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[captions copyright national cable satellite corp. 2015] [captioning performed by national captioning institute] >> president obama wrapping up his remarks.

if you missed any of his comments watch them later tonight on the c-span network or watch them any time on-line at c-span.org. and something that president obama talked about during his speech how much doctors who take medicare are paid. 392-37. 64 democrats joined 33 republicans to oppose the measure. the bill will re-authorize the children's health insurance program for two more years and the house is now in a two-week district work period and more live coverage from the house floor when they return here on c-span. >> here are some of our featured programs on the c-span networks.

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>> the story gets complicated when the question arises what ultimately happened to the ship, why was the ship allowed to enter the sea without escort, without the kinds of detailed warning that could have been provided to the captain but was not. and this has led to some very interesting speculation about was the ship essentially set up for attack by churchill or someone in the add mirget. it's interesting. i found no smoking memo and i would have found a smoking memo, but nothing from churchill to

somebody else saying, let's let the ship go into the sea because we want it to get sunk. >> microsoft bill gates is joined by ben affleck on capitol hill. and the need to continue funding for foreign aid. mr. gates warned there needs to be more in order to avoid another epidemic. the chair is lindsey graham. this is about two hours. senator graham: the subcommittee will come to order. our hearing is on diplomacy and development and national

security. and we have a very incredible panel of great americans and in their own way in balancing the schedules of these gentlemen had to be very difficult and each and every one of you made a sacrifice to be here. there are other places you needed to go, but the fact to share your testimony, your experiences, your thoughts and experiences about the 150 account means a great deal. as to senator leahy, we have been partners for several years on this account. i enjoyed working with him and tim and this is one area of the government that we are trying to make sure actually works and our relationship has grown over time and both committed to making sure that america stays involved in the world in a productive fashion. our panel today consists of mr. bill gates, co-chairman of the bill and lind after gates

foundation founder of microsoft. ben after fleck founder of the eastern congo initiative and actor. you are doing great work. john megrue, chairman of the apacks and chairman of the born-free africa and working with the u.n. dealing with the mother to child aids transmission. and james statistic stavridis from tufts university. and worn the uniform and i look forward to your view as a military commander about this account and scott ford is chief executive officer of westrock group and i had the pleasure to see what scott has done in rwanda regarding the coffee market. all of you are welcome and i

will let the first statement be by senator leahy. senator leahy: i think what is probably the most important is that we hear from the people who are here. we talk about diplomacy development and national security. it's really relevant. probably more so than any time sings world war ii. we know what our military can do and we have this huge economic and military power, but we ought to be showing the rest of the world some of the best parts of our society. talked to mr. gates earlier and when senator graham and i told our colleagues that they ought to pony up on money on infectious diseases, the country

has 320 million americans and at least match what bill and melinda gates are doing, but it also -- we know we have some problems with development, with partnering large contractor n.g.o.'s that might take a lot of money. i'm worried if we don't see what we want to see and with the cuts in the house and senate budgets we are going to have difficulties. we have to look at what actually makes life better for the people we're dealing with, but also for our own country. i like going into countries where the small country, we find one of our programs is actually about the only medical team that's ever been there where they worked on land mines or the

school that now has books instead of a one book for everybody. these are things that show us best as america. but i worked with senator graham over the years. he has been chairman and i have been chairman. we tried to make this as nonpartisan a bill as possible and we'll continue to do that. he's a good friend. he understands this program as well as any member of the senate, either party i served with. senator graham: contrary to popular opinion, the foreign assistance account is 1% of the budget. you can eliminate every penny we spend and not move the debt needle one inch, those who demagog that financial aid is the root of all problems, please stop because you don't know what the hell you're talking about. this account is designed to show

who we are as a nation, it's designed to enhance our national security and it's designed to deal with enemies of mankind such as radical islam aids, malaria and other diseases, poverty. it's designed to build people up so we can live in peace with them and have a better life and make the world a better place. it's designed to have an american presence that is nonlethal. you cannot protect america by just dropping bombs on people. this account in many ways is the best line of defense in terms of africa. we do not have a large military presence in africa but in a bipartisan fashion we have had developmental programs fighting aids and malaria trying to resolve conflicts in africa and this account has been the front

line. and the return on investment on behalf of the american taxpayer from this account, i will match it with any place in the budget. i have never seen what a small amount of money can do in a positive way better than here. $50 billion, and it is a large number but in the budget it is a rounding number, but the money we have appropriated each and every year is leveraged for the private sector and each one of these come if the private sector. in partnership with your government n.g.o.'s, faith-based organizations, the gates foundation we have created partnerships that every american should be proud of. and the day we stop doing what this account represents is our best days are behind us. we will have chosen a path that no other american has chosen

before, one of indifference and isolationism, one of we're not really responsible or the leading voice in the world. we are. and this account represents that philosophy. it is a good investment on behalf of the taxpayer. what you have received in rates of return, you cannot measure. and an entire generation of young african children saved from aids, turning the corner on malaria and in the congo, what mr. affleck has done is to take hell on earth and make it a bit better. and to mr. ford, what you have proven that the private sector can do is astounding. thank you all. we look forward to hearing your testimony. as we speak today, there will be a vote on the floor of the united states senate for a member of the senate has chosen

to reduce this account by 50%. and give that money to the military. here's what i would say on behalf of the military. they don't want this money. they want this account to survive and thrive. general matthus told me about how this account plays in the world as it is, he said senator, if you do away with the 150 account and withdraw from the world and these programs go away you better buy me more ammo. i couldn't say it better myself. so since republicans are in charge we'll start from the right with mr. gates. -- my right. mr. gates: good morning, mr.

chairman, senator leahy and other members of the committee. thank you for the opportunity to talk with you about the importance of u.s. foreign assistance. melinda and i in writing our letter for the foundation talked about what great things can happen if the united states and other countries maintain the generosity that they pass through this account. over the next 15 years, there are some amazing things that can be achieved. if we go back to 1960, we have a very dire situation. one child in five died before their fivet birthday. 2 years ago, by 1990, that rate was down to 1-10. since then it has been cut in half to 1-20. with the right investments over the next 15 years, we will be able to cut it in half in again 1-40. and there are many u.s. programs

that are absolutely essential to this decline in child mortality and to other gains in health and development worldwide. one specific program that makes a huge difference is the vaccine alliance. this public-private partnership creates a market for companies to develop vaccines that protect children in poor countries against the most common causes of death and illness. as an american, i'm proud that the united states government is one of their biggest donors. it has helped immunize half a billion children and prevented over seven million deaths. i can assure you that the parents of those children would be glad to vouch for simple facts, vaccines are safe and effective and save lives. another great example of this is

the fight against polio. the number of countries where that disease is endemocratic has fallen from 125 in 1988 to just three today. melinda and i predict that will be self-sufficient for food production. we are seeing great progress, much of it made possible by u.s. assistance. u.s. has a major impact in improving agricultural productivity in poor countries through usais through agricultural research in partnership with our land grant universities. in my written testimony, i discuss a number of u.s. programs that are delivering high returns on investment and having a positive impact to the global poor. but there is another area where foreign assistance will make a huge distance not only for the people of the world's poorest nations, but for the people of this nation as well. as you know, i tend to be optimistic about what the future

holds, but there are a small number of catastrophic events that could set back the progress of the past few decades. the most probable and most frightening of these threats is a large epidemic. as i note in my recent new england journal of medicine, i'm talking about something bigger than the ebola outbreak we have seen. ebola is not a disease that is spread very easily. what concerns me most is the prospect of an even more lethal disease which is also highly contagious. we have seen the flu pandemic of 1918 and 1919 which had a worldwide death toll of 30 million to 50 million. could an epidemic of this scale happen again? yes, it could. and it would spread far more easily than a century ago. i have come to congress on other occasions to ask for the

sustainment of u.s. foreign assistance. i have asked for this to prevent needless deaths and suffering. with ebola and the very real progress -- prospect of an even more infectious disease, the case is now even clearer. i'm asking you to assist foreign assistance programs not only as a way to help other countries to become more self-sufficient but as a necessary means of protecting this country from a future epidemic. the place to begin is with investments in basic health services in those parts of the world that are most susceptible to outbreaks of infectious disease. whether we are talking about preventing the next epidemic or building upon the enormous health gains, the time to act is now. the need for foreign assistance remains strong and recent events

demonstrate its urgency. thank you for inviting me to join you today. i look forward to your questions. mr. affleck: it's an honor to sit here in this room and speak before you. thank you for having me here. i'm humbled by this panel. thanks for having me follow the greatest and most important philanthropist in the history of the world. but it's an honor to sit next to mr. gates who has done extraordinary things in technology and philanthropy and doing so on your way to bridge. i want to thank you deeply for inviting me to testify. i'm the founder of the eastern congress initiative where grant making and advocacy, organization working with and for the people of the democratic republic of congo. i want to offer a special thanks

to the chairman for holding today's hearings. senator graham and others has proven time and time again to be a champion for smart effective u.s. foreign assistance. in august 2013, amid new violence, the senator brought a delegation. this marks the largest ever delegation of u.s. senators to visit this war-torn region. thank you for your confidence in the people of congo. and to senator leahy i would be remiss if i didn't acknowledge my co-star in "batman," but i understand you are quite good. good morning sir. i'm here today to offer a case study on the difference diplomacy is making where investments are transforming

communities in need advancing our nation's interests and creating opportunities both in the countries we assist. even though you heard about congress and its challenges -- congo, estimated five million deaths due to violence, disease and starvation. 2.7 million remain displaced and sexual violence. but these statistics tell you nothing about congo's future or about the extraordinary and resilient people working every day. despite the many challenges, the people refuse to be defined by the country's past and those who may question the effectiveness of our foreign assistance, u.s. diplomatic and financial investment in congo are working. it accounts for only 1% of the federal budget and 1% of that 1% is important and powerful

progress. let me give you an example. in the late 1970's, congo was coffee's leading exporters. production is less than 10% of what it once was. the families lost a vital source of income. three years ago, we saw an opportunity to revitalize congo sector. >> our government created a partnership. together, only in two years, we have trained and supported coffee farmers across four cooperatetives to increase the quality and quantity of their crop and maximize farmer profits. we brought in global trade specialist that keeps money in

the pockets of farmers and their families. but what we have been able to achieve together doesn't end there. these coffee farmers had no access to farming or line of credit. you can't do that let alone another emerging economy. we brought in westrock company to scale their businesses. scott was part of that delegation that visited congo. the final public peace was getting this peace into american homes. and we brought in starbucks. they will travel to the eastern region of congo to begin a partnership with us to develop congo as a key source of coffee. starbucks has purchased 40 tons and may not be a lot for starbucks but a heck of a lot. entirety of the cooperative's

export representing millions of cups of coffee. the largest coffee company is a clear testament. this isn't charity or aid in the traditional sense. it's good business. from a relatively modest investment farmers' income have more than tripled and can send their children to school and put food on the table and access proper health care. this public-private partnership has transformed the lives of thousands of families. all made possible because usaid agreed it could be done. but this is the beginning. it will launch an economic development fund that focuses on expanding our work not only in coffee but other strategic crops. we will work with 10,000 additional farmers over the next four years to build their business capacity and improve the quantity and quality of

their projects and secure direct access to premium markets. this work is scaleable and republically cabble and in five short years it will have an impact on individuals living in eastern congo. none of this would have happened without ussaid and without private sector partners to operate in one of the highest risk areas. it is a driving force. supporting the more than 60% of the people of congo, 40 million people whose families rely on agriculture as a primary source of income. feed a third of the world's population should not struggle to feed its own people or for basic health care. senators, the next two years represent a critical turning point. with local elections scheduled for later this year and national elections in 2016, we enter into

a window of opportunity for unprecedented democratic condition. engagement by secretary kerry and the ambassador have reached congo reach this moment. senator feingold served as special envoy. his leadership and the 15 trips he made during his 18-month tenure was the very direct intervention and we thank him for his service. the u.s. leadership played a vital role. to ensure this progress does not come undone, we urge you to join other groups like human rights watch in calling on the administration to appoint a new special envoy without delay. as we continue to make smart and effective investments, we will foster the next leaders who will carry their country forward to

stand as a model for the continent. mr. megrue: good morning and thank you, chairman graham, and ranking member leahy and members of the committee for allowing me to come today and talk to you about something which we are all very passionate about which is foreign aid and had a chance to get to know many of you. and so i understand the kind of pushback you get here at times but i would share a business perspective on why i think foreign aid has been so effective and so important. by way of flukes, i'm a business person and spent 0 years in buying companies and owning companies with a team trying to make them bigger and more efficient, but i'm here because

it has been more than the last 10 years working in africa in issues around health care agriculture, education and specifically the last three years, i started an organization called born free, which is fighting the transmission of--- h.i.v. from mothers to children. i follow three basic rules. i work on things that are fast, doable and great leadership that i can partner with. in mother to child transmission the statistics around that led by the u.s. foreign aid are astounding and in 2003 there were 600,000 babies born h.i.v. positive and 90% of those died in the first five years of life and last year down to 00,000. 6 % increase. this year, it will be less than 150,000, so 75% increase is

unheard of in improvements in global health. i know that we can eliminate mother to child transmission. secondly i mentioned things that are doable. mother to child transmission is doable for two main reasons, one is that the science is very clear and secondly that it's cheap. and having worked on other issues like education and agriculture there are significant debates about how to solve problems, but in the case of h.i.v. medicine is very clear and now very cheap. when you invest your money and others invest their money on the ground, we know it hits the ground effectively and without any debate about whether we are doing the right thing. the last thing i mentioned is great leadership and my experience in business it is the most important thing we go after and i talk about leadership in three areas.

first on the ground in africa. we work very closely with government leaders with health minimums sters and community health care workers all over africa and you don't get to the kind of statistics that i just mentioned, those kinds of improvements without those frontline people making it happen. and u.s. corporations, i work with many u.s. multinationals, chevron, g.e. and mack and others who are all investing along side the u.s. government in this particular issue. and not just doing it because of corporate and social responsibility but good business. this is the fastest growing market over the next two decades and committed to making these kinds of commitments. and last is the u.s. government and the leadership that it's providing and i have worked closely with the leaders that

usaid and pepfar and i can assure you they are making tough decisions to make sure our money is spent efficiently and for me as a philanthropist, knowing that that leadership is there keeps us inspired to be able to partner with the u.s. government. i'll share one final thought and that is that we have a clear exit strategy in areas like this. this is not funding that is going to be required from the u.s. forever. three years ago i was co-hosting a codel and in capetown and brought together some of the largest business people, health minister for a lunch and at the end of the lunch, one of the leading business people stood up and said two things. one, they said thank you to the u.s. government and secondly they said how important our investment has been in south africa getting over the hump and

starting to get at this. i said we won't need your help forever. i came back and looked at the statistics and sure enough in 2003, we were 100% of the h.i.v. response. 2008, we were 50% and now down to about 5% of the h.i.v. funding response and seeing those stories around africa where these countries feel an obligation to pick up these investments. so i know with continued investment that we will eliminate mother to child transmission. it will be one of the greatest accomplishments of this generation and i think an incredible accomplishment for the u.s. government and to be the leader in that but going to the budgets today now is not the time to blink or slow down. when you are really winning a battle like this. people like myself and other

panelists here, they are active and making sure that our money is well spent. thank you for giving me a chance to talk and i look forward to answering your questions. sss >> i'm here because i'm a member of the u.s. global leadership advisory council for national security and a group of senior retired military officers are part of that. mr. stavridis: i want to pick up

where some of my colleagues have left off which is to say from a military perspective, how important this kind of work is. we have a very strong and capable military. thank you to the congress for that, but we cannot create security in this 21 century simply with hard power. we need the tools of soft power which my co-panelists are talking about and plomeds in a nutshell. and to summarize we are very good at launching missiles today. we could improve of how we launch ideas. and plomeds and development allow us to do that. so cutting this kind of work, i think is a mistake at this time. i'll give you some practical examples. when i was the commander of u.s.

southern command before my time at nato, worked together on columbia. this is an area if you go back 15 years looked like syria does today, a complete humanitarian disasters, millions of people displaced and high levels of violence. it was an absolute disaster. we created something called plan columbia, which had a military component, but more importantly, it funded development and diplomacy, human rights, all of the soft power parts fitted together with the hard power. today columbia is a nation that has not only improved vastly but in a position to continue forward as an absolute lynch pin strategicically for the country. i witnessed the same sort of effect in the balkans.

if we think back, again looked like syria does today. 8,000 men and boys killed in a single day. extraordinary levels of violence rape, torture. yet today in the balkans, when they want to solve a dispute, they don't reach for a rifle but a telephone to call the european union, to call the united states. why? because we were able to use some hard power, but combine it with the soft power tools of diplomacy and development which are the long game. i'll give you a third example and it's current, it's what we are doing today in afghanistan, where senator graham has served as a reserveist coming on active duty in afghanistan working on the judicial process there. this is soft power. do we need hard power in afghanistan? absolutely unfortunately. but the long game is diplomacy

and development. you need both those things, when you bring hard and soft power together you create smart power. that's what i would advocate for. and to try and do defense without diplomacy and development, i'll simply repeat the quote that senator graham gave us earlier as my good friend jim will tell you if you scrimp on the development and the diplomacy, you are going to end up buying more ammunition. and as secretary gates would tell you we cannot kill our way to victory in these situations. we need hard power but we need these tools, development and diplomacy as well. i look forward to your question. senator boozman: i apologize

after scott testifies i have to run to a v.a. hearing and talk about overprescribing open yates. but i think all of you and i'm familiar with the work you have done. great examples of people who are using your time, resources for those who have no constituency at all in the sense of representation. scott, it's an honor to have you here. he jumped out and did something for his fellow man and as a result through his efforts and hard work, i think has raised the g.d.p. of rwanda by giving them a worldwide ability to sell their coffee at the international market versus -- so we appreciate your example and appreciate all you have done as the other witnesses. thank you mr. chairman. mr. ford: thank you very much. nice to be here with you.

we could play a game here, one of these is not like from the other. i didn't know this was going on when i stumbled into the coffee business in rwanda but learned about the important powers of the private and public sectors can meet in places like east africa and that accrues to our collective both continents' collective benefit. i was a c.e.o. of a corporation and been doing charity work in rwanda and i had spent some time with the president of rwanda. i discovered in some of those discussions that he and i we were an outliar in this regard. we had a common philosophy around the role of the state and what it can and can't do and the role of business and what it can and can't do.

the crux of our conversation centered around a shared belief that the state through its attendant bureaucracies can from the top down bring safety and security, political freedom and even religious freedom but it is materially limited in its ability to bring economic freedom. it's the final fruit of the tree, if you will. its economic freedom is only created in the private sector when people have learned to organ manage a for-profit business and mentor other people in that process. the group that benefits the most from a free market, private enterprise system is not the richest of the rich. they are everywhere in the world, it's the poorest of the poor. the president said if i came back to rwanda to invest in the business that helps the poorest

of the poor taste the benefits of the free market system because once they do they won't settle for a government that won't give it to them. i went back in 2009 and not sure that i could find anything to do in rwanda, but i thought i'll honor the request and go look and report that i looked. i got to rwanda and i looked at a whole host of things that are too long to go through here, but i ran into the effect that 20% of the people in rwanda make their cash income from the coffee business. and there were just two exporters that dominated the coffee trade. i then figured out they weren't paying the highest price for the coffee to the farmers and room for a third party to come in and pay more to the farmers and still make a profit. i have to make a profit or else i don't get to sustain the work. we started looking through how

can we go into the coffee business? we bought an abandoned bankrupt mill at auction, we hung a shingle out and went into business. in the first six months of our operations, we saw the price that the farmers in rwanda receive increase 30% to 50%. that was the power of someone setting a reasonable price in terms of the cost of the product. in addition, we have invested money on helping to improve their yields, helping to improve the quality. we were successful in rwanda and expanded into tan san anya and partnered with falcon company and finance and procure coffee from other parts of east physical and now behind the leadership of the eastern congo initiative and closely behind, kind of like going to -- we have

the united states ask us, would you go to congo? and i said not without batman and we have been doing the logistics and financial support. we then, i don't know what i was thinking, we started a coffee roasting business. it is restaurantcoffee.com. thank you for the ability to make the plug. starting businesses from scratch in this part of the world, my wife and my father stood with me and everyone else said i was a mad man. we have seen $100 million of incremental income go into the pockets of the farmers over the last six years. but that's a 50% increase in their standard of living. how do you impact 20% of the united states with a 50% increase in their standard of living.

i didn't know how to do it and i couldn't believe it was possible but it was because we got there and there were groups that were funded by the u.s. government and philanthropists like mr. affleck and mr. gates and the german development and investment corporation. all of these groups spending money to help the cooperatetives on the ground get their accounting together and be able to function, that is all supported by n.g.o.'s and supported by the u.s. and we have been building on that to translate the income differences. i will say this, i recognize in today's panel that we are just one company operating in a limited area of influence, and i hope we serve as an example of what an american private sector actor can look like when we

align with like-minded organizations, we can produce benefits that the poorest of the poor can literally taste and that accrues to america's -- i think it accrues to america's credit. if you want to ask questions about that and how that ripples into policy and things like that, i will answer. but it's an honor to be here today and i appreciate the invitation. senator graham: we will have that debate later on and take your words to the senate. mr. gates, you have been doing this quite a while in your private role. if the budget cuts are enacted that we're talking about under sequestration scenario a, but if we actually adopt what's being proposed in the senate today, 50% deduction, how would that be from your point of view?

mr. gates: i'm very enthused about the progress that is being made. so the tragedy as we see how close we are on polio eradication, that if we don't put out the resources now that disease will spread back and the amount of money you have to invest to get back to where we are would be gigantic. if you look at h.i.v. through pepfar and global fund, millions of lives of being saved and if you cut those programs h.i.v. through pepfar and global fund, millions of lives of being saved and if you cut back, there won't be enough medicine to keep people on treatment. the united states has done a great job of drawing other governments in. it's only through our generosity that that other money is activated. so if we cut back, i think we'll see other funds going away as well. other governments as a percentage of their economy are

often quite a bit more generous on foreign aid and even so because of the size of the economy and the technical expertise we bring the u.s. finds itself in a leadership role that i don't think anyone would be able to step up to that. it would be a huge set back for health all these things that we are devoting our lives to work on. senator graham: mr. affleck you have been involved in the security development. all these developmental programs whether it be private sector whatever, you have to have enough security so people from outside the region can come in and help. what's your evaluation of training the security forces as an american role? what benefit do we have, not just on the hard side, soft side, but training forces and

how important is that to you in terms of your potential success. mr. affleck: one of the greatest issues is lack of a security sector and not only that, there are times that the government preys on the population. we aren't going to pay you you live off the land. without -- and this is an area that we are working in but this is a top-down area. it requires leverage from the united states and local, regional actors to say, include -- try to end corruption and get soldiers paid. but one of the hardest things about that and that is to train soldiers properly. and we have been doing that. and the role is also controversial and it is required in light of what we are talking about which is this

public-private partnership building sustainable economic models where people are just not making a living, so they can continue to make a living and contribute to their society and see the ripple effect of this cycle and that aspect of security is important. you have areas in the north where we're doing work with coffee collecttives that are under threat. and when you have a state and i'm not saying anything new, when you have a state that is failing, it is more vulnerable. where you have a state where people are more prosperous, they are able to resist and in speaking to what the admiral said, i'm no expert but it makes sense to me, let's spend money this way before we spend money on bombs. this kind of training is something we can do. relatively inexpensive and

greatest in the world at knowing how to build and train militaries. senator graham: the reason i asked that question, not thousands of boots on the ground but mentor training role, we can enhance everything you are trying to do in the private sector. mr. affleck: you protect those abilities. you make people. scott is being modest. he is gap financing in places in the coffee industry where people aren't willing to do it. not only is he doing it but getting investors a legitimate return. in order to do that, you have to have a window of safety and that's one of the things we are trying to expand with a little bit of money and little bit of investment from the united states we create enough safety to encourage investment in public, private investments. senator graham: john, if we do

the budget cuts under sequestration that is being proposed what does that do to all the success that you have had in mother to child aids transmission? mr. megrue: the leadership of the u.s. has and continues to provide is critical to the success. people from u.k. and germany and most of the developed world have followed our lead on this. and so when we are making these kinds of investments in infrastructure and medicine and treatment and training to pull the rug out to the magnitude, the kind of numbers that are being proposed today, brings it to a complete stop. it's not the kind of thing you can meet or back and disease like h.i.v., what that does instead of mother to child

dropping dramatically and starting to drop, you have seen explosion right away. from my perspective and team on the ground we are really worried about that kind of move. senator graham: admiral, i know you aren't wearing the uniform today, would it be smart to take money out of this account and give it to d.o.d. and does d.o.d. need this money? mr. stavridis: it would be a huge mistake. you have to put these tools together to create real effect in security. i want to underline the troop and training point that ben was making in response to your comment, mr. chairman. and i'll put a number on it. to sustain an american forward in combat like afghanistan or iraq is $1 million a year.

we can finance, train and put effective afghan troops in the field as we do today for pennies on the dollar. so the efficiency of this i think is very, very important to underline. and i go back to what mr. gates and mr. megrue were saying along with mr. affleck, the cost here is minimal. you leverage the private sector and at the end of the day, the security is iceberg. the tiny tip that sticks up is the high end capability. so i think for those two reasons, taking money away from development and diplomacy and putting them into defense where we have strong levels of resources would be a significant mistake. senator graham: scott, would it be possible for you to have done all of the transformation in terms of the coffee business in

creating disposable income without the government infrastructure that exists today? mr. ford: if you don't have that apparatus in place guys like me have no where to go. senator leahy: the chairman's mentioned the efforts that are going to be made to cut this budget even further. the house and senate budget numbers were announced. certainly well below the fiscal year 2015. and talk beyond that. i'm thinking, admiral you mentioned the colombian project that i do remember -- and you may be interested in knowing when i had lunch with the president down there at one point and went out of his way to

praise you and the project. i mention that for whatever it's worth. assume these cuts where you have level funding from last year, of that, $50 billion is used to run the state department. our embassies our consulates, pay our diplomats, portion is used to fund ongoing programs that we are committed to, treaty obligations, like the u.n. let me ask this question of all of you and let's say there was $5 billion up for grabs. we spend it any way you want. any suggestions? mr. gates you and i have talked

about this many times in my office. where would you spend it? mr. gates: well amazing number of n.g.o.'s that work on areas of agriculture areas of health, and i'm sure they don't make a strong case of any increase that would be available. the basic structure in africa is very weak today. that weakness means that if an epidemic shows up, we wouldn't see it soon enough to go stop it and it would spread in the global economy very, very quickly. faster than the spanish flu did back in 1918. senator leahy: in the "new york times," you talked about that. mr. gates: we are very much at risk unless the basic health and health surveillance systems in africa get improved.

the current budget let's us do that at a certain rate. but if there were additional dollars, we would accelerate the basic infrastructure. the beauty of that is although it is an insurance policy to prevent an epidemic which would come to these shores, there is also year in and year out, amazing to lift people up and accelerate the time when these countries will be self-sufficient, both big contributors to the economy and educate their own economy. health and agriculture are pretty basic things and the formula for how you get better seeds out there, a primary health care, and a business-like way of looking at what countries have done it well in spreading best practices that is so much stronger today than 10 years ago or five years ago that extra money could be used very very

effectively. senator leahy: mr. affleck, in the congo i read a number of things and there you see things and you are seeing things that work. suppose suppose using your experience, we said, weerp going to make you the czar of that $5 billion, how would you spend it? mr. afleck: first thing i would do is surrender that title. first, you hear it's too dangerous, can't work on the ground. we want to support community organizations. i know i'm the little guy on the panel, the grassroots guy, so i can speak for the little guy. we saw a rot of grassroots

organizations. these coffee and cocoa collectors are perfect example of that we saw with the economic development fund alone is expandable and scaleable. all across this part of the country, you have many many, many n.g.o.'s, local con fwmbings olese groups that are in want only of money. it's not a question of where the money could go but of need. i will say that i take that your real point is around sequestration and cutting the budget and there's two ways to go. this is a nascent partnership. it's not like you have a line of people ready to sort of sign up to this exact way of doing things. we asked them to change their practice and so on. so in order to create a cycle, to have a contagion of success. that's what we've seen so far in two or three years.

i can tell you that taking away those checks, pulling the sheet out from under that will have the opposite effect. people will say, you can't work with them, can't believe what americans say this kind of process is never going to workful we'd rather revert to traditional aid where we stand around and hope someone -- senator leahy: i don't want to put words in your mouth but if that happened and you had to try to replicate it a few years from now -- mr. afleck: all the cost we'd spent would be gone and it would be twice as hard to try to do it again, to try to rebuild the infrastructure trork gather the personnel, to try to reassemble what we'd built and overcome a history of mist trust a history of disappointment and a history, and frankly people had gone elsewhere. whether it's to do more or less artis anal agriculture or in

the case of eastern congo, having joined a militia or working in an illegal mine. there's a lot of places people could be working if they're told there's no long aerojob for them farming cocoa or farming coffee. senator leahy: my time is about gone, i don't know if any of other three witnesses want to take a stab at this. >> the area i see the greatest leverage in our investment is investing in health care infrom structure not and in physical equipment but in talent. mr. grue: the africa systems are sorely understaffed. what we've seen is by providing what is essentially inexpensive talent, we can around very specific issues, whether it's malaria, tuberculosis, h.i.v., etc. their rate of improvement

is extraordinary. so in states like river state in nigeria where we've seen a 300% increase in 12 months of mothers on treatment, or another state where we've seen 160% increase, that's done by inserting people that health commissioners can use to mobilize their people and train their people in the right way. >> senator, i'd say very quickly i'd take a significant chunk of it and do what you see in this panel using state and aid that have the bureaucracies, leverage the private-public partnership and you see at state and a.i.d. small numbers of people who are expert at doing that. then i have to give a shoutout within this account for the peace corps. mr. stavridis: i think it's undervalued and underfunded. our largest co-heart every year

works in the door and they're peace corps volunteers. i hear their stories and know their impact in the world. it is so wildly disproportional to the tiny amount of resources they get. thank you. >> i'd just -- you don't have to spend it all, you could put it to work in credit. credit is the life blood of commerce and credit is what is dried up and missing. the u.s. banks have withdrawn completely from financing anything like what we do. mr. fort: the european -- mr. ford: our coffee business are funded by individuals, happens to be from the state of arkansas and the state of texas, who just care. and otherwise it's the chinese that have come in. so if you've got access to that kind of money, credit could use it too. senator leahy: preach to the converted, all of you do. mr. blunt: senator davis. senator davis: i want to thank

you, i want to thank you each for your passion your compassion your generosity, your kindness as well as your vision. senator daines: mr. gates i heard rumors you had a background in technology and i have great respect and watch what had you have done for our country and the worldism spent 20 years in the private sector as part of cloud computing. people back then thought cloud was to do with the weather. i'd be curious about your thoughts of how do you see technology affecting global health over the next 15 years? you've called that the big bet for the future. mr. gates: the main thing, how quickly these innovations that

are initially designed to be used in rich country how quickly they can become very powerful tools in the poor countries that we're talking about. we're looking at using cell phones to track the supply of medicines. it's been difficult to run supply chains in these countries. so often when you want malaria medicine or h.i.v. medicine or reproductive health tools they're just not available. and so we're going in right now together with usaid and others and looking at this supply chain capability and saying we should know whenever there's a stock out. as soon as you have that kind of information system, you're able to raise the reliability very, very dramatically. a lot of challenges in health care have to do with workers

showing up and the quality of their work. tracking the activity, having them take a photo when they come in in the morning taking a photo of what's in the clinic, that it's well maintained. we see a way to very efficiently improve the quality of the services delivered. so this digital rem is giving us this -- realm is giving us the unbelievable depift of patient tracking, supply track, labor quality. then of course over in the biological realm, creating new vaccines, new drugs, giving us the tools that will give us a chance to say that ma lair ark after we finish polio will be the next disease that we'll go after eradication. without that help of new technology, many of the goals that we have just wouldn't be realistic. because of breakthroughs that are -- some funded by n.i.h. some funded by foundations like ours. most funded by the commercial

sector where it's simply a reuse of the same cell phone or internet technology. that's why we can be so optimistic about what a little bit of aid money can do to help these countries. senator daines: you mentioned polio. as a rotarian i've been excited to be part of that effort and what you all did there, we're very very close to eradicating polio in the world. how can that story of the eradication of polio be a model for future success, when we look at other public hell issues that need to be tackled in order to bring parts of the world out of poverty and into economic success and stability? mr. gates: polio has been an amazing campaign and rotary has been the life blood of keeping the energy there. even as it proved to be more difficult than was expected back in 1988. today, we haven't had a case of polio in africa for over six months and the only two

countries we've seen cases in in the last six months were pakistan and afghanistan. even there where it's difficult, the government, the army, the n.g.o.'s are coming together system of we're very optimistic that in the years ahead we'll see the end of polio. there are a will the of lessons about how you orchestrate people and it's a commitment of the polio eradication campaign that we'll not just get rid of this disease but leave behind far stronger health systems for example, in the case of nigeria, as we did polio eradication there, we saw that the basic structure of the way they budgeted, the way they managed the supply chain, wasn't handled very well. and now through polio funded initiatives that's being put on a much, much stronger basis. so the success of polio will let us pick other diseases, including malaria, to go after, with the confidence that we've learned how to do it.

senator daines: thanks, mr. gates. mr. megrue, i was struck by your voice for the voiceless, the h.i.v. babies now born h.i.v. free. regarding the public-private partnership that's been described, we'll be discussing the funding and expanding our thinking beyond the funding side of which, what other barriers do you see we could work to remove or incentives to create, to foster more of what you all are doing? >> there's two pieces of that corporate investment and philanthropic investment. we do have a chance to accelerate the match funding ideas they've experimented both with other governments as well

as with corporations and large foundations like mr. gates'. because there is a big leverage point to have leadership like the gates foundation can provide to make sure not only -- which he does with his investments but that he can do in a highly leveraged way with the u.s. government's funding. so we see that in many countries, we're working right now and moving into kenya, uganda and angola and other places. but the u.s. government's investment in time and energy there has been central to creating the kind of dialogue that allows us to leverage what somebody like we can do. senator daines: thank you. mr. ford, given your background as well as the -- in the private sector and jumping into what you've done, any thoughts on that as well, other barriers we could work to remove, incentives to create to foster

what you're doing? mr. ford spst it's a bit of a stretch but the u.s. banking system from what i can see i know a lot of bankers, we did the largest l.b.o. that had ever been converted to a sale in the history of the u.s. in one check. i knew about every banker in the country. none of them would go with us to africa and they all pointed to the regulations facing them that cause them to say we don't know how to comply and so we don't know what they are and we're withdrawing. i had them tell me that fiss to face -- face to face, one after another after another. how that factors into what we're talking about here today is not clear to me but it's the reason we had to revert to gap fund big individuals with projects like this. senator daines: thank you. mr. chairman. senator merkley: you started

talking about the vaccine initiative. the basic numbers translate to about 25 bucks per vaccine, about 1 50rks0 per life saved. i've heard the international vaccination effort described as the single most cost effective way to influence global health. is that a fair way to put it? mr. gates: absolutely. there's two things we do by vaccinating children. one is that we save lives. as you said that comes down to less than a few thousand per life safed. but also for every life we save, there's about four children who would have grown up malnourished, that is, their brain and body would not have fully developed. if you look at the burden on the countries here, it's not just the level of debt it's the level of -- deaths therks level of sickness. even when those kits get a chance to go to school or eventually participate in the economy, the fact that their health has been so poor completely holds them back. and so the vaccine investments

would make the top of the list in terms of enabling them to support themselves. senator merkley: so the u.s. pledged $1 billion, as you mentioned. was that the amount you hoped for or should we have done more? >> we were -- mr. gates: we were very pleased the u.s. made an increase. in that case, every five years, the -- that fund gets replenished. we're a big contributor to the fund. we got a lot of other countries to step up in a big way. the u.k. is the single biggest contributeor to that we're the second, u.s. government would be third. so there's always room to do more but we were pleased with the increase. senator merkley: thank you. that was diplomatic and well stated. mr. afleck you've been traveling to east congo since 2007 how much did you get engaged in the challenges of

central africa? mr. afleck: you know -- i've done plays, i should be able to project. back then there was a lot of activity going on, and i didn't want to be a dilettante, i started doing a lot of reading and studying and meeting with folks and then i was shocked to see the degree to which the scale of which wars in central africa, particularly in congo, the great war of africa, was dwarfing what was going on in sudan. not to diminish that obviously but that it was -- i figured a if i had never heard of it and b, it was as big a tragedy as was being described, you know that ought to be a place i should get involve sosmed i started, whitney williams and i started this organization, started traveling there and we went around to about 11 countries around congo and started looking at it and thinking without the assumption that well, i'm a celebrity i

must be able to help, i thought, well what can i do? what can be done? there were base groups that weren't able to get the money from the united states. we wanted to be dexterous and we wanted to be nimble and really once i had been to congo a few times there was no turning back. you see a people suffering as much as these folks are suffering, fighting as hard as they're fight, i thought i'd get there and find people cowering and on the ground, instead you find people going to the market, trying to get a job, trying to take care of their family in the midst of -- senator depra ham was there. grenades going off and stuff. life flourishes and people try. people exhibit kindness and compassion and want to take care of their families. soifs moved by that that spirit that i thought this was the place i wanted to try to do everything i can.

>> i want to celebrate the -- senator merkley: i want to celebrate the model of, is there something i can have an impact on. to take it as seriously as you've taken it, to look for real solutions, you've said in your testimony something that caught me offguard. i would have said really? and that to was a country that could feed a third of the world. could you expand on that? mr. afleck: it's got the second biggest rain forest in the world. congo is a massive country. a lot of it is underpopulated this huge jungle, hydropopics there could power southern africa. it's also extremely wealthy in copper, tin, charcoal, lumber, it has every conceivable natural resource. that may be one of the great tranlcies of it, six or seven

countries there during the war trying to grab what they could, diamonds and -- it's just -- it's an incredibly -- it has incredible potential and you know, it suffered from king lie pold and the belgians and -- king leopold and the bell johns -- belgians and others, it's had a lot of bad luck but it's got a tremendous amount of luck. and the people are great people. they're taking step into democracy. they're taking to the streets to demand that democratic changes are transparent. it's an exciting time. but it requires our engagement, our continued engagement, a new envoy, continued engagement from the secretary and you know, to support these commitments that both folks in the private sector and they are -- the commitment to usaid there is important and morally important that we maintain the

continuity of these commitments. senator merkley: i appreciate that russ feingold prouth his -- brought his expertise to bear. there are elections in faw months? mr. afleck: there are elections. the -- they initially attached the elections to a census, sort of got it through the lower house. they're having this decor tedge -- -- they're having this thing to carve up the district the long and short of it is, diplomacy doesn't kansas a nickel and we need to be engaged diplomatically.

there's lts of suspicion in many african countries of some of the former colonial powers. there's nothing but a lot of respect and admiration for the united states and our people and we ought to avail ourselveses of that diplomatically. senator merkley: thank you. for the plans of the panel, each of you are doing really important, valuable work. so often international aid is framed as why should bewe be helping overseas when there's challenges here at home. it's a question worth asking. let's look at it the other way given the gravity of issues around the world shouldn't the u.s. as a leader be engaged? and doesn't it contribute to the relationships on the -- the partnerships that help address world security issues as well and you mentioned, admiral about the soft power side. what we're -- while we're going positive things for the quality of life we're doing things that are valuable to the united states. thank you for all of your work.

>> your work is inspirational. hopefully we'll have in part a shaving effect on the united states congress as we engage in a debate that will make your work harder. mr. afleck i wanted to continue talking about the world food program had run out of money to serve syrian refugees and the consequence of which was pretty clear. these were individuals who had no choice but to feed themselves and their family so if they weren't getting that sustenance from a legitimate source like the world food program then it was groups like isis itself where they were going to be forced to turn to for a paycheck and for a square meal for them and their family system of as we were battling isis, we were making decisions to underfund humanitarian resources that had the effect

of driving people to the very organizations that we are trying to eliminate in the region. i imagine this plays out in the congo, where you have choices to be made. you have militias from the large resistance armies, m-23, that are offering help to these people in the form of small paychecks and sustenance and if they don't have legitimate sources of income i imagine that that drives recrutement and -- drives recrutement to illegitimate sources. i would like to hear you talk more about how this plays into the die nam nick congo. mr. afleck: you see a correlation between increased security and increased development. like hezbollah in southern lebanon when they step in and fill those roles, it creates

problems. and if you look at, i was talking about the f.d.l., they essentially are present in areas where our coffee manufacturers and coe ke farmers are present. now if this all goes away, right, if this the funding is removed, if we're not there it creates a different environment. people have to flee, whether it's them or the depmbings lr or the many, many militias, oftentimes people are forced to join militias to protect what meager things they have. if they just have a job or a purpose, they will stick with it frankly under really, really run out of options. you can work for slave labor in some mine or engage in the kinds of activity that we collectively understand as abhorrent or virtually sort of slave labor. it's really, really important

that we support the civil society that's burgeoning in these cubtries and support economic growth so people have a place to go. i think you make a very good point and you know, congo, as it becomes better developed will no doubt become more peaceful. >> admiral one of the challenges we have is figuring out who to fund. mr. murphy: we have to fund really well organized nonprofits but in the end we have an interest in good governance and so there are reasons to run the money through local governmental institutions. i know the answer is different in each place, but as we look at some of the most dangerous places in the world, parts of africa that we're talking about today or the middle east what's your recommendation and guidance as to the source of this funding? mr. stavridis: you hit the nail

on the head, it is different in each of these venues but as a general proposition using an agency like a.i.d., millennium challenge or state as a betting authority can be very helpful. secondly depending on the individual state and most recently for example, afghanistan, we've had a lot of controversy about whether this aid should throw flu kabul or go directly out into the field. there are even microclimate, you will, wherein you can be confident in sharif in the north, relatively confident in the west but you ought to be a little more concerned as you get down toward orazcan province or a into kandahar. so there's no subse -- substitute for local knowledge and local expertise. you should turn first to the u.s. government as a vetting authority. i want to close by saying i'm very encouraged by some of the reforms that rod shaw put in

place at a.i.d. to increase that capability of this aspect of things. senator murphy: i want to close with a question to you mr. gates. you're a technology expert as senator daines noted but you also know something about marketing. we're in a position where most americans think we're spending 23 october---% of the budget on foreign aid, the reality is worse than it appears. yes we're spending only 1% but if you go back to the peak of foreign aid, the marshall plan, at that point we were spending .3% of g.d.p. on foreign aid. a program that i think everyone agrees has a good deal to do with the world order we're living in today. we got a 94% decline in foreign aid spending as a percentage of g.d.p. since 19 506789 and yet people still believe that it's much bigger, a much bigger share of the budget than it is. what's your quick recommendation as oto how we change people east perception? what are the twor three most

salient points from a marketing perspective to make people understand, make our constituents understand, that we've got to be dramatically increasing the share of the federal budget, or at least the portion of the federal budget we're spend on well run programs? >> most people grossly overestimate what portion of the budget is going to these things. if you ask them, what portion should go, they'll say, two two or three percent, our response is, great, we'd settle for that in a second. that would be a gigantic increase. in terms of share of budget or share of the economy, the u.s. is real tiffly low compared to other countries. mr. gates: in fact, the u.k. as an example raised their level up to be over three times what our level is at a time where they had very substantial deficits. and it was a decision that the relative impact of the aid dollars was very, very high. it's unfortunate that the

historic picture people have is crowded by aid given in the cold war where it's more about the bad guy who is our friend than the humanitarian impact. today the aid budget is not burdened by those things. we're able to go in with the same business-like thinking that i applied at microsoft and said ohio hey, is this money being spent the best way it possibly could? and the percentage of the usaid budget where our foundation is doing something in partnership with the u.s. government is very, very high. so we get the analytic capabilities of usaid that are better today than ever combined with ours and other people and so there's a lot of learning that's going on, areas like agriculture and livestock. it's very exciting the new things, we're talking ability how to get new seeds out thousand raise the productivity and how to create self-sufficiency and so if people knew how small it was and how careful we are to make

sure that there's impact, i think we get strong support for the modest level that we're hoping to maintain. senator murphy: thank you to all of you. thank you, mr. chairman. >> senator moran. senator moran: mr. gates, nice to see you again. we've had a conversation for several years about the eradication of polio in my role and capacity on the labor h subcommittee. it seems we're making significant progress, thanks to your organizations working with rotary international but there's been jut breaks of polio in kenya, i understand. how close are we and what more is it going to take to finally put this circumstance to an end? mr. gates: the first half of 2014 was a concern because we had cases that had come up in syria, cases that had come up in so mall ark spread to ethiopia and kenya.

fortunately those outbreaks are now under control. the country we thought would be the last, nigeria hasn't had a case since july 24. and so if we're lucky if we go another six months without finding a case, then we'd be quite sure. africa may have seen its last case. and so the focus now in pakistan and afghanistan is very intense, taking some of the same tactics that worked in nigeria and we have a period of relative stability where the area up in the area that taliban controls that kids weren't being vaccinated, because the pakistani army is in there we are able to vaccinate enough children to make a difference. so we're hopeful that the polio budget, the a combination of the foreign assistance candlelight and the c.c. budget, that has made a huge

difference. there was an increase there. c.d.c. is abamazing organization a great partner. i was down there spent today with tom freeden talking about ebola and how we work together. very impressive and the extra resources are making a difference. >> con gragelations on your success and thank you for your commitment. let me ask just the panelists generally, what has been the consequence of the effort by the united states and the world community in regard to ebola? what did -- what are lessons that are learned? what does it tell us we ought to know to prevent circumstances such as this from occurring with this disease or any other medical health affliction? what can we learn from the world response to the arrival of ebola in west africa?

my press staff will be disappointed that i didn't get an answer from ben afleck. mr. afleck: you made the right call. mr. gates: everything we do to build up stability reaching out to the poorest, most rural areas, when you don't have good primary health care, that means an epidemic can get started without the global awareness to go in there and intervene at the early stage. infectious diseases are exponentially explosive, the six months that we missed in gi nee because we didn't know -- in guinea because we didn't know what was going on that's what led it to -- to it being a gigantic outbreak. we're very lucky the agent wasn't more infectious. we're lucky that when it was recognized last august that the world, particularly the united states, c.d.c. has done a phenomenal job here, the u.s. military came in with the

logistical capabilities that were lacking there that was invaluable, but we're likely to see some time in the next 20 years a far worse pathogen than ebola and by having high quality primary health care, good surveillance in africa, where it's very likely to emerge, we'll be able to catch it at the early stage and not have it become like the 1918 spanish flu. so it really underscores the investments we have made and the need to do even better on the surveillance front. >> can i comment on that? i want to pick up on what mr. gates said there is a role, i think, for militaries here. this is a classic example of soft power. mr. stavridis: the militaries in which we invest so much have not only firepower capability but enormous logistics muscle. so as a kind of point of the

spear response to get all the real professionals in there, i think there's a role for the military. i'll add that speed is really the key in -- particularly if a pandemic morphs the way mr. gates is talking about, think world war ii, there are -- world war z, there are examples not only in the real world but in fiction, that would tell us we need to be ready for this. i do want to just underline that. >> i appreciate you -- mr. moran: i appreciate you mentioning that. we think that's not why we train military men and women for, why are they being called on to do that? mr. stavridis: a good way to think of that is an on and off switch. life is not an on and off switch. we don't fund the combat to be

in combat, on, or to be sitting at a pier or in barracks, off. it's between hard power and also to bring this logistics, this expertise this intelligence to bear in a crisis like this at speed. we can dial that rheostat toward soft power at that moment. it's a cost effective way to use our military. mr. moran: i -- senator moran: i appreciate that answer. i would use this moment to thank the kansas guard members called to duty in aftera -- africa. mr. gates i reiterate what you said about c.d.c. all frl agencies are subject to criticism. i'm a fan and supporter of dr. freeden and the efforts ebola and many other aspects of what c.d.c. is doing including prevention here in the united states and community health centers. thank you very much to the panel for being here.

>> thank you chairman graham for calling this hearing. i want to follow on the question mr. moran has been leading. i had the opportunity to visit liberia for the third time in december and visit with troops, missionaries folks from the uniform health service and see the work they were doing on the ground and see the impressive impact of the collaboration between significant private sector donors, between continent wide organizations and gass roots community groups. mr. coons: mr. gates as you referenced, we may face a pathogen more lethal, more rapid in its spread than ebola in the coming decades. it's likely we will. we've made significant progress in vaccines as well, developing a field test for ebola and making progress in vaccines for ebola brings hope about this

particular episode coming to an end within the next few months. in addition to the importance of having an african c.d.c. for early warning, how do you see the path forward on vaccine development and strengthening the capabilities for rapid characterization and rapt deployment of vaccine in the face of a more lethal pathogen? mr. gates: it's amazing to me how lit they will world has prepared for a serious epidemic. the u.s. has done more than any other country, but even there we haven't done enough. the ebola vaccine and the treatment called zmapp was partially ready but the time it took even using very unusual regulatory approval and trial processes, the time was too long for likely to have any impact on this particular epidemic. and so our state readiness

wasn't as strong as it needs to be. we do need to draw in other countries to contribute to these efforts. we do need to take the various agencies of the u.s. government to work on this and make sure we have an overall strategy. one thing i called for is that we ought to do in the same way we do war games to simulate challenges tugging at us on the military front that we ought to do germ games where we look and see how we would respond. the last time that was done in the united states 2001, dark winter looked at a smallpox epidemic and the resources proved inadequate. in that case. so there's a good foundation there's a lot of good science, n.i.h. is the lead for the many of these things. and so the idea that tools could be created quickly that is a possibility. but we're not there yet. to give -- to say that we're prepared. >> i think there's important lessons for all of taos learn

here both about the strength of community health system the capabilities of community responders, and the huge cost we ended up having to invest and the significant loss of life that could have been avoidled. senator coons: i hope we take your advice and work together in a responsible way. let me talk about natural resource exploitation. as you know well ben, the eastern congo has been exploited for natural resources. wildlife trafficking has caused problems in the congo basis and other plays on the continent. illegal mining and extractive misuses of natural resources. we're increasingly focused in a bipartisan way in the congress on how that funds extremism and transnational, both criminal and trifflet organizations. i'd be interested, mr. afleck, if you'd speak to what you've seen in eastern congo about this, and admiral stavridis

how these things have been put on the radar for national security issues. mr. afleck: senator thank you very much for the work you have done. one of the great unsung heroes on these issues. maybe partly sung. i don't know how sung you are. senator coons: i sing offkey so not very well sung. mr. afleck: as you point out there's a tremendous amount of oh resources there, gold it goes on and on. almost all of them are dominated by militia groups and quasi-military groups, that has the same effect of encouraging people who are not doing great things. i talked ability the adf in the north, there's the fdlr, the people who committed the genocide in ru wan dand the

organization they've funned and maintained inside congo which they're taking on halfheartedly. what happens is, when these industries are unregulated, they're controlled essentially by local mob ters -- mobsters who have allegiance to higher level organizations and you have a country that's consistently been in the top 10 list of failed states. so you have a security sector situation that's wide open to be exploited and manipulated. i think there's two things to do. one is to try as best we can to help them regulate these industries which is going to meet with a ton of resistance. and two, to try to really examine, look at these group, see where the money is doing some of them, one is an extremist muslim group. others are just as violent and hideous but subscribing to different religions. the truth is it's there. it's happening. and none of these extremist organizations, none of these militias survive even though

the cost of ak-47 there is 40 bucks, none of them survive without these resources. even -- i don't know if you saw the movie, that park which is fighting for its life literally, one of the things that's undermined them is a huge charcoal trade which is ill list and makes money. timber. things that wouldn't expect. all the resources that are there are being swallowed up by illegal organization who pay tariffs to the various powers that be and it's one of the things bedeviling this country and preventing it from achieving real progress. senator koontz: absolutely. thank you for your leadership on combating this and making it better known. admiral, how are we doing in bringing together resource in the fight against wildlife trafficing and illegal mining? mr. stavridis: as mr. afleck correctly points out it's the corruption and the financing

that comes out of it that then undermines these fragile demock circumstances creates ungoverned space and leads directly to security challenges which are global. and of course it's not just in the congo, it's in latin america and the caribbean, it's in afghanistan. it's in the caucus -- caucuses. and we tend as always to look first to the hard power solution but this is a case where many of the soft power things we're talking about career ating jobs, education opportunity, you play the long game and you have a better chance of creating security. i'll close by saying another aspect of this is the routes that come out of it system of if you're moving natural resources that you've stolen or you're moving cocaine or opium these routes create the opportunity to move weapons, extremists and at the really

dark end of the spectrum, weapons of mass destruction. that's another shrimp on the barbie of concern i'll throw out there. thank you. mr. coons: mr. chairman would i be overstaying my welcome if i asked a last question? >> not at all. mr. koontz: mobile telephone technology as transformed the possibility of connection to the modern economy through mobile banking. realtime knowledge about everything from incidents of violence campaign -- incidents in kenya were first documented using an open source platform. some realtime knowledge about the spread of ebola and being able to do tracking was significantly facilitated through cell phones which have now penetrated 70%, 80% of of many of the countries of africa. how do you think we might partner with african nations to both unlock the potential of access to resources and empowerment of small holder

farmers and women's cooperatives and how might we strengthen the ability of citizens to engage in the fight against corruption, against wildlife trafficking against extremism through the platform of mobile commube cases? any member the panel who chooses to answer. >> is this a technology question? mr. coons: that does suggest a first answer. mr. gates: it's exciting what we'll be able to do over the next decade. i'd say we're just at the very start of that. in the case of ebola we weren't able to track movements as well as we would have liked to. having in place the ability to look at the data and make sure we weren't violating people's privacy wasn't set up. i think now that we've, in a delayed way, looked at that day that, what we have known better that's a great impetus to move forward. in terms of the congo, the technology that's even more basic but more critical is satellite photography. the u.s. military of course funded the creation of those

technologies. now in civilian hands, people like digital tpwhrobe are able to show us, you know, knowing the population of d.r.c. knowing where the farming is taking place, we're doing a lot of funding people to do surveys like that we have medicines for things like sleeping sickness and figuring out where are the people and how do we get it out logistically, which is incredibly difficult. it's only because of these digital satellite platforms and over time the increased penetration of cell phones we think even in countries like that we'll be able to get in and do great things. as people are able to do digital transarkses on the cell phones things like remitances, getting back with lower fees, countries being able to understand their economy in a much better way, taking goth payments in an efficient and fairly corrupt before it gets out to the recipient.

if it can be done to the woman's cell phone that make a huge difference. there's a ton of pilot programs involved in this. many of them are involved in what you said preventing corruption by actually documents what's going on when it goes on. if you have to go back and say, did this seminar take place or was this pamente made? the paperwork of when it really did and when it didn't it's not easy to distinguish. but if you get photos taken while things are taking place, it's very possible to make it almost impossible for the money to go astray. there's a lot of promise. senator koontz: thank you. i appreciate the answer. >> can i add a practical example of what mr. gates just said is in afghanistan, where we pay $35 -- we pay 352,000 afghan troops but moved that to a mobile system. they don't have to go back to their village to take a tattered stack of currency and

b, it's document the corruption piece washes out. mr. stavridis: and another thing that's interesting is unmanned aerial vehicles drones, which have a bad rep far will the of reasons but here's a place they can be used effectively to do the kinds of surveillance that mr. gates is talking about in africa and other areas, to look at crop look at tracking to look at who is trying to go after the black rhino, etc. thanks. >> i think there's huge p ten rble for taos make a difference. mr. afleck: as mr. gates said earlier, existing cell phone technology is extremely potent from what i've seen. it's a question of training. and exploiting what's already there. and it makes a big difference. one of the steps that we've seen in congo that's been proposed and i think will be incredibly helpful is to use a kind of a cell phones for banking. so if you're a soldier the

money gets to you because it's transfered to you. the way it works now you make literally no money. you should see the bar -- barracks, they're tent cities. guys are stealing pots and pans that's why you have this impunity. these guys, and this is not evil people. they want to be soldier, they're put in this position. but if the pay didn't have to go through seven officers who all took the cuts and the guy before the soldiers who took the final cut, you'd see a revolutionized -- it would revolutionize the way armed forces work there and they would go from being a really protective force to a pernicious force. that's just one i know of. i'm sure there's many, many more. >> i'd like to -- mr. koontz: i want to thank the whole panel for their contributions today. and mr. chairman, i want to thank you for your leadership over many years and appreciate your calling this hearing today. mr. graham: we've got a hard

stop at noon but senator blunt is here so he'll be our last. inquisitor. mr. blubt: thank you. we had the secretary of labor at our hearing who wasn't nearly as popular as your panel. i have some questions for the record. let me just say that for the work this panel represents, the great private sector partnership that are going on out there with what we do in areas like pepfar, the mother aids transmission successes are incredible. the ag resources -- research successes are incredible. what's happening in the congo. this really brings a level of attention to your leadership and the work we're doing here and also the importance of finding successes that we can talk about where we started a program, we worked with local

partners and at some point we were able to walk away and leave that program with somebody else. it's the kind of thing that creates an understanding and an appreciation for the importance of what this subcommittee does and the partnerships here are incredibly important in encouraging our role to make a difference around the world. thank you, chairman, i'll have some questions for the record. senator graham: thank you, senator blunt. you've been on every trip i've put together. s that great subcommittee. mr. blunt: i'd like that struck from the record. mr. graham: and we've gone to great places like the congo. places that -- i think most people appreciate you going because it means a lot to us. and in two hours we're going to vote to cut this account in half so this is a perfect day

for you to be here. you made a compelling case, scott, we need some financing we don't have today. i think i've learned a lot from the hearing. you've made a compelling days case we're inside the 10-yard line, we're inside these problems. congo may be turning a corner. polio, we've got this stuff on the run. in two hours, the congress, the senate will have a chance to gut this account by 50%. only in america. only in washington. so in about 30 seconds apiece, tell me why that would be a good idea or a bad idea. scott? mr. ford: the footprint that america has in africa which is the only place i've got any direct experience and the good will that we have there through the public and private sector engaging with the rwandan leadership and the gong lease leadership -- and the congress lees leadership, to -- and the congo lembings se leadership,

to withdraw right before we win the game is to throw a pass on the 1-yard line. mr. graham: i'm sure you just made yourself a big hit in seattle. admiral? mr. stavridis: we ought to look hard at what's efficient here. the tiny cost of this account is represented in the president's budget is pennies on the dollar. it's like preventive medicine which we've talked about a lot today. do you want to spend money on massive treatment once the disease has taken place? haas hard power. or would you rather have a program that's prevent i have, that looks at health on a day-to-day basis. that's soft power. it is much less expensive. you need both. there are times when you have to have hard power. but that balance between hard power and soft power, that's smart power. let's be smart and not cut the development and diplomacy

tools, they are absolutely necessary. thanks. senator graham -- >> thank you senator. one of the most basic business tenets we learn early in our career is don't withdraw or blink when you're past the tipping point of success. mr. megrue: we've heard today national security and others. senator murphy asked earlier how to we explain this to the american public. i think part of it is ebs planing some of these incredible successes whether it's polio or what we've been able to accomplish in malaria or mother to child transmission or so many others. i think it's getting that message out there that will cause people to step back and realize that making a cut like you're talking about or proposing a cut like you're talking about, this is the wrong time to do it. and that we will be -- the local governments will be picking this funding up on their own as they have been. >> i think it would be politics

at its worst. mr. afleck: and really, truly shortsighted. what i have seen personally are people who now have a job that didn't used to have a job. who are moving into the marketplace. it's a model. even more so than 10,000 farmers. you would be destroying a model in its earlier most -- earliest, most nascent phase. that is saying business and investment is strong and powerful aid. it gives people self-confidence and a sense of meaning in their lives and brings goods to the market. practice of which has built this country and has proven beneficial to producers to consumers and to the people who live in those communities. and that model that's now starting to be practiced would be diminished and that, i think, would be a real tragedy because ultimately that model is not only going to save the american taxpayer a lot of money, it's going to bring the american taxpayer, it's going

to elevate the economy of the american taxpayer. it would be a crying shame because we're really onto something great. mr. gates: i'd go back to something senator graham said at the beginning which is that the impact per dollar in this budget particularly the health and agriculture pieces that i know best is probably more impactful than any money the u.s. government spends. yes, there should be a very high bar for spending money outside the united states in terms of the benefits to the people back here and to the impact that money has. but if you cut, say $3 billion from this budget we're saving lives for 1,500 -- for $1,500 per life saved and even better benefits for survivor. that's over two million children a year that would die for lack of those resources. something like three billion a year and the cut being proposed is way larger than that.

that matches all the money that our foundation spends in this area. we get a lot of visibility but people should understand that u.s. government, through its broad set of programs that we're partnering with is about 10 times in its total foreign aid budget than the money we've spent. that's the underpinning of why we're seeing progress we're seeing. and it's the foundation for making sure that a mass epidemic is caught at an early stage. >> can i just say one more thing briefly? there's a sense that if we do this, this is what we're doing, these are not priorities. my wife does extraordinary work with early childhood education and the central valley of california. mr. afleck spks -- mr. afleck: that's something she's very passionate about. i do work in the congo.

we can do both. we can do all these things. we can apply our values to our relatives, to our neighbors be they outside our national borders or be they within. i believe that's what america. is mr. gra. -- senator graham: each of you in your own way represent the best of our country. in two hours we're going to go fight for this account. thank you and the hearing is adjourned. >> the supreme court in a 6-3 ruling on wednesday revived a pregnancy discrimination lawsuit by a forme u.p.s. employee, sending the case back to the lower courts for further review. peggy young is a former u.p.s. driver denied a light duty assignment in her pregnancy after her doctor advised her to avoid lifting anything heavier than 20 pounds. u.p.s. will have to explain why they wouldn't accommodate her needs while giving temporary

assignments to workers recovering from on the job injuries. this is an hour. mr. bagenstos: u.p.s. would have granted that accommodation, because her 20-pound lifting restriction resulted from her pregnancy, u.p.s. rejected her request. if it means anything, must mean when an employee seeks an accommodation or benefit due to her pregnancy, she is entitled to the same accommodation. justice: you make it sound as