hundred million people are pushed back into poverty, defeating development, by health bills because they like prepaid risk pool schemes. these cannot be the future of health, especially when growing economies should afford better health for all without families going bankrupt. how do we turn this challenge into opportunity? at us-aid, we explore how we can support reform to increase coverage and lessen expenditure. money can be spent better. when possible, we'll descrus thousand to crowd in local investments of governments and private sector. unlike others, we are in these countries with -- great countries with economic power houses as strategic partners and

donors. my final point -- our five year success is measured to the contribution of savings lives among the poor and vulnerable, particularly mothers and children. strengthening health systems by up no vaition and improving leadership in the global health and international development. the port foe owe at us-aid uses many crucial areas for the health of poor people from family planning to control. a core belief of the global health initiative reflected in the strategic framework is improving the health of mothers and children and realizing a free jen ration. our areas have a great potential for impact. earlier this month, secretary clinton outlined a vision to accelerate the decline of infections by maximizing innovations like medical physicians and treatment as prevention supported by any

scientific studies. as a number of new hiv infections falls. the aids epidemic will enter a period of self-enforcing decline. these programs come from most work in countries, and us-aid contributes to the ambitious, yet achievable goal working with cdc and other agencies and partners. the current budget environment requires us to do work with greater efficiency and lower costs. while up gauging new partnerships and forcing country ownership for stainability. as i said before, we cannot solve the challenges of our time unless we solve them together. this challenge for collective action goes beyond combating a single disease. child survival is a paramount priority for the u.s. government. it is at the heart of us-aid's work and many of our elements from nutrition to malaria control and immunization and

growing challenges around birth itself. for those of you who are mothers and fathers, i know at times you have put yourself in the shoes of people you work to help. as a vice president biden put it at the celebration, imagine what it feels like to be stripped of your dignity because you can look your child in the eye and know that you will be able to provide for that child's needs. the world agrees that no child should die when it can be avoided. the idea of a child dying from a preventable cause is today a foreign culture for most american families. it's our duty to bring the reality home to every american and all the greater achievements to date and the remaining challenges. it is to such an understanding that we will be able to maintain strong support for the work we all do. the efforts on collaboration, innovation, and integration

skate -- accelerate the decline. dreaming of the day when differences between reasonable countries disappears, and it's not far, and the differences in europe 100 years ago have been solved around the world. we're close. a champion of the vision will share more of it in an upcoming forum in december. beyond specific additions or age groups, we challenge the world and ourselves 20 work in new ways. our mission in global health aligned with the principles and us aid map tapes the following -- responding to global health challenges, partnering strategically with a wide range of actors, accelerating the development and introduction of new technologies, scaling up evidence-based and locally

created health solutions. there's solutions promoting jeaned r equality and working first timely as effective doers of public trust. many of you are familiar with the present curve, those in public health, that plots the health outcomes against those domestic product for all countries over several decades. that graph shows the richer countries do better than poorer ones, but also the recent decades have better health outcomes from the same level of income. this has been atritted to knowledge, science, technology, local capacity. while development moves along the gdp line, our work takes the curves up. as others put it, it's not just about more money for health department, but more health for the money. to support our mission, we are

harnessing our staff in science. how do we adapt and sustain solutions? we are strengthening our country's support, monitoring innovation, and communication tuckses. we are strengthening work in health systems as well as technology and innovation. us-aid has a long tradition of supporting development, and endorsed a new platform for science, technology, and innovation. efficiency will be more than important than ever to continue to deliver health. public and private partnerships are using vaccines and treatments for tuberculosis. in the last decade alone, we formed more than 900 alliances for greater health impact. we will continue to test other model the like crowd sources and impacting areas to better believe in our mission. we also leveraging the potential of i.t. information technology

for global health. from 2006 to 2011, the number of mobile phone subscriptions in the developing world soared from 1.6 billion to 2.4 billion. it's been particularly dramatic. what this means for global health is only now starting to come into focus. us-aid's committed to leveraging the power of revolution to help women and their families. the agency harnesses the transition of health referred to earlier. this new paradigm calls for greater capacity for national stewardship of mixed public and private health systems and modernizing health for greater efficiency and equity. for this purpose, we will strengthen our health systems platforms in the agency. we are forcing greater support and gear to have the principles of the global health initiatives on the ground including greater

integration, country ownership, accountability, and stainability. where economic development and our problems are successful -- programs are successful, we'll work towards a transition to assistance of foreign aid. as we've done recently in latin america and eastern europe. usaid helped 30 countries in its history. we are not meant to be there forever. to conclude, investment in global health on a pillar of american leadership, advancing our national interests, making other countries more stable, and the u.s. more secure. they are from the expression of our values. we have an impressing great trust in our global health community, and i'm proud of the talent and dedication of our diverse us-aid staff. we can make progress in international developments and global health in recent decades,

and a crop of recent demographic health service results give hope for optimism. we cannot imagine death among children or mothers as well as a aids free generation. the department knows we are standing and the policy directives, and the us-aid initiatives position us to maintain momentum and move forward with game changing innovations and better health systems as cries ride the national transition of health. president kennedy once said, "the conquers of poverty is as difficult, if not more difficult, than the conquest of outer space." his vision? to reach the moon took a decade to be realized. that achievement said that humans are all together in this universe. i have to believe if we can develop technologies capable of sending men into orbit, we can find ways to develop better

health. the fact is, we have this small planet, and collectsively, we share the responsibility to ensure every man, woman, and child is provided with an opportunity to live and to succeed. given the tray trajectory of recent decades, i'm optimistic we can realize the founding vision of president kennedy and complete in our lifetime a peaceful revolution of human progress and health for all. thank you, all, very much. [applause] >> thank you very much, ariel, for that elegant presentation. we'll turn to our audience in a few minutes requesting quick comments and questions for ariel. we also have received a number of questions from folks online, and we're joinedded by a few

hundred -- joined by a few hundred people who are able to watch this, and i'll turn to those, some of those questions. there's quite of common -- comalty across the submissions. let me turn to all agencies involved in contributing to development in global health. obviously, the budget uncertainty is acute, and last week, we saw the outcome of the global fund board meeting, the admission that a $2.2 billion short fall in pledged contributions, fully a third of the funds pledged, and inability, really, to make new commitments for the next two years, and hopefully reorder some of those resources to keep sort of the emergency and immediate light sustaining

commitments alive in their core countries. for us as a country here in terms of bilateral budgets, clearly, we're living still in the midst of considerable uncertainty and angst about what will happen in this period, but it's fair to say that the resource base, the foundational resource base is going to, at best, be flattened more likely than not be dropping in this next phase. how badly is to be determined. ariel, in your view, as you look at this uncertainty and we know that development in global health have been the summit of a lot of -- subject of a lot of speech making later around the value and achievements and needs to preserve those, but i think also the pressures are going to build inevitably among all agencies like yourselves to pick your spots and protect your vital

interests and pick your spots in this next period, which makes for uncomfortable kind of decision making, but it's one that the global fund was forced into doing just most recently in saying, okay, these are the things we can and can want do, these are the dings that are most vital in moving forward. given the span of things that you talked about just a moment ago in terms of the core agenda of aid, how do you begin to prioritize and communicate to an american public about what the core, vital pieces of those are that as we head into the tough head winds of declining budgets, what -- how do you respond to that challenge, which i think is inevitable and going to be with us for the next period? >> thank you, steve. well, it is the case that the

economy has not been what we would like it to be, and budgets are being reviewed, and we're working with our colleagues in congress, with our colleagues in the administration. i think in general, this scenario, people would like to perfect, but also, we are divided on cuts discussed as we speak. ..

but among others those are the areas but the way they work for us that means not only the emphasis or the knowledge innovation but also the emphasis how the systems strengthening and work different with partners in the private sector but also we serve those are the areas which we are putting more emphasis. the entity we all share concerns over recent developments of the global fund are to funding evolving into more flexible way to respond to the idea specified any more added to the equation

to make sure that all recommendations of the board and increasing reviews will be implemented, and we are working of course with others to maintain to the fund. the fund is very important to the line of work we are to leverage others to the response. >> it was about a year ago that the quadrennial development and diplomacy review, the are was completed and the decision taken to call to a larger role as a leader in convening a leader and also a technical and managerial leader in respect to global health programs and to prove its value and its ability to do more in those areas looking forward. can you talk a little about

where we are in that process and there were some general benchmarks established, there were groups who carried it to try to refine the indicators but most importantly was really to sort of begin to substantiate and prove the case that aid was moving forward in demonstrating its capacity and leadership taking on more and more responsible the what has happened and what lies ahead in this because it is fundamental to the future the outcome of that process it is a liberation and very fundamental to the future of the bureau and of the agency ability to carry forward on the mothers and children and the age free generation and the other pieces that you talk about. >> it is indeed very important issues almost a year and they

have been moving along that and i want to recognize the senior who has indeed been driving a lot of the work in this base mark process over the last 12 months or so. basically a lot of promise has been made. the portfolio reviews to the counter strategies and better communications all of those pieces are very well. it happens to be the case to join the director only this year and there were many things on the strategy and the state department is only now moving validating the process that we have in place this year and working with the state department operations community

and we have a report to the secretary this january so that although the time line on the que pbr is september of 2012, we hope to have significant progress reports whose decision will be made to decide when and how. >> thank you. the question that came from the folks on-line that for a least four different questions that approach the issue of nutrition and there was another but raise the question of ground water sanitation and hygiene and i think what is prompted those questions is the realization that of course usaid plays a very important role in those other areas, and as you leave out your health free-market strategy, the question coming forward is can you explain how that will involve the linkages

and contributions in the nutrition and water sanitation. >> as you know it has always been a very important pillar of the work and it cuts across all of the conditions that in the making it available to the decisions and for that reason we are very much in the great promotion process in the last year or so on nutrition and the scaling up patrician and a lot of this is very much in her line with the president's initiative so there is a lot more there on the security and the supply side by working quite closely to make sure in the first thousand years of life after the second will

have the appropriate mission for the reasons we said before. some are to add that the providing food security and the nutrition the first 1,000 days of life will then also helped in the risk of obesity and related conditions, so we believe it is a very important area for the work. hygiene has also been a key point and click nutrition, it deals on the work on the rest of the agency. there is a lot on the provision of who has access to communities we hope there has been more hygiene and drinking water and again those are essential for the child survival growth that we have. >> thank you. i want to invite some comments and questions from the audience. please, what we will do is bring microphones over and start here. what we will do we will take

three or four. please identify yourself. there's three hands up here. if you could come and then if you could identify yourself and offer a quick comment or question i apologize the podium blocks your view of that. >> my name is michelle and i'm a professor of the global health law in wilmington delaware and in the field of the health sector reforms and the anti-corruption supply medicines access etc one of my observations over the last 15 years that i've been in this field coming from a field of just practicing law to a field of providing my role as a lawyer with that of public health and the global arena is lawyers are not active participants in the work that you do.

the u.s. aid and will begin the who and in others organizations that they don't seem to be in the field coming and from my observation and experience, there are many times when intervention that usaid and others try to implement our limited by the lack of analysis and understanding of the wide infrastructure that may have relevance to your desired outcome. i mentor students and one a program in health and the law and i have to ask myself sometimes where are these young bright minds going to go with the u.s. students or for instance, all over the world and i would like to invite you to consider having the presentation we did last week at the world bank on the justice and development will be demonstrated the variety of ways in which the lawyers and the law we have been

highly relevant to the outcome and that includes the world justice project connected if the rules law and the economic outcomes and therefore it's important to health. i would like to hear your thoughts on that and how we might bring in this extra army. >> thank you. the row right behind. please identify yourself and offer a quick comment. thank you. >> congratulations on the excellent presentation. two things. you made a comment on the initiatives and to comment on how you see the multilateral approach for instance how is who we had this vision of the world in this strategy coming and the second matter is related to the

strategy. >> thank you. right there if you could hand the microphone over, please. thank you. >> on a consultant. you mentioned the internet and your work and i wonder how it might be used to get together the community's working together by the funding to get transparency on some of the project. >> there is a woman right here. with the american society and wonder if you can address the goals for tuberculosis control particularly the need to scale up addressing the multi drug resistant. thank you. >> why don't we come back. we've got these questions on the table and those of you who would like to join in for the next round, please, do.

>> thank you. michelle as a political person i remember he began to learn from business lawyers and economies we need to engage all of those in the communities in the work. we've done a lot of that over the years and u.s. aid has been meeting in so many ways. the work beyond the bureau of the governance is paramount as you know. also the knowledge is crucial to provide guidance to the society. nigeria for example with fees legislation to allow the private sector to emerge with almost 40 hmos and nigeria that provide services. so again, the legislation would be important in the system's going forward it's not just the community work but as they mature the way for us to print

the sustainable future so to reform the space would oversee some of that. on the multilateral of course we are committed as you know the government in so many ways for the multilateral state especially the state issue have providing the normative guidance and so working always in tandem with ourselves we were very closely to take issue and we agree then we held a line. it is indeed a place where from mexico they have been taking place and so whether it is brazil or mexico, argentina, chile, you have to imagine that the world is changing their and that our role as a system also

has a role that we still are of course to the region when such an example more recently to the commitment to the region. the internet we don't have to say much the internet is there whether it is for sharing ideas, forming groups and forces, the number of possible that these are huge in learning and increasingly we are learning for many other areas making sure they are followed closely. the idea in the u.s. aid has been a lot. we have over 70 projects on the global portfolio and the countries are engaging. we have now strategy to bring the cohesive intelligence in a

very important news space for health and development. the technology as we know comes from the community that was the regional work, so i carroll lot of these. i think that we have a very successful the last 20 years normally and raise a great concern, so we know that in addition to the freedom we must ensure the possibilities are in place to prevent which is a lot cheaper and so this is a very important area. we show in supporting the programs but it is an area that is no doubt in terms of the preservatives on the survival before coming yet to the interactions we are trying to be supportive of the tools.

>> thank you. we have a hand up right here and in the front. yes, please. >> thank you i am with the phyllis foundation to the i work on maternal and newborn health and what i realized if you look at the focus on maternal health what is supposed to be the critical issue, and what you said with your presentation what do they work towards and so i wonder what kind of program to you have that actually addresses this learning in the productive health objective? thank you. saxby for. yes.

>> i'm a director of the program and as you know when we work with the nation mother to be partnered with usaid in the past in areas like the influence of preparedness and hiv prevention. and you mentioned health systems in your presentation and our experience in working with other nations their health system they really knew in the military health system and the civilian health sector, and as we build partners to wonder what you see would be the mad ~ the chemical will in assisting this. >> why was a career foreign service officer for many, many years, and now working with a

group based in the u.s. with health systems. i just have a question very supportive of your comments and out kind of going back again to words if focus on the health. i will point out though that in the mid-80s is focused on a very important child survival programs as well which then kind of dissolved and i'm wondering now given the importance of the health system that you talked about and moving back to words the focus on child survival and maternal health hell are you going to make this transition between the disease oriented and relatively successful with pepfar and pmi into a more horizontal kind of broad health systems approach focused on the child survival and maternal health. >> thank you. there is a hand right back here. yes.

>> just a second and we will get a microphone over to you. >> hello my question as in view of your attention on focusing on capturing or harnessing the economic transition for health, does that change the priority as a country and which they will be working or looking allocations of resources across the century, and second, with regard to the health system strengthening you suggested you might be doing it differently could you please me to describe a few of the things that you might see giving a little bit differently in that area than has been done before. thank you. >> let's get you a microphone, please. >> thank you. time with the international development. you spoke a lot, doctor about the relationship between poverty

and health and we all know that quite well and i'm wondering if you could share your vision as we are new here but your vision of how the global health initiative will incorporate economic strengthening and empowerment into your global health program we have five different angles. >> in the use for the planning it is central to child survival the permanent planning is also central for 20% for the planning it's important for the principal and it's also important because it helps the demographic success

to actually drive that. the military has in so many ways we work closely in the emergency response across and your relationship with others are very important in helping prevent hiv taking in that country so we have to continue that relationship there are so many it is hard for me to pin down but clearly it might be an area where there is no existence and relief and other situations of the opportunity in the 1980's we had an emphasis on the child survival revolution in many of you here with part of that and

the issue was sustainability and so how do we make sure at this time all the efforts that we are making can achieve that sustainability we don't have to go back. we have reached a new level in many countries now are around the world many regions and we need to be commended for those countries are requiring a great level of integration, so we are still built in the way vertically we are still accountable to the specific areas and we will probably not change that immediately but the global health initiative has more about all of the needs and so on to strengthen the sustainability. all of this requires so the

question that was asked by barbara to what extent has not had the same degree of silence of other areas to communicate of exactly what it does and how the coverage is to not only safer but normal infant mortality and the possibilities that we have to get us through vertically by supporting countries more integrated fashion the of the hugely important to allow us to understand the rest of the world and the country's how things are growing many are still thinking

that the private sector is two-thirds of the sector and how to engage in the private sector is very important and the poverty and health, well, we've noted it is one of the largest segments but usaid is very much as a whole and working to the first development and across the agency and the foreign portfolio it is crucial for the resource but most importantly because the payoff is huge. education and empowerment is huge and economic development and also in the health.

i think we have time for another round. i was going to ask one question and then we will turn to some of you here. we've had the chance recently to visit ethiopia and south africa and zambia is a couple things that can through powerfully from that trip. i want to ask you to comment on and that is that enormous upsurge of pressure from the partner government upon a i.t., cdc leadership to reduce the number of implementing partners of our non-governmental implementing partners to streamline and consolidate them and move them towards a way from

verdict service delivery and towards technical support to government organizations and move towards a greater direct funding by usaid and others of a partner and a government institution, and from the standpoint of the government of ethiopia or of south africa this is what the understand this country ownership is higher efficiencies, few are implementing partners not saying the partners don't remain very valuable, but it seems to be a core tension right now and a corps manager real challenge because we have many contact sought their implementing part nurse they can't just be in did overnight as a managerial challenges a political challenge in terms of whether you take a huge risk of accountability if you begin direct funding of the from the agencies and of course there's a lot of resistance from

plunging partners some of them are losers in this process in terms of being basically asked to phase out their work in some of these countries. i was struck by just how much turmoil and how much drama and the date is centering around that issue and how much it really lies as one of its key challenges you can talk about that. >> south africa are complex because south africa is in the upper of the economic situation letter and they are so committed it is allowing us to change so there is a change in south africa and in our commitment as well as other countries were in the success and the economic development allow us to do so, but it is a bigger point about

the way that we engage in what we call the procurement and one of the key elements. as we look at the way we operate the global enterprises often there is the merging of the two that allow us to provide the services scales because of that integration is one very successful plus the supply chain management, so there is an issue how do we change the way we do our business we also want the ownership which will then mean that we should be willing to support those that qualify the

transparency and capacity and so on but also the local ngo and this is not an easy transition or an overnight position but it is basically to get more of that capacity so that indeed our success sticks in the long term it will not be as dramatic as the celtics change is not but also speaking may not be as big because today it may be ten or 15% of our funding so even if we can go to 25 or 40% as a part of this reform the majority of the funding will still be in a similar way, but the other small part would be questioned in many of the countries to allow the local ngos and capacities and in the and so whether they are

positioning programs what you see is indeed the funding moves from the direct service provision into the assistance, the regional recommendation and that is just the path of doing business. >> thank you. we have time just for one more round of questions. we have a gentleman here in the front row. we have to hands here. we will take as many as we can so please, be patient. yes, sir. >> nice to see you. >> can you identify yourself? >> just to ask you and i don't know if you will be able to answer this question but one of the issues we have seen with our challenge of the international community in haiti he mentioned it is a priority. and there are the two questions at the beginning about the water and sanitation. what we see about the earthquake and so on, i mean some are going

in with limited numbers and these are good initiatives but not a way to solve the problem he has probably 50% with the lack of access to water. is there any discussion going on or anything that the global health initiative, global health bureau is doing as a counterpart because of the development to improve access to water in haiti and work with a new government? thank you. >> thank you. there are two women right there. please? >> thank you. joan, and i am mentioning this because i know this is an area you have a lot of experience. if human-resources are held, and i am concerned that with a broad rubric of the health system strengthening the area of the human resources getting lost. the private sector is taking up

a real i think leadership in this with the front line health workers coalition, the goal of a million new community health workers, but i think the government has to take a big role, too, and i would just like to hear what your thoughts are and how they can expand and foster this. >> right next to you. >> yes, government accountability office. earlier you mentioned the austere budget environment and you gave an ax handle as an example actually i think the moderator did, the global on how they have had to cut back on the future grant, and you spoke about procurement reform and i would like to know how the global health initiative could work with the other large donors

out there, the multilateral, the global fund to leverage resources. >> thank you, there was handpick here a moment ago. yes, right there. >> you mentioned health system strengthening many times and it is identified as a key part of the world initiative and there's a lot of specific arguments so i was wondering if you could speak a little bit to that. >> and then one of your right there, please. >> development finance international. can you elaborate on usaid strategy to address the non-communicable disease of the world?

>> thank you. i think we will close on that. >> thank you to view the great questions. clearly one is paramount as the housing and many others there's an incredible the state department has been coordinating a lot of this effort it is not as easy of course. and the destroyed the earthquake as you know it is a pretty to ensure they have been working very much so particular to ensure that that is the case. the vaccine access and the supply and you have to do right and notes is an area but i agree

the pretty. they were worried about them swallowing human-resources. well, the human-resources are from the line workers to the professionals to i would say the policy makers they would also be looking at neglecting it was true the window i began to understand and the reason was the economics only mixes when you understand the sector is a profit in a poor country and as they are moving and while we like to have the professional services in studying it is a lot more efficient and to be sure

you of the workers in those areas and so on. so it is paramount and usaid as you also know as the development to the capacity project for almost. how do we leverage others? that's what we try to do everyday, and we believe that time is right. in the oecd countries you have institutions in europe and the global fund is a platform for us to remain to keep it viable for engagement as well as many of the private sector and many of you work in the corporations, but more importantly would be how do we crawl back in the public financing for people in countries where the economics are not allowed.

it is up for renewal and so that is an opportunity for the work in the health systems and would guide us for that coming up. again, we do not have the office. it is important and we are doing a few things. one is we have a lot of information and the demographics allow us to understand the problems so we are trying to get the measures. the demographics have been so important in building the stories and monitoring the success so that is very important for us. second, we are -- we know that sometimes you have to do things like edifies them to quit

smoking and that is another thing that we are doing. third, community platforms. quite often it is healthy lifestyles and we have a lot of experience in the notification or mass communications on the whole for the healthy lifestyles and exercise and nutrition and diet, all of that itself is quite well where we are pressing to make it. i mentioned nutrition the first 1,000 days of life and probably to preempt the risk factors, so all of these are the pieces that we are doing today. we invest the earliest 30 billion on almost all and the 50 or 60 billion is almost all, and other industries will be on the table for many

conversations. it is very important in the future and we are preparing for the future, not jumping into we are sure our priorities are addressed. >> thank you. let me just close with one last question which has to do with looking forward to next year. we will of the international aid conference, the biannual global meeting will be here in washington in july, the third week of july, next year. it will be the first time in 22 years that this conference has been back on u.s. soil. the obama administration lifted the immigrant ban, the migrant visitor ban on the persons living with hiv and it became possible to do this. 20 to 25,000 people will be here for the full week. can you talk a little bit about how you see the impact and the value of all of this for an american public that hasn't witnessed this directly for over

two decades? and it is going to be coming in the middle of some budgetary times and a very heated presidential and congressional set of braces so getting the message is right will be very important and there's been a lot of deliberation about how to get the very best outcomes from this very important and historic moment. if you could offer this let's hear closing thoughts, please. >> as we noted in particular we are with the priorities times for the global health initiative sitting mothers, seating children and generations and issue those we have opportunities next year. they are asking about the particular one of the office, a major opportunity. i have to say that communities all along has been strong participants in this country and abroad, so we had it had been taking place here and others who have been so involved in the

work that we've done in the last few years, and so i think it is a great opportunity. nonetheless because it would bring attention, a lot of voices and stories all of them will never and in the end of the work that we do is the work that the american people ask us to do and to the extent they compare on saving mothers and children that should help the work that we do. so it is an opportunity for the others as well. spec at the hotel from nine a.m. to 2 p.m. we will be staging a major conference on the strategic power vaccines and have a cast their and the administrator ron shaw will be delivering an address, tony will be delivering an address and we have three very high level panels i won't go into all the

details but please join us either in person or online and dedication i want to thank barbara bennett and her staff for helping to make this event happened and from our staff, many people work very hard to pull this together. suzanne, julia, max fisher, carolyn, a great thanks to all of you i wish you the best of the fortune moving in this very ambitious agenda forward please join us. [applause] >> [inaudible conversations]

>> the notion of being a

lobbyist and having to go and try to be nice to people i don't like would be ridiculous. no, ali will not in any way be a lobbyist i do not intend to practice law. i might show up pro bono sunday for a gay-rights case. my intention would be to do a combination of teaching and lecturing. >> now a new hampshire primary awards banquet honoring senators john kerry, john mccain and the late david broder. the senators also participating in the discussion on the primary campaigning in new hampshire. past honorees include former senator bill bradley, patrick

buchanan, former senator gary hart and the gop presidential candidate mitt romney to read this is one hour and 45 minutes. [applause] >> the next part of our program is we recognize our special guests, and the way this is set up we are going to have a dialogue that will take place. it will be dan will moderated and he will be like the oprah winfrey of the presidential primary tonight. we are going to hear local the about some of those new hampshire moments and to senator mccain and senator kerry i will share with you what people consider new hampshire moments because there's 1i am aware of and it's bipartisan just like this event. it was 1996 when bob dole won the republican nomination, and that summer gephardt came to

manchester and needed to pick up some items at a drugstore and in that stopping at the drugstore on daniel webster highway. he walked in and put his purchase down on the counter and the kid at the register looked up and said you or gephardt and he said yeah and the kid said to him i don't believe it. bob dole shops here, too. [laughter] this is a true story. a year later you may remember bob dole did the infamous commercial and i ran into gephardt and he said to me you know in 1996 we didn't know what bob dole was fighting in the drugstore but we sure know now. [laughter] that is a new hampshire moment. if you would direct your attention to the monitors around the room we get a special deal for the folks for review to see at the new hampshire primary.

after he was elected i'm sorry, let me start that again. if you never had the chance to meet david broder, those who have will tell you is your loss. >> it just wasn't him. >> i've been covering politics for a very long time and as a journalist, not as a partisan i have a stake wanting to see this political system of hours worked deeded was without a question eight heightened political reporting much short of an introduction he would never realized they were standing next to a pulitzer prize winner. >> he wasn't the world's best dresser like a flannel shirt with a tiny camera cross in a very easy style and set a very powerful and out come when he wrote that column. >> a fixture on the national

talk-show often the topics center on something that he had written earlier in the week. estimate the late peter jennings looked to see what he was doing he was doing a story on a voter. he really liked the stage. he really liked the stage and talking to the people on the street, at events he would pick out not to those individuals you think he would pick out >> david broder was drawn to the new hampshire politics and witnessed a lot of it from mccarthy in 68 and chastising the publisher of the union leader and 72. >> david broder was right there

and wrote about that and he was here for a lot of the other significant moments. >> i remember him stressing to me kind of like a student even though he would always make you feel important that what is great about the primary here and when you are doing is you're seeing them become a duty to before they become presidential. you are seeing the real person here because they have to be the political leaders of the area and trying to understand what made us take. >> one exhibit came in 2008 when he approached the secretary of state and asked him for a list of the four small new hampshire towns as he wanted to get a feel for the voters were thinking. >> he kicked the town because he

had never been there. he said i've never been out there. what's it like? he says it's pretty small. it has a general store late in the center of the village so he spent about three hours in the afternoon. >> that night he would write an article predicting that barack obama would easily carry new hampshire in the general election no holes, no tracking just the result of a few conversations. >> it was from his personal context knowing that the town had been very close in the previous election and that it wouldn't be. >> david broder played ball the new hampshire would be his world series and the people he met along the way. he sat on it because he is my

favorite. he is my favorite. that's what made him a national treasure. i really do. ♪ [applause] >> let me introduce to you a senior from college marisa. [applause] >> good evening. my name is marra and i senior international relations major and president of student government association at st.

anselm college and an intern for senator shaheen. like all of you, i have a love for politics and the political process, and part of that is the appreciation of an influential journalist, david broder, who covered some of you come interviewed many of you and was friends with most of all of you. although david has passed, his work will continue to impact my generation and generations to come. david's exceptional character should be mirrored by all. although he acquired an impressive resume throughout his long career, he never lost sight of the people and the voters he worked to inform. this made him the perfect reporter to walk the streets of manchester, meeting people every

day and providing a real view of what was happening in the primary. bye taking an objective approach, david was able to see individuals and candidates for their accomplishments and credibility. rotterdam the party affiliation. david also stayed true to what he loved, covering the elections, including every presidential race since 1956. numerous elections and even races. to david every race was an important and needed coverage. and as a result, he spent a lot of time in the granite state. david broder is across generational role model because america needs more journalists like him today. the best tribute to david is to follow his example. do what you love and dewitt with

integrity. in commemoration, david broder is given the new hampshire primary award. i'm honored to present this award to his son, john schroeder, with remarks from his colleagues gambles of the washington post. [applause] >> young people like you inspire my father. we commemorated my father's birthday earlier this week and to mark the day of my brothers and i went out to city field to see them play my father's lifelong team the chicago cubs. 28 years ago my father and his sons went out to shea stadium to see the mets play the cubs, and then as now these were dog

teams. that here fighting for last place on the national. by the end of the second inning all those years ago, they were down by eight. as the innings went past the showed no signs of life, but my father never gave up hope. each that came up my father would be cheering on in to that team. when the cubs scored eight marrec to this rally in the ninth in winning and went on to win the game my father was triumphant at this victory on the road to the last place in the national. [laughter] and i think that love of the cubs, the lifelong believe supported his lifelong believe in another underperforming and will use institution american electoral politics. and i think my father very much felt reassured that this institution he left was

interested in such a significant way to the voters of new hampshire through their primary. and it's not too strong to say that my father loved the voters of new hampshire. not just for their kindness to a stranger appearing on a winter doorstep bringing them in sight for a warm cup of coffee and sharing their thoughts about the issue of the day, because also like my father the voters had never given up hoping the promise of american electoral politics. and for that reason on behalf of my mother, grandmother and my father's name i am honored to accept this award for him. thank you very much. [applause]

>> josh, there was was terrifi. it is an honor for me to be asked to participate in this dinner and i want to thank the institute for honoring david and having joshua pure. there are so many distinguished members of the audience i don't know where to begin in acknowledging people i would say to paraphrase president kennedy this is probably the biggest assembly to the political talent and bring the power ever gathered in new hampshire exit when david broder dined alone at the way fare. there was a lovely memorial service they have for david at the national press club back in april. the most memorable parts were by jos and his brothers george and matt and mike they were given the attention today that he would have been immensely proud of the sons that they produced.

as murderous the said and i think she captured david just right she knew everybody in this room in some way or another or at least everybody in this room knew him by watching he was the cal ripken of reporters on meet the press and was on "meet the press" 401 times over his career many of you know him because he covered personally in the state and talk to you because you're an adviser to a campaign. i know that many of you would call him a friend, and probably feel his loss as deeply as us for whom he was both a mentor and a colleague. dave loved new hampshire. he liked the place is that new hampshire was always his favorite whenever we were kind of dividing up assignments at the beginning of a campaign david would always say you go to iowa i will wait for you in new hampshire. [laughter] she enjoyed almost everything about his time here.

he enjoyed the ritual of the primary, the pace of the primary, the people. one of his favorite things was the quadrennial lunch he did with the reporters of the monitor on the afternoon of the primary. i know that he will always look forward to that year after year. he was called the dean for a reason. he brought to his reporting a seriousness of purpose unmatched integrity and believably keen insight. he was as competitive as anybody i ever knew. he hated when we got beat and occasionally we did, and if i was the person who got beat it was very clear he was unhappy about it. but he was always -- he carried himself with incredible humility. he was a reporter's reporter. he was thought of as a convent by many people but he never fought himself that way. she never believed he had all the answers. he knew the answers and insight came from doggett reporting. in the era of bigfoot journalism he walked very lightly.

he made space for other reporters on the "washington post" and he taught by a sample into the young reporters he was unfailingly generous and when he died the e-mails that many of us got from friends and colleagues and young people that we didn't know who were touched by david personally was a tribute to him. .. >> he loved these moments. he loved the night before the primary when the voters were about to speak, and as everybody knew, you couldn't predict what the voters here were going to

do. one of the young reporters said to him, do you have any words of wisdom or observations? watch ron paul is what he said. [laughter] he was a reporter's reporter, but he was not flawless. i love to tell this story on dave, and i told it while he was still alive, and i'll tell it now since he's gone. i was the political editor at the post in 18980. i never had to worry except for the night of the first new hampshire debate, not the national debate, the famous -- i paid for this microphone debate, but the earlier one. i was in the newsroom, and david called just as the debate was starting and said, oh, dan, we have a problem. he and lou misread what was happening. they decided to watch the debate on tv. local tv was carrying on a delayed basis. radio was carrying it, but they didn't know what station carried

it. david said to me, can someone in the newsroom cover us for a half hour while we get our bearings and figure this out. they joked about it afterwards, but we never trusted them on their own after that. [laughter] there's another funny memory of dave in new hampshire. the 1984 sickle, the first cycle we used laptops. if you knee him, he had a complicated relationship with technology. [laughter] so he set off for new hampshire for the first time armed with his laptop proudly, but as insurance, he also carried along his battered old typewriter, and when he got up here, the political editor remembers watching david type his stories on the typewriter and take the copy and put it next to the computer and retype it into the computer. [laughter] those are some of the fond memories. there's serious moments as

well. i remember the night before the new hampshire primary in 1984 #. we had done tracking with abc, the first time, and the tracking shows gary hart was in a tie as of that night. everybody expected that mondale would win the primary even though hart was making a move. there was confusion in the room, and somebody said what's it mean? dad said it means gary hart is probably going to win the pry marry, and -- primary, and walter will have a long ride to sale the nomination, if he can. he had those instincts always. he understood and could see around corners, and it was also obvious to him at other points in other races how things were moving. he was here for everything, to record jimmy carter's rise for reagan's win, for the george hw bush's victory here in 88, bill

clinton as come back, pat buchanan, the straight talk express, senator kerry's bounce back, and finally the remarkable events of 2008, which was, of course, his last primary. i think his most famous story was probably the one eluded to in the video, which was the 1972 story about edmund musky, weepy and voice choked with emotion. that was a controversial story. if you never read david'sing's accounting of it that he did in his book behind the front page, i commend it to you. it's a pro's prose example of revisiting someone's own work in the light of new information. it's the kind of person that david was. he never believed he always had it right, and even when he was convinced he had it right, he was prepared to re-examine it. i want to close by talking about

what david liked best about politics, which was talking and listening to voters as others have eluded to. david once said you can learn more about a campaign by talking to voters than you can ever learn by talking to a politician or political strategist. nobody in journalism paid more attention to the concerns of voters or cared more deeply about what they had to say, and i think that's why he liked this state in particular. he admired the independent spirit of voters here. he knew they would not be dictated to by conventional wisdom or herded into supporting this or that candidate because of happenings in states. he admired the responsibilities people here have about putting candidates through their paces. we'll hear about that a little later. he was grateful for their willingness to share their views with him. in honoring dave with the award, i think you honor yourselves and the rich tradition you have created. thank you very much for

remembering our friend. he was very special. thank you. [applause] >> if you direct your attention to the videos, we have one more for you. >> join me in welcoming the man who is going to take back the white house from george bush -- [applause] john kerry! >> 2004, senator john kerry won the primary by a couple of touchdowns. >> i love new hampshire. [cheers and applause] >> then, again, that was how it was supposed to be, even from the early days of his campaign. >> your courage, your courage can make sure that we do what's right for our country. >> he started out in that campaign as the front runner. everybody thought he was the person to beat.

>> he department give up. >> he really seemed like the dominant candidate and the front runner to a lot of people, and he came even out of new hampshire a lot, and campaigned all over the place. >> going and before and after things in the 24 hour fitness gym? >> the funny thing happened on the way to the win, a deep democratic field including the likes of weley clark, and others, and all valued his support, while folks were still not real sure about this senator from massachusetts. >> people always like this, you know, he's got money, he's kind of swift. >> i'm not sure how one's status is and how they believe they are, and i think it may have taken him awhile. >> i believe there's better ways

to do business here in america. >> if kerry was adjusting to the learning curve, a governor from neighboring vermont, was finding his swing just fine. halloween of 2003, the race shifted. howard deen was the life of the democratic party it seemed, and with the primary months away, the kerry campaign threatened to become fractured. >> there was a real sense of division within the party and within neighborhoods and among friends. >> by this time, republican strategists were gearing up for a bush-deen show down in the general election. >> it would be natural us for look at what a deen-bush race would look like. >> this race would be interesting. >> it was, at that point, that people really began to see who john kerry was and the fact that he was not going to give out, that he was going to keep fighting and come back, and he

made critical decisions. >> among those decisions, the firing of his campaign manager leading to the departure of two other top aids, but he refused to let his campaign or the media take their eyes off the ball. what the people want to know is what we're going to do to provide health care. this is all inside baseball. nobody's reading this other than you. >> maybe it's the fire in his belly giving the supporters the idea to put fire in other bellies as well. >> he said, john, listen, we want to bring you in the fire house, introduce you to the folks, and put on chili for you, and we had invitations saying come to the fire house with a candidate and chilly. he's still more chili than the ones he served. >> is it good? >> what's better than a chili fest than a bus tour, which also

seemed to catch fire. >> we have to turn the country around, and these are not just words. >> the group on board, some supported each others, others didn't, but it felt like a new launch, and it began to connect with people. >> we don't need commercials, but we need leadership. >> interaction with real people that make a difference in the primary, and that was the perfect example. you know, all the pundits had written him off, everybody at the national level say, oh, he's gone, cant win it. he kept working here, and he came back and won this because he went out and made his case to the people of the state. >> his approach was paying off not only in new hampshire, but also in iowa. the wheels were turning in his campaign while falling off of others. >> then we're going to watch in dc to take back the white house. [cheers and applause] >> by primary night, he took the biggest step towards the nomination and a special thanks to those who took him there.

>> unbelievably grateful to the people of the state who kept their hearts, minds open, they were willing to sort of take a look, begin, and i'll never forget that. it's the bond that will be with me for the rest of my life. [cheers and applause] >> he was a believer, and he believed that he made his case which has to happen in the primaries. [cheers and applause] [applause] >> to present the second award tonight, please welcome united states senator jean shaheen. [applause] >> hi, thank you very much, everybody. thank you. please be seated. thank you. please, sit down.

[applause] i am truly honored to be here with all of you, so many distinguished new hampshire politicians and luminaries to celebrate the new hampshire presidential primary and three of my personal political heros. david broder a legend in american reporter, john mccain, whose service we all know so well, and, of course, i get to give the award to john kerry. you know, you may remember that in 2004, i chaired john kerry's national political campaign for president, and now my husband, billy, was his new hampshire campaign chair, so in our household, it was john kerry for president every day all the time

24/7. stephanie can tell you that's true. as you heard in that video, early when he got into the race, everybody thought john kerry was going to be the nominee of the democratic party, but then as the video showed, by this time in 2003 as the new hampshire primary was really heating up, the pundits and the pollsters had pretty much written off john kerry, his lead dropped in the polls, and people thought he didn't have a chance, but they didn't know john kerry. he hung tough, and he decided to take his message directly to the voters of new hampshire, and showed not only what he was made of, but what the voters of new

hampshire are made of, and, of course, that's when the new hampshire firefighters came up with their idea of the khili suppers, and as dave lang says, they pointed out they had a candidate as hot as the chili they were serving, and i think john kerry ate 50 pounds of chili in that campaign, but they were a huge success, and they were a success because john kerry took his message and his candidacy directly to the voters. he didn't give up. he showed the courage, tenacity, the intellect, and the commitment that won him the democratic nomination, and i remember he fought for every vote. i can see him on granite street

at 6 a.m. on election day shaking hands in the blistering cold, and he stayed up there right until the polls closed. he won the new hampshire primary that day, and it was a victory as much for john kerry as it was for the new hampshire voters, and, you know, i supported john kerry because i thought he had the leadership this country needed at a time we really needed it, and i never thought that i would get a chance to serve with him and with senator mccain in the united states senate and to see up close and personal the kind of leadership that he still provides to this country in the united states senate. i've had a chance to serve with him on the foreign relations committee and to see the commitment and the passion that he brings to everything he does,

and when this administration needed a diplomat to go over to pakistan after the davis affair after osama bin laden was taken out, they called on john kerry. when we were trying to pass the new s.t.a.r.t. treaty, a significant piece of nuclear disarmerment, it was john kerry who led that fight and more than anybody else deserves credit for getting that done, and i think one of the things that i like to think about is that throughout his success, that he still remembers those chili feeds, the cold new hampshire days of retail politics, that john kerry brought out the best in the new hampshire primary, just as the new hampshire primary brought out the best in john kerry. please join me in awarding this

new hampshire primary award to john kerry. [applause] >> that is so beautiful, that is really something. [applause] >> i am really -- thank you, thank you. [applause] thank you very much. [applause] thank you very much, folks. [applause] [applause] >> thank you very much. i think i can come back here and safely again say with equal passion, i love new hampshire. [applause] i really -- this is very, very special. i can't tell you, just being in the presence of so many good friends., people -- one of the things that comes out of that, and i think john feels the same way and tells you, you just do make lifelong friends, and you have a sense of the people and

the state, the country comes out of it, that is simply unique. i'll never lose that, ever, no matter what i do in life, and i thank new hampshire for that. you made me a hell of a better candidate, forced me to look inside, dig down deep, get at it, and i was with rob portman of ohio the other day who serves on the super committee with me, and we were chatting about it, and he reminded me, you know, you only lost the presidency by half the people in the ohio state said yum on a saturday -- stadium on a saturday, and i said, thanks, rob, you better make it up for me. i'm counting on you to cut a deal here. we're going to get this done. [laughter] i can't tell you how special it is for me to be here with my pal, john mccain. a few days ago, john sent me a photo with the two of os sitting at the state of the union address, and on it he wrote, the two losers, together again.

[laughter] it was really sweet. [laughter] so being here in new hampshire is very, very special because here in new hampshire, john mccain and john kerry are 3-and-0. [laughter] so tonight, we're here as winners, and -- [applause] that's very special. [applause] you know, john and i got here this evening, took one of the john huntsman flights -- [laughter] by pass iowa, straight to new hampshire -- [laughter] and i was listening to governor, congratulations to you on an extraordinary -- will be an extraordinary year as you're getting there, and i think everybody is appreciative of your public service -- [applause] but i -- [applause] john was talking about the new media and the social media and tweeting and facebook and so on and so forth.

i don't tweet a whole lot because i think it's much more important for senators to make their mistakes and gaps in public in person, which i've been known to do occasionally. it's a pleasure to be here under the -- i was a fan, which means he never would have made it in washington today. [laughter] but this event brings us together to celebrate one of the most important journeys in america, how we choose our leaders. this is a room full of great memories and full of friendships i talked about a moment ago. there's one person not here who i want to thank and single out, and that is a great friend of

ms. shaheens, judy who is battling a form of leukemia and will have another operation down in boston, but all of us who got to know her love her dearly and send her our passionate hopes and wishes and prayers for a complete cure, and we admire her enormously. [applause] john mccain and i have been through a lot of battles together, and some we were not together, but they were battles. [laughter] both come here with a special respect for david broder. he really was what dan called him, a reporter's reporter, and i think, you know, represented something that we'd lost in american politics, which is tragic, which is a guy who, you know, didn't get swayed by sponsors or interests or the

inside game, but really always looked to the people. he was a people's reporter as well as a reporter's reporter, and he was a reporter who hung his hat on the truth for which we are all very, very grateful. i also thing i can say safely he'd be very, very proud i know of what josh said and his sons, but he'd also be very proud of dan balz, and how he carries on the tradition. dan, thank you for this evening with us and for doing what you do. [applause] let me -- [applause] let me just say a few words about new hampshire and where we are today, and then i want to sit down, and john will speak, and then we'll have a chance to talk a little, but, you know, i first heard or sort of sensed new hampshire as something special and different when i was a young naval officer in the gulf of tomkin in 1968, and, of

course, 1968 was a hell of a year up here. i got all that news, you know, drifting in, and i'll never forget, i had an interest in public policy and life, and i remember listening to the vote counts and getting the sense of what gene mccarthy was doing, and the power of new hampshire when new hampshire told the united states of united states it's over, you can't run anymore. human impact on -- huge impact on our nation and the course of history, and later on in 1999, i was up here, campaigning with billy sheen for al gore, never in my maiming nation really did -- imagination really did i think that five years later i'd be up here with some of those same people on my own journey because i thought al gore would win, we'd have eight years, and that would be that, but we all know what happened remembering tim russert and florida, florida,

florida changed the course for all 6 us and the course of the country, and i'll never forget all the personal parts of campaigning up here, traveling around in a too tight van with nick clemons and nick robinson, tooling around the city and listening to their bravado stories about their nights at the irish rover, a well-known bar here. [laughter] so that i was left in the morning, you know, driving around. i was struggling with the frost heaves, and they were struggling with the dry heaves -- [laughter] but that's another story, we won't do that one tonight -- [laughter] what stood out to me and still stands out to me as i come out here tonight is the sense of loyalty. the loyalty is amazing.

when new hampshire makes up their mind, believe me, their your friend for life, and when they make up their mind, they go the distance, and they are tough in the making up of their minds, and that's the beauty of what happens up here in new hampshire. i'll never forget visiting with the fire house and dave came on board early, and ultimately the firefighters came on board, and we had the incredible chili feeds you heard about which confounds me still to this day, i think wikileaks as happen insight to everything in government, but they don't have dave's recipe to chili yet. i don't know what's going on, dave, but it's a well kept secret. i feel guilty about that now because michelle obama is trying to campaign on good nutrition, and there's kerry serving 25,000 pounds of chili, not a good standard, but it got me to where we needed to go. [laughter] the truth is that loyalty was

carried on by a fellly by the name of bob banes who after his own campaign kept his promise to me made way back when i was front runner said i'll endorse you, but waiting until my campaign is over, begin every reason in the world, and bob could have taken the duck, but he didn't. he came out and stood up and endorsed me like he said, and he fought like hell to help us turn things around. similarly, right about the same time, the person who introduced me, your senator shaheen, came on board as the national chairwoman at a time it was tough, helped me make some tough decisions that began to turn things around, and i'll never forget going to the vfw hall in dover where bill clinton gave his last dog die speech, and it was said, you know, something

about and talking about dead dogs, here's the harry campaign, and we have this to say. [laughter] it was about the same time, i remember a supporter said to me r you know, the reason i support you is because you look like the old man on the mountain. [laughter] a week later, the old man on the mountain fell. [laughter] i said this is not a good oh men. [laughter] a couple days later, a couple days later, my campaign pollsters said, you know, the only way to win new hampshire is to save a drowning baby in the river. i decided differently. i believed in what you believe in. i will never forget the images people sitting cross legged in houses taking notes, writing down what you said, comparing it to what you had said a month ago, asking the tough follow-up questions, coming after you, an extraordinary process, where people really looked inside your

gut, your heart, your soul, and made a measurement about you, as individual as a human being and made a different kind of judgment from all the advertisements and prognosticators and the pundits. that's the value of new hampshire, and that's the value that i think is precious to the entire process of how we choose even a president of the united states in this country. i say that to you at a time when we are troubled. john mccain and i spent a lot of time together trying to get democracy in libya or in egypt or berma and other places, but he'd agree with me we have a challenge to improve our own democracy right here in the united states of america. we have to get rid of this shrill, almost desert of

dialogue, if you want to call it that. it is shocking to me that the degree to which critical issues facing our time today are lost in a sort of parallel universe so little to do with people's lives and so little to do with the challenges we face as a country. i know we can get there. john mccain knows we can get there. they know we can get there. the question in the next days is whether or not we're going to be able to find the critical mass that puts country ahead of party, that gets rid of, you know, looking for the facts and makes common sense decisions. the reason i know we can do that is to end by telling a quick story. late 1980s, early 1990s, john mccain and i decided that we really thought it was time to make peace in vietnam. may sound strange to some of

you, but it was a time the pow was criss crossing the country and had a sense people were left behind. it was a big question mark, and here was a place where there's many ways in the hearts and minds of people that we were still at war, and john and i understood that, and we thought that our interests, that our nation's interest, that our future lay in trying to get that behind us and in moving on, so john and i banded together, and improbable twosome who had differences over the war, but who found the common path to work for the interest of our country, and for ten years we slugged it out against some people who actually challenged john's senator, labeled him the candidate, challenged his patriotism, the man who spent six years in a prison, and that's what we faced. ultimately, john and i found our way back to vietnam together,

and i will never forget standing in the prison where john was held for a period of time, standing in the very cell that he had been imprisoned in, alone, just the two of us, as he described to me some of what had happened, and at that moment, i said -- i sort of felt to myself, and i thought about it a lot afterwards. you know, if we two can get over our feelings about the war and get over the difference of an arizona republican and a massachusetts democrat, we can come together to try to do what we're doing here and find commonground, then all the rest of these things ought to be easy because they're in the greater interest of our country. when ben franklin walked down the steps of constitution hall, a woman walked up to him and said after they'd finish their work, designing our nation, she said, what do we have dr. franklin? a monarchy or a republic?

he looked at her and said, a republic if you can keep it. that's the work that we face today, and i am very, very proud to be engaged in that work with john mccain, and with others in the senate, people who want to reach across and find not just the commonground, but find the higher ground. that's what builds our nation. the history of the senate is a place where people disagreed and great partisanship. people could have different ideologies and beliefs, but when the nation's interests were at stake, those people found a way to come together and put those interests ahead of all else. i think that new hampshire is going to contribute humanly to the effort to help us do that once again in this presidential race. i think david broder said perhaps in the bible there was a

line that said and new hampshire shall lead. [laughter] amen. i believe it will. thank you for the pleasure of being here. [applause] [applause] [applause] >> okay. if you will direct your attention, again, to the video monitors. >> you can want -- cannot buy an election in the state of new hampshire, my friends. >> he invented the town hall style of campaigning. >> working hard for you. >> he just has a way about him. there's something beyond charisma. >> thank you very much. >> too many politicians are too scripted all of the time, and the sort of format of new

hampshire, how you interact with voters was tailor made for a guy like mccain. >> but before he became new hampshire's mccain, he was gist a senator in arizona, and in the days of 1999, that didn't mean much to primary vote voters. >> a little difficulty getting them to come out. free ice cream, and we had 13 people. >> to jump start things, they turned to veteran, and students, and the latter providing a funny moment in a trip to king state. >> he's doing his five minute speech, topic of the day, opens it up to questions, the very first question from a college student was, will you please tell me your position on hemp? john mccain was truly flustered. he's looked around, and he says, you're going to have to be more specific. the only thing i know about hemp is that you make rope out of it, and that's what we usedded in

the navy. [laughter] >> well, there's lots of stories. >> another student had the gal to ask him if he had the energy for a campaign. >> thanks for the question, you little jerk. [laughter] >> it was that kind of humor that was turning the tide in john mccain's favor. i'm not exaggerating when i tell you a man came and told me he had been to five of my town hall meetings, which i also alleged was a testimony to my inability to close the deal. [laughter] >> turns out he was closing more deals than he thought, and by late summer of 1999, the momentum was building. >> it was month by month rising of three to four points,. >> i had a small gathering at my house, promised to have at least 20 people, and low and behold, over 150 people came. i'm going, what kind of -- >> 400 people lined up for

arizona senator john mccain's book signing. >> what's surprising and shocking about that is that we had a campaign plan, we followed it, and very little, if anything, took us off our game. [cheers and applause] >> come primary night, 2000, the evening was his. >> thank you very much. thank you and god bless, and welcome to our 115th town hall meeting here in new hampshire. [cheers and applause] >> i don't think too many of us were surprised the next day. we were surprised at the percentage of the votes, but we could feel -- >> it would go down as a textbook primary win, but then came 2007, and this time around, things were different. >> nice to see you, you haven't aged a bit since we did this in 2000. >> the first half of 2007 was a difficult time for everyone

involved in the campaign, especially john. [inaudible conversations] >> we department have to introduce john now. everybody knew john, and he was probably more under the microscope. the questions were tougher, and the crowds were bigger. >> along with the crowds, the campaign staff grew as well. >> they set up the apparatus of 150-160 people that you needed in washington. we had the offices, geared up for it, and then quite frankly, the fundraising was not there. it became pretty clear that we were spending at one level and we were raising at a lower level. >> a lot of people, more people were hired than should have been hired. you know, had this for all intensive purpose, a big bureaucracy of a campaign. >> at one point, it seemed the mccain campaign would not survive, and the reporters smelled blood in the water. >> one asked under what circumstances would you drop out? john mccain uttered the line only if i succumb to a fatal

disease before the primary. >> it was around that time the man known for straight talk wanted some of his own from his pomp advisers including walter peterson. it was a reckoning of sorts that didn't start well. >> everybody's going back and forth saying we should be doing this and that. >> that was a tough meeting because john was looking for very honest advice, although, he had his mind made up, i think, that he was going to stick it out because mccain is not a quitter, but hearing governor peterson and other folks reaffirm he couldn't win was really a very sort of poignant moment. >> he knew how to run in new hampshire, and he knew what he needed to do, and it was just the smartest thing he could have done, just going back to basics. [inaudible conversations] >> thanks very much. >> after focusing on new hampshire once again, things started to shift in the fall of 2007. >> people were starting to

listen. they said, hey, he was not dropped out. >> i talk to the people of nemplegz. i reasoned with you. i listened to you. i answered you. sometimes i argued with you. [laughter] >> by primary night, 2008, john mccain would stand tall once again, and while the bid falls short of the white house, his new hampshire connection was set in granite. >> he's done as much for the primary out here in new hampshire, the first in the nation primary as ever has. >> he's a remarkable person. one of the great honor of my life. he's one of my friends. >> i don't know if this will make the cut or not, but, john, i love you, i hope you have another 75 years, keep smiling and keep shining. ♪ [applause] >> to present our third award tonight, please welcome united

states senator kelly ayott. [applause] >> it is really an honor and it's overwhelming to be here with all of you tonight, and so many of you have worked so hard to preserve the first-in-the-nation primary, and truely an hop nor to give this -- honor, and my colleague, john kerry, very well deserved, and it's an honor to serve with you in the united states senate. it's very much -- it's surreal actually to be up here tonight to give this award to john mccain, someone who i have such great personal admiration for.

john has an extraordinary record of service to the people of this country and a long history with the people of new hampshire, and i thought about it, and i don't think you can understand or appreciate that special relationship and why new hampshire took to john mccain so much without an understanding a little about john's background. he comes from an extraordinary family, a distinguishedded military family -- distinguished military family with four generations of naval academy graduates. his grandfather was an admiral serving commander of a carrier force in world war ii. his father was commander in chief of the pacific forces in the vietnam war. his son, jack, is a naval academy graduate who now flies helicopters in the navy, but breaking ranks is his son, jimmy, who enlisted in the marines and served in iraq. finally, someone in the mccain family made something of themselves.

[laughter] john's own service as a pilot in the navy and his character is what drew so many in new hampshire to want to meet him. you will also find a veteran as a mccain town hall meeting. we all have come to admire mccain for his bravery, courage, and his integrity. he spent five and a half years imprisoned in vietnam, tortured by his captors, and when he was offered early release because of who his father was, he refused. john mccain puts principle first. just one example -- based on his own personal experience, john mccain bought members of his own party and spoke out against torture, leading to the effort to pass the detainee treatment act to ensure we live within our

values. [applause] john mccain never hesitated to do what he thought was right rather than what is politically expedient. a rare individual in politics. new hampshire's the place where his commitment to truth and politics found a name, straight talk. it was traveling across the state on his straight talk express that senator mccain's unique brand of candor and politics caught fire with very discerning new hampshire primary voters, not once, but twice. senator mccain would become a primary legend, and in my view, new hampshire's de facto third senator, was far from certain when he started campaigning home in 1999. with texas governor, george bush, wrapping up endorsements,

leading early in polls, the arizona senator faced an uphill climb, but true to his character, uphill climbs don't stop john mccain. moving from town hall to town hall, john mccain made the case for reform in washington to anyone who would listen and answered every last question to he was asked. although his early town hall attendees may have shown up just for the ice cream ring they left knowing they just witnessed something rare in politics, an honest, confident, leader with integrity, who republicked their view -- respected their views even if they differed from their own. they also saw someone who was firmly committed to changes business in washington and had a record to prove it. during his first new hampshire primary, john mccain disproved what the pundits had to say and the insiders thought about the race, and he won our primary by

19 points. while he may not have gone on to win the nomination that year, senator mccain left a lasting mark on new hampshire politics. since 2000, the free flowing meetings have been the hallmark of the new hampshire primary. to be taken seriously by voters here, you have to be completely accessible, can't get away with sound bites or poll driven answers. you have to go voter to voter, house party to house party, town hall to town hall, and meet the people of the state of new hampshire. agent years later the people of new hampshire and john mccain once again proved the pundits wrong when john made one of the greatest come backs in political history. they talk about bill clinton being the come back kid, john mccain is the come back kid in new hampshire. after being the early front

runner in 2008, john literally fell to being fifth in a four-person race. he was out of money, carrying his own bags, he was hoping steve would pick him up at the airport so he'd have a ride, and the media declared his candidacy dead, but he came to new hampshire, and he went town to town, voter to voter, and the crowds at the town halls grew from a handful to dozens to hundreds, and the people of new hampshire listened once again to the man that everyone had written off. so many of us have personal memories of our time with john mccain. for me, it was during my own primary. i did my first town hall meeting with john mccain, and i went home that night and i said to my husband, i said, even if i lose that race, that was the experience of a lifetime, to stand on the stage with jun

mccain. i would like to share with you an especially moving story from the campaign in 2008. after a town hall meeting, the mother of corporal matthew stanley who died serving in iraq asked senator mccain to wear a bracelet bearing her son's name. senator mccain promised to do everything in his pour to make sure that his death was not in vain, and true to his word, when so many others wanted to give up in iraq, john mccain stood up for the surge in iraq and said we can succeed even when it's not popular to do so, and i know senator mccain still wears corporal stanley's bracelet today. in 2008, the people of new hampshire again saw john mccain's character, his integrity, and when the results were in, senator mccain's powerful message of reform beat out money, defied washington's

conventional wisdom, and, again, propelled john mccain to victory in our primary. eventually, of course, he became our republican nominee. we were proud to have that role here as the first in the nation primary to propel him to that victory. [applause] a new hampshire primary has no greater friend in the republican party than my colleague, john mccain. when our first in the nation status has been threatened by bigger states, john has shown in word and in deed why new hampshire must remain first. for that, and for his decades of distinguished service to our country, i am very honored to award him tonight with the first in the nation primary award, and i just want to say on a perm note, i consider john mckane a

men -- john mccain, a mentor, someone today still working very hard to reform washington, and it is my privilege tonight to introduce john mccain. [applause] [applause] >> thank you. [inaudible conversations] >> well, thank you very much, kelly, for those kind words and that wonderful introduction, and i'm very pleased and proud to tell you that you have kelly ayotte and jean shaheen both serving on the senate arms

service committee fighting every day for the men and women serving in our mail tear. they -- military. they make a great team together, and i know new new hampshire can be very proud of them and their service to the country. i thank you, kelly, for your kind words, and thank you, jean, for your wonderful service to the state of new hampshire, thank you. [applause] so i have to begin by asking your sympathy for the families of the state of arizona because barry goldwater from arizona ran for president of the united states, and morris udall, and bruce babbit, and i ran for president all from arizona. this may be the only state that mothers don't tell their children that they can grow up and be president of the united states. [laughter]

[applause] i'm very honored to be here with my friend, john kerry. i was thinking as he was talking, when he and i first came to the senate not too far apart, there was a number of senators who had served in the vietnam war, and i guess at the beginning of 2013, they'll just be two of us remaining. i would, again, point out that our effort on behalf of normalization of relations between the united states of america was driven by the fact that back in that time into the 80s, a war was over in 73, but into the 80s and even into the 1990s, the wounds of that war were still fresh and unfortunately still divided our country and in many respects, prevented a lot of our vietnam veterans from coming all the way home. i'm very proud of the work that john and i did, and to show you

that if you live long enough, most anything can happen. there's a destroyer based in japan named after my father and my grandfather named john mccain, and last september, it paid a port visit to the port of denang that shows if you live long enough, anything can happen, especially if the chinese are behaving the way they are, but any way -- [laughter] barry goldwater said if i was elected and beaten his as, colorful language, you wouldn't have spent all those years in a prison camp. i said, you're right, barry, it would have been a chinese camp. [laughter] he was not amused. [laughter] josh, thank you for your moving words about your dad. i'll never forget it being a

freshman member of congress one day, and your dad came to my office, and i was literally tongue tied. i was so honored to meet the great david broder, and i think one of the things that you could be very proud of in this day of polarized media of msnbc and fox and back and forth, i could not tell you to this day whether dad broedr was a democrat, republican, libertarian or vegetarian. [laughter] he judged and reported on american politics with total and complete objectivity, and i know that you're proud of him, and, dan, you are carrying on in that tradition. i suspect you are a vegetarian, but anyway -- [laughter] and charlie bass and frank, thank you for your continued service, and i cannot come here without mentioning thee lovable

joe, and thank you for your continued direction, guidance, and insults -- lz as we try to -- [laughter] as we try to win the affection of the voters of new hampshire. thank you for your kind words, and thank you for your years of friendship. governor lynch, you know, he's unique fellow. i had a town haul meeting in hoppington, and he brought his daughter, and i was honored that he would be there. i think that he proved that you can govern with the approval of people of all parts of the ideological spectrum, and john, we appreciate your outstanding service as governor, which moves me then to tell the story of the two inmates in the state prison in the chow line, and one of them turned to the other and said the food was a lot better

in here when you were governor. [laughter] and you can't tell that joke in illinois, i'll tell you that. [laughter] other several other states. [laughter] bill, thank you for your steadfast advocacy and support of the first-in-the-nation status. a lot of would be candidates for president visit me, and i say if you really want to understand a little bit about new hampshire, you should read that wonderful book that bill has written about first-in-the-nation, and it's said, if you're a united states senator, unless you are under indictment or detoxification, you automatically consider yourself for a candidate for president of the united states, and i can't conclude without

mentioning that my beloved friend warren redman, we cherish his continued service and hope and pray for his good health as we know he's been having some of those problems lately. hugh greg, an institution here in new hampshire and a great guy. walter peterson, who continued to give me and all of us leadership and guidance throughout the years that we had the wonderful opportunity of being in his presence. i can only say to you from the bottom of my heart that i've been probably the luckiest person that you'll ever have the opportunity of knowing. i've had such great good forchip in my life to be able to be a part of this great nation and a part of the incredible experience of running for

president of the united states, but my fondest memories frankly will be of the experiences i've had here in new hampshire because it's such a unique place and the people are so unique. they believe we live free or die. they believe that they should examine every candidates they not only take it as a privilege, but they take it as responsibility, and it's. my great honor to meet some of the most wonderful acquaint acquaintances in the campaigns with so many wonderful people, and what you have done has contributed enormously to the democracy that people all over the world today in this thing they call the arab spring are looking at and want to emulate and want to be like, and i guarantee you that in the next

election, there will be people from libya and egypt and hopefully syria and other countries around the world who will be coming here because they were inspired by the example of the united states of america and what you do here in the great state of new hampshire. thank you and god bless. [applause] [applause] >> thank you, senator mccain and senator kerry. for the next 15 minutes, dan balz is going to facilitate a little discussion about those experiences during their presidential primary campaigns. ..