ousands and even millions of lives lost and dollars spent. these are things that dr. burke and others work on all the time. chairman, also in defense appropriations and judiciary, but we wanted to be here. you've all worked -- every one of you work so hard at this, on these issues. every one of you could find much easier things to tackle and i applaud you all. we've known each other for a number of years and you can sit back and just relax and say you're out pushing us all the time, and i don't want to say anything about pastor warren going after us on a moral issue, but a good pastor spoke to me about where our conscious should be on more than one occasion,

and that's important, but doctors, the expertise you bring, we need it. i'll hush up for these people, but i'm glad you're doing this, chairman. >> thank you, thank you for being a good partner here. madam ambassador lead us off. >> thank you, chairman graham and ranking member leahy and i'm honored to appear before you today, particularly this committee today, providing visionary leadership of the united states president's emergency relief plan since 2003. millions of men, women and children are alive today because of the compassion and bipartisan commitment of congress and president obama and the true generosity of american people. as you saw first hand and as the chairman mentioned, it's not

just a transformative global health program but an outstanding expression of american diplomacy. i'm privilege to be joined today by three great leaders in the global hiv/aids response. ambassador mark, whose steward stewardship has been extraordinary. pastor rick warren a voice of compassion for those affected by the epidemic. and sir elton john, a powerful advocate for those living with hiv/aids for decade. they have change the the very trajectory of the hiv/aids pandemic. at its core, they offered hope and healing and the possibility of health and prosperity in the place of sickness suffering, and death. today because of this 7.7 men, women, and children receive life saving treatment, and more than a million babies have been born hiv free. 6.7 million voluntary medical

mail circumcisions have been performed, and success has mentioned by the chairman is within our collective grasp. if we all focus accelerate, and sustain our efforts, they have deliberately strengthened all aspects of the health systems, not only supporting people who live with hiv/aids but programs around maternal child health and global health security, yet work as mentioned is far from done. every week nearly 40,000 people are infected with hiv, 7,000 of them young women. with the millions of young women enter the window of the most susceptibility of infection. we have to work diligently right now to get and stay ahead of this epidemic. according to u.p. aids if we do not act now, estimated 28 million new hiv infections by 2030. more infections than any global resources can support. actions taken over the next five

years will be critical. coordinated efforts could reduce the number of hiv infections to over 00,000 per year by 2030. as compared to our current trajectory, which is unthinkable of 2.5 million new infections per year, so they are pivoting, using a granular, yet transparent data driven approach to target evidence-based interventions to the highest burdened populations and geographic areas for maximum impact of every u.s. dollar, making this pivot is not an easy thing. it is the right thing. it will prevent new infections and lead to control of the epidemic. earlier this year, we launched a stainability index to provide an annual snapshot of the elements central to sustaining and controlling this epidemic including critical contributions partner countries are making towards their national response.

it leverages expertise of the whole united states government civil society, faith based organizations, and other partners including the private sector to address the glaring gaps in treatment and prevention. the hiv/aids treatment initiative or act is a $2 million partnership with the children's investment fund foundation to reach and treat 300,000 additional children living with hiv/aids by the end of 2016. dreams standing for determined resilient empowered aids free mentored and safe young women is a 2 10 million dollar partnership with the bill and me linda gates foundation and nike foundation to prevent hiv infection in adolescent girls and young women. finally, we can want control the epidemic without putting an end to the stigma and discrimination that force people living with and at risk for hiv aids to the very margins. all people need accesses to

services including key populations. at this critical time in the aids response, we know what needs to be done, and we have the tools to do it. the continued leadership of the united states is vital to ensuring that beachieve an aids free generation because the alternative is unthinkable. chairman graham, ranking member, members of the subcommittee the uncharted terrain will test resolve, but i'm confident we reach destination and ways in which we focus, strengthen, and accelerating the efforts and partnerships will has p our arrival. thank you again for the opportunity to to be here before you today. i'm foundly grateful for your ongoing and continuous unwaivering support of the sub committee. i look forward to your questions. >> thank you very much. i'd like to mention that bono could not be here today, wanted

to be, but he's had a very difficult accident, doing better but i want to recognize his contribution to the cause and communicated to me several times regretting not being here, but it's one the anchor ten innocents here worldwide, so i recognize the fact he's with us in spirit. >> that's right. i interject there. he's also kept a good sense of humor when i called him dr after the accident, back in dublin he said well, the fellow members of the band said it's a good thing he was wearing a helmet so he did not damage the sidewalks of new york. [ laughter ] >> okay just like that. mark? >> thank you very much mr. chairman. chairman graham, ranking member leahy leahy, thank you for the leadership. this committee, this chamber, this congress, and two administrations reached across party lines to reach those in need.

your compassion and insight reflect the best of the american people. you've changed the landscape from working to end death to we're being on brink of ending three plagues two around since recorded medical history in modern black death on the path to extinction. while building resilient economies, thank you, also, for including me in the panel. it's humbling to be here with a world famous preacher, performer, and expert scientist. all friends for years and i'll do my best to make three points. strengthen partnership, shared responsibility, and drive innovation innovation. advances in science, which i know you heard about before, and also the experience of the invest ment investment made over the last 15 years, on the brink of ending tuberculosis, around since

recorded medical history, and hiv/aids in the path to be not the epidemics anymore. to end them as public health threats. with your leadership that occurs of the new infections dropped dramatically. for example, 55 countries, 55 countries are on the path by the end of next year to reduce malaria by 75%. 26 of them on the path to elimination. it's been remarkable progress in reducing deaths. we now have a clear choice as ambassador pointed out, we can accelerate towards the goal of ending the epidemics or risk resurgence by undermining your investments of the last 15 years. the global funds contributed to the progress. we raised $4 billion a year in part to your generosity and contributed to 7 million people on treatment, and 12 million tested and treated for

tuberculosis and millions of bed nets distributed. global fund is the large funder much tb and exterm financing, and efforts are incredibly important. as the chairman pointed out, beyond the health of individuals, these diseases have enormous impact on economic loss in the developing world. for example, it's estimated that nigeria alone losing 3.5 billion dollars per year in its gdp because of malaria. the reality is healthy productive people make healthy productive nations and good trading partners. not just an issue of public health, but ending these diseases. as we pointed out, you pointed out, by working together, we can bring out the best in humanity. collect commitment changes the course of history ending the epidemics while lifting up human beings and lifting up those left behind and marginalized.

ambassador burke mentioned young women. young women are five to ten times more likely to be infected than young boys five to ten times more likely. they are driving the epidemic, and with the youth increase, there's risk of explosion undermining the progress made but new data suggests if we can work just to support and keep girls in school, hiv rates drop by 60%. if those girls stay in school, they do not get married early, pregnant early, but have economic opportunity to reinvest in education nutrition, and bringing opportunity to their children. we work closely with the dreams initiative usaid and others to intervene here to fundamentally change the course of the girls' history. investments in hiv tb, and malaria over the past decade bring a positive effect on overall health systems as well including responses to ebola. i was recently in sin gal, and women were trained to go

door-to-door in malaria, going door-to-door to prevent and fight ebola. how do we achieve the lofty goals of building resilient health systems in societies? through partnership. the goebl fund is probably the world's largest public-private partnership. we are the public-private partnership arm of the u.s. government's response to the diseases, and we work closely with ambassador burke's president's malaria initiative and others. for every dollar the u.s. crypts to the global fund, we leverage $22 from over 25 countries european commission, private foundations, corporations and the faith community. as part of the funds new approach to financing we require countries to match what we invest in what we invest in and lock resources. so far we have leveraged 3.9 billion dollars in the past two years in order to increase country's own contribution to

fighting their epidemics and as we know based on reports countries are now investing more in hiv than the external financing, which is pretty remarkable happening since 2012 and long provided 80% of the financing for tuberculosis and more for malaria. it's critical and private sector is as well. the global fund had billions donated, and bill and melinda gates, and bono, corporate partners contributing over $300 million. we are accessing high network individuals like countries from south africa, vietnam and commitments of over 100 million from the individuals, and we are working to get more. the faith community has dope a remarkable job with implementers where we fund 73% of them but also as funders, they church

handed over a check of $9 million last week up on the hill and rick warren did a great job advancing the disease fight against the disease, and people like elton john are deep in the community to ensure that those left behind those people in the community are not left behind. the private sector not only gives money, but partners with us to do things, coca-cola works with us to ensure distribution, who better to work with on distribution than drugs and commodities to get to people? we reduce the price of commodities. in two years through an initiative called an initiative we've launched, saving $500 million by veteran negotiations. now that's value for money. mr. chairman ranking member leahy and distinguished members, you are the leaders to make it happen. thank you for the support, ab we look forward to working with you and serving with you as your public-private partnership arm to fight diseases. >> dr. warren.

>> chairman graham, ranking member leahy members of the subcommittee thank you for inviting me to testify here today, and i have so much respect and admiration to you all, and agree the 150 account is probably the most effective account in the united states' budget, and it matters to the world and it's a matter of life and death to millions of people around the world. i'm founder of the global peace plan sending teams to 197 countries. i've sent, in my own church 24,000 of my members, serving in 19 7 countries, which is 57 more than the peace corp. has served. by the way before i address a matter of global health but thank you for the previous hearing on protecting religious

liberty abroad. it's a big issue, and i spoke to that in my printed remarks. as you know pr hearings previously, we are making progress on hiv, malaria, and tb, and while the momentum is headed in the right direction, now is the time to move for eradication eradication. a lot of times in the third quarter of a game, people say well, we know how the outcome's going to happen. let off the pedal and they'll leave the game. we can't do that now. the super bowl's a good example of what happens in the last second of the game. and i believe that it will take three catalytic factors in order to eradicate hiv, malaria, and tb. first, we must form a new perspective on foreign assistance. second, we must forge a new spertective, new partnership in distribution. and third we must fund a new

priority in the budget which would include ending sequestering. i covered this in detail in the written testimony. i want to spend most of the time on partnerships and new distribution, but i have to make a comment on forming a new perspective on assistance. there are voices today who sincerely believe we should either cut back or eliminate all foreign assistance. this idea resinates with a lot of voters for a couple reasons. first, they have no idea that this amount is actually less than 1% of the budge. they think it's a big amount. it's not. second, they don't realize the strategic value of foreign assistance. they've never considered that the right kind of a foreign assistance, especially for health, education and development may be the most effective and cost effect strategy for security against the next generation of terrorism. this is what i mean by a new perspective. now, proverb 3:27 says it's

morally wrong to hold assistance from those who need it. we have it in our power to help them. there are also strategic reasons for why. first, when america saves the lives of dying people from preventable diseases, we make friends. that's obvious. around the world i've been told please thank americans, it saved by husband's life we of wife ease life, children's lives, and kept our family from academic disaster and grateful to america, and we pray for you. when we make friends like that by saving lives, potential enemies are turned into grateful allies, and if somebody saves your life, you have zero desire to terrorize them, and in my travels, when poor countries are overwhelmed by pandemics, stuck in poverty, have no capital to create opportunities, they are graftful to resources, and resentment makings them right for angry ideologies.

so it is far more cost effective and cheaper for americans to send medicine and make frechds now than to sends troops to fight enemies later. medicines cost less than tanks and resources we budget for relief help education training, can save us from spending far, far more when resentment boils over. it's some charity that we do. it's strategically smart for america's security and safety to help people in pain. now, the second catalyst in eradicating preventable diseases is we have to forge partnerships in distribution. sometimes it -- you have to team tackle a player on a football field. he's so big, one person can't tick him down. this is where i call in to reference the three legs of the

stool. one leg of the stool falls over, a two-legal stool falls over, but three legs stand. i've been invited to speak multiple times and people say we need public and private partnerships. when i hear that, you're right, but only two-thirds of the way, you're leaving out the biggest sector, and that is the faith sector that dwarves the other two sectors. there's 600 million buddhists in the world, 800 million indues in the world, 1 preponderate 5 muslims in the world, and 2.3 billion christians in the world. the number of people without faith is small outside manhattan and parts of europe. [ laughter ] most people have a faith, and if you want to talk about distribution, you have to use faith communities. i could take you to 10 million villages around the world and only thing there is a church. in much of the world church is

the only social sector outside the capital. even if we have all the meds for tb, aids hiv, malaria and all the other diseases the issue of distribution will not be solved unless we mobilize local churches. let me just give you one illustration illustration. at the end of president bush's term of office he invited me to be the closing speaker at the global summit on malaria. i said, i'll come if i can bring pastors from africa. at the end of the talk, i stood up, i'll show you three slides that show you why you can't solve any global problem without the faith community and so i said, let me show you one example. i've been in 164 countries, and i said we went to rwanda what would you like the western province of rwanda needs health care. we went there, put up a sign a

map of rwanda, western rwanda, and i said, here's the three hospitals for about a million people. it's a two days like to any of the hospitals and that's not good enough health care. two days to get health care. now, by the way, two of the three hospitals they are faith based, so you would not have them if not for the church. put up the next slide. here, 18 clinics. i said, these 18 clinics, now it's only a day's walk, but if you've been to developing countries, a clinic is a bottle of aspirin on a shelf or less than that. i said, now that's better than three hospitals, but i said, by the way, only 16 of those are faith based, and you wouldn't have those without the church. i put up the third map covered with dots. here are the over 600 churches in the division. now, where would you like to get your health care? two days walk, one day's walk, or five minutes away? melinda gates said, i get it

rick. the church could be the distribution center for health care. i said, it has been for 2,000 years. put it in perspective. the church invented the hospital. if we're going to absolutely eradicate diseases, we have to do a combination of the public sector, the private sector and the faith sector. the three legs of the stool. again, i'd encourage if -- if there's any way to end sequestering, i'm in favor of that. there are lot of areas i think where we could cut the budget. this is an area budget that should be increased for strategic reasons. thank you. >> thank you very much, rick. sir elton john. >> thank you very much. mr. chairman, senator leahy members of the subskmeetcommittee, thank you for the opportunity to let me testify this morning. it's a very daunting task sitting at a table with three amazing people who are in the

trenches every day fighting this disease who do incredible work. i'm humbled by being here and humbled amongst the company i'm keeping. in 2003 at their invitation of senator ted kennedy, i had the honor of speaking before the senate health committee in my capacity as the founder of the elton john aids foundation. i created the foundation in 1992 to address the dying need to provide basic services and support to those dying from aids. over the past 23 years, we have raised over 321 million dollars to fund organizations that provide direct treatment and prevention efforts in dozens of countries around the globe. the first time i testified before congress 12 years ago, almost no one had access to medicine in africa where the epidemic was most acute. people were being infected and

dying by the millions even though we very literally had the drugs to save their lives in our hands. at that point 12 million children in africa had been orphaned by aids. african leaders declared aids to be a state of merge worldwide more than 30 million people were hiv positive. the disease left nothing but dispair, ruin and fear in its wake. i saw it with my own eyes as i traveled to the hardest hit regions on behalf of my foundations. without funds needed to make life saving drugs available in africa, my foundation invested in dramatically expanding care and a hospital network. across south africa, uganda and kenya, we gave a dignified death to more than 800,000 men, women, and children. and then we provided food, shelter, and basic education to over 3 million orphans left in

their wake. it was a compassionate response, but it did not solve the problem. in those years, the epidemic was only escalating until in a time of great need and ur jengency, a republican president and democratic majority created pep. the emergency plan for aids relief. leaders from both sides of the aisle said america can and america will lead the world in the global fight against aids. today, thanks to the unprecedented actions of congress an hiv positive mother in south africa can give birth to a healthy hiv free baby who can live to be raised. today, thanks tots generosity of the american people, 9.4 million

men, women, and children have access to live saving antiviral treatment. where there was dispair, ruin and fear, there is now hope life, laughter, and love. it's done more than just save lives, but provided basic infrastructure and trained more than 100,000 health care workers to prevent future outbreaks in countries like botswana, tans knee ya, kenya and uganda. congress's strong support for the global fund for aids, tb, and malaria enabled it to generate investments from governments and corporations worldwide and leverage $2 for every $1 invested by the united states, thereby expanding its reach and impact. i'm grateful this has included up to 1 billion pounds from the united kingdom over the last three years. for my foundation too, the leadership is transformational. way we once invested in hospice

care for the dying is now repurposed to treat the living. they had over 3 million people and linked more than 4 u,000 parents to life saving treatment on the continent since 2012. combined with efforts by the united states, we contributed to the 48 % global reduction in mother to child transmission of hiv. in short we are no longer bailing out a sinking ship but helping steer it into a safe harbor harbor. mr. chairman, because of the actions of this congress, the course of the aids epidemic was altered for all of humanity. because the american people had the optimism, ingenuity, and the will to make a difference, the lives of a million people around the world have been saved. i'm here today with a simple message. the aids epidemic is not over,

and america's continued leadership is critical. there is a window of opportunity before us, a window through which we can very clearly see the end of aids within my lifetime. we cannot afford to let the window close. if our efforts flag drug resistance will surface, transmission rates will rise, and this disease which knows no boundaries will once again become a ruthless pandemic with disastrous and far reaching consequences. i have stood at too many bed sides in america, england, and across africa watching people die in pay. to bear the thought of going back to those dark days is unthinkable. on the other hand, if we continue the historic work of the global fund, if we honor the ho 40 million lives lost over three decades, we can and will see the

day where aids is no longer a horrifying global killer, but contained and controlled chronic illness. mr. chairman, this is the most powerful legislative body in the world. this congress, indeed, has the power to end aids. you have the power to maintain america's historic commitment to leading to the global campaign against this disease. i'm here today to ask you to use that power, to seize this window of opportunity, to change the course of history and one day soon, i hope to extend my thanks to you to this congress to the united states of america, not only for fighting this disease, but for ending it once and for all. thank you. >> and end it right on time. amazing. [ laughter ] after this how would you like to vote against this account? [ laughter ] what would you say? the terrorists want you to vote?

i guess that's the only thing i can think about. anyway mark, name countries that could do more that are not. >> thank you, mr. chairman. it's a long list, and i came from one china actually last night, they once received sources from the global fund, but now are giving. >> could they do more? >> they can and we're working to invest with them. >> what about the gulf countries? >> they could definitely do considerably more in the fight against the three diseases. parts of southeast asia, tieland is transitioning from a support from a recipient of the global fund -- >> we're not asking people to give who got their own problems but talking about people with economic ability to give that are not. >> well these countries do have considerable economic ability, and they are stepping up. >> what about europe? >> howeurope is doing well in a number of places, and the u.k.

sir elton john -- >> where is germany? >> germany increasing commitment as is currently number five or six, japan is number five. >> in terms of economic power in europe, how does germany rank? >> well, they are certainly number one. >> so they are number five in giving, number -- >> through the global fund, they increased significantly their commitment, for example, and increased commitment to us and made commitment to do more. >> okay. thank you very much. >> rick, these churches, new distribution network will you take anybody that comes? >> absolutely, in fact after i made that presentation at president bush's malaria conference, i said we're going to prove i can do it faster, than any ngo or government. i went to the area of rwanda, and i asked pastors, i said, are you interested in us training your people in basic health care

because you'll never have a doctor in your village, never enough doctors for every village in the world. 18 pastors said yes. i said grab two people from your congregation, and we'll start training them in basic health care. the muslims came to us train us. we said, sure. this is a human issue, not a religious issue. you pick two out of your mosques. two mosques chose people to be trained. that group grew to 60, and we trained them to 100 and 20 120, and then 340, on and on multiplying this last august, i went to that area of rwanda doing a rally of over 3,000 trained health care workers who visited seven families a week, making hospital calls making house visits and we did that with very little money. these people are saying we -- we started off with simple stuff like washing our hands and hang

out the sheets to dry, and how to do sanitation and dressing wounds stitching a wound but they know how to administer and do peer -- what's the word i want? peer coaching to ensure they do their compliance with the drugs. it can be done, and now we have many other countries asking for the same model. >> madam ambassador what will sequestering do to our ability to get this thing put away in terms of aids and how would that affect the program if we'd fully implement sequestering? >> well, i think you heard from my testimony we are doing everything that ke with to focus every dollar we have because there's always more need than there are dollars. we take a strong responsibility on ensuring we focus the dollars we have optimally. any cut in those dollars --

>> do you know how much the program would be cut by 2021? >> you have mentioned it would be extraordinary. >> i want you to find a number and tell me. if you don't know the number you need to know it. >> we can find it and get it for you. >> yeah. i want everybody at the global fund, tell me what the number is. i want to tell my colleagues, there's x dollars today and y dollars tomorrow and this is what it means. you should know these numbers because they are dramatic. sir john, you have been following the battle for a long time and say we're close. what's the worst fear? >> the worst fear is stigma to me to be honest with you. we are saying especially in africa countries the lgbt community suffering under draconian laws. when people like that who are suffering from hiv a penalized

they go underground and the disease is spread even further. stigmatizeing people because they have hiv is the worst thing one can do. that's the -- for me the biggest problem we face. once we get people on drugs it's fantastic, but getting people to feel unashamed, to feel that they are okay with this virus, and not to feel as if they are threatened by their own governments because they maybe have a sexual orientation that the leader of the government does not approve of is incredibly important, not just a human crime, but it is a medical crime as well. there's to sides to the copy. one, you're telling people they are worthless, and two, people who are worthless are sick saying they are not treatable. you drive them underground. you make them feel worthless and making -- my whole thing with my organization, my foundation, is nobody should be left behind.

listen, we live in a world which is so materialistic, narcissistic. the world needs compassion and leaders to show compassion and the current pope is someone i revere very much because he's showing compassion in a humane way than the two predecessors did. this is vital to the recovery of self-belief, self-worth in this world. if people are toll they are worthless and upnloved where are we as human beings? if christ was alive today, and i believe in christ, he would be apalled how people are stigma stigmatize stigmatized. people need to be included to feel love and feel compassion. without that ingredient in the mixture of medicine and everything else, then we face an ongoing battle. i really encourage governments throughout the world who are saying that homosexuality is a sin, everything like that they are making their disease worse in the long consequences for

that for their country, their economy is going to suffer, and the disease will spread further. it's inhumane. it's inhumane for people suffering from this disease. >> from a private sector point of view have you been able to raise adequate funds even though the economy is crippled throughout the world? are people still giving? >> they are. we have many many other rivals and very, very, you know there's a lot of people suffering from many diseases. as far as this is done, it's treated malaria tb, and it -- the more you teach people -- rick said to train people to train in countries where they have not got enough medical staff, if you train people to -- in africa, for example, when we started, people are not used to taking a pill. they are not used to that. they are used to having a local healer give them something, so it's a matter of education. i think once you tell people, if i have an event, tell people, look, this is what we do, build somewhere to educate people or

mothers to mothers transmission, and you can see this is improve ing the knowledge of the disease, the treem you give people, then people dip into their pockets and i think when we started it off with this disease, there were so many foundations. there's not as many standing but we all work together, and i think we're a very strong force, a force for good, and i think we had a -- we had a meeting last night, and the feeling i get from the american people is so touching. you have to remember i'm british, i've come here in 19 70 and this country gave everything to me as a professional musician and gave everything to me as a human being, and the strength and the willingness to help people and the rest of the world touched me so much. it was ryan wade who pointed out to me that my life was a disorder. i was a drug addict

self-abscessed ass hole. excuse me. ryan and his wonderful family turned my life around because he was a young boy who had aids. he was a hemophiliac he was treated very badly by people who were ignorant and should have known better but he was not angry about it. he forgave. we have to have compassion. we have to have forgiveness. we have to have inclusion of everybody whether it's drug user users users, prisoners, people who are gay, transgender people, we are all human beings and children of god. if we throw that away, then we're throwing everything down the drain, so my you know, when i explain this to people, and people are good people. i believe in the goodness of the human spirit. look at this room here, for example, and we do not have problems raising money. that's a long winded answer to the question, but, no, people are generous, explain where the money is going, show them what

it's doing, they dip into their pockets. >> thank you senator. >> thank you, mr. chairman. i -- i didn't think it was long winded at all. something to be heard over and over and over again. this one thing ambassador questions have been asked on dollars, please give us -- be very honest and direct in what some of the cuts would count. tim was in my office who has worked on this and others are more knowledgeable in the nitty-gritty than i am but the numbers i see are devastating. they are devastating and they are not anywhere near the numbers that we in a bipartisan way have supported in the past,

so don't sugar coat it. make it very clear. sir elton, you talked about how much less expensive it is for prevention than care for after the fact and, well, i know pastor warren and i talked about this before, and you were mentioning about holeding a quilt when you were speaking last night, and my dear friend i grew up with from vermont, and when he was diagnosed, and he was actually a public figure rest his soul, he -- when he was first diagnosed, i remember being osterized. my wife and i came to a large gathering, and people were trying to avoid him. this was some years back. my wife is a registered nurse.

chef walk she walked up and gave him a big hug and a kiss. up until he died, that changed his wife. until that people avoided him. people knew my wife. she's a lot more popular in vermont than i am. [ laughter ] they saw her do that and they went up and so keep on pointing that out, it's just not long winded. it's important. even today people need to hear that. we've known about hiv and aids for more than 30 years, and it's still a huge -- in the united states, we have pockets in the united states where it's growing. you'd think that with all the education, it'd be cutting back.

the things we should be doing differently in combatting this, are we focusing on the right countries? i mean, we've nope we're going to have a finite amount of money. how do we spend it best? sorry to put you on the spot, but we're struggling with that here. >> how do you spend it best? well, you still continue what you're doing. the -- giving the antiviral drugs to people that can have access to them, and getting the infrastructure in countries where there is no infrastructure so that people actually can receive drugs and get them on a daily basis because a lot of the people live in rural area, and they do not know how to do it. you have to educate. you have to educate people education is very important. prevention is very important. and you heard earlier the term young juvenile women in africa

account for, you know, juvenile women now, it's the second cause of death largest cause of death is juvenile women death through aids, this is catastrophic. you have to educate them. you have to spend the money very, very wisely. that's all i can say, mark. do you have anything to add on that or not? >> and we all try the thing that -- and, i said, we're seeing increases in parts of this country and, i mean, -- >> yeah. >> and, you would think it would be decreasing everywhere in the world, and sir elton talk about young women in africa, and we're seeing it, men and women in this country, i mean, what's -- where are we missing the point? >> i don't know in rural south, it's a very big problem. mopgs young gay men having sex

with men it's a big problem. i think maybe because they feel that they are not going to die that this disease has, you know, we mentioned it, someone mentioned it, you know, this disease can be a manageable disease, you can live with this disease, and i think in this country, which is -- has all the sophisticated medicine available, that people are having unsafe sex they think well if i have unsafe sex, i'm going to be okay because there's a pill i can take. not really knowing or understanding the consequences of what that pill might do to their body in the long run, but in africa, they don't have that option. they just want to live. over here they are -- they are able to live because they have the medicine available, and africa and asia, they don't have that option with some people because they don't have the medicine. i think you've seen a rise, a cyclical.

happens every ten year, and this disease starts to rise again amongst the young and i'm at a loss to explain it because you know, everyone knows the consequences of being hiv positive. you can live a safe and healthy life like a diabetic. easier to treat someone with hiv than a diabetic. that's the explauation why there's a rise. in the rural south it's a huge problem, a problem as well. i think i look again a lot is stigma. a lot of people not wanting to admit they have the disease. not a lot of people are tested, walking around not knowing they have the disease, and so, there's a lot of fear, even in a country so sophisticated as in america and great britain, the same thing is occurring. >> thank you. the last question and i can ask

questions all day long, but i -- the president's fiscal year, 2016, there's an impact fund this award government that takes steps to to understand and realign national programs to combat hiv aids in the most areas most severely affected, and i understand you're implementing a similar realign realignment of funds. now, some who challenge that say that there are areas that are going to receive less funding and that's going to be severe impact on them. would you like to explain what's happening? >> thank you senator. so there's two things that we're doing. we are fortunate because of the way congress set it up that we have granular data down to the

site level, and we know precise precisely now where there is hiv and where there is not hiv. what we found over the last ten years is a real evolution that in areas where there's very little hiv we have excellent coverage of all services. sometimes over 100% because people have come over the border to access services. in areas where hiv is the most prevalent prevalent, where the incidents are the highest in kenya our service delivery is at a 30 to 45%. we created an inequity between areas where we've been overreceivering and areas where we have substantially been over serving the population and working with governments to go through information in a very careful way so what you described at the end of the question does not happen. we are committed, obviously, to maintaining all of the services in the areas that are very low burden and are working with governments and global funds to ensure that there's a safety

net. we're also working and geographically mapping the sites down to the absolute precise gps coordinates so we can tell you there's ten sites here all within half a kilometer, and we only need two, so it will be much more effective to have two sites there all within walking distance, all less than half hour walking distance and increase the number of sites in the very high burdened areas because what is happening if you're a pregnant woman in kenya, you have a much lower chance of being diagnosed and linked to services than if you're a pregnant woman 50 kilometers away. this is the type of work we've been doing. >> thank you. senator danes. >> thank you chairperson. i want to thank the passion and compassion of the panel today. that's greatly appreciated in a city not characterized by compassion, you bring that here today, and we thank you for

that. i was struck, sir elton john in a statement you made in the testimony, there's a window of opportunity before us, a window in which we request clearly see the end of aids within my lifetime. what is the greatest barrier that you've seen to accomplished in that goal? >> well a reduction in funds, a reduction -- [ laughter ] that would be a huge blow. the world has to step up. keep the funding going. the more funds we get, the more medicine wet get to people, the more we can educate them. to put it bluntly, we talked about africa and asia, but we have not talked about russia or the middle east. countries that do not even talk about it, and we have no idea what the epidemic is like there but i have a suspicion that it's not great, but they do not talk about it because it's not part of their thing to admit that they have a huge problem so the

more money that's begin, the more we can -- once those figures are released, and we don't know about china either, we have to maintain the funding, and so that is the biggest biggest thing we have to do. we have to educate people, and we have the stigma, again we have to make people feel they are loved and not shamed. that's a big issue. i think rick would agree with me. >> absolutely. >> what he does with his church the church preaches love. and that's what we must also do but along with the funding, which is so essential, and that's why i'm here today, all here today saying that we hope the united states' government and the congress and the senate will not cut the funding because if they do, it's going to be a complete disaster again. going back to square one, and it's going to get worse. it's a mixture of coming together everybody, everybody, some other countries have to step up to the plate here. america can't do this all on its own. i don't think e.u. is doing

enough, and, obviously, china is not doing enough, and japan is not doing enough. as a panel of people we have to do what do we do here to make people step up to the plate and make sure america is not the only people or the only country in the world doing this. it can't. it can only provide 33% of the global fund. so as a panel here, we have to go away and say listen, the other countries have to step up to the plate but funding is important. the more money we can, the more we stabilize the world, and the more compassion we can show to people with aids, than i think that's the -- that's the way to go. it's a mixture of both. it's not -- i would not say it's an easy solution. it's not. >> well, thank you for the thoughtful response on it and i want to pivot here for a moment and ask dr. warren a question and in your testimony, you call religious liberty america's first freedom. i think you even made opening

remarks thanking the panel for the protections, fieging for that, the first phrase of the first sentence in the bill of rights, our founding fathers cared a great deal and the country's fight for independence. in your view what's the state of religious liberty in the country today, and are we doing enough to protect it? >> as i pointed out in the written testimony, religious liberty is what america was founded on. it's the first freedom. that's not by accident. it's the first freedom the first phrase of the first sentence of the first paragraph of the first amendment. it comes before freedom of speech, before freedom of the press, before freedom to assemble, before the right to bear arms, before every other freedom because if i do not have the freedom of conscious to believe what i want to believe i don't need freedom of speech. if i don't have to freedom to believe what i want to believe, i don't have the freedom to

assemble. if i cannot practice believes, i don't need the freedom of the press. that's very, extremely important, and it's all part of what i call holistic assistance that the kind of assistance that is needed around the world is it's not just -- meds are not enough. you have -- we have to do all -- you -- the whole reason we started the peace plan is because when we dealt with people with aids, we realized, oh, they need education. oh, they need job training. oh, there's poverty issues here and so all these things are holistic. as a church, all the things that elton talked about we have a little -- urch. we say there's six things a church can do. we care for and support the sick. that's the c. we handle testing and counselling, u unleash volunteers, r, remove the

stigma c, we champion healthy behavior and, we, h, help with nutrition and medicine. that's a holistic approach. you can't just do one thing. i even think religious liberty falls into that one of the factors. i've had this in china with the chinese bureau, and so -- >> so back to a comment that elton john made as well about the need for funding. you mentioned the tax code should incentivize generosity. >> i do believe that. >> what do you view of the importance of charitable donations in efforts to fight poverty, fight global health issues in the u.s. and overseas. >> well, as a pastor, of course, i'm interested in people's personal growth and growth in character. if you tax me and then use that money to help the poor i don't get any credit for it.

if you incentivize my generosity and then i am generous i grow in character by being generous. now, i'm -- obviously, in favor of the government funding, increasing funding for these things. there's a lot of things we could cult, and this should be expanded. i believe that the 150 line attempt really does need to be expanded. it's so minuscule, and we get more bang for the buck but i also believe at the same time this is not the committee for it, that we have to incentivize generosity, that the tax code should reward generosity rather than cap it, and, of course americans are the most generous nation there is, but we could be more generous if we create a system that encourages it. people, whatever's reward is is repeated. >> great, thank you. >> thank you, mr. chairman. >> thank you, chairman graham, and i just want to start by thanking you and ranking member

leahy for the partisan and commitment for ensuring we have thorough evidence to look hard at human suffering and at the opportunities we have to do good in the world and to do good well and to do it in a way that's sustainable and bipartisan and effective. i really appreciate your leadership on these important and valuable issues. i want to thank the panel today for reminding us of what it means to be american and what we can do when we do the best in our national spirit and we bring our best capabilities to the floor. reverend warren, i appreciate you reminding us we have a junction to not withhold good from those who deserve it when it's in our power to help them. i appreciate compelling and personal testimony sir elton john, how a change in your own life was brought forward by ryan white and dramatic impact you made across the world and how the two of you in relationship are helping demonstrate what it means to accept, to welcome, to

love, and celebrate a wide range of people who are otherwise suffering. i agree with you fighting stigma against lgbt community in africa is one of the most important things we can do to avoid marginalization, to avoid the spread of the disease, and, frankly, show humanity, so in my limited opportunities as the chair of the last four years, visiting 15 countries, i press hard on that point because the human consequences of ongoing oppression based on orientation are real. this is a real threat. we all face it across the world. if i could, thank you so much for your leadership of the global fund. as you know, in the last congress, i introduced a maternal and child health bill, i hope we'll renew this this congress, and that would give access to innovative financing techniques to strengthen the amount of resources available for maternal and child health. that's the core issue we're

talking about here today is how to staepustain the environment with valual investments. what's the opportunities here for innovative financing, and what do we do legtsislatively to facilitate that? >> thank you. innovation is a big field. one of the most important things to do is get other countries to contribute as the chairman was mentioning, and we are actively pushing on that all around the world, not just from the traditional donors, but from others. captions copyright national cable satellite corp. 2008 captioning performed by vitac