for pepfar, it is all about results. by targeting the most complex diseases in a modern history, taking it to scale with urgency and commitment in a resource- challenge setting, the united states has challenged the conventional wisdom on really what is possible. our response to the global aids crisis has also transformed the health sector. we are seeing more and more after the initial investment in infrastructure. while focusing on hiv, pepfar's investments have strengthens national health systems so that they can deliver essentials services for all the needs of their people, including the non- hiv needs of h.i.v.-positive people. clinics and hospitals that no longer were overwhelmed with dealing with aids now have the capacity to address other health issues that our people face. beyond that, we have rebuilt hospitals and clinics, increase quality and numbers of health care workers, put in patient information systems, put in quality-control laboratories, and strengthen our procurement and distribution systems. our focus

pepfar will remain america's commitment to an aids-free generation. i have asked the ambassador to take the lead on developing and sharing our efforts on the next stage. we want the next congress, the next secretary of state, and all of our partners here and around the world to have a clear picture of everything we have learned and a road map that shows what we will contribute to achieving an aids-free generation. reaching this goal is a shared responsibility. it begins with what we can all do to break the chain of mother to child transmission. this takes leadership every level from investing in health care workers to removing the registration fees that discourage women from seeking care. we need community and family leaders from grandmothers to religious leaders to encourage women to get tested and demand treatment if they need it. we also have a shared responsibility to support multilateral institutions like the global fund. as the united states has stepped up our commitment, so has saudi arabia, japan, germany, the gates foundation, and others. i e

we will bill pepfar platform to screen for breast and cervical cancer. we launched this in zambia last september. when returned last month, president bush and i were thrilled to see their progress. thank ribbons less red ribbon has expanded beyond the capital city and across the country. multiple >> are now screening, diagnosing, and treating women for car cervical cancer. already, more of 14,000 women have been screened. nearly 40% of those women are hiv-positive. nearly 1/3 of all the women screamed tested positive for pre-cancerous or cancer is cervical cells. of those who tested positive, more than 80% could be treated immediately with cryotherapy. [applause] the first lady of zambia is a doctor in obstetrics and gynecology. she is a champion for the pink ribbon/red ribbon efforts throughout her country. since her husband became president of zambia last fall, she has worked to focus national attention on maternal health and mortality. earlier this week, she hosted a conference for africans to discuss aids and cervical cancer. his strong leadership is

for our part, pepfar will remain at the center of americans' commitment to an aids-free generation. i have asked the ambassador to take the lead in sharing our blueprint for the goals and objectives for the next phase of our effort and to release this blueprint by world aids day. what all of our partners here at home and around the home want to have a clearer picture of everything we have learned and a road map that shows what we will contribute to achieving an aids-free generation. reaching this goal is a shared responsibility. it begins with what we can all do to help break the chain of mother-to-child transmission, and this take leadership at every level, from investing to health-care workers to removing the registration fees that discourage women from seeking care. we need community and family leaders, from religious leaders to encourage women to get tested and demand treatment if they need it. we have a share this possibility to support multilateral institutions like the global fund. in recent months, as the united states has stepped up our commitment, so have saudia arabia, ja

she said outreach done in africa-- part of the president's emergency plan for aids relief, or pepfar, made progress, slowing the spread of the disease. dr. wafaa el sadr leads the international center for aids care and treatment programs at columbia university-- a pepfar partner. >> i realize sometimes when we say that the epidemic in parts of the united states is similar to epidemics in parts of africa that this is quite alarming statement and maybe disturbing statement to many but its true and there are lessons learned, lessons that we can learn from the response in some african countries. >> suarez: she says pepfar-style outreach could work in high- incidence american neighborhoods. >> to actually reach out, go to the homes, in those most affected communities and approach people, talk to them about h.i.v., talk to them about the importance of knowing whether they have h.i.v. or don't have h.i.v. and if you find out that they are h.i.v. infected linking them to care and if you find out that they don't have h.i.v. infection then to offer them prevention interventions. >> suarez: afri

and so here begins pepfar. wonderful.narrator: the president's emergency plan for aids relief. in the years since, the u.s. has spent nearly $32 billion on aids around the world. although there were controversial political and financial conditions to the funding, pepfar has had an impact-- the number of new cases overseas has dropped, year by year. >> i think that america has been very generous about providing health care as well as hiv/aids prevention to other parts of the world, to people who wouldn't get those kinds of care. and i think that that's what makes us who we are as a country. that we do extend ourselves, we do reach out, we try to make the quality of life better for other people. but i don't think that we can lose sight of the fact that we've never really been able to achieve those goals for americans. >> i believe we should make an investment in other countries but i also know that i'm in africa right now. as a state i'm there... sometimes my staff feels like we're there. every time we test another young pe

pepfar is starting to build sustainable health systems that will help us finally win this fight.deliver an aids-free generation. it is hard to overstate how sweeping or how crusher this change is. when president obama took office, we knew if we were going to win the fight against aids, we could not keep treating it as an emergency. we had to fundamentally change the way we and our running global partners did business. so we have engaged diplomatically but ministers of finance and health, but also president and prime ministers to listen and learn about their priorities and needs in order to attract the best way for to get. -- together. that has required difficult conversations about issues that some leaders do not want to face, like government corruption in the procurement and delivery of drugs or dealing with injecting drug users. but it has been an essential part of helping more countries manage more of their own response to the epidemic. we have also focused on supporting high-impact intervention, making tough decisions driven by science about what we will and will not fund, we

effort to build that community along with so many domestic and normal partners and in particular, pepfar has coordinated the power of us working together to plan, coordinate and collaborate to save lives. as we go forward let us reflect on the past would accelerate our efforts in the fight against hiv/aids for the future. here in the united states, we believe the national hiv strategy can bring us closer to a vision of a society where new infections are rare and everyone receives the care they need and deserve. you can follow our efforts to implement the strategy on aids.gov. my hope is that together we can seize this moment of opportunity and channeled its momentum towards achieving our goal of an aids free generation. thank you very much. [applause] the house judiciary committee is considering a bill that would allow states to tax internet transactions even when the seller doesn't have a presence in the stake. at this hearing members heard from tennessee governor and utah state representative wayne herber. this is two hours and 45 minutes. >> without objection to the chair is authorize

able to implement for what we've discussed over the last day or so the extraordinary affect of the pepfarrogram, the global fund philanthropy such as the bill and melinda gates foundation, the clinton foundation, but importantly recently the assumption by the host countries of their own response will become and this has really been very important. so i want to take a look at this. just a couple of minutes of this. what happens when you take an efficacious clinical trial based scientific observation and you try to scale without regionally or locally to see if it becomes effective. there are many examples. i'm just going to give you a few. what about the positive effect of scaling up any retrofire roles? take a look at the red dots which is a percentage of mothers who are actually being treated. take a look at the diminishing blue bar, the number of the percentage of children who are born of hiv. it works. what about the fact that if you treat people do you really save their lives? we now have 8 million people receiving antiretroviral some of middle-income countries, which in fact 840,000 a

and pepfar started by president bush and the global fund that the global world supports, but people arethe numbers like they used to. >> but polls indicate, nick, 6 of 10 americans believe in cutting foreign aid and believe it amounted to 25% federal spending, and is that fact overficti overfiction? >> it is fiction. people believe it is a quarter of the budget and they want it slashed to 10%, but foreign aid amounts to about 1% of the federal spending, and in fact, the humanitarian component of it is only about half of 1%. >> how much further do you believe we need to go? no doubt we have made progress, but where should we get to? >> well, on aids we have been pretty good on the treatment side of it and once people are infected we are good at providing treatment to help people stay alive. and one thing that we have done very well is prevention. there are campaigns about abstinence and being faithful to your partner and for whatever reason that has not worked terribly well. people are aware of the danger, but it just seems remote, and they continue to have unprotected sex, and one of th

i am very grateful to pepfar. the national government and the health minister is here today, dramatically reduce overhead and the entire health care work force of the country. i applaud these efforts and i think more of this can, should, and must be done are around the world. having said that, we all know that money is not the only impediment to meeting our goal. two years ago, we heard about the promise of combination prevention. we heard about the evidence of this prevention. we agreed about the impact of male circumcision, accelerated action in that area. we heard about promising ways to improve the effectiveness of treatment including point of care technology. something our foundation has been involved in. we did not know how to implement these programs that scale but i think most of you left vienna willing to act, eager to act, and a newly energized. two years of progress though none of these proposals have been taken to scale. many hard questions remain. and we could spend a lot of time talking about the har

working with presidents bush and obama to establish pepfar. i know it's a source of great pride to president george w. bush, the leadership he provided, the support he gave, and the pride i think he takes in pepfar. we salute him for that. president obama has continued that work. we're doubling the support for global health initiatives and doubling our investment in the global fund. these commitments and more have helped families in the united states and the vill as of africa and communities worldwide for these actions -- worldwide. these actions have saved lives and there's much more to do. with the international aids conference coming to washington, d.c., we have an opportunity to recommit ourselves to the cause of a world without hiv-aids. that is the challenge that is the goal. we can turn the tide together. after 20 years in congress nothing surprises me much anymore but one thing that does is that after all this time we don't have a cure, but we're hopeful. with the aids conference, when it opens its doors next week, we must stand united