[Senate Hearing 117-] [From the U.S. Government Publishing Office] STATE, FOREIGN OPERATIONS, AND RELATED PROGRAMS APPROPRIATIONS FOR FISCAL YEAR 2022 ---------- U.S. Senate, Subcommittee of the Committee on Appropriations, Washington, DC. NONDEPARTMENTAL WITNESSES [Clerk's note.--The subcommittee was unable to hold hearings on nondepartmental witnesses. The statements and letters of those submitting written testimony are as follows:] Prepared Statement of the Accountability Counsel Dear Chairman Coons, Ranking Member Graham, and members of the subcommittee: On behalf of Accountability Counsel, thank you for this opportunity to provide input on the FY 2022 State, Foreign Operations, and Related Programs (SFOPs) appropriations process. In this written testimony, we will provide recommendations for the U.S. International Development Finance Corporation (DFC), the U.S. Agency for International Development (USAID), the U.S. Export-Import Bank (EXIM), the U.S. Department of the Treasury (specifically, the U.S. executive directors at multilateral development institutions), and the U.S. Department of State (specifically, the U.S. National Contact Point for the OECD Guidelines). Accountability Counsel amplifies the voices of communities around the world to protect their human rights and environment from the impacts of internationally financed projects, including projects funded by development agencies and development finance institutions, private banks, and export credit agencies. Despite good intentions and even with the best due diligence, projects financed by these actors can result in harm to the very communities they are meant to benefit. When negative environmental, social, or labor impacts result from these projects, the affected communities must be made whole. Our requests center on ensuring that local communities most affected by U.S. investments have robust avenues to raise concerns about any unintended impacts from these investments and receive redress when harm occurs. Several institutions, including the World Bank and the Chinese-led Asian Infrastructure Investment Bank, have developed independent accountability mechanisms (IAMs) \1\ to address environmental and social concerns from project-affected people. In addition to addressing grievances, IAMs can provide valuable lessons learned to their institution for the strengthening of future projects. The United States has been a strong champion of IAMs at the multilateral development banks and for its own bilateral foreign investments, with members of both parties recognizing the benefits of these feedback channels. The FY 22 SFOPs bill provides opportunities to further strengthen accountability for U.S. assistance and international investments. Doing so will help ensure that U.S. investments meet their mark and address unintended impacts that can undermine sustainability and lead to reputational damage for the U.S. government and companies. In this spirit, we provide the following recommendations: 1. Include bill language to allocate at least $750,000 to resource the DFC's accountability mechanism. Section 1415 of the BUILD Act requires DFC to operate an IAM to address environmental, social, and human rights concerns related to the DFC's financing. For this mechanism to be effective, it has to have dedicated resources to carry out its functions. It is a common feature of IAMs at other international financial institutions to have a separate budget for the IAM that is controlled by the mechanism. Items this budget would cover would include the director and staff's salaries, resources for dispute resolution processes, compliance review investigations, and advisory notes as well as outreach to project- affected communities. 2. Include bill language to allocate at least $500,000 to resource USAID's new accountability mechanism, and enact report language to ensure that the mechanism contains the key features of an IAM. In directing USAID to establish an accountability mechanism in the explanatory statement \2\ to the FY 21 appropriations law, Congress took an important step to ensure that USAID has an effective avenue to address unintended negative environmental and social impacts to communities from USAID's activities. To be effective, USAID's accountability mechanism must adopt international best practices \3\ and incorporate the standard features of an accountability mechanism, including dedicated staff and compliance, dispute resolution, and advisory functions. As with the DFC's mechanism, the new USAID mechanism will need dedicated resources to operate effectively. 3. Include report language directing EXIM to create an IAM. Although it is positive that EXIM has taken steps to increase opportunities for feedback from communities affected by its financing in recent years, EXIM's current Environmental and Social Project Information and Concerns complaint process is inadequate. The complaint process is not independent from management and the lines of EXIM's operations, which undermines its legitimacy. EXIM should create a fully independent IAM that follows international best practices. While EXIM has an Office of the Inspector General (OIG), an IAM would serve a different function as an IAM can receive complaints related to environmental and social harm directly from affected communities and can facilitate a dispute resolution process or conduct a compliance investigation. In fact, in its 2015 report \4\ on the Sasan Power Limited project in India, the OIG recommended that EXIM create a formal complaint process to address community concerns. To ensure that the IAM is robust and incorporates international best practice, EXIM should conduct a notice and comment period and public consultation to design the IAM. 4. Include report language directing the U.S. executive directors at each multilateral development institution to use the voice and vote of the United States in the respective institution to provide resources to remediate unintended negative impacts from the institution's activities, including those confirmed by the institution's independent accountability mechanism. Although the multilateral development institutions have IAMs to address grievances related to projects, often resources are not immediately available to facilitate full and effective remediation of the harms confirmed by the mechanism. Given the U.S. government's support for strong environmental and social policies and accountability at the multilateral development institutions, the U.S. should support initiatives to ensure that remedy is provided for harmed communities. 5. Include report language directing the U.S. National Contact Point for the OECD Guidelines for Multinational Enterprises to issue a report to the Committees on Appropriations, Senate Foreign Relations Committee, and House Foreign Affairs Committee addressing how the National Contact Point has implemented the recommendations received during its 2017 Peer Review. In addition to championing accountability at development and international financial institutions, the U.S. has also championed responsible business conduct around the world, including in the publishing of the first U.S. National Action Plan on Responsible Business Conduct.\5\ The U.S. National Contact Point for the OECD Guidelines for Multinational Enterprises (U.S. NCP), housed in the State Department, is one of the only non-judicial avenues available for people harmed by U.S. multinational corporations to seek redress and remedy. In 2017, the U.S. NCP underwent an OECD peer review process whereby it received feedback from other countries' national contact points and various stakeholders, including civil society organizations. Since the publication of the peer review report \6\ in 2019, there has been little public information on how the report's recommendations and other recommendations provided during the peer review have been addressed and implemented. Given the importance of promoting responsible business conduct and facilitating remedy when harm occurs, the NCP should publicly demonstrate how it is incorporating the recommendations to strengthen its operations. Thank you for your consideration of our requests. We look forward to continued engagement with you to ensure that U.S. assistance and investments respects the rights and voices of local communities and upholds our national commitment to accountability. --------------------------------------------------------------------------- \1\ Accountability Office FAQs, Accountability Counsel), https:// www.accountabilitycounsel.org/accountability-resources/accountability- office-faqs/ (last visited June 28, 2021). \2\ Further Consolidated Appropriations Act, 2021, SFOPS Statement, https://www.appropriations.senate.gov/imo/media/doc/DivisionK-- SFOPSStatementFY21.pdf--page=94. \3\ This includes incorporating the UN Guiding Principles on Business and Human Rights effectiveness criteria for non-judicial grievance mechanisms--legitimacy, accessibility, predictability, equitability, transparency rights-compatibility, and serving as a source of continuous learning. Office of the U.N. High Commissioner for Human Rights, Guiding Principles on Business and Human Rights: Implementing the United Nations ``Protect, Respect and Remedy'' Framework, U.N. Doc. HR/PUB/11/04, Principle 31 (2011), http:// www.ohchr.org/Documents/Publications/ GuidingPrinciplesBusinessHR_EN.pdf. \4\ OFFICE OF INSPECTOR GENERAL EXPORT-IMPORT BANK OF THE UNITED STATES, REPORT ON THE PROJECT FINANCING OF SASAN POWER LIMITED (2015), https://www.exim.gov/sites/default/files/oig/reports/FinalSasanReport-- Redacted.pdf--page=44. \5\ RESPONSIBLE BUSINESS CONDUCT--FIRST NATIONAL ACTION PLAN FOR THE UNITED STATES OF AMERICA (2016), https://2009-2017.state.gov/ documents/organization/265918.pdf. \6\ OECD, NATIONAL CONTACT POINT PEER REVIEWS--UNITED STATES (2019), http://mneguidelines.oecd.org/United-States-NCP-Peer-Review- 2019.pdf. --------------------------------------------------------------------------- [This statement was submitted by Margaux Day, Policy Director, and Stephanie Amoako, Senior Policy Associate.] ______ Prepared Statement of AIPAC For FY2022, AIPAC urges the Subcommittee's full support for $3.3 billion in security assistance for our strategic partner Israel as outlined by the 2016 U.S.-Israel Memorandum of Understanding. The Middle East is at a crossroads between the current path of turmoil and the road to a more peaceful future. On the one hand, just last month Hamas and Palestinian Islamic Jihad targeted millions of Israeli civilians with over four thousand rockets. On the other, Israel and four Arab states last fall signed the Abraham Accords, setting aside outdated hatreds to forge new partnerships based on mutual acceptance and respect. Despite the pandemic, these states have undertaken a flurry of activity to cement budding commercial, trade, cultural, and personal relationships. The region's hope for a brighter future lies in overcoming rejectionism and embracing normalization with Israel--our strongest ally and the region's democratic anchor. Congress' strong bipartisan support for Israel's security not only helped Israel defend itself last month against the unprecedented rocket assault from Gaza, but also made the realization of normalization with key Arab states last year possible. There has simply been no better return on our foreign assistance dollars than Congress's investment in Israel. Moreover, Congress has consistently encouraged Israel's neighbors to negotiate peace, including key roles securing Israel's peace treaties with Jordan and Egypt and encouraging Israeli peacemaking efforts with the Palestinians. As President Biden has said, ``The only time progress has ever been made in the Middle East is when the Arab nations have known that there is no daylight between us and Israel.'' America's ironclad support for Israel's ability to defend itself by itself has enabled the Jewish state to soundly defeat every attack designed to destroy it. Last year's agreements placed before us the vision of a Middle East at peace with itself, where Arabs and Israelis are mutually invested in each other's economies and futures. Actualization of this vision would strongly secure U.S. national security interests and make Americans safer at home and abroad. It would also benefit Palestinians and open new prospects for peace. Investing in peace through economic partnerships and people-to-people programs is the model of the Nita Lowey Partnership for Peace Fund. This fund was established in last year's bill and authorized for a full five years, and we urge the Subcommittee to provide $50 million this year. The program enjoys strong bipartisan support and indicates Congress' belief that peace between peoples is at the heart of a lasting two-state solution. israel's growing defense requirements Beyond Hamas, other dangerous actors seek to escalate tensions and mire the region in chaos. Foremost among these is Iran, which continues its aggressive behavior and pursuit of a nuclear weapon's capability. In fact, Tehran has grown more belligerent over the past several years: in addition to funding anti-Israel proxies and targeting Israeli-owned commercial vessels at sea, it has directly challenged U.S. warships in the Persian Gulf. Iranian forces have repeatedly fired missiles at our diplomats and troops in Iraq, and Tehran has used its proxies to strike crucial oil installations of our ally Saudi Arabia. Jerusalem's contribution to containing Iranian mischief and helping U.S. forces in the region is more important than ever. As the U.S. looks to reduce its regional military presence, Israel's actions constraining Iranian activities in Lebanon, Syria, and Iraq help advance American interests. Confronting these complex and broad-ranging threats requires Israel to invest heavily in its own defense, including procurement of a wide range of advanced technologies and maintenance of a ready force that can engage in an ongoing low-level ``conflict between wars.'' Spiraling defense costs have forced Israel to spend about 5 percent of its GDP on security--more than any other industrialized nation. The actual costs to the Israeli economy are even higher when considering lost productivity and the need for reserve duty, internal security, civil defense, and anti-terrorism spending. And Israel is projecting significant increases in its defense spending over the next decade. Apart from its own efforts, Israel clearly relies on critical support from America--Israel's strategic partner in upholding its qualitative military edge (QME). In accordance with the President's budgetary request, AIPAC strongly urges the Subcommittee to approve $3.3 billion to Israel in security assistance for fiscal year 2022, as called for in the 2016 U.S.-Israel Memorandum of Understanding, and to resist attaching political restrictions to that aid. By doing so, this Subcommittee will both enhance Israel's security and the prospects for peace. In addition, AIPAC supports a robust, bipartisan foreign aid program that ensures America's strong global leadership position. At just one percent of the federal budget, foreign aid is a relatively small cost-effective investment supporting critical U.S. interests and enhancing global stability and economic growth. Foreign aid enables the United States to support key allies like Israel, spur our job-creating exports, stem the spread of diseases, and help countries in turmoil avoid becoming breeding grounds for terrorism. regional challenges Israel continues to face unprecedented turmoil on its doorstep. Beyond the threat it faces from Gaza, Israel must contend with regional threats emanating from Lebanon, Syria, Libya, Iraq and Yemen. Sub-state actors often dominate the landscape, and one dangerous state actor, Iran, is taking full advantage of the changing realities. We urge the Subcommittee to maintain longstanding provisions in the bill and report that ensure strict oversight and reporting requirements for policy affecting Lebanon, Iran, Syria and the Palestinians. In this new environment, Israel confronts countless challenges. To the northeast, Iran seeks to establish a permanent military presence in Syria. Iran's Supreme Leader Khamenei and the IRGC do not conceal that they seek Israel's destruction. To the north, Hezbollah effectively dominates Lebanon, exploiting Beirut's ongoing crises to tighten its hold on the levers of power. With an estimated 150,000 rockets and missiles--more sophisticated and accurate than ever and located inside homes, schools, and hospitals--Hezbollah poses a dangerous threat to Israel. We urge the Subcommittee continue the reporting requirements addressing Hezbollah's military buildup, including its efforts to acquire an arsenal of PGMs. In the Gaza Strip, Hamas- an American and EU-designated terrorist organization--has demonstrated conclusively its commitment to its terrorist goals. Rather than help its own population, Hamas has used its resources to expand its military capabilities and construct an elaborate terrorist infrastructure-including a broad network of tunnels -to attack Israeli communities. Six million Israelis live within range of Hamas' increasingly accurate rocket arsenal, and many of them spent days in bomb shelters during the recent conflict. Obviously, the international community must do its utmost to prevent Hamas from reconstituting this threat. As this Subcommittee considers assistance for Gaza, it must ensure-as President Biden has directed-that any aid not go to Hamas or strengthen its terrorist infrastructure. Further to Israel's south, Iranian-backed Houthis are creating new concerns for Jerusalem. In early 2021, an IDF spokesperson reported that Israel had intelligence confirming that Iran was sending ``smart weapons'' to Yemen that could target Israel. Israel also needs to prepare for the possibility of a nuclear-armed Iran. Tehran's recent nuclear brinkmanship signals its continued nuclear ambitions. In January, Iran announced it had begun enriching uranium to 20 percent purity at Fordow. In February, Tehran suspended compliance with the Additional Protocol, triggering a crisis at the IAEA and forcing the hurried negotiation of an interim understanding expiring in June. In March, the IAEA confirmed that Iran had started enriching uranium at its underground Natanz plant with a second type of advanced centrifuge, the IR-4. Iran has also conducted approximately 20 ballistic missile tests in defiance of U.N. prohibitions, including long-range missiles capable of delivering a nuclear warhead. In sum, these threats highlight the unprecedented strategic challenges Israel faces today. Whereas Israeli military planners used to confront enemies with conventional weapons and armies, today the threats to Israel's existence come from a broad array of forces with a diverse set of weapons -conventional and unconventional, symmetrical and asymmetrical--that are largely aimed at Israel's civilian population. It is in America's vital interest for Israel--our sole reliable democratic ally in the region -to have the military capabilities it needs to decisively defeat these enemies. bias against israel in the international community Israel's security challenges are compounded by challenges it faces at the United Nations and other international fora, where detractors have hijacked the process to isolate and demonize the Jewish state. U.S. support for Israel at multilateral organizations, especially its longstanding vocal leadership at the UN, has been crucial in pushing back against an ongoing, systematic attack on Israel. Last month the Human Rights Council once again demonstrated its pervasive unfairness toward Israel, creating an open-ended international investigation to target Israel--this time for defending its civilian population against indiscriminate attacks by U.S.-designated terrorists. Israel is also facing an unjust and unfounded case against it at the International Criminal Court. The toxic anti-Israel environment in these institutions is nothing new, and it further poisons Israeli-Palestinian relations at a time when reconciliation is crucial. Strong U.S. support and continued efforts to promote fairness and fight bias in the international arena are crucial. U.S. leadership will also be critical to achieve needed changes at the United Nations Relief and Works Agency. We urge the U.S. to insist on reforms at UNRWA, especially in the organization's education curricula that incite violence and hatred and its approach to refugee status that has exacerbated the human cost of the protracted conflict. u.s. assistance helps maintain israel's qualitative military edge against mutual threats U.S. support for Israel through annual security aid has helped the Jewish state maintain its QME, which Congress has defined in legislation as Israel's ``ability to counter and defeat any credible conventional military threat from any individual state or possible coalition of states or from non-state actors.'' This military superiority has historically prevented war by deterring regional adversaries from attacking Israel. Due to U.S. support for Israel's QME, prospective aggressors know they would face a U.S.-backed ally armed with the world's most advanced weapon systems-both American and Israeli. At the same time, when deterrence has failed, the American- made defense hardware provided to the IDF has enabled the Jewish state to protect itself against the mounting threats. This crucial support has also helped create the environment for regional Arab-Israeli peace that we have seen begin to unfold. We believe that continued U.S. aid to Egypt and Jordan is also important to helping ensure stability in the region, as is the strong U.S. commitment to the Multinational Force and Observers mission in the Sinai. israel: a vital strategic partner As a long-standing pillar of America's Middle East security framework, the U.S.-Israel strategic partnership combats common threats and furthers U.S. policy objectives. These threats include terrorism, regional aggression and destabilization by armed Iranian proxies, weapons proliferation, counterfeiting, cyber warfare, and the spread of extremism. In this context, Israel's military strength and geo- strategic location provide a strong deterrent to regional actors opposed to the U.S. Coordination between Israeli and U.S. military counterparts has expanded considerably as Iran's disruptive behavior from Syria to Yemen to Iraq and the Arabian Gulf has metastasized since 2015. One portent of even stronger U.S.-Israel cooperation with other regional allies is the recent transfer of Israel from our military's European Command area of responsibility to Central Command. Israel's stable, democratic, and reliably pro-American orientation ensures that we can consistently rely on our alliance with the Jewish state. This has been an enduring constant through Republican and Democratic administrations and across a range of Israeli governments. For over 30 years, both the U.S. and-Israel have benefitted from joint military training exercises and joint research and development against common threats-from high-end weapons and cyber-attacks to improvised explosive device (IEDs) and terrorist tunnels. Twice each year, U.S. Marines conduct desert warfare training with their IDF counterparts, and American soldiers and security officials regularly visit Israel to study its approach to urban combat. U.S. pilots hold simulated combat training with the Israeli Air Force. In addition, Israel and the United States have cooperated on a wide range of intelligence-sharing programs, including monitoring Iran, Syria, al- Qaeda, and other terrorist groups and sponsors. In the biennial Juniper Cobra exercise, U.S. and Israeli forces practice an integrated defense to counter the growing threat from ballistic missiles and long-range rockets. Given a U.S. desire to reduce overseas commitments, Israel's role as a reliable ally in a critical region is more important than ever. cooperation produces critical new military, defense and civilian technologies With America's support, Israel has developed an advanced, multi- layered missile defense shield protecting Israel's population centers and providing a degree of protection to deployed American forces. The $500 million in annual U.S. missile defense funding support outlined in the current MOU is matched by Israel's own investments and in-kind contributions for Iron Dome, David's Sling, and Arrow. AIPAC also strongly supports the expansion of U.S.-Israel civilian cooperative programs. These programs have made America stronger through the development and introduction of technologies relating to energy efficiency, cybersecurity, and water scarcity. Israel has in recent years also brought some of these technologies to the developing world - furthering sustainability, helping lift millions out of poverty and creating enormous possibilities for cooperation between Israel and our development agencies. We urge continued funding for the $2 million USAID-Israel international development cooperation program. conclusion As Congress considers U.S. priorities for the Middle East, one thing remains certain: ensuring Israel's security promotes American values and vital interests. This Subcommittee-headed ably by Chairman Coons and Ranking Member Graham-deserves great credit for its stalwart advocacy for the U.S.-Israel relationship and the overall foreign aid budget over the years. That includes not only reliably providing the full funding that is so vital to keeping Israel secure and strong, but also codifying the equally important policy provisions dealing with so many aspects of U.S. policy in the Middle East. This bipartisan support will remain even more critical as America and Israel continue to work together to meet the challenges and opportunities that lie ahead. [This statement was submitted by Howard Kohr, CEO.] ______ Prepared Statement of the Alliance for International Exchange As Executive Director of the Alliance for International Exchange, I appreciate the opportunity to submit testimony supporting funding of $1.1 billion for educational and cultural exchange programs administered by the U.S. Department of State's Bureau of Educational and Cultural Affairs in Fiscal Year 2022. As the collective public policy voice of the exchange community, the Alliance comprises nongovernmental organizations representing the international educational and cultural exchange community in the United States. We greatly appreciate our productive working relationship with the Subcommittee and its strong and consistent support for exchange programs. This appropriation will allow the U.S. Department of State to reinvigorate and expand educational and cultural exchange programs, a cost-effective public diplomacy tool, with unique capacities to adapt rapidly and effectively to foreign policy and national security priorities, while building relationships with strategic audiences in key countries. Exchange programs enable the U.S. to build relationships with current, emerging, and future leaders, and provide opportunities for engagement with youth, women and girls, as well as program alumni. It further allows the U.S. Department of State to provide opportunities for young Americans to study and research abroad, equipping them with the skill set they need to succeed in today's global marketplace. We believe U.S. funding for exchange programs should be balanced and strategic by reaching a range of people from many different countries. Our country is very well served by supporting initiatives to discover and cultivate emerging leaders; language and area studies programs that prepare U.S. citizens for the workforce; capacity development for women; youth engagement; exchanges of cultural and artistic expression; interactions with international athletes; and virtual exchanges that connect people who are unable to travel. This comprehensive approach to exchanges has been very effective in advancing our nation's strategic interests and should be maintained. supporting u.s. national security U.S. Department of State exchange programs allow the U.S. to engage with wide and diverse audiences and emerging leaders from around the world, many of them from countries key to our national security interests. American students studying abroad through U.S. Department of State exchange programs are ambassadors of the next generation of American leaders, highlighting our most promising young people and promoting American values around the world. U.S. Department of State evaluations repeatedly show that international exchange participants who visit the United States complete their programs with a better impression of our country, the American people, and our values. U.S. ambassadors around the world consistently rank exchange programs among the most useful catalysts for long-term political change and mutual understanding. One in three current world leaders has participated in a U.S. Department of State exchange program. Notable exchange program alumni include 583 current or former heads of government, 84 Nobel Prize winners, 64 representatives to the United Nations, 31 heads of international organizations, and 97 members of the U.S. Congress, according to U.S. Department of State data. Between the global pandemic, rising nationalism, challenges to democracy, climate change, increasing distrust between people, and the weaponization of disinformation, it is more important than ever to acknowledge the value of exchange programs in supporting national security. This educational and cultural exchange programs appropriation would help further our foreign policy objectives through more initiatives like the following: a youth program connecting U.S. community colleges with peers in Jordanian and Iraqi institutions to co-develop solutions for sustainability challenges faced by businesses; the 2020 Elections Virtual Reporting Tour which convened 214 journalists from 114 different countries and enabled international journalists to generate more than 1,200 media products with credible reporting; and, a Virtual Alumni Reunion of the Pan-Africa Youth Leadership Program (PAYLP) which engaged over 300 participants from 30 countries across sub-Saharan Africa and encouraged participants to recommit themselves to their community. Given the myriad global challenges, it is critical that the U.S. both rebuild and construct anew the human networks needed to successfully tackle these and future challenges. Building and maintaining networks is important for creating sustained connections and is also a cost-effective way to enhance the impact of exchanges. This appropriation would allow for: rebuilding volunteer and community networks which have eroded from the Covid-19 pandemic; providing financial incentives for communities and organizations to support exchanges once again; and supporting alumni networks through events, programs, and administrative costs. strengthening the u.s. economy U.S. Department of State exchange programs are a cost-effective investment that not only enhance America's long-term competitiveness but also provide significant and immediate economic impact in communities across the country. Most of the U.S. Department of State exchanges budget is spent either on Americans, American businesses and organizations, or in the United States. The 430+ EducationUSA Advising Centers supported by the exchange program appropriation facilitated 1,075,496 international students coming to the U.S. in the 2019-2020 academic year. These students who were enrolled at U.S. colleges and universities across the U.S. contributed $38.7 billion to the U.S. economy and supported 415,996 jobs, according to NAFSA: Association of International Educators. U.S. Department of State exchange programs provide opportunities for Americans to build international experience and connections, expand their global perspective, and gain foreign language and cross-cultural skills that are critical to business and national security. increasing mutual understanding Exchange programs have a proven track record of building respect and increasing mutual understanding between Americans and citizens of countries around the world. For example, 94% of exchange students from Muslim-majority countries reported having a deeper, more favorable view of the American culture after their stay in the United States, according to a U.S. Department of State evaluation of the Kennedy-Lugar Youth Exchange and Study (YES) Program. Support from Congress allows the U.S. Department of State to strategically align its programs with key U.S. foreign policy interests and to facilitate exchange experiences for more than 55,000 American and international exchange participants each year, including: --Bringing emerging and future leaders to the U.S. on programs like the Kennedy-Lugar Youth Exchange and Study (YES) Program between the U.S. and countries with significant Muslim populations; the Future Leaders Exchange (FLEX) Program for high school students from Eurasia; the Young Leaders Initiatives in Africa, Southeast Asia, and the Americas; and the International Visitor Leadership Program (IVLP); --Expanding opportunities for young Americans to study abroad through programs like the Benjamin A. Gilman International Scholarship Program; --Continuing to engage students and scholars through the renowned Fulbright Program; --Engaging and training young professionals through programs such as the Congress-Bundestag Youth Exchange (CBYX); and --Broadening engagement with youth, women and girls, as well as program alumni. Increasing mutual understanding also requires expanding exchanges to include new audiences. With this appropriation for educational and cultural exchange, program sponsors could achieve objectives like the following: expanding programs that prioritize underserved communities in the U.S.; expanding domestic outreach and recruitment of host families and students; and building relationships with other regions of the world to diversify inbound exchange programs. Additionally, a critical part of incorporating new audiences is successfully integrating technology. Learning from the lessons of the COVID-19 pandemic, program sponsors are continuing to incorporate virtual elements or fully virtual programs after the pandemic. Although virtual programming helps reduce costs for participants, it comes with higher administrative costs for program sponsors who must build necessary virtual infrastructure, hire and train staff to effectively use virtual tools, and acquire reliable virtual platforms. This appropriation should allow for virtual activities to successfully complement traditional face-to-face exchanges, furthering the reach and impact of these programs worldwide. Again, thank you for the opportunity to express our support for funding of $1.1 billion for U.S. Department of State educational and cultural exchange programs in Fiscal Year 2022. We look forward to working with the Subcommittee to ensure that international exchange programs continue to play a vital role in supporting U.S. national security, strengthening our economy, and increasing mutual understanding between the U.S. and countries around the world. Thank you for your consideration. [This statement was submitted by Ilir Zherka, Executive Director.] ______ Prepared Statement of the Alliance for Middle East Peace Chairman Coons, Ranking Member Graham, and Members of the Subcommittee: First and foremost, I would like to thank the members of this Subcommittee who have contributed and supported Israeli-Palestinian peacebuilding projects throughout the years. Your continued leadership saves lives, alleviates suffering, and furthers American values and ideas. My name is Avi Meyerstein, and I am the Founder and President of the Alliance for Middle East Peace (ALLMEP), the region's largest network of peacebuilding organizations. On behalf of our coalition of over 150 organizations building partnerships, cooperation, and peace between Israelis and Palestinians, I urge this Subcommittee to continue its longstanding support for critical people-to-people and peacebuilding programming in Israel and the Palestinian Territories by providing funding of at least $50,000,000 for the Nita M. Lowey Middle East Partnership for Peace Act in the Fiscal Year 2022 State, Foreign Operations, and Related Programs bill, with at least $35,000,000 of this amount provided for the new People-to-People Partnership for Peace Fund at USAID. In the last month, Israelis and Palestinians have suffered horrific violence. Over 200 Palestinians lost their lives, including 6 members of an ALLMEP staff member's family. More than 3,000 rockets were launched into Israel, terrorizing Jewish and Palestinian Israeli alike, and killing over 15 people. In the West Bank, at least 20 have lost their lives due to unrest. In mixed Jewish-Palestinian cities in Israel, violence peaked with an unprecedented and disturbing wave of mob violence, with Arabs and Jews attacking the ``other.'' We saw communities coming apart at the seams as dehumanization runs rampant. This wave of violence leads us to one important conclusion: we cannot allow a return to a familiar and unstable status quo which repeatedly increases violence and animosity while rendering a final resolution of the conflict impossible. The ceasefire should not encourage complacency from the United States Government. All the tinder that led to this explosion not only remains but is rapidly continuing to re-accumulate. We must address this situation head-on, and Congress has the unique opportunity to support the Administration in creating a new strategy that takes a long-term approach and tackles realities and attitudes on the ground that will either determine whether we create the conditions for peace or else see further bloodshed. Last year, Congress delivered a game-changing tool that, if fully implemented and leveraged, has the potential to radically change these dynamics on the ground: the Nita M. Lowey Middle East Partnership for Peace Act (MEPPA). ALLMEP would like to thank all the sponsors who pushed for this pioneering legislation that helps set a new standard for international support, in terms of both strategy and capacity. In particular, we would like to commend Congresswoman Nita Lowey, whom the bill is named after, Congressman Jeff Fortenberry, Senator Lindsey Graham, Senator Chris Coons, and Senator Tim Kaine for their leadership in advancing this legislation. MEPPA offers the one thing that has always stood between proven civil society initiatives and widespread change: the promise of sufficient peacebuilding resources to operate at the same scale as the conflict itself. MEPPA creates the opportunity to do for the Middle East what the International Fund for Ireland did in Ireland, where the US and other governments created and funded the IFI to deliver and sustain peace. Rigorous analyses and evaluations conclusively and consistently demonstrate that people-to-people and reconciliation programs work-- creating greater trust; enhanced cooperation; increased ``conflict resolution values;'' decreased aggression and loneliness; and fewer hazardous environmental and health conditions between project participants from opposing sides of the conflict. Equally important, these projects give participants tangible ways to work toward a better future, embedding a win-win paradigm that challenges the zero-sum narrative that risks further destabilization in the region. In a July 2019 program evaluation by USAID, participants in US- funded people-to-people activities in Israel and the West Bank had an increased belief that peace is possible, compared to their peers, and came away with positive feelings about their counterparts.\1\ The evaluation also found that a significant percentage of participants stayed connected with one another despite violence, social stigma, and the challenges of meeting in person regularly.\2\ In 2014, researchers evaluated the impact of the Parents Circle Families Forum Dual Narrative Project, History through the Human Eye. The program was designed for bereaved Palestinian and Israeli families to attend multiple dialogue sessions, where they share their own stories, as well as get the opportunity to hear the firsthand experience of Holocaust survivors and Palestinian refugees. The program concludes with an exercise that challenges the other to ``stand in the other's shoes'' and represent the other's stories with empathy. 77% of participants reported an increased belief in the possibility of reconciliation, 71% reported improved trust and empathy for the other, and 68% reported increased levels of acknowledgment and knowledge of their counterpart's narrative.\3,4\ A similar study was conducted on participants of the Near East Foundation's Olive Oil Without Borders program. The project consists of 3,400 Israeli and Palestinian olive producers working together to export 4,500 tons of olive oil from the West Bank to Israel, producing over $25 million for Palestinian farmers. 90% of participants reported increased trust in ``the other'' and 77% indicated an intention to continue cross-border cooperation.\5\ While the case for peacebuilding has been made with the passage of MEPPA, it is important to return to this data and remember just how transformative an impact the future could hold. Indeed, the network of organizations and participants engaged in this work played a critical role in calming the recent crisis, mobilizing thousands of people--both Jews and Palestinians--to march together for peace and unity in the face of unprecedented street violence. People-to-people peacebuilding is one of the few proven tools for addressing ethnic and territorial conflict. Especially with a conflict as deep-seated and mired in mistrust as the Israeli-Palestinian conflict, it is incumbent on us all to deploy this tool with seriousness and rigor. We know it is effective in disrupting some of the most firmly embedded attitudes mentioned earlier, which conflicts thrive upon. Repeated studies cited in this testimony, by the United States Institute of Peace, and by USAID demonstrate that these programs are effective, and that their results can be transformative and long- lasting. We see all around us the alumni of these programs being disproportionately represented as leaders and activists in the movements and campaigns to end the conflict. If we know it transforms individuals and families, then we have a responsibility to work to ensure it can do the same with entire communities and societies. The single-biggest impediment is the availability of adequate resources. As such, we urge this Committee to allocate $50,000,000 towards the Nita M. Lowey Middle East Partnership for Peace Act. MEPPA offers incredible promise, not only because it makes the single largest investment ever in Israeli-Palestinian peacebuilding, but also because it promises to bring a new kind of investment--one that can take a coordinated, holistic, field-wide view to deploy resources strategically for maximum impact. Our entire sector is deeply grateful for Congress's continued support and leadership in peacebuilding programs. I thank you for all your previous support for the passage of the Nita M. Lowey Middle East Partnership Fund for Peace Act and look forward to working together on the FY22 appropriations package. --------------------------------------------------------------------------- \1\ Brown Guzman, Danice & Khatiwada, Lila. ``Expanding the Reach of Impact Evaluations in Peacebuilding: A Retrospective Evaluation of CMM P2P Activities in Israel/West Bank,'' USAID (United States Agency for International Development, July 2019), https://pdf.usaid.gov/ pdf_docs/PA00TVV3.pdf, 4. \2\ Ibid, 20. \3\ Ned Lazarus. ``A future for Israeli-Palestinian peacebuilding.'' Britain Israel Communications Research Centre (2017), 48. \4\ Anat Reisman-Levy & Jamal Atamneh. ``Evaluation Research: Narrative for Change.'' Parents Circle- Families Forum (2014-2017), 13. \5\ Charles Benjamin. ``Near East Foundation Annual Report 2016.'' Near East Foundation (2016), 11. [This statement was submitted by Avi Meyerstein, Founder and President.] ______ Prepared Statement of the American Bar Association Chairman Coons, Ranking Member Graham, and Members of the Subcommittee: My name is Patricia Lee Refo and, as President of the American Bar Association (ABA), I am pleased to submit this statement on behalf of the association. Thank you for this opportunity to reiterate the importance of continuing U.S. leadership and support for the promotion of democracy, human rights, and the rule of law around the world. The ABA appreciates that there is wide bipartisan agreement in Congress that programs to promote the rule of law internationally are valuable and cost-effective investments of U.S. taxpayer dollars that enhance both the national security and economic prosperity of our nation. Support for these programs is also consistent with our values as a nation. The ABA supports increased funding for Democracy, Human Rights, and Governance (DRG) programs for Fiscal Year 2022, including no less than $2.5 billion for Democracy Programs. Specifically, the ABA supports a renewed commitment to promoting rule of law programming within the DRG sector. Countries with weak or deficient respect for the rule of law invariably suffer a variety of ills, and the lack of rule of law leaves the constituent population without the tools to address these challenges. Properly understood, rule of law is akin to an immune system of governance. When it is healthy and robust, government can systematically address a wide array of issues-corruption, cybersecurity, terrorism, and climate change to name a few. When the immune system is compromised, the converse is true, and the ability of a government to fully utilize foreign assistance for sustainable development is in doubt. Funding for rule of law assistance is a force multiplier for the U.S. government because, when countries increase rule of law, the constituent population is empowered to enforce their own rights, grow their own economy, and effectively utilize the assistance they receive. As a long-time implementer of rule of law programs, the ABA can attest that the U.S. receives significant returns on this investment. For more than 30 years and in more than 100 countries, the ABA, through our Rule of Law Initiative (ABA ROLI), Center for Human Rights (CHR), and International Law Section (ILS), works to protect human rights, and promote justice, economic opportunity, and human dignity through the rule of law. Founded just after the fall of the Berlin Wall, ABA ROLI's early efforts focused on assisting Eastern European countries to draft constitutions and laws. The program also helped embolden judges, prosecutors, lawyers, and legal educators to take the lead in establishing--or in some cases re-establishing--the rule of law after decades of communism and repression. The early model of American lawyers offering pro-bono services to their colleagues in developing democracies remains at the heart of our global programs. In fact, lawyers, law firms, and other experts have contributed more than $300 million in pro bono support for our programs. Through ABA ROLI, CHR, ILS, and other initiatives, the ABA has a framework in place to respond to requests for assistance from every region of the world and can provide expertise in virtually every area of law, including such areas as advancing women's rights, combating trafficking in persons, fighting corruption, reforming judicial systems, ensuring access to justice, and defending human rights. Our programs work in close cooperation with government institutions and civil society organizations, including bar associations, judicial training institutes, ministries of justice, law schools, police, United Nations missions, and an array of non-governmental organizations. In 2020, ABA ROLI executed more than 100 programs in 50 countries in every region of the world with funding from the U.S. Department of State, U.S. Agency for International Development, and other multilateral donors and private foundations. aba roli in sub-saharan africa In 2020, ABA ROLI supported 24 programs in nine Sub-Saharan countries including Burkina Faso, the Central African Republic, Democratic Republic of Congo, Eswatini, Liberia, Niger, Somalia, Southern Africa, Tanzania, Uganda, Sudan, Zambia, and the African Union. Our work in Sub-Saharan Africa seeks to promote accountability for human rights violations, strengthen justice sector institutions, and increase access to justice for historically marginalized populations, particularly the rights of women and the poor. We emphasize a multi-disciplinary approach to the provision of assistance, using information and communications technologies to overcome weak or absent justice infrastructure, and empower individuals and communities to defend their rights and advocate for their futures. aba roli in asia and the pacific In Asia and the Pacific, ABA ROLI implemented country-specific programs in the Philippines, Pakistan, Sri Lanka, Maldives, Malaysia, and Vietnam, as well as a South-East Asia regional program to combat corruption. The division has previously operated country programs in Afghanistan, Cambodia, China, Fiji, India, Indonesia, Laos, Mongolia, Nepal, Papua New Guinea, Solomon Islands, Thailand, and Timor-Leste. The division's programs include substantive areas such as: anti- corruption, human trafficking, wildlife trafficking, access to justice, freedom of expression and religion, child rights, business and human rights, counter-terrorist financing, strengthening law-related institutions, and improving the skills and cooperation of legal actors such as prosecutors, judges, and lawyers. aba roli in europe and eurasia Originally known as ABA CEELI, the Europe and Eurasia Division has worked in 28 countries across the region. Today, we implement country- based and regional programs in Albania, Armenia, Bosnia & Herzegovina, Belarus, Georgia, Hungary, Kosovo, Macedonia, Moldova, Kazakhstan, Kyrgyzstan, Romania, Russia, Serbia, Tajikistan, and Ukraine. These programs have: increased access to justice and transparency of the judicial process; educated populations about their rights and responsibilities; supported efforts to combat trafficking in persons, cybercrime, drug trafficking, and other transnational crimes; and strengthened legislation and legal institutions in countries seeking European Union accession. aba roli in latin america and the caribbean ABA ROLI's Latin America and the Caribbean Division operates programs in El Salvador, Mexico, Peru, and a regional program covering El Salvador and Guatemala. Our work in the region includes a wide array of rule of law thematic areas: strengthening LGBTQ organizations; supporting legal education in transitions to accusatorial criminal justice systems; strengthening the investigation and prosecution of transnational organized crime, corruption, illegal gold mining and related crimes, money laundering and drug trafficking, hate crimes, feminicide and trafficking in persons; assisting institutions to strengthen judicial oversight; bolstering the capacity of forensic laboratories and of justice institutions to use forensic evidence in criminal cases; and providing technical support to legislative and policy reform in substantive areas. aba roli in the middle east and north africa Currently, the Middle East and North Africa Division maintains offices or operates bilateral programs in Jordan, Lebanon, Morocco, Libya, and Tunisia. It also conducts regional programs involving other MENA countries. These programs focus on judicial development, women's rights, the role of women in the legal and judicial profession, legal education reform, legal profession reform, human rights and access to justice, governance, and anticorruption. Since initiating work in the region in 2004, ABA ROLI has conducted nearly 150 programs in 17 countries, including dozens of assessments of legal systems and related issues. aba roli's global thematic programs Two of ABA ROLI's global thematic programs include the Criminal Justice Collaboration and Partnership (CJ-CAP) and the International Justice Sector Education and Training (IJET) programs, both funded by the Department of State's Bureau of International Narcotics and Law Enforcement Affairs. CJ-CAP empowers small groups of criminal justice actors to develop a coordinated, interagency approach to tackling cross-cutting criminal justice problems that cannot be addressed by one agency alone. The IJET program brings small groups of justice-sector professionals to the U.S. for month-long fellowships to empower them to implement strategic reform in their home country's justice sector. Each IJET fellowship includes a combination of seminars and training, peer- to-peer exchange, institutional visits, and an embedded mentorship with a leading U.S. professional. Following the IJET fellows' return to their country, ABA ROLI and their mentors continue to support the implementation of their change plans by providing expertise and material resources. Focused on enhancing collaboration and strengthening evidence-based programming among justice sector practitioners in the U.S. government and beyond, JusTRAC+ fosters opportunities for information sharing and dialogue and supports learning by improving access to evidence-based practices. In 2020, ABA ROLI coordinated the efforts of the JusTRAC+ thematic communities of practice on Justice Sector Measurement and the Nexus of Transnational Organized Crime and Corruption to develop two knowledge products. Both tailored as practical guides for practitioners in the field, one focused on court performance measurement, and the other focused on countering corruption-enabled transnational crime. The JusTRAC+ Knowledge Portal (www.justracportal.org/) being built by ABA ROLI's team, which features curated resources and discussion boards, will be debuted in 2021. Women and Girls Empowered (WAGE) is a global consortium to advance the status of women and girls, led by ABA ROLI in close partnership with the Center for International Private Enterprise, Grameen Foundation, and Search for Common Ground. WAGE works to strengthen the capacity of CSOs, private sector and semi-private sector organizations, including micro finance institutions in target countries to: 1) improve the prevention of and response to gender-based violence; 2) advance the women, peace, and security agenda; and 3) support women's economic empowerment. In this context, WAGE provides direct assistance to women and girls, including information, resources, and services they need to succeed as active and equal participants in the global economy. WAGE also engages in collaborative research and learning to build a body of evidence on relevant promising practices in these thematic areas. the aba center for human rights The ABA Center for Human Rights, established a decade after ROLI, promotes and protects human rights worldwide by defending advocates who face retaliation; rallying thought leaders on crucial issues; and holding abusive governments accountable under law. Through its Justice Defenders Program, funded since 2011 by a grant from the Department of State's Bureau of Democracy, Human Rights, and Labor, CHR supports lawyers, journalists, and advocates protecting human rights, anywhere in the world. To date, the program has leveraged more than $2 million in free legal assistance to more than a thousand advocates worldwide. CHR recently has enhanced this program with significant funding from the Clooney Foundation for Justice. CHR also combats impunity by helping to strengthen U.S. and international law to ensure that people who commit mass atrocities are held accountable. CHR also fights modern slavery by working with the Uniform Law Commission to fortify state law to ensure that human traffickers find no haven in the U.S., and works to protect LGBTQ persons, advance global health by shaping a human rights framework for confronting public health challenges, and improve international standards to protect human rights from harmful business practices. modes of delivery and choice of implementing instrument We urge the Subcommittee to continue to recognize the benefits of assistance delivered through non-profit NGOs. We note that previous bill language directs USAID to implement civil society and political competition and consensus building programs abroad in a manner that recognizes the unique benefits of grants and cooperative agreements, and request that the Subcommittee expand the language to include rule of law programs. Non-profit organizations funded through grants and cooperative agreements are more likely to develop long-term relationships that build capacity and allow for sustainable assistance efforts. In addition, NGOs are more likely to leverage U.S. assistance dollars through the contributions of volunteers and additional sources of funding. Independent U.S.-based NGOs are best positioned to work as true partners with local leaders to make sure the outcomes are owned locally but are operated under the oversight of experienced implementers that also serve as fiduciaries of American taxpayer dollars. conclusion The U.S. has been able to play a critical leadership role in the world because it has, over multiple administrations of both parties, maintained a values-based foreign policy that advances the conditions for a peaceful and prosperous world. Failure to sustain and fund that policy risks ceding our leadership position to those who would remake the global order in ways that will certainly not serve U.S. interests. Establishing governments, legal structures and institutions based on the rule of law are necessary prerequisites to establishing resilient democratic societies and successful market-based economies. Programs such as those outlined above are cost-effective means through which to advance both the interests of individuals in participating countries and U.S. foreign policy, and we urge you to continue to support them for Fiscal Year 2022. [This statement was submitted by Patricia Lee Refo, President.] ______ Prepared Statement of the American Councils for International Education: ACTR/ACCELS Mr. Chairman, Thank you for the opportunity to provide testimony to the Subcommittee on behalf of American Councils for International Education. I am requesting that the Subcommittee recommend funding in the fiscal year 2022 State, Foreign Operations bill of at least $1.1 billion for programs under the Department of State's Bureau of Educational and Cultural Affairs (ECA). Further, I ask that funding within ECA be provided at the current amount of $113.86 million for Citizen Exchange Programs and that the Critical Languages Scholarship program be funded at a level of $15 million. I also ask that funding of at least $3 million be recommended for Research and Training for Eastern Europe and the Independent States of the Former Soviet Union Program. As President of American Councils for International Education, I have the privilege of overseeing one of the leading nonprofit organizations administering U.S. Government and privately funded exchange and educational development programs in areas critical to U.S. interests around the globe. I am also the President of the National Council for Eurasian and East European Research, created in 1978 to develop and sustain long-term, high-quality programs for post-doctoral research on the social, political, economic, environmental, and historical development of Eurasia and Central and Eastern Europe. American Councils is among the administering organizations for the State Department's programming to increase mutual understanding between the U.S. and the world. The past year has posed monumental challenges to the critical international exchange and educational development efforts, bringing international mobility to a standstill due to the COVID-19 pandemic. The ability for organizations like American Councils to convene in-person activities in the U.S. and countries that are crucial to our foreign policy objectives was severely impacted. Although much good and effective work was done on virtual platforms to promote region-to-region and people-to-people connections that are of the utmost importance to the United States, valuable time and opportunities for engagement have been lost. Creating an increased sense of urgency are the efforts of countries such as Russia and China to continue promoting competing outreach initiatives around the world. Significantly, as the implementation of people-to-people programs between the U.S. and these two countries has become increasing difficult, Russia and China have stepped up efforts to build ties in critical areas like Central Asia, Central and South East Europe, the Middle East, and Africa. It is crucial that the U.S. strengthen its outreach efforts wherever possible and close the gap that has been created by the pandemic. The United States Congress has always played a vital role in defining our national goals for countries and regions of strategic and national security importance to the United States, and the Subcommittee is to be thanked for embracing these activities. Innovative programs in education, research, and training, as well as activities promoting critical thinking and media literacy, not only serve national security interests, but highlight the role of the U.S. as a leader in these areas and demonstrate the unmatched effectiveness of the U.S. education system. No instrument of ``soft power'' is more cost-effective than American outreach to the rising generation of young leaders and professionals through congressionally funded programs. They provide a significant long-term multiplier effect at relatively low cost, as alumni later rise to increasingly important roles in government, the private sector, and the NGO community. It is also important to acknowledge that resources used on effective public diplomacy reduce the amount of funding required for defensive action. Without a doubt, these programs benefit not just the countries on which they focus; they also benefit the U.S., which must strategically engage with the global community. educational and cultural exchange (ece) To be effective, U.S. public diplomacy must reach beyond the English-speaking citizens in foreign capitals. The non-Fulbright side of the State Department exchanges account does precisely this. It provides for some of the most cost-effective and universally admired international education programs in public diplomacy today. The Future Leaders Exchange (FLEX) program for Eastern Europe/ Eurasia and the Youth Exchange and Study (YES) program for nations with substantial Muslim populations were created by the U.S. Congress and boast today over 40,000 active alumni, most under the age of 40. Most recently, American Councils was proud to facilitate the expansion of the FLEX program into several Central European countries, where the U.S. needs to maintain a strong voice in the increasingly competitive global landscape. Programs like FLEX and YES are critical to U.S. interests, as are counterpart programs like the Critical Language Scholarship Program and the National Security Language Initiative for Youth that place similar numbers of U.S. high school and university students overseas to learn critical languages like Arabic, Chinese, Korean, and Russian, as well as less-commonly taught languages like Hindi, Persian, Turkish, and Urdu. These programs provide access to students who would not otherwise have the means to study abroad and, in doing so, help to build national capacity by preparing a generation of diverse citizens who will be better able to deal with the economic and cultural complexities of the 21st century. They also deliver professional development support to early career teachers and researchers in the U.S. and overseas, and provide vitally important immersion language training, internships, and field work support for U.S. students and graduate students in a dozen languages and regions of the world that are deemed critical by the U.S. government. For that reason, I ask that the Subcommittee include in this legislation language in support of the following exchange programs: Future Leaders Exchange Program (FLEX) Youth Exchange and Study Program (YES) Teachers of Critical Languages Program (TCLP) Professional Fellows Program (PFP) Young Southeast Asia Leadership Initiative (YSEALI) Educational Advising Centers (Education USA) National Security Language Initiative for Youth (NSLI-Y) Critical Language Scholarships Program (CLS) eurasia/south east europe programs The U.S. currently supports a number of relatively new and unusually important assistance programs in the Eurasia/South East Europe region, which, based on my own experience, deserve particular consideration as models of focused U.S. assistance. Each contributes to meeting the challenges of preparing a new generation of citizens for the demands of the globalized economy and the concomitant needs for stronger workforce development, professional education, reduction of corruption, and greater social cohesion. These programs include the support of merit-based testing for university admissions in Ukraine and the support of collaborative research and language training for U.S. and Eurasian scholars under the State Department's highly respected Title VIII Program. Without this support for American scholars, the U.S. risks a future without area specialists who can help us navigate these complicated relationships. I ask that the Subcommittee provide support for the following programs: Research and Training in East European/Eurasian Regions (Title VIII program) Ukraine: Knowledge Transfer Initiative for Ukrainian Public Diplomacy Academic Integrity and Quality Initiative (AcademIQ) conclusion Mr. Chairman, as you proceed with decisions on the fiscal year 2022 bill, I request that you continue to provide strong funding for the Department of State's Bureau of Educational and Cultural Affairs and Foreign Assistance programs, particularly the programs mentioned in this statement. Thank you very much for your consideration. [This statement was submitted by Dr. David Patton, President.] ______ Prepared Statement of The American Foreign Service Association (AFSA) The American Foreign Service Association (AFSA) is grateful that Congress voted to increase the Fiscal Year (FY) 2021 International Affairs Budget and, once again, reject proposed cuts to diplomacy and development funding. In FY22, AFSA hopes to build on the momentum of FY21's funding increases by increasing the amount of Foreign Service positions and shifting more positions back to the field. We have recently seen that field work in action-when Foreign Service members spearheaded the successful effort to bring more than 100,000 Americans home during the global COVID-19 pandemic. In the FY22 SFOPS Appropriations bill, AFSA is seeking: A $30 million increase above the FY21 enacted level to the State Department's ``Overseas Programs'' account and the following report language that specifies the restoration of at least 100 mid-level FSO positions from Washington to posts overseas: ``The Secretary of State shall increase the Department by at least 100 Foreign Service positions, specifically mid-level Foreign Service officer positions (grades FS-03, FS-02, and FS-01), at overseas posts.'' Also, additional funds to the State Department's ``Human Resources'' account for the creation and filling of 1,000 new Foreign Service positions and additional funds to USAID's ``Operating Expenses'' account for the creation and filling of 650 new Foreign Service positions. AFSA has made the case that maintaining a robust diplomatic capability is vital to preserving America's global leadership role. Our leadership was built on a foundation of military might, economic primacy, good governance, tremendous cultural appeal-and the diplomatic prowess to channel all that power, hard and soft, into global leadership that has kept us safe and prosperous at home. A 2019 Chicago Council on Global Affairs survey found that seven in ten Americans support an active U.S. role in the world, a record high of the past five decades. We would like to partner with our congressional supporters to ensure that today, and years from now, full teams of U.S. diplomats are in the field, deployed around the world to promote and protect U.S. interests. For a tiny percentage of the overall budget, the Foreign Service builds the relationships that enable Americans to conduct business all around the world and keep threats at bay, reducing the need for military action. If the United States retreats diplomatically, we leave a vacuum that will be filled by others. In the face of more aggressive competition from China and Russia, the opportunity costs of leaving American embassies short staffed is rapidly increasing. Doing so erodes our nation's diplomatic power at our own peril. Creating and filling 1000 new State Department positions and 650 new USAID positions will accomplish three major things: create a training float so members of the Foreign Service are better prepared for their jobs, allow expanded intake from an increasingly diverse U.S. population, and enable the foreign affairs agencies to meet expanding mission requirements. 1. Members of the Foreign Service receive quality training on the front end and on the basics; before they go to their first assignment- for language training, for certain leadership positions, etc. For example, a mid-level ranked Public Affairs officer may never take training on core public diplomacy functions because there is never time. The officers are usually shuttled between language training and their next post, without the opportunity to simply study and learn how to do their jobs better. This training float will enable members of the Foreign Service to perform higher quality work and provide temporary duty officers to perform jobs while others attend training. 2. A significant increase in positions also provides the opportunity to expand representation to traditionally underrepresented groups. Diversity in foreign affairs agencies is not reflective of the U.S. population; and general expansion of the Foreign Service while targeting underrepresented groups will aid in both the recruitment and retention of a more diverse Foreign Service. 3. Today, the U.S. is facing new threats and issues diplomats did not have to reckon with 10 years ago. Russia has resurged as a major national security threat, and U.S. diplomats have reported Russian foreign policy revolves around simply disrupting liberal democracy. China now has a larger diplomatic presence than the U.S., having more posts overseas and outnumbering American diplomats five to one in African countries. More positions will enable the Foreign Service to meet its expanded mission requirements to counter any threats to our global leadership and influence. Complementing the need for new positions is the need for more members of the Foreign Service at posts abroad. Members of the Foreign Service recall being asked during the height of the ``civilian surge'' in Iraq to identify positions U.S. embassies could sacrifice for the cause of ensuring that every position in Iraq was filled with Foreign Service volunteers. Well over a decade later, those positions have not been returned to the overseas posts from which they originally came. The Foreign Service finds itself struggling in short-staffed sections at embassies around the world that gave up those same positions 10 years ago. State's Overseas Staffing Board concluded in its most recent report that America has too few diplomats in the field. The Overseas Staffing Model showed a deficit of almost 200 overseas positions in ``core diplomacy,'' (the term used for political and economic officers, as well as chief of mission positions). Without those core diplomacy positions, the State Department routinely misses opportunities to bring business to the U.S., assert the values of democracy, and protect core foreign policy interests. Our nation needs a full team of diplomats and development professionals in the field keeping threats at bay and protecting our prosperity-combating the conditions that enable terrorism to take root, protecting against pandemics, and promoting the rule of law and open systems that allow U.S. companies to compete and thrive. The documented deficit in overseas core diplomacy positions needs to be addressed as soon as possible if we are to avoid losing further commercial, economic, and even political ground to rising great power competitors. These three requests-a $30 million increase to the ``Overseas Programs'' account and report language specifying the restoration and filling of 100 positions in the field, along with 1000 new State Department positions to fill for general expansion of the Foreign Service, will enable America to have a full team in the field and at home. AFSA also greatly appreciates congressional bipartisan support for foreign assistance as a critical component of America's national security. However, long-standing staffing and operational challenges, including the hiring of career members of the Foreign Service at USAID, remain. USAID is expected to continue making requests for contractors, Foreign Service Limited (FSL) appointments, and other non-career staff. Many of these non-career hires are not competed through USAJobs.gov- which raises questions of transparency and propriety. The numbers suggest that USAID headquarters will be comprised primarily of short- term contractors and limited appointees, while employees abroad will primarily be career officers. Therefore, the field-informed perspectives and Civil Service long- term trained personnel will dwindle in percentage to the non-career high turnover hires. Over time, this lack of career officers will seriously reduce the effectiveness and threaten the institutional knowledge of USAID. Thus, AFSA would like to partner with our congressional supporters to provide additional ``Operating Expenses'' funding for 650 additional USAID career Foreign Service positions--our fourth request. AFSA would also like to point out that career USAID Officers are both less expensive than short term contractors or FSL appointments, and long term provide field-driven perspectives and expertise which enable more effective foreign aid. A clear prioritization and increase of career Foreign Service positions at USAID, accompanied by a pause of further FSL appointments, would send the signal to our diplomats that they will continue to be supported by Congress. Thank you for your consideration of these requests. [This statement was submitted by Ambassador Eric Rubin, President.] ______ Prepared Statement of the American Hellenic Institute (AHI) Chairman Coons, Ranking Member Graham, and Members of the Subcommittee, I am pleased to submit testimony to the Subcommittee on behalf of the nationwide membership of the American Hellenic Institute (AHI) on the Administration's proposed FY2022 foreign aid budget. The Administration's budget aims to confront 21st century security challenges. The budget's vision for the United States is to ensure it ``. . . plays a lead role in defending democracy, freedom, and the rule of law'' by recommending a significant increase in resources to: ``strengthen and defend democracies throughout the world; advance human rights; fight corruption; and counter authoritarianism.'' \1\ In keeping with the best interests of the United States, AHI opposes: (1) any proposed foreign aid and assistance to Turkey from the United States; (2) any proposed reduction in the aid levels for the UN Peacekeeping Force in Cyprus. Further, AHI recommends an FY2022 funding level of $1.5 million for NATO ally Greece's International Military Education and Training (IMET) program as authorized for appropriation in The Eastern Mediterranean Security and Energy Partnership Act. The Act also authorized $500,000 for the Republic of Cyprus' IMET program for FY2022, which AHI recommends. In 2020, the U.S. Department of State provided, for the first time, IMET program funding for the Republic of Cyprus. AHI welcomed this policy development, and urges that this policy be continued. Finally, AHI recommends robust investment for Foreign Military Financing (FMF) assistance for Greece, in the amount of at least $10 million, due to its strategic importance to the United States as the Subcommittee will see presented in this testimony. The East Med Act authorized appropriations of $3 million for FMF assistance in FY2020. U. S. Interests in Southeast Europe and the Eastern Mediterranean.--The U.S. has important interests in southeast Europe and the eastern Mediterranean. It is in the United States' best interest for the region to be politically, economically, and socially stable, and for democratic principles to flourish, including adherence to the rule of law. Significant commerce and energy sources pass through the region. With Greece's close cultural, political, and economic ties to the Mediterranean countries, including Israel; Western Europe, the Balkans, Eastern Europe, and the Middle East, Greece is strategically situated in a vital region to be an ideal strategic partner for the U.S. America Values Its Alliance with Greece.--Greece is an immensely valuable link as ``a pillar of stability'' in the region as several high-level U.S. government officials have noted. The U.S.-Greece relationship has reached new heights by virtue of an ongoing Strategic Dialogue, where avenues for cooperation among many sectors, including: regional cooperation, defense and security, and trade and investment, among others, are plotted for implementation. Greece is a pivotal and dependable NATO ally to advance U.S. interests and is a frontline state against terrorism. The Mutual Defense Cooperation Agreement between the United States and Greece illustrates the two allies' commitment to address over a longer term the security challenges in the region. The Agreement currently is under revision. After it is upgraded, it will offer more flexibility to deepen cooperation in the defense sector, according to Greece's Minister of Defense Nikos Panagiotopoulos. For its part, Greece further demonstrates its commitment to the Alliance as a top contributor to the defense efforts of NATO. Greece is estimated to spend 2.68% of its GDP on defense expenditures in 2020 in accordance with NATO standards despite battling economic challenges. By percentage of GDP, Greece is second to the U.S.\2\ Greece is also important for the projection of U.S. strategic interests by being home to the most important U.S. military facility in the Mediterranean Sea, Souda Bay, Crete. It is a base from where joint USN/USAF reconnaissance missions and air refueling support for U.S. and NATO operations were implemented successfully, and it continues to be immensely important. Military installations located at Souda Bay include the NATO Maritime Interdiction Operational Training Centre (NMIOTC) and the NATO Missile Firing Installation (NAMFI). To illustrate Souda Bay's importance, these figures show the volume of operations conducted there: --In 2020, at least 90 U.S. and 40 NATO (total 130) ships made a port visit at Souda Bay. It also has been noted by U.S. government officials how Souda Bay allows United States Navy vessels-especially aircraft carriers-the ability to dock, make needed repairs and maintenance, and resupply, all within a couple of weeks and without having to return to Naval Station Norfolk. According to U.S. Ambassador to Greece, Geoffrey Pyatt, in a March, 20, 2021 statement: ``Souda Bay is the jewel in the crown of US- Greece defense cooperation . . . the unique capacities the Souda provides to support US presence in the strategically dynamic East Med.'' To further demonstrate that Greece's value extends well beyond Souda Bay: --NATO Joint-Command HQ: Thessaloniki hosts a NATO Rapid Deployment Corps combined with its Third Army Corps for two years. --Operation Atlantic Resolve: Greece enables a substantial portion of the U.S. Army's 10th Combat Aviation Brigade to enter the European theater through the port of Thessaloniki and to depart through Alexandropoulis. Alexandroupolis is being recognized as a city with increased geostrategic importance, which can also contribute to economic development and energy security. --The 101st Combat Aviation Brigade of the U.S. Army, from October- November 20, 2020, and from February-Mar 21, 2021, stationed and trained at Volos and Stefanovikeio. --The U.S. and Greece held a joint military exercise in May 2021 as part of a larger ``DEFENDER-Europe'' program, which, according to the U.S. Army, is ``an annual large-scale U.S. Army-led, multinational, joint exercise designed to build readiness and interoperability between U.S., NATO and partner militaries.'' Greece was one of only four participating countries whose port was used to deploy equipment into Europe and to host a ``DEFENDER-Europe 21'' logistical center. --USAF temporarily operated MQ-9 Reaper Drones from Greece's Larisa Air Force Base. --Increased aircraft and soldier involvement at Stefanovikio Hellenic Army airbase improves NATO transit capability. --The trilateral naval exercise ``Noble Dina'' between the U.S., Greece, and Israel is held annually off of the coast of Souda Bay. Greece is also an active participant in peacekeeping and peace- building operations conducted by international organizations, including the UN, NATO, EU, and OSCE. In sum, it is evident Greece contributes significantly to U.S. interests. AHI strongly contends these actions justify a robust investment by the U.S. in Foreign Military Financing assistance to Greece. Regional Instability.--The successful projection of U.S. interests in the Eastern Mediterranean depends heavily on the region's stability. A key to peace and stability in the region is for good neighborly relations among NATO members and respect for the rule of law. Therefore, the U.S. has a stake in focusing on the problems that are detrimental to U.S. interests and to call out those who cause instability in the region. Turkey is the fundamental cause of instability in the eastern Mediterranean and broader region: --Turkey's unilateral claims against sovereign Greek territory in the Aegean which are in violation of international law, and Turkey's refusal to refer its unilateral claims to binding international arbitration. --Turkey's aggression against Cyprus which includes its continuing illegal occupation of 37.3 percent of Cyprus. --Turkey's numerous incursions into Cyprus' Exclusive Economic Zone (EEZ), illegal drilling in Cyprus' EEZ that were supported by Turkish warships and drones, and demonstrated ``gunboat diplomacy.'' --Turkey's continuing violations of Greece's territorial waters and airspace, numbering over 7,000 violations in 2020, which are in violation of international and U.S. law, including the Arms Export Control Act (AECA). There were 4,605 airspace and 3,215 maritime incidents. --Illegal immigration via Turkey that threatens Greece's economic development and the peace and stability of Europe. --The Turkey-Libya Memorandum of Understanding (MoU) on maritime borders, which has been resoundingly dismissed by the international community as illegal. --Turkey's open support for Hamas, and active role in terror financing, in violation of international and U.S. law, including the Arms Export Control Act (AECA). --Turkey's exacerbation of the Nagorno-Karabakh conflict by encouraging Azerbaijan's aggression against Armenia, including transiting Syrian mercenaries with ties to jihadist groups to fight on behalf of Azerbaijan. Turkey.--Turkey continues to demonstrate it is not a true and dependable U.S. and NATO ally. The U.S. government, both executive and legislative branches, rightly sanctioned Turkey for its procurement of the Russian-made S-400 missile defense system under Countering America's Adversaries Through Sanctions Act (CAATSA) in December 2020. Those penalties should be expanded. AHI calls for the continued inclusion of appropriations language that direct the suspension of delivery or transfer of F-35 aircraft to Turkey until reports detailing the impact of Turkey's purchase of the S-400 missile system from Russia on U.S. weapon systems such as the F-35s are provided to Congress. In addition, Turkey's support for Hamas has been evident. President Erdogan has hosted Hamas' top leadership, including individuals designated as global terrorists. Hamas' recent attack against U.S. ally Israel only further highlights Turkey's role as a malign regional influence. We oppose any foreign aid for Turkey and any other assistance programs from the United States. This includes most favored nation trade benefits including textile quotas and the transfer of any nuclear related assistance which we oppose as not in the best interests of the U.S. AHI applauded the United States' decision to terminate Turkey's designation as a beneficiary developing country under the Generalized System of Preferences (GSP) program, which became effective May 17, 2019. AHI has long argued for this type of action by the U.S. government, especially in testimony presented to this Subcommittee, until the following actions are taken: (1) the immediate withdrawal of all Turkish troops from Cyprus; (2) the prompt return to Turkey of the over 180,000 illegal Turkish settlers in Cyprus; (3) the Turkish government's safeguarding the Ecumenical Patriarchate, its status, personnel and property, reopening the Halki Patriarchal School of Theology, returning church properties illegally seized, and the reversal of Hagia Sophia's status, returning it to a UNESCO-designated museum; (4) the cessation of violations against Greece's territorial integrity in the Aegean and of its airspace; (5) the cessation of illegal interference in the exclusive economic zone (EEZ) of the Republic of Cyprus; (6) Turkey must cease its support and promotion of a ``two-state'' solution regarding Cyprus, in violation of United Nations resolutions and the position of the U.S. government; (7) Turkey must cease its egregious violations of important United States laws, in particular the Arms Export Control Act & the Countering America's Adversaries Through Sanctions Act (CAATSA). Of course, Turkey's ongoing human rights, freedom of speech, and religious freedom violations are problematic. Cyprus.--The illegal military occupation of the Republic of Cyprus by 40,000 Turkish troops continues. As long as the Republic of Cyprus remains under Turkish military occupation, a strong UN peacekeeping force must be maintained on the island. Congress can assist the Republic of Cyprus by reaffirming the United States' position that assistance appropriated for Cyprus should support measures aimed at solidifying the reunification of Cyprus and the unified government in Cyprus. It would provide a settlement, should it be achieved, with a chance to succeed. Therefore, AHI recommends the following language from Title III of the Consolidated Appropriations Act of 2012 be included in the FY2022 State, Foreign Operations, and Related Programs Appropriations bill: Assistance provided to Cyprus under this Act should foremost ensure that the United Nations Peacekeeping Force in Cyprus (UNFICYP) can fully implement its mandate, while remaining available to also contribute to the creation of a conducive environment for the settlement talks under the auspices of the UN Secretary-General's Good Offices. Furthermore, in the event of reunification, further assistance should be used to contribute towards the cost of reunification, including towards monitoring provisions, facilitation for settlement of the property issue, supporting and underpinning the new federal structures of a reunified island and assisting with the construction of a strong unified Cypriot economy able to cope with the new challenges, and strengthening the contacts between the two communities as conducive to reunification, in a way agreed to between the United States and Cyprus. The last UN-led attempt, which took place in Crans-Montana in 2017, aimed to achieve a just and viable solution to the near 47-year division of the Republic of Cyprus, ended without reaching an agreement because of Turkish intransigence. Instead of helping to provide stability by promoting a just settlement supported by both Greek Cypriot and Turkish Cypriot communities, Turkey continued to insist on antiquated and obstructive stances, such as its insistence to maintain the Treaty of Guarantee with a right of future unilateral Turkish military intervention. More recently, during the latest 5+1 informal meeting in Geneva at the end of April 2021, aiming to assess whether there was sufficient common ground for the resumption of the negotiations, Turkey fundamentally changed its official position on the form of settlement of the Cyprus problem, insisting on a ``two-state-solution'' to solidify its occupation of the island, contrary to UN Security Council resolutions and the stated position of the United States government. Furthermore, Turkey hinders the humanitarian work of the Committee on Missing Persons's (a previous recipient of USAID support) by denying access to areas under its occupation, including Turkish military zones, in order to excavate for the remains of 996 Cypriots still missing (including four US citizens) following the Turkish invasion of Cyprus in 1974. Congress should call on Ankara to constructively support the reunification efforts, in accordance with the UN Security Council Resolutions calling for a bizonal, bicommunal federation, as well as for a solution that embodies the full respect of the principles and laws of the European Union, of which Cyprus is a member state. The new state of affairs ought to safeguard that a reunified Cyprus would have a single international legal personality, a single sovereignty and a single citizenship. AHI is also concerned with energy security. AHI contends the U.S. must continue to support the sovereign rights of the Republic of Cyprus to explore and develop the resources within its EEZ free of any third- party interference. As mentioned, Turkey's threats in Cyprus' EEZ endanger U.S. companies. International Military Education & Training (IMET)--Greece and Cyprus.--AHI recommends FY2022 funding for Greece's IMET program at $1.5 million and the Republic of Cyprus's IMET program at $500,000. The recommended funding levels are in line with the authorization of appropriations passed in The Eastern Mediterranean Security and Energy Partnership Act. For Greece, the country experienced 11 fiscal years (FY2006-FY2017) of a steady decline of its IMET funding levels. It resulted in the drastic decrease in the number of Greek military students participating in the program. An investment of $1.5 million in FY22 will help address that 11-year decline in funding, but more investment is needed to make up for ``lost time.'' For the Republic of Cyprus, which received its first IMET program funding in FY21, it is critical to continue this investment in FY22. It will be the next step in a series of positive developments since the Statement of Intent that the U.S. and Republic of Cyprus signed in November 2018. Since then, Cyprus has assigned a defense attache to the Embassy in Washington, the Cyprus Center for Land, Open-Seas, and Port Security (CYCLOPS), an innovative security site that has been partially funded by the U.S., is scheduled to begin operations in January 2022; and the U.S. implemented a partial lifting of an arms prohibition on Cyprus. The U.S. must fully and permanently lift its arms prohibition on Cyprus and remove Cyprus from the list of countries to which arms sales are prohibited under International Traffic in Arms Regulations (ITAR) and calls for appropriations language to direct this of the U.S. Department of State. The IMET program advances the professional military education of the Greek and Cypriot Armed Forces. It enhances interoperability with U.S. forces, and in Greece's case, NATO forces. Through the training of Greek and Cypriot military and noncommissioned officers in a multitude of professional military education and technical courses in the U.S., IMET offers strong U.S.-Greece and U.S.-Republic of Cyprus mil-to-mil relations. It is an effective and wise investment toward a key component of U.S. security assistance. It also helps the U.S. because it contributes toward the strengthening of U.S. security interests in an important part of the world by training and promoting the professionalization of the Greek and Cypriot Armed Forces. Thank you for the opportunity to present them in our written testimony to the Subcommittee. --------------------------------------------------------------------------- \1\ ``Budget of the United States Government Fiscal Year 2022,'' https://www.whitehouse.gov/wp-content/uploads/2021/05/budget_fy22.pdf, pages 22 and 23. \2\ 2020 estimate. https://www.nato.int/nato_static_fl2014/assets/ pdf/2021/3/pdf/210316-pr-2020-30-en.pdf --------------------------------------------------------------------------- [This statement was submitted by Nick Larigakis, President.] ______ Prepared Statement of the American Society of Tropical Medicine and Hygiene The American Society of Tropical Medicine and Hygiene (ASTMH)-the largest international scientific organization of experts dedicated to reducing the worldwide burden of tropical infectious diseases and improving global health -appreciates the opportunity to submit testimony to the Senate Appropriations Committee's Subcommittee on State, Foreign Operations, and Related Programs (SFOPs). The COVID-19 pandemic has made it all too clear that the U.S. must invest in research on, treatment for, and surveillance of tropical diseases and other infectious diseases. When we invest in preventative measures, we save lives and head off pandemics. These investments in addition, support strong science and create trusted relationships with valued colleagues around the world to respond to these challenges. Congress must provide robust funding for global health efforts. We respectfully urge you to increase the funding levels proposed in the President's FY22 budget for global health programs in the FY22 SFOPS appropriations bill. Many global health programs have long been flat funded and will require additional resources, not only to reinvigorate programs that have been put on hold due to the pandemic, but to ramp up innovation and impact. We must end once and for all the vicious cycle of underinvestment followed by panic. We would like to highlight two specific USAID programs. Neglected Tropical Diseases (NTDs): NTDs are a group of 20 infectious diseases and conditions that disproportionately affect poor and marginalized populations. NTDs coexist with poverty and thrive in places with limited access to clean water, sanitation, and protection from the carriers of disease. NTDs remain persistent threats to global health and economic viability, killing more than 500,000 each year and causing significant morbidity and mortality in more than 1 billion people worldwide. Children suffer greatly from NTDs, as NTD infection leads to malnutrition, cognitive impairment, stunted growth, and the inability to attend school. Every low-income country is affected by at least five neglected tropical diseases simultaneously, while there are 149 countries and territories affected by at least one NTD. Over the past year, COVID-19 has made the successful treatment of these diseases even more challenging. While the global challenge of NTDs may seem daunting, the NTD Program at USAID has made remarkable progress in treating and even eliminating NTDs. Launched in 2006, the NTD Program as of 2021 has leveraged roughly $1 billion in federal funding to secure $26 billion in donated drugs and expand to 32 countries. In total, the program has distributed 2.8 billion treatments to 1.4 billion people.\1\ The NTD Program has successfully curbed multiple NTDs, with 315 million people no longer requiring treatment for lymphatic filariasis (elephantiasis), 151 million people no longer requiring treatment for blinding trachoma, and 10 million people no longer requiring treatment for onchocerciasis (river blindness). Eleven countries have eliminated at least one NTD entirely. These figures show the tremendous return on investment that federal funding for NTD treatment achieves. Every $1 invested by the U.S. government leverages $26 in donated medicines for mass treatment campaigns. Combined with the low, 50-cent cost of rapid-impact packages of medication that treat an individual for the five most common NTDs, NTD treatment is one of the best buys in public health. These gains cannot go to waste. While other countries debate drastic cuts to their NTD programs, the U.S. has shown how effective national NTD programs can be. The U.S. must continue to lead and encourage its allies to join in these life-saving efforts. We respectfully join the NTD Roundtable in calling for an increase to $125 million for FY22 for the USAID NTD program. Funding has been near level since 2014. Neglected tropical disease (NTD) activities around the globe were halted at the onset of COVID-19 pandemic. Now, following World Health Organization (WHO) guidelines, many NTD programs are resuming worldwide. Costs to implement NTD programs during COVID-19 have increased and we are conducting analysis to determine the full impact. These costs include infection prevention measures, such as hand sanitizer & PPE, but also new modes of working to accommodate physical distancing, such as increased venues and number of days for training community drug distributors, increasing number of vehicles to transport teams to allow some distancing, etc. An increased investment could: --Advance NTD elimination in priority countries, saving lives and livelihoods. --Expand number of treatments in existing areas and add new geographic areas, potentially those listed by WHO as still needing support. --Expand urgently-needed investments in research and development-- including diagnostics and drugs--for NTDs to ensure tools and strategies are available to overcome emerging challenges. --Support greater integration with complementary programs necessary for the success of NTD prevention, control and elimination efforts, including WASH, nutrition, education, One Health and vector control. Estimates show that with the strong support of programs like the USAID NTD program in the next 5 years, 15 additional countries will eliminate at least one NTD as a public health problem. This illustrates the cumulative impact of the U.S. investment. In the last 15 years, 10 countries have eliminated one NTD. This is life changing considering that these diseases that have been destroying lives for centuries. Malaria: While we have seen tremendous success as a result of U.S. funded efforts to eliminate malaria, the disease remains a significant global health threat. Despite our ability to treat and prevent malaria, it is still one of the leading causes of death and disease worldwide, with nearly half the world's population living in the 87 countries and territories where malaria is endemic.\2\ Malaria poses the most significant threat to poor women and children, but it is also a major threat to our military and other travelers to the tropics. In 2019, there were about 229 million new cases of malaria and an estimated 409,000 deaths.\3\ Thankfully, the President's Malaria Initiative (PMI) has made remarkable progress since 2005 in lowering these sobering infection numbers, distributing almost 400 million nets and providing hundreds of millions of treatments and tests. The 22 PMI focus countries have successfully lowered child mortality. That said, however, USAID must continue to strengthen and invest in these programs and in research and development of new tools to maintain progress, especially as COVID-19 impedes malaria treatment access. Though we have dramatically reduced the number of cases of malaria, the effort to ultimately eliminate the disease depends on providing adequate funding for the proven interventions. In 2019 alone, PMI provided more than 47 million insecticide treated mosquito nets, more than 79 million antimalarial treatments, and protected 18.6 million people through indoor residual spraying. Furthermore, malaria efforts at PMI, USAID, and the State Department should work hand-in-hand with the CDC's Center for Global Health, the NIH, and the malaria research programs funded by the Department of Defense. We respectfully request Congress provide $902.5 million for the President's Malaria Initiative for FY2022. This funding will address global supply chain disruptions caused by COVID-19 leading to increased manufacturing and freight costs for malaria commodities, support the changeover to next generation bed nets necessary to combat insecticide resistant mosquitoes. The funding will also increase training and support for community health workers to deliver lifesaving commodities for malaria and other global health threats including the COVID-19 pandemic. International Partnerships--ASTMH encourages robust funding and participation in important international partnerships such as the Global Fund, vaccine partnerships, and the World Health Organization. Global Fund--The Global Fund is a 21st-century partnership that brings together governments, civil society, the private sector, and people affected by disease in order to accelerate the end of AIDS, tuberculosis, and malaria as epidemics. Investments in the Global Fund support local prevention, treatment, and care services that strengthen overall local health systems and economies. U.S. investments in the Global Fund have and will continue to save lives and fight diseases--in endemic countries, where American diplomats and service members are also stationed, and at home, by preventing the spread of AIDS, TB, and malaria. Vaccine Partnerships--U.S. contributions to GAVI, the Vaccine Alliance, and other vaccine partnerships like the COVAX facility, which is co-led by GAVI along with the World Health Organization and the Coalition for Epidemic Preparedness Innovations (?CEPI), multiply the impact of USAID programs through coordination and increased cost- effectiveness. The U.S. should lead by example in support of effective international partnerships of this sort and not back away from its leadership role. World Health Organization--ASTMH is thankful that the U.S. will remain a member and valued partner of the WHO. To protect American lives, we need the WHO to continue to be on the front line at the next outbreak and pandemic. International collaboration is central to research, particularly on diseases and pandemics. The WHO plays a key role in fostering scientific collaboration. It serves as a surveillance system as new diseases and outbreaks emerge and supports the sharing of vital information, data, and clinical samples. The U.S. and global research community needs this system and the data that is generated to develop vaccines and treatments. conclusion The vast majority of infectious diseases do not emerge in the U.S.; instead, they thrive elsewhere often long before a catalytic event occurs that rapidly mobilizes the threat bringing it to the U.S. It is our lack of urgency and response to address these threats while they exist as remote tropical diseases that allows their spread and increases our domestic vulnerabilities. It is not a question of whether a new infectious disease outbreak will occur, it is a matter of when and what it will be. For this reason, Congress needs to support sustainable investments in U.S. global health research and development to increase our knowledge, understanding, and tools to confront infectious disease. ASTMH appreciates the opportunity to share its expertise and we hope you will provide the requested FY22 resources to the programs identified above that will help improve the lives of Americans and hundreds of millions worldwide. --------------------------------------------------------------------------- \1\ USAID NTD Fact Sheet. https://www.neglecteddiseases.gov/wp- content/uploads/2021/02/USAID-NTD-Fact-Sheet.pdf \2\ CDC, Malaria's Worldwide Impact. https://www.cdc.gov/malaria/ malaria_worldwide/impact.html \3\ World Malaria Report (2020). https://www.who.int/teams/global- malaria-programme/reports/world-malaria-report-2020 [This statement was submitted by Julie Jacobson, President.] ______ Prepared Statement of the Animal Welfare Institute Thank you for the opportunity to submit testimony on Fiscal Year 2022 funding priorities for the U.S. Department of State and to request report language regarding the Explosive Detection Canine Program. Dogs dying from parvovirus, heat stroke, and renal failure caused by tick-borne disease. Dogs infested with fleas and ticks. Emaciated dogs living in feces-filled kennels and eating off the floor. The latest puppy mill horror? No. These were the conditions endured by dogs trained in the United States and given to ``foreign partner nations'' to supplement their antiterrorism efforts-under a program financed by millions of US tax dollars. In 2019, the State Department's Office of Inspector General (OIG) released a report documenting the unconscionable mistreatment of dogs sent overseas under the Explosive Detection Canine Program (EDCP). This situation came to light only after a whistleblower-a veterinarian who had worked for the private contractor that trained the dogs-raised serious concerns about their health and welfare. For over 20 years, the State Department has been sending highly trained explosive detection dogs to foreign countries ``to enhance the ability of their law enforcement to deter and counter terrorism.'' The EDCP, however, failed to properly monitor the recipient countries' care of the dogs. In Jordan alone between 2008 and 2016, 10 dogs died ``while others were living in unhealthy conditions.'' Yet between 2016 and 2019, the United States supplied an additional 66 dogs to that country. ``The Department conducts health and welfare follow ups infrequently and inconsistently,'' observed the OIG. The report noted that the program lacked policies, procedures, and written standards to ensure the health and welfare of the dogs, and no written documents were produced ``until after a draft of the report was provided in June 2019.'' No policies were in place for canine adoption or retirement, and the OIG expressed concern that dogs may be left in kennels at the end of their working lives. Working conditions and the quality of nutrition and veterinary care were discovered to be so substandard, in fact, that the dogs were unable to perform their jobs and ``had lost the will to work.'' Concern was expressed that, if the dogs were in such poor physical and psychological health that they could not perform their duties accurately, were lives being endangered due to missed explosives? After the report's release, Sen. Charles Grassley (R-IA), then chairman of the Finance Committee, and Sen. Mark Warner (D-VA), then vice-chairman of the Intelligence Committee, wrote to then-Secretary of State Mike Pompeo expressing deep concerns about the program and asking the secretary how he planned to remedy the problems. It is shocking that a program this expensive and supposedly this critical to antiterrorism efforts has been run so haphazardly. Until it can be established that all of the recommendations in this report have been implemented, the program should be suspended and all dogs returned to the United States. It is time to stop putting highly intelligent, trained, and, above all, innocent animals into situations where their lives are in danger, not from the work they do but from the poor care they receive. In light of this history and the apparent lack of follow up, AWI requests the following report language stating that the Committee will withhold further funding for the program until the State Department provides the Committee with a report about the EDCP program: ``In September 2019, the State Department's Inspector General issued a deeply troubling report documenting the unconscionable mistreatment of dogs sent overseas through the Explosive Detection Canine Program (EDCP), under which dogs trained in the United States are given to `foreign partner nations' to supplement their antiterrorism efforts-financed by millions of US tax dollars. This situation came to light only after a whistleblower, a veterinarian who had worked for the private contractor that trained the dogs, raised serious concerns about the animals' health and welfare. ``According to the report, the EDCP failed to properly monitor the recipient countries' care of the dogs. Special concerns were expressed about Jordan, where between 2008 and 2016, 10 dogs died, while others were living in unhealthy conditions. `The Department conducts health and welfare follow ups infrequently and inconsistently,' observed the OIG. The report noted that the program lacked policies, procedures, and written standards to ensure the health and welfare of the dogs, and no written documents were produced `until after a draft of the report was provided in June 2019.' No policies were in place for canine adoption or retirement, and the OIG expressed concern that dogs may be left in kennels at the end of their working lives. Five recommendations were made `[t]o ensure that canines provided to foreign nations by the Department under the Antiterrorism Assistance Program are provided proper care and treatment . . .' ``After the report was released, Sen. Charles Grassley (R-IA), and Sen. Mark Warner (D-VA) wrote to then-Secretary of State Mike Pompeo expressing deep concerns about the program and asking the secretary how he planned to remedy the problems. ``A second OIG report was issued in December 2019 because `the Office of Inspector General (OIG) received notice of additional canine deaths that warrant[ed] immediate Department action.' ``In light of these reports, the Committee will hold further funding for this program in abeyance until the Department provides the Committee with a detailed written accounting of the policies and procedures that have been put in place to implement the OIG's 2019 recommendations, including an assessment from the OIG of the success of these policies and procedures in improving the health, welfare, and retirement options for dogs used in the EDCP, along with an update on the status of every dog currently in the EDCP or retired from the EDCP since June 2019. Moreover, this report should address allegations of `fraud, cronyism, misuse of government funds, and whistleblower retaliation' raised in letters to then- Secretary Pompeo from then-Rep. Trey Gowdy, and the late Rep. Elijah Cummings and Rep. Katie Porter.'' [This statement was submitted by Nancy Blaney, Director, Government Affairs.] ______ Prepared Statement of the Armenian Assembly of America Chairman Christopher Coons, Ranking Member Lindsey Graham, and distinguished Members of the Subcommittee, the Armenian Assembly of America (Assembly) welcomes the opportunity to provide the following testimony regarding U.S. assistance and policy for the South Caucasus region generally and Armenia and Artsakh (also known as Nagorno- Karabakh) specifically. Today, Turkey and Azerbaijan are working to dismember and depopulate Armenia and Artsakh. ASSISTANCE TO ARMENIA--Despite undertaking an obligation to resolve the Nagorno Karabakh conflict peacefully through the OSCE Minsk Group, Azerbaijan launched an unprecedented war against the Armenian people last Fall. For six weeks (44 days), the Azerbaijani military, with the full and open support of Turkey, and with the use of over 2,500 jihadist mercenaries transported to and deployed in Azerbaijan, attacked and targeted the Armenian people. As a result, Armenians, having already faced a genocide in the 20th century, were forced yet again to rebuild in the wake of serious human and structural devastation. All Americans can be proud of President Joe Biden's April 24, 2021 statement reaffirming the U.S. record on the Armenian Genocide. Upwards of 100,000 people--mainly children, women, and the elderly--were forcibly displaced from their homes, while hospitals, schools, and churches were destroyed by missiles, cluster and white phosphorus munitions, and drone strikes. Given these unprecedented developments, Senate Foreign Relations Committee Chairman Bob Menendez, while speaking on the floor of the Senate last November, called for ``a substantial investment in humanitarian and development assistance along the lines of $100 million to make a difference for those on the ground.'' We concur and urge not less than $100 million in FY22 for Armenia's development and recovery after Azerbaijan's ruthless war, which continues today with ongoing border incursions in violation of Armenia's sovereignty. The Assembly commends the electorate of the Republic of Armenia for its continued and consistent commitment to democracy and the rule of law during Armenia's June 20, 2021 parliamentary elections. The Assembly welcomes the preliminary findings of the International Election Observer Mission which were found to be ``competitive and generally well-managed'' and that ``fundamental rights and freedoms were generally respected,'' as was the freedom of expression, which is guaranteed by Armenia's constitution. This positive assessment of the democratic elections and established culture of democracy in Armenia was shared by the U.S. Department of State: ``The United States is committed to strengthening our partnership with Armenia based on shared democratic values. We commend Armenia for the progress it has made with respect to reforms and anti-corruption efforts and encourage Armenia to continue along this path, in line with the aspirations of the Armenian people, as expressed in the spring of 2018.'' ASSISTANCE TO ARTSAKH--The people of Artsakh are facing an ongoing humanitarian crisis resulting from the unprovoked 44-day war. The Assembly, therefore, urges not less than $50 million in assistance to Artsakh. This direct funding, which we strongly encourage USAID to oversee from Stepanakert, will help empower the people of Artsakh to reconstruct their communities, rebuild their lives, and resettle in their homes. It also serves as an opportunity for the U.S. to have a presence in the region and sends an important message about America's commitment to democratic governance. The Assembly also welcomes the initiative by Senators Chris Van Hollen (D-MD) and Todd Young (R-IN) who, along with 32 of their colleagues, are calling for $2 million to support demining in Artsakh. THE PEACE PROCESS--The United States, as a Co-Chair of the OSCE Minsk Group, has a vested interest in advancing peace in and bringing stability to the South Caucasus region. The Assembly appreciates the Administration's recent statement urging all parties to return to ``substantive negotiations under the auspices of the OSCE Minsk Group Co-Chairs to achieve a long-term political settlement to the Nagorno- Karabakh conflict.'' The governments of Armenia and Artsakh have consistently indicated their desire to peacefully resolve the conflict and have offered confidence-building measures to help reduce tensions and build trust. Azerbaijan, however, chose a different path--one of blockade, bellicose rhetoric, and ceasefire violations, leading to the deadly war it launched last Fall. In the absence of U.S. leadership, the Armenian people found themselves in a dire situation and its democratic government was pressured into a one-sided, Russian-brokered arrangement with the signing of a trilateral (Armenia, Azerbaijan and Russia) ceasefire statement on November 9, 2020, which negates America's long-standing role as Co-Chair of the OSCE Minsk Group. In a clear sign that Azerbaijan is not serious about establishing peace or respecting international human rights conventions to which it is a signatory, the Aliyev regime has repeatedly violated the November 9, 2020 ceasefire, including the holding of an estimated 200 prisoners of war (POWs) and captured civilians. In addition, Aliyev marked Armed Services Day on June 26, 2021 by saying that: ``Nagorno-Karabakh is the land of Azerbaijan'' and that ``there is no territorial unit called Nagorno-Karabakh, there is no concept of the Nagorno-Karabakh conflict . . . We have destroyed Armenia.'' There is also ample reason to believe that the ongoing breaches of the November ceasefire statement, as well as the 44-day war itself, have occurred at the direction of Turkey's authoritarian President Recep Tayyip Erdogan, whose destabilizing actions in Cyprus, the Eastern Mediterranean, and with respect to hostilities in Libya and Syria are well-documented, seeks to further destabilize the South Caucasus region and circumvent the OSCE Minsk Group process. The United States should not allow corrupt and authoritarian regimes to sideline U.S. leadership and leave the world's first Christian nation and fledgling democracy in peril. The Assembly urges the U.S. Co- Chair to the OSCE Minsk Group to uphold the fundamental principles of democracy, the right to self-determination, and the universal human rights of the people of Artsakh. SECTION 907 OF THE FREEDOM SUPPORT ACT--In light of the 44-day war, which included the recruitment, transport, and deployment of thousands of jihadist mercenaries to Azerbaijan by SADAT, a Turkish private security firm whose founder, former Turkish brigadier general Adnan Tanriverdi, is a close confidant of Erdogan, the Assembly urges Congress to uphold the fundamental tenets of Section 907 of the FREEDOM Support Act. Congress took a principled stand against Azerbaijani aggression with the adoption of Section 907 of the FREEDOM Support Act in 1992, and needs to do so again. Section 907 of the FREEDOM Support Act states that U.S. funds ``may not be provided to the Government of Azerbaijan until the President determines and so reports to the Congress, that the Government of Azerbaijan is taking demonstrable steps to cease all blockades and other offensive uses of force against Armenia and Nagorno-Karabakh.'' In the aftermath of the September 11, 2001 terrorist attack on American soil, a national security waiver was added to Section 907. The exercise of the waiver is valid so long as it ``will not undermine or hamper ongoing efforts to negotiate a peaceful settlement between Armenia and Azerbaijan or be used for offensive purposes against Armenia.'' Given last year's 44-day war, which resulted in a death toll of over 4,000 soldiers and civilians, some brutally beheaded according to Human Rights Watch and as documented by Columbia University's Institute for the Study of Human Rights and its ``Project on Atrocities in Artsakh,'' nearly 10,000 wounded soldiers, upwards of 100,000 Armenians forcibly displaced from their homes, the destruction of vital infrastructure including hospitals, and the deliberate erasure of Armenian cultural and religious heritage sites, providing U.S. assistance to Azerbaijan sends exactly the wrong message. The recruitment and deployment of jihadist mercenaries, ISIS- style beheadings and bodily mutilations, the targeting of cultural and religious sites, and the opening of a ``Military Trophy Park'' in Azerbaijan's capital, Baku, replete with Armenian mannequins featured in a dehumanizing manner and an entrance made with helmets of killed and captured Armenian soldiers, is not acceptable and should not be rewarded. These are practices that we oppose and must denounce because they violate the most basic principles upon which civilized nations stand. We urge that no U.S. taxpayer dollars be used to support Azerbaijan and that starts with upholding the letter and spirit of Section 907 of the FREEDOM Support Act, which if done previously would have saved lives. We further recommend that Congress ensure that no military assistance be provided to Azerbaijan. In addition, based on credible reports that Azerbaijani forces committed gross human rights violations during and after the 44-day war, the application of the Leahy Law should be seriously considered. Azerbaijan should not be rewarded for its blatant and ongoing violations against the Armenian people, including the holding of an estimated 200 prisoners of war (POWs) and captured civilians. In this regard, the Assembly strongly supports the inclusion of report language calling for the immediate release and repatriation of all POWs and captured civilians held by Azerbaijan. ARMENIA IS THE ONLY COUNTRY IN THE WORLD FACING DUAL BLOCKADES--A centuries-old nation, Armenia was the first country to adopt Christianity as its official state religion in 301 A.D. Throughout the centuries, Armenians have maintained their faith, even during 70 years of oppressive Soviet rule. Today, despite the dual blockades imposed by Turkey and Azerbaijan, Armenia continues to show its resilience. According to the World Bank, since independence ``Armenia's economy has undergone a profound transformation'' and ``sustained growth, ambitious growth, as well as inflows of capital and remittances that have created a market-oriented environment.'' Imagine the impact of Armenia's democratic and economic reforms if it was not blockaded by two of its four neighbors. The United States has spoken clearly about the need for Turkey to lift its three decades-long blockade of Armenia and establish diplomatic relations, both of which are also required under international treaties. The Assembly urges report language requiring a full accounting of the steps that the Administration is taking and will take to end the only blockade in the world of a democratic country. Finally, we believe that the provisions of the Humanitarian Aid Corridor Act should be broadened to preclude assistance to Turkey and Azerbaijan as long as they continue to blockade Armenia. U.S. MILITARY ASSISTANCE--Given Armenia's ongoing support to America before and after 9/11, including Armenia's participation in multilateral peacekeeping operations in Afghanistan, Kosovo, Iraq, Lebanon and Mali, the Assembly supports not less than $10 million in military assistance to Armenia for FMF and IMET. Such assistance not only further strengthens Armenia's NATO Partnership for Peace activities, but also supports NATO interoperability and modernization of Armenia's Peacekeeping Brigade. NATO Secretary General Jens Stoltenberg welcomed the partnership between the Alliance and Yerevan during a meeting at the UN General Assembly and thanked Prime Minister Pashinyan for Armenia's strong contributions to NATO's training mission in Afghanistan and peacekeeping mission in Kosovo. The Assembly also urges Congress to address the significant imbalance in U.S. security assistance provided to Azerbaijan compared to Armenia (over $100 million in security assistance was provided to Azerbaijan in fiscal years 2018 and 2019) and prevent any further misuse of U.S. funds. ASSISTANCE TO MINORITIES AT RISK IN THE MIDDLE EAST--The Assembly has consistently sounded the alarm on this issue and remains deeply concerned about the ongoing violence in Syria, Iraq, and across the region, and its impact on minority populations caught in the middle, fleeing for their lives, and seeking refuge in new lands. The Assembly strongly believes that Christian and other minority communities must be afforded protection and safeguarded wherever they happen to reside. The specter of another genocide today is a very real concern for the Armenian people, who were targeted for annihilation in the twentieth century. In this regard, the Assembly is deeply grateful for the historic passage of Armenian Genocide resolutions in the House and Senate in 2019 and President Biden's affirmation of the Armenian Genocide this April 24, 2021. President Biden's affirmation of the Armenian Genocide, along with Congress, marks a pivotal milestone in the arc of history in defense of human rights. By standing firmly against a century of denial, the President and Congress have charted a new course. Affirmation of the Armenian Genocide enhances America's credibility and recommits the United States to the worldwide cause of genocide prevention. We commend Administration officials for publicly acknowledging the Armenian Genocide and urge Congress to ensure that no U.S. funds will be used to deny the Armenian Genocide. CONCLUSION--Chairman Coons, Ranking Member Graham, and distinguished Members of the Subcommittee, on behalf of the Armenian American community, the Assembly would like to express its sincere gratitude to Congress for its assistance to Armenia and Artsakh. Armenian Americans gratefully remember the support that the U.S. provided after the 1988 earthquake in Armenia, as Armenia moved boldly toward independence in 1991, during Artsakh's struggle for freedom and democracy, and through America's proud record of humanitarian intervention during the 1915 Armenian Genocide. The Armenian Assembly of America greatly appreciates your attention to these policy matters and looks forward to working with you. [This statement was submitted by the Armenian Assembly of America.] ______ Prepared Statement of the Armenian National Committee of America (ANCA) This panel has played a vital role in strengthening Armenia's independence and fostering bilateral U.S.-Armenia relations, meeting humanitarian needs, providing technical assistance, supporting Armenia's aid-to-trade transition, and investing in a durable and democratic peace between Nagorno Karabakh (Artsakh) and Azerbaijan. Now, more than ever, Artsakh and Armenia are in need of strong bilateral relations with the U.S. and a robust aid program to rehabilitate it from the devastating impact of the war with Azerbaijan and Turkey and the COVID-19 pandemic. On September 27th, Azerbaijan-- led by corrupt dictator Ilham Aliyev--launched a brutal aerial and ground attack on the Republic of Artsakh, targeting civilian population center, churches, hospitals, and schools, resulting in thousands of deaths and forcing Artsakh's women and children to seek safe-haven in neighboring Armenia. The 44 day onslaught continued with the military support of Turkey, which paid radical jihadist mercenaries from Syria and Libya to fight against Armenians, while supplying Azerbaijan with military equipment, including U.S. F-16 fighter jets to provide air cover for their bombing raids and white phosphorus that permanently destroyed Artsakh's verdant forests. The illegal use of cluster munitions and white phosphorus are well documented by international observes as well as our own Department of State. Turkish Bayraktar drones--which include U.S. parts and technology--were deployed by Azerbajan in that countless attacks against churches, hospitals, schools and other civilian infrastructures to destabilize and depopulate Artsakh. The joint Azerbaijan and Turkish forces took advantage of the COVID-19 Pandemic and U.S. Presidential elections in their timing of the attacks. Now it is time for Congress to engage in efforts to rehabilitate and prevent another outbreak of war. Thus, our specific requests related to the FY22 State, Foreign Operations, and Related Programs bill are for the following three provisions: 1) Nagorno Karabakh Of the funds appropriated under title III of this Act and prior Acts making appropriations for the Department of State, foreign operations, and related programs not less than $250,000,000 shall be made available for global health, humanitarian, and stabilization assistance for Artsakh: Refugee Relief: $100,000,000 Housing: $20,000,000 Food Security: $20,000,000 Water/Sanitation: $25,000,000 Healthcare: $25,000,000 COVID-19: $25,000,000 Rehabilitation: $33,000,000 Demining/UXO: $2,000,000 Since Fiscal Year 1998, direct U.S. aid to Nagorno Karabakh (Artsakh) has provided the people of Nagorno Karabakh (Artsakh) with maternal health care, clean drinking water, and life-saving demining by the HALO Trust. While the exact percentage of territory requiring clearance remains uncertain, the HALO has reported that the recent attack on Artsakh has resulted in enormous levels of contamination by cluster munitions, rockets, and other explosive ordnance. These hazards are still present near homes, and litter farms and streets--presenting a grave humanitarian risk. Further, the removal of explosives is critical to continuing to rebuild infrastructure decimated during the conflict. In the wake of last fall's attack on Artsakh, we also encourage the panel to support funding for refugee relief and rehabilitation efforts. The war caused over 100,000 refugees to flee from Artsakh to neighboring Armenia. Approximately 55,000 families have returned to Artsakh but many have nowhere to return to because their homes were either bombed or has been taken by Azerbaijani forces. The war has also left over 1,000 children either orphaned or in a single parent household. Lastly, the war has injured thousands of soldiers, many required amputations and now are in need or prosthetic limbs and long- term rehabilitation. 2) Armenia Of the funds appropriated by this Act, not less than $100,000,000 shall be made available for assistance for Armenia. Armenia--a Christian nation deeply rooted in Western democratic values--has, despite the crushing economic impact of Turkish and Azerbaijani blockades, stepped forward as an ally and partner for the United States on a broad array of complex regional challenges. The Armenian military has been among the highest per capita providers of peacekeepers to U.S.-led deployments, including those in Afghanistan, Iraq, Lebanon, Kosovo, and Mali. We commend the Subcommittee's commitment to American Schools and Hospitals Abroad, and encourage continued support through this program for the American University of Armenia and the Armenian American Wellness Center. We also ask the panel to prioritize supporting Armenia's role as a regional safe haven for at-risk refugees. 3. Azerbaijan No funds appropriated or otherwise made available under this Act may be provided to the Government of Azerbaijan until the President determines, and so reports to the Congress, that the Government of Azerbaijan is taking demonstrable steps to cease all blockades and other offensive uses of force against Armenia and Nagorno-Karabakh. AND EUROPE AND EURASIA SEC. 7046. (a) Azerbaijan INSTRUCTION.--The Secretary of the Treasury shall instruct the United States executive director of each international financial institution to vote against any extension by the respective institution of any loan or grant to the Government of Azerbaijan, except to meet basic human needs or to promote democracy, unless the Secretary of State certifies and reports to the Committees on Appropriations that Armenian Prisoners of War have been returned home safely and that war crimes, including but not limited to beheadings of Armenian civilians and soldiers have been fully investigated by an independent third party. We remain troubled that the Administration's waiver of Section 907 of the Freedom Support Act and the $100 million security package to Baku that adds equipment, tactical abilities, and offensive capabilities to the Azerbaijani arsenal, while freeing up its own state resources for renewed cross-border action against Artsakh and Armenia. The Administration should cease sending military aid to Baku. As the Subcommittee considers issues related to Azerbaijan, we draw your attention to how its government has, in the last year, failed key Congressional tests of its commitment to peace: 1) Azerbaijan launched military war games in late May of 2020 with the assistance of Turkey, violating the OSCE peace agreements. 2) Following these military exercises, Azerbaijan launched a 3-day attack on the northern border of Armenia, targeting civilian infrastructures, including a PPE facility. 3) In September 27, 2021 Azerbaijan, aided by Turkey launched a surprise offensive attack against Artsakh. 4) On June 3, 2021, Azerbaijan, directly violating the peace agreement signed between Armenia and Azerbaijan on November 7th invaded Armenia in the southern border area of Syunik and continues to take soldiers in that region prisoner, shoot at civilians, and cause injury and death. 5) Over 7 months after the fighting has ceased, Azerbaijan continues to illegally hold over 250 known Armenian civilians and servicemen as prisoners of war, torturing them and killing many of those who are held captive. In closing, we would like to emphasize, once again, the necessity for the U.S. to assist in Armenia and Artsakh's economic and humanitarian efforts and to immediately stop all military assistance to Azerbaijan. The ANCA, as always, thanks you for your leadership and looks forward to working with the Subcommittee to strengthen the U.S.-Armenia alliance, promote regional stability, and advance American interests and our shared democratic values. [This statement was submitted by Tereza Yerimyan, Government Affairs Director.] ______ Prepared Statement of The Asia Foundation (TAF) Chairman Coons, Ranking Member Graham & Members of the Subcommittee: I am honored to submit this testimony as President of The Asia Foundation (TAF). We are deeply grateful for the confidence the Committee has shown in the Foundation. For 67 years, the Asia Foundation has advanced the interests of the United States in supporting stable democracies, good governance, the political and economic rights of women, climate action and free markets in the Indo- Pacific. Established in 1954, The Asia Foundation is a private, non- profit, nongovernmental organization headquartered in San Francisco. An annual appropriation is authorized under The Asia Foundation Act of 1983 (22USC4402). The Act acknowledged the importance of sustained funding for TAF and endorsed its ongoing value and contributions to U.S. interests in the Indo-Pacific. We pledge to you that with your continuing support, the Asia Foundation will sustain its work across the Indo-Pacific. In order to build on Congress' investment in the Foundation, The Asia Foundation is asking for $20,000,000 for Fiscal Year 2022, the same level as enacted in FY2021 and consistent with the President's FY2022 request. During the COVID-19 pandemic,TAF's work with governments and local communities proved to be more in demand than ever. The flexibility of appropriated funding has made it possible to immediately address needs identified by partners, including combatting the upsurge in gender based violence, public information campaigns on Covid-19 with government and civil society groups to address misinformation and disinformation efforts, and planning for economic re-birth for many communities affected by unemployment, economic displacement, challenges to inclusion and other consequences of the pandemic. During the crisis, most importantly, TAF has found ways to maintain its ongoing programs and have impact. In FY2022, TAF will expand new technology driven programs to expand economic empowerment, and address the future of work in the region, particularly as it affects women. TAF will also increase its program activities in Pacific Island nations important to U.S. interests, to bolster democratic institutions, address disinformation in a post-Covid period, build civil society and expand opportunities for women. TAF will also expand climate resilience initiatives in one of the most vulnerable regions of the world. TAF operates through 18 country offices in Asia. Through those offices, we identify and establish relationships with reform-minded individuals and organizations that merit our help as they seek to advance shared goals and interests. We believe that those we nurture today will ensure future security cooperation, development partnerships, rule of law, and fair trade between the U.S. and vital nations of the Indo-Pacific. Appropriated funding is critical to TAF's ability to continue operating as a unique American asset across the Indo-Pacific region. TAF is an especially cost-effective investment for the Congress in a time of budget constraints. TAF's hallmark is its ability to respond rapidly during unexpected crises. The challenges and opportunities presented by the COVID-19 pandemic have shown that TAF's close relations with partners, minimal bureacracy and ability to leverage funds have enabled it to address immediate needs, especially related to gender based violence and economic dislocation causes by shutdowns and curfews throughout Asia. As second and third waves of Covid hit areas of the Indo-Pacific, TAF remains active and prepared to continue to move quickly. TAF has conducted a series of rapid assessments on the impacts of Covid, including specifically on women and in the Pacific. Making the most of taxpayer dollars, TAF continues to diversify its funding, raising roughly four dollars from non-USG sources for every dollar of direct appropriation it has received for the past decade. Sufficient appropriated funding is essential to maintaining TAF's strong presence across the Indo-Pacific, specifically in countries of priority interest to the U.S. No other organization has the long history and presence of the Asia Foundation in critically important countries such as Afghanistan, Myanmar, Malaysia, Thailand, Vietnam, China, Philippines and Indonesia. Trust is built on continuity, and it is because of TAF's consistent local presence throughout the region that it has become such a trusted partner to local civil society organizations and individual reformers in advancing democratic reform and free markets in the region. At a time when the U.S. is working to support democracy, human rights, address climate change and ensure a prosperous, rule-based order in the Indo-Pacific, TAF's ability to advance these goals on the ground is more important than ever. New challenges to American interests in the region and TAF's unique ability to respond to those challenges justifies the request for an appropriation of $20 million. how is the asia foundation unique amon g other organizations operating in asia? The Asia Foundation is first and foremost a field-based organization. Through a cost-effective combination of grant-making and direct program operations managed by our 18 permanent offices in Asia, TAF maximizes program impact while keeping costs low. Through its network of offices, TAF undertakes action-based research to inform activities across the region, including perception surveys, surveys of conflict and violence and gender equality, economic scorecards and rapid assessments on the pandemic, natural disaster relief and other critical issues facing the region. The most well-known is the annual Survey of the Afghan People, which has been conducted for 15 years. With this baseline information and evidence based data, TAF delivers programs to meet local needs, improving the lives of Asia's citizens and contributing to cooperative U.S.-Asia relations. This has especially been true during the pandemic, as travel is restricted, but TAF offices have remained in place. TAF promotes reform by providing training, technical assistance and seed funding to hundreds of established and emerging Asian partner organizations, reform-minded individuals and future leaders. These longstanding investments in human capital have paid off. TAF has important relationships with Asian governments and leaders and at the same time maintains links to local communities built on decades of trust and ongoing engagement. As country specialists, TAF country representatives act as a substantive resource for program partners and implementers. TAF also acts as a resource on political and economic trends and issues for U.S. Embassies across Asia, especially as U.S. officials' movements and outreach have been more circumscribed due to security concerns. TAF often responds to Embassy requests to provide books for American Centers through TAF' s flagship Books for Asia program, and sent a shipment to the U.S. Embassy in Fiji as recently as May 2021. TAF continues to work with U.S. Embassies in complementary ways on sensitive issues that cannot be addressed by the USG directly. how does the asia foundation contribute to u.s. interests in the indo- pacific region? The U.S. has vital economic, political and security interests in the Indo-Pacific. TAF's engagement has led to better governance, stronger economies, and empowered citizens in many parts of the region. In turn, these developments have helped deepen economic relationships and increase security cooperation between Asian countries and the United States. The core areas of TAF's work directly contribute to advancing U.S. strategic goals, strengthening democratic institutions and the rule of law. TAF programs reinforce U.S interests by improving the business policy environment in Asian countries through better governance, procurement practices and transparency. TAF convenes dialogues where American and Asian policymakers discuss common approaches with emerging donors in the post-traditional aid environment. TAF works with partners to examine the conditions facing newly advanced middle-income countries where countries have progressed beyond development assistance, but still face governance and other challenges as key economic and security partners of the U.S., such as Malaysia, Vietnam and Thailand. Transitions take time, and appropriated dollars allow TAF to make long- term investments in positive ways. what would the foundation do with sustained funding? FY 2022 funding at $20 million would position The Asia Foundation to maintain and expand programs in countries struggling with corruption, internal conflicts and weak democratic processes and institutions. TAF' s programs have deepened over the years to address the root causes of extremism, and governance at the national and sub- national level. TAF is harnessing the use of technology to increase program impact. TAF uses evidence-based approaches by conducting primary research that is used as a basis for our own programs but is also shared, valued and used by other donors and governments. Priorities include promoting inclusive economic growth and entrepreneurship, especially in marginalized communities, and addressing governance and women's empowerment issues in the Pacific Islands, where concerns about outside influences have become stronger. TAF's goals continue to be: --Expand community resilience, youth leadership and security in areas vulnerable to extremist recruitment in Malaysia, Indonesia and other parts of Southeast Asia; --Counter corruption and improve public accountability efforts in Sri Lanka, Timor Leste, Vietnam and Mongolia; --Strengthen women's empowerment programs throughout Asia, including developing economic opportunity and entrepreneurship for women, supporting girls' education through scholarships, combatting trafficking and gender-based violence; --Promote engagement of traditional and religious leaders in community development, women's empowerment, election observation and education in Indonesia, Afghanistan, and Bangladesh; --Sustain TAF's signature initiative, the Books for Asia program, which has provided over 51.7 million English-language books and digital content to more than 20 Asian and Pacific Island countries, and TAF's e-book platform Let's Read, with young local web developers and authors to create original children's book content, freely accessible online for download and use in local schools, libraries and institutions. This digital library now has over 6,200 new books in English and 42languages, including minority languages, in nine countries, including Cambodia, Indonesia, Myanmar, Nepal, Laos, Vietnam, Thailand. --Renew programs in key Pacific Island countries to improve governance and services; build capacity for civil society and government on principles of democracy; protect women's rights and reduce gender-based violence and; facilitate coordination in disaster risk management and resilience. New collaborations with the technology sector include: --TAF's Resiliency Initiative with Facebook looks to build tolerance, promote inter-faith and inter-ethnic understanding, and reduce extremism. The program will support civil society organizations to devise and run online campaigns. Facebook is the most popular and widely used social media platform in many countries in Asia and often the main way to access information online. --Facilitate the development of the Asia Pacific Information Disorder Index, an assessment that will take a whole of government approach to evaluate the capacity of governments to respond to information disorder threats, initially in PNG, with possible expansion to Fiji and Vanuatu. conclusion Funding at $20 million will allow The Asia Foundation to invest in innovative programs that have received Congressional encouragement. We believe TAF's track record demonstrates that we can leverage appropriated dollars and make efficient use of those funds to advance U.S. interests in the Indo-Pacific region. We appreciate the Committee's longstanding trust of and support for The Asia Foundation. The Congressional appropriation authorized in the 1983 Asia Foundation Act has been and remains invaluable to TAF's ability to achieve results on the ground and fulfill our shared mission to maintain U.S. presence and advance U.S. interests in the Indo- Pacific.We respectfully urge that the Committee support FY2022 funding for The Asia Foundation at $20 million, consistent with the President's request. (A full listing of Asia Foundation programs may be found on our website at www.asiafoundation.org.) [This statement was submitted by David D. Arnold, President.] ______ Prepared Statement of the Association of Public and Land-Grant Universities (APLU) The Association of Public and Land-grant Universities (APLU) requests at least $70 million for the Feed the Future Innovation Labs in FY2022 to provide resources for the Labs to address new food supply and security needs given the pressures of the COVID-19 economic downturn. We also respectfully request that the appropriation be made in the legislation, which has been the practice in most recent years, rather than the committee report. The 20 Feed the Future Innovation Labs are led by 13 U.S. universities in partnership with over 40 other U.S. universities, including seven Minority Serving Institutions. The research leaders at these universities work with USAID missions and developing country research institutions on critical issues to advance global food security and contribute to U.S. economic and national security. Over the past decade, the Feed the Future Innovation Labs have registered notable successes in addressing issues that disrupt the food supply, including post-harvest losses, food safety and access, and pest management. For example, researchers at the USAID Innovation Labs developed: --19 new sorghum lines resistant to the greenbug aphid in 2018. The lines were developed using germplasm collected by the sorghum research program from many parts of the world. Today, many American sorghum producers plant improved varieties developed by USAID-supported research. --13 common bean varieties and 2 blackeye pea varieties were developed by Feed the Future Innovation Lab researchers, registered as intellectual property, and have been made available to growers. Now, these varieties are commercially grown in the U.S. (beans in Michigan, Minnesota, Nebraska, North Dakota, and cowpea in California). --Low-priced grain storage bags that contain an ultrasonic device capable of monitoring insect activity. The hermetic plastic bags are designed to kill insects that cause post-harvest losses. The bags are produced by seven companies, sold annually to three million farmers in 58 countries, and used to store many crops including beans, corn, sorghum, rice, and coffee. The pandemic's disruption of food and agriculture systems is reducing hard-won gains of reduced poverty and food security. The Innovation Labs are helping to reverse and buffer against these setbacks. The economic downturn from COVID-19 is projected to increase the number of food-insecure people by 22 percent to 844.5 million people. USAID and Feed the Future Innovation Lab personnel have worked with governments and development partners to promote a safe and functioning food system throughout the pandemic. The Labs have mobilized their extensive networks at multiple levels and across countries to mitigate pandemic impacts, manage stress in food and health systems, and reduce risk of rapid spread of COVID19. International competitors continue to seek to displace the United States as the agricultural innovation leader by fostering greater ties with developing nations and in emerging markets. As a result, there has never been a more important time to maintain an international presence and demonstrate U.S. institutional excellence to reinforce alliances that contribute to national security and international well-being. Graduate student training is one way that the Innovation Labs contribute to food security and resilience via development and soft diplomacy. In 2019 alone, they supported 529 students, primarily at the graduate level from 39 nations. These students are future leaders in their respective countries. The requested increase in funding would create opportunities to avert current and emerging threats related to pests and disease through new partnerships, to combat the food insecurity impacts COVID19, address climate change challenges, and build capacity and resilience against new threats. about aplu APLU is a research, policy, and advocacy organization dedicated to strengthening and advancing the work of public universities in the U.S., Canada, and Mexico. With a membership of 244 public research universities, land-grant institutions, state university systems, and affiliated organizations, APLU's agenda is built on the three pillars of increasing degree completion and academic success, advancing scientific research, and expanding engagement. Annually, its 201 U.S. member campuses enroll 4.2 million undergraduates and 1.2 million graduate students, award 1.2 million degrees, employ 1.1 million faculty and staff, and conduct $46.8 billion in university-based research. [This statement was submitted by Caron Gala, Director, Governmental Affairs, Agriculture and International Development.] ______ Prepared Statement of the Basic Education Coalition Chairman Coons, Ranking Member Graham, and Members of the Subcommittee: I am pleased to submit testimony on behalf of the Basic Education Coalition, a group of leading U.S.-based organizations and academic institutions working together to promote expanded, equitable access to quality education. My name is Candace Debnam, and I am the Co-Chair of the Coalition's Board of Directors as well as the Executive Director of School-to-School International. To enhance U.S. foreign assistance efforts and improve educational opportunities for children in need, we urge Congress to provide $1.050 billion for Basic Education in the Fiscal Year 2022 State, Foreign Operations, and Related Programs bill, with at least $900 million provided as bilateral U.S. Government assistance. Our Coalition is extremely grateful for the Subcommittee's bipartisan commitment to fighting extreme poverty and improving access to education for children around the world, and we thank you for increasing the funding for Basic Education in the Fiscal Year 2021 State, Foreign Operations, and Related Programs appropriations bill. Funding for Basic Education enables USAID and implementing partner organizations to work in collaboration in some of the most challenging contexts around the world, and the increase in Fiscal Year 2021 resources will allow us to expand Basic Education programs to vulnerable populations, address gaps in education service delivery, and strengthen international education systems. The future development of all nations around the world is predicated upon children and youth acquiring the skills needed to lead their countries into a more prosperous, equitable, democratic, and inclusive society. However, COVID-19 disrupted the lives and education of over 90 percent of the world's children and youth and severely exacerbated a pre-existing global learning crisis.\1\ The consequences of protracted school closures around the world are undeniable. In addition to the loss of instructional time, school closures can negatively affect children's mental and physical health, nutrition, and well-being. For children who have been deprived of access to school and distance learning during COVID-19, global learning loss poses a generational threat. Research indicates that a three-month school closure could cost children over a year's worth of learning and, if left unaddressed, many children will never catch up.\2\ Those who were already at a disadvantage prior to the pandemic will fall even further behind as lack of access to critical learning resources will lead to a widening of the achievement gap.\3\ This will have real consequences over time for the United States and our partners abroad as studies show that lifetime earnings and economic productivity would be drastically higher on a global scale if all children benefited from a complete education and full health.\4\ To reaffirm the United States' commitment to the Sustainable Development Goals, remedy the losses caused by COVID-19, and return all children and youth to safe learning environments, Congress should prioritize funding for Basic Education funding in fiscal year 2022 and seek to expand access to and improve the quality of education in our partner countries. Domestic education budgets in low- and middle-income countries will be negatively affected by COVID-19 in the coming years due to lower economic output and tax revenue, and U.S. foreign assistance will be more vital than ever during this time to overcome the educational challenges that have been created and exacerbated by COVID-19. Over the past decade, the United States has led international development efforts to improve the acquisition of literacy skills among early grade learners. The focus on literacy as the essential building block to longer-term educational attainment has yielded improved reading scores, the creation of evidence-based national reading programs, and greater access to quality teaching and learning materials for students, teachers, and governments. However, far too many children still lack access to quality education and are failing to meet developmental milestones. Prior to COVID-19, 258 million children and youth were already out of school and more than 600 million learners were not achieving minimum proficiency levels in reading and mathematics.\5,6\ United Nations officials warn that an additional 24 million children could now drop out of school due to the pandemic,\7\ tragically reversing a global trend that has seen a decrease of nearly 118 million out-of-school children and youth since 2000.\8\ In response to COVID-19, USAID has mobilized more than $900 million for education assistance and rapidly adapted programming in more than 50 countries to support continued learning during the pandemic. Despite widespread school closures, USAID programs employed a variety of in- person and distance approaches in 2020 to reach more than 24 million learners from pre-primary through secondary education levels. To make sustained progress on U.S. economic and foreign policy goals and achieve a more equitable and prosperous world, access to safe, quality education must improve in our partner countries. Citizens of low-income countries need widespread literacy, numeracy, and critical thinking skills that are acquired in pre-primary, primary, and secondary school to collectively make social progress and grow their economies. Basic education lays the foundation for improved health and nutrition outcomes,\9\ slower population growth,\10\ democracy and political stability, and promotes greater gender equality, understanding, tolerance, and hope.\11\ Widespread educational attainment will also strengthen international efforts to build resilience to the harmful effects of climate change,\12\ and a significant increase in global funding is needed to meet the demand for quality education and make improvements in access to early childhood education, girls' education, disability-inclusive education, and education in emergencies. Early grade reading will continue to be the bedrock for all future learning and skills acquisition, however, to equip students with a broad range of skills, schools and wraparound services should offer holistic support for basic needs and overall well-being. Literacies of various kinds, a broad base of mathematical conceptual understanding, science foundations, and social-emotional skills are required for children to develop into healthy and productive members of their societies. In many low- and middle-income countries, too few students arrive at primary school on track developmentally and ready to learn. An estimated 250 million children globally fail to meet their developmental milestones,\13\ meaning nearly one-third of the world's children are entering elementary grades without the cognitive, social- emotional, motor, and language skills they need to fulfill their potential. U.S. foreign assistance needs to expand programs that improve early childhood care and education, including pre-primary education and multi-sectoral early childhood development interventions for children ages 0-8. While inclusion of children with disabilities and marginalized populations is essential to quality education at all levels, it is especially important during the early years, as they are the foundation and gateway to fruitful, lifelong learning. Children need additional support to make the transition from primary to secondary school so that the growing youth population has the opportunity for gainful employment and personal achievement.\14\ Higher-level skills that are acquired in secondary school should prepare students for participation in the fast-paced, rapidly changing global economy. Automated technologies will continue to replace low- skilled labor and employers will increasingly demand technical, social, and critical-thinking skills. Digital literacy and information engagement skills, including the ability to identify misinformation, build emotional resilience to it, and reflect on one's own information consumption, will be needed for the positive development of children and youth moving forward. It is also imperative for U.S. foreign assistance to aim to break down gender-related barriers to educational attainment in countries where there is persistent gender disparity in school enrollment and completion, particularly in secondary school when girls are most likely to dropout. In many contexts, entrenched social and cultural norms can limit girls' access to quality learning opportunities, and girls face risks of child marriage, early pregnancy and motherhood, gender-based violence, seclusion during menstruation, and greater responsibility for household labor than boys. To address these barriers, girls' education programs must promote holistic and multi-sectoral solutions that prioritize gender equity and broaden support for girls' education at every level of society. As COVID-19 has shown, resilience relies on the capability and ingenuity of people and leadership at the familial, communal, regional, and national levels. Local leaders and educators can engage families and communities, respond quickly to changing demands, and innovate in real time to adaptively meet local needs such as distance learning, remedial learning, girls' education, and skills development. To ensure that aid leads to sustainable change, leadership development programs should be created at the country level in consultation with communal, regional, and national stakeholders, with the goal of spurring local innovation and knowledge sharing. Further developing the education workforce will also be necessary to sustainably improve a global education system that supports learners and learning for the future. U.S foreign assistance should seek to strengthen the education workforce, including through the recruitment of diverse talent, and address the quality of teacher pre-service and in-service trainings and certification programs. Finally, we've learned from COVID-19 that school systems need to be prepared and resourced to facilitate and support extended periods of remote learning during a time of crisis. Lack of access to technology, the internet, toys, books, and other learning materials furthers the learning equity gap for children living in low-income households, those from marginalized communities, and those with disabilities, and should be addressed to ensure that learning can continue for all children in future emergencies. The U.S. government must make a more concerted and coordinated effort to include education as part of the immediate response to an emergency, including by fostering improved collaboration across U.S. humanitarian and development departments and agencies. A quality education for all is the bedrock of societal progress, and the benefits of our investments now will be reaped by generations to come. A fully resourced USAID will develop innovative solutions to global challenges and will have the capacity to directly address country needs. The Basic Education Coalition looks forward to working with Congress to ensure that quality education remains a pillar of our foreign assistance and that the U.S. Government Strategy on International Basic Education is a success. Together, we can help alleviate poverty, strengthen education systems, foster stability and security, and spur economic growth, both abroad and here at home. Thank you for your continued support and for your consideration of our request. --------------------------------------------------------------------------- \1\ United Nations Educational, Scientific and Cultural Organization. ``COVID-19 Impact on Education.'' Accessed October 8, 2020. \2\ Kaffenberger, Michelle. ``Modeling the Long-Run Learning Impact of COVID-19 Learning Shock: Actions to (More Than) Mitigate Loss''. RISE Insight (June 4, 2020). \3\ DeStefano, Joe, Ben Piper, and Jonathan Stern. ``Calculating the Educational Impact of COVID-19: Closed Schools, Lost learning, Unequal Impact.'' RTI SHARED (April 21, 2020). \4\ The World Bank Group. ``If Countries Act Now, Children Born Today Could Be Healthier, Wealthier, More Productive.'' (October 11, 2018). \5\ United Nations Educational, Scientific and Cultural Organization Institute for Statistics ``New Methodology Shows that 258 Million Children, Adolescents and Youth Are Out of School.'' (September 2019). \6\ United Nations Educational, Scientific and Cultural Organization Institute for Statistics. ``More Than One-Half of Children and Adolescent Are Not Learning Worldwide.'' (September 2017). \7\ United Nations Educational, Scientific and Cultural Organization. ``UNESCO COVID-19 Education Response: How Many Students Are at Risk of Not Returning to School?'' (July 30, 2020). \8\ Kaffenberger, Michelle. ``Modeling the Long-Run Learning Impact of COVID-19 Learning Shock: Actions to (More Than) Mitigate Loss''. RISE Insight (June 4, 2020). \9\ Mondal, Md Nazrul Islam and Mahendran Shitan. ``Factors affecting the HIV/AIDS epidemic: an ecological analysis of global data.'' African Health Sciences (2013): p.: 301-310. \10\ Murray, Sam. ``How Education Can Moderate Population Growth.'' World Economic Forum (July 27, 2015). \11\ Sperling, Gene, and Rebecca Winthrop. ``What works in girls' education.'' The Brookings Institution (2016). \12\ Striessnig, Erich, Wolfgang. Lutz, and Anthony G. Patt. ``Effects of educational attainment on climate risk vulnerability.'' Ecology and Society (2013)18(1): 16. \13\ Black, Maureen, Susan Walker, Lia Fernald, et al. ``Early childhood development coming of age: science through the life course.'' The Lancet (October 4, 2016). \14\ The International Commission on Financing Global Education Opportunity. ``The Learning Generation: Investing in Education for a Changing World.'' (2016). [This statement was submitted by Candace Debnam, Co-Chair, Basic Education Coalition and Executive Director, School-to-School International.] ______ Prepared Statement of the Bethany Christian Services Chair Coons, Ranking Member Graham, and Members of the Committee: On behalf of Bethany Christian Services, we are grateful for the opportunity to provide our outside written testimony and recommendations for the FY 2022 State Foreign Operations Appropriations bill. usaid/children in adversity/vulnerable children programming We urge the Senate to increase funding levels for programs to implement the United States Government Advancing Protection and Care for Children in Adversity (APCCA) and the Global Child Thrive law within the Children in Adversity Office/Vulnerable Children account at USAID. Specifically, we request a total funding level of $35 million in FY 2022 for this account, an increase of $10 million from the FY 2021 enacted level. This funding request would allow USAID's Children in Adversity team to begin the process of implementing the Global Child Thrive Act and further the U.S. government's goals of ensuring that every child has the conditions for healthy growth, nurturing family-based care, development and learning, and protection from violence, exploitation, abuse, and neglect in alignment with the strategy of APCCA, launched in 2019. These funds allow USAID to integrate early childhood interventions into international programs serving young children and their families. USAID should be able to plan and budget for activities that enable children to remain in or return to the care of their families, or when appropriate, other close family members or foster families, and decrease the percentage of children living in institutions. In addition to our funding request, we would like to make the following recommendations to help provide for the full implementation of APCCA and the Global Child Thrive Act. --USAID's implementation of the United States Government Advancing Protection and Care for Children in Adversity (APCCA) strategy should be continued as a whole-of-government approach to coordinate assistance to orphans and vulnerable children, as mandated by Public Law 109-95. --USAID's objectives of building strong beginnings, putting family care first, and protecting children from violence, abuse, and neglect deserve Congress's continued support. --As children are particularly vulnerable to the psychological impacts of conflict and forced displacement, interventions should be prioritized to assist children recovering from trauma, those in fragile contexts, those experiencing developmental delays or disabilities, children outside of family care, and children on the move. --We should also support mental health programs for vulnerable caregivers and children in emergency assistance programs. --USAID should be encouraged to partner with organizations of all sizes, including community and faith-based organizations, that demonstrate an expertise promoting deinstitutionalization, permanent family-based care, foster care programs in and outside of family networks, and preventing unnecessary family separation. population, refugees and migration (prm)/migration and refugee assistance/unaccompanied refugee minors resettlement programming Bethany urges the Committee to provide robust funding for the present and future resettlement of unaccompanied refugee minors (URM) including those who have fled ethnic cleansing and other forms of persecution. It is our hope that funding provided for FY 2022 refugee resettlement purposes will continue to support resettlement of qualifying URM who have been referred to the U.S. from UNHCR or NGOs. This is necessary to maintain this vital protection avenue for the most vulnerable refugee children. In addition, it is our hope that the Bureau of Population, Refugees and Migration (PRM) will ensure expedited processing for URM who are on the verge of aging-out of URM program eligibility. The URM program has provided thousands of children with renewed hope for the future, yet more than 150,000 children became unaccompanied or were separated from their families in 2019, a significant underestimation given the limited number of countries reporting data. Family reunification may be possible for some of those children; others, after careful best interest determinations, may be among those who would greatly benefit from the U.S. URM program. Increasing conflict and rising inequality are contributing to the mass displacement of children, including URM, from their homes, endangering their survival, disrupting their education, and exposing them to severe protection risks, including trafficking, violence, abuse, neglect, and exploitation. At the same time, U.S. support for URM has fallen precipitously. In FY 2015 the U.S. resettled 294 refugee children, compared to only 116 in FY 2018, 156 in FY 2019, and 101 in FY 2020--a significant decline. In FY 2020, the COVID-19 pandemic halted processing and travel for most URMs, resulting in an increased number of youth turning 18 and ``aging out'' of their chance to enter the URM program. It is vital that this population of vulnerable children get expedited processing to ensure that they can access protection. Approximately 13,000 children have entered the United States through the URM program since its inception in 1980--from places like Democratic Republic of the Congo, Eritrea, Burma, and Afghanistan. While the total number of children resettled through the URM program is relatively small, the program has a tremendous impact on the children it serves. The URM program provides culturally and linguistically appropriate foster care to unaccompanied refugee children and youth. Through the program, unaccompanied refugees receive care, educational support, and case management to help the children thrive and achieve self-sufficiency. The U.S. should commit to increasing the life-saving refugee resettlement practices in a way that reflects the gravity of the global refugee crisis. This includes a continued strong commitment to unaccompanied refugee minors. child protection in state department/international disaster assistance and migration and refugees assistance program Bethany encourages the Committee to recognize the need for additional protection of displaced children at the Office of Foreign Disaster Assistance and the Bureau of Population, Refugees, and Migration. These offices can play an increasing leadership role to protect children in humanitarian crises and ensuring that protection is integrated across other humanitarian sectors. Child protection programming is essential to ensuring child well- being and survival during and after emergencies and in refugee contexts. Children represent an outsized percentage of those impacted by humanitarian emergencies. In times of crisis, children face increased risk of all forms of violence and exploitation, especially in developing countries. Emergencies exacerbate pre-existing protection concerns and create new ones. As described in the 2012 Minimum Standards for Child Protection Humanitarian Action, the range of protection concerns faced by children in humanitarian contexts comprises: Lack of access to asylum procedures; separation from parents and caregivers; sexual violence and sexual exploitation; mental disorders and psychosocial distress; forced recruitment into armed forces and armed groups; early marriage; trafficking, smuggling, sale and illegal adoption, inappropriate adoption; physical violence and harmful practices; unexploded ordinances and landmines; child labor; and detention. These categories are not discreet but interconnected and compounding. An estimated 50 million children are on the move. More than half of these children, 28 million in total, have fled violence and insecurity. Increasing conflict and rising inequality are contributing to a mass displacement of children from their homes, endangering their survival, disrupting their education, and exposing them to severe protection risks, including violence, abuse, neglect, and exploitation. Currently, nearly one in every 200 children globally is a child refugee. Between 2005 and 2015, the number of child refugees under the United Nations High Commissioner for Refugees' (UNHCR) mandate more than doubled. According to the Alliance for Child Protection in Humanitarian Action, child protection in conflict and crisis settings has been deprioritized in recent years and evidenced by statistics on funding. Protection in emergencies activities is underfunded, typically receiving approximately one third of the total amount requested and proportionately less than the overall humanitarian response. Child protection in humanitarian action saves lives. The committee agreed with this as demonstrated by the inclusion of language consistent with the requested in previous committee reports. Thank you for the opportunity to present the priorities for Bethany Christian Services for the FY 2022 State-Foreign Operations Appropriations bill. Please do not hesitate to contact us with any questions. about bethany christian services Bethany Christian Services (Bethany) is an international nonprofit organization headquartered in Grand Rapids, Michigan. With a presence in more than 30 states and in several countries, Bethany offers a wide array of services with a common mission: to serve vulnerable children and families and help them thrive. Through services in the U.S. and around the world, Bethany impacts hundreds of thousands of lives every year. For over 45 years, Bethany has served displaced people, caring for refugee children who have lost their families and homes, supporting asylum-seeking families through alternative to detention case management services, and helping refugee families resettled in the United States thrive. [This statement was submitted by Chris Palusky, President and CEO and Tawnya Brown, Senior Vice President.] ______ Prepared Statement of the Better World Campaign Chairman Coons, Ranking Member Graham, Members of the Subcommittee- thank you for the opportunity to provide written testimony in support of a robust foreign affairs budget in FY 2022. The accounts funded by this legislation support U.S. assessed and voluntary contributions to the United Nations. Specifically, we recommend $2.701 billion for the Contributions for International Peacekeeping Activities (CIPA) account, which funds U.S. assessments for UN peacekeeping missions, and $548 million for the Peacekeeping Operations (PKO) account, which funds voluntary contributions to regional peacekeeping initiatives and assessments for UN activities in Somalia. We also support the inclusion of language that enables us to pay our contributions to UN peacekeeping at the full assessed rate. In addition to peacekeeping-related funding, we request $1.662 billion for the Contributions to International Organizations (CIO) account, which funds U.S. assessments for the UN Regular Budget and a host of UN specialized agencies, including the World Health Organization (WHO). In addition, we ask that you provide robust funding for UN relief activities in Yemen, Syria, Venezuela, and other humanitarian emergencies, including $646.5 million for the International Organizations and Programs (IO&P) account. We hope you will also consider funding important bilateral and multilateral programs, including family planning programs ($1.74 billion), the President's Malaria Initiative ($770 million), the Global Fund for AIDS, Tuberculosis and Malaria ($1.56 billion), Gavi, the Vaccine Alliance ($290 million), and USAID's polio program ($61 million). These important bilateral and multilateral programs are partner with and are amplified by the UN's work and are critical bipartisan U.S. foreign policy priorities. The UN: Supporting Robust Investments in a Critical Force-Multiplier for the U.S. While the world has changed significantly since the UN's founding in 1945, its role as a force-multiplier for the U.S.-a key forum for multilateral diplomacy to mitigate conflict, and a mechanism to address challenges that no country can resolve alone-remains as vital as ever. The last year in particular has dramatically underscored the maxim that ``if the UN did not exist, we would have to invent it.'' For example: --The World Health Organization (WHO) has played a central role in addressing the COVID-19 pandemic, distributing diagnostic kits and millions of items of PPE to dozens of countries with weaker health systems; carrying out public awareness campaigns in dozens of languages in 149 countries; and disseminating technical guidance to local health authorities. WHO is also at the center of a cooperative effort, along with the UN Children's Fund (UNICEF) and other partners, to equitably distribute COVID-19 vaccines worldwide, launching a facility, known as COVAX, that aims to distribute 2 billion vaccine doses to low and middle-income countries this year. --UN humanitarian agencies have scaled up operations to respond to humanitarian needs that have been exacerbated by the pandemic and its global economic shocks, providing food, shelter, clean water, medical care, educational support, and other life- sustaining services to tens of millions of people around the world. The importance of the UN's work in this arena is felt particularly strongly in countries like Yemen, where years of brutal conflict have left more than 80% of the population in need of humanitarian assistance. --UN peacekeepers have continued working to protect civilians and promote stability in hotspots and fragile states across three continents. In Mali, for example, UN peacekeepers are supporting U.S. counterterrorism objectives, working with French and African partners to help prevent extremist groups linked to al-Qaeda and ISIS from gaining and holding territory. The U.S. has long been one of the organization's most powerful member states, using its position and influence to drive the UN's agenda and work in a direction that promotes our core foreign policy and national security interests. The U.S. also benefits from the burden-sharing aspects of the UN's work: with regards to peacekeeping, we provide just several dozen uniformed personnel out of a force that totals more than 75,000. Additionally, the GAO has repeatedly determined that UN peacekeeping missions are eight times cheaper than deploying U.S. forces, making them a relative bargain for American taxpayers. Despite this, the U.S. has not always lived up to its commitments. Since FY17, we have accrued more than $1.1 billion in arrears on our assessments for UN peacekeeping, due to Congressional enforcement of an arbitrary statutory cap that prevents us from contributing more than 25% of mission budgets. This cap has remained in place since the mid- 1990s, despite the fact that our assessment rate for peacekeeping has shrunk from a high of 32% when the cap was first enacted to the 27.89% rate in effect today, as well as the fact that our contributions to the UN regular budget are subject to a ceiling of 22%, below what we would be paying if our share of the global economy and per capita income were the only criteria. Continuing to enforce the cap and accrue arrears is harmful for several reasons. First, the UN does not have a standing army, and depends on voluntary contributions of troops, police, and essential equipment from member states. The UN's top contributors of uniformed personnel are generally low and middle-income countries like Bangladesh, Rwanda, Senegal, and Jordan, who possess fewer financial resources and depend on reimbursement payments to sustain complex and often hazardous peacekeeping deployments. Unfortunately, U.S. arrearages have contributed to a significant cash crunch at the UN, which means that the UN is perpetually delayed in making these payments, sometimes by as much as 6-12 months. If these shortfalls are allowed to fester and grow, it would affect the willingness and ability of countries to participate in UN peacekeeping, potentially leaving operations that the U.S. has repeatedly voted to support on the Security Council with significant personnel and equipment shortages. Second, accruing arrears undermines our ability to push for necessary reforms at the UN. During the Obama Administration, the U.S. and UN worked together to adopt a number of measures, cutting the cost per peacekeeper by 18% and reducing the number of support staff on missions to lower administrative costs. The UN also undertook important efforts to combat sexual exploitation and abuse by UN personnel, adopting policies that shortened the timeline of investigations, increased public reporting and transparency about suspects and the status of investigations, provided legal aid and other forms of support to victims, and took action against contingents from troop-contributing countries with a history of abuse allegations. All of this was done at a time when the U.S. was not enforcing the cap. By contrast, failing to pay our dues in full alienates likeminded countries, sends the message that we are more interested in punishing the UN than improving it, and makes it less likely that future U.S. entreaties around cost, efficiency, and accountability will be taken seriously. As the U.S. approaches assessment rate negotiations this year and seeks to maintain UN budget discipline and support full implementation of the Secretary- General's reform agenda, payment of our arrears will be essential to lining up support from other UN member states. Finally, our financial delinquency is a gift to our strategic competitors, who are more than happy to fill the vacuum when we step back at the UN. For example, China has significantly expanded its role at the UN in recent years: it is now the second largest financial contributor to both the UN peacekeeping and regular budgets, the ninth largest troop-contributor to UN peacekeeping operations, and has helped place Chinese nationals in key positions, including the top posts at 4 of the organization's 15 specialized agencies. With increased financial contributions and engagement comes more leverage, and Chinese diplomats have increasingly sought to use this dynamic to call out the U.S. for being the UN's ``largest debtor'' while simultaneously working to undermine the UN's human rights work, including as part of peacekeeping missions. The U.S. has long supported efforts by UN peacekeeping operations to monitor and promote human rights in their areas of operation, protect civilians, and address gender-based violence. These essential activities could increasingly be in jeopardy if the U.S. does not meet its financial obligations. For this reason, my organization is encouraged by the President's FY 2022 request, which includes funds sufficient to fully pay our anticipated peacekeeping dues, $300 million to help pay down our arrears, a call to lift the peacekeeping cap, and a commitment to fully pay back our arrears in 2 years. My organization's own request numbers for the CIPA and PKO accounts include lifting the peacekeeping cap and funding to pay our FY22 dues and our arrears in-full in one year, similar to what was done in 2009. We also hope that you will fund the CIO account-which provides U.S. assessed contributions to the UN regular budget and dozens of other organizations-at the level called for in the President's request. We also request language requiring the State Department to fund UN assessments earlier in the calendar year. The practice of waiting until the end of the fiscal year to pay our regular budget dues has led to repeated liquidity crises at the UN, harming the organization's ability to deliver vital programs and services. The UN regular budget funds numerous activities, including special political missions deployed to support peace processes and facilitate democratic transitions in countries that have undergone conflict. Just recently, in Libya, the UN helped negotiate a permanent ceasefire and secured adoption of a political roadmap calling for the formation of a unity government and the holding of national elections in December 2021. If these efforts at political reconciliation are successful, they could end a civil war that has drawn in outside powers and negatively impacted stability in the Mediterranean region. In addition, the role of the UN as a conduit for international assistance and technical expertise will take on an even greater role as the U.S. withdraws the last of its military forces from Afghanistan this year. Meeting our financial obligations to these and other programs under the CIO account is therefore critical to supporting many of our nation's broader national security objectives. Global Health: Immunizations, Malaria and Family Planning As COVID-19 has shown us over the last year, health systems around the world can be threatened in the time it takes for a plane to round the globe. U.S. investment in the Global Polio Eradication Initiative (GPEI) has strengthened country health systems and provided vital tools, infrastructure, and skilled workers capable of not only eradicating polio but also fighting other vaccine-preventable diseases, like measles and yellow fever. This network of assets, spearheaded by the WHO, will be essential to ensuring equitable and timely distribution of a COVID-19 vaccine. Pivoting polio resources to the pandemic was vital to many countries' ability to respond to the pandemic threat, but it has come at a cost. Polio vaccination campaigns were paused during the summer, and at least 60 million children were not vaccinated. Pakistan alone has identified a staggering 800,000 high-risk children under the age of five in the country's most vulnerable districts. Now is the time for continued political commitment to realize what will be one of the greatest public health achievements in history and ensure that all children live polio-free forever. Supporting the State and Foreign Operations contributions to GPEI at $61 million will be important to ending polio. Since its founding in 2000, Gavi, the Vaccine Alliance, has played a vital role in the purchase and delivery of life-saving vaccines for children in the world's poorest countries. During the pandemic, Gavi is co-leading a global solution to accelerate the development and manufacture of COVID-19 vaccines, as part of a broader effort that also includes diagnostics and treatments for the virus. The facility, called COVAX, will also guarantee rapid, fair, and equitable access to safe and effective COVID-19 vaccines for people in all countries. This collaboration already boasts the engagement of over two-thirds of the world's countries and operates by pooling the purchasing power of participating countries. Ensuring Gavi is properly funded at $290 million will help it respond to COVID-19 and support its core operations. COVID and malaria share 7 of 10 primary symptoms, including most notably fever. During the onset of the pandemic, several international analyses, including reports from the WHO and the Lancet Commission, indicated that delays in intervention delivery could result in a staggering increase in deaths from malaria. Studies estimated malaria death rates could double this year alone. Programs like the President's Malaria Initiative (PMI) and the Global Fund to Fight HIV, Tuberculosis, and Malaria have had to respond quickly through updated guidance on service delivery and resource mobilization to avoid disruptions in intervention campaigns and ensure the fight to eliminate malaria stays on track. Malaria already places a strain on health care systems throughout sub-Saharan Africa: the disease accounts for 40-60% of all inpatient and outpatient cases in the region. Continued strong support of the Global Fund at $1.56 billion will lower preventable deaths and strengthen health systems. PMI currently operates in 27 focus countries in sub-Saharan Africa and the Greater Mekong Subregion in Asia, working alongside national malaria control programs to optimize and scale up proven, cost-effective interventions such as long-lasting insecticide- treated bed nets, anti-malarials, and rapid diagnostic tests. Funding PMI at $770 million will help to end malaria, which will lower health care costs, increase productivity, improve capacity to respond to disease outbreaks, promote economic security and stability, and serve as a blueprint that could be used against other diseases of poverty. COVID-19 has been particularly hard on women and girls. The UN and our bilateral family planning and gender empowerment programs are critically important for women and girls around the world. The UN Population Fund (UNFPA) has also played an important role in combatting COVID-19, including providing needed PPE in countries and helping victims of gender-based violence, which spike in humanitarian emergencies. Unfortunately, more than 303,000 women die from largely preventable complications related to pregnancy and childbirth each year. 214 million women would like to delay or avoid pregnancy but do not have access to or aren't using modern methods of contraception. With access to contraceptives, unintended pregnancies would drop by 70%, maternal deaths would drop by 67%, and newborn deaths would drop by 77%. To meet the unmet need, the U.S. share of international reproductive health and family planning funding would be $1.74 billion (including $116 million for UNFPA). UNFPA operates in places like Syria and Yemen or after humanitarian disasters in Nepal to ensure that every pregnancy is wanted, every birth is safe, and every young person's potential is fulfilled. They provide safe birthing and dignity kits after disasters, help install solar lighting in refugee camps, and provide contraceptives in more than 150 countries to prevent maternal mortality and improve the status of women. UN Women plays an important role in creating policies to eliminate discrimination against women and girls, empower women, and achieve gender equality. We believe the Subcommittee should support UN Women at $17 million in FY'22 in the IO&P account. Further robust funding should be made available to promote gender equality in U.S. government diplomatic and development efforts through programs promoting women's political leadership, implementation of a multiyear strategy to respond to gender-based violence, and supporting the execution and monitoring of the Women, Peace and Security Act. [This statement was submitted by Peter Yeo, President.] ______ Prepared Statement of the Bread for the World Before I begin, I would like to thank Chairman Coons and Ranking Member Graham for your leadership on this subcommittee in championing poverty-focused programs. Amid the converging crises of COVID-19, climate change, and ongoing conflicts around the world, the work of this committee--at this moment--could not be more critical. Thank you for your leadership philosophy that emphasizes considering all who are affected, including people in the most vulnerable and at-risk communities. Members of the committee, thank you for this opportunity. I am Rev. Eugene Cho, President and CEO of Bread for the World. We are a grassroots collective Christian voice urging our nation's leaders to end hunger at home and abroad. Bread for the World is committed to promoting and supporting the dignity of those affected by extreme poverty, food insecurity, conflict, and marginalization around the world. On behalf of our network of 250,000 members, churches, and partners, thank you for your ongoing bipartisan support for robust funding levels of poverty-focused international affairs budget accounts over the last few years. We applaud the inclusion of funding for the international response to COVID-19 in both the FY 2021 Omnibus Appropriations bill and emergency COVID-19 legislation, as well as in the American Rescue Plan Act. As COVID-19 has exacerbated existing disparities around the world, adding significant international humanitarian, global health, and poverty-focused aid to our response means saving more lives. Over the last 30 years, we have seen incredible progress in reducing global hunger. In 1991, 25 percent of the world's population experienced hunger. That fell to just under 10 percent in 2019. This translates to more than 100 million people who did not suffer from hunger or malnutrition in 2019, but who would have 30 years before. Such an accomplishment would not have been possible without the U.S. government-and specifically this committee-investing in people around the world. But the challenges we now face threaten to reverse this hard-won progress. Before COVID-19 struck, more than 1 in 5 of the world's children younger than 5 suffered from stunting (i.e., being far too short for their age) because they were chronically malnourished. Nearly 7 percent of children worldwide were affected by wasting (severe acute malnutrition). The number of children affected by one or both of these forms of malnutrition are likely to not only have already increased significantly, but also to continue to rise today, because of the global pandemic. Public health measures, while necessary to slow transmission of the virus, imposed constraints on children's access to nutritious foods and essential nutrition services. It may be years before the full impact on children is known. If we genuinely want to eradicate poverty and malnutrition in all its forms once and for all, we must take immediate and courageous action to advance poverty-focused development assistance. Genesis 1:27 reminds us, as people of faith, that every person is created in God's image and that God longs for every person to live a life of dignity and good health. As COVID-19 has exposed and exacerbated existing global inequalities, it is essential to respond by providing robust international humanitarian, global health, and poverty-focused assistance. This will save the lives of millions of people and help advance well=being. We urge increased investment in programs that respond to the urgent needs of our most vulnerable neighbors. As you move forward with the FY 2022 appropriations process, we especially urge you to continue to fund critical hunger, malnutrition, and poverty-focused programs. All poverty-focused development and humanitarian assistance funding is crucial for achieving our shared global goals, including the 2030 Sustainable Development Goals. For the greatest impact on ending hunger, Bread for the World urges Congress to prioritize funding in the following appropriation accounts: --$300 million for Nutrition in Global Health Programs at USAID. These programs at USAID focus on evidence-based interventions that affect the very foundations of children's survival and their physical and cognitive development. The modest funding increases of recent years simply do not begin to keep pace with rising malnutrition, particularly since the COVID-19 pandemic began. --$1.2 billion for Feed the Future. Feed the Future is the U.S. government's primary global hunger and food security initiative. With 12 target countries spanning the globe, Feed the Future has helped more than 23 million people escape poverty and more than 5 million families live free from hunger. --$46.8 million for the International Fund for Agricultural Development. IFAD programs strengthen resilience, improve food security, and help reduce poverty. Households reached by IFAD have increased their agricultural production by 44 percent. --$5.27 billion for International Disaster Assistance. The International Disaster Assistance account allocates humanitarian assistance to countries experiencing the impact of natural disasters, conflicts, and other crises, including funding for treatment of acute malnutrition. --$1.43 billion for the International Development Association at the World Bank. IDA is one of the largest sources of assistance for the world's 74 lowest-income countries, and it has tripled its financing for food security since 2008. --$224.2 million for the African Development Fund. In the last three years, AfDF has increased financial support 17-fold to Africa's least developed countries. In 2019, the African Development Bank Group's Feed Africa initiative reached 20.3 million people on the continent with agricultural programs. --$89.9 million for the Asian Development Fund. The AsDF provides grants to the Asian Development Bank Group's 15 lower-income member countries to help reduce poverty and improve quality of life. Between 2017 and 2019, AsDF worked with more than 150,000 farmers to enable them to gain access to quality farm inputs. --$2 billion for the Green Climate Fund. GCF works in developing countries to lower greenhouse gas emissions and build resilience in the face of climate change impacts. This includes support for smallholder farmers through climate-smart agriculture. The fund has approved $8.4 billion for 173 projects in 190 countries. --$202.5 million for Sustainable Landscapes. Sustainable landscapes programs at USAID use investments in forestry, agriculture, and land usage to reduce greenhouse gas emissions while increasing productivity and reducing rural poverty. Improving soil health, which is crucial to food security and nutrition, is an example of a sustainable landscape project. --$480 million for Biodiversity. Biodiversity programs help to conserve ecosystems through activities such as protecting watersheds and preserving tropical forests. USAID has helped 1.5 million people get jobs and improve their incomes through natural resource management. Biodiversity is necessary for food production; many crops and livestock that humans depend on for food are threatened with extinction by decreasing biodiversity. --$158.92 million for the Global Environment Facility. GEF helps communities begin to reverse environmental degradation that threatens local livelihoods, including in agriculture and fisheries. The Resilient Food Systems program has invested $1.2 billion in strengthening food security by improving the use and management of 3.2 million hectares (8 million acres) of land. We also request that you fund these critical programs within the Agriculture Appropriations bill: --$2 billion for Food for Peace. The Food for Peace program at USAID is the U.S. government's largest provider of overseas food assistance. In the 50-plus years since it was established, Food for Peace has directly benefited more than 3 billion people in 150 countries. --$264 million for McGovern-Dole, including $25 million for Local and Regional Procurement. The McGovern-Dole International Food for Education and Child Nutrition Program supports education, child development, and food security in low-income countries. Since 2003, the program has provided school meals to more than 40 million children in 40 countries. Funding for these important appropriations accounts saves lives and enables children to thrive. Specifically, increasing the existing global nutrition account to $300 million would prevent stunting in more than 550,000 children, treat more than 3 million children with wasting (severe malnutrition), prevent anemia in up to 12 million new mothers, and ultimately save the lives of 160,000 children. In addition to the moral imperative to assist our neighbors, we know that this small investment of less than 1 percent of our federal budget provides a strong return on investment (ROI). Studies show that, for every dollar invested in nutrition, a country can generate a $16 ROI as a result of lower healthcare costs and increased worker productivity. Nutrition programs help equip low-income countries for long-term economic success, reduce the risk of conflict, and promote longer-term health benefits for their populations. We also know that these types of foreign aid are popular with the American public. A 2017 poll by the University of Maryland Program for Public Consultation found that 8 in 10 respondents favored humanitarian assistance, and two-thirds of respondents favored aid that helps countries in need develop their economies, agreeing that this is in the economic interest of the United States. At Bread for the World, we believe God's love in Jesus Christ compels us to perform actions that show how we love our neighbors as ourselves. Whatever your personal and faith motivations, I hope that you continue to expand your legacy of promoting human rights, addressing the needs of the most vulnerable, partnering with countries for shared goals of prosperity, and investing in people around the world. Now more than ever, the world needs U.S. commitment to poverty- and nutrition-focused development. Thank you for your continued support. May God continue to bless your work. [This statement was submitted by Rev. Eugene Cho, President and CEO.] ______ Prepared Statement of Catholic Relief Services Chairman Coons, Ranking Member Graham: On behalf of Catholic Relief Services (CRS), the international relief and development agency of the Catholic community in the U.S, I respectfully request that you increase poverty-reducing humanitarian and development assistance in Fiscal Year 2022 (FY22) appropriations. To address unprecedented global challenges, we urge Congress to increase the international affairs budget to $71.6 billion to allow for more poverty-reducing assistance. We urge you to prioritize the accounts below to at least the levels indicated. ------------------------------------------------------------------------ ------------------------------------------------------------------------ Maternal and Child Health (USAID)................... 879,000,000 Nutrition (USAID)................................... 150,000,000 Vulnerable Children (USAID)......................... 35,000,000 HIV/AIDS (USAID).................................... 330,000,000 Malaria (USAID)..................................... 785,000,000 Tuberculosis (USAID)................................ 325,000,000 Neglected Tropical Diseases (USAID)................. 102,500,000 Global Health Security (USAID)...................... 995,000,000 PEPFAR/Global Fund (DOS)............................ 5,930,000,000 Development Assistance (USAID)...................... 4,075,097,000 International Disaster Assistance (USAID/BHA)....... 4,682,362,000 Migration and Refugee Assistance (DOS/PRM).......... 3,981,331,000 Emergency Refugee and Migration Assistance (DOS/PRM) 1,000,000 Complex Crises Fund (USAID)......................... 60,000,000 Millennium Challenge Account (MCC).................. 912,000,000 Atrocities Prevention Board (DOS)................... 5,000,000 Contributions for International Peacekeeping 1,928,614,000 Activities (DOS/IO)................................ Peacekeeping Operations (DOS/IO).................... 469,459,000 Green Climate Fund (Treasury)....................... 1,250,000,000 U.S. Institute of Peace............................. 45,000,000 Anti-Trafficking in Persons (USAID and DOS)......... 99,000,000 ------------------------------------------------------------------------ CRS works with 1,915 partners to serve more than 140 million people in 115 countries. Grounded in our belief in the dignity of every human person, we will continue to work until all of God's children can fulfill their human potential. Our work overseas is complemented by our movement building in the United States. We invite Catholics and people of good will to stand in solidarity with poor and vulnerable communities and to advocate in support of U.S. leadership around the world. Our experience affirms that the U.S. can play a constructive role in advancing peace, justice, and wellbeing. Numerous global challenges demand a strong U.S. response. U.S. leadership will be critical to end the COVID-19 pandemic and prepare for future health crises; care for our common home and address climate change; mitigate human suffering and address the root causes of instability; and strengthen local capacity to bring about transformational change. i. end covid-19 and prevent development backsliding Strong FY22 appropriations will be essential to help end the COVID- 19 pandemic, prepare for future health crises, prevent further development backsliding, and foster a sustainable recovery. The United States must lead a global effort to distribute vaccines equitably and efficiently. Manufacturing adequate supply, delivering vaccines from ports into peoples' arms, and overcoming vaccine hesitancy within communities will be significant challenges. We recognize the generous appropriation Congress allocated to GAVI last year. To help overcome vaccine hesitancy, we urge the Committee to recommend utilizing faith- based organizations and faith leaders to disseminate positive messaging for vaccine acceptance and to counter mis-and dis-information. Faith- based organizations and faith leaders have a rich history of responding to health crises, including well documented successes such as promoting vaccinations against Polio in Nigeria in the early 2000s. To help prepare for future health crises, Congress must continue to support strengthening health systems, including programs that treat, prevent, and control malaria and fight HIV and AIDS. Lastly, the Committee must prevent development backsliding and foster a sustainable and inclusive recovery. The World Bank estimates that the health, economic, and social impacts of COVID-19 will increase the number of those living in poverty between 143 and 163 million people in 2021. Food insecurity and malnutrition, displacement, and gender-based violence are all on the rise. Educational achievement is falling. We also urge attention to the disturbing increase of violence against children due to the pandemic and urge increased attention to child protection and support for vulnerable families. We appreciate recent increases to health, development, and humanitarian accounts as well as supplemental resources to prevent, prepare for, and respond to COVID-19. To achieve long-term human development goals, we need to do more. We strongly recommend Congress increase appropriations to life-saving Global Health accounts, Development Assistance, and Economic Support Funds that achieve the goals of poverty reduction and integral human development. ii. care for our common home and address climate change The health and wellbeing of each person will also depend on how we care for the environment and our common home. CRS is committed to ensuring all people achieve dignified and resilient livelihoods in flourishing landscapes. Everywhere we work, communities tell us that the climate is changing and that storms are more intense. Urgent action is needed to help communities adapt to stronger and more regular climate events that disproportionately impact and displace poor and vulnerable communities. Therefore, Congress must increase investments in the Green Climate Fund and other multilateral and bilateral development accounts that support adaptation, clean energy, and sustainable landscapes alongside agriculture and WASH. Investments in disaster risk reduction, land restoration, and water and climate-smart agriculture can make a measurable difference in the lives of those most impacted by climate change. Our experience informs this position. In Sierra Leone, CRS helped improve water security in urban Freetown by increasing the capacity of watershed management structures; utilizing natural infrastructure and climate change adaptation strategies to reduce storm water runoff; and establishing the business case for a Western Area Peninsula Water Fund, which will serve as a governance and financing mechanism for nature- and community-based water catchment conservation and development. In Lesotho, CRS helps communities to better manage their water and soil, revitalizing farmland pastureland, preventing erosion, and restoring ground water and springs. Keeping soil healthy can also mitigate climate change by sequestering carbon in soils at the same time as it supports increases in crop production. And in Ethiopia, CRS trains farmers and producers in food storage and preservation to minimize crop losses, and water harvesting techniques to increase water availability for crops and livestock. In addition to increased funding, we urge the Committee to engage with USAID as they renew a climate change strategy. The Committee should encourage the agency to expand restoration efforts to include revitalizing ecosystems across multiple landscapes, including agriculture lands; to support just solutions for those communities most impacted by climate change; and to integrate peacebuilding into natural resource management and land tenure issues. iii. end human suffering and address the root causes of conflict and instability Conflict and instability remain the largest driver of forced displacement and create the greatest need for humanitarian aid. More than 80 million people are displaced from their homes, and an estimated 272 million people are at risk of becoming severely food insecure by the end of 2021. The United States has been a global leader in providing lifesaving humanitarian assistance and protection to people in need, but we must do more to end human suffering, foster peace, and address the root causes of conflict and instability. The Horn of Africa continues to face the desert locust reinvasion, increased droughts and floods, political crises, and ongoing conflict. COVID-19 and violence have also increased vulnerability and insecurity in the West Bank and Gaza. Political and economic instability in Venezuela have led more than 5 million people to flee. To respond to these and other humanitarian crises, the Committee should urge the Administration to depoliticize humanitarian aid and improve humanitarian access. The Committee should also increase allocations to International Disaster Assistance, Migration and Refugee Assistance, and Emergency Refugee and Migration Assistance. We recognize that these social, economic, and political crises require more than humanitarian aid. We must leverage diplomatic and peacebuilding tools to prevent conflict and promote good governance. Congress must increase investments in the Complex Crisis Fund and provide strong funding for peacekeeping, atrocities prevention, and the U.S. Institute of Peace. Moreover, Congress must increase resources to Development Assistance and direct Economic Support Funds to address the root causes of human suffering that contribute to forced displacement. For example, our brothers and sisters in El Salvador, Guatemala, and Honduras face numerous challenges to survive and thrive in their home communities. Evidence generated from CRS programs and a recent CRS migration study demonstrate that poverty-reducing development assistance addresses the push factors of migration and promotes rootedness in communities. As the Committee works with the Administration to address the root causes of migration from Central America, we urge it to prioritize programs that (1) grow formal job opportunities and support job-relevant education and training; (2) create more equitable decision-making spaces between women and men; (3) improve climate adapted agricultural practices; and (4) target vulnerable families and marginalized populations, including women, indigenous communities, and youth. iv. strengthen local capacity and empower local leadership Ending COVID-19, caring for our common home, and addressing conflict and instability will not be sustained without strengthened local capacity and empowered local leadership. Local actors and the international aid community are demanding locally owned and led humanitarian and development assistance, which when done well produces more effective and sustainable results. For CRS, local leadership extends beyond direct or prime funding to sharing capacity and shifting power dynamics. From 2016-2018, CRS implemented the Preparing to Excel in Emergency Response (PEER) project, a privately funded program aimed to strengthen the emergency response capacity of local faith organizations in India, Indonesia, Jordan, and Lebanon. In 2020, as these organizations rushed to serve millions of people in response to COVID-19, CRS conducted a study to understand if capacity strengthening investments made during PEER were sustained and utilized during COVID- 19 response. All 22 partners interviewed for this study felt their organization applied lessons learned from participating in PEER and were working with improved systems, which enabled a more effective emergency response. These findings illustrate how local actors can lead critical emergency response efforts and provide examples of how investments made in their capacity can advance localization of humanitarian response. Bipartisan momentum exists to advance local leadership. From the Bush Administration's implementation of PEPFAR to the Obama Administration's USAID Forward and from the Trump Administration's Journey to Self-Reliance to the multilateral Grand Bargain, bipartisan initiatives have highlighted the importance of local leadership. While some components of these initiatives have been more successful than others, none have been able to shift prioritization adequately and systemically. We urge the Committee to recognize that local and national nongovernmental leadership is critical for effective and sustainable assistance. Further, we urge the Committee to direct the USAID Administrator to prioritize making funds available to local and national nongovernmental entities and invest in holistic capacity strengthening for local leadership and sustainable self-reliance. We also urge more transparency on how and where funds are made available to local entities. v. aspire for greater change In Pope Francis' recent Encyclical, Fratelli Tutti, he wrote, ``What we need in fact are states and civil institutions that are present and active, that look beyond the free and efficient working of certain economic, political or ideological systems, and are primarily concerned with individuals and the common good.'' We applaud Congress for their strong bipartisan support for the above accounts, but the human needs call us to forge a deeper commitment to increase resources and strengthen tools that can tackle the urgent crises of our times and allow every person to reach their God-given human potential. We urge the Committee to work with the Administration to commit to doubling international poverty-reducing humanitarian and development assistance by 2025. While we continue to aspire for transformational change, we have grave concerns about providing taxpayer funding for activities inconsistent with the Catholic faith and basic human rights. Therefore, we strongly urge Congress to maintain the Helms Amendment in FY22. Moreover, efforts to integrate areas of programs that not all agree are morally acceptable is not in the best interest of the U.S. as it is important to preserve a diversity of providers that have strong legitimacy and credibility with local partners. Chairman Coons, Ranking Member Graham, thank you again for your leadership. We look forward to working with you to be more present and active forces for the common good. [This statement was submitted by Sean Callahan, President and CEO.] ______ Prepared Statement of the Committee on International Justice and Peace United States Conference of Catholic Bishops (USCCB) On behalf of the Committee on International Justice and Peace of the United States Conference of Catholic Bishops (USCCB), I thank the Subcommittee on State, Foreign Operations, and Related Programs for this opportunity to submit testimony on appropriations for FY 2022. Together with Catholic Relief Services, our overseas relief and development agency, we urge you to increase funding for the international poverty-reducing humanitarian, development, and peacebuilding accounts specified in the table below. ------------------------------------------------------------------------ Appropriations Agency Account Amount in $,000 ------------------------------------------------------------------------ USAID............................ Maternal Health and $879,000 Child Survival. USAID............................ Nutrition.......... $150,000 USAID............................ Vulnerable Children $35,000 (orphans and displaced). USAID............................ HIV/AIDS (USAID $330,000 Programs). USAID............................ Malaria, TB, Global $2,207,500 Health Security & other NTDs. DOS/PEPFAR....................... HIV/AIDS (State $5,930,000 Funding/PEPFAR). USAID............................ Development $4,075,097 Assistance (including water, education). USAID/OFDA....................... International $4,682,362 Disaster Assistance. DOS/PRM.......................... Migration and $3,981,331 Refugee Assistance. DOS/PRM.......................... Emergency Refugee $1000 and Migration Assistance. USAID............................ Complex Crises Fund $65,000 and Atrocities Prevention Board. MCC.............................. Millennium $912,000 Challenge Corporation. DOS/IO........................... Contributions to $1,928,614 International Peacekeeping Activities. DOS/IO........................... Peacekeeping $469,459 Operations and Peace. DOS/IO........................... U.S. Institute of $45,000 Peace. DOS/IO........................... Green Climate Fund. $1,2500,000 DOS/IO........................... Combatting $99,000 Trafficking in Persons. ------------------------------------------------------------------------ In his 2020 encyclical on fraternity and social friendship, Fratelli Tutti, Pope Francis teaches, ``The decision to include or exclude those lying wounded along the roadside can serve as a criterion for judging every economic, political, social and religious project. Each day we have to decide whether to be Good Samaritans or indifferent bystanders . . . .'' (#69). Such aid is proof of our nation's compassion and gives life to our values as a nation and as a world leader. Our assistance cannot stop there. Pope Francis stated in his 2013 apostolic exhortation, Evangelii Gaudium (Joy of the Gospel), ``The need to resolve the structural causes of poverty cannot be delayed . . . Inequality is the root of social ills'' (#202). He adds that the growing inequality in the world ``eventually engenders a violence which recourse to arms cannot and never will be able to resolve'' (#60). At a time when the United States continues in its response to the COVID-19 pandemic, it is important that we show our compassion to a world struggling to survive this pandemic, conflict, hunger, and massive displacement. We would like to offer our strategic recommendations on how the United States can rebalance and refocus its international assistance to better align with the problems and threats that our world faces. As the pandemic continues with no end in sight, we strongly urge the United States to: 1. Global Servant Leadership to a World Confronting Existential Global Threats The COVID-19 pandemic is the latest human-made global issue in what some researchers have called the `Anthropocene' where human activity is now the dominant force affecting our entire planet. Our place in the world demands enlightened global unifying leadership to resolve conflict and promote the common good of humanity. Issues like climate change; sea and air pollution; disappearing flora and fauna; COVID-19 and future pandemics; conflict; cyber security; autonomous weapons; migration and refugees; and trafficking of people, arms, and drugs threaten all of humanity. The U.S. should lead the United Nations Security Council and the G- 20 towards solutions. The State Department will need increased resources and skilled statesmen to do this. USAID will need greater resources from Treasury in the Green Climate Fund to help low-income countries adapt to and mitigate the effects of climate change. The United States will also need to invest more in global health programs to deal with future pandemics and provide funding to manage the cross- border migration of people and trafficking of illicit goods. Although the United States and China have serious disagreements over international treaties, democratic norms, and China's threats to neighboring countries, the United States will need to find ways to challenge China where we must on issues of human rights and justice, but also push towards cooperation where needed to protect humanity from the serious threats above. 2. Move Towards a More Just Balance Between Defense, Diplomacy, and Development After 20 years of war in Afghanistan and 18 in Iraq the U.S. has moved from endless war towards dialogue and negotiations that will allow stakeholders in both conflicts to determine their own future. The only pathway to guarantee peace and prosperity in Afghanistan and Iraq and eventually in Syria and Yemen must come from sustained, open, and inclusive dialogue and negotiations between legitimate political leaders from all sides of the conflicts in these countries. As a party to these conflicts, the United States needs to shift significant resources to its diplomats, regional strategists, and civil society builders to facilitate and support these negotiations. Leaders and stakeholders must come to realize that a just peace can only come from a new shared social contract that creates a legitimate, democratic, accountable government, public administration, military, and police; and promotes a free and vibrant populace living in a society that guarantees their full civil and human rights. Despite this, State Department's budget is historically low in comparison to that of defense. In 1950, State's budget was around half the size of defense. Today State receives only 10% of what the Defense Department is allocated. Since 9/11 most of the increases to State's budget went to improve physical security at overseas posts. Recently, many observers argued that the State Department's role, its staff, and resources have been diminished, leaving many seasoned diplomats disempowered while others have left. One plan taking shape in the Senate is to increase funding to State Department by $12 billion, or a 21% increase. James Stavridis, a retired U.S. Navy admiral and former NATO supreme commander, argues that the United States urgently needs to deploy skilled diplomats, thinkers, and strategists who can imagine the future of conflict and reverse engineer its causes to avoid it. He quotes Sun Tsu, ``The greatest victory is that which requires no battle.'' The Church has understood this imperative for years. In Fratelli Tutti Pope Francis says, `` . . . it is very difficult nowadays to invoke the rational criteria elaborated in earlier centuries to speak of the possibility of a ``just war''. Never again war!'' (#258). 3. Address State Fragility and Conflict in the Most Vulnerable Countries After the 9/11 attacks our Bishops' conference warned, ``Our nation must join with others in addressing policies and problems that provide fertile ground in which terrorism can thrive.'' We urge our political leaders to look beyond a focus on counterterrorism to address the poverty and powerlessness that make some people easy recruits for violence and terror. Over the last few years, the U.S. Congress and successive Administrations have passed the Elie Wiesel Global Atrocities Prevention Act. It affirmed the Atrocities Prevention Board (now called the Atrocities Early Warning Task Force) efforts to coordinate all relevant Federal Government agencies to address fragility and prevent conflict. The Obama Administration created the Complex Crisis Fund to finance short term efforts to head off conflict before it breaks out. The U.S. Bishops also supported the Global Fragility and Violence Reduction Act passed in December 2019 to develop and adopt best practices and strategies in six pilot countries. These bills elevated the mandate for U.S. policy to strengthen fragile states-to help them build resilience against the alarming growth of violent extremism, rebel insurgencies, social violence, and repression in their own societies. The bills were designed to prioritize non `strategic' countries like Somalia, Nigeria, Mali, Burkina Faso, Niger and, Mozambique where terrorist groups have found ungoverned spaces to set up shop. Of the 30 most fragile countries in the 2020 Fragile State Index created by the Fund for Peace, 20 are in Africa. Of the 54 conflicts in the world, the 2019 Upsala Conflict Data Program estimates that 25 are in Africa. If Africa is the center of conflict in the world, it is also ground zero in terms of extreme poverty. The Brookings Institution estimates that by 2030 31 countries will be home to 80% of people living in extreme poverty. Africa now accounts for 66% of the world's extreme poor and could reach 90% by 2030. (WB-9 Oct 2020) In these countries, the presence of terror groups is really the last symptom of a massive failure of the state to govern with justice towards the common good, allowing a fragile state to become a failed state. Concentrating only on armed responses to the terrorist presence in such a country is equivalent to giving an aspirin to treat the headache of a man dying of malaria. Fragility and conflict also exist in the absence of terrorists in the Central African Republic, Cameroon, South Sudan, and Burundi where local insurgents operate causing enormous suffering. Here conflict is the result of poor governance, group grievances, mismanagement of latent conflict, repression, human rights violations, and crushing poverty. In still other countries such as Rwanda, Uganda, Chad, Togo, Congo, Brazzaville, and Zimbabwe, people live under conditions of repression and corruption where the seeds of violence have been planted, but violent conflict is still latent. In these countries conflict prevention is urgent if people are to escape the ravages of violence. In addition, we are deeply concerned about the early warning signs of new violence resulting from the impacts of the COVID-19 pandemic. Already data modeling show that as a result of the pandemic, 13 more countries will likely experience conflict over the next two years, nearly doubling the pre-pandemic prediction. While fragile countries in Africa currently account for two thirds of the world's people living in extreme poverty and the world's conflicts, they receive less than one quarter of total programmable aid from the Organization for Economic Cooperation and Development countries. We urge Congress and the Administration to focus on and invest more State and USAID resources in reducing fragility and preventing violent conflict in the most vulnerable countries in our world. The U.S. should increase the capacity of the State Department Bureau of Conflict and Stabilization Operations, expanding their peacebuilding, reconciliation and social cohesion efforts and integrating them into humanitarian and development programs; increase funding to the Atrocities Prevention Fund; and allocate $200 million for the Prevention and Stabilization Fund. 4. Place a Greater Priority on Empowering Civil Society and Faith-Based Groups One commonality in all fragile countries is the economic and political dominance of government institutions and private, for-profit corporations, while a vast and varied array of private, independent civil society associations struggle to protect civil rights, fight corruption, and promote free and fair elections and justice. Often faith-based institutions are some of the few civil society institutions remaining with enough credibility, authority, and institutional cohesiveness to stand up to corrupt and repressive governments. Across Africa, Latin America, the Middle East, and Asia, the Catholic Church, along with other Christian and Muslim denominations have echoed the prophets of old and denounced modern-day corruption, repression, defrauded elections, state violence and insurgencies, often at the risk of their own personal and institutional peril. They have organized peace and justice institutions, electoral monitoring teams, political mediation efforts, and negotiations between armed groups and the government. Their efforts are courageous, but often too small and underfunded. Peacebuilding experts know it requires a generation or more to transform conflict. We urge you to make a generational commitment to greatly increase funding to local civil society organizations' efforts to defend the human and civil rights of people struggling to survive repression and violence. This funding must be long-term, flexible, and nimble while ensuring accountability and impact. This can be done through three-way strategic partnerships between USAID, American civil society institutions like Catholic Relief Services, and their local civil society and faith-based partners. In closing we must also be clear that the U.S. Bishops strongly opposes any expansion of taxpayer funding of abortion as part of this appropriations legislation. The longstanding, bipartisan, and life- saving Helms Amendment policy must be included before this bill moves forward. Legislation that fails to include this longstanding bipartisan policy directly threatens human life and dignity and should be opposed until this fundamental problem is remedied. [This statement was submitted by Bishop David J. Malloy, Chairman.] ______ Prepared Statement of Edesia Nutrition Edesia appreciates the opportunity to submit testimony to the Senate Appropriations Subcommittee on State, Foreign Operations, and Related Programs. Since 2010, Edesia has worked in partnership with the U.S. government to promote life-saving interventions for beneficiaries and greater global stability and national security for Americans by supplying evidence-based nutritional support to vulnerable children worldwide. We request that the Subcommittee fund International Disaster Assistance (IDA) at a level of $5.27 billion, and the Nutrition in Global Health at a level of $300 million. The IDA account provides critical food, shelter, and medical assistance to those facing humanitarian crises, both natural and manmade. A portion of IDA funds go toward Emergency Food Security Programming Nutrition (Title III) in the Global Health Account support technical assistance to introduce and increase nutrition activities in priority USAID countries, including nutrition education and delivery of services such as micronutrient supplementation. Funds for these programs support the critical work of the private and non-profit sector alike to further America's mission of peace and security aboard. As the world faces unprecedented challenges brought on by the Coronavirus pandemic, including food supply chain and market disruption, it is imperative that these accounts are fully supported by Congress to help the most vulnerable populations. As of April 2021, the World Food Program (WFP) estimates that 296 million people in the 35 countries where it works are without sufficient food-111 million more people than in April 2020. In addition to tackling the Coronavirus, the world is currently in the midst of several humanitarian disasters--both conflict and climate-related--that have exacerbated malnutrition. In 2019, 77 million people in 22 countries experienced hunger due to armed violence and insecurity. South Sudan, Nigeria, Yemen, and Somalia are experiencing extreme need, intensified by conflict. For the fourth year in a row, gains against hunger and malnutrition have stalled. Extreme climatic events drove almost 34 million people into food crisis in 25 countries in 2019, 77 percent of them in Africa. The number of people pushed into food crisis by economic shocks more than doubled because of the Coronavirus pandemic. Unless action is taken, these numbers will only worsen as an estimated 33 percent of global soils have degraded endangering food productions and forecasters are predicting a 55 percent change in climate conditions this year due to La Nina affecting crop yields. Continued financial support of food aid and humanitarian assistance leadership from the United States is needed now more than ever. Humanitarian aid is life-changing for recipients, and provides benefits to citizens of the United States, by creating both jobs and economic opportunities in agriculture and manufacturing, future trading partners abroad, and improved worldwide security. While serving those in need globally, current food assistance programs simultaneously provide benefits for Edesia in Rhode Island, as well as our suppliers from other states (including Iowa, Wisconsin, New York, Georgia, North Carolina). Edesia is a Rhode Island-based non- profit manufacturer of high quality, peanut-based ready-to-use therapeutic and supplementary foods that are used to treat malnutrition in children around the globe. Through innovative manufacturing, we have reached over 14 million children in 55 countries with our products since 2010. This includes over 50,000 metric tons of Ready-to-Use Food products (RUTF and RUSF) made from U.S. agricultural goods for programs supported by the USAID and the USDA--equivalent to providing over 6 million acutely malnourished children with lifesaving treatments. We are proud of the part we play in helping to save the lives of children around the world--children who would not be reached without the generosity of the American people and the hard work of USAID, USDA and the United States' Congress. Saving these lives also helps to build safer world--healthy children have the ability to grow and reach their full potential. As an American manufacturing company, we recognize the important part that U.S.-manufactured in-kind food assistance plays around the world. Our partnerships with the U.S. government not only allow us to reach children in need, but also allow us to create economic growth at home. Since our opening in 2010, we have gone from a company of 20, to today having a team of over 100. In 2016, we expanded into a new 83,000 square foot facility that can produce over 20,000 MT of nutrient-dense food aid products per year, made from high-quality, U.S.-sourced ingredients (e.g., peanuts, soy, dairy, sugar) that support U.S. farmers, U.S. transportation companies and the U.S. economy. Annually, we purchase over $30 million of high-quality, U.S. sourced raw materials. Our country's lifesaving assistance abroad allows us to create opportunities here at home. Edesia is an industry leader in innovation and has been a critical partner of the U.S. government to ensure that United States remains a leader in fighting world hunger. Our work supports the second UN Sustainable Development Goal (SDG) of ``Zero Hunger'' with a target of ending all forms of malnutrition by 2030. An emphasis on nutrition security and aid that is fit-for-purpose, such as specialty nutritional products for treating and preventing malnutrition, will be increasingly important in order to reach the SDG goals for 2030. Thank you for providing Edesia the opportunity to submit testimony. As funding for international food aid programs are reviewed by your Subcommittee, we hope you will use us as a resource; we are highly experienced in the area of specialized food aid, and as a non-profit business, we understand the economics while also remaining committed to the goals. Please do not hesitate to contact us if the Subcommittee has any questions or would like further information. [This statement was submitted by Navyn Salem, Founder & CEO, and Maria Kasparian, Executive Director.] ______ Prepared Statement of the Elizabeth Glaser Pediatric AIDS Foundation Chairman Coons, Ranking Member Graham, and distinguished Members of the Subcommittee, thank you for the opportunity to submit testimony in strong support of the foreign affairs budget, in particular the President's Emergency Plan for AIDS Relief (PEPFAR) and the international organizations and partners critical to its success. My name is Charles Lyons, and I am the President and CEO of the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF). Founded over 30 years ago through a mother's determination, EGPAF is committed to a comprehensive response to the global fight to end HIV and AIDS through research, global advocacy, strengthening of local health care systems, and growing the capacity of governments and communities in the world's most affected regions to respond to urgent needs. I am proud to be leading a mission-driven organization, working closely with families, communities, countries, and donors fighting for an AIDS-free generation. I am asking you today to not only continue robust funding to end the global HIV/AIDS epidemic, but also to ensure that children are at the forefront of the U.S. global AIDS response. Additionally, I ask that U.S. global health investments are leveraged to address the COVID-19 pandemic and set countries on the right path for long term success and sustainability. This June, we marked the 40th anniversary of AIDS.\i\ This is a particularly meaningful anniversary for EGPAF, as it has also been 40 years since Elizabeth Glaser became HIV-positive and unknowingly passed HIV to her daughter, Ariel. At EGPAF, we work to keep Elizabeth and Ariel's spirits alive through our efforts to reach women, children, and families affected by HIV around the world. Much has changed over the last 40 years. When AIDS was first documented in 1981, children were not even part of the conversation, and the epidemic would go on to ravage African countries and communities for almost another two decades before the U.S. interceded. However, we did know something 40 years ago that remains extremely relevant today: the global movement to end AIDS can and will evolve, innovate, leverage, and grow in order to meet any obstacle keeping us from realizing the end of AIDS. Now as the U.S. and the world work to address the advent of a new epidemic, we know that the unprecedented and sustained bipartisan support that has driven progress against HIV will be needed to win the fight against the coronavirus but also the new challenges created by the convergence of HIV and COVID-19. As a long-time PEPFAR implementing partner, EGPAF has not just watched the progression of the global AIDS response, we have evolved in tandem. Since we began working internationally, in collaboration with PEPFAR and other partners, EGPAF has reached over 32 million pregnant women worldwide with services to prevent transmission of HIV to their babies, including nearly 88,000 in the last year. Over the last twenty years, we have averted nearly 400,000 new infections in children. EGPAF is currently supporting more than 1.8 million men, women, and children on treatment, including nearly 90,000 children, so they can live long, healthy, and productive lives.\ii\ Since our inception in 1988, there has been a 95 percent decline in new pediatric HIV infections in the United States.\iii\ Globally, new pediatric infections have been reduced by more than half since the year 2000.\iv\ This year, the 3 millionth infection will be averted in children due to support from the PEPFAR program.\v\ However, progress reaching pregnant and breastfeeding women has stalled, and our efforts need increased focused attention. While nearly four decades have past since Elizabeth fought for Ariel to have access to the same HIV medicines as adults, still only slightly more than half of children living with HIV are on the treatment they need to survive and thrive. This is especially concerning due to the rapid progression of the disease in children. Without treatment, 50 percent of children living with HIV will die by the age of two and 80 percent will die by the age of five.\vi\ This inequity is only increasing, with the gap between adult and pediatric treatment coverage rates growing each year.\vii\ The lag is so severe that while children only make up 5 percent of all HIV infections, they represent 14 percent of AIDS-related deaths.\viii\ These 2019 statistics are all the more worrying, as they do not represent the impacts of COVID-19 related disruptions. Countries are reporting decreases of 25 percent or more in prevention of mother to child transmission (PMTCT) services, including HIV testing and treatment initiation of pregnant women.\ix\ Nearly 12 million women across 115 countries have lost access to family planning and unintended pregnancies have risen--which is correlated to increases in HIV infections in pregnant women and transmissions to children.\x\ In a majority of priority countries, pediatric and adolescent treatment has dropped over the last year, with one third of countries reporting a decrease of greater than 10 percent.\xi\ These HIV service disruptions illustrate that the lasting impacts of COVID-19 will be felt for years to come, especially for children. This is the first time in approximately 20 years where there could actually be an increase in new HIV infections and AIDS related deaths in children.\xii\ Ten years ago, we were anticipating an ``AIDS-free generation'', today we are working to keep progress from slipping away. Children were absent from the most recent PEPFAR strategy--it would be unconscionable if the next five years of the PEPFAR program does not prioritize ending AIDS for all people, not just the easiest to reach adults.\xiii\ We respectfully ask you to use your considerable influence to express to the Office of the Global AIDS Coordinator that Congress insists children are prioritized within the PEPFAR program. The COVID-19 pandemic has substantially affected how we reach people at risk for and living with HIV, especially pregnant women and children who need additional interactions with the health system. As African countries have cycled through lockdowns, the ability of our programs to provide in-person, face-to-face, patient-centered care has ebbed and flowed, and like many of the partners working in communities impacted by HIV and COVID-19, we have had to constantly adapt to determine the best practices to meet the challenges of any particular day. In many ways, responding to COVID-19 felt like returning to the start of the HIV epidemic--trying to understand the best way to reach patients with minimal information, but a lot of determination. One key difference, however, is that now we have significantly more tools in our response tool box, thanks to the long-term U.S. investments in health systems through PEPFAR and other global health programs. These critical investments have trained and supported hundreds of thousands of healthcare workers, built a complex laboratory infrastructure, and most importantly, established deep ties to the community. Because EGPAF's global footprint spans 17 countries, we were able to quickly share information and best practices across country programs and could troubleshoot difficulties as they arose. Some adaptations included quickly scaling up multi-month dispensing of antiretroviral therapy to ensure HIV clients could reduce visits to crowded health facilities, moving the dispensing of ART and other commodities from clinics to communities, and establishing text or phone-based counseling and support services, including important adherence support for adolescents most at risk of falling out of treatment. However, our programs cannot be successful if the system in which we are working collapses. Through our experience, we know that frontline healthcare workers form the foundation of any health system and have faced innumerable challenges over the past year. In order to bolster healthcare workers, EGPAF supported ministries of health across multiple countries to provide psychosocial support for frontline workers. Additionally, we were able to communicate across our country programs and with USAID, CDC and the Office of the Global AIDS Coordinator to ensure challenges and lessons we were learning to assist workers and deliver services were shared expediently. These agile programmatic shifts meant early dire predictions of the impact of COVID-19 on the HIV epidemic have not been fully realized, but adjustments came at a cost.\xiv\ Modifications to keep healthcare workers and clients safe are often more expensive and left gaping holes in programming, most notably for prevention services which have been dramatically reduced. As vaccines begin to slowly roll out in the communities where we work, there will need to be a recovery agenda to regain the progress we have lost. The word often used to describe PEPFAR's response to COVID-19 is ``resilience.'' While HIV and related services are still significantly impacted each day, the strong footprint of the program ensures that the global HIV response has not broken down. Instead, the program's investments form a key component of the global COVID response, especially in countries deeply affected by HIV. As an organization who takes our responsibility to steward tax dollars very seriously, we feel it would be unfortunate if the two decades of global AIDS investments and assets were not capitalized for the COVID-19 response, while concurrently accelerating HIV programming. The fact of the matter is, HIV programming cannot ignore the other global pandemic in our midst, and both responses much be intertwined. By leveraging the PEPFAR platform, the U.S. government can ensure global health dollars are being efficiently used to accelerate vaccine distribution and begin the global recovery. The last year of the PEPFAR program has been marked by resilience, but its future should not just be based on its ability to withstand tremendous pressure. Rather, we must ensure PEPFAR is properly resourced to finish the job that a bipartisan Congress and Presidential Administrations have supported for 18 years--ending AIDS. The PEPFAR program has been essentially flat funded for 10 years. Innovations and efficiencies have led to growth of the program, but increased resources are necessary as the program responds to COVID-19, charts a recovery agenda, and accelerates towards HIV goals and targets. A recent UNAIDS analysis shows that money invested in the fight against HIV is money well spent--each additional US$1 invested in the HIV responses of low- and middle-income countries will yield a return of more than US$7 in health benefits.\xv\ Furthermore, additional funds are essential for addressing the widening gap between pediatric and adult HIV outcomes. I ask today that you remember the vision Congress had those years ago at PEPFAR's inception and increase funding for the PEPFAR program. I want to also express support for our global partners--the Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Health Organization (WHO), the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the United Nations Children's Fund (UNICEF). I am very concerned about proposals to reduce or eliminate funding to these organizations. PEPFAR's success is due in large part to the collaboration of countries, communities, related U.S. supported programming, and international partners. The prospect of ending AIDS in children will be jeopardized without their programming, expertise and commitment. 2020 and 2021 have felt like years characterized by numbers--days in lockdown, COVID-19 cases and deaths, vaccines administered. We see the same tendency in the HIV epidemic, the urge to condense complex epidemics into discrete data points that are easier to grapple with and absorb. But it is vital to remember that each of those numbers represents an individual, a person with a family whose life matters. People like Yasinta, a Masai woman living in Tanzania who was recently diagnosed with HIV. After a PEPFAR-supported community health worker reached her at her home, administered an HIV test and enrolled her on treatment, her health began to rapidly improve. And as Yasinta said, ``This program gave me a second chance.'' \xvi\ --------------------------------------------------------------------------- \i\ CDC, Morbidity and Mortality Weekly Report, Pneumocystic Pneumonia--Los Angeles. June 5, 1981. \ii\ EGPAF Global Data Dashboard. \iii\ CDC, HIV Surveillance Report. Diagnoses of HIV Infection in the United States and Dependent Areas, 2019. May 2021. \iv\ Start Free Stay Free AIDS Free-2020 report. \v\ PEPFAR, Latest Global Results. January 20, 2021. \vi\ UNICEF, Women: At the Heart of the HIV Response for Children. July 2018. \vii\ UNAIDS, AIDSinfo. \viii\ UNAIDS, End Inequalities. End AIDS. Global AIDS Strategy 2021-2026. \ix\ UNAIDS, Prevailing Against Pandemics by Putting People at the Centre. 2020. \x\ UNFPA, Impact of COVID-19 on Family Planning: What we know one year into the pandemic. March 2021. \xi\ UNICEF, Reimagining a resilient HIV response for children, adolescent and pregnant women living with HIV. November 2020. \xii\ UNAIDS, AIDSinfo. \xiii\ PEPFAR, Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020). September 2017. \xiv\ Lesosky, M. and Myer, L. Modelling the impact of COVID-19 on HIV. August 2020. \xv\ UNAIDS, Global Commitments, Local Actions. June 2021. \xvi\ EGPAF, ``This Project Gave Me a Second Chance.'' December 2020. [This statement was submitted by Charles Lyons, President and CEO.] ______ Prepared Statement of The END Fund Dear Subcommittee on State, Foreign Operations, and Related Programs: We write to you in our capacities as Chair of the Board and CEO of the END Fund, a private philanthropic initiative dedicated to ending neglected tropical diseases (NTDs) such as blinding trachoma, elephantiasis, and intestinal worms that affect over 1.7 billion people globally. The END Fund is made up of thousands of supporters from across the globe and has been a proud and long-time collaborator with the USAID NTD Program, co-funding programs to fast-track disease elimination efforts and collaborating on technical innovation across dozens of countries. The success of our partnership has been largely built on coordination with the United Kingdom through its Foreign, Commonwealth & Development Office (FCDO). However, significant budget cuts made recently by the FCDO have had a devastating effect on global NTD programming and put much of our collective progress at risk. Until recently, the FCDO and USAID coordinated to support 37 national NTD programs and co-invested in 15 of those, many of which were expected to eliminate at least one NTD in the next five years. Unless we are able to figure out a Plan B, many of these milestones will not be met and over 200 million people across 24 countries will not receive the treatment they need. The END Fund is doing its part to reach out to every private philanthropic donor in our network in an attempt to raise funds and ensure these people aren't left behind. But private philanthropy won't be enough. Over $1 billion of donated medicines from pharmaceutical companies like Merck, Pfizer, and J&J are at risk of going to waste if we can't identify funds to deliver them. We understand that the next FY USAID annual budget is currently under review, and would love to encourage you and the whole team involved in setting the USAID budget to consider an increase from the approximately $100 million annual budget from previous years to at least $125 million per year, and ideally even more if possible. This would make a huge difference to ensuring disease elimination efforts stay on track and vulnerable people don't further suffer from disability, blindness, stunted growth and missed school days caused by NTDs. While simultaneously working to mobilize emergency resources, the African members of the END Fund board--along with a coalition of hundreds of partners across Africa--are launching an African NTD Leadership Initiative to step up local leadership and sustainable solutions to long-term implementation of NTD programs. We recognize that aid and philanthropy aren't the long-term solutions to the health problems in developing countries. But this transition will take time, and we look forward to collaborating with USAID and the other global funders and supporters of NTDs to ensure that no one misses out on the treatment they need in the short-term. We would be honored to provide you with an in-depth briefing on the current situation and share more with you about how the END Fund can support the critical work of USAID's NTD Program. We thank you so much for your consideration of an increased USAID budget for NTDs this coming year. Sincerely, William Campbell Board Chair, The END Fund [email protected] Ellen Agler CEO, The END Fund [email protected] the end fund represents a private sector perspective on the value of usaid's ntd program The END Fund represents the dedication and commitment of a broad donor base, which in the U.S. is composed of approximately 4,000 private philanthropists, companies, high-net-worth individuals, and foundations spanning all 50 states who have collectively helped the END Fund to raise hundreds of millions of dollars since 2012 to tackle NTDs. There are several reasons why continued U.S. leadership incentivizes our donor base, detailed below: --Momentum among a growing group of U.S.-based activist philanthropists. Inspired by the Giving Pledge community, a number of whom have contributed to the END Fund, our board of directors and leading donors represent a group of deeply committed activist philanthropists who continuously invest their time, professional network, expertise, and finances into tackling NTDs. This group is spearheaded by our Board Chair, William I. Campbell, who served as a Senior Advisor to the Chairman and CEO of JPMorgan Chase from 2008 until 2012, and has held numerous leadership positions in major U.S. corporations for over two decades. --Cost-effectiveness and a public-private partnership at a grand scale. At the 2012 London Declaration on NTDs, leading pharmaceutical companies collectively pledged as many NTD treatments as the world had the capacity to deliver at the time. Companies such as Bristol-Myers Squibb, Gilead, GSK, Johnson & Johnson, Merck & Co., Inc., and Pfizer continue to pledge billions of dollars of donated drugs per year that is leveraged by the program delivery investments by USAID and its partners in private philanthropy through the END Fund. This unprecedented investment from the U.S. pharmaceutical industry is matched only in the ambition of those partners supporting the drug delivery (including USAID and the END Fund), and that of our partners in governments where these treatments are needed most. The scale and scope of the opportunity to continue to impact the world through this partnership remains hugely significant. --De-risking private investment. Due to the substantial NTD funding from USAID to date, the END Fund's private philanthropic donors feel more comfortable making higher risk investments, pushing boundaries, and investing in innovation in the NTD sector, ultimately catalyzing the kind of progress needed to provide over 1.7 billion at-risk people with the treatment and support they deserve. --Efficiency and collaboration. The END Fund participates in regular global donor meetings with USAID among others to ensure we are effectively coordinating investments across geographies and time, such that the whole impact of our partnership is greater than the sum of its parts due to the synergies from this collaboration. The END Fund works to ensure that our investments are complementary to USAID investments, often covering geographies where USAID is not present or covering aspects of programming that may not be included in USAID budget. --A legacy of partnership. In 2012, USAID directly contacted the END Fund after a coup in Mali as USAID was no longer able to support the NTD program under a new, non-democratically elected government. USAID wanted to ensure Mali's national NTD program was not compromised as a result of political upheaval and its funding withdrawal, and requested support from the private capital represented by the END Fund. We were proud to put private capital to work quickly and nimbly and step in with two years of support for Mali's national NTD program in order to sustain the gains made through years of support from USAID. This is just one of now many examples of how the END Fund and USAID have ensured our work is complementary. --Labor productivity and employability. Due to the aforementioned drug donation program, the cost-effectiveness of NTD program investments in achieving health and education outcomes is second to none. For example, we know from the work of a recent Nobel laureate in economics, Michael Kremer, adults who are dewormed as children will earn 20% more than those who were not, and receiving annual deworming treatments can reduce school absenteeism by up to 25%. We also know from studies that the world can avert several hundred million disability adjusted life years and gain several hundred billion dollars' worth of productivity gains if current goals for NTD control and elimination are met. The knock-on impact of such investments has significant influence on the education level, skill level, and ultimately economic participation and productivity of any country's workforce. [This statement was submitted by Ellen Agler, CEO, and William Campbell, Board Chair.] ______ Prepared Statement of the Friends Committee on National Legislation Chairman Coons, Ranking Member Graham, and Distinguished Members of the Committee, thank you for allowing me to testify in support of robust funding for peacebuilding in the FY2022 State, Foreign Operations, and Related Programs Appropriations bill. The Friends Committee on National Legislation, or FCNL, was founded in 1943 by members of the Religious Society of Friends, also known as Quakers. From our early days--amid the Second World War--until today, we have advocated for peace and sought a world free of war and the threat of war. In pursuit of these ends, we strongly support robust funding for accounts that prevent and reduce violent conflict in the FY 2022 SFOPs appropriations bill, including $60 million for the Complex Crises Fund at the U.S. Agency for International Development (USAID), $25 million for the Atrocities Prevention Fund at the State Department, and $500,000 for Atrocities Prevention Training at the State Department and USAID. The challenges the United States faces around the world today cannot be resolved with bullets and bombs. In order to draw down and end our country's endless wars, FCNL urges an increased investment in peacebuilding, development, and diplomacy. One percent of humanity--1 in every 97 people\i\--is now forcibly displaced from their homes, including over 80 million who were forced to flee persecution, conflict, violence, and human rights violations.\ii\ Meanwhile, climate change is worsening resource scarcity and natural disasters, pushing fragile states beyond their abilities to cope or adapt. In the past decade, the number of water- related conflicts and violence has increased by 270 percent.\iii\ Over the next three decades, an additional 1.5 billion people are expected to face food insecurity.\iv\ Compounding these issues, the COVID-19 pandemic has spared no country-large or small, industrialized or developing, resilient or fragile. The pandemic has exacerbated the drivers of conflict and fragility around the world, leading to rising violence and decimated economies that will far outlast the virus itself. In fact, the Bill & Melinda Gates Foundation found that the COVID-19 pandemic has set back an important measure of global development by ``about 25 years in about 25 weeks.''\v\ In particular, FCNL is deeply concerned about the early warning signs of new violence resulting from the impacts of the COVID-19 pandemic. Advanced data modeling by the Josef Korbel School at the University of Denver shows that as result of the pandemic, 13 more countries will likely experience conflict over the next two years, a more than 50 percent increase over their pre-pandemic prediction.\vi\ However, the virus need not be followed by violence. Right now, peacebuilders are working around the world, on the frontlines of the pandemic to ensure that the public health responses are conflict-sensitive and support sustainable peace.\vii\ Peacebuilding provides an indispensable tool in responding to and recovering from this pandemic by both preventing immediate outbreaks of violence and healing fractured societies over the long term. With focused and dedicated assistance, the United States can be a powerful force for peace and development during this global crisis. The full list of accounts that support peacebuilding, conflict prevention and violence reduction efforts is attached below, along with the levels of funding we recommend. I would like to highlight three of these accounts. The Complex Crises Fund (CCF) enables USAID to respond to early warning signs and escalating crises before violence erupts. It is the only account designed to fill immediate, short-term needs during emergent crises. Even before the COVID-19 pandemic struck, the CCF was in high demand- having directly supported initiatives to prevent violence and conflict in 29 countries over the last decade.\viii\ The CCF has enabled urgent peacebuilding programs that have disseminated essential information, facilitated dialogue, and promoted civic engagement in order to defuse rising tensions and strengthen communities' resilience. Now, with the pandemic further exacerbating conflict drivers, the flexibility that CCF provides USAID to respond rapidly to escalating crises is even more essential. As such, we urge that you allocate $60 million to USAID for the Complex Crises Fund. Additionally, we urge significantly increased support to the Atrocities Prevention Fund, which is the State Department's only funding dedicated solely to the prevention of mass atrocities and genocide. We know that society-wide crises, such as famines, pandemics, and political strife, too often become triggers or justifications for mass violence and atrocities. During such crises marginalized groups, especially migrants and ethnic or religious minorities, are often scapegoated and attacked. We have already seen rising levels of such identity-based violence around the world-including here in the United States against Asian-Americans. Genocide is an extreme form of this identity-based violence, and without urgent and effective prevention efforts, the second order impacts of the pandemic could take more lives than COVID-19 itself.\ix\ The Atrocities Prevention Fund enables the Department of State to support critical mass atrocity and genocide prevention efforts and to implement recommendations of the interagency Atrocity Early Warning Task Force. Given the increased risk of mass atrocities resulting from the COVID-19 pandemic, we urge you to appropriate no less than $25 million for the Atrocities Prevention Fund. In tandem, we urge $500,000 be made available for the State Department and USAID to conduct Atrocities Prevention Training for Foreign Service Officers in countries at risk of mass atrocities. As mandated in the Elie Wiesel Genocide and Atrocities Prevention Act (P.L. 115-441), the training improves the ability of our diplomatic and development professionals around the world to recognize and respond to the early warning signs of mass atrocities. I know that your committee has previously endorsed more robust funding for atrocity prevention, and we are deeply appreciative of this support. Last year you included $10 million for the Atrocity Prevention Fund as well as $500,000 for the State Department and $250,000 for USAID for Atrocities Prevention Training, which we hope you will build upon this year. Chairman Coons, Ranking Member Graham, and Distinguished Members of the Subcommittee, thank you for the opportunity to testify on this important matter. Genocide, mass atrocities, and other forms of violence against civilians are not inevitable. But the COVID-19 pandemic has sharply raised the risk of their occurrence. By supporting peacebuilding, conflict prevention and violence reduction efforts, the United States can be a powerful force for the protection of human lives, rights and dignity. I thank you for your consideration and for working to build peace in this time of great tragedy. FULL LIST OF FCNL RECOMMENDATIONS FOR FY2022 STATE, FOREIGN OPERATIONS, AND RELATED PROGRAMS APPROPRIATIONS ------------------------------------------------------------------------ FY22 FCNL Account Name FY21 Enacted Request ------------------------------------------------------------------------ Atrocities Prevention Fund.......... $5,000,000 $25,000,000 Atrocities Prevention Training...... $500,000 $500,000 Complex Crises Fund................. $30,000,000 $60,000,000 Conflict Stabilization Operations... $2,500,000 $14,500,000 Contributions for International $1,456,314,000 $2,701,032,000 Peacekeeping Activities............ Contributions to International $1,505,928,000 $1,595,928,000 Organizations...................... Democracy Fund at USAID............. $100,250,000 $100,250,000 Human Rights and Democracy Fund at $190,450,000 $190,500,000 State.............................. Multi-Donor Global Fragility Fund... $25,000,000 $25,000,000 Prevention and Stabilization Fund... $100,000,000 $200,000,000 Reconciliation Programs............. $25,000,000 $30,000,000 Transition Initiatives.............. $92,043,000 $112,000,000 U.S. Institute of Peace............. $45,000,000 $45,000,000 ------------------------------------------------------------------------ --------------------------------------------------------------------------- \i\ United Nations High Commissioner for Refugees. (2020). Global Trends Forced Displacement in 2019. https://www.unhcr.org/ globaltrends2019/ \ii\ United Nations High Commissioner for Refugees. (2020). Mid- Year Trends 2020. https://www.unhcr.org/statistics/unhcrstats/ 5fc504d44/mid-year-trends-2020.html \iii\ Institute for Economics & Peace. (2020) Ecological Threat Register 2020: Understanding Ecological Threats, Resilience and Peace. https://www.visionofhumanity.org/wp-content/uploads/2020/10/ ETR_2020_web-1.pdf \iv\ Ibid. \v\ Bill and Melinda Gates Foundation. (2020). 2020 Goalkeepers Report. https://www.gatesfoundation.org/goalkeepers/report/2020-report/ \vi\ Moyer, J. D., & Kaplan, O. (2020, July 6). Will the Coronavirus Fuel Conflict? Foreign Policy. https://foreignpolicy.com/ 2020/07/06/coronavirus-pandemic-fuel-conflict-fragile-states-economy- food-prices/ \vii\ International Alert. (2020). COVID-19 peacebuilding response. https://www.international-alert.org/covid-19-peacebuilding-response \viii\ USAID. (2020, Oct. 1). Complex Crises Fund. https:// www.usaid.gov/who-we-are/organization/bureaus/bureau-conflict- prevention-and-stabilization%20/complex-crisis-fund \ix\ Ferguson, Dr. K. (2020). Atrocity prevention and Covid-19 Opportunities and responsibilities. Protection Approaches. https:// protectionapproaches.org/ap-and-covid [This statement was submitted by Diane Randall, General Secretary.] ______ Prepared Statement of the Friends of the Global Fight Against AIDS, Tuberculosis and Malaria Thank you, Chairman, and members of the subcommittee, for steadfast support of America's leadership in the fight against AIDS, tuberculosis (TB) and malaria. The U.S. investment you have championed has saved millions of lives and has brought the end of these deadly epidemics within reach. Your bold support of an increase in fiscal year 2020 funding for the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) helped spur the rest of the world to increase investment. I want to offer my deep appreciation for congressional support for efforts to respond to the COVID-19 crisis globally, including the contribution of $3.5 billion to the Global Fund's COVID-19 Response Mechanism. Future progress against the AIDS, TB and malaria epidemics depends on ending the new pandemic of COVID-19. Today I am writing to request sustained U.S. support of the Global Fund at $1.56 billion for fiscal year 2022 (FY22). proven lifesaving impact Since its creation in 2002, the Global Fund partnership has saved more than 38 million lives. This achievement includes a remarkable 61 percent decline in AIDS-related deaths, a 25 percent decline in TB deaths and a nearly 50 percent decline in malaria deaths in countries where the Global Fund operates. In 2019 in countries and regions where the Global Fund invests, 20.1 million people were on antiretroviral therapy for HIV, 5.7 million people with TB received treatment and 160 million mosquito nets were distributed. However, these achievements remain at risk from COVID-19. FY22 funding will serve as the third and final year of the U.S. commitment to the Global Fund's sixth Replenishment. Friends of the Global Fight requests flat funding for the Global Fund at $1.56 billion, consistent with the contributions from the U.S. for the two previous years of the Replenishment cycle, as well as the president's FY22 budget request. This level of support in FY20 and FY21 would not have been possible without the strong bipartisan support in Congress for the work of the Global Fund. The U.S. contribution continues the unique matching requirement, encouraging burden sharing by others. By law, the U.S. can only contribute up to 33 percent of the Global Fund's standard operating budget. For every dollar the U.S. contributes, the Global Fund must secure two dollars from other donors, or risk leaving U.S. money on the table. The 15.6 percent increase from the U.S. in FY20 encouraged other major donors to increase their support, including increases of more than 15 percent from France, Germany, the United Kingdom, the European Commission, Canada and Italy, just to name a few. The Global Fund won $1 billion in pledges from the private sector as well. Since the Global Fund achieved its $14 billion Replenishment fundraising goal in 2019, the organization was on track to save an additional 16 million lives; cut the number of deaths from AIDS, TB and malaria by nearly half; and prevent 234 million infections. However, COVID-19 could set back progress on those epidemics by a decade if not addressed (detailed below). The Global Fund also plays a consequential role in economic growth, supporting healthier workers and increasing the number of consumers for U.S. exports, and growing trade partners abroad-all directly benefiting the American people. The Global Fund projects that it will generate $19 in economic returns and health gains for every $1 invested, contributing to direct economic benefits for the U.S. The Global Fund supports non-health interventions to achieve its mission, consistent with calls from members of Congress in both parties. Global health aid through the work of the Global Fund has been key in advancing human rights and economic opportunity, particularly for women and girls and other key populations at risk of contracting HIV, TB or malaria. It is supporting adolescent girls to stay in school to reduce their probability of HIV infection and financing legal services to marginalized people to reduce the barriers to accessing health services. We were very pleased to see the Global Fund ranked as one of the ``12 very high-scoring'' organizations on gender equality in the Global Health 50/50 Report. amplifying the impact of bilateral programs The Global Fund importantly reinforces the impact of U.S. bilateral global health programs. These include the President's Emergency Plan for AIDS Relief (PEPFAR), the President's Malaria Initiative (PMI) and USAID's TB program. Friends encourages increased appropriations for these highly effective programs. U.S. bilateral programs and the Global Fund work closely together to maximize the results from U.S. investments in global health. Moreover, the Global Fund adds value to U.S. bilateral programs by making long-term country-ownership more viable. The Global Fund requires that affected populations, civil society, faith and private sector voices be included in local implementation and on its own board. A 2019 study determined Global Fund support advances key areas of good governance. global fund response to threats from covid-19 COVID-19 has led to serious impacts on fragile health systems in many low- and middle-income countries. Congressional leadership has been crucial in helping these countries respond to the pandemic. I especially want to thank the members of this subcommittee for their support of the Global Fund's work to respond to COVID-19. The inclusion of $3.5 billion in the America Rescue Plan for the Global Fund's COVID- 19 Response Mechanism, as well as contributions to other Access to COVID-19 Tools Accelerator pillars, will be instrumental for vaccine delivery, protecting health workers, scaling tests and treatment, and bringing this pandemic to an end. The Global Fund created the Response Mechanism to help countries fight COVID-19 and mitigate its impact on AIDS, TB and malaria programs. The Global Fund's advantage is that it can rapidly deliver funding to existing local partners in more than 120 countries--with all of the same accountability and transparency present in normal Global Fund operations. In 2020, the Global Fund's COVID-19 Response Mechanism distributed nearly $1 billion in desperately needed aid to assist low- and middle-income countries. An audit by the Global Fund's independent Inspector General in April 2021 found this first phase well-managed, effective and accountable. It is important to note that by establishing the COVID-19 Response Mechanism the Global Fund is not straying from its core mandate. Indeed, if it does not address the grave challenges presented by COVID- 19, the Global Fund, its donors and their partners risk losing the progress on AIDS, TB and malaria that they have worked so hard to achieve. On March 30, 2021, the Global Fund Board--on which the U.S. sits- unanimously approved phase two of the mechanism. Lack of funding had put the COVID-19 support on hold for several months, with no other international institution filling the void. Now, strong support from the United States and other major donors makes this lifesaving work possible. Thank you. To complement the efforts of COVAX and U.S. bilateral and multilateral investments in combating COVID-19, the Global Fund's COVID-19 aid will focus on: --Essential non-vaccine elements of the COVID-19 response which help to distribute vaccines, including scaling up diagnostics, treatment and PPE --Adaptations to HIV, TB and malaria programs to mitigate the pandemic's indirect impacts --Urgent health system enhancements to support the two points above, such as lab strengthening, community-led interventions to support transmission reduction, reinforcement of clinical care and enhanced disease surveillance Funding proposals to the COVID-19 Response Mechanism will be developed by Global Fund Country Coordinating Mechanisms. The Global Fund will continue to leverage technical expertise when reviewing these requests by using current Global Fund structures. The Global Fund has also established a new technical advisory group to review the COVID-19 related aspects of countries' funding requests. We will keep you abreast of how the contribution from the U.S. to the COVID-19 Response Mechanism is deployed in the coming months, as well as contributions from other donors. A second contribution from Germany of 140 million euros was recently announced, which follows 150 million euros from Germany last June. We are encouraged that the Biden Administration has helped with diplomatic outreach to other donors. global fund contributions to pandemic preparedness and response As COVID-19 has shown, future pandemics are inevitable--and the world must address the drivers of new pandemics as well as be prepared to respond quickly and effectively once new threats arise. We were pleased to see the introduction of the International Pandemic Preparedness and COVID-19 Response Act from Senators Risch and Menendez, which would require a formal strategy to prepare for pandemics. That bill, along with legislation developed in the House, calls for plans to improve the global health architecture in support of pandemic prevention, preparedness and response. As the Senate--and this subcommittee--considers such plans and the funding they may require, the United States and other countries should turn to the Global Fund to play a central role in any new pandemic preparedness and response structure. The Global Fund is capable of playing an expanded role in several areas of pandemic preparedness, building on investments it already makes responding to AIDS, TB, malaria and COVID-19. A January 2021 study published in the Lancet determined that Global Fund-supported programming is actively engaged in multiple aspects of health security and over one third of its investments promote health security. The Global Fund is already one of the largest sources of international funding for global health security and is in the process of considering a range of options as it develops its next six-year strategy. The Global Fund must continue its focus on AIDS, TB and malaria, but it could embed expanded global health security programming in its ongoing work to strengthen health systems. The Global Fund is ready to deliver funds with its proven speed, accountability and transparency, ensuring that pandemic preparedness resources build on platforms used to fight existing diseases and strengthen local health systems. Using the Global Fund would bring more coherence--rather than fragmentation or silos--to any new plans. conclusion Friends thanks the Appropriations Committee for your leadership in the battle against the world's most deadly epidemics, and we ask the Committee to maintain funding for the Global Fund at $1.56 billion in FY22, the final installment in the sixth Replenishment. We also support increased allocations to PEPFAR, PMI, TB at USAID, and the overall foreign assistance budget. We again express our profound thanks for the U.S. contribution to the Global Fund's COVID-19 Response Mechanism and look forward to ongoing conversation on the best ways to deliver healthcare access for the poor, marginalized and stigmatized. We welcome dialogue on fully leveraging the Global Fund as a key asset on pandemic preparedness and response. The U.S. should be proud that it played such an instrumental role in building the capacity of the Global Fund to be ready to rise to an unprecedented global challenge. With its nearly two decades of experience fighting major infectious disease killers and building procurement and supply chain capabilities, the Global Fund has scaled up a substantial response to fight COVID-19 and protect our long-term investments in AIDS, TB and malaria programs. We ask Congress to once again set an example for the world and invest in defeating AIDS, TB and malaria and helping vulnerable countries respond forcefully to COVID-19 and future pandemics. [This statement was submitted by Chris Collins, President and CEO.] ______ Prepared Statement of Fundacion para la Democracia Panamericana The President and Congress should make no unilateral concessions, but rather ask Cuba to make irreversible steps toward the recognition of fundamental human rights. These steps should include: the unconditional release of all political prisoners; the end of repression; respect in law and in practice of freedom of expression, association-including independent political parties-, public assembly and economic freedom. In the past, policies of concessions to the leaders of the Cuban one-party totalitarian state have exacerbated threats to US national security, precipitated migration crises and emboldened the Cuban military to increase its foreign interference\1\. As long as Cuba remains a dictatorship that acts with impunity, the United States is undermining our own interests and those of our allies in the hemisphere. Therefore, our foundation recommends a robust development budget supporting democracy and human rights namely to advance the national security objectives and foster peace and prosperity in the region. In this document, we -the Fundacion para la Democracia Panamericana or FDP- present to the Appropriations Subcommittee on State, Foreign Operations and Related Subcommittee a summary of the current situation on the island as well as the challenges that the operations of the Havana regime constitute for national security, democratic stability, and peace in our hemisphere. island The Cuban regime has lost international sympathy and does not have internal popular support. Families are suffering a deep humanitarian crisis caused by the corrupt state management and the communist policies now aggravated by the Covid-19 pandemic. It is clear that authorities have not been able to control the pandemic. Furthermore, the sanitary crisis is accompanied by large outbreaks of other infectious diseases--such as scabies--related to the poor hygienic conditions to which Cubans are subjected due to the failure of the health care system and the economic crisis. At the same time, citizens do not enjoy basic freedoms, including the right to the redress of grievances, or even to receive international humanitarian aid. Control over the population is maintained through increased repression; nevertheless, more and more Cubans are expressing their discontent in social networks and by protesting in the streets\2\. It is necessary to contextualize what happened during the year 2020 and the first 5 months of 2021 in numbers: The Center for Incident Reporting at FDP has registered 496 arbitrary detentions since the beginning of the pandemic. This figure is lower than the actual number and must be supplemented with research made by other independent organizations. The arrests increased after the imposition of the Additional Specific Sanitary Provisions of May 2020 and the declaration of national emergency announced on August 28, 20203. More than 810 victims suffered harassment from agents of the Ministry of the Interior. These agents conduct surveillance at activist's places of residence, as well as employ other intimidation mechanisms. At least 219 of these victims reported that these agents prevented them from leaving their homes due to their activism and several continue to be shut in by these agents or suffer these instances frequently. Furthermore, 490 people reported direct harassment. The Center for Incident Reporting at the Fundacion para la Democracia Panamericana also documented 249 acts of repudiation conducted by repressive agents to threaten and intimidate activists and independent journalists. Some of these attacks put entire households at risk; in fact, in response to our request, the Inter-American Commission on Human Rights (IACHR) ruled in favor of granting a precautionary measure of protection for several families, which the regime has completely ignored. We also registered at least 101 cases of torture and other cruel, inhumane or degrading treatment wherein violations to the physical integrity of the victims occurred during: arrests, interrogations, in prison and public roads. On June 28th, 2021, the Center received a testimony from an independent journalist, stating that he was violated sexually while he was detained. At a time when the pandemic is reaching record numbers across the Island, from the FDP Center for Incident Reporting, we express grave concern about the systemic application of these and other patterns of human rights violations, and their drastic consequences amid the humanitarian crisis Cuban families are living in. It is evident that as peaceful protests increase (more than 1000 public protests have been registered thus far in 2021), along with the mobilization in favor of democratic change in Cuba, acts of terror from the regime against citizens increase as well. The deliberate use of coercion and violence against specific groups to instill fear in the population is the definition of terrorism and the dictatorship practices it daily in Cuba. The regime exercises State terrorism against the Cuban people. Consequently, we respectfully request your commitment and support to the right to have human rights that the Cuban people is demanding. US-Cuba relations should be defined by clear principles focused on human rights and take lessons from historical success cases such as the global campaign to end apartheid in South Africa. threats On Exodus In light of the situation, it is important to let you know that we believe that the Cuban regime is discretely encouraging an exodus that will escalate. The intention behind this would be to pressure the United States government to have to sit at the negotiation table using the migration issues as leverage. In other words, to obtain unilateral concessions that could allow the regime to remain in power longer. This last item is corroborated by some people inside Cuba who state that Cuban police agents sometimes tell people that ``the United States is now more prone to welcoming Cubans who leave the Island because there is a new administration in power''. Actually, there are already thousands of Cubans migrants stranded on the southern border. Reports from, Caibarien, Villa Clara, also make reference to the relaxation of Cuban coast guard surveillance. We suggest that the US government warn the Cuban regime of the serious consequences that such malicious conduct entails. There is a new silent, but increasing, exodus of Cuban rafters. Since Oct. 1, 2020, Coast Guard crews have interdicted 465 Cubans, that is more than 9 times the number of Cuban migrants in Fiscal Year 2020 and far exceeded the total number of intercepted in fiscal year 2019.\3\ We alert the United States government because of the human cost and the national security threat that a massive exodus represents. This situation enables criminals to engage in human trafficking. In some cases, we suspect the Cuban regime has been involved in trafficking of migrants as well, while seeking additional sources of income. At the same time Cuban people's call for human rights rises and a reality emerges with increasing clarity: that demand for democratization of Cuba's political and economic system is the only solution for ensuring stability in the region and sustainable long-term relations between the United States and Cuba. The United States must avoid falling into the trap of yielding to the pressures of the dictatorship and support the Cuban people in their desire to carry out an orderly and peaceful transition to democracy. This is the only way to guarantee that the motivation of the exodus is stopped. On Interference The 62-year tolerance towards totalitarianism in Cuba demonstrated by the world's democracies has impeded the stability of democracy in our continent and caused serious threats to the national security of several states. As has been widely documented, the Cuban intelligence apparatus of the Castro regime (G2), infiltrated the entire hemisphere from social movements to guerrillas and criminal organizations. During these years, Cuba has served as a center for the dissemination of authoritarian models, such as the so-called 21st century socialism, as a sanctuary for terrorists from around the world and as an accomplice to the enemies of the free world. During 2019, the attacks on democratic regimes in Latin America have been especially intense, according to the allegations of the OAS General Secretariat, an entity that was forced to make itself available to ``the member states in their efforts to make against the destabilization efforts organized by the Venezuelan and Cuban dictatorship.'' On January 16, 2021, the cover of SEMANA magazine reveals a secret dossier entitled ``Cuban Interference Strategy in Colombia's Independence and Sovereignty Issues.'' There it is stated verbatim: ``Cuba executes a strategy of interference in Colombia through the orientation of Cubans with diplomatic cover in solidarity social organizations, the infiltration of cooperation programs with local authorities and their financing through the ELN\4\.'' The installation and maintenance of the dictatorship in Venezuela have been advised and directed until today by the Cuban regime, with the terrible effects that this has had for the region, including the massive exodus of Venezuelans. The CASLA Institute has exposed that the Cuban militia with DGCIM credentials have committed crimes against humanity. Meanwhile, the Cuban regime still receives oil barrels from Venezuela on a daily basis that they sell at market price. On attacks What the Cuban people need now and what the American people need now is the same: leaders who will speak up and act often about the Cuban Government's role as a trojan horse, allowing access to global actors like Russia, China and Iran who threaten the peace and stability of our hemisphere. There is a real danger to the US in under prioritizing this threat. This threat was confirmed by the episodes of the so-called ``sonic attacks'' against US and Canadian diplomats that occurred for the first time in Havana and that have already affected at least 130 US federal employees around the world. Events such as those that caused the Havana Syndrome can only have taken place in Cuba with the knowledge and participation of the Cuban regime's intelligence services. Once again, the only way to close the door to the dire consequences that these global actors produce is to support Cuban citizens in their right to have human rights and to move towards democracy. recommendations Cuban people have the will and the right to ascend to human rights and build a democracy that helps strengthen the much-needed stability in our hemisphere. We recommend a robust democracy promotion budget for Cuba to advance the national security and democratic stability objectives in our whole hemisphere. Independently, taking into consideration all the proposals received by members of civil society during this Pasos de Cambio, an initiative that has worked this year towards the development of joint proposals on the themes of foreign relations with Cuba, citizen mobilization, and transition, we maintain that the US government should consider the following path in its policies pertaining to Cuba: 1. Base on rights.--The President and Congress should make no unilateral concessions, but rather ask Cuba to make irreversible steps toward the recognition of fundamental human rights. We urge the Administration to recognize the members of the opposition and civil society in Cuba and in the diaspora as valid interlocutors. 2. Humanitarian Assistance--Manifest solidarity with the people. Publicly announce the desire of the United States to promote humanitarian aid from the American people to the Cuban people. It is important that this support be directed only toward the Cuban people, directly to the citizens, preventing any kind of intervention by or benefits to the regime. 3. Commit to the empowerment of the Cuban people, exclude the oppressors.--Continuing to shut down the dictator's sources of funding, which are used to sustain the Cuban military and the Ministry of the Interior, the regime's oppression apparatus. Many of these companies are already on the United States Department of State's list of restricted entities and sub-entities associated with Cuba, updated on January 8, 2021. The individuals from the regime involved in narco- terrorist activities should also be sanctioned. --Targeting sanctions. Imposing individual political, financial and diplomatic sanctions \3/4\ and consider utilizing the Global Magnitsky Act \3/4\ to the heads of the regime involved in serious human rights abuses. --Using all available tools to influence those in positions to make the decisions necessary to accept the people's call for a transition to democracy. --Sullivan Principles: Using the South African experience, require US companies still doing business with Cuba to mandatorily embrace social responsibility principles based on the Sullivan Principles\5\, so companies do not engage in enriching the rulers at the expense of exploiting/ discriminating nationals. 4. Hemispheric leadership for peace.--The United States can and should ally with Latin American countries to support the Cuban people. Invite the sister Republics of our hemisphere to take similar steps to support democratic change in Cuba. Utilize all the tools of the inter- American system, with the help of the OAS, the IDB, and other hemispheric institutions, to implement a comprehensive strategy of maximum influence on hemispheric dictators, for them to submit to the will of their peoples and give way to democratic multiparty systems. Specifically, there should be no reward for malevolent behavior, no invitations to the Summits of the Americas, no ``normalizing'' the Cuban regime as it is. The regime should continue to be excluded from the hemispheric community of nations until it complies with the articles of the Inter-American Democratic Charter. --------------------------------------------------------------------------- \1\ Refer to the Mariel boatlift, 1980; the Cuban Rafters Crisis, 1994; the shooting down of the Brothers to the Rescue's airplanes in international waters, 1996; the crisis of Cuban migrants stranded on the southern border of Nicaragua, 2015; and the expansion of the influence and interference of the Castro regime in Venezuela and the rest of Latin America. \2\ At least 1000 public protests were registered since January 1, 2021. \3\ Officially instated via publication in official gazette No. 44 of August 31, 2020. \4\ Cuba: el dosier secreto https://www.semana.com/nacion/articulo/ cuba-el-dosier-secreto/202146/. \5\ Reference Movimiento Democracia position in regard to Sulivan Principles. [This statement was submitted by Dr. Angel Omar Vento, President.] ______ Prepared Statement of the Girls Not Brides USA Chairman Coons, Ranking Member Graham, and members of the Subcommittee, we are submitting this testimony for your consideration on behalf of Girls Not Brides, a global partnership of more than 1,300 civil society organizations from over 100 countries committed to ending child marriage and enabling girls to fulfill their potential. Girls Not Brides USA became the first official Girls Not Brides National Partnership in 2012. Before then, the group was known as the U.S. Child Marriage Coalition, and currently is comprised of 60 civil society organizations all working to end child marriage and respond to the needs of already married girls across the globe. Girls Not Brides USA is not a recipient of U.S. foreign assistance, but is co-chaired by and comprised of many organizations that receive U.S. funds for global development work. Over the last year, we have focused on supporting the advancement of legislation critical to addressing the root cause and drivers of child marriage, including the Keeping Girls in School Act and the Girls Leadership, Engagement, Agency, and Development Act (S. 634/HR 1661). We have also been actively engaging in budget and appropriations- related efforts to ensure that ending child marriage is funded as a priority across the U.S. government's foreign assistance efforts. As such, we were pleased to see a 12% increase in funding to the State Department in the President's FY22 discretionary request. However, we were disappointed at the lack of reference to global spending to address child marriage through foreign assistance. We hope that the funding appropriated by this committee will include more robust funding for combatting child marriage and investing in adolescent girls worldwide. We request no less than $30,000,000 for projects, programs, and initiatives to reduce the incidence of child marriage and address the needs of married girls consistent with section 1207 of Public Law 113-4. We recommend $5,000,000 of this funding be dedicated as a new US commitment to the joint UNICEF and UNFPA Global Program to End Child Marriage. Child marriage is a human rights abuse and a form of gender-based violence. It occurs across cultures and contexts all over the globe. Girls who are married as children are frequently deprived of their rights to health, education, and safety. For example, they are at higher risk of experiencing dangerous complications in pregnancy and childbirth. Childbirth and pregnancy related complications is the leading cause of death for adolescent girls globally- and critically, 90% of births to adolescent girls occur within a marriage. Girls who are married as children are also more likely to never finish their education. They are more likely to face food insecurity and malnutrition, and experience other forms of violence throughout their lives. Child marriage drives cycles of poverty, poor health, illiteracy, and gender-based violence that have negative impacts on overall sustainable development and global peace and security. Significantly, the World Bank estimates that global gains from ending child marriage could reach more than $500 billion per year. With the global spread of COVID-19, Girls Not Brides USA members are seeing dramatic increases in child marriage due to the socio- economic impacts of COVID-19 and related containment measures. For example, anecdotal data from World Vision's global programs revealed that child marriages more than doubled between March-December 2020, compared to 2019. Education disruptions, food and economic insecurity, restrictions on movement, and disruptions to essential protection and health services for girls, are all increasing both the incident and risks of child marriage. Experts have predicted 10 million additional child marriages over the next 10 years if we do not act quickly. This is in addition to the already projected 12 million child marriages that occur each year, representing the biggest increase in child marriage rates since 1995. We urge Congress and the Administration to make bold commitments to a gender-sensitive approach to COVID-19 response and recovery globally. All policy and programs in response to the crisis across sectors should be shaped by a gender analysis and programming to prevent and respond to child marriage must be prioritized and robustly funded. The impacts for girls are dire and the risks urgent. Programming to prevent and respond to child marriage must be holistic, as the drivers and impacts cut across key sectors. Such programming should include, for example, safe, quality education, mental health and psychosocial support, and programming designed to support girls' leadership skills building, so that they are empowered to make decisions about their own lives across policy-making spaces. Evidence has shown that the most impactful efforts to prevent child marriage and address the needs of already married girls require a holistic and multisectoral approach. And such an approach must be coordinated across government agencies and the White House. Given the extreme needs and risks for adolescent girls around the world, we urge Congress and the Administration to commit to prioritizing adolescent girls through US foreign policy and assistance. In addition to robust foreign assistance, we recommend leveraging key upcoming global moments like the Generation Equality Forum in June for an announcement demonstrating United States leadership and commitment to adolescent girls' rights and ending child marriage across the globe. A public commitment to adolescent girls at such major global moments will ensure adolescent girls get the political attention needed to drive concrete action and funding, and to mobilize the global community to eradicate child marriage under the 2030 sustainable development goals' target 5.3. Thank you for this opportunity to offer testimony to the Subcommittee and for your bipartisan leadership in supporting a strong foreign assistance budget. [This statement was submitted by Whitney Groves and Aria Grabowski.] ______ Prepared Statement of the Global AIDS Policy Partnership The Global AIDS Policy Partnership (GAPP), a coalition of more than 70 advocacy and implementing organizations committed to ending AIDS for the next generation by expanding and improving global HIV programming and outcomes, asks Congress to increase funding levels for global HIV/ AIDS programs by $750M in the Fiscal Year 2022 State and Foreign Operations Appropriations legislation. Significant progress, realized through U.S. investments, has been made in controlling the HIV/AIDS pandemic globally. In the absence of a vaccine or cure for HIV, the global community, including the President's Emergency Plan for AIDS Relief (PEPFAR), has made meaningful and measurable strides towards ending the pandemic as a public health threat by bringing new infections and deaths down through evidence-based, community-responsive interventions. However, there are still 1.7 million new infections each year and 38 million people living with the disease. By the end of 2019, 81% of people living with HIV knew their HIV status, over two-thirds were accessing antiretroviral therapy, and 59% were virally suppressed. By June 2020, an estimated 26 million people living with HIV were accessing treatment, falling short of the 30 million target set for 2020. There remains a wide gap in treatment coverage between adults and children, with only 53% of children having access to life-saving critical care compared to 68% of adults. Furthermore disparities are equally felt along gender lines. In Sub-Saharan Africa, 67 percent--or an estimated 280,000--of annual new HIV infections in young people occur in adolescent girls and young women. However, a decline in resources over the past few years, and, recently, the impact of COVID-19, have put a significant strain on HIV programming, resulting in the world missing the 2020 targets. While there has been intensive action and progress against HIV in some places and among some populations, others including men who have sex with men, transgender individuals, sex workers, people who inject drugs (PWID), and people in prisons and other closed settings have borne the largest burden of the pandemic. With the onset of the COVID-19 pandemic, many HIV services, particularly prevention services, stalled. HIV testing fell 41% in 2020 and tuberculosis referrals fell 59%. Voluntary medical male circumcision ground to a halt in a number of countries. In addition to the direct effect on HIV services, 50% of facilities surveyed in Africa and 37% of those surveyed in Asia recorded COVID-19 infections among their staff. These infections, and sometimes deaths, take health workers out of the rotation in countries where there is already a severe shortage of staff, and it decreases morale for those that remain. Facilities made the adaptations that they could--moving staff around, increasing overtime hours, increasing the amount of a medication that could be obtained in one-visit, transferring to telehealth visits where appropriate--but prevention work requires in- person contact. Many of these community relationships need to be rebuilt, and it's impossible to know how many new HIV infections could have been prevented. The good news is that these gaps can be closed. With the political will to transform systems, we can reach the most vulnerable and not only save lives, but ensure the quality of those lives. We know what works, and have demonstrated that U.S.-funded interventions can be life-changing. By 2019, more than 40 countries had surpassed or were within reach of the key epidemiological milestone towards ending AIDS. New HIV infections declined by 23% globally between 2010 and 2019, with some countries having tremendous success--in Swaziland, HIV incidence declined by 50% in five years, with new infections falling at a rate of 1,000 per year. Among the 15 countries implementing the DREAMS initiative, the latest results show a 25% or greater decline in new HIV diagnoses among adolescent girls and young women in nearly all of the regions implementing DREAMS across 10 high-burden African countries. These strategies, paired with new and promising innovations, can end HIV by 2030 if given the necessary support and resources to do so. PEPFAR has shown it is a responsible shepherd of U.S. dollars, using evidence and data to allocate funds with increased effectiveness and efficiency. With essentially flat funding for over ten years, PEPFAR has increased the number of people it directly or indirectly supports from 6.7 million people at the end of FY 2013 to 17.2 million people today. PEPFAR also increased its support of voluntary medical male circumcision procedures in Eastern and Southern Africa to reduce the risk of HIV transmission from 4.7 million men at the end of FY 2013 to 25.3 million men at the end of FY 2019. In FY2019, PEPFAR supported 17.2 million people on antiretroviral treatment (ART). Since the program's inception, 2.8 million babies have been born HIV-free to pregnant women living with HIV through prevention of mother-to-child transmission (PMTCT) programs funded by PEPFAR. The Global Fund, which provides more than 20 percent of all international financing for HIV/ AIDS, has saved 38 million lives since its inception in 2002. Overall, the number of deaths caused by AIDS, tuberculosis (TB), and malaria each year has been reduced by nearly one-half since 2002 in countries where the Global Fund invests. In addition to the direct effects on HIV incidence, PEPFAR countries also see greater overall health outcomes, increased country capacity, increased gender equality, and increased economic development. Investments in HIV programming act as effective diplomacy, strengthening partnership with national governments and improving ties with partners. U.S. leadership in the fight against HIV and other leading infectious disease killers worldwide is a moral imperative, a public health imperative, a human rights imperative, and a security imperative. Global resources to fight HIV and AIDS have decreased since 2017, leaving a 30 percent shortfall for what is needed to fully respond to the pandemic. According to UNAIDS, increases in resources for HIV responses in low- and middle-income countries stalled in 2017, and funding decreased by 7 percent between 2017 and 2019. We expect that funding will face even more cuts this year as governments grapple with their response to COVID-19. While domestic contributions make up 57 percent of all resources available, global financial support is still a critical element of success. Increasing PEPFAR funding by $750 million in this fiscal year would show the U.S.'s commitment to ending AIDS as a public health threat, making a significant down payment in the fight to end AIDS and motivating other funders to step up. Twenty years into the program, PEPFAR continues to show the world the United States' compassion and effectively addresses the challenges of HIV/AIDS through prevention, care, and treatment programs and policies that are grounded in science and respect human rights. This program improves and saves lives around the world and continues to advance the U.S.'s development goals and national security. However, continuing to do more with less eventually reaches a point of diminishing returns. A dollar can only move so far. Without increased resources and support coupled with sound policy and a commitment to civil society consultation at all levels, we cannot reach the goals that we have been chasing for over four decades-an end to the HIV pandemic. Closing that chapter of history and continuing our legacy of helping end pandemics would put one of the greatest human achievements on the U.S. ledger. [This statement was submitted by Kevin Fisher.] ______ Prepared Statement of the Global Campaign for Education--United States As the Executive Director of the Global Campaign for Education-US (GCE-US), I represent a diverse coalition of more than 80 international nonprofit organizations, faith-based groups, and advocates dedicated to ensuring quality, universal education for all children and youth. We urge you to support effective investments in education globally by allocating at least $1.1 billion to the Basic Education account, including at least $150 million for the Global Partnership for Education (GPE) and at least $50 million for Education Cannot Wait (ECW), both of which complement U.S. bilateral education efforts. This funding will ensure that the United States (U.S.) Government, particularly through the Department of State and the United States Agency for International Development (USAID), continues to play a leadership role in critical efforts to achieve universal quality, inclusive education, which is more important than ever, in light of the impacts of the COVID-19 pandemic around the world. The power of education is clear--brighter futures, healthier communities, and increased economic growth for individuals and countries. Education increases security and stability, spurs economic growth, and provides proven results across development sectors. As outlined in USAID's Education Strategy, ``the U.S. Government recognizes that its investments in international education serve as a force multiplier for all of its work in international development.'' Addressing education means more than just addressing learning: education support is also vital to creating positive outcomes for stopping the spread of disease\i\ and reducing gender disparities.\ii\ The COVID-19 pandemic and ongoing humanitarian emergencies have rendered bilateral and multilateral investments in education all the more critical. School closures during the COVID-19 pandemic have impacted over 91% of the world's school-aged children and youth. When children and youth are out of school, they may be exposed to the results of education loss, including regression in foundational knowledge, increased exposure to health and well-being risks (both psychosocial and physical), and increased risk of not completing school.\iii\ Additionally, World Vision estimates that, because of the pandemic, an additional 85 million children worldwide may be exposed to physical, sexual, and emotional violence.\iv\ The risks are even higher for girls and children with disabilities. For example, teenage girls experience a 65% increased risk of pregnancy when schools are closed during a crisis, which is estimated to result in one million girls not returning to school in sub-Saharan Africa after the pandemic and a $10 billion loss for the region.\v\ Underlying health conditions can make children and youth with disabilities more vulnerable to the consequences of the pandemic. They face additional barriers to accessing remote learning strategies and enrollment or re-enrollment efforts when schools reopen.\vi\ Schools often deliver key health, nutrition, water, sanitation, and hygiene supports, like ECW has via schools in Cameroon, Mali, Chad, and Burkina Faso.\vii,viii\ Failing to act now to address this monumental gap could result in a lost generation--a generation without education and with severely limited opportunities for economic prosperity, in addition to its impact on health, poverty reduction, and climate change. According to a World Bank study\ix\ and numerous experts, educating girls is a key aspect to fighting climate change.\x\ The Malala Fund estimates that in 2021 climate-related events will prevent at least four million girls in low- and lower-middle-income countries from completing their education: If current trends continue, by 2025 climate change will be a contributing factor in preventing at least 12.5 million girls from completing their education each year. Schooling provides skills to overcome climate-related shocks, including the critical thinking capabilities needed to process and act on the risk of weather reports. Countries that have invested in girls' education have suffered far fewer deaths from droughts and floods than countries with lower levels of girls' education.\xi\ Despite the challenges of COVID-19, USAID and multilateral partners have found effective solutions to address evolving education needs. USAID programs reached more than 24 million learners in 2020 from pre- primary through secondary levels through a variety of in-person and distance approaches in order to navigate school closures.\xii\ Complementing these bilateral programs, GPE and ECW are making significant strides to build more resilient, national public education systems and education in emergencies, including during the COVID-19 pandemic. In the first year of the pandemic, ECW has mobilized $45.4 million across 27 countries and reached over 9 million vulnerable boys and girls.\xiii,xiv\ GPE mobilized over $500 million across 66 countries, reaching 355 million children.\xv\ GPE is a unique, multi-stakeholder partnership, and the largest global fund solely dedicated to transforming education in lower-income countries. It brings together developing country partner governments, donors, international organizations, and civil society to pursue the shared objective of equitable, quality education for all, providing financial and technical support to ensure educational opportunities in developing countries. GPE focuses on leveraging more and better domestic financing as the most significant and sustainable form of funding for education. To receive GPE funding, governments must commit to making significant domestic investments in education. GPE supports educational continuity and helps partners keep their education systems functioning through wars, displacement, crises, climate disasters and health emergencies, including the ongoing COVID-19 pandemic. ECW brings together governments, humanitarian and development actors, donors, and civil society to deliver a collaborative and rapid response to the educational needs of children and youth affected by crises, emergencies, and conflicts. ECW ensures that education and learning are central components of humanitarian response efforts, and that emergencies and crises do not disrupt a child's right to education. ECW's investments have reached children and youth in some of the most challenging crisis settings: ongoing armed conflicts, forced displacement, refugee exodus, and climate-related emergencies. When the pandemic hit, ECW mobilized quickly with almost half of the $45.4 million used in the COVID-19 response targeting refugees and people who were internally displaced.\xvi\ With the implementation of the U.S. Government Education Strategy, the development of the Advancing Protection and Care for Children in Adversity strategy, and the Global Child Thrive Act, USAID and its partners have a solid foundation to improve the lives and futures of children and youth around the world. These strategies seek to address the needs of the world's most at-risk and to intervene when children and youth need it most, providing nurturing environments to keep children safe, fostering their early development, and engaging them in quality, inclusive education from the early years. While these strategies are eloquent on paper, they must be backed by sufficient financial resources to be effective, particularly in light of the resulting impacts of the COVID-19 pandemic. Robust funding can address the education needs that existed prior to the pandemic and give us the chance to build back better, supporting Sustainable Development Goal 4 to ``ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.'' \xvii\ For FY2022, we recommend funding the Vulnerable Children account with at least $35 million to support implementation and reporting as mandated by the Global Child Thrive law, which was enacted into law in January 2021. The COVID-19 pandemic has made it more imperative to fund effective humanitarian and development assistance, which is why we urge that this funding not come at the expense of other development or humanitarian accounts. We strongly support sustained funding for the entirety of poverty-focused development accounts, which work together to serve the common goal of building a safer and more prosperous world. Recognizing that global education is a force multiplier for all our work in international development, it is vital that the U.S. provides at least $1.1 billion for the Basic Education account in the FY2022 State and Foreign Operations Bill, including at least $150 million for GPE and at least $50 million for ECW. --------------------------------------------------------------------------- \i\ https://www.eccnetwork.net/sites/default/files/media/file/ EducationInEbola_JointAdvocayBrief.pdf \ii\ https://www.edu-links.org/topics/gender-and-girls-education \iii\ https://www.educationcannotwait.org/covid-19/ \iv\ https://www.wvi.org/stories/ghana/covid-19-could-put-85- million-children-risk-physical-sexual-and-emotional-violence \v\ https://www.wvi.org/sites/default/files/2020-08/ Covid19%20Aftershocks_Access%20Denied_small.pdf \vi\ https://thedocs.worldbank.org/en/doc/147471595907235497- 0090022020/original/ IEIIssuesPaperDisabilityInclusiveEducationFINALACCESSIBLE.pdf \vii\ https://reliefweb.int/report/cameroon/ecw-announces-us1- million-grant-ensure-access-education-newly-arrived-refugees \viii\ https://www.unhcr.org/5ea7eb134.pdf \ix\ https://documents1.worldbank.org/curated/en/ 328491468340475205/pdf/WPS5342.pdf \x\ https://gemreportunesco.wordpress.com/2015/12/02/education-a- powerful-response-to-climate-change/ \xi\ https://openknowledge.worldbank.org/handle/10986/3827?- show=full \xii\ https://www.usaid.gov/sites/default/files/documents/ USAID_Covid_factsheet_v5c-508.pdf \xiii\ https://www.educationcannotwait.org/tag/covid19/ \xiv\ https://www.educationcannotwait.org/education-cannot-wait- investments-reach-refugee-and-other-vulnerable-children-and-youth-in- response-to-covid-19-pandemic/ \xv\ https://www.globalpartnership.org/covid19 \xvi\ https://s30755.pcdn.co/wp-content/uploads/2021/05/ ECW2021CFI_web.pdf \xvii\ https://sdgs.un.org/goals/goal4 [This statement was submitted by Jennifer Rigg, Executive Director.] ______ Prepared Statement of the Global Health Council Global Health Council (GHC) is the leading membership organization for nonprofits, businesses, universities, and individuals dedicated to saving lives and improving the health of people worldwide. GHC thanks the Subcommittee for the opportunity to share this testimony in support of the Global Health Programs account within the International Affairs Account (Function 150). For Fiscal Year (FY) 2022, GHC urges continued support for global health at a minimum of FY21 levels enacted by Congress. However, we must caution, that in order to achieve U.S. global health goals and meet our commitments, we ask that you support a greater investment in global health programs for FY22, which includes at least $15,151,500,000 for global health programs at the Department of State and for the U.S. Agency for International Development; $540 million for water in all accounts, and $134 million for UNICEF. These investments yield positive outcomes that support U.S. interests and leadership abroad. Global health funding supports maternal and child health, including the U.S. contribution to Gavi, the Vaccine Alliance; nutrition; HIV/ AIDS; malaria; tuberculosis; family planning; neglected tropical diseases; and vulnerable children. Continued funding for global health is critical to reaching the finish line on the bold global health initiatives to which countries around the world, including the United States, have committed resources. These targets include: achieving the first AIDS-free generation; ending preventable child and maternal deaths; and eradicating polio, measles, and malaria. U.S. investments draw attention to and prioritize solutions that address non- communicable and other neglected health threats that are increasingly affecting the economies of key trading partners. These investments work well beyond their intended targets by helping to protect the health of Americans by strengthening countries' capacity to better prevent, detect, and respond to infectious disease outbreaks. We know these programs work and have secured their place as some of the most critical and cost-effective forms of U.S. foreign assistance. These are a critical component of how the United States engages with the world. By investing in global health and development, the U.S. can build healthier and more self-reliant communities, which ultimately become economically and politically stable. A reduction in these investments would roll back the progress already made and undermine U.S. foreign policy. In recent years, we have seen practitioners and U.S. agencies working harder than ever to integrate global health programs and services in a way that leverages and maximizes investments while increasing the efficiency and effectiveness of these programs worldwide. The past year has shown that existing U.S. global health programs helped to detect, treat, and respond to the COVID-19 pandemic as it spreads. Without the infrastructure in place from existing programs, the outcomes for many COVID-19 patients may have been far more devastating. The strain placed on these programs in light of the pandemic has threatened our long-term goals and drastically reduced the number of people seeking preventive care, medication, and treatment, for other illnesses. We have not yet seen the full effect of the pandemic across health systems globally. As a result of the effects we have already seen of the pandemic, GHC recommends that Congress consider the establishment of a Global Pandemic Preparedness Fund to help the United States better detect and respond to emerging threats. A dedicated, disease-agnostic, multilateral financing mechanism would rapidly accelerate pandemic preparedness by providing new funding and technical assistance to partner countries to develop and accelerate health security action plans, close gaps in preparedness, and promote compliance with the International Health Regulations. By maintaining U.S. investment in global health, we will continue to build upon the hard work and achievements of the past to ensure a healthier future for the entire world. Moreover, Americans consistently support global health and development assistance funding. Especially in a moment where cooperation is needed to bolster health systems and preparedness worldwide, the U.S. must support critical investments in global health. Global Health Council thanks the Subcommittee for the opportunity to submit written testimony. For more information on our recommendations for U.S. investments in global health, visit http:// ghbb.globalhealth.org. [This statement was submitted by Kiki Kalkstein, Director of Advocacy & Engagement.] ______ Prepared Statement of the Global Health Technologies Coalition On behalf of the Global Health Technologies Coalition (GHTC), a group of 37 nonprofit organizations, academic institutions, and aligned businesses advancing policies to accelerate the creation of new drugs, vaccines, diagnostics, and other tools that bring healthy lives within reach for all people, I am providing testimony on fiscal year (FY) 2022 appropriations for global health programs at the US Agency for International Development (USAID). These recommendations reflect the needs expressed by our members working across the globe to develop new and improved technologies for the world's most pressing health issues. We appreciate the Committee's support for global health, particularly for continued research and development (R&D) to advance new drugs, vaccines, diagnostics, and other tools for longstanding and emerging health challenges, including COVID-19. To this end, we strongly urge the Committee to continue its established support for global health R&D by robustly funding the global health accounts at USAID and the State Department, at or above the levels included in the President's budget request; instructing USAID to prioritize R&D within each of the disease and condition areas under the Global Health Programs account and to consider setting minimum funding targets for innovation activities in each health area from future increases to the account; and instructing USAID to develop and publicly release a new five-year strategy on health-related R&D detailing how USAID will work across programs to implement a holistic global health R&D strategy-developed with input from program leads within the Global Health Bureau, consultations with nonprofit and private-sector partners, and leadership of other relevant federal departments and agencies. US investment in the development of new vaccines, drugs, devices, diagnostics, and other health technologies is essential to addressing some of the world's most pressing health challenges-achieving an AIDS- free generation; curbing the spread of malaria, tuberculosis (TB), and neglected tropical diseases (NTDs); addressing antimicrobial resistance; and ending preventable child deaths. Over the past year, the importance of strong investment in global health R&D has become clearer than ever before as scientists raced to develop the tools desperately needed to diagnose, treat, and prevent COVID-19. We have watched with awe as scientists have shattered speed records for vaccine development, forged unique collaborations to advance science across borders, and deployed an unprecedented amount of energy and resources from a range of health areas to tackle this global foe-upending assumptions about how science works, and how fast. Now, well over a year into the official declaration of the COVID-19 global pandemic, we have a robust set of tools to defeat this threat in high-income countries but still lack the tools needed to meet the unique needs of patients and health workers in low-resource settings, where basic resources like electricity, laboratory capacity, and reliable cold chain storage cannot be taken for granted. This is the next frontier of R&D for COVID-19: ensuring that we have the right tools to defeat this pandemic in every corner of the globe, which is ultimately essential for securing America against this historic threat. We are grateful for the Committee's ongoing support for global health R&D and recognize that you face difficult decisions in balancing many priorities for annual appropriations and the allocation and use of emergency appropriations for unprecedented R&D and public health needs over the past year. We welcome the recent allocations of emergency funding for Gavi, the Vaccine Alliance; Global Health Programs at USAID; the President's Emergency Plan for AIDS Relief (PEPFAR); and the Global Fund to Fight AIDS, Tuberculosis and Malaria in the last two COVID-19 relief packages-however, we note that critical needs remain unmet, including funding to support the development and deployment of COVID-19 products designed for use in low-resource settings, and that USAID has yet to allocate the contribution to the Coalition for Epidemic Preparedness Innovations (CEPI) included in the American Rescue Plan Act. New global health tools and technologies hold promise to dramatically improve the lives of those living in the poorest countries around the world both to extinguish the COVID-19 pandemic and tackle long-standing global health challenges, and even as we work to scale up delivery of existing tools, we ask for your support for continued innovation in FY22. Critical Need for New Global Health Tools.--While we have made tremendous gains in global health over the past fifteen years, millions of people around the world are still threatened by HIV/AIDS, TB, malaria, and other neglected diseases and health conditions. In 2019, TB killed 1.4 million people, more than any other infectious disease at that time, while 1.7 million people were newly diagnosed with HIV. Nearly half of the global population remains at risk for malaria, with drug-resistant strains growing. Women and children remain the most vulnerable. Around 68% of all global maternal and child deaths occurring in sub-Saharan Africa, with 1 out of every 13 children in the region dying before the age of 5-often from vaccine-preventable or other communicable diseases. These figures highlight the tremendous global health challenges that remain and the need for sustained investment in global health research to deliver new tools to combat endemic and emerging threats. New tools and technologies are critical, both to address unmet global health needs and to address challenges of drug resistance, outdated and toxic treatments, and difficulty administering current health technologies in poor, remote, and unstable settings. We must also continue investing in the next generation of tools to prepare for emerging threats. The COVID-19 pandemic has again demonstrated that we do not have all the tools needed to prevent, diagnose, and treat many neglected and emerging infectious diseases-a reality foreshadowed by the recent Zika and Ebola epidemics. The life-saving effects of the COVID-19 vaccines demonstrate the power of having the right tools to respond to a health emergency. These new vaccines, developed with critical funding the US government, are highly effective and built upon past global health research advances. Notably, the Johnson & Johnson vaccine is based on technology used in its Ebola vaccine and Zika, respiratory syncytial virus, and HIV/AIDS vaccine candidates and the Moderna-National Institute of Allergy and Infectious Diseases (NIAID) vaccine platform was previously being used to develop vaccines against other respiratory viruses and the chikungunya virus. This demonstrates how strong, sustained investment in R&D allows us to tackle today's health threats and prepare for those of the future. It is critical we keep investing in the development of next-generation tools to fight existing and emerging disease threats so that we have tools ready to go when we need them. USAID Contributions to Global Health R&D.--USAID is the only US agency with a mandate to focus on global health and development. For that reason, the agency is uniquely positioned to support the end-to- end development of new global health technologies-from defining a global health challenge, designing a tool to address it, developing that tool through clinical trials, and delivering that tool to communities most in need-in a way that is not replicated elsewhere in the US government, particularly for late-stage research and product development. USAID's global presence and unique understanding of the needs of patients in different settings and contexts is key to developing health innovations that are transformative on the ground. We applaud the efforts that USAID has made in fostering innovation in health technologies, including: --Partnering across government agencies and among private-sector partners to identify breakthrough innovations to combat infectious disease epidemics in response to recent outbreaks of Ebola and Zika. USAID's Fighting Ebola Grand Challenge identified 1,500 innovative technologies to advance the fight against Ebola and advanced 14, including a low-cost, battery- operated tool used during both the Ebola and COVID-19 responses that manages the flow rate of intravenous treatments with a simple gravity system, replacing the need for expensive, difficult-to-use infusion pumps. The Combating Zika and Future Threats Grand Challenge received over 900 crowdsourced technology proposals and selected 26 projects to fund, which cut across vector control, vector and disease surveillance, diagnostics, and other interventions. In March of 2020, USAID issued a request for information for proposals for low-cost, scalable innovations that could support the international COVID-19 response, including new products and service delivery approaches. It received hundreds of proposals for potentially game-changing innovations, but funding is urgently needed to advance and scale them, potentially through the launch of a Grand Challenge focused on COVID-19 and global health security. --Establishing a five-year partnership with CEPI to advance the development of vaccines against priority emerging infectious diseases including Lassa fever, Middle East Respiratory Syndrome (MERS), Nipah, Chikungunya, Rift Valley Fever, and Ebola. --Supporting research to develop safe, effective, and accessible tools to prevent HIV in the developing world-including HIV vaccines and microbicides, which have tremendous potential to prevent HIV infection in women-and a low-cost, rapid, disposable HIV/AIDS diagnostic test designed for infants. --Supporting the development of vaccines, antimalarials, insecticides, and novel vector control tools against malaria, including a promising single-dose cure. --Playing a key role in the global effort to fight TB by supporting research to develop innovative, new drug regimens and diagnostics for drug-susceptible and drug-resistant TB, including the world's first child-friendly TB medicines, developed with critical seed funding from USAID and introduced in 2015, and a new all-oral treatment regimen that reduces the time it takes to treat drug-susceptible TB from six months to four months. USAID expertise on implementation and scale-up of these innovations is a critical piece of the product development cycle and ought to be appropriately prioritized. --Developing interventions to help women and children during childbirth in low-resource settings where there may not be electricity, refrigeration, or trained health workers. --Developing new drugs and diagnostics for a select group of neglected tropical diseases (NTDs), including tools to fight dengue and other mosquito-borne diseases that have been deployed from Indonesia to the Florida Keys with promising results. Global Health R&D Funding at USAID-Addressing Critical Gaps.--USAID is an important partner in global health product development, and it is critical for the agency to bolster this function of its global health programming. This means that global health programs within USAID require robust funding to ensure they have appropriate resources, both for ongoing programs and forward-looking R&D efforts. For the vast majority of USAID's global health programming, there are no dedicated funding streams or programs expressly supporting global health R&D. This means that decisions on USAID's investments in developing new global health technologies-the tools needed to make programming more successful and efficient and to further the agency's global health mission-are made at the program level, based on overall funding allocations for each disease or population-specific health area. To ensure research is appropriately prioritized, global health programs need appropriate resources. GHTC strongly supports increasing funding for USAID Global Health Programs at or above the levels proposed in the President's FY22 budget request to allow for transformative investments in the new drugs, vaccines, diagnostics, and other tools to accelerate global health gains while sustaining current programming needs. While some areas of USAID's global health portfolio are leading the way in R&D, there are other areas where a lack of resources and prioritization are acute. For example, USAID does not currently incorporate research for new vaccines for TB into its programming, and has made limited investments in new preventative technologies, despite TB being the world's greatest infectious disease killer prior to COVID- 19. USAID could also advance its role in R&D for NTDs. While the agency does important work to provide treatments for five of the most prevalent NTDs, new tools are needed to reach the end game for these diseases, including more sensitive diagnostics to ensure that elimination goals have been met-which, in addition to meeting clear epidemiological needs, would improve resource allocation and ensure that US investments have the desired results. Relatively small investments in R&D for new NTD tools could have an incredible return for both public health and our historic investment in the effort to end NTDs. USAID recognizes the value of global health R&D, but this recognition is not always clearly articulated in the many strategic documents and frameworks that guide the agency's work. Congress has an important opportunity to correct this by requesting a new five-year strategy on health-related R&D from USAID detailing how the agency will work across programs to achieve global health R&D goals. The strategy- vital to ensuring that innovation fuels USAID's global health mission and R&D is appropriately prioritized-should be developed with input from program leads within the Global Health Bureau, consultations with external nonprofit and private-sector partners, and leadership of other relevant federal departments and agencies. The strategy should detail how USAID coordinates with stakeholders to support innovative global health product development to address critical gaps, particularly for late-stage research and product introduction; include specific investment and target outcomes for research and product development across disease areas and crosscutting challenges like global health security and antimicrobial resistance; and detail where additional USAID investment in innovation could accelerate progress towards global health goals. Once developed and released, detailed annual reporting on this strategy-which should be made promptly available on the USAID website-would be vital for appropriate congressional oversight. GHTC stresses the need for USAID to continue to prioritize science, technology, and innovation to advance its global health and development mission. GHTC urges the Committee to continue to direct USAID Global Health Programs to include and expand R&D for new tools, allocate sufficient resources to support this work, and encourage detailed, public annual R&D reporting by USAID, which provides the only insight policymakers and advocates have into the agency's R&D decision-making processes. Collaboration Across the US Government.--In addition to USAID, support for global health R&D in the US government comes from the Department of Defense (DoD), the Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Biological Advanced Research and Development Authority (BARDA), and the National Institutes of Health (NIH). Each of these agencies play a unique and essential role in moving new global health technologies from concept to reality, and strong interagency collaboration is essential to leverage limited US government resources and ensure taxpayer dollars are used most effectively. To this end, we urge the Committee to encourage USAID to work with CDC, DoD, FDA, NIH, HHS, and BARDA to develop a whole-of- government strategy for global health R&D to coordinate priorities and resources and streamline operations. Investing in Global Health R&D as a Strategic National Security and Economic Decision.--Global health R&D is important for delivering lifesaving tools to those who need them most. However, US government investments in R&D-through USAID and other agencies- yield benefits in addition to humanitarian and development goals. As COVID-19 has dramatically demonstrated, health crises abroad can become health crises at home, and it is imperative that we sustainably invest in R&D for a broad range of neglected infectious diseases so that we understand emerging disease threats and have tools ready for them. Additionally, global health R&D is a smart economic investment in the United States, where it drives job creation, spurs business activity, and engages academic institutions. In fact, 89 cents of every US dollar invested in global health R&D benefits US-based researchers, many of whom conduct their research at US universities. US government investment in global health R&D between 2007 and 2015 generated an estimated 200,000 new jobs and $33 billion in economic growth. Global health research that improves the lives of people around the world-while also promoting global health security, creating jobs, and spurring economic growth at home-is a win-win investment. Recognizing this, GHTC respectfully requests that the Committee sustain and increase US investment in global health research and product development by robustly funding the global health accounts at USAID and the State Department, at or above the levels included in the President's budget request; instruct USAID -in collaboration with other agencies involved in global health-to prioritize R&D within each of the disease and condition areas under USAID's Global Health Programs account; and direct USAID to develop and publicly release a new five- year strategy on health-related R&D detailing how USAID will work across programs to implement a holistic global health R&D strategy. These steps are vital to sustaining the life-saving global health innovation work led by USAID which is fundamental to the achievement of the United States' broader global health goals-which we all understand more clearly than ever are inseparable from our health and prosperity here at home. [This statement was submitted by Jamie Bay Nishi, Director.] ______ Prepared Statement of the Global Partnership For Education Mr. Chairman and members of the Subcommittee, thank you for the opportunity to bring you up to date regarding the work of the Global Partnership for Education (GPE) and its 76 developing country partners as the COVID 19 pandemic continues to unfold in many of these countries. On behalf of our partners, I respectfully ask the Subcommittee to recommend at least $150 million, under the United States Agency for International Development's Development Assistance account, as the US Government's fiscal year 2022 contribution to the Global Partnership for Education. I also request that the Subcommittee recommend at least $1.1 billion from various accounts in the bill for overall basic education funding, including $50 million from accounts in the bill for Education Cannot Wait. Thanks to support from the US and other partners, the GPE has delivered impressive results over the past decade: 160 million more children are in school in our partner countries and double the number of girls are on the path to gender equality in these countries. Tens of millions of teachers have been trained and await return to the classroom once schools, many of them only just built over the last decade, are re-opened. Sixty-seven million more students now have access to professionally trained teachers. COVID 19 remains the overwhelming context and challenge for education throughout the developing world. Although the US and other wealthy nations have seen their vaccination rates climb steadily over the past eight months, most of our developing country partners are only just beginning to receive COVID vaccines, with schools remaining closed for hundreds of millions of children and illness and death rates continuing to climb. According to the World Health Organization, vaccination rates in sub-Saharan Africa are currently barely over 1 percent of the population. At its height, the pandemic forced some 1 billion children out of school for the bulk of an academic year--today in mid-2021 hundreds of millions remain out of school. The Global Partnership for Education remains concerned that continued school closures are impacting girls in particular and will lead to an increase in early marriages, domestic abuse and drop-out rates. Many of these girls and other marginalized children will never return to school. GPE responded quickly to the pandemic last spring as it was unfolding and re-directed over $500 million in less than six months to help 66 countries respond to the COVID crisis and ensure distance learning occurred, while also preparing for a safe return to school. GPE resources continue to support low tech distance learning programs targeted toward the most vulnerable and disadvantaged children, including girls, children with special needs and disabilities, and no-tech programs for children without access to electricity or internet connectivity. For example: In Niger, the focus of the COVID response program funded by GPE is on the most vulnerable children, including those living in rural areas, girls, and refugee and internally displaced children. The program is supporting the continuity of learning outside schools and adaptation of school curricula to new ways of learning, and preparation for the safe reopening of schools. It also provides for crosscutting activities, including needs assessment, capacity building, monitoring and evaluation of learning, and production of knowledge that will serve to both enhance the performance of the education system and strengthen its resilience. In Tanzania-Zanzibar the online lessons developed have been uploaded on the Ministry of Education's website and YouTube and the installation of water and sanitation facilities in needy schools has very much enhanced student attendance. Furthermore, supporting teachers to teach remedial classes to cover the loss of time during school closure has very much motivated their performance in the classrooms. In Ghana, a learning management system has been developed and was launched during the National Education Week. It provides a platform for online-learning and on-going communication and teacher between students, parents, and teachers. This has provided needed support to remote-learning during the school closures. The platform will be integrated with all distance learning modules and will be available on laptops, tablets, and smartphones. the global partnership for education (gpe) The Global Partnership for Education is a public-private partnership of donor and developing country governments, UNICEF, UNHCR, the World Bank and other international organizations, civil society, teachers' associations, and the private sector and foundations all working together to ensure a more effective and efficient response to the global education challenge. GPE provides financial and technical support to 76 partner countries where the great majority of out of school children reside and where the national education systems require the most urgent support. USAID and other donor governments are often engaged in the local education groups that bring partners together at country level, support the confirmation of the highest priorities and help monitor progress. The new GPE now features a ``compact"-based operating model that strengthens the link between development of national sector plans, reforms of the system and their implementation. Additionally, the GPE model continues to place strong emphasis on domestic resource mobilization for education and more effective use of those resources. gpe's impact over the last 20 years Access to education.--Since 2002, up until the COVID pandemic developed, 160 million more children were in school in GPE partner countries. This included 82 million additional girls in school in GPE partner countries--double the number compared to 2002. As an example, in Mauritania, girls' secondary enrollment in six rural areas tripled when GPE funded additional schools. Learning Outcomes and Improving Quality of Education.--To improve education and learning outcomes, GPE has trained an average of 350,000 teachers each year. In Ghana, GPE has supported the government to raise primary school completion to 100% in less than 10 years. Fragile and/or Conflict-Affected Countries--Responsive Support.-- Almost 30 of GPE's 76 partner countries are classified as fragile and/ or conflict affected due to a natural disaster, such as an earthquake or protracted conflict. 76% of GPE implementation grants were allocated to partner countries affected by fragility and conflict in 2019 compared to 44% in 2012. --Prior to the COVID pandemic, much of the world's out of school children resided in such countries. GPE has developed new flexible, accelerated and responsive funding policies that enable swift and flexible support when crises unfold and create extensive challenges to education systems. For example, GPE is the largest donor supporting the continuity of education in Yemen, representing over $70 million over the past 4 years. --Additionally, as noted previously, GPE support also addresses the needs of refugees in partner countries. In Bangladesh and the Central African Republic, GPE will provide $14.6 million in emergency funding to support the education of tens of thousands of children displaced by conflict and violence. Gender Equality. Ensuring that girls have access to education has been a top priority of the GPE since inception and much progress has been achieved in many partner countries. However, much more needs to be done to ensure gender equality. GPE has hard-wired gender equality into its operating model and has created a new $250 million Girls Education ``Accelerator'' Fund to target support to very poor countries which have much progress to make on gender equality. gpe's fourth replenishment: a new case for investment GPE launched a new Case for Investment in October of 2020 which sets out an ambitious objective for the five-year period between 2021 and 2025--the transformation of education systems in scores of developing countries so that every boy and girl can get 12 years of quality education and one year of pre-school. The financing campaign is being co-led by UK Prime Minister Boris Johnson and Kenyan President Uhuru Kenyatta, who are actively reaching out to all donor and developing country governments, the private sector and foundations, and civil society to mobilize the $5 billion required from all sources over the next five years to deliver the following key results: Enabling of 175 million girls and boys to learn; 140 million students with access to professionally trained teachers; 88 million more children, of which 48 million will be girls, in school; Lifting 18 million people out of poverty; And saving 2 million girls from child marriage. As the UK Government holds the presidency of the G7 Summit later this June, Prime Minister Johnson has advised all G7 members that global and girls' education will feature as key global priorities at the Summit. Additionally, PM Johnson and President Kenyatta will co- chair the Global Education Summit: Financing GPE 2021-2025 in late July, which is designed to assess the progress achieved over the past three years, consider the ambitious agenda ahead and secure the new financing commitments needed to transform education in scores of countries over the next five years. the us is a key gpe partner The United States, through USAID, is an active participant on GPE's Board, a member of the executive committee and is closely engaged at a technical level on the development of GPE's policies and strengthening of its funding and operational models. USAID also often serves as a member of the local education group in many partner countries, a key priority setting and program monitoring body in all countries. USAID missions also work with ministries of education in GPE-supported countries on the formulation of national plans and applications for GPE support. fiscal year 2022 united states support for gpe and basic education Mr. Chairman, I urge the Subcommittee to recommend a fiscal year 2022 U.S. contribution to the Global Partnership for Education of $150 million. I also urge you to support an overall fiscal year 2022 level for basic education of at least $1.1 billion, $50 million from various accounts to support Education Cannot Wait, and $134 million for our close partner UNICEF, which serves as a grant agent for GPE in many crisis and conflict countries. Thank you for your consideration. [This statement was submitted by Alice Albright, Chief Executive Officer.] ______ Prepared Statement of the Global Policy and Advocacy, International Rescue Committee (IRC) Chairman Coons, Ranking Member Graham, and members of the subcommittee, on behalf of the International Rescue Committee, a global humanitarian aid organization that offers emergency aid and long-term assistance to people in crisis in over 40 countries and helps refugees and other displaced people integrate into their new communities across dozens of cities in Europe and the Americas, thank you for this opportunity to testify on the needs of people fleeing conflict, violence, persecution, and disaster. The following testimony strongly urges increased funding levels for International Disaster Assistance ($5.27 billion); Emergency Refugee and Migrant Assistance ($50 million); Migration and Refugee Assistance ($4.12 billion); Basic Education ($1.1 billion); Malnutrition ($300 million); Vulnerable Children ($35 million); and for a three-fold increase in funding for gender-based violence. In an era in which humanitarian need is vastly outstripping humanitarian financing, it also asks Congress to introduce novel language to improve the effectiveness, transparency and accountability of humanitarian financing. Finally, it supports the allocation of 20,000 additional Special Immigrant Visas for U.S.- affiliated Afghans. increasing capacity to respond to crises and fragile contexts The compounding challenges of COVID-19, climate change, and conflict are driving unprecedented humanitarian need and attendant instability: this year, 235.4 million people--1 in every 33 people--are in need of humanitarian assistance, 40% more than in 2020. These needs are vastly outpacing humanitarian funding. Humanitarian Response Plans (HRPs) continue to be underfunded by nearly 40%. The greatest gaps in response remain in fragile, conflict-affected states that drive the majority of displacement, and where impacts of the pandemic are reversing decades of hard-won progress to protect women and girls, increase access to education, and reduce poverty, hunger, and disease. As the IRC's 2021 Watchlist reveals, 20 countries, representing just 10% of the global population, account for 85% of humanitarian need, 84% of all refugees, and 88% of populations internally displaced. The US must focus and scale up humanitarian financing and programming in these contexts to help reverse these trends. We urge Congress to ensure that at least 50% of bilateral and multilateral economic and humanitarian assistance goes to these to these fragile and conflict affected states, to address urgent needs and their root causes. We further urge Congress to: --Increase International Disaster Assistance (IDA) to $5.27 billion, $588 million higher than the FY22 Presidential Budget Request, to support direct disaster and emergency relief, rehabilitation, reconstruction, and the ability to address root causes of conflict at scale, including in Northern Central American, where increasing numbers of those internally displaced by violence are overwhelming communities of first refuge. --Double funding for nutrition programming to $300 million to respond to rising malnutrition. The number of food-insecure people worldwide increased by 82% in 2020 as a result of the pandemic. To meet rising needs, we recommend Congress direct a portion of these funds for the rapid scale-up of a simplified protocol for testing and treating acute malnutrition with the help of community health workers, which could significantly expand the reach of existing nutrition programming. --Bridge global gaps in education and early childhood development interventions for refugee and conflict-affected children by appropriating $1.1 billion for Basic Education--compared to $682M requested in FY22--with at least $150 million dedicated to education programs in conflict zones and settings with high rates of displacement; and $35 million for the Vulnerable Children program. Prior to the pandemic, refugee children were already five times more likely to not be in school than their peers. Now, more than half of refugee girls may not return as schools reopen. Despite rising need, less than 3% of humanitarian aid is allocated toward education. This is no time to retreat from education funding. Further, 71 million children under the age of five have lived in conflict areas for their entire lifetimes, leaving them without access to the necessary foundations of healthy human development. Yet just 3% of development assistance and 2% of humanitarian assistance globally is for Early Childhood Development. In order to support successful implementation of the 2021 Global Child Thrive Act, we further recommend that USAID and the Department of State conduct a pilot program in up to three crisis contexts to jointly provide the full range of early childhood development interventions to displaced populations. --Triple funding for the prevention of and response to gender-based violence (GBV). Less than 1% of global humanitarian assistance is allocated to GBV programming despite disproportionate impacts of conflict and crises on women and girls. These impacts accelerated with the pandemic, with an estimated 15 million additional cases of GBV for every three months of pandemic lockdown. restoring us global leadership on refugee protection and resettlement Violent conflict has increased 75% over the last decade; accordingly, the number of people forcibly displaced has nearly doubled since 2010, with over 80 million people now forcibly displaced and the number of refugees increasing by 8 million just over the last four years. There are now over 26 million refugees worldwide, with nearly 90% of them hosted in low- and middle-income countries straining to provide support. On average over the last decade, fewer than 1% of refugees have been resettled and fewer than 3% have been able to return home. Against this backdrop, humanitarian leadership from wealthy nations has been in retreat, with humanitarian aid levels stagnating and global resettlement slots offered by wealthier nations dropping more than 50% over the last four years, while over 1.4 million refugees await resettlement. Urgent and expansive US financing and leadership is needed to support refugees overseas and incentivize host countries to provide access to jobs, education, and other pathways to self-reliance for refugees; and to rebuild, anchored by US resettlement commitments, global resettlement commitments. We urge Congress to: --Increase Migration and Refugee Assistance (MRA) to $4.12 billion to respond to emerging, growing, and protracted refugee crises, including in the Western Hemisphere, and to rapidly restore the US Refugee Admissions Program. The previous administration issued four consecutive, all-time low, annual refugee admissions goals; reduced arrivals by 86%; and dismantled the US global refugee referral and processing infrastructure. To meet the President's ambitious and necessary goal of admitting 125,000 refugees next fiscal year, the Bureau of Population, Refugees and Migration must be equipped to support capacity building, program expansion, and innovation, including expanding resettlement and protection programming in the Americas, where needs rose by 489% from 2020 to 2021--more than any other region in the world. --Fund Emergency Refugee and Migration Assistance (ERMA) to at least $50 million to support rapid response to unforeseen and emerging refugee and migrant needs. The President recently drew down $46 million from this account for the purpose of meeting humanitarian needs of vulnerable refugees and migrants in Central America and the President's Budget Request estimates that there will be a $50 million drawdown on this account next fiscal year. We further recommend that the authorized funding level be raised to $200 million and that the Secretary of State be authorized to draw down ERMA funds. --Ensure emergency protection for US-Affiliated Afghans jeopardized by the US military withdrawal. The US withdrawal from Afghanistan will leave tens of thousands of Afghans under mortal threat as a direct consequence of their affiliation with the US mission. The US must be prepared to meet its commitment and moral obligation to help its allies escape violent retribution for their critical assistance. We urge the allocation of 20,000 additional visas in the FY22 State, Foreign Operations, and Related Programs bill. We also recommend that the Committee include report language directing the protection of surviving spouses and children of SIV applicants who are killed before receiving their visas. We further urge the Committee to direct the Department of State to designate US-affiliated Afghans for Priority 2 status under the US Refugee Admissions Program, a measure that will provide a critical pathway to protection and family reunification in the long-term; and to request that the Biden-Harris administration's inter-agency review of SIV processing and vetting, as directed in President Biden's Executive Order 14013, be shared with Congress. improving the effectiveness, transparency and accountability of financing We thank Congress for appropriating nearly $20 billion in supplemental funding to fight the COVID-19 pandemic and its impacts globally, including $11 billion in the American Rescue Plan relief bill. What is needed now is to ensure this funding as well as funding to be allocated in FY22 is effective, transparent and achieves outcomes in the lives of the most vulnerable. We urge Congress to: --Increase the volume of funds to frontline responders. Frontline NGOs and community-based organizations are uniquely situated to quickly scale COVID-19 prevention and mitigation measures, including last-mile vaccine delivery in complex humanitarian contexts. In some contexts, where governments either cannot or will not respond, they are already delivering 80% of health services. In addition, frontline NGOs-including international, national, and community-based NGOs that have built trust with communities over years of delivering services-are critical when responding to a complex crisis like a pandemic. However, in recent years, almost two-thirds of global humanitarian assistance has gone through multilateral agencies, including 80% of funding for the COVID-19 global appeal--even though funding can take up to 8 months to reach frontline actors. --Support multi-year planning for protracted humanitarian crises. Of the IRC's 20 Watchlist countries, 13 crises are protracted, with humanitarian response plans averaging 15 years. However, humanitarian grants remain about one year in length on average, hampering strategies to support the development and self- sufficiency of long-term displaced populations, and introducing program inefficiencies. A comparative analysis of two IRC cash programs in Somalia found that the longer-term program cost 44% less in delivery costs for every dollar transferred. These crises require multi-year programming and thus multi-year financing to implementing partners to better meet the immediate and long-term needs of crisis-affected populations. We recommend USAID and the Department of State commit to jointly develop multi-year humanitarian strategies for protracted crises and agree on a target for increasing the number of multi-year humanitarian awards, contingent on available funds, to help ensure that long-term needs are met and people caught in crisis can move from dependency to self-reliance. --Increase transparency on humanitarian financing flows and program results. Humanitarian financing is not routinely or completely reported to public systems, like the Financial Tracking Service (FTS). The FTS shows funding flows from donor governments to immediate recipients, but not the secondary recipients of that funding. For example, there is no transparency on where 80% of funding for the Global Humanitarian Response Plan (GHRP) has gone past first-level recipients because these recipients- including UN agencies-generally do not publicly report to FTS the pass-through of their financing to frontline implementers, including international, national, and community-based NGOs. Moreover, there is no consistent framework for reporting results, miring implementing agencies in multiple and duplicative reporting requirements, while failing to provide comprehensive-and comparable-information on outcomes achieved. USAID and the Department of State should develop and adopt (1) a single standard for financial reporting and transparency, requiring implementing partners to report the speed, amount and grant length of passed-through funds, and the recipients of funding through the full transaction chain to frontline implementers; and (2) a single outcome and indicators framework for the health, safety, education, and economic well-being of crisis-affected populations, disaggregated by population status and gender. By taking these steps, the US can lead the way for a reformed humanitarian system. Thank you for your long-standing commitment to humanitarian action. Proliferating humanitarian crises are robbing generations of their human potential and exacerbating instability and insecurity, from the Middle East to Africa to Central and South Asia and Latin America, with direct consequences for US interests. Urgent and expansive US humanitarian leadership can reverse these trends, galvanize others to do more, and restore America's reputation for protecting the most vulnerable. [This statement was submitted by Nazanin Ash, Vice President.] ______ Prepared Statement of the Global Water 2020 Imagine giving birth in a healthcare facility where the midwife is unable to wash her hands, or being a young girl who can't attend school because you have to collect water for your family's daily needs. For millions of people around the world this is the daily reality--the inability to access safe drinking water and proper sanitation and hygiene in their homes, schools, and communities. Through the water and sanitation account at the U.S. Agency for International Development (USAID), U.S. investments help countries to provide safe water, sanitation and hygiene, or WASH, and to properly manage water resources. These programs ensure that girls can safely use the toilet at school, that newborns are less likely to die of preventable diarrhea, and that patients in a hospital will not acquire an infection while at the facility. To that end, Global Water 2020 recommends for Fiscal Year (FY) 2022 no less than $540 million for water and sanitation programs at USAID to accelerate access to safe WASH in some of the poorest regions of the world. Since FY 2008, these investments have helped almost 54 million people gain access to safe drinking water and 38 million people gain access to sanitation. In FY 2018-2019 alone, that's over 11 million people with water and over 10 million people with sanitation. Investing in WASH also reduces morbidity and mortality from WASH-related illnesses, such as typhoid and cholera, and other infections. In addition, funding for WASH helps countries build water infrastructure and support water service providers that can sustainably provide services to a growing customer base. This foundation strengthens governance and finance, as well as self-reliance, in partner countries. Improving access to WASH directly contributes to the achievement of other U.S. global health priorities including improving child nutrition and reducing acute malnutrition, ending preventable child and maternal deaths, containing the spread of infectious diseases such as the flu and coronaviruses, and controlling and eliminating neglected tropical diseases. Resilient and sustainable WASH programs also support economic development and progress across other development sectors such as education, food and nutrition security, agriculture, women's empowerment, environmental conservation, and poverty alleviation. The COVID-19 pandemic has raised awareness of how the simple act of washing one's hands could help to slow the spread the coronavirus, but at the same time presented a challenge to the over 3 billion people who are unable to wash their hands at home. WASH, along with handwashing, also means accessing adequate sanitation and ensuring supply chains for soap and cleaning supplies for healthcare facilities, markets, schools and other high-trafficked places. These are some of the defenses against the spread of the coronavirus and its variants, as well as other infectious diseases such as the flu, diarrheal diseases, and Ebola. Investing in sustainable WASH now helps to continue the fight against COVID-19, but also puts the global community ahead of the next pandemic--whether it be another coronavirus, Ebola outbreak, or the yet to be identified disease X and perhaps prevent billion-dollar emergency supplementals in the future. An FY 2022 appropriation of $540 million for water security, sanitation, and hygiene could: --Help support long-term water service continuity and prevent future utility disruption with loans and financial tools in areas where economic challenges from COVID-19 threaten consistent service provision; --Provide resilient and sustainable safe drinking water services to an additional 900,000 people in Africa, Asia, and Latin America from the previous fiscal year; --Promote school attendance of girls and children with disabilities with accessible and/or separate sanitary facilities; --Scale-up evidence collection, analysis, and learning to support the expansion of proven WASH interventions to enhance resilience, sustainability and self-reliance by building local, long-term capacity; strengthening institutions and the rule of law; and sharing best practices and lessons learned; --Contribute to the goal of universal WASH access, which would prevent 9.1% of the global disease burden and up to 6.3% of all deaths, including the prevention of nearly 830,000 deaths from diarrheal diseases; --Provide WASH to often-overlooked healthcare facilities and schools, thereby strengthening resilience to disease outbreaks and improving pandemic preparedness that protects Americans at home; and --Support cross-sectoral work USAID has underway in other areas impacted by WASH, including maternal and child health; food security, livelihoods, and nutrition; Neglected Tropical Diseases; and economic development programming. This multisectoral approach to development is more effective and resilient if WASH is prioritized. It is also important to note that U.S. leadership has directly spurred partners across the fifty states such as civic groups, faith communities, foundations, universities, schoolchildren, corporations, nonprofits, and others to substantially increase their own efforts to provide safe drinking water and sanitation, resulting in many more diseases prevented and lives saved. This leadership has led to stronger partnerships among the State Department, USAID, and American citizens (e.g. Rotary's partnership with USAID). Access to safe WASH underpins the stability and health outcomes of communities around the world. These investments help to ensure that newborns get a healthy start in life, that girls stay in school, and that healthcare workers are able to provide quality care in a safe environment. Global Water 2020 thanks Congress for its longstanding bipartisan support for this important work, and looks forward to continued U.S. leadership in WASH. [This statement was submitted by John Oldfield, Principal.] ______ Prepared Statement of The HALO Trust (USA) the department of state conventional weapons destruction program As the world's largest humanitarian demining NGO, The HALO Trust submits this testimony as a partner of the U.S. Government in addressing threats to peace, security, and human lives posed by improvised explosive devices (IEDs), landmines, unexploded ordnance (UXO), and insecure weapons stockpiles. The HALO Trust is an independent partner of the Department of State's Conventional Weapons Destruction (CWD) program. We are helping to save lives and restore livelihoods in more than 25 countries and territories. State Department humanitarian demining programs play a leading international role in preventing casualties, allowing displaced families to return to their livelihoods, supporting economic development, ensuring post-conflict stabilization, and promoting safety through securing weapons and explosive materials that could fall into terrorist hands. Our presence in remote locations across the globe has also positioned U.S. implementing partners to provide emergency relief when we are needed--whether we are called upon to provide immediate support in the wake of a natural disaster or prevent the spread of COVID-19. Given the importance of global demining and weapons security programs, we respectfully ask that you include the following requests in the FY 2022 SFOPS budget: 1. $262.85 million for the State Department's Conventional Weapons Destruction program; 2. Specific allocations for Conventional Weapons Destruction Programs in Laos, Vietnam, and Cambodia ($75 million), Sri Lanka ($10 million), Angola ($10 million), Zimbabwe ($4 million), Afghanistan ($30 million), and Nagorno Karabakh ($2 million). 3. Of funds allocated to Conventional Weapons Destruction activities in Afghanistan, $5 million should be directed to support the clearance of improvised explosive devices (IEDs) in Afghanistan. the state department conventional weapons destruction (cwd) program The State Department CWD program has many benefits, but serves three primary goals: 1) To enhance regional security by destroying and securing weapons, at risk of diversion to terrorists, insurgents, and other violent non-state actors; 2) To improve stability and prosperity by clearing landmines and unexploded ordnance (UXO) contamination, thereby returning land to safe and productive use; and 3) To promote US foreign policy.\i\ Saving lives The most obvious benefit of CWD programs is saving lives. The Landmine Monitor recorded more than 130,000 casualties between 1999 and 2018, and with at least 5,554 killed or injured by a landmine or cluster bomb in 2019 alone. Most casualties were civilians, not military forces. And, tragically, 43% of the victims in 2019 were children.\ii\ Landmines continue to affect families and communities long after conflict has ended, threatening lives and disrupting livelihoods. No parent should fear that their child might suffer a fatal injury simply by walking to school or playing outside. Landmines kill indiscriminately, and we must continue to eliminate these threats. Economic Development CWD activities also promote economic development that can transform communities after conflict. Within weeks of mine clearance, displaced families can return home and plant crops. Communities can build roads, schools, hospitals, and vital infrastructure. In Sri Lanka, a woman named Jeysurajan returned to her community with her family after being displaced by conflict for almost ten years. Upon returning, Jeysurajan and her family were able to build a small home and decided to plant crops to earn an income. However, on the first day of planting Jeysurajan discovered a landmine, and then continued to unearth more around her home. Fearing for her children's lives, Jeysurajan and her family had to leave their home once again. The land around the family's home is currently being cleared, and Jeysurajan hopes to soon return home and grow crops to support her family. Security and Stability in Fragile States The explosion of explosive precursor chemicals in Beirut earlier this year brought the importance of explosive and ammunition management into sharp focus. Weapons security management programs funded by the CWD account support security objectives, through ammunition storage training and the destruction of insecure weapons, such as shoulder- launched missiles capable of downing aircraft. Since 1973, over 60 civilian airliners have been hit with these types of air defense systems.\iii\ State Department partners have secured over 41,000 shoulder-launched missiles, ensuring that these deadly weapons cannot fall into the hands of arms traffickers and violent extremists.\iv\ In the Northern Triangle, weapons and ammunition security management programs also help to combat the illicit flow of black-market weapons that fuel violence and emigration. Countering Malign Chinese Influence The State Department's CWD program helps counter Chinese influence by providing local jobs and serving as a highly visible form of popular U.S. assistance. While China uses debt trap financing to seize control of national assets in Africa, Southeast Asia, and elsewhere, US demining programs work in these same regions to take land that is currently too dangerous to use and transform it into an economic asset available to impoverished local populations. Every day, thousands of deminers with U.S. flags on their chests provide an unquestionably positive service to communities. supporting cwd programs in laos, vietnam, cambodia, sri lanka, afghanistan, angola, zimbabwe, and nagorno karabakh Laos, Vietnam, Cambodia Laos remains heavily impacted by U.S. cluster bomblets as the most heavily bombed country in history. Funding is needed to support the removal of U.S.-origin UXO, as well as capacity-building, survey, clearance, victim assistance, and risk education programs to reduce the impact of UXO on school children and communities. Clearance of U.S. legacy ordnance in Vietnam has significantly contributed to our growing strategic partnership, in addition to preventing casualties. Increased funding will expedite the removal of ordnance, eliminating these explosive hazards that still contaminate an estimated 25,500 square miles of land in Vietnam. Cambodia continues to suffer the impacts of significant landmine contamination from U.S. cluster bomblets and other explosive hazards. Additional resources are needed to remove U.S. legacy ordnance and support risk education programs to minimize the deadly impact of UXO on communities. Funding at a level of $75 million for these three countries combined will allow the U.S. to demonstrate its commitment to removing the deadly remnants of its war arsenal, while providing the State Department with flexibility to spend CWD funds within this region to maximize impact. Sri Lanka Since the end of Sri Lanka's decades-long civil war in 2009, U.S. demining assistance has been critical to allowing thousands of families displaced by the war to return to their homes in northern and eastern provinces. U.S. demining efforts have also enabled the reopening of schools and hospitals, the reconstruction of thousands of homes, as well as the reconstruction of the Jaffna railway--enabling access to Sri Lanka's northern ports. Hundreds of thousands of mines have already been destroyed, and an allocation of $10 million will keep Sri Lanka on track to be mine-impact free in the near future. Angola Landmines in Angola have injured more than 80,000 people since they were first used in its civil war, but with the help of U.S. foreign aid, nearly 100,000 landmines have been destroyed. Demining must continue, especially in the rural areas of Angola, where some communities have been waiting decades for assistance. Funding at a level of $10 million for demining in Angola is also necessary for the U.S. to implement The DELTA Act, legislation passed in December 2018 in support of wilderness management in the Okavango Delta region. In southeast Angola, landmines near the headwaters of the Okavango Delta kill elephants and other wildlife, hamper efforts to conduct biodiversity research, and interfere with anti-poaching initiatives. The Angolan Government has already provided $18 million last year to support demining in two national parks in this area, as part of its $60 million pledge for demining in the region. This sizeable investment presents a unique opportunity for the U.S. and Angola to strengthen their partnership while supporting human safety and the development of a conservation economy in Angola. Zimbabwe Zimbabwe possesses very dense, unfenced minefields close to houses, schools, and clinics that kill livestock weekly and separate communities from viable sources of water. Over 1,600 casualties\v\ have occurred due to explosive hazard accidents. Due to the predictable mine-laying patterns along the Zimbabwean borders, demining teams in Zimbabwe have one of the highest mine-destruction rates of any global program. Supporting $4 million for CWD programs in Zimbabwe will allow the country to achieve mine-free status as quickly as possible. Afghanistan In Afghanistan, the demining sector has the capacity to support security by clearing massive amounts of landmine and other explosive contamination that threaten civilians, aid workers, and the Afghan National Defense and Security Forces (ANDSF). Funding at a level of $30 million can also support stability through reintegration efforts. The demining sector has successfully employed former-Afghan local police and demobilized ex-combatants as deminers, thus removing incentives for people to return to the fight. The presence of IEDs in Afghanistan has presented a particular danger to civilians and military personnel. Afghanistan contains over 5,400 acres of known IED contamination, and, IEDs have caused nearly 80% of civilian casualties from explosive devices in the past 10 years. Currently, U.S. humanitarian demining funding does not directly support the clearance of IEDs in Afghanistan, though these items continue to represent a greater humanitarian threat as compared to other explosive contamination in the country. An allocation of $5 million of CWD funds allocated to Afghanistan focused on the clearance of IEDs would further support safety in the country. Nagorno Karabakh In Nagorno Karabakh, a territory located between Armenia and Azerbaijan, residents have suffered from the threat of landmines for almost 30 years. The recent conflict in Nagorno Karabakh resulted in massive levels of contamination by cluster munitions, rockets, and other explosive ordnance. These hazards continue to present a grave humanitarian risk as explosives are still present near homes, farms and streets. In addition, these remnants of war remain an obstacle to rebuilding critical infrastructure decimated during conflict. U.S. funding for demining in Nagorno Karabakh ended in March 2020 and no funding is currently planned. An allocation of $2 million in FY22 will allow ordnance removal activities to scale up and ensure families can return to their livelihoods without fear of explosive threats. conclusion Since 1993, the U.S. has led global demining efforts, providing more than $4 billion in assistance to more than 100 countries for CWD activities.\vi\ With U.S. support, over 15 previously mined countries and territories around the world are now mine-free. We hope to see many more countries soon join this list. U.S. demining and weapons security programs save lives, enable stabilization and rebuilding after countries have been ripped apart by conflict, enhance security, and promote U.S. interests while making a tangible difference in the lives of communities worldwide. For these reasons, we hope the subcommittee will support strong funding for the State Department CWD program, for CWD programs in Laos, Vietnam, Cambodia, Sri Lanka, Angola, Zimbabwe, Afghanistan, and Nagorno Karabakh. Thank you for your consideration. --------------------------------------------------------------------------- \i\ U.S.A., Department of State, Office of Weapons Removal and Abatement in the Bureau of Political-Military Affairs. (2020). The United States' Commitment to Conventional Weapons Destruction (19th ed., January-December 2019, p.5). Waynesboro, VA: McClung Companies. \ii\ International Campaign to Ban Landmines. (2020, November 12). Landmine Monitor 2020: Major Findings. Retrieved from http://www.the- monitor.org/en-gb/reports/2020/landmine-monitor-2020/major- findings.aspx \iii\ U.S.A., Department of State, Office of Weapons Removal and Abatement in the Bureau of Political-Military Affairs. (2020). The Interagency MANPADS Task Force: Building Partnerships to Protect Civilian Aviation (19th ed., January-December 2019, p.62). Waynesboro, VA: McClung Companies. \iv\ Ibid. \v\ Zimbabwe. (2017, January 2). Retrieved from http://www.the- monitor.org/en-gb/reports/2019/zimbabwe/casualties.aspx \vi\ U.S.A., Department of State, Office of Weapons Removal and Abatement in the Bureau of Political-Military Affairs. (2021). A Message from Assistant Secretary Timothy Alan Betts (20th ed., January- December 2020, p.3). Waynesboro, VA: McClung Companies. --------------------------------------------------------------------------- [This statement was submitted by Chris Whatley, Executive Director.] ______ Prepared Statement of the Helen Keller International Mr. Chairman: I am Kathy Spahn, President and Chief Executive Officer of Helen Keller International, and it is a pleasure to provide testimony to the Committee on critical programs in global health. I urge the Committee to recommend in fiscal year 2022, under the U.S. Agency for International Development's (USAID) Global Health Programs and Development Assistance accounts, at least $4.5 million for blind children; at least $22.5 million for vitamin A supplementation; $200 million for nutrition; and $984 million for the Maternal and Child Health account. I also urge the Committee to support increased funding of at least $25 million over the fiscal year 2021 appropriated level of $102.5 million for the control and elimination of Neglected Tropical Diseases. Finally, under the Development Assistance account, I request that the Committee continue strong support for nutrition and agriculture, and support for women farmers. For more than a century, Helen Keller International has saved the sight and lives of millions. Today, we are as determined as ever to accomplish even more on behalf of children and adults in developing countries, especially given the COVID-19 pandemic and its devastating secondary impact on nutrition and healthcare. Helen Keller International has programs in 19 countries in Africa and Asia, as well as here in the United States. Co-founded in 1915 by the deaf-blind advocate for the poor and marginalized, Helen Keller, Helen Keller International is a leading nonprofit organization that helps the most vulnerable people in the world to achieve their true potential. We fulfill this mission by designing and implementing programs, based on science and local collaboration, that save lives, improve sight, and improve nutrition for over 300 million people each year. But the need is still enormous. helen keller international response covid-19 In many parts of the world, the coronavirus pandemic has overwhelmed clinical services and brought economies to a standstill. Helen Keller International provides sight and life-saving preventive health services to tens of millions of people in Africa and Asia. Our services are focused on people who are most vulnerable: young children, pregnant women and nursing mothers, subsistence farmers, and communities suffering from diseases of poverty, including preventable blindness and malnutrition. Our work is already being affected by the COVID-19 pandemic: approximately 60 percent of programming has been paused or slowed. For example, campaigns to treat neglected tropical diseases and provide vitamin A supplementation were postponed in Africa in 2020. In short, the pandemic is not only creating new problems and risks--it is also exacerbating existing ones. Helen Keller is currently focused on addressing three imminent dangers posed by the pandemic: the COVID-19 disease itself, other diseases, and hunger. We are communicating with millions of people in communities throughout Africa and Asia about steps that individuals and households can take to minimize their risk of contracting the coronavirus and other communicable diseases. Where possible, we are doing so through a vast network of community health workers. For example, in Nepal, a country with high rates of mobile phone ownership, we are using phone calls, texts, and social media to reach more than 600,000 people. Helen Keller is also supporting the provision of basic water infrastructure. People cannot take measures to wash their hands frequently if they do not have the means to do so. In seeking to address this basic need, Helen Keller helped to install thousands of handwashing stands and provided soap in Mali, Niger, and Senegal. We have continued our longstanding commitment to vitamin A supplementation (VAS), an intervention that Helen Keller International pioneered, and that has saved millions of lives over the past 40 years. To protect populations from the potentially catastrophic impact of exposure to COVID-19, we had to minimize large gatherings and close contact, therefore, mass vitamin A supplementation campaigns were postponed until the second half of 2020. This disruption put hundreds of thousands of already vulnerable children at even greater risk for disease, but we have successfully adopted revised VAS distribution protocols to minimize COVID-19 risk while maximizing vitamin A's life- saving benefit. We have achieved this by delivering VAS house-to-house, employing COVID-risk mitigation measures including social distancing, masking, use of hand sanitizers and, where possible, virtual training of health workers. The coronavirus outbreak is already impacting the economic well- being and food supply of millions of people in countries where we work. Helen Keller is taking a diverse, comprehensive range of actions, adapted to each context. In Cameroon and Bangladesh, we are distributing food and cash vouchers. In Senegal, we are expanding an existing program that targets malnutrition among children to serve entire communities with locally produced enriched foods. In Mozambique, we are providing farmers with seeds and training so they can increase their food supply. Like many of our partners, we recognize the need to simultaneously contain the virus and address its economic, health, and nutritional consequences. neglected tropical diseases (ntds) I am deeply concerned about the recently announced decision by the U.K. Foreign, Commonwealth, and Development Office (FCDO) to withdraw UK support to global Neglected Tropical Disease programs as part of drastic cuts to their overall development assistance. Neglected Tropical Diseases impact the world's most vulnerable people. This group of diseases blind, disfigure, and disable people in the poorest areas of the world--keeping them in a cycle of poverty. The US and UK have had a strong and highly successful partnership since 2012 in the global effort to eliminate Neglected Tropical Diseases. The UK cut of approximately $114 million USD for the elimination and control of the highest burden NTDs threatens the tremendous progress made to date--especially the global elimination of trachoma, a disease that causes chronic suffering and irreversible blindness. FCDO was co-investing with USAID to support NTD programs in 15 countries. This abrupt cut (of approximately $114 million USD) will result in immediate gaps and will threaten the achievement of USAID- supported control and elimination goals. FCDO funding in 2021/22 was targeted to provide: --Over 270 million NTD treatments --50,000 surgeries to prevent blindness from trachoma --35,000 corrective surgeries for hydrocele (caused by lymphatic filariasis) Now more than ever, I urge the Committee to continue the leadership of the United States in tackling Neglected Tropical Diseases by supporting increased funding of at least $25 million over the fiscal year 2021 appropriated level of $102.5 million for NTDs. This additional investment will not cover the gaps left by the UK withdrawal, but will serve to protect the US investments made to date, particularly those for the elimination of lymphatic filariasis, blinding trachoma, and onchocerciasis (River Blindness). blind children Your Committee has consistently supported a program for blind children in developing countries. In partnership with USAID, the program has helped to save the sight of hundreds of thousands of children. Blind and visually impaired children who live in poverty in developing countries must depend on their families-many of whom can barely afford to feed themselves-and on government health systems which, in most cases, cannot provide much help. These children are at grave risk of being in ill health, poorly educated and less productive if they lack access to critical eye health and rehabilitation services. Most of these children do not need to become blind or visually impaired since highly effective preventive and curative measures are available to combat visual impairment in children. For example, we can prevent blindness from vitamin A deficiency for pennies a child. We can also help students to see a blackboard clearly for the first time and to fulfill their educational potential by establishing systems for school-based vision screening and the provision of sight restoring eyeglasses. We request the Committee recommend at least $4.5 million in funding for programming to addressing blindness and visual impairment in children. vitamin a deficiency With the past support of USAID, Helen Keller has become a recognized leader in distributing vitamin A capsules to children in countries across the world. Vitamin A is essential for healthy eyesight and the optimal functioning of the immune system protecting children from life-threatening diseases. Providing vitamin A to children between the ages of six months and five years reduces the risk of mortality by up to 23 percent overall and helps prevent disease, visual impairment and blindness. While vitamin A supplementation saves the lives of millions of children each year, considerable need remains unaddressed. Continued support is needed to address the more than 100,000 child deaths that still occur annually due to vitamin A deficiency. Vitamin A programs are a proven and cost-effective way to prevent visual impairment and blindness in children and to save lives, therefore we request that the Committee recommend at least $22.5 million for vitamin A supplementation. food security, nutrition and maternal and child health Malnutrition remains a major public health crisis globally. It results from not only having enough food, but not having enough of the right food. Nearly 145 million children's growth is underdeveloped due to chronic malnutrition, and this often has lifelong consequences including stunted growth, being more prone to infection and premature death, performing worse in school, being less productive, and earning less than their non-stunted peers. Helen Keller International supports the continuation and expansion of nutrition programs to support infants, young children and women of reproductive age. I ask that the Committee recommend $200 million under the nutrition-specific account within global health programs for fiscal year 2022. With this forward-looking commitment, the United States will continue to be a valued global leader in combating the scourge of malnutrition. By doing so, the United States will also, as it has in the past, spur additional essential investments by other countries and donors. I urge the Committee to continue its support and Committee report language on a food security and agricultural strategy that includes improvements in nutrition (with measurable outcomes) as a central objective, and specifically focuses on supporting smallholder families, particularly women farmers and other vulnerable populations. These investments in agriculture can increase food availability and access, improve food security, increase dietary quality, raise incomes, and empower women. It will go a long way to mitigating the impact of COVID- 19 on a generation of young children. Over the past 50 years, thanks in part to programs financed under the USAID Maternal and Child Health account (MCH), the global child mortality rate has been cut in half. However, every year more than six million children under five years old (more than 15,000 each day) continue to die from mostly preventable causes. Funding under the MCH account is essential to reach and save more of those children and their mothers. Thank you for your consideration of my testimony and recommendations for support. [This statement was submitted by Kathy Spahn, President and Chief Executive Officer.] ______ Prepared Statement of the Institute of International Education On behalf of the Institute of International Education, I am pleased to submit testimony in support of the Fulbright Program ($304 million) and the Benjamin A. Gilman International Scholarship Program ($16 million), both of which are funded by the Department of State, Educational and Cultural Exchange Programs, and implemented by the Institute of International Education. I am also pleased to submit testimony on the IIE-Scholar Rescue Fund. The Fulbright Program, operating continuously for 75 years, is the flagship U.S. government sponsored international exchange program-- supporting Americans to study, conduct research, and teach English overseas, and foreign students and scholars who contribute to U.S. universities and communities, while furthering their scholarship. No program reaches as many corners of the world or the United States as the Fulbright Program does. We are seeking the Committee's support for a total funding level of $304 million in FY2022. The Fulbright Program has demonstrated its unique capacity to adapt quickly to global challenges, while engaging diverse audiences in the U.S. and 160 countries around the world. Even in the midst of a pandemic, we know the Fulbright Program is resilient. While most international mobility has been paused, Fulbright continues to operate in person enabling future leaders the opportunity to make the global connections needed to solve problems. Increased funding of $30 million would support up to 1,000 additional grant opportunities, to engage more Americans, more U.S. colleges and universities, and more diverse communities at a time when re-engagement with the post-pandemic world is critical. Over the past year, the number of applicants for both the U.S. Student and Scholar Programs has increased by more than 10%. A funding increase of roughly 10% could help meet this pent-up demand and enable Fulbright to expand into priority areas. Additional funding would allow the U.S. to build upon proven models of the Fulbright Program to address pressing issues like climate change, democracy building, and countering disinformation and undue foreign influence. The Program operates where others cannot, fostering goodwill toward America, and establishing a scholarly network where research and development can flourish. Last year, 95% of Fulbright Scholars (Visiting and U.S.) felt their participation in the Fulbright Program promoted international cooperation and strengthened global ties, while 96% of Fulbright Visiting Scholars felt more positively about the U.S. Similarly, 90% of Fulbright Students (Foreign and U.S.) believed that the Fulbright Program helped strengthen relations between the U.S. and its partner nations, and 98% of Fulbright Students shared their experience with others in their home or professional community. The Fulbright Program advances U.S. diplomatic and national security interests, builds bilateral ties and brings in resources from foreign governments and the private sector that significantly leverages this appropriation. Over 80 foreign governments contribute nearly $100 million annually, with 30 foreign governments matching or exceeding the U.S. government's annual contribution. Increasing U.S. contributions to the Fulbright Program will only compound this unique bilateral financing model and lead other donors to increase their contributions proportionally, substantially increasing the impact of program. The Fulbright Program has a significant benefit to U.S. citizens and our economy. Today's Fulbright Program includes students and scholars from all U.S. states and territories. Nearly 1,300 U.S. higher education institutions--half of which are public and over 125 of which are minority-serving institutions--are both hosting and/or sending Fulbright students and scholars. Through a Fulbright experience, thousands of Americans each year, including many first-generation college students, gain skills and global knowledge that advance their careers. The Program provides U.S. Embassies with a platform for positive engagement with government and civil leaders and acts as a catalyst to attract foreign students to study in the U.S. at colleges and universities in all 50 states--topping one million students since 2015. Funding for foreign Fulbright students and scholars is spent inside our borders, bringing significant revenue to American colleges and universities and to their local communities. Some 4,000 visiting Fulbright students and scholars were on their grants during the spring semester of 2020 and remained in the US for the remainder of the academic year. Including foreign Fulbrighters, international students studying in the United States spend approximately $40 billion on U.S. goods and services annually and created over 400,000 U.S.-based jobs last academic year. Fulbright alumni, totaling nearly 400,000, have become leaders and contributed greatly to society--including 37 current or former heads of state or government, 60 Nobel Laureates, 88 Pulitzer Prize winners, 75 MacArthur Foundation Fellows, 16 Presidential Medal of Freedom recipients, and thousands of leaders across the private, public and nonprofit sectors. The Fulbright Program creates an unparalleled sphere of influence--future leaders who benefited from U.S. higher education and gained understanding of American communities and our people. This past year, due to COVID-19, the US Scholar Peer Review and US Student National Screening Committees, which represent all institution types and a range of backgrounds in a variety of disciplines, pivoted to a virtual review format and hosted over 315 committees with nearly 1,000 reviewers participating from over 400 institutions. Foreign applicants are among the most highly vetted students and scholars coming to the United States. These students are reviewed and nominated by a bi-national U.S.-foreign government Fulbright board or U.S. Embassy, approved by the presidentially appointed Fulbright Foreign Scholarship Board, meet rigorous academic requirements for admission by a host U.S. university, and undergo the U.S. State Department's standard consular visa screening. Fulbright's sustained commitment to increased institutional diversity makes the Program more inclusive and accessible to nontraditional applicants. The HBCU Institutional Leaders Initiative recognizes HBCUs that have demonstrated support for Fulbright Program opportunities on campus. The commitment to diversity and inclusion is also highlighted in the expansion of the network of Fulbright Student and Scholar campus representatives at U.S. colleges and universities to serve diverse populations underrepresented in education abroad and competitive fellowships, and in the prioritization of outreach to Minority-Serving Institutions (MSIs), community colleges, higher education institutions in rural and economically disadvantaged areas, and military academies. Currently, over 1,700 U.S. higher education institutions have a Fulbright campus representative, including more than 350 MSIs and 300 Community Colleges. Fulbright takes steps to ensure that the Program's diverse participants have successful and rewarding exchange experiences. The Program has made an investment in initiatives and structures to support diverse participants' inclusion, safety, and security while on program, which includes the hiring of regional diversity and inclusion liaisons, stationed abroad, as well as support for various internal and alumni working groups. This whole of program alignment helps to bolster the diversity of people interested in international careers, such as the U.S. diplomatic corps. In FY19, Congress expanded the Program's commitment to American national security by creating the John McCain Fulbright Scholar in Residence Fellowship for international faculty in national security fields in selected countries to be placed at Federal Service Academies and think tanks. The United States Naval Academy will host two Fulbright McCain Scholars-in-Residence who will contribute to the Academy's internationalization efforts, bringing expertise in the Baltics and the Indo-Pacific. From its inception, the Fulbright Program has benefited from bipartisan Congressional support. During the last several years of pressure on the Federal budget, Fulbright has proven its value to the U.S. and our relationships internationally. While there are many competing demands and worthwhile investments for the Federal government, Congress has the opportunity this year to expand the Fulbright Program into priority areas to further connect the next generation of leaders from around the world, such as making Fulbright more inclusive by reaching more diverse participants, building on initiatives in priority regions that relate to combatting climate change, and securing the 75-year legacy of this important foreign policy tool. The Benjamin A. Gilman International Scholarship Program enables undergraduate students of limited financial means to study or intern abroad, thereby gaining skills critical to our national security and economic competitiveness. The award is solely reserved for American undergraduate students who are eligible for a Federal Pell Grant. Since the program's inception in 2001, more than 33,000 undergraduate students from 1,335 universities across the nation have received a Gilman scholarship to study in more than 150 countries. More than 12,000 applications are received annually for less than 4,000 scholarships. By supporting undergraduate students who have high financial need, the program has been successful in supporting students who have been historically underrepresented in education abroad and expanding access throughout the country. In light of the pandemic, the Gilman Program supported alternative, credit-bearing virtual study abroad programming while in-person travel was unavailable and offered increased flexibility to defer or change their programs, supporting students' continued international engagement and academic progress. Gilman Scholars are more diverse than the national study abroad population. Sixty-nine percent of Gilman Scholars represented racial or ethnic minority groups, compared to a 30% national average for study abroad. Gilman scholars represent more than 1,300 U.S. higher education institutions. Twenty-two percent of recipients are from HBCUs, other minority-serving institutions or community colleges. Further, 57% of recipients are first-generation college students. The Gilman Program is critical to our national security and economic competitiveness. Of Gilman recipients, 29% are studying STEM subjects, and 56% study a language--35% study Critical Need Languages. The Gilman Program continues to demonstrate a commitment to our Armed Services. Preference is given to Veteran applicants, who have been awarded scholarships at twice the rate of total applicants for the Program. With the support of the U.S. Congress, the Gilman-McCain Scholarship supports undergraduate child dependents of active-duty service members to study or intern abroad on credit-bearing programs. In addition, Gilman Scholars positively impact their communities while carrying out follow-on service projects that aim to inform and encourage more American students to study and intern abroad. They serve as influential role models by their exemplary achievement through their international exchange experience, and many continue to pursue advanced degrees and are active in seeking solutions to global challenges. This makes it all the more urgent that Congress invest in our national security and economic prosperity by fully funding the Benjamin A. Gilman International Scholarship Program. We support maintaining the FY21 funding level of $16 million to continue to make study abroad available to more Americans. iie's scholar rescue fund Protecting the lives and work of threatened scholars has always been at the core of IIE's mission. This legacy dates to 1920, when the leaders of the newly founded IIE created the Russian Student and Scholar Fund to provide emergency assistance to hundreds of university students and scholars caught in the crossfire of the Bolshevik Revolution and Stalinism. Since then, IIE has led special efforts to support academics in need during every decade. In 2002, IIE established the Scholar Rescue Fund (IIE-SRF) to ensure that emergency support and academic opportunities would always be available to academics whenever and wherever they may be in danger. Nearly 20 years later, IIE-SRF remains the only global program that arranges and funds fellowships for threatened and displaced scholars at partnering higher education institutions worldwide. It has saved the lives and scholarship of over 900 scholars from 60 countries in partnership with more than 430 hosting institutions in 50 countries. Despite the devastating impact of the COVID-19 pandemic on higher education institutions and communities worldwide, IIE was able to continue assisting vulnerable scholars throughout 2020 and the initial months of 2021. During the period of April 1, 2020, through March 31, 2021, IIE-SRF supported more than 100 scholars from 22 countries to resume their academic work in safety on host campuses in 23 countries across five continents. These scholars have exhibited remarkable resilience throughout the pandemic as they continue to share their expertise, advance scientific knowledge, and struggle for more just societies. IIE-SRF's university partners have also demonstrated their ongoing commitment to providing critical practical support to threatened academics across the globe, despite budget cuts and other challenges. The work of IIE-SRF is more pertinent today than ever before. In diverse contexts across the globe, professors and researchers are living amidst the world's worst conflicts and repressive regimes, resulting in threats to their physical security, the indefinite interruption of their scholarly work, and the endangerment of entire disciplines in particular countries. In 2020, IIE-SRF received more requests for support than any year in its history. These applications reflect an alarming number of threats to scholars in such diverse contexts as Afghanistan, Belarus, Burma/Myanmar, Cameroon, China, Ethiopia, Iran, Syria, Turkey, Venezuela, and Yemen, among other countries. Yemen faces the world's most urgent higher education crisis, with widespread violence, disease, and instability threatening university professors and making education and scientific research unattainable. Nearly half of all applications to IIE-SRF in 2020 came from Yemeni academics. The program responded by awarding more fellowships to scholars from Yemen than the next three countries combined. By keeping these scholars safe and productive in academic roles across the globe, IIE-SRF is preserving and enhancing Yemen's intellectual capital--the ``brain save'' of the country's best and most promising professors and scientists until it is safe for them to return. If these scholars do not receive support now, many lifetimes of work--and potentially the entire Yemeni academy--will be lost, with a catastrophic impact on generations to come. When sectarian and other violence in Iraq was at its worst in recent years, IIE-SRF launched the Iraq Scholar Rescue Project (ISRP), a public-private partnership, funded in part through the Department of State, which saved the lives of hundreds of Iraqi scholars. Devastatingly, IIE-SRF is preparing for an Iraq-style avalanche of applications from threatened scholars in Afghanistan, which is likely to become the world's next higher education emergency. With the scheduled withdrawal of U.S. troops in September 2021, experts predict that countless Afghan university students and scholars will face severe threats from the Taliban. This is particularly true of scholars connected to U.S. institutions and alumni of U.S. government-funded exchange programs, religious minorities, democracy and human rights advocates, and especially women. Drawing on the success of the ISRP, there is already an established program that has the global networks, tested model, and reliable track record to respond to a looming crisis of this scale. The impact of IIE's work to rescue scholars extends well beyond the immediate lives saved. There are many examples, historical and current. During the 1930s, IIE's Emergency Committee in Aid of Displaced Foreign Scholars supported Dr. Felix Bloch, a physicist who had fled Nazi Germany, to continue his scientific research at Stanford University. Bloch's research on nuclear magnetic resonance would later be applied to develop the MRI and earned him the Nobel Prize. More recently, IIE- SRF partnered with institutions in South Africa and Kenya to provide safe haven and research opportunities to Nigerian virologist Dr. Marycelin Baba during the height of the Boko Haram attacks on Maiduguri, Nigeria. When the situation in Maiduguri improved, Baba returned to direct her home university's World Health Organization- accredited Polio lab. She has played a direct role in eradicating the disease in Nigeria. In April 2021, IIE published a study documenting the achievements and impacts of more than 200 IIE-SRF alumni from 38 countries on their home countries, host communities, and academic disciplines. To Rescue Scholars is to Rescue the Future: An Impact Study of the IIE Scholar Rescue Fund (2002-2020) offers concrete evidence of the enduring influence of the IIE-SRF fellowship on these scholars' lives and careers, as well as the sizeable impacts they have made in their classrooms, laboratories and beyond. Thank you for the opportunity to submit testimony before this committee. [This statement was submitted by Allan E. Goodman, President and CEO.] ______ Prepared Statement of the Interaction Chairman Coons, Ranking Member Graham, Members of the subcommittee, thank you for receiving my testimony concerning the FY 2022 State, Foreign Operations, and Related Programs bill. My name is Sam Worthington, and I represent InterAction, where I am CEO. On behalf of the InterAction coalition, I thank the subcommittee for its leadership and support for foreign assistance programs. In my testimony, I will highlight the challenges we are facing and the importance of investments in development, humanitarian, and democracy programs. We recommend increases above the FY 2021 enacted levels for 46 accounts in the State, Foreign Operations bill, which are too numerous to list here, but I have included in a table at the end of my testimony.\1\ InterAction is the largest alliance of international NGOs and partners in the United States. Our members work to eliminate extreme poverty, strengthen human rights and citizen participation, safeguard a sustainable planet, promote peace, and ensure dignity for all people. Since 1984, InterAction has helped mobilize hundreds of international NGOs to think and act collectively, enabling a collective NGO voice to promote more principled and effective development policies and humanitarian action. Choose to Invest, a product created by InterAction and its members, provides the Administration, Congress, and other interested stakeholders with funding recommendations and justifications for 52 programs covering development, democracy building, health, and humanitarian assistance-46 of which are funded in the State, Foreign Operations bill. I will highlight a few critical challenges facing the world right now and the importance of investment in these areas. Every day, InterAction members see how U.S. foreign aid saves lives. American foreign assistance helps communities around the world as they work to end extreme poverty, assist refugees and internally displaced people, support the advancement of human rights, promote resilient democratic societies, and spur inclusive economic growth. Foreign assistance builds economies, supports peace, and advances American values. Investing in foreign assistance is a strategic and moral imperative for the United States. With forced displacements consistently rising, democracy backsliding, and inequality growing, investment in this critical foreign policy pillar did not keep pace with global need even before the pandemic. COVID-19 then triggered the deepest global recession since the 1930s, exacerbating these trends and setting back global poverty reduction efforts-communities around the world will be grappling with setbacks for years to come. InterAction appreciates the supplemental funding Congress provided to fight COVID-19 internationally. However, the United States needs to investment more to speed the end of the COVID-19 pandemic, minimize its indirect impacts, and make up for insufficient funding for global needs in the past. To address these issues and the rising challenges facing the world, InterAction is recommending significant funding increases above the FY 2021 enacted levels and the President's Request in many accounts. This year we are especially focused on accounts related to COVID-19, displaced people, climate change, and democracy. Development. The need for increased funding for Development Assistance and the Economic Support Fund has never been greater. As the subcommittee knows, COVID-19 created an economic shock that has ruined livelihoods, intensified food insecurity, disrupted education, increased vulnerability for women and children, and exacerbated inequality. The World Bank estimates that nearly 40 to 60 million people have been pushed into extreme poverty because of COVID-19, undermining decades of progress. It is estimated that half of the world's 3.3 billion global workforce are at risk of losing their livelihood. People who work in the informal economy have been the most vulnerable as many do not have access to social protection or quality health care. Global Food Security Strategy programs, including Feed the Future, have strategically adapted to meet new and existing needs in the context of COVID-19. However, there is still significant unmet need and the number of people living in hunger continues to rise. Water, sanitation, and hygiene (WASH) programs are significantly underfunded given their importance in overall health, nutrition, and political stability. Nearly 2.2 billion people still do not have safe sanitation access, while about 2 billion do not have access to a safely managed water source. The pandemic has only compounded access issues and reinforced the need to improve global WASH access. Increased support for Basic Education will provide children in marginalized communities with safe and equitable access to quality, inclusive education. Due to COVID-19, many education systems will also need assistance in designing and instituting remedial education programs to address school closure-related learning loss. In addition, more than 1.5 billion students and youth have been impacted by school closures, and at least 463 million schoolchildren cannot be reached by digital and broadcast remote learning programs. Increased funding for Democracy, Human Rights, and Governance is critical to ensure countries are equipped to handle the challenges of maintaining sustained development, particularly with marginalized groups in light of COVID-19. Without strong political institutions and governments responsive to its citizens' needs, efforts to maintain other areas of development and growth of civil society are at a greater risk of failure. On average, countries undertaking the process of democratization experience a 20% increase in GDP over a 25-year period. In addition, democracy can better ensure the rights and participation of largely disenfranchised groups within society--critical as countries adapt to climate change. The condition of human rights and democracy has worsened in 80 countries since the pandemic began. In the wake of COVID-19, disinformation can spread, crackdowns on civil society have persisted, democratic backsliding increased, and autocratically minded leaders continue to undermine democratic norms. It is vital that Congress increases funding for vulnerable populations. For LGBTQI+ people around the globe, violence, stigma, and discrimination undermine access to services, and nearly 70 countries continue to criminalize same-sex relationships. Increased funding for the State Department's Global Equality Fund and USAID's Protection of LGBTQI+ Persons will promote global LGBTQI+ rights and support decriminalization efforts, build the capacity of LGBTQI+ civil society, and provide safety and security grants to LGBTQI+ human rights defenders. Global Health. Increased investment in all areas of Global Health is needed to combat not only COVID-19, but also the impacts of the pandemic on overburdened, fragile health systems and the people they serve. The pandemic has disrupted and damaged routine medical care around the world. Attention to traditional ongoing global health issues, including tuberculosis, HIV/AIDS, nutrition programs, malaria, neglected tropical diseases, and maternal and child healthcare has in many cases fallen by the wayside in the wake of the pandemic as already overburdened healthcare systems struggle to keep the spread of disease under control. Due to COVID-19 related disruptions, an additional 124,000 children are projected to be infected with HIV and acute child malnutrition may increase by 50% for children living in poverty. UNICEF has estimated that an additional 1.2 million children will die of preventable causes. Increased funding for international family planning and reproductive health will support broader access to contraceptives and reduce the rates of unintended pregnancies, unsafe abortions, and maternal deaths. It is estimated that more than 218 million women in low- and middle- income countries want to avoid pregnancy and have an unmet need for modern contraceptives. Investment in Global Health Security programs support the prevention and detection of-and rapid response to-emerging disease threats like Ebola and COVID-19 to stop outbreaks from spreading. Increased funding is needed to build and strengthen emergency operation centers, improve systems that monitor and track outbreaks worldwide, and bolster the health workforce in affected countries. Humanitarian Assistance. Funding increases for all the humanitarian accounts, including International Disaster Assistance and Migration and Refugee Assistance are necessary to meet the increasing needs caused by COVID-19 and persistent conflict. COVID-19 magnified the threats faced by nearly 168 million vulnerable people in need of humanitarian assistance and protection around the world. The pandemic overwhelmed health systems as health impacts combined with conflict, political, and economic instability. The continued spread of COVID-19 exacerbates existing humanitarian crises in countries like Syria and Yemen and is made worse by chronic shortages of life-saving health and hygiene interventions, as well as hunger and economic collapse. Border closures, trade restrictions, and confinement measures have prevented farmers from accessing markets and harvesting crops. The most marginalized people in low-income countries, including small-scale famers and indigenous peoples, have been the hardest hit. 270 million people could require food assistance in 2021 as the threat of famine looms over multiple countries, including Ethiopia. Violence against women and marginalized groups in humanitarian settings has been another effect of the pandemic requiring additional attention. Climate Change. Climate change is an existential threat that exacerbates inequality and poverty. It must be funded accordingly. An estimated 120 million people will slip back into extreme poverty by 2030 if we fail to tackle climate change. Left unaddressed, nearly 200 million people could require humanitarian assistance for climate- related disasters by 2050, roughly double those in need today. Nearly 90% of those who fall ill due to climate change are children under five, and by 2040, almost 600 million children will live in areas with extremely limited water resources. The world's most vulnerable people have been the first and hardest hit by climate change, are least responsible for the crisis, yet bear an enormous cost to address it. COVID-19 has both compounded these challenges in addition to revealing opportunities for progress. Increases in both bilateral and multilateral climate channels are sorely needed. Specific programming and increases directed at Adaptation are necessary to help communities prepare for environmental degradation that threatens their security and livelihoods. Increases are also needed in Sustainable Landscapes, Renewable Energy, and Biodiversity. Bold investment in the Green Climate Fund and the Climate Investment Funds will send a strong signal to the world that the U.S. will lead and follow through on its climate commitments. Multilateral Development Banks. Investment in the multilateral development banks is also an investment in climate finance. Approximately 1/3 of funds to International Development Association (IDA) support climate programming. Additionally, increased funds to clear arrears at IDA and the African Development Fund, and the Asian Development Fund will be used in the same manner as ordinary resources to fund poverty reduction and climate programming, while restoring leadership at those institutions. Prior to the COVID-19 pandemic, investment in critical foreign assistance did not meet global needs, despite foreign assistance being a strategic and moral imperative for the United States. Preexisting needs coupled with COVID-19 and the secondary impacts of the pandemic as well as the looming threat of other crises makes the criticality of increased investment in foreign assistance accounts even greater. The United States needs to do its part as a global leader to invest in helping the people and communities around the world that will be grappling with these development and humanitarian setbacks for years to come. ------------------------------------------------------------------------ ACCOUNT ($ in thousands) Recommended ------------------------------------------------------------------------ USAID Operating Expenses 1,456,981 U.S. Dpt of State Diplomatic Programs 9,628,514 U.S. Institute of Peace 47,250 Millennium Challenge Corporation 957,600 Development Finance Corporation 833,677 Development Assistance 4,200,000 Economic Support Fund 4,021,547 Microfinance 278,250 Global Food Security Strategy 1,202,614 Basic Education 1,092,500 Adaptation 265,500 Renewable Energy 268,500 Sustainable Landscapes 202,500 Biodiversity 480,000 Water and Sanitation 540,000 Democracy, Rights & Governance 2,537,850 Sec. 7059, 7046 Gender 525,700 Reconciliation Programs 40,000 Conflict and Stabilization Operations 5,000 National Endowment for Democracy 320,000 Transition Initiatives 112,043 Complex Crisis Fund 33,000 Prevention and Stabilization Fund 200,000 International Disaster Assistance 5,274,434 Migration and Refugee Assistance 4,118,400 Emergency Refugee & Migration 50,000 Assistance Maternal and Child Health 983,825 Nutrition 240,000 Vulnerable Children 30,000 HIV/AIDS (USAID) 379,500 HIV/AIDS (State) 5,025,500 Global Fund AIDS, TB & Malaria 1,560,000 Family Planning and Reproductive 750,000 Health Global Health Security 275,000 Neglected Tropical Diseases 117,875 Malaria 885,500 Tuberculosis 366,850 Int'l Peacekeeping Activities 2,701,000 Peacekeeping Operations 548,000 International Organizations and 646,500 Programs International Development Association 1,299,769 African Development Fund 224,232 Asian Development Fund 89,986 International Fund for Agricultural 46,800 Development Global Environment Facility 158,920 Clean Technology Fund 200,000 Green Climate Fund 1,000,000 ------------------------------------------------------------------------ --------------------------------------------------------------------------- \1\ A more comprehensive list of InterAction's recommendations can be found in Choose to Invest at https://www.interaction.org/choose-to- invest-fy-2022/and in the table on the final page of my testimony. [This statement was submitted by Samuel A. Worthington, CEO.] ______ Prepared Statement of the International Fund for Animal Welfare Chairman Coons, Ranking Member Graham, and Members of the Subcommittee: Thank you for the opportunity to offer testimony on the FY 2022 State, Foreign Operations, and Related Programs (SFOPS) Appropriations Act. The International Fund for Animal Welfare (IFAW) has 15 offices globally and works in more than 40 countries around the world. IFAW takes a holistic approach to innovating solutions for tough conservation challenges like conflicts between humans and wildlife, and illegal wildlife trafficking. Recognizing the unbreakable connections between the health and well-being of animals and people, we support and empower communities to coexist with and value native wildlife and help those communities develop tools to protect their wild heritage. IFAW appreciates this Subcommittee's support in the current fiscal year (FY 2021) in providing funding for many important conservation programs, and requests your continued support for the U.S. Agency for International Development (USAID) Biodiversity Programs ($500 million), the USAID sustainable landscapes programs ($200 million), Tropical Forest and Coral Reefs Conservation Act (TFCRCA) implementation ($20 million), the Global Environment Facility (GEF) ($149.3 million), and the U.S. State Department and USAID combating wildlife trafficking programs ($200 million) in the FY 2022 SFOPS Appropriations Bill. We also request support for a new fund: a new Fund for Global Health Security and Pandemic Preparedness through the CDC Global Public Health Protection USAID's Global Health Security accounts ($2.5 billion). The year 2020 was marked, as was the year before it, by ever-more disturbing news about the state of our natural world. It was the second hottest year on record, knocking 2019 to the third hottest year in Earth's history.\1\ Changing climate conditions spurred storms and other natural disasters of increased frequency and severity: hurricanes, cyclones, flash floods, and wildfires wreaked havoc in communities around the world with deadly results.\2\ Trafficking in wildlife and wildlife parts remained the fourth most lucrative criminal enterprise worldwide with an estimated annual revenue of $20 billion- add in illegal logging and fishing, and that number skyrockets to $1 trillion or more.\3\ And we all suffered the effects as a deadly zoonotic pandemic caused by human interference with wildlife, COVID-19, forced world-wide lockdowns, sickening more than 175 million people to date, and causing millions of deaths around the globe.\4\ The environmental, biodiversity, and pandemic crises we continue to face are not the product of bad luck; they are the direct results of human activities. On June 10, 2021, a report on Biodiversity and Climate Change was released on a workshop co-sponsored by the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services (IPBES) and the Intergovernmental Panel on Climate Change (IPCC)--the first ever collaborative workshop co-sponsored by the two organizations.\5\ This peer reviewed report warns that ``changes in climate and biodiversity, driven by human activities, have combined and increasingly threaten nature, human lives, livelihoods and well-being around the world. Biodiversity loss and climate change are both driven by human economic activities and mutually reinforce each other. Neither will be successfully resolved unless both are tackled together.'' \6\ Fortunately, as we have been the architects of our current crises, it is within our power to change our shared trajectory, and this Subcommittee has jurisdiction over critical programs that can help to do just that. Given the severity of the challenges we face, IFAW respectfully asks the Subcommittee to exert its leadership in order to reverse the alarming and interrelated climate and biodiversity emergencies by making substantial increases in funding for the important conservation programs within your purview. Doing so will help to protect biodiversity, and will in turn have significant protective effects against future wildlife-borne diseases entering the human population, promote healthy ecosystems, fight climate change, improve climate resilience, and safeguard human health and wellbeing in communities around the globe--including here in the United States. It will also demonstrate the United States' continued conservation leadership, and signal to the international community the importance of investing in conservation. USAID Biodiversity Programs support conservation efforts in more than 50 countries in partnership with foreign governments, non- governmental organizations, private sector companies, and local communities. Biodiversity loss, habitat destruction, and trade in wildlife are all linked to zoonotic spillover--the jump of diseases from animals into human populations--as we've seen with the COVID-19, SARS, Ebola, and other viral outbreaks. Because they protect ecosystem and wildlife health, USAID Biodiversity Programs help to shield us from spillover events. USAID Biodiversity Programs tackle threats to wildlife and ecosystems through direct actions to restore habitat and conserve species, as well as by strengthening educational programs focused on One Health. They also address underlying issues that lead to the loss of biodiversity, including improved livelihoods, countering corruption, and social and gender inequality. Because biodiversity loss exacerbates land degradation, food insecurity and poverty, it can contribute to social unrest. These USAID programs are always critical to our national security interests, economic prosperity, global stability, and global health. In the wake of economic aftershocks of the COVID-19 pandemic, they are more important than ever, and require more support to ensure past gains are not lost due to current extreme pressures. IFAW has looked at the increased need these programs face in the wake of COVID-19, the biodiversity crisis, and climate change. For FY22 we request $500 million for the USAID Biodiversity Conservation and natural resource management programs. The GEF is an independent international financial facility made up of 183 countries, private companies, and non-governmental organizations. The GEF provides grants to address global environmental issues, including wildlife trafficking, habitat and landscape preservation, and climate change adaptation. These programs focus on innovative projects in developing countries that provide real impact, improve sustainability, and protect our shared global environment. All GEF projects are closely monitored and evaluated for efficiency and effectiveness; overall, the GEF leverages more than five dollars for every one dollar invested by private partners and donor countries. The U.S. strongly influences GEF strategies and programming, and GEF projects support many U.S. security and economic priorities. IFAW requests $149.3 million in FY22 for ongoing support of the GEF, in line with the President's budget. USAID Sustainable Landscapes Programs promote sustainable land use, reducing deforestation, strengthening environmental resilience, protecting waters, and conserving biodiversity. Programs focus on target states and regions where land degradation is rampant. USAID sustainable landscapes programs have leveraged more than $500 million in investments and partnered with companies with more than $4 trillion in global sales since 2012 in order to reduce deforestation and forest degradation around the world.\7\ COVID-19 must serve as a wake-up call: protecting and restoring ecosystems is an important defense against zoonotic spillover, and we need to invest in these programs now to prevent future pandemics. IFAW therefore requests $200 million to fund the USAID sustainable landscapes programs in FY22. The TFCRCA was first enacted in 1998 as the Tropical Forest Conservation Act, and offered eligible countries the opportunity to reduce the official concessional debt they owed to the U.S. government while generating funds locally to conserve biological diversity and protect ecologically and economically vital forest ecosystems. In 2019, Congress reauthorized the Act and expanded its authorities to include coral reef ecosystems. This highly successful and innovative ``debt- for-nature'' program has produced tremendous returns on investment over the last two decades, and by supporting the long-term protection of tropical forests in developing countries, it is also contributing to efforts to address climate change, the prevention of future pandemics due to zoonotic spillover, and biodiversity loss. For FY22, IFAW requests $20 million for the TFCRCA. U.S. Department of State and USAID Wildlife Trafficking Programs crack down on the illicit trade in live wildlife and wildlife parts and products, which is among the four most lucrative criminal industries worldwide. There is clear evidence of an increase in poaching due to COVID-19--either because of food scarcity, or because of reduced anti- trafficking capacity in hard-hit areas. Sophisticated multinational criminal syndicates generate an estimated $20 billion or more annually from wildlife trafficking. Evidence has demonstrated linkages between trafficking in wildlife and other criminal enterprises, including trafficking in arms, drugs, and even terrorist activities. Therefore, disrupting wildlife trafficking networks can help to combat criminal endeavors that threaten security and stability. Congress and the Administration have directed U.S. agencies to take strong steps to address the transnational organized crime of wildlife poaching and trafficking through the END Wildlife Trafficking Act and the Transnational Organized Crime Executive Order. U.S. State Department Bureau of International Narcotics and Law Enforcement (INL) supports programs to increase the capacity of wildlife law enforcement to detect, interdict, and seize illegal wildlife products and enhance investigative and law enforcement functions of our foreign enforcement partners, among other goals. USAID supports projects to strengthen anti-poaching and wildlife law enforcement, strengthen judicial systems and rule of law, disrupt transit hubs and reduce consumer demand for illegal wildlife products. These programs are all the more significant in the wake of COVID-19. For FY22, we request $200 million for USAID/ State Department Wildlife Trafficking Programs; funds as necessary to support Wildlife Enforcement Networks, particularly in the Horn of Africa, Southern Africa, .South America, and the Caribbean; provide support for International Law Enforcement Academies; direct INL to implement international cybercrime agreements and engage in international efforts to combat wildlife trafficking online. Fund for Global Health Security and Pandemic Preparedness.--New outbreaks of diseases are accelerating nearly exponentially,\8\ driven by deforestation and trade in wild and domesticated animals. Experts agree that total annual global investments of as little as $20 billion annually to prevent and contain outbreaks will avert $31-$50 trillion in economic losses.\9,10\ Economists estimate the cost of COVID-19 borne by the United States alone to be at least $16 trillion- not counting government relief expenditures.\11\ Global costs are much higher. Even the boldest of pandemic prevention plans are modest indeed when compared to the human and economic devastation we are facing currently. Such fund is aligned with President Biden's National Security Directive 1 goal ``to develop a health security financing mechanism to . . . assist developing countries in preparing for, preventing, detecting, and responding to COVID-19 and other infectious disease threats'' and ``creating an enduring international catalytic financing mechanism for advancing and improving existing bilateral and multilateral approaches to global health security.'' \12\ Pandemic prevention and containment is a global responsibility, and the United States should not bear all the costs. IFAW requests an initial appropriation of $2.5 billion to create the Fund as a part of the Global Health Security Agenda to bring other donors to the table in advance of the UK G7 Summit.\13\ In closing, thank you for the opportunity to share IFAW's priority requests to promote conservation in the FY22 State, Foreign Operations, and Related Programs Appropriations Act. Wildlife and their habitats are more than our national heritage, they are essential to human health and happiness. We appreciate the continued support of this Subcommittee for conservation efforts globally and within the United States. With your support, we look forward to a bright and healthy future for many generations of Americans and people around the world. Thank you. --------------------------------------------------------------------------- \1\ https://www.noaa.gov/news/2020-was-earth-s-2nd-hottest-year- just-behind-2016 \2\ https://www.usnews.com/news/best-countries/slideshows/here-are- 10-of-the-deadliest-natural-disasters-in-2020 \3\ http://pubdocs.worldbank.org/en/482771571323560234/ WBGReport1017Digital.pdf \4\ https://www.washingtonpost.com/graphics/2020/world/mapping- spread-new-coronavirus/?itid=sf_coronavirus_sn_mapping-spread-new- coronavirus_2 \5\ https://ipbes.net/sites/default/files/2021-06/ 20210609_workshop_report_embargo_3pm_CEST_10_june_0.pdf \6\ https://ipbes.net/sites/default/files/2021-06/ 20210606%20Media%20Release%20EMBARGO%203pm%20CEST%2010%20June.pdf \7\ https://www.usaid.gov/climate/sustainable-landscapes \8\ https://www.wsj.com/articles/a-deadly-coronavirus-was- inevitable-why-was-no-one-ready-for-covid-11597325213 \9\ https://www.mckinsey.com/industries/public-and-social-sector/ our-insights/not-the-last-pandemic-investing-now-to-reimagine-public- health-systems \10\ https://science.sciencemag.org/content/369/6502/379 \11\ https://news.harvard.edu/gazette/story/2020/11/what-might- covid-cost-the-u-s-experts-eye-16-trillion/ \12\ https://www.whitehouse.gov/briefing-room/statements-releases/ 2021/01/21/national-security-directive-united-states-global-leadership- to-strengthen-the-international-covid-19-response-and-to-advance- global-health-security-and-biological-preparedness/ \13\ Note that SFOPs funds for GHSA pass through both CDC Global Public Health Protection, and USAID's Global Health Security accounts. [This statement was submitted by International Fund for Animal Welfare.] ______ Prepared Statement of the Internews I am honored to provide testimony on behalf of Internews to the Subcommittee on the importance of citizen access to trusted, quality, and locally relevant news and information. I urge the Committee to include language in the Committee's fiscal year 2022 report supporting continued funding under the Department of State and the U.S. Agency for International Development (USAID) for health information, internet freedom, independent media, democracy and civil society development programs. I am deeply grateful to the committee for its years of leadership on foreign assistance and democracy issues. Internews, an international non-profit organization headquartered in California, has worked to improve the flow of civic-minded, locally produced news and information for nearly 40 years. Annually, Internews supports more than 1,000 local partner organizations and institutions to strengthen the information ecosystems that make it possible for people everywhere to access quality, trusted, local information. Internews is proud to work in partnership with USAID and the U.S. Department of State in advancing our shared vision that functioning, independent media and access to information saves lives, improves livelihoods, and holds institutions accountable. Today, more than a year into the global COVID-19 pandemic, we have witnessed up close the urgency of access to timely, trusted information. Support for independent media is most thought of in the context of advancing democracy. It is indeed the ``fourth estate'' of democracy. But this past year underscored the critical importance of independent media in delivering lifesaving information during public health crises. I request the Committee: Expand support for global health, humanitarian, democracy, human rights and governance projects that support local independent media to deliver high-quality, contextually appropriate information to ensure citizens around the globe can make informed choices for the health of their families, especially during pandemics. I am very grateful for the Committee's leadership and support for programs which advance independent media, internet freedom, and overall freedom of expression. These programs are both essential for building a democratic society and are also root solutions to solving the world's most pressing issues, from pandemics to environmental degradation to extreme poverty. independent media as a centerpiece of foreign assistance Accurate information, delivered by trusted local media, is key to engaging citizens to heed public health guidance, debunk disinformation and misinformation, take action on climate change, and participate in democratic governance: --COVID-19 & Global Health: Information is the first line of defense against the spread of communicable diseases such as COVID-19. It is essential that complex, life-saving information, which is overwhelmingly produced in English, be interpreted and localized by science-savvy local journalists in all corners of the world. To address misinformation that undermines public health directives and vaccination efforts, research demonstrates the critical importance of proactively communicating accurate information through local media, which command trust in their communities. --Internet Freedom: Unfettered access to an open, interoperable, secure, and reliable internet is essential to economic development, civic participation, health, and education. While 60% of the world's population is now online, anti-democratic regimes continue to restrict access to quell political opposition. Greater support is needed to bring digital connectivity to all corners of the globe, ensure online safety for women and other marginalized groups, and protect human rights online. --Disinformation & Misinformation: Misinformation about COVID-19 and vaccines undermine efforts to bring the pandemic under control. Disinformation from bad actors undercuts the legitimacy of elections, pollutes civic debate, and stokes violence offline. A comprehensive strategy to address disinformation and misinformation requires a three-pronged approach: ensure the production and free flow of quality information; empower citizens with media literacy skills to recognize falsehoods; and establish stronger accountability mechanisms for those who create, propagate, or amplify disinformation. --Climate Change: To build the global will to meaningfully address the climate crisis, it is essential that citizens understand how climate change harms their communities. Local journalists are key to engaging their communities on the threats posed by larger and more frequent floods, wildfires, and droughts, as well as the impacts of climate change on health and livelihoods. Journalists play an equally critical role in exposing corruption and holding both the public and private sectors to account for their role in environmental degradation. --Democracy Building: Attempts to silence news media or disrupt the free flow of information on the internet have not garnered the urgent attention they deserve. Not only is a more forceful diplomatic response needed, so too is greater support for digital rights activists, citizen journalists, and independent media working to hold anti-democratic governments accountable. conclusion: building healthy information environments In these challenging times, the United States' commitment to advancing democracy and bringing COVID-19 under control around the globe cannot waver. Generous support of independent media around the world is one important way to deliver on that promise. I consistently see examples of increased accountability and real progress in changing lives and empowering people through accurate information, delivered by trusted local media. Change does not happen overnight, and the needs are complex. Beyond simply supporting press freedom and journalist safety, we must invest in promoting the sustainable business models, legal frameworks, and technical tools needed to preserve the critical role of news and information as a cornerstone of democracy. Local media, internet freedom, citizen media, and civil society institutions empower and stabilize communities while supporting American development, diplomacy, and national security goals. [This statement was submitted by Jeanne Bourgault, President and Chief Executive Officer.] ______ Prepared Statement of the Jesuit Refugee Service/USA On behalf of Jesuit Refugee Service/USA (JRS/USA), I appreciate the opportunity to present our views on the importance of investing in refugee assistance programs--including refugee education--in the FY22 State & Foreign Operations Appropriations bill. Specifically, we urge the Subcommittee to include $4.1 billion for Migration & Refugee Assistance and $1.1 billion for basic education programs, including $50 million in funding for Education Cannot Wait (ECW). While the COVID-19 pandemic has caused death and disruption across the globe, it has not diminished the need to provide safety and assistance for millions of people who have fled war, persecution, and violence. Systems that provide protection to the forcibly displaced have been tested over the last year, but we must renew our commitment to building stronger mechanisms that can withstand public health emergencies. Refugees have been at particular risk during the pandemic as they face lost livelihoods, increased poverty, further isolation, and insufficient aid. At the same time, conflicts did not cease over the past year. Violence and persecution in places like the Tigray region of Ethiopia and Myanmar have resulted in thousands of new refugees and unspeakable abuses. U.S. engagement and support for refugee assistance programs has a direct impact on the well-being of refugees and other displaced people who are often the most marginalized members of society. Now more than ever, the U.S. must once again be a leader in helping those who are at their most vulnerable. According to the United Nations High Commissioner for Refugees (UNHCR), there are 82.4 million forcibly displaced worldwide as a result of persecution, conflict, violence, human rights violations or events seriously disturbing public order. This number has steadily increased over recent years as conflict continues in many parts of the world, factors like climate change increase the vulnerability of those already forced to flee, and fewer long-term durable solutions are available to those who have been displaced.\1\ As an organization working with refugees and other forcibly displaced persons in 57 countries, we at JRS/USA understand the needs of those we serve. With support from the State Department's Bureau for Population, Refugees, and Migration (PRM), we can provide life-saving assistance and help improve their quality of life. In places like Cameroon, Iraq, and Thailand, the U.S. and JRS/USA are partnering to provide access to education, livelihoods, and healthcare for refugees who otherwise would have no place to turn. critical funding for refugees The Migration & Refugee Assistance account funds lifesaving programs and plays a vital role in asserting U.S. leadership and national interests around the world. U.S. funding--including support for UNHCR--helps meet the basic needs of displaced persons, including access to food, water, shelter, healthcare, and education. These programs assist developing countries that host 86 percent of refugees as well as countries that have significant populations that are internally displaced.\2\ Maintaining stable and humane conditions for displaced persons and host communities during early onset emergencies and protracted crises is critical for ensuring stability and security. Given that we are currently facing the worst displacement crisis on record, involving multiple complex humanitarian emergencies and a global pandemic, it is critical that support for the Migration & Refugee Assistance account remains strong. UNHCR estimates that some 76 percent of all refugees find themselves in a protracted crisis, defined by UNHCR as one in which 25,000 or more refugees from the same nationality have been in exile for five consecutive years or more in a given host country.\3\ Protracted refugee situations often receive very little public attention and ever-decreasing financial support. As a result, refugees find themselves in hopeless situations lacking opportunities for advancement and prosperity. Refugees in protracted refugee situations often face protection and human rights challenges, such as restricted movement or confinement in camps, sexual and physical violence, and lack of access to legal employment, police protection, and systems of justice. Critical support from the U.S. not only allows them to fulfill basic needs such as food, water, shelter, education, and health care, but this assistance also helps them to learn a livelihood and achieve self-reliance. Cameroon hosts over 300,000 refugees from the Central African Republic who have fled ongoing violence and instability in their home country.\4\ In partnership with PRM, JRS is providing both young refugees and members of the host community with an eight-month professional training program focused on a range of skill sets including hotel management, hair and beauty, business administration, and healthcare assistance. Students participating in the training program not only learn a vocational skill, but how to live and work side by side. It has helped to address discrimination against Central African refugees in the country and build bridges between communities while supporting young refugees as they plan their own futures. One student said, ``At the beginning I was not so sure about the idea of studying with people I didn't know, but I told myself, we can complement and assist each other.'' Not only does U.S. leadership on refugee issues send a signal for other governments to follow our example, but U.S. support for refugee assistance programs has a clear, tangible impact on people's lives--as evidenced by this kind of program. prioritizing refugee education Providing access to education for refugees and others who are forcibly displaced provides another vivid example of the impact of U.S. investment and engagement. Not only does education offer an important form of protection for children, but education also engenders hope as it prepares refugees to meet future challenges. Education provides stability and a sense of normalcy, and acts as a form of vital psychosocial support to children whose lives have been disrupted by crisis. Yet, prior to the pandemic, 48 percent of refugee children were out of school with 77 percent enrolled in primary school, 31 percent in secondary school, and only three percent in higher education.\5\ An even greater number--128 million--conflict-affected children lack educational services, denying them their right to an education and making them more vulnerable to violence, trafficking, child labor, child marriage, and recruitment by armed groups.\6\ One year into the COVID-19 pandemic, close to half the world's students are still affected by partial or full school closures.\7\ Historically, financial support for refugee education has not been a priority, but the need is arguably more important now than ever before. Continued and increased support from the U.S. Government, as well as multilateral partnerships like Education Cannot Wait and the Global Partnership for Education, play a critical role in helping forcibly displaced people build a future for themselves and the communities in which they live. In 2019, only 3 percent of humanitarian funding was allocated to education.\8\ Through robust funding of global education programs, and by ensuring that education is a core part of humanitarian assistance, we can ensure that more displaced children are gaining access to a quality education. This includes encouraging bilateral donors, multilateral entities, and corporate donors to take part in these efforts. The current U.S. Government Strategy on International Basic Education established important goals to improve measurable learning outcomes and expand access to high-quality basic education for all, particularly marginalized and vulnerable populations. In FY19, U.S. Government education programs reached more than 14.5 million children and youth in 23 countries affected by crisis and conflict.\9\ Yet, U.S. bilateral assistance cannot tackle this global challenge alone. Multilateral partnerships play an important role in building the political will necessary to create sustainable change and help bring a diverse group of actors to the table to achieve these critical goals. education cannot wait Launched in 2016, Education Cannot Wait is the first global movement and fund dedicated to education in emergencies and protracted crises. ECW gathers international humanitarian and development aid actors, along with public and private donors, to help reposition education as a priority on the humanitarian agenda, usher in a more collaborative approach among actors on the ground and foster additional funding to ensure that every crisis-affected child and young person is in school and learning. The U.S. Government has played a critical role in ECW's transformative efforts, contributing a total of $33 million in financial assistance in addition to $25 million in annual appropriations in FY20 and FY21. The U.S. also provides technical support to ECW and its partners and plays a leadership role in ECW's governance structure. This has been a collaborative effort, with USAID and PRM working together to contribute resources and share leadership responsibilities. To date, ECW has raised over $695 million from 21 donors, including the private sector. With both rapid response and multi-year funding platforms, ECW has already supported education in 39 crisis-affected countries, reaching 3.9 million children and youth and training over 46,000 teachers.\10\ ECW-supported programs span a wide spectrum of context-specific activities designed to meet education needs for crisis-affected children and youth aged 3-18 years old, including girls (48 percent), refugees, and internally displaced children. Programs are implemented through various grantees, including UN agencies, and international and national NGOs. ECW was able to mobilize its Emergency Response Fund early in the pandemic and has disbursed over $45 million in funding to support COVID-19 education response efforts. These investments have reached more than 9.3 million children and over 56,000 teachers by maintaining continuous access to education through distance, online, and radio learning; information campaigns on health and hygiene; risk communication and community engagement; psychosocial and mental health support; and water and sanitation facility upgrades in schools and learning centers. We want to extend our sincere thanks to Chairman Coons, Ranking Member Graham, and members of the Subcommittee for championing access to education for the most vulnerable, and for including $25 million for ECW in the FY20 & FY21 State & Foreign Operations Appropriations bills. By demonstrating bipartisan Congressional support for ECW and education in conflict and crisis settings, the U.S. can continue to be a leader in ensuring that youth can learn and thrive. post-secondary education for refugees As mentioned earlier, only 3 percent of refugee youth are enrolled in some form of post-secondary/higher education. This includes technical and vocational education and training as well as university courses and this percentage has remained stagnant year after year. In its Education 2030: Strategy for Refugee Education, UNHCR established a goal of increasing the refugee enrollment rate in higher education to 15 percent by 2030.\11\ Through our programs, JRS has found that there is a significant need for employment, income generation, and satisfying career paths for young refugees. The opportunity to work, earn a living, and be self- reliant is one of the most effective ways for refugees to rebuild their lives. Refugees have their dignity and hope reaffirmed when they acquire the means to earn their own living and support their families. The U.S. Government Strategy on International Basic Education notes that U.S. Government interventions will ``address international educational needs across the spectrum, from early childhood to primary and secondary education to workforce development and vocational training, in both formal and non-formal settings.'' \12\ We urge the Committee to consider report language that highlights UNHCR's goal to increase refugee enrollment in higher education programs to 15 percent by 2030. This gesture can help draw attention to this important issue and galvanize U.S. Government support for investments in long-term, sustainable programs that will help refugees build a future for themselves and their families. conclusion In a post-pandemic world, how we respond to the millions of families and children who have been forced to flee their homes impacts not only their future but the future for all of us. Now is not the time to turn our backs on helping to meet their most basic needs. We thank Congress for its past support for these critical programs, including its longstanding commitment to, and support for, UNCHR, and urge the Subcommittee to include $4.1 billion for Migration & Refugee Assistance and $1.1 billion for basic education programs, including $50 million in funding for Education Cannot Wait in the FY22 State & Foreign Operations Appropriations bill. Thank you again for your time and consideration. --------------------------------------------------------------------------- \1\ UNHCR (2021). Global Trends: Forced Displacement in 2020. https://www.unhcr.org/60b638e37/unhcr-global-trends-2020 \2\ UNHCR (2021). Global Trends: Forced Displacement in 2020. https://www.unhcr.org/60b638e37/unhcr-global-trends-2020 \3\ Ibid. \4\ UNHCR (April 30, 2021). Operational Data Portal. https:// data.unhcr.org/en/situations \5\ UNHCR (2020). ``Coming Together for Refugee Education.'' https://www.unhcr.org/en-us/publications/education/5f4f9a2b4/coming- together-refugee-education-education-report-2020.html \6\ Education Cannot Wait (2021). ``Education Cannot Wait: A Case for Investment.'' https://www.educationcannotwait.org/cfi/ \7\ UNESCO (2021). ``Education: From disruption to recovery.'' https://en.unesco.org/covid19/educationresponse \8\ Global Education Monitoring Report (July 2020). ``Policy Paper 41: COVID-19 is a serious threat to aid to education recovery.'' https://reliefweb.int/sites/reliefweb.int/files/resources/373844eng.pdf \9\ U.S. Government Strategy on International Basic Education. Report to Congress. April 1, 2019-March 31, 2020. https://www.edu- links.org/about/strategy \10\ Education Cannot Wait (June 4, 2021). ``ECW Results Dashboard.'' https://www.educationcannotwait.org/about-us/ \11\ UNHCR (2019). ``Refugee Education 2030''. https:// www.unhcr.org/5d651da88d7.pdf \12\ USAID (2018). ``U.S. Government Strategy on International Basic Education.'' https://www.usaid.gov/education/usg-strategy [This statement was submitted by Joan Rosenhauer, Executive Director.] ______ Prepared Statement of the Johnson & Johnson Global Public Health On behalf of Johnson & Johnson's 134,500 global employees, I am pleased to provide written testimony to the Senate Appropriations Subcommittee on State, Foreign Operations, and Related Programs in support of sustained and increased funding in Fiscal Year (FY) 2022 appropriations related to the global public health activities of the Department of State and the United States Agency for International Development (USAID). In my role as Global Head of Johnson & Johnson Global Public Health, I am acutely aware of the need for critical U.S. investments in global public health initiatives to save lives around the world and protect the American people from the spread of deadly infectious diseases. The global reach of the COVID-19 pandemic, and the human and economic devastation left in its wake, has been a stark reminder that no country is immune to the impact of infectious disease. Consistent and robust funding by the U.S. for global preparedness and response is needed to combat the COVID-19 pandemic, to reduce mortality from other epidemics such as HIV/AIDS and tuberculosis (TB), and to detect and respond to new and re-emerging diseases like Ebola in Africa in February 2021. This pandemic has also shed light on how nations can be better prepared for future health emergencies. Advances in science and new global partnerships can equip countries to prevent, identify, and respond to such hazards. During the pandemic, the U.S. government has built on a foundation of earlier investments. U.S. leadership in the Global Health Security Agenda (GHSA) beginning in 2014 contributed to enhanced capacity of many countries in their laboratory networks, surveillance systems, emergency operation centers, and other components of a public health emergency response. Following the 2014-2016 Ebola outbreak, the U.S. supported the creation of the Africa Centers for Disease Control and Prevention which has led much of the COVID-19 public health response in Africa. The U.S. government must continue to identify and help fill gaps in the global preparedness and response architecture for public health emergencies. At Johnson & Johnson, our vision for global health security is to outsmart epidemics and pandemics by developing vaccines and therapeutics for diseases such as COVID-19, Ebola, TB, and HIV/AIDS. Our strategy drives research, development, and access to innovative products and technologies for people living in lower-income countries. Public-private partnership with the Biomedical Advanced Research and Development Authority (BARDA) has been key to the development of our COVID-19 and Ebola vaccines. We have partnered with the Department of State, USAID, and the Centers for Disease Control and Prevention (CDC) to support equitable global access to life-saving vaccines and therapies. Equitable access is at the forefront of the Johnson & Johnson COVID-19 response. Our single-dose vaccine is compatible with standard vaccine distribution channels and aligns with the World Health Organization's recommendations for medical interventions in a pandemic setting, which emphasize ease of distribution, administration and compliance. Johnson & Johnson has entered into an Advance Purchase Agreement (APA) to provide up to 400 million doses of vaccine to African Union member states through 2022, and an APA with Gavi, the Vaccine Alliance (Gavi) to provide up to 500 million doses of vaccine to COVAX through 2022, including for 92 low- and lower-middle income countries. Our Ebola vaccine regimen received marketing authorization from the European Commission in July 2020 and World Health Organization prequalification in April 2021. It has been used in outbreak response in the Democratic Republic of Congo (DRC) and since 2019, the government of Rwanda has vaccinated 160,000 people in a campaign near the border with the DRC. Building on a 20-year commitment, Johnson & Johnson is a private- sector leader in the fight to end the global TB epidemic by 2030. Through partnership with USAID, we have enabled our multidrug-resistant TB (MDR-TB) treatment to be provided in 145 countries. In 2020, the pediatric formulation of our MDR-TB medicine received U.S. Food and Drug Administration (FDA) approval and in March 2021 we launched a collaboration with USAID in high-burden countries to improve programs that identify children with drug-resistant TB and provide lifesaving care. The funding by the Subcommittee to the Department of State and USAID is crucial for bilateral and multilateral programs that enhance global health security, including GHSA; Gavi; the President's Emergency Plan for AIDS Relief (PEPFAR); the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund); the Coalition for Epidemic Preparedness Innovations (CEPI); and health systems strengthening efforts, among many others. These U.S. investments support vital research and development and improve the capacity of lower-income countries to detect and respond to an outbreak before it spreads to other countries. These are critical resources to fight COVID-19 and prevent increased deaths from HIV and TB. The U.S. will not be safe until there is global control of the COVID-19 pandemic. Johnson & Johnson commends the Committee for providing $4 billion for Gavi to purchase vaccines for lower-income countries through COVAX. The U.S. government must continue to play an important role in the global response through bilateral programs and support to global initiatives such as Gavi and CEPI. The emergence of new Ebola outbreaks in Guinea and the DRC earlier this year was a warning that outbreaks are occurring at an increasing frequency and affecting more communities. Scientific evidence revealed that a survivor transmitted the virus five years after the initial infection, demonstrating longer virus persistence than previously thought. It is time to shift the public health paradigm from vaccinating only after an Ebola outbreak to providing vaccines to high- risk populations before an outbreak. The U.S. government can advance global health security by supporting expanded Ebola vaccine access for high-risk populations in Africa. While combating emerging and re-emerging diseases, the global community continues to be plagued by the enduring HIV/AIDS and TB pandemics, which could be worsened by the spread of drug resistance. The Stop TB Partnership reported significant declines in the number of people diagnosed and treated for TB during the COVID-19 pandemic, setting progress back by 12 years. Increased resources for USAID's global TB program will enable countries to implement public health measures such as diagnostic testing for both TB and COVID-19. Care for individuals with HIV/AIDS and HIV/TB co-infection has also been impacted by quarantines, disrupted supply chains, and the focus of the community health workforce on COVID-19. Johnson & Johnson commends the Committee for providing $3.5 billion for the Global Fund to respond to COVID-19 and protect AIDS, TB, and malaria programs. Sustained U.S. contributions to PEPFAR and the Global Fund-where U.S. funding leverages additional donor resources-are critical to ensuring that more lives are not lost to other diseases while we fight COVID-19. Johnson & Johnson looks forward to working with the Subcommittee and our partners at USAID and Department of State to advance our shared global public health objectives in the months ahead. I thank the Subcommittee for its work on these important issues and for considering this perspective. [This statement was submitted by Martin Fitchet, MD, Global Head.] ______ Prepared Statement of the Kiwanis International and the Kiwanis Children's Fund Mr. Chairman, it is an honor to provide testimony to the Committee on behalf of 550,000 Kiwanis-family members in nearly 16,000 Kiwanis family clubs, with more than half located within the United States. We appreciate the opportunity to testify in support of the Kiwanis/UNICEF program to eliminate maternal and neonatal tetanus. We are seeking the support of this Committee to recommend $2,000,000 in the FY 2022 bill for maternal and neonatal tetanus (MNT) and $3,500,000 for iodine deficiency and iodine nutrition. This funding would come from the U.S. Agency for International Development's Global Health Programs, Maternal and Child Health and Nutrition accounts. While this request is for funding to support our global health efforts, Kiwanis and its members do so much more. Kiwanis International clubs around the world have been supporting their local communities during this pandemic. While COVID-19 has disrupted normal club activities, it has resulted in more creativity in our service. Our members have sewn masks and celebrated graduations and school milestones in new ways. Clubs have prepared and distributed meals, arranged delivery of food for first responders and collected donations for servers at local restaurants that normally host Kiwanis meetings. Additionally, the Kiwanis Children's Fund distributed over $165,000 in grants to support clubs' targeted efforts in communities in 11 countries. These funds are used for online learning materials and equipment, hand sanitizer, surgical masks, diapers, vitamins, toiletries, hygiene kits, food banks and replacement meals for school lunches. maternal and neonatal tetanus For over 10 years, Kiwanis and its members have been working to eliminate the deadly disease of maternal and neonatal tetanus (MNT). Kiwanis launched its global campaign The Eliminate Project in 2010, to help save or protect more than 61 million mothers and newborns from MNT. Tetanus is a preventable disease that kills one baby every 21 minutes. Participation and funding by the United States is imperative to the success of eliminating MNT. In many developing countries, women give birth at home without the support of a healthcare worker and without a clean, sterile blade to cut the umbilical cord. This, and other factors, can lead to tetanus poisoning in the newborn baby, causing severe spasms and an excruciatingly painful death. It is a terrible disease in which human contact exacerbates the baby's pain; a mother's touch hurts, leaving the baby to writhe in agony, unheld for days until he or she dies. MNT results when tetanus spores, which are present in soil everywhere, enter the bloodstream. It is mainly caused by a lack of access to sanitary birthing conditions, unclean instruments used to cut the umbilical cord and unclean post-partum cord care. MNT is easily prevented by a series of vaccine doses to women of childbearing age, who pass the immunity on to their children. The series of vaccines cost roughly $3.00, which includes the vaccinations, syringes, safe storage, transportation and more. Women who are properly vaccinated with the tetanus vaccine will have immunity through most of their childbearing years and their babies are protected through the first two months of life. When vaccinated for tetanus, women learn about maternal health, they become empowered to take control of their well-being and that of their newborns. We believe these women matter, they deserve to give birth to healthy babies, and their babies deserve to achieve their full human potential. In partnership with UNICEF, Kiwanis committed to and has raised $110 million to immunize women in countries where MNT is still a major health threat. More than 6,000 Kiwanis-family members and clubs in the United States alone have contributed to the fundraising campaign. We are now tackling the hardest leg of a difficult journey. Twelve countries remain at risk, with more than 52 million women who still need to be vaccinated. Since 2000, MNT has been eliminated in 47 countries, thanks to the work of national governments, UNICEF and partners. Between 1999 and 2018, more than 161 million women in some of the world's most remote places were vaccinated against tetanus, saving thousands of newborns from death due to tetanus every year. In July 2014, USAID announced that it was joining as a partner with Kiwanis to help eliminate MNT. Kiwanis has been working in partnership with USAID to strengthen its programs on MNT and to provide funding through the UNICEF global effort. Kiwanis' global volunteer network and strength in reaching communities and leaders, along with UNICEF's field staff, technical expertise and unbeatable supply chain, are working to eliminate this cruel, centuries-old disease and pave the way for other interventions. iodine deficiency and nutrition Our other global effort focuses on iodine deficiency, the world's leading cause of preventable mental impairment, that has been kept under control through a global movement to iodize edible salt. Iodine, a micronutrient that naturally occurs in some foods, is an essential element for normal growth and development in humans. Iodine is not synthesized by the body and is required to be provided through the daily diet in the recommended amounts. It is required for proper functioning of the thyroid gland, which in turn regulates many biochemical reactions and the proper skeletal and central nervous system development in fetuses and infants. While many of the disorders resulting from severe iodine deficiency in dietary intake have virtually disappeared (goiter, cretinism, stunting, stillbirth), insufficient iodine during pregnancy leads to brain damage that can reduce a child's IQ by 8 to 10 points. Even mild- to-moderate iodine deficiency at school age can reduce IQ by 3 to 5 points. Adequate iodine during early life is critical to children's ability to reach their full potential. As many as two dozen nations have been documented as currently showing iodine deficiency while insufficient data exists for many others. Thanks to iodized salt, most infants and children of the world have had correct brain development. Adequate iodine in the diet during pregnancy and until age 5 will greatly improve a child's healthy brain development and readiness to learn as he/she enters primary school grades. Insufficient iodine during pregnancy leads to brain damage that can reduce a child's IQ by 8 to 10 points. Adequate iodine during early life is critical to children's ability to reach their full potential. Kiwanis International first invested in universal salt iodization to virtually eliminate iodine deficiency disorders in 1994. In partnership with UNICEF, USAID and several governments, global access to iodized table salt increased from less than 20% to 88% today. Kiwanis had raised and invested more than $100 million from its members and clubs for this effort. Iodine deficiency disorders (IDD) were a public health problem in most countries of the world until a few short decades ago. Iodine deficiency, the world's leading cause of preventable mental impairment, has been kept under control through a global movement to iodize edible salt. Universal salt iodization continues to be the most effective way to introduce iodine into the dietary intake of a deficient population. The cost of prevention is small--$.05 a year per individual for a lifetime of protection against iodine deficiency. On average, every dollar spent on salt iodization yields a $30 return on investment through improved learning, which leads to greater productivity in later life that boosts economies of the nations in which these children live. Recent developments in food fortification, like double fortified salt (adding iron, zinc, folic acid, etc.), or adding iodized salt to rice, flour, maize, tea, bouillon cubes, condiments, etc. offer promising results to extend the efficiency of this very inexpensive health intervention. Funds provided through USAID and its public/private partnership with Kiwanis International, UNICEF, and the Iodine Global Network are preventing brain damage and other adverse outcomes for millions of children by supporting new and sustaining existing programs to iodize salt. USAID funding at the level of $3,500,000 will provide continued funding to keep global attention to this permanent intervention and to address the needs of the few countries that are still at risk of iodine deficiency disorders. support for partners We have a very effective partnership with UNICEF and urge you to support UNICEF in its request for a U.S. fiscal year 2022 contribution for the UNICEF core resource budget of $134 million. We also support funding for the Maternal and Child Health account at a level of $984 million. a personal experience As the executive director of an organization that has members in more than 80 nations around the globe, I have had the opportunity to travel to and experience unique cultures in almost half of those countries. I have witnessed firsthand the success of our public-private partnership to eliminate maternal and neonatal tetanus. For example, in Madagascar, I was present to see immunization day at several health clinics in villages seemingly in the middle of nowhere, and I was amazed to see how many mothers and their young children showed up to receive a tetanus immunization. That meant for the hundred or so children that I saw in a single day, approximately five who would not have survived beyond a fifth birthday were immunized. Because of the Kiwanis/UNICEF/USAID cooperation, these children had a much better chance of surviving. Our investment there had brought the death rate for neonatal tetanus down to less than one death per thousand live births. Fortunately, Madagascar was validated as being ``tetanus free'' by the World Health Organization, and together we funded the work that made that outcome possible. I have been an active member of our organization since my youth. It is a privilege to now serve in the leadership role of Kiwanis International and the Kiwanis Children's Fund (the charitable arm of the Kiwanis organization). More than two-thirds of our global Kiwanis family membership is American. Our members have been extremely generous of their personal resources to raise most of the US$100 million to date to eliminate MNT. We are committed to global elimination. Today about 68 infants will die from MNT somewhere in the world. Our commitment is to keep working to reduce that number to zero. We look forward to continuing our joint effort with UNICEF and USAID. Thank you for your support in this important work. conclusion Mr. Chairman, I ask you to join us in our efforts working to eliminate MNT and supporting iodine nutrition. Help continue targeting the last countries to be certified for the elimination of MNT and protect the lives of hundreds of thousands of children. Help us ensure that no baby suffers this excruciating seven-day death ever again by recommending $2,000,000 within the Global Health, Maternal and Child Health account for the elimination of maternal and neonatal tetanus. It will help continue targeting the last countries to be certified for the elimination of MNT and protect the lives of hundreds of thousands of children. Funds provided through USAID and its public/private partnership with Kiwanis International, UNICEF, and the Iodine Global Network are preventing brain damage and other adverse outcomes for millions of children by supporting new and sustaining existing programs to iodize salt. USAID funding at the level of $3,500,000 in the Global Health, Nutrition account will provide continued funding to keep global attention to this permanent intervention, and to address the needs of the few countries that are still at risk of iodine deficiency disorders. Thank you for your consideration. [This statement was submitted by Stanton D. Soderstrom, Executive Director.] ______ Prepared Statement of the Lions Clubs International (LCI) Dear Chairman Coons, Ranking Member Graham, and Members of the Committee: As the world's largest volunteer service organization with 1.4 million members worldwide and 400,000 members in North America, Lions Clubs International and its Foundation, Lions Clubs International Foundation (LCIF), are committed to global health and education initiatives. We urge the Senate Subcommittee on State, Foreign Operations to provide robust funding for international programs that address the burden of cancer in children and promote increased survivorship for childhood cancer. Specifically, we request that the Committee continue to support and encourage collaborative efforts between the private sector, the non-governmental community, the United Nations, and other relevant multilateral organizations to address childhood cancer globally. Furthermore, we encourage the Committee to allow the Department of State and USAID access to funding as is consistent with the Consolidated Appropriations Act for FY21. This funding will provide critical support to help establish sustainable long-term solutions to diagnose and treat pediatric cancer in sub-Saharan Africa. According to United Nations and World Health Organization statistics, cancer is a leading cause of death for children. Additionally: --There are 300,000 new cases annually --57% of childhood cancer cases go undiagnosed in many parts of the world --Survival rates are 80% in developed countries, and 20% in lesser developed countries. Much work needs to be done to improve access to drugs and treatment, train healthcare providers, improve facilities and technology, and address socio-cultural barriers to improve global childhood cancer survival rates. Lions around the world have been working to increase awareness for childhood cancer as a ``global signature priority program'' with the goal of providing community knowledge of potential causes, signs, and symptoms of childhood cancer, improving rates of early detection and treatment, and reducing stigma. Lions and LCIF have established a partnership with Texas Children's Hospital's Global HOPE program and Baylor's College of Medicine to build long-term capacity in Sub-Saharan Africa. The program aims to effectively diagnose and treat children with cancer and blood diseases, and to improve childhood cancer survival rates. Launched in 2017, Global HOPE is a transformational initiative that is improving the standard of care for children with cancer in Sub- Saharan Africa. Building on the foundation of Baylor College of Medicine's International Pediatric AIDS Initiative (BIPAI) in treating childhood AIDS in Africa, and relationships with governments and National Ministries of Health, Global HOPE has been able to treat nearly 7,500 children and train over 1,500 African healthcare professionals in the care of pediatric hematology-oncology. The LCIF Board of Trustees approved a 2-year strategic partnership between LCIF and Global HOPE to cooperate in building long-term capacity in Africa to treat and dramatically improve the prognosis for children with cancer and blood disorders. This partnership will help strengthen the local healthcare infrastructure, which includes the constructions of 3 state-of-the-art clean pharmacies to effectively provide the multi-disciplinary care necessary to treat children. LCIF's support will enhance Global HOPE current facilities in Uganda, Malawi, and Botswana. Thank you for the opportunity to present the priorities for Lions Clubs International and our Foundation for the FY 22 State, Foreign Operations Appropriations bill, and please do not hesitate to contact me with any question. about j. frank moore iii, lions clubs executive administrator J. Frank Moore, of Daleville, Alabama, is Lions Clubs International's current Executive Administrator and a Past International President of the organization. He was elected to serve as president of Lions Clubs International at the association's 84th International Convention in Indianapolis, Indiana, USA, July 2 through 6, 2001. Past President Moore is an educator by profession and a former superintendent of education for the Daleville City Schools in Daleville, Alabama, USA. A member of the Daleville Lions Club since 1975, Past President Moore has held many positions within the association, including chairperson of the LCI Centennial Action Committee. He also served as chairperson of the Lions Clubs International Foundation, international director on the association's board of directors, and vice chairperson and international coordinator of Campaign SightFirst II, the most successful fundraising initiative of Lions Clubs International Foundation and our association. Moore has received numerous awards in recognition of his service to the association, including the Friends of Humanity Award presented by Lions Clubs International Foundation, and the Ambassador of Good Will Award, the highest honor the association bestows upon its members. He is also a Progressive Melvin Jones Fellow. In addition to his Lion activities, he is a member of the Army Aviation Museum Foundation executive committee, and a former chief executive officer of the Association of the United States Army. [This statement was submitted by J. Frank Moore III, Executive Administrator.] ______ Prepared Statement of the Methane Action and Remineralize the Earth Chairman Coons, and Members of the Subcommittee: Last week, the world-renowned former science advisor to the U.K., Sir David King of Cambridge University, declared we have five years left to solve the climate crisis and announced a new Climate Crisis Advisory Group to help reduce emissions, remove greenhouse gases already emitted and restore the climate to truly healthy temperatures and functioning. See, https://www.businessgreen.com/news/4033355/reduce-remove-repair- climate-crisis-advisory-group-sketches-climate-priorities. In April, Sir David, Michael Mann and Michael McElroy of Penn State, Rob Jackson of Stanford, Simon Levin of Princeton, Eric Davidson of the University of Maryland, Frank Keutsch of Harvard, Shaeed Naim and Duncan Menge of Columbia, William Schlesinger and Stuart Pimm of Duke, Jennifer Powers of the University of Minnesota, Quinlai Zhuang of Purdue, Margaret Torn of Berkeley, Deborah Lawrence of the University of Virginia and William Peterjohn of West Virginia University led a group of 31 scientists from the U.S., Canada, U.K., Europe and Japan who signed a letter in advance of the White House Climate Summit declaring that governments need to expedite 1) the reduction of emissions, 2) the deployment of methods of removing excess ambient methane and other greenhouse gases (GHGs) from the atmosphere and 3) the development of governance capable of ensuring the safe and effective use of those methods. (See, MethaneAction.org). Our testimony focuses primarily on how this Subcommittee can help prepare the U.S. and its allies to develop the global governance called for by those scientists whose research is bringing to bear potential solutions unlike any deployed so far. Peer reviewed science and ongoing laboratory tests indicate that they and their colleagues may be able to deploy safe and efficient methods that can return and sustain methane levels from the current concentrations of 1.94 parts per million to the pre-industrial norm of .8 ppm within this decade, buying time to deal with the long-term problem of CO2 as methane is 84 times as potent as CO2 over the 20 year period of its primary impact. Continuing this research is dependent, however, on at least modest government support, which we urge you and your colleagues on the Interior and Energy Subcommittees to consider in the FY22 appropriations process. This year the United Kingdom announced 23 new major grants to U.K. entities to develop new CO2 and methane removal technologies but those grants were based on earlier submissions and did not appear to cover the latest and most promising methane removal approaches. We believe it's appropriate and necessary for the U.S. to play a leadership role in the research, development and deployment of these methods. We filed complementary testimony on June 24th with the Interior-EPA Subcommittee and on June 25th with the Energy and Water Subcommittee urging them to follow suit with specific grants, contracts, and policies. We ask that you compare notes with those Subcommittees in order to ensure the best fit for each Subcommittee and recommendation that you find useful. For example, some of the research would be done more efficiently in some cases with non-U.S. principal investigators who are already, with too little funding, working on these approaches. The overall program should in any case be geared for both international cooperation and policy coordination with the U.S. playing a strong role. First, however, we recommend that you write the Secretary of State and ask him to assure the Committee that the US will not accept any limit--whether in the Glasgow COP26 negotiations, the WTO reform set for this summer, or any other forum on the ability of the US, the EU, or any jurisdiction to tariff or embargo goods and services the climate footprint of which is greater than that allowed for comparable domestic production. Current international trade and environmental law that the U.S. helped establish provide that nations should not harm the environment or health of other nations and that they have the right to support their domestic industries and populations by embargoing or tariffing imports from countries that do not require comparable performance especially if such measures are also in support of existing international conservation efforts. (See, Shrimp and Sea Turtle Appellate Decisions of the WTO). That series of decisions essentially reaffirmed the U.S. Congress action in the late 1980's that protected endangered sea turtles and ensured fair competition for American shrimp fishermen and women by banning the importation of shrimp from countries that did not require sea turtle excluder devices.\1\ Given upcoming preparatory meetings, we urge that this letter to the Secretary of State be sent no later than the first week of July. From this point on, our testimony will largely be the legislative language we recommend. I. Integrate Greenhouse Gas Removal In Policies and Programs.--In order to reduce greenhouse gases and other climate forcing agents (GHGs) to historically healthy levels as soon as possible, the Secretaries of State and Treasury, the Administrator of USAID, the Chief Executive Officers of the Millennium Challenge Corporation, the Trade and Development Agency, the U.S. International Development Finance Corporation and the Export Import Bank, and the other agencies using funds appropriated in this bill, and using their voice, votes and leadership accordingly in the International Financial Institutions including, but not limited to, the World Bank Group and the Strategic Climate Fund and the Global Environment Facility, shall: A) In consultation and cooperation with the Special Envoy and Domestic Advisor on Climate Change, the Administrator of the EPA, and the appropriate departments and agencies, use their authorities to facilitate the deployment of methods of limiting emissions of, and removing from the atmosphere methane, carbon dioxide and other greenhouse gases, and black carbon (or ``soot'') (hereinafter ``GHGs''); incorporate such methods in their actions, including but not limited to their foreign assistance, intergovernmental cooperation, international finance programs, and bilateral and international trade and other negotiations; and B) Report to the Committees of jurisdiction and the public on the plans for, and progress in so doing, within 60 days of enactment and annually thereafter. II. Ensure Global Governance of GHG removal methods.--Beginning no later than one week after the date of enactment and continuing thereafter, the Secretary of State, in consultation with the Special Envoy for Climate Change, the US Trade Representative, and the agencies participating in the affected U.S. delegations, shall propose and pursue resolutions and agreements, including both existing and new agreements, for: a) Supporting the proper assessment, deployment and governance of methods of reducing the atmospheric presence of GHGs to historic healthy levels and the current and proposed interventions to reduce global warming, including but not limited to non-sequestration and non- GHG removal interventions; b) Ensuring the sufficient, safe and proper use of technologies for reducing the emissions of GHGs and/or the climate forcing impact of them; and c) Actively removing GHGs from the atmosphere, within or apart from existing international agreements in a manner that is complementary to their objectives and not preemptive of conservation and restoration efforts or the powers of jurisdictions to adopt more assertive or stricter measures. The agreements and fora in which the Secretaries shall incorporate these priorities shall include, but not be limited to, the UNFCCC and its protocols, accords, and agreements, the London Convention on Marine Pollution (via the International Maritime Organization), the Vienna Convention on the Protection of the Ozone Layer and its protocols, UNECE Convention on Long-range Transboundary Air Pollution, the Convention on Migratory Species, the Convention on Biological Diversity and other conservation agreements, the major international and bilateral trade agreements, the United Nations, and UNEP, FAO, UNDP and any other relevant subsidiary bodies; There is appropriated for the above in FY22--$12,000,000. III. Comprehensively assess atmospheric methane sources, sinks and solutions and develop a global plan for atmospheric methane reduction.--The Secretary of State shall by December 1, 2021, in cooperation with the Administrator of the EPA, commence or commission a report from the National Academy of Sciences or other capable institution(s) or group(s), such as Sir David King's Climate Crisis Advisory Group, to be delivered in draft form by July 1, 2022, and in final form not less than 6 months later, providing (1) an assessment of the size and changes occurring in emission and sinks of methane globally; (2) an analysis of the likely impact of atmospheric methane on climate change and other problems caused by atmospheric methane; (3) a review of each major methane emission source and sink to determine what options are available to affect their impact on atmospheric methane levels; (4) a review of all possible, and all currently practicable, technologies, programs, policy and regulatory changes that could help reduce atmospheric methane levels, whether by abatement (emissions reduction) or remediation (Greenhouse Gas Removal), and for each proposed technology or policy change, consideration of their technological readiness, likelihood of success, barriers hindering implementation, cost-effectiveness and cost-benefit analysis, and likely overall impact on atmospheric methane levels; (5) the development of national and global plans for atmospheric methane reduction, that provide goals and recommendations, and discuss options for investment in new technologies, possible regulatory and land management changes, and other means for reducing atmospheric methane, and the barriers to implementing them. The Secretary shall ensure that the report and plan are produced with the cooperation of appropriate government agencies, including but not limited to the EPA, EIA, USAID, IEA and those included elsewhere in this title. The Secretary shall further ensure that authors include a range of conservation biology, oceanic, agronomy and atmospheric scientists, among others, as well as economists, engineers, policy makers, regulatory experts. The Secretary is directed to commission from his regular budget a report updating the initial report every two years. There is hereby appropriated for this assessment and report-- $4,000,000. IV. Integrate Climate Restoration across the Government. The Secretaries and Administrators funded by this title shall integrate the policies and priorities of this title into the regular order of business and carry out within their budget authorities and amounts appropriated for each of the affected agencies independent of further appropriations. This section, however, hereby also provides such authorization as may be necessary to conduct these actions through FY2028 as well as appropriations for FY2022. --------------------------------------------------------------------------- \1\ As a freshman in the House, if I recall correctly, in the mid- 1990s current Ranking Subcommittee Member Senator Graham intervened to help block an amendment to curtail protection of endangered species overseas. He noted that if timber producers from South Carolina and the rest of the southeast could conserve the red-cockaded woodpecker and other listed species then our foreign aid and trade should uphold the same standards and not help their foreign competitors to undercut them. That statutory protection of Sec. 7(a) of the Endangered Species Act remains global but a regulation exempting impacts of U.S. agency actions in other countries from the process of interagency consultation with the Fish and Wildlife Service and the National Marine Fisheries Service unfortunately remains in place. In consultation with EPW you could correct that in this bill. That should enhance the recovery of elephants and whales that the IMF now finds worth billions for the GHG sequestration that their ecological effects bring about. (See, https:// www.imf.org/en/News/Podcasts/All-Podcasts/2020/09/21/Elephants) [This statement was submitted by John M. Fitzgerald.] ______ Prepared Statement of the Millennium Water Alliance Chairman Coons, Ranking Member Graham, and Honorable Members of the Subcommittee: We write in support of funding of not less than $540 million in Fiscal Year 2022 for water supply, sanitation, and hygiene (WASH) programs administered by the U.S. Agency for International Development under the Sen. Paul Simon Water for the Poor Act of 2005 (P.L. 109- 121), as amended by the 2014 Water for the World Act (P.L. 113-209). Since Congress enacted the Sen. Paul Simon Water for the Poor Act of 2005, the House Appropriations Committee has shown sustained support for investment in WASH through international assistance programs that have saved millions of lives, transformed USAID's WASH programming and capacity, and empowered more communities to maintain and operate their own infrastructure to ensure access to WASH for the next generation. As you prepare for FY 2022, we seek your continued strong leadership to fund USAID's important cross-sectoral work under In FY 2019 and FY 2020, enacted funding for these programs has been maintained at $450 million each year; for the three years prior to that, it was $400 million per year. Given the extraordinary circumstances of the past 1-\1/2\ years of global pandemic, and the very limited application to any water and sanitation programming by USAID from last year's emergency supplemental funding, we ask that you appropriate not less than $540 million for this programming in FY 2022. Today, almost 2.2 billion people around the globe lack regular access to safe water, and 4.2 billion lack access to basic sanitation. Poor sanitation amplifies the venues for many infectious diseases, some of which can be reduced or eliminated with better sanitation practices and very basic systems. Sanitation has a massive impact on the environment, endangers safe food supplies, and in particular affects children's health.\1\ Each year, more than 297,000 children under five die from diarrheal diseases, which could be prevented by improved water, sanitation, and hygiene.\2\ A strong investment in WASH programs helps to safeguard US strategic interests. Investment in WASH is central to help prevent pandemic disease; had more developing nations had stronger WASH systems in place, their response to COVID-19 would have been far more effective and undoubtedly help stem the spread of the disease. Better WASH also helps to improve governance in developing nations, opens new markets for U.S. exports, and ultimately promotes U.S. job creation. The $90 million increase over the FY 2021 appropriation would: --Provide long-term, safe drinking water, sanitation, and hygiene services to an additional half million people in Africa, Asia, the Middle East, and Latin America; --Contribute meaningfully to efforts to provide WASH in healthcare facilities, prevent infectious disease outbreaks, and help end the transmission of cholera and Neglected Tropical Diseases; and --Amplify the impacts of cross-sectoral work USAID is doing in other areas related to WASH, including food security, livelihoods, economic development, gender, and nutrition. This work is more effective and resilient if WASH is addressed. --Assist USAID in long delayed by much needed data collection and analysis to increase program efficiency and provide the tools needed for even longer-term sustainable infrastructure and governance in the field, essential in building systems to reduce the impact of future epidemics. The courageous and consistent leadership of this Subcommittee over the years has been essential to the progress made since passage of the 2005 Act and remains one of the most demonstratable achievements in the history of U.S. foreign assistance. The 20 member organizations of the Millennium Water Alliance work in more than 90 countries around the world to alleviate poverty, build democracy, and represent the best of America to millions of grateful people. On their behalf, we thank you. the millennium water alliance Action Against Hunger-US Acacia Water CARE Catholic Relief Services Desert Research Institute Food for the Hungry Global Communities HELVETAS IRC WASH Living Water International Mortenson Center-University of Colorado Boulder Pure Water for the World Safe Water Network Save the Children Water4 WaterAid America Water For People Water Mission World Vision --------------------------------------------------------------------------- \1\ WASHData.org May 2021 \2\ https://www.unwater.org/water-facts/water-sanitation-and- hygiene/ --------------------------------------------------------------------------- [This statement was submitted by John Sparks, Director of Advocacy & Communications.] ______ Prepared Statement of The Nature Conservancy The Nature Conservancy (TNC) thanks the Subcommittee for its strong support of global biodiversity conservation and climate change investments. With over 60 years of experience in pioneering conservation in coordination and cooperation with private landowners, businesses, and federal, state, local and tribal governments across the United States, TNC implements on-the-ground conservation in all 50 states and more than 70 countries and territories around the world. As the world's largest conservation organization with over one million members, TNC is committed to finding practical, science-informed, equitable solutions to address the country's conservation, environmental and climate challenges to benefit nature and people. The role of effective development assistance and international leadership is more critical now than ever before. The ongoing pandemic has created a humanitarian and global health crisis impacting countries and communities around the world. Given the critical need to address the intertwined biodiversity, climate change and public health crises, investments focused on climate-sensitive, inclusive and sustainable natural resource management will increase stability and support economic prosperity while advancing U.S. strategic interests around the world. Leadership on biodiversity conservation occupies a special place in U.S. foreign policy. Foreign assistance has been a cornerstone of U.S. policy for more than 70 years. Support for such assistance draws upon many sources, including the innate generosity of the American people in the face of acute needs in countries with far fewer resources than those of the United States. Foreign assistance directed to biodiversity and climate change programs is making a meaningful difference, particularly at the U.S. Agency for International Development (USAID), U.S. Departments of State and Treasury, the International Development Finance Corporation, Millennium Challenge Corporation, U.S. foreign policy mechanisms, and U.S. investments in natural resources agencies operating globally and contributions to multilateral financial and environmental institutions. These collectively help address many challenges to natural resource management while also strengthening local livelihoods. But it also reflects a consensus that such assistance--including the conservation of natural resources--is in the United States' national security and economic interests. Prior to the pandemic, several global entities--public and private--had turned their attention to steep declines in nature that risks destabilizing the very systems we depend on for our survival. This trend is expected to continue. According to the most recent findings of the Inter-governmental Panel on Biodiversity and Ecosystem Services (IPBES), three-quarters of the world's land and two-thirds of its marine environment have been significantly altered by human actions. We have lost half of the world's forests, half of coral reefs, 70 percent of wetlands and dammed two-thirds of the world's main rivers. Wildlife populations have on average declined by 60 percent since 1970 and there is the potential for our actions to cause the loss of 1 million species. This massive loss of nature--species and ecosystems on land and in the oceans--threatens direct human health and well-being through impacts like decline in food production and freshwater availability. The ecological crisis also threatens the stability of the entire planet through greater alteration of our climate. Global leaders are currently negotiating commitments that will not only shape where and when to conserve biodiversity but how to implement commitments which would require additional financial resources, as well as efforts to reduce the need for financial resources by reducing harmful financial flows. By teaming up with the Paulson Institute and Cornell University, TNC published the Financing Nature report on how to meet the world's biodiversity finance needs. The report estimates the global annual biodiversity financing gap biodiversity at US$700 billion. This can manifest in different ways. For example, U.S. leadership has inspired the strong commitment made by the G7 recognizing the dual crises of climate change and biodiversity loss as well as explicitly linking the climate and biodiversity finance issues. Natural climate solutions represent one of the most cost-effective methods for large-scale capture of greenhouse gas emissions. Nature- based solutions support the sustainable management and use of nature to address critical challenges such as climate change, water and food insecurity, biodiversity protection, human health and disaster risk management. They provide several co-benefits for people and nature, including preserving biodiversity and supporting more resilient communities and livelihoods by protecting fisheries and improving farmland. Leading by example, the United States should make deployment of natural climate solutions a critical component of the pandemic assistance and recovery effort. This will augment the contributions of other developed countries and multilateral institutions. In the face of crises affecting nature and people, doubling down on U.S. leadership and investment through targeted foreign assistance could not be more paramount. The future well-being of the United States, in part, depends on making the world more stable, safe and secure. By investing in proven international conservation programs that help less-developed countries better manage their natural resources and protect their forests, fisheries and wildlife from bad actors and natural disasters, the United States protects its own national and economic security. As Congress turns its attention to economic recovery in the face of COVID-19, including securing U.S. security and trade interests globally, we urge strengthening existing international biodiversity and climate change commitments while also addressing preventing future pandemics at the source and limiting the likelihood of zoonotic spillovers. We hope any immediate investment in (a) global health programs, (b) curbing high-risk wildlife markets that trade in species known to carry transmissible zoonotic diseases, or (c) mitigating the impacts that a precipitous loss of revenues from travel and tourism in and around national parks, protected areas and community-run conservancies, do not supplant core funding in Fiscal Year 2022 (FY22). The following programs exemplify the critical role international conservation efforts play in U.S. foreign policy. Promoting ``natural security'' boosts America's national security. As such, we respectfully request the Congress to continue its investments in global biodiversity conservation through the natural resource agencies of the U.S. government and, specifically, through the following foreign assistance mechanisms in FY22: USAID Biodiversity Conservation Program.--Most U.S. foreign assistance for on-the-ground conservation is delivered through USAID and its robust portfolio of conservation programs. USAID is working with communities, non-governmental organizations (NGOs) and governments to develop natural resource policies and management practices that conserve biodiversity and sustain local livelihoods. These programs help protect some of the largest, most at-risk natural landscapes and the livelihoods of millions of people who directly depend on natural resources for their survival and economic growth. For example, the USAID-funded and TNC-implemented Endangered Ecosystems of Northern Tanzania program is working to improve coordination, communication and collaboration between organizations, government and communities towards a joint vision of a resilient, healthy and connected rangelands across northern Tanzania. To date, the project has supported improved natural resource management of over 619,000 hectares of biologically significant areas and engaged 9,300 community leaders in training. However, the pandemic is impacting conservation efforts, starting with a collapse of tourism across Africa and the increased risk that is posed by this collapse to both biodiversity and local communities. Private philanthropy and NGOs acting swiftly have been able to mitigate this challenge. For example, TNC's Africa Wildlife Crisis Fund provided interim support, and funding to the critical recovery needed for the communities that depend on this industry. However, the long-term commitment and stability provided by USAID cannot be underestimated and will only need to be enhanced to address the pace and scale of conservation needed to ensure nature and people are resilient. We request Congress to fund the USAID Biodiversity Conservation Program at $500 million in FY22, to meet critical development and administrative priorities such as increasing community resilience and reducing resource competition and conflict across Africa, and improving natural resource management and decreasing illegal, unreported and unregulated fishing in the Indo Pacific region. USAID Sustainable Landscapes.--Tropical forests continue to be one of the most threatened ecosystems in the world, but efforts funded in part by Congress are advancing conservation in these areas. As noted above, natural climate solutions can be an effective means to reducing greenhouse gas emissions. REDD+ (Reducing emissions from deforestation and forest degradation, and the role of conservation, sustainable management of forests and enhancement of forest carbon stocks) continues to evolve as a policy framework that incentivizes developing forest countries to curb deforestation while addressing rural poverty, good governance, land tenure issues and securing emissions reductions. We are encouraged by the recognition of natural climate solutions by the U.S. government in its 2021 Nationally Determined Contribution (NDC) in both terrestrial and marine environments as a driver in climate ambition and resilience. The USAID Sustainable Landscapes Program supports efforts to halt deforestation and forest degradation, promote sustainable and responsible forestry practices, and prevent illegal logging in the world's largest, most biologically diverse forests, including in the Amazon, Central Africa's Congo Basin, and Southeast Asia. Through this program, the United States has supported efforts through multilateral funds such as the Forest Carbon Partnership Facility and the Forest Investment Program to scale up this framework. This program is augmented by two additional investments by USAID for Climate Adaptation (funded in FY21 at $177 million) and Renewable Energy Program (funded in FY21 at 179 million). We request that the USAID Sustainable Landscapes Program be funded at $200 million in FY22 and additional investments in climate adaptation and renewable energy are strengthened. Global Environment Facility (GEF).--With more than 5,000 projects in 170 countries, the GEF is the largest single financier of conservation. For 28 years, with $21.1 billion in strategic investments, the GEF has leveraged $114 billion in co-financing from the philanthropic, public and private sectors. As an independent international financial institution, the GEF unites donor and recipient countries with U.S. corporations and NGOs by providing grants to support natural capital and improve management of natural resources. America's investment in the GEF also yields a very high rate of return. For every dollar the United States invests in the GEF, it generates another $40 from other countries and partners. The GEF has supported the improved cooperation and governance of one-third of the world's large marine ecosystems. For example, its Common Oceans program-- working with over 60 public and private sector partners to address overfishing, bycatch and pollution in international waters achieved a reduction in the number of major tuna stocks experiencing overfishing from 13 to five and reduced the mortality rate of dolphins, sea turtles and other marine mammals caught by Pakistani gillnet fisheries in the northern Arabian sea by 98 percent. The GEF support has also been critical to placing 12 percent of the world's terrestrial area under protection, resulting in 3,300 protected areas spanning 2.1 billion acres containing at least 700 globally threatened species. The GEF has invested over $1 billion to address land degradation, which affects over 3.2 billion people, especially rural communities, smallholder farmers, and the very poor in the drylands of Africa and Asia. Its Food Systems, Land Use, and Restoration Program promotes sustainable land management to increase food security for smallholders and communities that depend on farming for their livelihoods. We request $149.3 million in FY22, of which $136.5 million be earmarked exclusively for the third installment of the U.S. contribution to the seventh replenishment of the GEF. Tropical Forest and Coral Reef Conservation Act (TFCCA).--Since first enacted in 1998, the TFCCA has offered eligible countries the opportunity to reduce their official concessional debt owed to the U.S. government while generating funds locally to conserve biological diversity and protect ecologically and economically vital forest ecosystems. In 2019, the Congress expanded the authorities of TFCCA, popularly known as the ``debt-for-nature'' program by allowing for coral reef conservation efforts. TFCCA agreements have saved more than 67 million acres of tropical forests in countries such as Botswana, Brazil, the Philippines and Indonesia. TNC and our partners have together contributed an additional $22.5 million to 12 of the 20 total agreements under the TFCCA, enabling more debt to be treated. In addition to seeking a longer-term reauthorization for this program with the inclusion of coral reefs, we request $50 million in FY22 for the Tropical Forest and Coral Reef Conservation Act. Science, Finance and International Cooperation.--Two United Nations conventions-the Intergovernmental Panel on Climate Change (IPCC) and the United Nations Framework Convention on Climate Change (UNFCCC)-have received implementation funding from the U.S. government. The IPCC, for example, has received broad bipartisan support for providing high- integrity science on climate change since the panel's creation in 1988. Similarly, the UNFCCC has been the primary space for policymakers to mount an international effort to tackle these risks. The United States has won plaudits worldwide for leading on climate action. U.S. foreign assistance also leverages substantial private investment in energy efficiency and renewable energy technologies. Continued funding of a modest budget line will signal that America continues to place an importance on climate science and wants a place at the table in negotiations. Green Climate Fund (GCF).--The GCF is a multilateral fund established in 2010 to foster climate-resilient development and zero- emission investment. It advances its mission by using a range of financial instruments to support projects and programs that promise the greatest impact in reducing greenhouse gas emissions and building climate resilience in developing countries. It also seeks to advance its mission by mobilizing private sector capital and fostering stronger policy environments that better address the challenges of a changing climate. The GCF funds activities across a variety of sectors, including transport; water and other infrastructure; energy generation and efficiency; and land use, including agriculture and forestry. As of March 2021, the GCF has approved 173 projects, using $8.4 billion in funding and attracting $21.9 billion in co-financing. The United States made a signed commitment of $3 billion over four years (2014-2018) to the fund, of which $1 billion has been paid. It is critical for the U.S. government to regain its leadership role and make meaningful contributions on the GCF Board. The Global Climate Change Initiative (GCCI) is the current funding mechanism for the GCF. GCCI helps countries both mitigate and adapt to climate change through important multilateral and bilateral engagement with major and emerging economies. We urge the Congress to support the GCCI, including funding for the GCF. We request a $2 billion contribution in FY22 towards the Green Climate Fund to demonstrate clear U.S. commitment and incentivize developing countries to further reduce their greenhouse gas emissions. Through collaboration with the U.S. government, TNC is supporting work which empowers host country governments to safeguard natural resources, co-develop and deploy nature-based solutions to improve the resilience of people and critical ecosystems on which all life depends. Our projects help to strengthen local capacity, leverage private sector partners and empower women and youth in the improved economic development of their communities. While a vast majority of these projects are administered directly through federal agencies furthering U.S. foreign policy and assistance goals, TNC also supports strengthening international funding at U.S. natural resources agencies such as at the U.S. Forest Service (International Program), U.S. Department of the Interior and U.S. Fish & Wildlife Service (International Programs, Wildlife Trafficking and Wildlife Without Borders Programs) and the National Oceanic & Atmospheric Administration (International Program) by supporting programs and partnerships that further the United States' foreign policy goals. We stand ready to partner with and support the U.S. government to achieve its foreign assistance goals for the wellbeing of our planet and its people. We urge the Subcommittee to continue investing in our common security through formidable foreign assistance programs. [This statement was submitted by Tom Cors, Director of Lands.] ______ Prepared Statement of the Neglected Tropical Diseases (NTD) Support Center Thank you for allowing me to provide written remarks on behalf of the Neglected Tropical Diseases Support Center of the Task Force for Global Health. The NTD Support Center supports USAID's work on the elimination and control of Neglected Tropical Diseases (NTDs) with a focus on operational research to ensure the success of its programs that target such NTDs as elephantiasis, blinding trachoma, river blindness, intestinal parasites and schistosomiasis. I am writing to thank the Committee for its unwavering support for USAID's NTD portfolio and to urge an increase in this year's appropriation to $125 million from the current level of $102.5 million. The Task Force for Global Health, founded in 1984 to advance health equity, works with partners in more than 150 countries to eliminate diseases, ensure access to vaccines and essential medicines, and strengthen health systems to protect vulnerable populations. Our programs and expertise include polio, influenza, COVID-19, hepatitis, vaccine safety, distribution and access, and health systems strengthening, as well as NTDs. NTDs are parasitic and bacterial infections that affect more than one billion of the world's poorest people, causing profound sickness and disability, including blindness, and imposing a devastating economic and social burden on the communities and countries affected. Many NTDs can be treated and prevented through annual treatment with safe and effective drugs. The NTD Support Center, with co-funding from USAID, UK aid and the Bill & Melinda Gates Foundation, manages an operational research portfolio that is concentrated on improving the equity and effectiveness of NTD programs. Research supported through USAID includes projects focused on the development and introduction of new diagnostic tools that enable programs to make better decisions about when to start and stop treatment as well as testing new strategies to provide care for patients disabled by elephantiasis. Outcomes from these research projects are shared with all NTD-endemic countries through the USAID's implementing partners and the World Health Organization. The Task Force is also proud to partner with USAID on this effort through our programs that manage NTD drug donations: the Mectizan Donation Program, supported by Merck & Co, Inc. and the International Trachoma Initiative, supported by Pfizer. The United States has been a longstanding and well-recognized leader in global efforts to eliminate the transmission of NTDs and to achieve sustainable development goals. Since its start in 2006, the USAID NTD program has supported the distribution of 2.8 billion safe and effective treatments to more than 1.4 billion people in more than 25 countries. USAID's program targets five of the most common NTDs that have proven, cost-effective health interventions including Lymphatic Filariasis (elephantiasis); Blinding Trachoma; Onchocerciasis (river blindness); Schistosomiasis (snail fever); and Soil-transmitted Helminths (hookworm, roundworm, whipworm). Its achievements include: --315 million people no longer requiring treatment for Lymphatic Filariasis or elephantiasis --151 million people no longer requiring treatment for Blinding Trachoma --10 million people no longer requiring treatment for onchocerciasis --Ten countries having eliminated at least one NTD as a public health problem (meaning the levels of infection and disease are now beneath the threshold set by the World Health Organization) --15 additional countries estimated to eliminate at least one NTD as a public health problem within five years Because medicines that can cure or eliminate these diseases are made available without cost from their pharmaceutical manufacturers, the programs working towards the elimination and control of NTDs are often referred to as the ``best bargain in global health.'' The USAID program has leveraged more than $26 billion in donated medicines through an unprecedented public-private partnership with the pharmaceutical industry. Every $1 invested by the U.S. Government leverages $26 in donated medicines for mass treatment campaigns. USAID also funds research leading to exciting innovations including those for diagnostics, treatments and cures, vaccines, and vector and biological control tools. Operational research optimizes strategies for using new tools in the field and has been endorsed by the World Health Organization in guidance taken up by ministries of health. These innovations benefit all countries, regardless of whether they receive U.S. funding or not. A key pillar of USAID's program is sustainability. Partners are working with 12 national ministries of health, along with ministries of education, finance, environment, and water and sanitation, to develop long-term plans for sustainability and country ownership, reinforcing national governance and ownership and strengthening health delivery systems and integration into national health plans. Recognizing the importance of integration to sustainability, the USAID NTD program began the scale-up of its cross-sectoral activities in 2018, including increasing access to safe water and hygiene in schools and communities in five countries to control and prevent NTDs. 2021 challenges COVID-19.--The COVID-19 pandemic has brought new challenges. NTD activities were halted in March 2020 and are now resuming their work. Costs to implement NTD programs during COVID-19 pandemic have increased including infection prevention measures, such as hand sanitizer & personal protective equipment (PPE), and have also required new modes of working to accommodate physical distancing, such as increasing the number of distribution venues and number of days for training community drug distributors, increasing number of vehicles to transport teams to allow some distancing, etc. Complementary funding cuts.--Another challenge has resulted from proposed cuts in NTD funding from the United Kingdom's Foreign, Commonwealth and Development Office (FCDO, formerly known as DFID). UK aid support for NTDs is expected to be cut by 90%--a loss of more than $150M in country support and equal to more than a third of the global NTD implementation funds. Prior to this, FCDO investments were closely coordinated with USAID to maximize the reach of NTD programs and their impact. The FCDO cuts will create a gap in the 15 countries in USAID's portfolio where there was significant co-investment of USAID and FCDO funds. Bipartisan discussions are underway to encourage other countries to help fill the gap. The requested $25 million increase will allow USAID to ensure that progress toward its most urgent goals is not sidelined. Because USAID is already operating in these countries, the institutional mechanisms required to use these additional funds have already been established and are fully operational. This increased financial support will protect the US investment to date, stabilizing and reducing the impact of the FCDO cuts on a highly successful portfolio. Increased USG support will enable countries to continue the push towards sustainable NTD programs with reduced future dependence on external funding. budget request Funding for the NTD program has been near-level since 2014. In FY19 its funding increased from $100 million to its current level of $102.5 million. An increase is needed to accelerate progress on high-value activities. Accelerating progress: With this additional funding, USAID and its partners can also continue and expand upon the excellent progress that has been made and to ensure that America's leadership and forward momentum continue to advance NTD elimination in priority countries, leading to stronger economies, workforces and business partners and saving lives and livelihoods by: --Expanding the number of treatments in existing areas --Adding new geographic areas, potentially those listed by WHO as still needing support --Increasing capacity to move from control to elimination of onchocerciasis in some areas --Expanding urgently-needed investments in research and development-- including diagnostics, drugs and operational research- for NTDs to ensure tools and strategies are available to overcome emerging challenges --Supporting greater integration with complementary programs necessary for the success of NTD prevention, control and elimination efforts, including WASH, nutrition, education, One Health and vector control Eliminating NTDs contributes to economic development in these countries, reducing poverty and building new markers for US businesses. Looking forward, USAID expects to continue as a major partner working with the World Health Organization to achieve the ambitious goals of the newly launched 2021-2030 NTD road map, including 1) reducing the number of people requiring NTD interventions by 90%; and 2) eliminating at least one NTD in 100 countries. Thanks to your support, fifteen countries supported by USAID's NTD program are expected to eliminate at least one NTD in just 5 years. We appreciate your consideration of this request and are available to answer any questions you may have and to be a resource for you on issues related to NTDS. [This statement was submitted by Patrick J. Lammie, PhD, Director.] ______ Prepared Statement of the Office Of Inspector General, USAID Mr. Chairman, Ranking Member, and Members of the Subcommittee: Thank you for the opportunity to provide a statement for the record on the major management challenges USAID faces in providing development and humanitarian assistance. The USAID Office of Inspector General's core mission is to strengthen and safeguard U.S. foreign assistance. We work across the agencies we oversee-and with oversight partners worldwide-to promote effectiveness, efficiency, and accountability in foreign assistance programs and operations and prevent and detect the fraud, waste, and abuse that can jeopardize their success. USAID stands out among the agencies we oversee for the scale of its activities and the challenges it faces in their implementation. In fiscal year 2020, USAID managed $30 billion in budgetary resources. The inherent complexity of coordinating and implementing this level of foreign assistance-especially in areas affected by crisis and conflict- and the urgency to respond to the COVID-19 pandemic create major challenges for USAID. As the Agency exercises flexibility to adapt to different country contexts and ensure beneficiaries receive the assistance they desperately need, it must maintain strong safeguards and risk management practices to confront these challenges. Our independent oversight remains critical to helping USAID advance U.S. foreign assistance objectives during this challenging time. Our audits, investigations, and other oversight activities are designed to promote the overall effectiveness of agency programs and operations. Our focus on strategic, cross-cutting oversight enables us to drive actions that get at the root of significant problems affecting USAID's complex programs and operations. This approach also reflects our continued focus on emerging priorities. For example, last year we realigned work to elevate oversight of agency responses to COVID-19. This year, we have formed a new taskforce within OIG to drive and inform oversight of aid and assistance programs in the Northern Triangle countries. We remain committed to addressing these and other current and emerging priorities and sharing the results of our work with you and other stakeholders. Our report on top management challenges facing USAID in fiscal year 2021 demonstrates the impact of our work.\1\ This statement highlights the top management challenges-including the COVID-19 response and other key risk areas-that need USAID's attention now and into the foreseeable future. oversight of usaid's covid-19 response The COVID-19 pandemic poses a significant public health crisis. More than a year after its emergence-and in the wake of 169 million confirmed cases and almost 3.5 million deaths as of the end of May 2021-COVID-19 has disrupted economies, strained democratic institutions, and deepened existing humanitarian crises. The pandemic also emerged in an international environment marked by increasing great power competition and disinformation campaigns by hostile actors. USAID was tasked with responding to COVID-19 overseas, receiving additional appropriations beginning in March 2020 to do so. While the Agency leveraged its experience responding to other disease outbreaks such as Ebola and Zika, the rapid spread of COVID-19 worldwide exacerbated challenges USAID faces, especially in nonpermissive settings, and increased risks related to monitoring programs and global health supply chains. USAID had to respond to a multifaceted global emergency that forced almost all staff to shift to virtual work, while many overseas staff departed their posts. USAID began to program significant levels of COVID-19 funding as both implementers and beneficiaries also faced similar constraints caused by lockdowns, border closings, supply chain disruptions, and movement restrictions. The pandemic required a whole-of-government effort. Our past work has identified interagency coordination, especially related to responding to public health emergencies, as a challenge for USAID.\2\ Although our work has helped position USAID to better respond to COVID- 19, the scope and scale of the pandemic and its impact have stretched the Agency, and competing interagency priorities remain a significant challenge area. For example: --Our recent audit found that USAID's ventilator donation program marked a significant departure from the Agency's customary practices for responding to public health emergencies and its original pandemic plans.\3\ While USAID initially focused on preventative measures to thwart the spread of COVID-19, the National Security Council directed the Agency to spend about half of its global health funding from the March 2020 supplemental funding on ventilators for the sickest patients. Directives from the National Security Council specified the recipient countries, how many ventilators to send, and which models to use, which did not align with USAID's initial response planning. --This audit also found that USAID had limited control over ventilator donations and that monitoring mechanisms were not in place at the time of delivery. USAID had limited information about the location of ventilators within countries. The need to effectively track ventilators is underscored by the work of OIG special agents in recovering 191 USAID-procured ventilators that were stolen in Florida while en route to El Salvador. We plan to follow up on actions the Agency is taking to locate ventilators sent overseas and establish an asset management tracking platform. When we analyzed the impact COVID-19 has had on USAID's ability to monitor its programs, we noted challenges to program monitoring efforts. Such challenges included movement restrictions and technology challenges that limited the Agency's ability to conduct in-person site visits, limited in-person verification of data from implementers, and kept staff from engaging directly with beneficiaries. USAID missions, nonetheless, adapted their approaches to monitoring and tapped into related policy flexibilities and guidance designed to help them. However, the extent to which these approaches and flexibilities have been effective remains unknown and will likely be seen through mechanisms such as program evaluations and independent financial and performance audits.\4\ Looking ahead, OIG remains committed to robust oversight of ongoing and new USAID pandemic response efforts and funding. Given U.S. commitments to support the international delivery of COVID-19 vaccines, we are focused on combatting potential fraud facing this effort and have forged relationships with oversight counterparts at leading international organizations involved in vaccine delivery. We are conducting an evaluation of USAID's efforts to develop and implement a COVID-19 vaccine strategy, and are planning work on USAID's efforts to address the second-order effects of COVID-19. This includes identifying new pandemic threats and preserving gains in the Agency's HIV, malaria, and tuberculosis programs in the wake of COVID-19.\5\ managing risks inherent to humanitarian assistance and stabilization activities amid a public health emergency of international concern In fiscal year 2020, USAID spent approximately $6.6 billion on humanitarian assistance activities. The United Nations estimated that 235 million people-1 in 33 people worldwide-would need humanitarian assistance and protection in 2021, the highest figure in decades.\6\ The inherent risks in crisis and conflict settings demand distinct approaches for planning, implementation, and monitoring that enable flexible but controlled responses. The flow of billions of dollars in aid and assistance also creates opportunities for fraud and diversion of U.S.-funded goods to the illicit market and terrorist or other sanctioned groups. Further, sexual exploitation and abuse has been a longstanding problem in the foreign aid sector given the inherent power imbalance between aid workers and vulnerable beneficiaries. USAID has taken steps to understand, evaluate, and mitigate risks to help prevent fraud and other abuses before they occur. Nevertheless, our work continues to identify vulnerabilities that inhibit USAID assistance from having the intended impact or reaching those who need it most. For example: --USAID guidance and practices do not always encourage transitioning from humanitarian assistance, as we found in Iraq. Though the number of internally displaced Iraqis steadily declined following the territorial defeat of ISIS in 2017, USAID has yet to ensure transition planning was incorporated into its annual planning process, conduct forums for coordinating humanitarian assistance with longer-term stabilization efforts, and ensure implementers submitted complete transition plans for their projects when required.\7\ --In crisis settings, USAID often works through public international organizations (PIOs), like the World Food Program, to reach beneficiaries. Yet doing so limits USAID's control and visibility over U.S.-funded humanitarian assistance, and in turn, limits its ability to identify and mitigate risks. Our recently completed and ongoing work highlights constraints on USAID awareness of threats to its programming. For example: --Prior to making humanitarian assistance awards, USAID follows a range of due diligence measures to mitigate the risk of assistance inadvertently falling into hands of terrorist organizations. However, our work has identified vulnerabilities in USAID's vetting practices and limitations in accessing and monitoring national security information.\8\ Certain USAID- funded implementers have also concealed past ties to designated terrorist entities when bidding on USAID awards by falsifying a certification designed to reveal this information. --USAID may contract third-party monitors-often hired locally, and who may have fewer access restrictions-to observe on-the-ground programming on USAID's behalf. Our recent work in Iraq and Africa's Lake Chad region illustrates how gaps in USAID management have limited the use and effectiveness of this monitoring technique.\9\ USAID has similarly faced challenges in managing acute risks related to fraud and criminal behavior in crisis settings. For example: --Our multiyear investigation revealed bid rigging, contract steering, and invoicing schemes that compromised humanitarian assistance intended for displaced Syrians. As a result of our work, a major international, nongovernmental organization (NGO) paid $6.9 million to settle a False Claims Act case related to grossly inflated invoices submitted to USAID, and an NGO procurement official was extradited to the United States and sentenced to 40 months in prison on a related bribery charge. --A recent audit found that USAID lacked a framework for managing fraud risks in a humanitarian response. While USAID had taken initial actions to mitigate related risks in its Syria response, it did not sustain monitoring of cross-border activities susceptible to fraud.\10\ Another recent audit on USAID's response to the Venezuela regional crisis noted that while USAID's humanitarian assistance operating units had incorporated practices to manage fraud risks, their guidelines for implementers lacked risk management requirements.\11\ --While USAID has increased its focus on protecting beneficiaries from sexual exploitation and abuse (SEA), the Agency still faces barriers in responding to allegations, preventing perpetrators from recirculating through the aid sector, and holding implementers accountable for failing to detect, report, or respond to allegations. Our audit of USAID's approach to respond to and prevent SEA noted that the Agency had not built in consistent pre-award measures and did not monitor implementers' efforts to prevent SEA or have related guidance in place to enable staff to effectively perform this function. USAID also lacked clearly defined roles and responsibilities and a centralized tracking mechanism for responding to and managing SEA allegations. The Agency plans to address the report's nine recommendations to improve USAID's controls for preventing and responding to SEA.\12\ USAID continues to make progress toward understanding and mitigating risks in crisis settings. Its recent actions include establishing three new bureaus to promote coordination and improve field support, regularly assessing new risks and evaluating approaches for strategically managing them, issuing new Agency guidance to codify vetting policies and procedures, and providing training and guidance for staff and implementers on when and how to use third-party monitors. To help protect U.S. funding from malevolent actors, we will continue to prioritize addressing allegations of fraud and misconduct affecting humanitarian assistance, conduct fraud awareness briefings for USAID staff and implementers, and leverage new and existing relationships with oversight counterparts working in humanitarian assistance and stabilization settings. In addition, we have an audit underway that focuses on humanitarian response activities in Yemen. promoting local capacity and improving planning and monitoring to achieve sustainability of u.s.-funded development USAID's development programs complement broader U.S. Government diplomacy and defense efforts to safeguard and advance U.S. national security and economic interests. USAID has recognized that the long- term success of international development depends on host country commitment and capacity to sustain gains. Yet our audits reveal ongoing challenges to achieving sustainability of U.S. foreign assistance programs, particularly when the imperative to achieve specific development outcomes competes with goals to develop local capacity. For example: --USAID has recognized the importance of strengthening health systems to meeting overall health goals and improving countries' abilities to react to large-scale health emergencies. While USAID aimed to strengthen countries' overall health systems, programs instead prioritized gains tied to primary health goals-like achieving an AIDS-free generation-because of how those health goals were tracked and received designated funding.\13\ --Some USAID missions in Africa operated parallel supply chains alongside host government systems and hired consultants to do the work of government officials. The Agency took this approach to ensure global health goals were met and that beneficiaries had uninterrupted access to critical medicines for malaria, tuberculosis, and HIV/AIDS, but in doing so, missed opportunities to build local capacity.\14\ USAID also continues to face challenges in providing effective oversight and conducting evaluations of the activities it implements. For example: --USAID requires operating units to conduct at least one performance or impact evaluation during each Democracy, Human Rights, and Governance (DRG) project to help expand the Agency's knowledge base. However, we found USAID focused primarily on less costly performance evaluations, with some missions in Europe and the Middle East lacking substantive impact evaluations.\15\ --Effective monitoring of large awards like USAID's $9.5 billion award to implement procurement and supply management activities for the Global Health Supply Chain Program is key to ensuring that health commodities such as medicines and supplies are delivered as planned. However, USAID could not determine the extent to which reported performance metrics of its largest supply chain project reflected actual improvements in performance.\16\ --USAID engages with the private sector to help achieve sustainability. In a recent audit, OIG identified six engagement approaches that USAID generally used in an effort to boost private sector investment in foreign development, but also found that insufficient Agency-wide guidance, data, and metrics limited USAID's ability to conduct, manage, and oversee engagement with the private sector.\17\ Our recent and ongoing investigations further illuminate how gaps in effective oversight and monitoring of activities can result in shortfalls in USAID programs and fraud, waste, and abuse. For example: --We found that a Ugandan implementer failed to report fraudulent activity on a social marketing health project and the implementer's staff solicited bribes from USAID field staff to conceal the reporting of nonexistent activities. USAID terminated the implementer's cooperative agreement based on an OIG referral and issued a $4.9 million dollar bill of collection in April 2020. --Another investigation similarly uncovered systemic mismanagement, inadequate internal controls, and insufficient financial accounting by a U.S.-based university, which affected a development project in Honduras. As a result of our investigation, USAID issued a $4.4 million bill of collection to the university in July 2020. --Lastly, a joint investigation we conducted with the Special Inspector General for Afghanistan Reconstruction identified a scheme to defraud the Government of Afghanistan of over $100 million, which USAID had provided to Afghanistan to construct an electric grid through the country's national power utility. As a result of our joint investigative work, the individual responsible for the scheme pleaded guilty to wire fraud. Despite these issues, USAID continues to take steps to improve sustainability, increase local capacity, and enhance oversight of its activities. For example, in response to our related audit recommendations, USAID revised its vision for strengthening health systems, outlining how countries can increase the capacity of their local health systems and shift the focus of investments from specific functions and disease areas to integrated approaches for strengthening health systems. USAID also updated country strategies to increase emphasis on sustainability and self-reliance and increased awards to local organizations in recipient countries. The Agency is still working to use data to better manage its engagement with the private sector. We have numerous audits underway that further our oversight in the areas of program sustainability and monitoring activities. This includes audits that will assess how USAID is addressing risks associated with direction to increase President's Emergency Plan for AIDS Relief (PEPFAR) funding to local organizations in Africa, and how USAID missions are using third-party monitoring data to oversee programs in Asia. reconciling priorities with external stakeholders to efficiently and effectively advance u.s. foreign assistance objectives U.S. foreign assistance involves multiple Government agencies, donors, and local actors-each having its own priorities and strategies for advancing shared interests. Achieving development goals around the world often goes beyond unilateral efforts by USAID, depending on multilateral efforts where USAID may be the lead agency, a key partner organization, or a significant financial backer of responses. To further U.S. foreign policy and national security objectives, USAID must exercise its role and responsibility as the premier development agency by effectively navigating the divergent priorities and functions of multiple stakeholders to achieve complementary but distinct goals. Doing so is critical to enabling USAID to respond quickly to changing priorities even when decisions extend beyond its immediate control and authority. Our work has examined USAID adaptations to external factors influencing its operations and work to coordinate with other agencies and international organizations to advance development objectives. USAID has frequently had to make strategic adjustments in response to policy developments outside of its control. For example: --Decisions made outside of USAID have affected the Agency's staffing and impacted its ability to monitor programs and ensure their sustainability. Past quarterly reporting on Iraq has highlighted the effects of posture adjustments and deteriorating security conditions on staff levels in Iraq, bringing USAID expatriate staff levels down by more than 75 percent as USAID's programs in the country grew. In Afghanistan, we found that while USAID made staffing cuts per State Department direction, it did not fully assess the risks that corresponding programming cuts could have on the sustainability of its investments, or properly prepare staff or stakeholders for risks associated with these staff reductions.\18\ --A recent OIG memo on lessons from the fiscal year 2019 budget process highlighted interagency constraints on budget execution, describing how outside factors-such as external reviews and differing opinions on the direction of foreign assistance programming-affect USAID's ability to obligate funds.\19\ Our work also addresses challenges USAID has encountered in coordinating with others to promote effective programming: --In responding to the Venezuela regional crisis, USAID needed to coordinate with multiple stakeholders. However, our audit found USAID faced significant policy, coordination, and strategic planning challenges in responding to the crisis. Issues we identified stemmed from not having a process for documenting directives from the National Security Council, as well as not having developed joint strategic humanitarian response plans with the State Department.\20\ --Effective coordination between USAID and the State Department can help maximize resources and outputs and avoid redundancies in achieving U.S. foreign policy goals around DRG programs. Our audit found that this coordination primarily occurs in the field, but that not all missions had established or maintained DRG work groups-and therefore, the agencies may miss opportunities for strengthening DRG coordination in the field.\21\ --In some cases, legal requirements prevent USAID from supporting beneficiaries who would otherwise fit the profile of a targeted population. A recent audit found that this was the case with USAID's crime and violence prevention program in El Salvador, where U.S. and local laws prevented USAID from working with individuals at the highest risk of engaging in criminal and violent activity, including active gang members and chronic offenders associated with MS-13. While the Treasury Department granted USAID a 2-year license to include gang members as program beneficiaries, the authorization took about 2 years, delaying programs for the highest risk group.\22\ --USAID frequently relies on PIOs to implement key programs and activities. We reported in late 2018 that USAID's insufficient oversight of PIOs put its programming at risk.\23\ This work prompted USAID to include a standard award provision for PIO awards with a requirement to report fraud and misconduct allegations directly to OIG. Maximizing partnerships with U.N. agencies and multilaterals and reconciling differences among Federal agencies are important to effectively and efficiently advance U.S. foreign assistance objectives. USAID continues to take steps to address challenges in doing so. For example, USAID now has a dedicated office to provide better oversight of PIOs. To ensure USAID's investments are safeguarded to the maximum extent possible, we coordinate extensively with oversight partners at the State Department and Defense OIGs on oversight of contingency operations. We also coordinate with the State Department, Department of Health and Human Services, and Peace Corps OIGs on oversight of international HIV/AIDS, malaria, and tuberculosis programs. Additionally, we worked with DFC OIG in a supporting and advisory role to assist in establishing that office as it builds internal capacity. We have established key relationships with counterpart oversight offices throughout the world-such as the European Anti-Fraud Office, the Integrity Vice Presidency of the World Bank Group, and Inspectors General of the World Food Program and the Global Fund-as well as equivalent units at UNICEF and Gavi, to ensure fraud and corruption risks are mitigated through joint investigations and information sharing. addressing vulnerabilities and implementing needed controls in agency core management functions To carry out its mission effectively and efficiently, USAID relies on a network of support functions for managing Agency awards, finances, information, and human capital. USAID has made progress in strengthening its controls over core management functions, but our recent audits and investigations show that gaps in USAID's controls remain. These gaps are even more critical to address due to the additional operational challenges presented by the pandemic. --Award Management. Our audit of USAID's grant close-out process identified weaknesses in communication, procedures, award de- obligation, documentation, and employee training and certification-along with over $178 million that USAID could de- obligate from expired awards and put to better use.\24\ Our audit of USAID's procurement and management of its $9.5 billion award to implement procurement and supply management activities for its Global Health Supply Chain Program determined that weaknesses in planning and evaluation processes hindered USAID's ability to fully support key decisions made in the design and award of the contract.\25\ --Financial Management. USAID must comply with financial management requirements to ensure the Agency maximizes its resources. While our audit of USAID's financial statements for fiscal years 2020 and 2019 did not identify any material weaknesses in USAID internal control over financial reporting, we identified two significant deficiencies related to recording accrued expenses and account management.\26\ --Information Management. USAID depends on information systems for all facets of business. Our audit of USAID's Development Information Solution system found that although USAID was making progress in the development and implementation of the system, its deployment was behind schedule and not on track to provide the Agency with advanced reporting to improve evidence- based decision making.\27\ In addition, in the past year, the Agency's expanded use of telework to protect the health and safety of staff during the pandemic has increased risks to the Agency's information systems and calls for additional diligence. In June 2020, USAID's Chief Information Officer reported a 400 percent increase in cyberattacks on the Agency since the start of the pandemic. Our most recent audit of USAID's information security program identified needed improvements in risk management, configuration, and identity and access management; security training; information security continuous monitoring; and contingency planning.\28\ --Human Capital Management. USAID has faced challenges maintaining an adequately trained workforce at the staffing levels needed to accomplish its mission. In the last 10 years, about one-third of our performance audits identified staffing or training as a cause of or factor that contributed to reported shortcomings. While the Agency is making efforts to develop a strategic workforce plan to align its human capital with current and future goals, we have an ongoing audit that will look at USAID's human capital hiring mechanisms. In addition, whistleblower retaliation against employees of USAID implementers who report fraud or misconduct in the performance of a USAID award remains a concern. Between 2018 and 2020, we recorded a 21 percent increase in whistleblower retaliation allegations received by OIG. concluding observations about continued oversight We appreciate your interest in our work and continuing support for our office's independent oversight mandate. We value opportunities like this to share our observations and keep Congress fully informed on our oversight of development and humanitarian assistance programs and operations. USAID OIG remains committed to maintaining the highest levels of accountability, adding value, and ensuring that USAID prudently uses every dollar it receives. Our fiscal year 2020 audit and investigative returns amounted to nearly four times the amount we receive to support our operations. In addition to these financial returns, our recommendations have triggered foundational changes in policy and programming around global health and humanitarian assistance, Agency procurements, and accountability over awards to PIOs. Building on our recent accomplishments, we look forward to discussing with the Committee our priorities, plans, and anticipated resource requirements for ensuring effective oversight in fiscal year 2022. This includes rapidly responding to emerging oversight requirements, increasing our capacity to respond to whistleblower retaliation allegations, and addressing oversight requirements associated with increased investments in COVID-19 response efforts. We will continue to maximize our impact by taking a strategic approach to our work and leveraging key partnerships within the oversight community and with the agencies we oversee. --------------------------------------------------------------------------- \1\ USAID OIG, ``Top Management Challenges Facing USAID in Fiscal Year 2021,'' November 13, 2020. As required by statute, we annually identify and report the top challenges facing the agencies we oversee and the progress made in managing them. Visit our website to view all OIG reports referred to in this statement. \2\ USAID OIG, ``Lessons From USAID's Ebola Response Highlight the Need for a Public Health Emergency Policy Framework'' (9-000-18-001-P), January 24, 2018. \3\ USAID OIG, ``USAID Had Limited Control Over COVID-19 Ventilator Donations, Differing From Its Customary Response to Public Health Emergencies'' (4-936-21-002-P), February 24, 2021. \4\ USAID OIG, ``USAID Adapted To Continue Program Monitoring During COVID-19, But the Effectiveness of These Efforts Is Still To Be Determined'' (9-000-21-007-P), May 21, 2021. \5\ USAID OIG, ``COVID-19 Oversight Plan for Fiscal Years 2021- 2022,'' October 22, 2020. \6\ United Nations Office for the Coordination of Humanitarian Affairs, ``Global Humanitarian Overview 2021,'' December 10, 2020. \7\ USAID OIG, ``Enhanced Guidance and Practices Would Improve USAID's Transition Planning and Third-Party Monitoring in Iraq'' (9- 266-21-003-P), February 19, 2021. \8\ USAID OIG, ``Limits in Vetting and Monitoring of National Security Information Pose Risks for USAID Humanitarian Assistance and Stabilization Programs,'' Classified Advisory, January 15, 2020. \9\ USAID OIG, ``Enhanced Guidance and Practices Would Improve USAID's Transition Planning and Third-Party Monitoring in Iraq'' (9- 266-21-003-P), February 19, 2021; ``USAID Has Gaps in Planning, Risk Mitigation, and Monitoring of Its Humanitarian Assistance in Africa's Lake Chad Region'' (4-000-21-001-P), October 15, 2020. \10\ USAID OIG, ``Weaknesses in Oversight of USAID's Syria Response Point To the Need for Enhanced Management of Fraud Risks in Humanitarian Assistance'' (8-000-21-001-P), March 4, 2021. \11\ USAID OIG, ``Enhanced Processes and Implementer Requirements Are Needed To Address Challenges and Fraud Risks in USAID's Venezuela Response'' (9-000-21-005-P), April 16, 2021. \12\ USAID OIG, ``USAID Should Implement Additional Controls To Prevent and Respond To Sexual Exploitation and Abuse of Beneficiaries'' (9-000-21-006-P), May 12, 2021. \13\ USAID OIG, ``More Guidance and Tracking Would Bolster USAID's Health System Strengthening Efforts" (4-936-20-001-P), October 21, 2019. \14\ USAID OIG, ``USAID'S Global Health Supply Chain Would Benefit From More Rigorous Risk Management and Actions To Enhance Local Ownership'' (4-936-20- 002-P), July 10, 2020. \15\ USAID OIG, ``Additional Actions Are Needed To Improve USAID's Democracy, Human Rights, and Governance Programs'' (8-000-20-001-P), November 26, 2019. \16\ USAID OIG, ``Award Planning and Oversight Weaknesses Impeded Performance of USAID's Largest Global Health Supply Chain Project'' (9- 000-21-004-P), March 25, 2021. \17\ USAID OIG, ``Improved Guidance, Data, and Metrics Would Help Optimize USAID's Private Sector Engagement'' (5-000-21-001-P), December 9, 2020. \18\ USAID OIG, ``USAID Needs To Implement a Comprehensive Risk Management Process and Improve Communication As It Reduces Staff and Programs in Afghanistan'' (8-306-21-002-P), March 19, 2021. \19\ USAID OIG, ``Lessons From USAID's FY 2019 Budget Process Highlight Interagency Constraints and Areas That Require Continued Attention,'' Memorandum, March 2, 2021. \20\ USAID OIG, ``Enhanced Processes and Implementer Requirements Are Needed To Address Challenges and Fraud Risks in USAID's Venezuela Response'' (9-000-21-005-P), April 16, 2021. \21\ USAID OIG, ``Additional Actions Are Needed To Improve USAID's Democracy, Human Rights, and Governance Programs'' (8-000-20-001-P), November 26, 2019. \22\ USAID OIG, ``USAID/El Salvador's Crime and Violence Prevention Programs Need to Focus More on High-Risk Individuals To Advance Security Goals'' (9-598-21-001-P), November 30, 2020. \23\ USAID OIG, ``Insufficient Oversight of Public International Organizations Puts U.S. Foreign Assistance Programs at Risk'' (8-000- 18-003-P), September 25, 2018. \24\ USAID OIG, ``USAID Complied with the GONE Act but Still Has a High Risk of Delayed Grant Closeout'' (0-000-20-002-C), March 31, 2020. \25\ USAID OIG, ``Award Planning and Oversight Weaknesses Impeded Performance of USAID's Largest Global Health Supply Chain Project'' (9- 000-21-004-P), March 25, 2021. \26\ USAID OIG, ``Audit of USAID's Financial Statements for Fiscal Years 2020 and 2019'' (0-000-21-001-C), November 16, 2020. \27\ USAID OIG, ``USAID Was Not On Track To Achieve Performance and Cost Savings Goals for the Development Information Solution System'' (A-000-21-001-U), May 6, 2021. \28\ USAID OIG, ``USAID Generally Implemented an Effective Information Security Program for Fiscal Year 2020 in Support of FISMA'' (A-000-21-004-C), January 7, 2021. --------------------------------------------------------------------------- [This statement was submitted by Thomas J. Ullom, Acting Inspector General, USAID.] ______ Prepared Statement of the Oxfam On behalf of Oxfam, thank you for the opportunity to submit testimony on the FY22 State, Foreign Operations and Related Programs Appropriations bill. Oxfam is a global organization working to end the injustice of poverty. We help people build better futures for themselves, hold the powerful accountable, and save lives in disasters. Our mission is to tackle the root causes of poverty and create lasting solutions. U.S. leadership in addressing COVID and new and ongoing humanitarian challenges has never been more critical. We urge the Committee to support the Administration's request for $69.1 billion, in order to restore U.S. leadership in supporting poverty-focused development, humanitarian assistance programs, and international organizations. We believe that in addition to new funding, locally led development must be at the core of US foreign aid, we urge the Committee to prioritize country partnerships and domestic resource mobilization. We appreciate the chance to elevate the following issues: COVID-19 vaccine access and delivery and highlight our strong support for gender, climate and multilateral funding. covid-19 vaccine access & delivery As our country expands access to COVID-19 vaccines through the broadest vaccination campaign in U.S. history, the rest of the world is suffering. Few of the six billion people living in low- and middle- income countries will be vaccinated against COVID-19 this year and many may not be vaccinated until 2024, if ever. Virus variants threaten to make struggles with coronavirus an enduring fact of life. Millions more people will die, and tens of millions of people will be pushed into extreme poverty. The only way to get the pandemic under control is to massively accelerate global vaccine manufacturing and strengthen health systems to turn vaccines into vaccinations. We urge the Committee to do everything in its power to help the world manufacture billions more doses of COVID-19 vaccine and strengthen global health systems. An ambitious manufacturing operation and vaccine delivery program would benefit the world and will help prevent the spread of variants while reviving economies and reestablishing U.S. leadership. gender The COVID-19 global pandemic reversed gains made toward gender equality. According to the World Economic Forum's ``Gender Gap Report,'' it will now take nearly 140 years to close the gap between men and women; before the pandemic, it was estimated to take 100 years. The UN rang the alarm bell on the ``shadow pandemic'' of spikes in intimate partner violence over the last year as people were confined to their homes in the context of mounting anxiety and economic stress linked to the pandemic. At the peak of the crisis, UNESCO data showed that over 1.6 billion learners in more than 190 countries were out of school, pushing women out of the workforce to provide child care. An estimated 11 million girls may never return to school. Underpaid care workers-of which over 90 percent are women-at long-term care facilities for people with disabilities and the elderly were overburdened. The hospitality, tourism, and food sectors were hit hard and left women unemployed; Oxfam estimates show that women in formal employment lost $800 billion in income in 2020. During the pandemic, people in the LGBTQIA+ community experienced further restriction of their rights by governments around the world. As the United States Government develops strategies to address COVID-19's aftermath domestically and globally, it must recognize that recovery has to center the needs of women and gender-diverse people, and that by investing in gender equality and women's empowerment, it has an opportunity to become a leader in the post-pandemic world. Given the administration's commitment to a whole-of-government approach to gender and its prioritization of gender equality in aid and development assistance, it is imperative that the FY22 budget provide funding commitments commensurate to the crisis conditions so many women find themselves in. Instead, the current $1.2 billion request falls short of the gender requests made each year under the second Obama administration, including the FY2017 $1.3 billion request. The government should signal its leadership on gender by committing no less than $2.1 billion-scaling up funding from the FY2021 $525.7 million request under the Trump administration-in FY22 to promote gender equality and women's empowerment in the United States Government's diplomatic, development, and humanitarian efforts. According to a McKinsey report on the regressive effects of COVID-19 on women, failing to take action now to address gender inequality will have significant consequences on gender parity and slow down global economic growth over the next decade. Thus, a commitment of at least $2.1 billion will address the long-lasting effects of the pandemic on gender equality and help ensure we do not return to a pre-pandemic status quo that left women and gender-diverse people behind. To set a path to a gender-equitable recovery in the post-COVID-19 era, across US foreign aid and assistance, programs and policies should integrate a gender analysis and consider differential gender impacts, with a commitment to mainstream gender in all projects by 2025 to ensure 100 percent of funding qualifies as ``Gender Equality/Women's Empowerment-Secondary''. An additional category for funds to feminist and women's rights organizations should also be added. We urge the Committee to commit no less than $270 million to this category for FY22, and to scale up this commitment in subsequent years. Further, gender stand-alone programming would strengthen the US' performance to achieve gender equality globally; we request a commitment to scale up gender equality and women's empowerment programs within the ``Gender Equality/Women's Empowerment-Primary'' CBJ category to 20% of international funding by 2025. The requested $200 million for the Gender Equity and Equality Action Fund (GEEA) is important for the global recovery from COVID-19. However, to sufficiently address the health and economic emergencies and the subsequent impact these have had on women, the GEEA should be scaled up beyond the FY21 funding allocated to its predecessor, W-GDP. The administration's domestic focus on investing in the care economy is timely as women have suffered disproportionately from economic fallout of the pandemic in the US and abroad, in part due to their care work responsibilities; this same focus should be brought to US foreign assistance programming. A scaled-up gender investment will enable the United States Government to follow through on commitments made to gender equality and women's empowerment, including gender equality prioritization by the US Development Finance Corporation and the Millennium Challenge Corporation; the administration's commitment to address the root causes of irregular migration, including sexual, gender-based, and domestic violence, from Central America to the United States; support of LGBTQIA+ rights and advancing inclusion for the community; resumed funding of the United Nations Population Fund; and support of the implementation of the Women's Entrepreneurship and Economic Empowerment Act and the Women, Peace, and Security Act. climate Across the world, climate change is causing devastating impacts. However, it is the world's poorest and most vulnerable communities who are hit the hardest, suffering from loss of lives and livelihoods, damaged homes and schools and, at times, being forced to flee their homes. Despite being hit the hardest by climate change, these vulnerable communities are the best agents of change to address the climate crisis, yet they lack the resources to mitigate and adapt to our changing climate. Developed countries, such as the US, have a responsibility to help these vulnerable communities in order to reduce suffering and support a just transition to a net-zero economy in an effort to keep average global temperatures below 1.5 degrees Celsius. This is why the US must scale up its international climate finance commitments after years of neglect and ensure these investments effectively reach those who need it the most. We urge the Committee to significantly scale up multilateral and bilateral international climate finance and provide clear direction that climate investments must provide meaningful and substantial support for addressing climate impacts. This starts with fulfilling the outstanding $2 billion pledge to the Green Climate Fund and a new investment of $100 million to the Adaptation Fund, a multilateral fund dedicated to supporting vulnerable communities in adapting to the impacts of climate change. This also includes taking a food-first approach to scaling up investments for climate-related and global food security activities, based on the needs and priorities of a country driven process, in order to boost food and nutrition security, support the resilience of agricultural livelihoods in vulnerable communities and drive mitigation and net-zero efforts that prioritize the rights, livelihoods and food security of local communities. These investments are only a start considering the mounting costs of climate-related disasters, such as hurricanes, floods and droughts, that wreak havoc on the poorest and most vulnerable. However, the Committee has an opportunity to send a strong political signal that the US supports the world's most vulnerable communities while re-establishing US global leadership in addressing the climate crisis. In addition to enhancing the quantity of international climate finance, it is just as important to enhance the quality of these investments. Multilateral and bilateral climate investments must be grounded in aid effectiveness principles--such as country and community ownership, localization, transparency, and accountability in decision making--in order to ensure US investments leave a sustainable impact and effectively reach those most in need, particularly women, marginalized communities and Indigenous peoples. Additionally, investments in international climate initiatives must not displace existing Official Development Assistance (ODA), which is critical for addressing global challenges such as poverty, conflict and food insecurity. international organizations We urge the Committee to fully fund the second installment of the U.S. contribution to IDA19, as well as additional funds to eliminate arrears. As the largest source of concessional finance for many countries, the International Development Association (IDA) provides significant support for health systems, vaccine acquisition, education, infrastructure, and other public services that are critical to ending the pandemic as well as supporting an equitable recovery. For the past year, IDA has dramatically increased support for low-income countries facing the unprecedented health and economic crises caused by COVID-19- committing over half of the resources available for the 3-year IDA19 replenishment period in the first year alone. Fully funding the U.S. commitment to IDA and addressing arrears will ensure IDA has the resources it needs to continue supporting low income countries, and enhance U.S. credibility and influence at the institution. The Committee should also call for a strong policy package alongside a robust IDA20 replenishment to ensure IDA resources support a stable, equitable, climate-just recovery. While the World Bank's effort to frontload resources in response to COVID-19 was welcome, it could do much more to provide debt-free financing for vaccines, build resilient public health and education systems, support governments to raise taxes fairly, address gender inequality, and increase ambition on its climate change agenda. Given the urgency of the climate crisis, the Committee should also call for critically needed reforms to enhance transparency in the World Bank's climate finance accounting and to end support for fossil fuels. [This statement was submitted by Mark Clack, Director of Government Relations and Public Policy.] ______ Prepared Statement of the Pandemic Action Network On behalf of the Pandemic Action Network-a network of over 120 non- governmental organizations that work together to drive collective action to help bring an end to COVID-19 and ensure the world is prepared for the next pandemic-I am pleased to offer testimony for Fiscal Year 2022 State and Foreign Operations Appropriations. To ensure the United States heeds the lessons learned from COVID-19 and helps ensure the world sustainably prioritizes and invests in pandemic preparedness, we respectfully urge you to substantially increase funding for global health security (GHS) through the State Department and the U.S. Agency for International Development (USAID). Specifically, Pandemic Action Network urges the Committee to prioritize: --No less than $2 billion for a multi-year U.S. contribution for a new enduring, catalytic, international pandemic preparedness financing mechanism, as prescribed in National Security Memorandum 1, Sec. 4; --No less than $675m for USAID's bilateral Global Health Security programs, including $200m for the Coalition for Epidemic Preparedness Innovations (CEPI) and $200m for a new GHS Grand Challenge initiative to advance health security innovations. --No less than $300m for USAID's Emergency Response Fund. The COVID-19 pandemic has laid bare the grave health and socio- economic consequences of repeated failures to prioritize and invest in health security and pandemic preparedness both at home and abroad. The pandemic had already cost over 600,000 lives in the United States and nearly 4 million around the world, and reversed years of progress in global health and development. While vaccination efforts have begun to dramatically reduce COVID-19 transmission in the U.S., the pandemic continues to spread globally as most of the world's population still lacks access to vaccines and other lifesaving tools and new variants of the virus continue to emerge. Until the virus is controlled around the world, Americans will not be safe and our domestic recovery will continue to stall. The COVID-19 pandemic was an avoidable disaster. Infectious disease experts around the world had been warning for decades of the threat of a fast-moving respiratory virus pandemic. Yet a persistent culture of panic and neglect has prevented forward-looking and long-term investments in global health security. U.S. leadership and international cooperation is essential both to end this pandemic and to prepare for the next one. The Pandemic Action Network urges this committee and Congress to break this dangerous cycle once and for all and commit to increased ?and sustained ? investments in pandemic preparedness in Fiscal Year 2022 and beyond. GHS and Pandemic Preparedness Financing Mechanism.--To help ensure that the world is better prepared to prevent or rapidly contain the next pandemic threat, the US should urgently help establish and seed fund a new multilateral financing mechanism to incentivize global and national investments in pandemic preparedness, with the focus on closing critical health security gaps in low- and-middle-income countries with the weakest health systems. The new financing facility should be funded with a minimum initial capitalization of $10 billion from public and private financiers, including a US$2 billion catalytic contribution from the United States. The COVID-19 pandemic demonstrates the perennial failure of the international community to adequately invest in pandemic preparedness- and we cannot repeat this dangerous mistake. Recent estimates point to at least an annual $5-10 billion annual global funding gap over the next 10 years to make the world better prepared for future pandemics; this figure is likely higher now given the toll COVID-19 has taken on countries with the weakest health systems. While a growing number of countries have taken ownership to develop national action plans for health security, most of these plans lack sufficient funding for implementation. The need is most acute in low- and- middle-income countries. Creating a new multilateral financing mechanism focused on strengthening country preparedness, in combination with increased funding for existing U.S. bilateral and multilateral global health programs, will change this equation. It will help save millions of lives and trillions in future economic losses by stopping future outbreaks at their source before they spread and become another deadly and costly pandemic. Taken together, these investments will incentivize country ownership of pandemic preparedness, accelerate closing of critical global health security gaps, and build more resilient health systems that will strengthen our collective frontline defenses against emerging pandemic threats before they can spread. Pandemic Action Network is pleased that President Biden called ``for creating an enduring international catalytic financing mechanism for advancing and improving existing bilateral and multilateral approaches to global health security'' in National Security Memorandum 1. Congress should support an initial investment of $2 billion to jumpstart this new facility through the State Department budget and urge other donor nations and private funders to join this U.S.-led effort. USAID.--USAID's ongoing work in global health security is also critical to pandemic preparedness and must be upscaled. By taking a ``One Health'' approach, USAID's global health security programs recognize the links between humans, animals, and environmental health and work to strengthen partner country capacity to address risks posed by zoonotic spillover. Coupled with the Agency's Emergency Response Program, these investments help partner countries build the platforms to detect, prevent, and respond to urgent infectious disease outbreaks, which keeps Americans and our partners safe. But USAID can do even more to advance global pandemic preparedness with the targeted resources. USAID launched the Grand Challenges to crowd source and fund needed innovations to combat Ebola and Zika, which yielded better personal protective equipment and tools appropriate for use in low-resource settings. A permanent Grand Challenge for Global Health Security can play a forward-looking role to incentivize innovations to detect, prevent, and rapidly respond to emerging infectious disease threats. CEPI.--Funding for U.S. participation in the Coalition for Epidemic Preparedness Innovation (CEPI) is also critical. We urge this Committee to both advance a $200 million commitment for Fiscal Year 2022, and support CEPI's new five-year plan of action toward the goal of developing novel vaccines within 100 days of detection of a novel pathogen that could pose a pandemic threat. CEPI's priority is ensuring equitable global access to vaccines for diseases with epidemic and pandemic potential. We are seeing firsthand the impacts of the inability of low- and middle-income countries around the world to access COVID-19 vaccines for their populations: continued deaths, economic emergencies, and risks of reversing hard-won progress against a novel and changing pathogen. U.S investment in CEPI is vital to ensure development of vaccines that are appropriate, accessible, and affordable across all income settings and to develop vaccines and platform technologies for the next ``Disease X''. COVID-19 makes evident that a pandemic threat anywhere can quickly become a pandemic threat everywhere. The case for investment has never been so clear. Congress should lead and ensure that our global health and development investments are both increased and leveraged to build a better prepared international system-and to make COVID-19 the last pandemic. [This statement was submitted by Carolyn Reynolds, Co-Founder.] ______ Prepared Statement of the PATH Chairman Coons, Ranking Member Graham, and members of the Subcommittee, thank you for the opportunity to submit written testimony regarding fiscal year (FY) 2022 funding for the US Agency for International Development (USAID), the Department of State, and related multilateral public-private partnerships. I am submitting this testimony on behalf of PATH, a global team of innovators and advocates working to solve the world's most pressing health challenges so all people and communities can thrive. We respectfully request that this Subcommittee allocate no less than $69.1 billion for the FY22 State- Foreign Operations Appropriations bill. Doing so would restore funding for the State-Foreign Operations bill to maintain current investments in critical programs that promote global health security and health system strengthening, women and children's health, and global health research and innovation. Sustained funding for foreign assistance is more critical now than ever. Within SFOPS, we support no less than $984 million for USAID's Maternal and Child Health account, of which $290 million should be for Gavi, the Vaccine Alliance as well as $902.5 million for the President's Malaria Initiative. Lastly, we support the President's FY22 Budget Request, recommending $745 million for USAID's global health security programs-out of which we request $200 million be allocated to Coalition for Epidemic Preparedness Innovations (CEPI)-and $250 million for the Department of State to establish a new multilateral health security financing mechanism. Using cost-effective strategies and bolstering health system strengthening efforts As an organization that partners with the public and private sectors in the US and in nearly 70 countries, PATH sees firsthand the tremendous impact that US-supported global health and development programs have with relatively modest investments. These investments are further maximized through traditional and innovative financing mechanisms, in tandem with efforts to strengthen countries' overall health systems toward sustainability and ownership. USAID programs have supported health system strengthening (HSS) efforts for more than 30 years with critical resources, technical expertise, and global leadership to sustain global health gains. Many of these efforts are supported through the Office of Health Systems and guided by the renewed Vision for Health System Strengthening 2030 which articulates a comprehensive approach toward improving health systems to advance USAID and national health priorities. However, funding currently available to the USAID Office of Health Systems for direct awards is insufficient to meet current challenges or strategically drive programs in the field. We request that this Subcommittee allocate $100 million to USAID for cross-cutting, health system strengthening programs, particularly support for health workers who are critical to continued COVID-19 response efforts, including through administering immunizations. Such an initiative would provide central level support to USAID missions, incentivizing them to align programming toward a common strategic purpose based on USAID's 2030 vision. Strengthening global health security USAID plays a critical role in helping strengthen pandemic preparedness and response through the Global Health Bureau's Global Health Security Agenda and Emerging Pandemic Threats programs. These investments support partner countries to reduce transmission of diseases between animals and humans, strengthen workforce development and disease surveillance, and enhance collaboration with national and community stakeholders to monitor viruses with pandemic potential. USAID's global health security work is further bolstered with programming in HIV/AIDS, tuberculosis, malaria, maternal and child health, and neglected tropical diseases, all of which strengthen health systems to enable them to better detect and respond to a variety of disease threats. Congress must dramatically increase support for this critical health priority which has, until recently, been overlooked and underfunded. Referencing the President's FY22 budget request, we support the requested $855 million increase over FY21 enacted funding to the Department of State and USAID global health programs. We urge the committee to allocate $745 million for USAID's global health security programs, including core bilateral programming, replenishing the Emergency Response Fund, and dedicating $300 million for contributions to support multilateral initiatives leading the global COVID-19 response through the Access to COVID-19 Tools (ACT) Accelerator. We also recommend $250 million for a new multilateral financing mechanism needed to support pandemic preparedness efforts, including through incentivizing domestic investments in low- and middle-income countries. As we have seen through COVID-19, vaccines play a critical role in responding to disease outbreaks. Within the funding for multilateral initiatives allocated to USAID's global health security programs, we are requesting no less than $200 million to support the COVID-19 related efforts of CEPI to address urgent global manufacturing and research priorities on the virus variants driving the current wave of the pandemic. CEPI holds both the mandate and expertise to continue to accelerate the development of vaccines needed globally and to counter emerging virus variants contributing to the humanitarian and health emergencies in India and Brazil. An immediate investment in CEPI is a key component to increase global production and delivery of COVID-19 vaccines to the world, develop and adapt vaccines to address the variants, accelerate an end to the acute phase of the pandemic, and get ahead of the next emerging threat. We are in a race against time; this investment cannot wait. Reducing maternal, newborn, and child deaths and leveraging public- private partnerships Every day, more than 14,000 children die from preventable or treatable causes, and more than 830 women die due to complications during pregnancy and childbirth. These preventable deaths primarily occur in resource-limited settings where women and children lack access to basic health care services. There is consensus among scientists and global health experts that ending such deaths is achievable but will require increased investment in scaling up interventions that tackle the leading killers of women, newborns, and children. Many of these are simple and low-cost, such as promoting healthy practices like breastfeeding and handwashing and ensuring access to lifesaving drugs for infections. Investments in the maternal and child health (MCH) account have lifesaving impact. These investments helped more than 84 million women and children gain access to essential-and often lifesaving-care in 2019 alone. But COVID-19 has put this progress at risk. Without additional interventions, years of progress in reducing maternal, newborn, and child deaths is set to be reversed. Experts estimate that the severe reductions in coverage of essential maternal and child health interventions caused by COVID-19 could result in 1.2 million additional child deaths and 57,000 additional maternal deaths every six months during the pandemic. That signifies a loss of a decade of progress, during which the US government invested more than $12.36 billion in maternal, newborn, and child health. We urge the committee to provide $984 million for global maternal and child health programs that further enable sustainable development. USAID has effectively advanced maternal and child health outcomes by leveraging American bilateral assets with multilateral technical support and financing to catalyze country commitments. In line with the new global immunization strategy, Immunization Agenda 2030, USAID has provided bilateral technical and commodity assistance to more than 100 countries in support of national child immunization programs. This impact is maximized through USAID's relationship with Gavi, the Vaccine Alliance, which provides new and under-utilized vaccines to developing countries. This public-private partnership has enabled the immunization of 822 million children since 2000, saving an estimated 14 million lives. In June of 2020, Gavi launched its third replenishment with an ambitious goal of immunizing an additional 300 million children-saving 8 million lives-by 2025. Through the passage of H.R. 133 in December of 2020, Congress committed an additional $4 billion to support global COVID-19 immunization efforts through Gavi. To ensure the greatest impact, this additional funding must be complemented with additional funding through the MCH core account to provide the technical support needed to scale- up and support these new rollouts and enable countries to provide more equitable access to new vaccines. The bilateral funding that supports the backbone of these vaccine programs must also meet the moment to ensure the vaccines become vaccinations. Fighting to eliminate malaria Another example of USAID's vital work is the tremendous progress made in fighting malaria through the President's Malaria Initiative (PMI). PMI's work to scale up malaria interventions in partner countries is contributing to global efforts that have helped save an estimated 7.6 million lives and prevented 1.5 billion malaria infections since 2000. Yet, close to half the world's population remains at risk of malaria. In FY20 alone, thanks to bipartisan support and despite significant challenges caused by COVID-19, PMI invested $746 million across its portfolio, delivering mosquito nets to 80 million people, and providing 9 million children with preventative treatment and 63 million people with rapid malaria tests. An added challenge in tackling malaria is the expansion of drug and insecticide resistance which threatens the effectiveness of current interventions. As our current drugs and insecticides are rendered less and less effective, it is imperative that new tools-whether new drugs and vector controls tools or entirely new classes of interventions, such as vaccines-be available to ensure that decades of US investment to fight malaria are not lost. To this end, PATH has been partnering with the US government, private sector, and country partners to drive innovation for new tools and strategies to control and eliminate malaria, including development of the world's first malaria vaccine for young children in Africa. This vaccine-RTS,S-is currently in large- scale pilot introduction in areas of Ghana, Kenya, and Malawi, and could prove to be an important complementary tool to the existing anti- malarial toolkit. Congress should fully fund PMI at $902.5 million, as additional resources are critical to the success of PMI's country programs. Disruptions of essential health services due to the COVID- 19 pandemic are having a catastrophic impact, according to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, in Africa, malaria diagnosis and treatment has fallen roughly 15 percent during the pandemic, and more than 20 percent of facilities have reported stockouts of medicines for treating children under 5. In Asia, diagnosis and treatment has fallen almost 60 percent due to COVID-19, and 37 percent of facilities have reported COVID-19 infections amongst their health workers. Financial resources are needed to make greater investments in malaria research and development (R&D) for new tools to accelerate progress, such as improved diagnostics, novel insecticides, and next-generation vaccines, as well as in operational research to optimize the impact of tools as they emerge from development. Finally, Congress should exercise its oversight of all relevant US agencies that are implementing malaria programs to ensure that programs are using high-quality data, ensuring efficiency, cost-effectiveness, and progress toward a world free from malaria. Protecting the United States through leadership in global health R&D We ask that the Subcommittee continue to affirm its support for the role that USAID plays in advancing innovations to ensure that people in low-resource settings have access to high-quality health tools. USAID's innovation-focused initiatives have shown great success in leveraging US investments, and USAID should continue to look for ways to engage private-sector expertise and investment. For example, the agency's Saving Lives at Birth Grand Challenge has leveraged over $150 million from other donors and created a pipeline of over 100 potentially lifesaving innovations, like rapid diagnostic tests to detect pre- eclampsia, new formulas of drugs to stop post-partum hemorrhage, and wearable technology to prevent hypothermia in newborns. USAID's investments to increase access to new tools are complemented by efforts to draw in new private sector resources through the Development Finance Corporation (DFC). The DFC's Health and Prosperity Initiative, along with two recent initiatives to expand vaccine manufacturing in India and Africa in partnership with other bilateral and multilateral donors, leverage its abilities to crowd in resources from the private sector to make a significant difference in the manufacturing capabilities in low- and middle-income countries, improving the ability to respond to COVID-19 and future pandemics. Reaching pockets of poverty and overcoming weakness in health systems demands new technologies, including drugs, vaccines, diagnostics, and devices, stronger investments in digital health to guide decision making, and more robust manufacturing capabilities in low- and middle- income countries which will help ensure adequate global supply of lifesaving products. We ask the Subcommittee to continue to support the DFC's efforts to include innovation its health care strategy and recommend that the subcommittee request a report on how investments in innovation will drive health development outcomes. An investment in health, at home and around the world With strong funding for global health and development programs within USAID and through public-private partnerships, the US government is improving access to proven health interventions in the communities where they are needed most, while also investing in solutions for tomorrow's challenges. Fully funding the International Affairs account is a critical opportunity to help countries responding to the current COVID-19 pandemic and other threats to health and mobilize domestic, corporate, and other partner resources. Through this investment, the US can improve the health of populations around the globe and invest in global economic growth-ensuring that people everywhere can reach their full potential. We appreciate the Subcommittee's consideration of our views and urge Members to ensure that the US maintains our position as a champion for global health and development. [This statement was submitted by Jenny Blair, Manager.] ______ Prepared Statement of the Planned Parenthood Federation of America Planned Parenthood Federation of America (``Planned Parenthood'') is pleased to submit testimony for the record to the Senate Appropriations State, Foreign Operations and Related Programs Subcommittee regarding global sexual and reproductive health priorities for FY 2022. We respectfully request $1.17 billion for international family planning and reproductive health programs, including $74 million for the United Nations Population Fund (UNFPA), without onerous and unnecessary restrictions and the elimination of policies that undermine the health and rights of people around the world, especially the global gag rule. Planned Parenthood is the nation's leading reproductive health care provider and advocate and a trusted, nonprofit source of primary and preventive care for people in communities across the U.S. as well as the nation's largest provider of sex education. As experts in sexual and reproductive health care, we reach 2.4 million people in our health centers, 1.1 million people through educational programs, are back by 17 million supporters, and see 198 million visits to our website every year, the majority of which originate outside of the U.S. People come to Planned Parenthood for the accurate information and critical resources they need to stay healthy and reach their life goals. For many patients, Planned Parenthood is their only source of care--making Planned Parenthood health centers an irreplaceable part of this country's health care system. Through our international arm, Planned Parenthood Global, we provide financial and technical support to nearly 100 innovative partners in nine countries in Africa and Latin America for service delivery and advocacy to expand access to reproductive health care and empower people to lead healthier lives. increasing funding for international family planning and reproductive health programs International family planning and reproductive health programs are essential to empowering women and improving the health and lives of millions of people. These programs are central to achieving a number of U.S. global health goals, including reducing rates of unintended pregnancy, maternal, infant, and child mortality, and mother-to-child HIV transmission. Globally, 218 million women want to delay or prevent pregnancy but face barriers to using modern contraceptive methods.\1\ The burden of these challenges falls on Black and Brown women who live in low and middle income countries and face the most significant barriers to health care access in countries worldwide due to systems that are rooted in and reinforce white supremacy, neocolonialism, and gender inequality. Addressing this unmet need is key to delivering on global health, development, and foreign policy goals. Current funding levels make it possible for 27.4 million women and couples to receive contraceptive services and supplies, averting 12.2 million unintended pregnancies, 4.1 million unsafe abortions, and 20,000 maternal deaths \2\ but after 11 years of stagnant funding, more is needed to invest in women and girls and truly transform communities and achieve gender equality. A critical component of U.S. investments in reproductive health is the U.S. contribution to the United Nations Population Fund (UNFPA), which works in more than 150 countries worldwide, including many where USAID does not operate programs. UNFPA promotes human rights standards and is working to end preventable maternal deaths, unmet need for modern contraception, and harmful practices like gender-based violence, female genital mutilation and child marriage. Furthermore, UNFPA is essential to delivering maternal and reproductive health care in crisis and humanitarian settings, including in places like Yemen, Syria. and Venezuela. The COVID-19 pandemic has exacerbated existing barriers to accessing sexual and reproductive health care. UNFPA estimates that in the first year of the pandemic, 12 million women experienced disruptions in contraceptive access, with disruptions averaging 3.6 months and resulting in 1.4 million unintended pregnancies. Increased investments for international family planning and reproductive health programs are necessary to address pandemic-related disruptions and further bolster access to reproductive health care worldwide. Planned Parenthood requests a minimum of $1.17 billion for international family planning and reproductive health programs, including $74 million for the United Nations Population Fund (UNFPA), without onerous and unnecessary restrictions. While the President's FY 2022 budget request took an important first step to increasing funding for these accounts, the Senate State, Foreign Operations and Related Programs Appropriations bill should go beyond this proposal. The requested funding increase would put the U.S. government on track to fund its fair share ($1.74 billion) of the global financial commitment necessary to address the unmet need for modern contraception by FY2024. permanently repealing the global gag rule Under the previous administration, the global gag rule (also known as the Mexico City Policy) was expanded to an unprecedented level to apply to all U.S. global health assistance and even resulted in funds from other donors and governments being gagged. The expanded version of the policy prohibited foreign organizations from receiving any U.S. global health assistance if they provide, counsel, refer, or advocate for legal abortion in their country, even if these activities are supported solely with non-U.S. funds. This undermined access to many critical health care services, silenced advocates, and rolled back years of progress on health care access for communities worldwide. While the global gag rule is often framed as an issue related to abortion, the policy affected providers offering a range of health care services, including family planning, maternal and child health, nutrition, and HIV/AIDS prevention, care, and treatment. When in place, the global gag rule restricts the medical information health care providers may offer, limits free speech by prohibiting local citizens from participating in public policy debates, and impedes access to basic health care by cutting off funding for many of the most experienced health care providers. Under previous versions of the global gag rule, which more narrowly applied to U.S. international family planning funding rather than all global health assistance, the global gag rule resulted in increased unintended and high-risk pregnancies, unsafe abortions, and maternal deaths. Research published on August 1, 2019 in the Lancet found that under President George W. Bush, the global gag rule corresponded with a 14% decrease in access to modern contraceptives, a 12% increase in pregnancies, and a 40% increase in abortion rates, many of which were likely to be unsafe, across 26 impacted countries in sub-Saharan Africa.\3\ Research on the expanded global gag rule, as in effect from 2017- 2020, further demonstrates the policy disrupts the delivery of a range of health services in areas of the world that are most in need. Loss of funding led to discontinued programs and reductions in services from high-quality providers, including those who offer youth-friendly access to contraception, treat children for malaria and malnutrition, and support pregnant women with HIV prevention and treatment services. Research by amfAR shows the global gag rule resulted in many PEPFAR implementing partners altering the health services and information they provide, including non-abortion related services such as contraception and HIV, and their partnerships.\4\ These disruptions were reported in 31 of the 45 countries surveyed including in areas with high HIV- prevalence, like South Africa, Eswatini, and Mozambique.\5\ The research indicates there may be a disproportionate impact on key and marginalized populations, such as adolescent girls, young women, and men who have sex with men, who are more reliant on outreach services and integrated care models that are adversely impacted by the global gag rule because organizations who provide comprehensive reproductive health care are also often the ones best able to serve and reach key and marginalized populations. We welcome the action of the Biden-Harris administration to rescind the global gag rule, and call on Congress to take action to protect against this policy from returning under future administrations by permanently repealing the global gag rule. The looming threat of reinstatement of the global gag rule undermines the sustainability of global health programs and the pace of progress. Long-term partnerships between the U.S. government and local organizations and the communities that they serve cannot be built and maintained if there is a change in U.S. government policy every time the U.S. presidency changes party control. Permanent repeal of this policy will help ensure U.S. global health programs support countries to expand reproductive health care, build sustainable partnerships, and foster civil society participation to make lasting and equitable progress on improving health care access and outcomes. Ending the global gag rule is also supported by 70% of Americans.\6\ To eliminate the harm of the global gag rule and ensure that resources can be effectively deployed to qualified providers of comprehensive care and information, Planned Parenthood requests that language to permanently repeal the global gag rule be included in the FY2022 State, Foreign Operations and Related Programs appropriations bill. removing barriers that undermine global health programs The U.S. commitment to global health, including family planning and reproductive health, should be consistent across all programs. Policy restrictions that impede human rights and limit the information and services available to people to make their own informed decisions about their bodies and their lives are a stark example of neocolonialism, taking advantage of the uneven relationship between the U.S. and the countries that receive foreign aid. To ensure that accurate information about family planning and reproductive health and rights is freely available and that programs are justly and effectively administered, we also recommend the following changes to the State, Foreign Operations and Related Programs appropriations: --Include language to require the State Department to report on reproductive rights in their annual country reports on human rights. --Require that information provided about the use of all modern contraceptives--not just condoms--as part of U.S. funded projects or activities is medically accurate and includes the public health benefits and failure rates. --Ensure that funds available in the HIV/AIDS Working Capital Fund are made available for other global health and child survival activities to the same extent as HIV/AIDS pharmaceuticals and other products and not limited to ``child survival, malaria, tuberculosis, and emerging infectious diseases,'' which would increase effective procurement without decreasing funding from any other critical area. --Exempt family planning and reproductive health programs from a variety of prohibitions on assistance that can and have been enforced against country governments, consistent with the treatment of child survival, HIV/AIDS, and other disease- specific programs. Finally, the FY2022 State, Foreign Operations and Related Programs bill should delete reference to the Helms Amendment, which prohibits the use of U.S. foreign assistance funds for ``the performance of abortion as a method of family planning.'' This provision hurts millions of people around the world who seek access to care from health, gender-based violence and humanitarian programs supported by U.S. foreign assistance. It restricts the ability of individuals to make their own personal medical decisions and access comprehensive reproductive health care. The Helms Amendment has been in the Foreign Assistance Act of 1961 since 1973 and has subsequently been reiterated in two separate sections of the appropriations bill every year for over 30 years. Removing the reiterations of this policy in FY2022 appropriations would be a powerful step toward removing policies which control the health care and bodily autonomy of Black and Brown people around the world and ensuring U.S. foreign policy expands access to quality, comprehensive sexual and reproductive health care services including safe, legal, and accessible abortion, for all. Planned Parenthood issues these requests in the hopes that we can protect and build upon federal investments to make quality sexual and reproductive health care accessible so that all people, no matter who they are or where they live, can lead healthier lives. --------------------------------------------------------------------------- \1\ Sully, et al., Adding It Up: Investing in Contraception and Maternal and Newborn Health, 2019, New York: Guttmacher Institute, 2019. \2\ Guttmacher Institute. Just the Numbers: The Impact of U.S. International Family Planning Assistance, 2020. https:// www.guttmacher.org/article/2020/07/just-numbers-impact-us- international-family-planning-assistance-2020 \3\ Brooks, N., Bedavid, E., & Miller, G. USA aid policy and induced abortion in sub-Saharan Africa: an analysis of the Mexico City Policy. The Lancet Global Health. 7.8 (2019):E1046-E1053. [Online]. https://www.thelancet.com/journals/langlo/article/PIIS2214- 109X(19)30267-0/fulltext#seccestitle \10\ 4 Planned Parenthood Global (2019). Assessing the global gag rule: Harms to health, communities, and advocacy [Online]. \4\ amfAR. (2018). Impact of Mexico City Policy in PEPFAR [Online]. https://www.amfar.org/pepfar-mexico-city/. \5\ amfAR. (2019). How Expanded Mexico City Policy Is Disrupting Global HIV Programs [Online]. https://www.amfar.org/infographic- expanded-mexico-city-policy/. \6\ Hart Research Associates. (2020, September 25). Key Findings from Survey on Global Gag Rule. Retrieved from https:// www.plannedparenthood.org/uploads/filer_public/6c/59/6c5906ef-4022- 4bbc-b209-403eaf413c88/me12884_ggr_memo_release.pdf --------------------------------------------------------------------------- [This statement was submitted by Jacqueline Ayers, Vice President, Public Policy and Government.] ______ Prepared Statement of the Refugee Council USA Chair Leahy, Vice Chairman Shelby, and members of the subcommittee, thank you for the opportunity to submit funding and oversight recommendations for Fiscal Year (FY) 2022 on behalf of the 29-member organizations of Refugee Council USA (RCUSA)1 dedicated to refugee protection, welcome, and integration, and representing the interests of refugees, refugee families, volunteers, and community members across the country who support refugees and resettlement. By maintaining robust funding for international humanitarian assistance for refugees and other vulnerable populations, the U.S. strengthens national security, foreign policy, economic, and humanitarian interests. The U.S. Refugee Admissions Program (USRAP) is a longstanding bipartisan humanitarian program that enables the United States to provide lifesaving protection to some of the world's most vulnerable people. RCUSA recommends the following funding levels for State, Foreign Operations, and Related Programs (SFOPs) for the following three accounts: $4,118,400,000 for Migration and Refugee Assistance (MRA); $5,274,434,000 for International Disaster Assistance (IDA); and $50,000,000 for the Emergency Refugee and Migration Account (ERMA). RCUSA also recommends that Congress provide sufficient funding to the USRAP in order to meet President Biden's commitment to set the annual refugee admissions ceiling at 125,000 refugees in FY 2022, and to lay the foundation for further growth. humanitarian and strategic purposes for assisting refugees and internally displaced people The U.S. government invests in lifesaving humanitarian assistance and permanent solutions for refugees and other forcibly displaced people in accordance with our national values, international obligations, and strategic interests. Forcibly displaced people often lack necessary food, water, shelter, healthcare, education, livelihood options, and protection. Beyond these grave humanitarian concerns, large-scale forced displacement is an urgent strategic and security concern for the countries and regions in which displaced people find safety. U.S. funding helps to meet the basic human needs of persons fleeing persecution while they are displaced; supports permanent solutions to their displacement; and assists the countries hosting them. By funding these accounts, the U.S. government expresses the humanitarian values of the American people while pursuing important strategic interests-supporting key ally countries that host refugees, relieving pressures that have the potential to destabilize sensitive regions, and maintaining our international reputation as a country that protects the oppressed, promotes stability, and contributes to orderly, safe migration. Under Republican and Democratic administrations alike, the U.S. has long leveraged its willingness to resettle a small percentage of the world's refugees. In response, host countries often provide safe haven, aid, and integration opportunities for the vast majority of refugees, including access in host countries to education for refugee children and work visas for refugee adults. The strategic use of U.S. resettlement and other support to host countries has prevented further destabilization in fragile regions, providing many with viable alternatives to onward migration. Key strategic allies disproportionately affected by forced displacement have benefited, such as Jordan, Turkey, Thailand, Kenya, and Uganda. three crucial accounts for refugees and forcibly displaced people Migration and Refugee Assistance (MRA).--The Migration and Refugee Assistance (MRA) Account funds the work of the Department of State's Bureau of Population, Refugees, and Migration (PRM). PRM helps to ensure that individuals and families fleeing life-threatening situations can find temporary protection in countries to which they are displaced, often located near their home countries. This funding also supports refugees' pursuit of the three durable solutions: voluntary repatriation back to their home country; integration into a host country; and third-country resettlement when the first two solutions are not viable. The crises in Syria and Venezuela continue to escalate dramatically, and there are similarly serious humanitarian challenges in Afghanistan, Central African Republic, the Democratic Republic of Congo, South Sudan, Burma/Myanmar, Iraq, and Central American countries. This account is critical to ensure that PRM can continue to service currently displaced populations while responding to numerous emerging humanitarian crises. Overseas Refugee Assistance helps maintain humane, stable conditions for refugees and host communities during the period of displacement until the refugee crises can be resolved. In a few situations, it helps maintain safe, humane operation of refugee camps. In the vast majority of refugee situations, funding facilitates the host countries' expansion of its community response, builds infrastructure to accommodate refugees, and invests in refugees' ability to be resilient, self-sufficient, and contributing members of the host community's economy. Overseas assistance also covers some costs related to refugees' pursuit of durable solutions. We are currently facing the worst displacement crisis on record with more than 80 million displaced persons worldwide, including more than 29.6 million refugees, forty percent of whom are children. Refugee Admissions helps refugees unable to find safety, security, and well-being in their home country or a host country to find a new life in a third country through resettlement. Among the 29.6 million refugees worldwide, UNHCR estimates that 1.45 million refugees need resettlement. Actual annual resettlement has amounted to less than 1% of the global refugee population. Although the number of refugees resettled is proportionally very small, those who need it have no other option. They might be from a religious minority, race, nationality, or member of a social group that is as oppressed and targeted in the host country as it is in their country of origin. During the 40-year history of its resettlement program, the U.S. has been the global leader among resettlement countries, of which there were 29 as of 2019. The U.S. has chosen to exert its global power by providing life-saving resettlement to over three million refugees over the history of the program. This is one of our nation's proudest and longest-standing traditions, including resettling Jewish refugees during World War II, Vietnamese refugees in the 1980s, and more recently refugees from the Sudan, Bosnia, Bhutan, Burma/Myanmar, Iraq, Afghanistan, Syria, and the Democratic Republic of the Congo. Refugees undergo rigorous vetting prior to arrival, often lasting eighteen to twenty-four months, and once resettled, tangibly contribute to American communities. Emergency Refugee and Migration Assistance (ERMA).--ERMA, an emergency Presidential draw-down account, provides an important safety valve during emergencies, allowing the U.S. to meet rapidly occurring and unforeseen humanitarian needs. This funding allows the U.S. to respond quickly and effectively to unanticipated crises, to relieve human suffering and support regional stability. Examples of how ERMA has provided lifesaving support in recent years include food, shelter, health care and/or protection for internally displaced persons (IDPs) and/or refugees from Mali, Sudan and Ethiopia (2012); from Syria (2013); and from South Sudan (2014). While the former administration did not draw down ERMA, the new administration is expected to do so. RCUSA expects the administration to spend down the ERMA account for the remainder of FY 2021 and recommends $50 million in funding for FY 2022 to replenish FY 2021 ERMA draw downs. RCUSA further recommends that the authorized funding level for ERMA be raised to $200 million and that the Secretary of State be authorized to draw down ERMA funds. International Disaster Assistance (IDA).--International Disaster Assistance (IDA) is administered by the USAID Bureau for Humanitarian Assistance and assists people during natural and human-made disasters. Such humanitarian crises cause significant internal displacement and regional pressures throughout the world. IDA helps to save lives, restore and maintain human dignity, and prevent internally displaced persons from having to flee their home countries and become refugees. Given the substantial rise in IDPs served through IDA from 40 million in 2017 to 45.7 million in 2020, and the number and growing complexity of forced displacement crises, we urge a substantial increase for IDA to $5.27 billion. critical investments in the u.s. refugee admissions program In light of urgent resettlement needs, President Biden has committed to restoring the USRAP to allow for the admission of 125,000 refugees in FY 2022. In order to meet this commitment and rebuild the USRAP after four years of systematic dismantling, funding needs for refugee resettlement are projected to increase substantially in FY 2022. While the annual refugee admission goal has averaged 95,000 over the four decades of the program, with the goal exceeding 200,000 under both Democratic and Republican administrations when U.S. humanitarian and strategic interests required, the annual goal fell to an all-time low of 15,000 under the last administration. Refugees, as newcomers to the United States and as individuals who have lost their country, loved ones, and virtually all possessions, are in need of transitional support to gain self-sufficiency. And just like all of us, they share the vulnerabilities and challenges related to COVID-19. Throughout the pandemic, however, they have shown their resilience and how they contribute to their new communities with many of them employed as essential workers in healthcare and the U.S. food supply chain. It is critical that the administration and U.S. communities have the capacity they need to help refugees integrate and thrive. In addition to funding, RCUSA recommends that Congress direct the State Department's Bureau of Population, Refugees, and Migration (PRM) to ensure expedited processing for unaccompanied refugee minors (URM) who are on the verge of aging-out of URM program eligibility, particularly in light of USRAP's suspension in admitting URM in the previous administration. We further recommend that Congress direct PRM to issue regular, quarterly reports to the Appropriations Committee about the status of the USRAP and SIV pipelines, ongoing implementation of Executive Order 14013, changes to refugee processing and adjudications. We also urge Congress to make permanent the Lautenberg program, fund the community consultations process, direct PRM to expand and improve family reunification (P-3 and I-730) processing, and expand and strengthen the Central American Minors (CAM) program. an urgent moment to protect u.s.-affiliated persons in afghanistan Given the withdrawal of U.S. troops in Afghanistan by September 11th, 2021, it is incumbent upon the administration to develop emergency protection plans for the approximately 17,000 Afghans and their derivatives who will remain in danger. While the Afghan Special Immigrant Visa (SIV) program has successfully offered protection to thousands of Afghan allies from a lifetime of fear or even death, in its current state, it is insufficient to provide rapid protection in an evolving emergency situation. The program has long been challenged by systemic delays and backlogs: despite Congress mandating that processing take no more than nine months, the State Department estimates that the process takes an average of almost two years. It is critical that the administration take steps to ensure that the program can operate efficiently moving forward. RCUSA urges that Congress allocate at least 20,000 visas in the FY 2022 SFOPS spending bill or through another appropriate bill. RCUSA also urges Congress to increase the annual allotment of visas for the 1059 program from 50 to 150 visas. Congress should also conduct oversight into the administration's implementation of the President's February Executive Order on Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration, which directed a review of the SIV program's processes and capacity. In closing, RCUSA urges Congress to adopt the above funding levels; fund U.S. refugee resettlement to restore U.S. global leadership on refugee protection; and approve an additional 20,000 Afghan SIVs and ensure the protection of at-risk U.S.-affiliated Afghans. Thank you for your consideration. FY 2021 Funding Needs for Refugees and Displaced Persons in Department of State Accounts ---------------------------------------------------------------------------------------------------------------- FY 2022 Refugees and Displaced Persons Accounts FY 2021 Enacted President's FY 2022 RCUSA Request ---------------------------------------------------------------------------------------------------------------- Recommended Migration and Refugee Assistance.............. $3,432,000,000 $3,845,000,000 $4,118,400,000 International Disaster Assistance......................... $4,395,362,000 $4,682,362,000 $5,274,434,000 Emergency Migration and Refugee Assistance................ $100,000 $100,000 $50,000,000 ---------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------- \1\ A list of RCUSA member organizations can be viewed at RCUSA.org. --------------------------------------------------------------------------- [This statement was submitted by Refugee Council USA.] ______ Prepared Statement of the Results On behalf of RESULTS and our grassroots advocates across the U.S. I want to say thank you for the role the Senate SFOPS has played in including emergency funding for global vaccines in the December 2020 COVID relief package and the inclusion of global aid resources in the American Rescue Plan Act. We are grateful for the continued U.S. investments in some of the highest-impact, effective mechanisms and programs that save lives, improve futures, and help countries to deliver quality health and education to children and families experiencing poverty. I urge you to give particular priority to key global health and education efforts in FY22, including: the Global Fund to Fight AIDS, TB, and Malaria; bilateral tuberculosis programs; maternal and child health, including Gavi, the Vaccine Alliance; and nutrition programs in global health; and Basic Education, particularly the Global Partnership for Education. Global Health--Tuberculosis.--This committee's leadership and support for increased global tuberculosis funding over the past 4 fiscal years must be commended--we have seen and deeply appreciate your efforts to raise TB into the spotlight and to increase the resources for the USAID bilateral program. But unfortunately, for decades before, TB was stuck at the bottom of political priority lists, which allowed it to climb to the top of the list of global infectious killers. Every year, TB sickens about 10 million people and causes about 1.4 million deaths. That burden does not fall evenly. TB disproportionately impacts people who are already in poverty and otherwise pushed to the margins, largely in countries facing the consequences of colonialism, resource extraction, and unjust global lending policies. And now, more than ever, efforts to get ahead of this dire disease are critically important for saving lives. As the COVID-19 pandemic continues to disrupt and destabilize health systems around the world, this ancient killer has once again found stronger footing. Lockdowns and fear of COVID-19 stopped many from getting tested and treated for tuberculosis (TB). Supply chains for TB medicines and diagnostics have been disrupted. And national TB programs have been pushed to the brink as staff and funding are pulled to the COVID-19 response. Global progress against TB was already slow and fragile. And now data is showing that 12 months of COVID-19 has eliminated 12 years of TB gains in many countries with high rates of TB. But this moment of enormous public health challenge is an opportunity to create a better way of working that can fight both diseases. We can invest in systems that will not only find and treat people for both COVID-19 and TB, but that will help prevent future pandemics. We must attack the current pandemic and while preparing for the next one. In many countries, existing TB programs formed the backbone of national and local COVID responses. Infection control, lab capacity, respiratory disease expertise, active outreach, and contact tracing were all capacities built in TB programs. The challenge is that TB programs were already hugely underfunded, and COVID further diverted resources. With increased funding and adequate staffing, resourcing, and testing supplies, these same programs could instead not only bring an end to TB as a global killer, but also provide a respiratory disease response platform for future pandemics. Domestic country budgets have long been the biggest funders of TB programs, but now those budgets are stretched thinner due to COVID-19-- even as needs have grown. As an established global leader on TB, USAID can play a critical role to support locally led TB programs, rapidly adapt and restore critical TB services during the pandemic, prevent a dangerous reversal of progress, and strengthen TB programs for the future. With an increased annual TB budget of $1 billion, USAID could have a transformative impact on TB efforts globally while helping build the systems needed to prevent the next pandemics. We only need to look at the President's Emergency Plan for AIDS Relief (PEPFAR) or the President's Malaria Initiative to see that U.S. commitment on a global health issue can have a massive impact. With this increased TB budget, USAID could: --Support local health workers and programs to save more lives from TB and recover momentum against the disease by expanding access to treatment for all forms of TB, including MDR-TB, increasing its support for TB prevention, and making more investments in TB research and development. --Expand its list of priority countries, helping even more national TB programs fight both COVID-19 and TB. --Expand the integration of TB and COVID-19 testing networks in priority countries by training staff on bidirectional testing, ensuring adequate diagnostic equipment and facilities, and building back up the human resources available to fight both diseases. --Channel additional resources to community-based organizations, which are now even more important for maintaining and improving TB services. --Address urgent procurement and supply challenges affecting access to TB medications, as well as diagnostics needed for both TB and COVID-19. This relatively modest level of annual investment could have a transformative impact on TB efforts globally, while creating health systems that will help prevent future pandemics. An allocation of $1 billion for bilateral TB programs in FY2022 would allow for a more aggressive response to finding the missing TB cases, scale up innovative approaches that reach more people, in more regions of the world, and invest more in research and delivery for even better TB diagnostics, vaccines, and medications. Global Health--Nutrition.--With this committee's bipartisan support, anti-hunger programs and child survival have been incredible pillars of the U.S. global health programs since the 1980s--helping to cut the number of under-five child deaths in half. But, pre-COVID-19, malnutrition still contributed to about half of the deaths of children under-five. In projections of the increased death toll due to COVID-19-related service disruptions, wasting, a form of severe malnutrition, is the biggest driver of additional child deaths. Proper nutrition is critical to healthy growth, laying the building blocks for cognitive abilities, motor skills, and socio-emotional development. During the first 1,000 days between pregnancy and a child's second birthday children's brains grow faster than at any other stage of life. This window of rapid development is also a time of extreme vulnerability. If a child is fighting a bout of disease such as pneumonia or malaria and is already malnourished, the likelihood of survival is greatly diminished. The obvious role nutrition plays in a child's life makes it even more shocking that globally nearly 20 percent of all children under the age of five are chronically undernourished or ``stunted.'' That's 149 million young children failing to grow well each year because they did not get the right micronutrients and vitamins needed to thrive-and that's before the COVID-19 pandemic caused additional economic pressures and disruptions and stress on health systems. Overall funding for this crisis has increased, but it remains one of the least-addressed global public health challenges. 2021 is a critical moment for building partnerships on global nutrition and U.S. government leadership is key for gaining the political momentum necessary to reach the global goals on nutrition. The consequences of early malnutrition are devastating and permanent, but they are also entirely preventable. We cannot afford to press pause on the crisis of child malnutrition while we fight the COVID-19 pandemic. If we want to reach all children everywhere, we will need to scale up and accelerate our efforts to prevent malnutrition, as well as provide new resources to support partner countries to address the impacts of the COVID-19 pandemic. An allocation of $300 million for Nutrition within Global Health would be a key component of our goal of improving the delivery of the ``Power 4''--multiple micronutrient supplements for mothers, supporting exclusive breast-feeding, scaling up Vitamin A, and expanding specialized wasting treatment. These resources would provide leading interventions for reducing stunting, reinforce our other investments in child survival programs, and set the foundation for improved health and gains in economic development. Global Partnership for Education (GPE).--Due to the pandemic, the number of out-of-school children could grow substantially for the first time in decades, while stretched national budgets could hinder education quality. At its peak, the number of children out of school ballooned to 1.6 billion--about a six-fold increase from the start of the pandemic. And many more learners are at risk of falling behind or permanently stopping their education. World Vision released a report last year estimating 1 million girls may not be able to return to school because of adolescent pregnancies occurring during the lockdowns. The education crisis brought on by COVID-19 threatens the historic progress made by communities globally to get millions more children in school that was bolstered by this subcommittee's annual support. The pandemic only worsens ongoing disparities in global education; decades of colonialism, resource extraction, and unjust global lending policies have created enormous barriers to education in dozens of lower-income countries. Urgent action is needed now to ensure the current education crisis does not turn into a permanent catastrophe for an entire generation. The Global Partnership for Education is on the frontlines of the current education crisis. As the pandemic wreaks havoc on school systems around the world, GPE has mobilized its largest-ever emergency response--becoming the largest provider of education grants in the COVID-19 response. GPE has distributed $500 million to help partner countries reopen schools safely or enhance remote learning. As a result, 355 million children have been able to continue their education. GPE is also working in countries with the greatest need. In 2019, 76% of GPE funding went to countries affected by conflict and fragility In this high-stakes moment for global education, GPE is the right mechanism for donors like the United States to play their part in transforming education. This July, the UK government is hosting a Global Education Summit where GPE must raise at least US$5 billion for 2021-2025 to fund country plans to transform education systems for more than 1 billion children. U.S. leadership and commitment of a multi-year pledge will be critical to ensuring this plan is fully realized. A U.S. contribution of $150 million to the Global Partnership for Education in FY2022 along with continued strong support of bilateral education funding would have a powerful impact on the lives of children worldwide, help leverage both domestic and donor resources, and demonstrate our government's continued leadership to improving education for all. ADDITIONALLY--adding language in the fiscal year 2022 SFOPS bill in support of GPE's 5-year strategy would send a strong signal to this administration about the value of GPE's role in reaching under-served and vulnerable populations with access to quality education. [This statement was submitted by Crickett Nicovich, Associate Director, Policy and Government Affairs.] ______ Prepared Statement of the Rotary's Polio Eradication Advocacy Task Force for the US Chairman Coons, members of the Subcommittee: Rotary appreciates the opportunity to encourage continued funding in FY 2022 to support USAID's Polio Eradication Initiative. These efforts support the broader Global Polio Eradication Initiative (GPEI), which is an unprecedented model of cooperation among national governments, civil society and UN agencies working together to reach the most vulnerable children through the safe, cost-effective public health intervention of polio immunization. Rotary appeals to this Subcommittee for continued support in the amount of $65 million--level funding--to recover polio eradication progress disrupted by the COVID- 19 pandemic, to support essential polio eradication strategies and innovations that will support the interruption of polio virus transmission, and to protect countries which are polio free but which remain at risk, and ensure the long term sustainability of a polio free world. progress in the global program to eradicate polio Since the launch of the GPEI in 1988, eradication efforts have led to more than a 99.9% decrease in cases. Thanks to this committee's support, over 19 million people have been spared disability, and over 900,000 polio-related deaths have been averted. In addition, more than 1.5 million childhood deaths have been prevented, thanks to the systematic administration of Vitamin A during polio campaigns. In 2020, the WHO AFRO region was certified wild polio virus-free after four years without detecting any cases, making it the fifth of six WHO regions to eliminate the virus. This achievement follows the certification of the eradication of Type 3 (WPV3) in October 2019 and wild poliovirus type 2 (WPV2) in September 2015. The eradication of wild polio virus from regions and eradication of strains of the polio virus is further proof that a polio-free world is achievable. Only two countries, Afghanistan and Pakistan, have confirmed cases of wild polio since August of 2016. As of 3 June 2021, only 2 cases of wild polio virus have been confirmed--one each in Pakistan and Afghanistan. Significant reductions in detection of virus transmission in environmental samples in 2021 are also cause for cautious optimism. Both countries are working to capitalize on low levels of virus transmission by working to reach missed children, prioritizing communities which have had low coverage or which have been resistant to immunization; and ensuring thorough microplanning of immunization and other eradication activities. In Afghanistan, there are increased efforts to target children living in areas which have been inaccessible. This ongoing work is challenging within the context of the NATO withdrawal of troops and related insecurity. Outbreaks of circulating vaccine-derived poliovirus are ongoing in several countries across Africa and Asia and require continued focus and attention. These were further exacerbated by COVID-19 pandemic- related disruptions in immunization campaigns. These outbreaks are not a failure of the vaccine, but result from a failure to sustain sufficiently high levels of routine immunization which causes the live, but weakened form of the virus used in the vaccine to revert over time to a more virulent, wild-like form. The program has developed a specific Strategy for the Response to Type 2 Circulating Vaccine- Derived Poliovirus, including the use of a new, more genetically stable vaccine, the novel oral polio vaccine type 2 (nOPV2), for outbreak response. The COVID-19 pandemic has posed new challenges for global polio eradication activities. In order to protect communities and staff, the Global Polio Eradication Initiative paused immunization campaigns and other essential activities for several months in 2020. In countries that have successfully resumed activities, the programme has developed strategies for prevention and control of COVID-19 and is providing resources such as masks and hand sanitizer to keep frontline health workers protected while ensuring that campaign elements meet physical distancing requirements. As a result of the pause on activities, and also due to the potential exposure to COVID, the number of vulnerable children has increased the real threat for wider spread of the virus. UNICEF, WHO and Gavi estimate that at least 80 million children under the age of one are at risk due to the COVID-19 related disruption to vaccination activities. These challenges are further compounded by the extraordinary economic and financial constraints in both at-risk countries and from donors which may divert essential political and financial commitments. This combination of progress in the midst of ongoing challenges underscores the urgency of continued focus to protect the vulnerable gains made toward polio eradication as the COVID-19 pandemic continues to disrupt polio immunization and eradication activities; and to stop polio virus transmission in these most complex environments while sustaining high levels of population immunity in polio free areas. Continued support for global surveillance is also essential to monitor and detect cases and virus transmission and provide confidence in the absence of cases. usaid's vital role in global polio eradication progress The United States is the leader among donor nations in the drive to eradicate polio. Funding provided by Congress contributed ensured USAID's continued vital programmatic contributions in 2020. USAID remained steadfast in its support for polio eradication and adapted to working in a COVID-19 environment despite constraints resulting from the COVID-19 pandemic as well as changes in US policy toward the World Health Organization in 2020. USAID continued to support polio surveillance and the laboratory network through WHO wherever limited funds were available. These funds were critical for sustaining surveillance wherever possible and catching up once the COVID restrictions allowed people and specimens to move as needed. In addition, USAID concurred with the decision by the Polio Oversight Board to use human resources and physical infrastructure, such as surveillance laboratories, to support COVID-19 pandemic response, at no additional cost to USAID. This has demonstrated the added-value of sustaining the polio system for diseases of public health concern and part of USAID's long-term investment approach. USAID's support for polio immunization campaigns increased as funding shifted to UNICEF for surge staff and communication activities which were invaluable polio immunization campaigns and other essential eradication activities resumed. USAID's support to the CORE Group (NGO) Polio network continued in seven of eight countries (India, Nigeria, Ethiopia, Kenya, Somalia, South Sudan, and Uganda. The Afghanistan program is tailored to that more restricted environment) throughout the year. These NGOs continue to promote polio immunization campaigns whenever they are scheduled, encourage families to seek vaccination even during COVID and minimize disruptions to routine immunization services, and they were able to continue their community-based surveillance activities throughout the pandemic. In addition, the NGOs became role models and advocates for masking, distancing, and handwashing to mitigate COVID-19 transmission, they used their long-standing trust in communities to support contact tracing, while giving reminders about routine immunization. USAID Support for improved quality USAID worked to identify and address (as locally appropriate) gaps or vulnerabilities that may cause setbacks by promoting high quality immunization campaigns through better planning and feedback, identifying reasons for missed children through independent monitoring and post-campaign surveys. USAID also supported tracking of the virus through enhanced disease surveillance by communities themselves and through health facilities and expanding environmental surveillance to reduce the potential for missing low level virus transmission. USAID staff and Missions Virtually, USAID staff continued to provide technical support to USAID Missions, Ministries of Health, and coordinated with other donors throughout the year. USAID staff reviewed National Emergency Action Plans, participated in all polio oversight and technical meetings, and continued to promote and disseminate lessons learned across countries for overall program improvement. USAID/HQ and Mission staff were actively engaged in the development of the updated GPEI Strategy--2022- 2026. fiscal year 2022 budget request Rotary respectfully requests $65 million in FY 2022 to support USAID's Polio Eradication Activities; the same level of funding provided in FY 2021. With Congress' continued support for polio eradication in FY 2022, USAID will continue its work to stop polio transmission in the remaining polio endemic countries and protect the polio-free status of at-risk countries by reaching all children with vaccine, and effective Acute Flaccid Paralysis (AFP) and environmental surveillance to support rapid case detection and response. the role of rotary international Rotary is a global network of leaders who connect in their communities and take action to solve pressing problems. Since 1985, polio eradication has been Rotary's flagship project, with members donating time and money to help immunize nearly 3 billion children in 122 countries. Rotary's chief roles are fundraising, advocacy (including resource mobilization and political advocacy), raising awareness and mobilizing volunteers. There are nearly 300,000 members throughout the United States who have raised more than US$400 million of the more than US$2.2 billion Rotary has contributed to the Global Polio Eradication Initiative. This represents the largest contribution by an international service organization to a public health initiative ever. These funds have benefited 122 countries to buy vaccine and the equipment needed to keep it at the right temperature, and support the means to ensure it reaches every child. More importantly, tens of thousands of our volunteers have been mobilized to work together with their national ministries of health, UNICEF and WHO, and with health providers at the grassroots level in thousands of communities. Rotary also plays a key role in encouraging country level accountability. Rotary has National PolioPlus Committees, in the endemic countries and over 20 outbreak/at-risk countries. These national committees work to keep the spotlight on polio eradication amidst competing priority from the community level to the federal level. benefits of polio eradication Since 1988, tens of thousands of public health workers have been trained to manage massive immunization programs and investigate cases of acute flaccid paralysis. These trained community health workers and the system of national and subnational emergence operations centers that support coordination of polio eradication activities are often used to support the response for natural disasters and other diseases, including the COVID-19 pandemic. Cold chain, transport and communications systems for immunization have been strengthened. The global network of 145 laboratories and trained personnel established by the GPEI also tracks measles, rubella, yellow fever, meningitis, and other deadly infectious diseases and will do so long after polio is eradicated. Besides the savings of more than $27 billion in health costs that has resulted from eradication efforts since 1988, a sustained polio free world will generate $14 billion in expected cumulative cost savings by 2050, when compared with the cost countries will incur for controlling the virus indefinitely. Polio eradication is a cost-effective public health investment with permanent benefits. On the other hand, as many as 200,000 children could be paralyzed annually in the next 10 years if the world fails to capitalize on the more than $17 billion already invested in eradication. Success will ensure that the significant investment made by the US, Rotary International, and many other countries and entities, is protected in perpetuity. [This statement was submitted by Anne L. Matthews, Chair, State, Foreign Operations, and Related Programs Appropriation Subcommittee.] ______ Prepared Statement of the Save the Children Thank you for the opportunity to testify to the significant and increasing needs facing the most vulnerable children around the world. Save the Children is a nonprofit, child-focused organization working in more than 100 countries around the world. We build capacity for countries to deliver and provide direct support for health, education, protection, food security, livelihoods, and disaster relief for more than 197 million children, including 1.1 million here in America. Save the Children is grateful to this Subcommittee and Congress for supporting strong funding for the international response to COVID-19 in multiple bills throughout 2020 and early 2021. These investments are critical for slowing the spread of the virus, responding to outbreaks, and addressing life-threatening social and economic impacts, such as hunger and increased poverty. The pandemic, however, still rages in many parts of the world, and we are at a crossroads. The World Bank estimates that up to 124 million people will be forced into poverty by COVID-19, the first increase in more than two decades. The continued spread of COVID-19 and its variants threaten access to essential health services, such as maternity care for pregnant women and routine immunizations for young children. According to the World Food Program, 41 million people in 43 countries are on the brink of famine due to the confluence of conflict, climate change, and increasing food prices and other economic challenges--many stemming from the secondary effects of the pandemic. An entire generation of children have had their education disrupted, and for particularly vulnerable groups like girls and refugees, millions may never return to the classroom. These converging and compounding crises imperil progress toward the UN's Sustainable Development Goals and has shown us all that achievements for the most vulnerable are hard won, but incredibly fragile. Current budget levels are not sufficient to meet the demands of the moment, and Congress must prioritize investments that will promote global stability and prosperity and protect a generation of children. We understand that Congress has many difficult choices to make, but the magnitude of challenges at this time requires us to be bold. The world's poorest children will pay the highest price of inaction. To meet increased needs for U.S. global leadership and poverty- focused health, development and humanitarian assistance, investments of $69.1 billion in the FY22 Department of State and Foreign Operations Appropriations bill are required, including: --$984 million for Maternal and Child Health in Global Health Programs; --$240 million for Nutrition in Global Health Programs; --$5.27 billion for International Disaster Assistance; --$4.1 billion for Migration and Refugee Assistance; --$1.2 billion for Global Food Security; --$1.1 billion for Basic Education, including $150 million for the Global Partnership for Education and $50 million for Education Cannot Wait; --$30 million for Combatting Child Marriage; and --Support for the President's budget request for USAID Operating Expenses. The International Affairs Budget constitutes just one percent of federal spending, and significant increases can be provided while maintaining fiscal responsibility. Further, the U.S. can and should pair increased investments with a diplomatic strategy to encourage other donor countries sharing our values to increase their foreign aid contributions, making the most out of American taxpayer dollars. Maternal and Child Health (FY22 request: $984 million), Nutrition (FY22 request: $240 million).--Even before the pandemic, increased focus on ending preventable child and maternal deaths was urgently needed. The first month after birth carries the highest risk of death for newborns and their mothers. We know which interventions will save their lives, such as quality antenatal care and skilled birthing attendance, yet each year 2.5 million newborns still die, 2.6 million babies are stillborn, and more than 300,000 women die as a consequence of pregnancy or childbirth. Adding to these existing challenges, the emergence of COVID-19 has severely disrupted access to essential health services, and as a result, fewer women are receiving critical antenatal care or giving birth at health facilities. In particular, flexible, bilateral funding for maternal and child health has remained relatively flat since FY17--despite strong bipartisan support for these programs--and increased resources are needed for this category of maternal and child health funding. Furthermore, U.S. leadership is needed to convene global stakeholders around the goal of ending preventable child and maternal deaths. The U.S. should start by undertaking a strategic review of its Acting on the Call framework, including meaningful consultations with Congress, civil society, USAID Missions, and local organizations and stakeholders, and finalize an updated framework that takes into account current challenges and progress made since 2014. It should also look to co-host a global maternal and child survival conference as a follow-on to the 2012 Child Survival Call to Action to galvanize renewed or accelerated national and global commitments. Children in Emergency and Conflict Situations (FY22 request: $5.27 billion for International Disaster Assistance and $4.1 billion for Migration and Refugee Assistance).--Children are the most vulnerable group within any conflict or emergency. The UN estimated that at the beginning of 2020, nearly 170 million people needed humanitarian assistance globally, which was an increase of about 25 percent from 2019. In 2021, this number is expected to increase to 235 million, a 40 percent increase over 2020, with half the disaster-affected population being children. Before the pandemic, children were already facing a triple-threat to their rights from conflict, climate change, and acute food insecurity. International Disaster Assistance (IDA) is vital in responding to natural and man-made disasters and addressing the needs of children, who are among those most at-risk in such crises. As noted earlier, 41 countries are on the brink of famine, including Yemen, South Sudan, and Nigeria. U.S. estimates find that up to 900,000 people in Ethiopia's Tigray region now face famine conditions amid a deadly and worsening conflict. Today, nearly 80 million people are estimated to be forcibly displaced worldwide, representing an increase of nearly 10 million people in just one year, according to UNHCR. Forty percent of those are believed to be children. Funding for Migration and Refugee Assistance is vital in supporting the State Department's Bureau for Population, Refugees, and Migration to provide life-saving assistance to millions of refugees and displaced persons. With the world currently experiencing the largest number of forcibly displaced persons since World War II and the protraction of crises in Venezuela, Myanmar, and beyond, increasing funding for MRA is critical to preventing the loss of life and creating stability in volatile regions. Children are exceptionally vulnerable to violence in humanitarian settings, and more data is needed to better understand and address their unique protection needs. Save the Children supports exploration of a pilot humanitarian Violence Against Children Survey (VACS) in a well-established internally-displaced persons or refugee settlement camp. VACS have been carried out in development context to help illuminate the magnitude, nature, and consequences of violence, which helps governments and stakeholders better prevent and respond to violence against children. Global Food Security (FY22: $1.2 billion).--Feed the Future is a dynamic whole-of-government approach that tackles global hunger and malnutrition through high-impact solutions improving agricultural productivity, expanding markets and trade, preventing child malnutrition, and strengthening the resilience of vulnerable people over the long term. It has been highly impactful in lifting millions of people out of poverty. The program builds on the Food for Peace Title II emergency program by targeting the next level of vulnerable populations with high-impact interventions that address chronic hunger and poverty. Amidst rising food insecurity around the world, funding will ensure the program protects successful results in the COVID-19 context and continue to reduce poverty and child stunting in Feed the Future priority countries. Basic Education (FY22 request: $1.1 billion, including $150 million for Global Partnership for Education and $50 million for Education Cannot Wait).--At the height of the pandemic, an estimated 1.6 billion students globally--91% of the total--were out of school. For the first time in human history, an entire generation of children globally have had their education disrupted. Save the Children estimates that up to 9.7 million children are at risk of dropping out of school due to rising levels of child poverty. We have seen that girls face greater risks than boys when their schools closed, with many forced into early marriage. USAID's education programs ensure that students have the necessary skills to be part of the global workforce, have safe learning opportunities, and have equitable access to quality education. We also support the Global Partnership for Education and Education Cannot Wait multilateral programs. The Global Partnership for Education (GPE) helps build strong and resilient education systems so that more children in the poorest countries, especially girls, get the education they need. G7 leaders recently endorsed two new global targets to achieve 40 million more girls in school and 20 million more girls reading by age 10 by 2026, and GPE is an important vehicle through which this ambitious agenda can be implemented. Strong U.S. support for GPE is particularly critical this year, as the partnership kicks off a five-year replenishment cycle and seeks to address the long-term impacts of the pandemic on children's learning. Education Cannot Wait (ECW) is the first global fund dedicated to children's education in emergency settings, providing much needed educational support for children who would otherwise be missing out during times of conflict and natural disasters. We strongly support additional funding for ECW this year given its fast work to respond to the education crisis caused by the COVID-19 pandemic. Combatting Child Marriage (FY22 request: $30 million).--The Combatting Child Marriage account supports programs that lower rates of this form of gender-based violence, empower girls, and promote positive norm change in communities. Evidence shows that child marriage exposes girls to increased violence throughout their lives, denies them access to support systems, and perpetuates cycles of poverty and gender inequality, with both short- and long-term repercussions for girls' education and health. The economic impacts of COVID-19 are projected to cause a significant increase in child marriage, on top of the 12 million that occur each year. The World Bank estimates that global gains from ending child marriage could reach more than $500 billion per year. USAID Operating Expenses (FY22: Support President's budget request).--USAID Operating Expenses are foundational and necessary to all of the aforementioned program areas. To effectively contribute to stable societies and project American values overseas, USAID requires fully funded and trained staff. Funding Operating Expenses facilitates USAID's efforts to drive innovation, attract and retain skilled development talent, oversee program implementation, improve transparency and accountability, evaluate results, and apply a strong learning agenda for future programming. In addition, local governments and organizations are the most knowledgeable about the needs in their communities, and we strongly support USAID efforts to promote locally- led development. USAID Operating Expenses also funds key components of the gender equality agenda. Increased U.S. investment must be made in gender and age disaggregated data to measure progress towards gender equality. This account is essential for implementing key provisions of the Women's Economic Empowerment and Entrepreneurship Act, which requires the integration of gender equality and female empowerment throughout USAID programming and that a gender analysis shape all strategies, projects, and activities of USAID. Full execution of this requirement must be supported by funding for key gender staff positions. [This statement was submitted by Christy Gleason, Vice President, Policy, Advocacy, and Campaigns.] ______ Prepared Statement of Special Olympics Chairman Coons, Ranking Member Graham, and Members of the Committee: On behalf of Special Olympics International, we are grateful for the opportunity to provide our outside written testimony and recommendations for the FY 2022 State Foreign Operations Appropriations bill. Specifically, we recommend that the committee allocate $10,000,000 over four years for the Special Olympics Young Athletes program through the State Department's Diplomatic Programs/Education and Cultural Exchange Programs Account. about special olympics and young athletes As you may know, the mission of Special Olympics is to provide year-round sports training and athletic competition in a variety of Olympic-type sports for children and adults with intellectual disabilities (ID), giving them continuing opportunities to develop physical fitness, demonstrate courage, experience joy and participate in a sharing of gifts, skills and friendship with their families, other Special Olympics athletes and the community. Participating in Special Olympics has shown to improve health and developmental outcomes, inspire joy, improve self-confidence, bolster family relationships, foster inclusion, and improve parents' expectations of their children with ID. While this is crucial for people with ID of all ages, Special Olympics' traditional sports program is only available to athletes ages eight and over. To meet the needs of children aged 2 to 7 years old, Special Olympics created Young Athletes, a play-based early childhood intervention for children with and without ID, in 2005. Young Athletes introduces basic sport skills, like running, kicking, and throwing, and offers families, teachers, caregivers and people from the community the chance to share the joy of sports with all children. Young Athletes also provides children of all abilities the same opportunities to advance in core developmental milestones. Children learn how to play with others and develop important skills for learning--such as learning to share, taking turns, following directions, and understanding different perspectives and abilities. These skills help children in family, community, and school activities. The program provides the following benefits as it welcomes children and their families into the world of Special Olympics: --Motor skills. Children with ID who took part in Young Athletes developed motor skills more than twice as fast as others who did not take part. --Social, emotional, and behavioral skills. Children in Young Athletes saw greater increases in social skills and decreases in challenging behaviors, like tantrums or self-harm, compared to those who did not participate. --Expectations. Family members reported significant positive changes in their own attitudes and expectations towards their child and those of community members towards their child with ID. --Sport readiness. Young Athletes helps children develop the fundamental movement skills that serve as a foundation for participating in sports when they are older. --Acceptance. Inclusive play helps children without a disability to better understand and accept others. Young Athletes is a fun way for children to become active and establish healthy habits for the future. It is critical to teach children healthy lifestyle behaviors while they are young as it can support children in achieving developmental and educational outcomes, while also establishing the foundation for a lifetime of physical activity, friendships, and learning. the challenge There are over 200 million children under the age of five in low- and middle-income countries that are at risk of poor developmental outcomes, which means they may be delayed in skills like walking, talking, or reading\1\. Some of these children with delays in development may also be diagnosed with ID. Unfortunately, the link between ID and poverty is correlative, and it reinforces vulnerability and exclusion. Children who live in poverty are more likely to become disabled due to poor access to healthcare, clean water and basic sanitation, as well as malnutrition, and dangerous living and working conditions\2\. Additionally, once a child is disabled, they are more likely to be denied basic resources that would mitigate or prevent deepening poverty. Children with ID are destined to perpetuate the cycle of poverty if they are unable to access, and participate in, early childhood intervention programs, like Young Athletes. Throughout the world, public awareness and family education about intellectual disabilities is inadequate or simply non-existent. Further, families can face stigma, shame and isolation after their child is diagnosed with ID. Similarly, children with ID have very limited access to critical early childhood interventions and services. Approximately 90% of children with disabilities in developing countries are not in school\3\. Lack of access, coupled with limiting societal views--even in the United States--means we are not recognizing the full potential of children with ID. expected outcomes: young athletes as a catalyst for change Over the last 16 years, Young Athletes has expanded to 130 countries across Special Olympics' seven regions. In 2019, the program offered in-person support to over 575,000 children with and without ID (including in the United States), along with virtual and at home support during the COVID-19 pandemic in 2020. While significant, these numbers represent a small fraction of the approximately 60 million children with ID under the age of 15 globally. Now more than ever, there is a dire and urgent need for this type of programming. Our request for $10,000,000 over four years will support Special Olympics Young Athletes outside of the United States and would have an immediate impact on the health and development of children with and without intellectual disabilities. This funding would significantly support Special Olympics in building digital and in-person activities to reach our goal to expand programming to impact 1 million children with and without ID--a growth of 539,000 children outside of the United States--by 2025. With an average cost of $40 per child for 8 weeks of participation in Young Athletes, reaching our goal will cost nearly $22 million over the next four fiscal years. A State Department investment of $10,000,000 over four years, which would be complemented by private support, would allow Special Olympics to scale Young Athletes quickly and effectively in order to bring this critical early childhood program to one of the most underserved populations of children around the world. Young Athletes is a standardized, evidenced-based model that is simple to set up, inexpensive to run, and can be implemented in a variety of environments. Young Athletes programming takes place in homes, schools, and communities, led by families, teachers, and volunteers who are supported by Special Olympics training and resources. The program follows standardized lessons corresponding to foundational skills developed through interactive play and uses the Young Athletes Activity Guide and basic sports equipment, which can be easily substituted for household items to ensure children in every community can participate (e.g. substituting a sport cone with a box or a plastic soda bottle filled with sand). After two months of participation in Young Athletes, children with ID gained seven-months in motor skills and saw significant improvements in social skills.\4\ The advantages children with ID gain by participating in Young Athletes hold over time. At five and ten month follow-ups, children who participated in an 8-week program maintained a four-month advantage in development. Moreover, parents and caregivers rated their children with ID as having fewer challenging behaviors, indicating changes not only in child outcomes but in the parent-child relationship as well. Finally, family members reported significant positive changes in both their own attitudes towards their child and those of community members towards their child with ID.\5\ By addressing both the developmental and attitudinal challenges faced by families of children with ID, Young Athletes has illustrated the impact of early interventions on health and development outcomes. For children like Subah, a five-year old from Pakistan, the impact of Young Athletes has introduced her to an entirely new world. Subah was diagnosed with cerebral palsy as a young child and was not able to walk or even sit without the support of a wheelchair. After just three months of Young Athletes, Subah is now walking, kicking, and playing with her friends at school. Her parents are overjoyed with the power of play. Young Athletes challenges expectations, forges relationships, fosters support networks, and builds crucial skills for young children. Young Athletes' impact has a ripple effect that extends benefits beyond the participants in the program to the family and community. It provides a forum for educating families, changes family perceptions on the value and worth of their child and provides opportunities for families to come together to share challenges and rewards. In these critically important ways, Young Athletes can serve as a catalyst around the world and become an important mechanism to enhance social inclusion for children--indeed all people--with ID throughout the world. Thank you again for the opportunity to testify on the FY SFOPS FY2022 Appropriations bill. We look forward to working with the committee and other programs that will have a positive impact on global health, inclusion, and social acceptance for people with intellectual disabilities. about timothy p. shriver, ph.d. Timothy ``Tim'' Shriver leads the Special Olympics International Board of Directors, and together with 6 million Special Olympics athletes in more than 200 countries, promotes health, education, and a more unified and inclusive world through the joy of sport. During his time with Special Olympics, which he joined in 1996, the organization has developed proven programming for all aspects of a Special Olympics athlete's life: leadership, health, education, and family support. His commitment to inclusion is evident in the Special Olympics athletes serving on the international Board of Directors, hundreds of thousands of health professionals trained in adaptive health care protocols, partnerships with organizations like the World Health Organization, and Unified Champion Schools creating a Unified Generation in which all people are included and accepted. Shriver drove the largest expansion of Special Olympics, growing the movement from one million athletes to over six million athletes and unified partners leading the ``Inclusion Revolution'' around the world. Shriver has harnessed the power of Hollywood to challenge unconscious bias and share stories of inspiration, co-producing DreamWorks Studios' 1997 release, Amistad, and Disney Studios' 2000 release, The Loretta Claiborne Story. He is Executive Producer of The Ringer, a Farrelly Brothers film, Front of the Class, a Hallmark Hall of Fame television movie, and The Peanut Butter Falcon released in 2019. In 2014, Shriver wrote the New York Times bestseller Fully Alive: Discovering What Matters Most, where he shares the life changing impact of people with intellectual disabilities and their capacity to inspire others to see the world in a more meaningful way. Before joining Special Olympics, he cofounded and currently chairs the Collaborative for Academic, Social, and Emotional Learning (CASEL). He is a member of the editorial board of the Disability and Health Journal. Shriver is Founder of UNITE.US, a member of the Council on Foreign Relations, President of the Joseph P. Kennedy Jr. Foundation, UNESCO Chair for ``Transforming the Lives of People with Disabilities, their Families and Communities, Through Physical Education, Sport, Recreation and Fitness'' at the Institute of Technology, Tralee, Ireland, a member of the Bank of America Global Advisory Council, and Co-Founder of Lovin' Scoopful Ice Cream Company. Shriver earned his undergraduate degree from Yale University, a master's degree in Religion and Religious Education from Catholic University, and a Doctorate in Education from the University of Connecticut. He and his wife Linda Potter live in the Washington, DC area and have 5 adult children and 3 grandchildren. --------------------------------------------------------------------------- \1\ UNICEF. (2009). Early Childhood Development: A Statistical Snapshot Building Better Brains and Sustainable Outcomes for Children. New York, NY. \2\ Mitra, S., Posarac, A., & Vick, B. (2013). Disability and Poverty in Developing Countries: A Multidimensional Study. World Development, 41, 1-18. \3\ UNICEF. (2014). Global initiative on out-of-school children: South Asia regional study. \4\ Favazza, P. C., Siperstein, G. N., Zeisel, S., Odom, S. L., & Moskowitz, A. L. (2011). Young Athletes intervention: Impact of motor development. Washington, DC: Special Olympics, Inc. \5\ Smith, A., Ralston, R., Dubois, L., Anderson, T. (2019). The impact of Participation in Young Athletes on Families of Children with Intellectual Disabilities. Poster presented at the 52nd annual Gatlinburg Conference on Research and Theory in Intellectual and Developmental Disabilities, San Antonio, TX. [This statement was submitted by Tim Shriver, Chairman.] ______ Prepared Statement of the TB Alliance TB Alliance appreciates the opportunity to submit this testimony for the record to the Senate State and Foreign Operations Appropriations Subcommittee. TB Alliance is a not-for-profit organization dedicated to the discovery, development, and delivery of better, faster-acting, and affordable tuberculosis (TB) drugs that are available to those who need them. Together with stakeholders in the TB advocacy community, TB Alliance requests that Congress appropriate $1 billion to the United States Agency for International Development's (USAID) TB program. TB is the second-highest global infectious disease killer after COVID-19, causing 1.5 million deaths globally in 2020. Unfortunately, TB is poised to again become the greatest single global infectious disease killer now that the COVID-19 pandemic is being brought under better control. TB, including the rapid spread of drug- resistant TB, poses a serious health security threat and, unfortunately, we do not have the tools (vaccines, drugs and diagnostics) we need to end the pandemic. The current arsenal of TB drugs, a 100-year-old vaccine, and diagnostics pale in comparison to what we have learned is possible in the response to the current COVID-19 pandemic. This is not a science problem, it is a resource problem. More funding is needed immediately for USAID's TB program, which is a key investor in late-stage research and development of new TB breakthrough products. tb alliance: a tb product development partnership TB Alliance is a not-for-profit product development partnership (PDP), based in the United States but with a global reach. PDPs develop new products for people suffering from diseases and health threats underserved by traditional markets. TB is an example of this type of global challenge as it is a disease that, although existing in virtually every country of the world, primarily impacts poor people living in the world's poorest countries. PDPs build partnerships between the public, private, academic, and philanthropic sectors and play a critical role in developing urgently needed health innovations that would otherwise not exist. PDPs, like TB Alliance, are critical to achieving global development and health security goals-unfortunately, we will not meet the 2030 World Health Organization goals to end TB and most likely we will never eradicate TB without a significant investment in new tools. PDPs are proven, prolific engines in product development and global health progress. USAID has been a key research and development (R&D) partner for diseases of poverty, including to TB Alliance. Increased investment in USAID's TB program-with a portion of this funding being allocated specifically to R&D-will help to create impactful new TB treatments and products that will pay for themselves multiple times over and free up resources for health systems in low- and middle-income countries. USAID's TB program plays a unique role in supporting late-stage product development that is not found elsewhere in the US government. While the National Institutes of Health (NIH) is a more traditional research partner for many familiar diseases impacting the United States and other high-income countries, its investments in early-stage research only advance if the private sector invests in late-stage clinical trials, product manufacturing, and delivery of the product to patients. Unfortunately, the private sector is not willing to invest to any significant degree in poverty related neglected diseases as there is no commercial market to incentivize that engagement. This is certainly the case with TB, perhaps the quintessential disease of poverty that primarily impacts the poorest of the poor in all countries, but especially in low- and middle-income countries. The COVID-19 pandemic has underscored the power of science. Amazing progress can be made in a relatively short period of time when there is a concerted, well-funded attack on a disease-but even the massive private sector investment in COVID-19 tools would not have happened without early investment in research from governments and promises to purchase vaccines and end products to make them accessible to patients. This is a prime example of how adequate investment can unleash the powers of science and technology to conquer a disease. Without enough political will or resources we cannot and will not be able to end the TB pandemic. a success story: a new treatment for drug resistant tb In 2019, pretomanid, a drug developed by TB Alliance, was approved by the U.S. Food and Drug Administration (FDA). Since TB must be treated with a combination of drugs (usually referred to as a regimen), pretomanid was developed as part of a novel regimen for the treatment of highly drug-resistant forms of TB, including extensively drug resistant TB (XDR-TB). With pretomanid, TB Alliance pioneered the concept of regimen development for TB-instead of developing a single drug to be added to existing treatments, pretomanid was developed as part of a specific set of drugs comprising a fixed regimen, in this case bedaquiline, pretomanid, and linezolid, together referred to as the ``BPaL'' regimen. This approach can markedly accelerate clinical development, protect new drugs from developing resistance, and ensure that there is rigorous clinical evidence for the use of a specific combination. The regimen development model has since become the gold standard for TB research and is applicable to developing new therapies for other diseases that require treatment with multiple agents. Prior to the BPaL treatment regimen, XDR-TB patients were traditionally treated with combinations of up to eight antibiotics, including daily injections for 18 months or longer, with success rates on the order of 25%. BPaL is a three-drug, six-month, all-oral regimen, which had a 90% cure rate in the pivotal clinical trial. Pretomanid has subsequently been approved by other regulatory agencies including the European Commission and the Drug Controller General of India. It is only the second drug approved for drug-resistant forms of TB by the FDA in more than 40 years, the first approved as a part of a set treatment regimen as well as the first to be registered by a not-for-profit. TB Alliance initially in-licensed pretomanid in 2002, leading it through a full pre-clinical and clinical development program; the FDA submission ultimately detailed data from a total of 19 clinical studies, of which all but two were fully sponsored by TB Alliance. Throughout its development, TB Alliance has collaborated with and received significant support from USAID as well as numerous governments and philanthropic institutions. Partnerships have included academic and civil society organizations as well as the private sector. The vast network of partners is representative of the unique PDP capabilities to build diverse and effective coalitions to drive global health innovation. Coordination with private and public sector partners has continued since US FDA approval of pretomanid through global commercialization partnerships with Viatris, Macleods, Lupin and Hongqi pharmaceuticals to ensure global coverage and affordability. Pretomanid was also added to the catalog of medicines of the Stop TB Partnership's Global Drug Facility, making it available to 150 countries which represent the vast majority of the global TB burden. These efforts ensured that pretomanid was available around the world as quickly as possible after approval and that generic competition was in place to help drive affordability and a stable supply. An independent analysis has concluded that the savings potential for health systems from the BPaL regimen is between $700 million and $1.1 billion in U.S. dollars through the next two years, potentially freeing up resources to treat an additional 220,000 people with TB. The success of pretomanid and the BPaL regimen would not have been possible without USAID support. conclusion The COVID-19 pandemic has shown us what is possible with the appropriate investments and demonstrates the power of innovation unleashed by adequate resources. As the Subcommittee considers funding for FY 2022, we ask that you include $1 billion for USAID and increase investments into R&D so more life-saving treatments like pretomanid can be developed and accessed by those who need them most. We look forward to working with the Subcommittee on global health initiatives and hope that you will consider TB Alliance as a resource. Thank you in advance for your time and consideration. [This statement was submitted by Dr. Mel Spigelman, President and Chief Executive Officer.] ______ Prepared Statement of the U.S. Global Leadership Coalition investing to protect american families Chairman Coons, Ranking Member Graham: On behalf of the U.S. Global Leadership Coalition--a diverse network of over 500 businesses and NGOs and bipartisan leaders from across the country--thank you for the opportunity to testify about the important resources provided in the State-Foreign Operations Appropriations bill. Today, I ask that you support a strong and effective International Affairs Budget funded at $71.6 billion in FY22, including no less than $69.1 billion for the FY22 State-Foreign Operations Appropriations bill. The last time I was physically on Capitol Hill was March 12, 2020. I was testifying before the House State-Foreign Operations Appropriations Subcommittee in the Rayburn House Office Building just hours before Congress closed to the public due to growing concerns about the spread of COVID-19 across this country. While the pandemic was top of mind, I remember that morning being one of the last ``normal'' moments before cases surged in America and around the world, irrevocably changing lives from Dover to Dakar and from Columbia to Chennai. Since that day--just over a year ago--there is no question that the world has been upended. The global COVID-19 death toll has exceeded 3.9 million, including more than 600,000 Americans. The pandemic has severely impacted the global economy and jobs here at home, and is fueling global crises from conflict to hunger to migration. I speak for our entire coalition of businesses, NGOs, faith-based organizations, veterans, mayors, and community leaders across the country in expressing gratitude for Congress's longstanding bipartisan support for America's development and diplomacy tools and for your personal leadership. In recent years, Members on both sides of the aisle have overwhelmingly rejected calls to dramatically cut international affairs programs and have worked together to ensure strong funding for the International Affairs Budget. As we look to the future, this is a critical inflection point. America's recovery and our prospects for prosperity and security are at stake. But the good news is--we know what we are up against, we know what it will take to get this right, and we know on a deeply personal level that America's fate is inextricably linked to what happens around the world. The reality is that the world has dramatically changed since March 2020. That's why it is imperative for our own recovery and our future to respond with additional resources for our international affairs agencies and programs. I urge this Subcommittee and this Congress to meet the moment by ensuring that our relatively small but critical investment in development and diplomacy truly reflects the urgency of America's health and economic recovery. Unprecedented Global Needs As the last 15 months have made clear, COVID-19 has dramatically reshaped the global landscape in new and unforeseen ways with important consequences for all Americans. Let me highlight a few examples that illustrate the magnitude of the growing global challenges and their impact on the lives of Americans here at home. --The COVID-19 pandemic pushed nearly 100 million more people into extreme poverty in 2020 compared to before the pandemic, according to new data from the World Bank. Last year, we saw the first increase in global poverty since 1998, not only causing more human suffering, but creating rising migration and mounting instability in the world. --The pandemic is expected to cost the global economy over $22 trillion in lost output by 2025, and failure to distribute COVID-19 vaccines equitably around the world could cost an additional $9 trillion. America's economic recovery depends on the recovery of low-income and emerging markets that have been hardest hit by the pandemic. --COVID-19 has exacerbated armed conflict and extremism, with fatalities caused by militant groups in Africa rising by a third in 2020. Increasing political violence and growing instability around the world has implications for U.S. national security. --Since we now know that it only takes 36 hours for a pathogen to spread around the globe and that 70% of the world remains underprepared to prevent, detect, and respond to this type of public health emergency, Americans won't be safe if the rest of the world isn't ready--whether it is responding to COVID-19 or preparing for the next pandemic. COVID-19 has wreaked havoc in America and across the globe. Decades of progress has been made in building a more stable and prosperous world--in Africa, Asia, and Latin America--helping the most vulnerable while creating opportunities for our own citizens. But we have seen a reversal of this progress, with backsliding continuing each day this pandemic goes on. Reversing these trends won't happen overnight and will require sustained new investments by the U.S. and our partners around the world. To better understand the impacts of the COVID-19 pandemic and the investment levels needed across the International Affairs Budget to protect the health, safety, and economic interests of Americans, the USGLC coordinated a strategic Global Needs Assessment with input from a broad array of national security and foreign policy experts across the political spectrum. The needs assessment identifies at least $14 billion in new resources across the International Affairs Budget for FY22 to advance U.S. health, security and economic interests and mitigate the global health and humanitarian impacts of the pandemic. Key investment areas identified are: --Improving pandemic preparedness; --Responding to global health and humanitarian crises; and --Bolstering American economic competitiveness and helping countries on their journey to self-reliance. The Administration's FY22 International Affairs Budget request is a smart proposal that would get us halfway there, but it's abundantly clear that more is needed if we are going to keep Americans healthy and safe. America's Recovery at Stake Protecting our Health.--With a majority of American adults fully vaccinated against COVID-19, life in the United States is slowly beginning to return to a semblance of normalcy. While this is an important milestone on the road to recovery here at home, we cannot forget that this pandemic is far from over around the world and the threat from variants puts these gains in jeopardy. From India to Brazil, COVID-19 cases are surging, and death tolls are rapidly rising. Africa has received less than 2% of COVID-19 vaccines to date according to the UN, and at the current rate it is expected to take until 2023 for 60-70% of Africa's population to be vaccinated. The urgency to inoculate the world cannot be understated and without U.S. leadership it is more likely collective efforts will fall short. The recent G7 announcements from the U.S. and our allies pledging 1 billion vaccine doses to those in need is a historic step forward. Americans want the U.S. to lead. A recent Kaiser Family Foundation poll revealed that 3 in 4 adults believe the U.S. should ``play at least a major role'' in global vaccine distribution, especially if it means America can help other countries without depleting the domestic vaccine supply. Yet new research shows that additional investments are needed to ensure the equitable delivery and distribution of COVID-19 vaccines throughout the developing world, particularly in ``last mile'' communities. Not to mention the reality that Russia and China are taking advantage of this moment to increase their own global vaccination efforts to further their own interests abroad, many of which do not align with ours. Keeping us Safe.--At a time when global crises were already on the rise, COVID-19 has increased instability, fueled conflict, and exacerbated humanitarian emergencies from hunger to poverty to migration. Political violence increased last year in nearly half of the world's countries including Yemen and Ukraine, according to the Armed Conflict Location & Event Data Project, and the UN's counter-terrorism chief recently warned that terrorist groups are exploiting the pandemic and appealing to new ``racially, ethnically, and politically motivated violent extremist groups.'' Tragically, the pandemic has not only disproportionately impacted the most vulnerable in the developing world but has severely limited efforts by the U.S. and others to provide much-needed assistance in places like South Sudan. Humanitarian and development assistance are cost-effective tools to prevent and reduce conflict--helping to stabilize weak and fragile states, stem the drivers of extremism, and keep us safe at home. Promoting Economic Recovery.--We know that America's road to economic recovery is tied to the rest of the world, but COVID-19 has disproportionately impacted emerging markets that are critical for U.S. businesses to recover and grow. As the world shuttered early in the pandemic, U.S. exports to countries in the developing world--countries like Brazil, India, and Mexico--fell by as much as 50%. The cost of failing to achieve global vaccine equity will hurt advanced economies-- regardless of their own vaccination rates--as much as developing countries, and recent studies also suggest that this could harm the U.S. economy by up to $670 billion over the next five years. We also cannot lose sight of the global competition we faced even before COVID-19. On the continent of Africa, China had already surpassed the United States a decade ago as the top exporter to close to 20 countries--some of the world's fastest growing markets. As a member of the Development Advisory Council of the U.S. International Development Finance Corporation, I have been pleased to see the DFC's new efforts in partnership with Congress to enhance and leverage America's development finance toolkit. Budgeting for a New Reality Each year, Congress faces the difficult task of distributing finite resources across many priorities. This year is no exception. But the consequences of inaction when it comes to fully resourcing our international affairs toolkit are simply too great. As I think back to my testimony in March 2020 when I talked about investing in pandemic preparedness, I often ask myself, what's it worth? COVID-19 has taken so much from us as individuals, families, and communities over the past 15 months. On a personal note--I recently was able to hug my 88-year-old mom and she met my 4-month-old granddaughter for the first time during the COVID-19 pandemic. I'm sure many of you on the subcommittee have finally been able to hug your parents, children, or grandchildren again. So, when we ask ourselves ``what's it worth'' to invest 1% of our federal budget to make sure we do what it takes to prevent a global pandemic from ever happening again, my answer is simple: everything. Thank you for your unwavering support of America's international affairs programs and your commitment to strengthening the critical resources needed to advance America's global leadership. Our coalition looks forward to working closely with you and your colleagues in the coming weeks and months to ensure that funding for the FY22 State- Foreign Operations bill reflects the unprecedented challenges and opportunities we face today to advance America's interests in the world. [This statement was submitted by Liz Schrayer, President and CEO.] ______ Prepared Statement of the U.S. Overseas Cooperative Development Council The U.S. Overseas Cooperative Development Council (OCDC) is requesting $18.5 million for the FY2022 Cooperative Development Program (CDP) of the Development Assistance account in the FY2022 State-Foreign Operations and Related Programs Appropriations bill. For more than five decades, USAID has supported the development of cooperatives as part of its foreign aid program, mainly through the Cooperative Development Program (CDP) that is designed to bring U.S. leadership to the mission of capacity building for the development and growth of cooperative businesses and cooperative systems around the world. This request for $18.5 million is the same as was provided in FY2021. who is ocdc and what is our interest in usaid's cdp program? The U.S. Overseas Cooperative Development Council (OCDC) has a membership of nine U.S. cooperative development organizations (CDOs) with expertise in sectors as diverse as agriculture, finance, health, energy and information technology. These OCDC members are successful U.S. cooperatives who are part of a robust U.S. cooperative sector that contributes more than 2 million jobs and over $65 billion in annual revenue to the U.S. economy. It is estimated that more than 120 million Americans benefit from their membership/participation in one or more of the nearly 30,000 cooperatives that exist throughout all sectors of the U.S. economy. In addition to being leaders in the U.S. domestic cooperative community, OCDC members have a shared interest in being champions, advocates, and promoters of effective international cooperative development. Individually and collectively, they have an impressive record of achievement, and they bring many resources to this international work from the private sector. They apply their expertise and approaches to development in a wide range of countries, settings, and sectors. They share their business expertise and send their members around the world as volunteers to build sustainable cooperative businesses, while also building goodwill for the U.S. And they develop trading relationships between cooperatives in the U.S. and those in developing countries, which increases jobs at home and security around the world. Examples of impacts achieved by OCDC members include: Equal Exchange: Fair Trade-certified coffee cooperatives in Ethiopia, Rwanda, East Timor, and Central America link thousands of smallholder farmers directly with global markets and their premium coffee prices. Frontier Co-op: Support cooperative member's organic cultivation practices, enhance their socio-economic wellbeing, provide education facilities, and support the economically disadvantaged at-large in member villages in Sri Lanka. Genex: Based on a foundation of business consulting provided by Genex through CDP funding, more than $94 million of host government investments has been leveraged for agriculture cooperatives in South Africa. Global Communities: Through the establishment of the Agency to Support Housing Initiatives, the organization facilitated the building of 1,140 new units of cooperative housing at 33 sites in Poland, with an estimated 4,560 individuals benefiting from the housing. Participating cooperative members contributed over $39 million to finance their housing projects, with 34% of the units financed by mortgage loans issued by local banks. HealthPartners: 46,000 members of health-care co-ops in Uganda now have reliable access to care, including bed nets to prevent malaria and Zika. Land O' Lakes Venture 37: Their work with the dairy sector in Rwanda has focused on partnering with cooperatives that have leveraged economies of scale through horizontal or vertical integration working with each partner to improve operational management, organizational governance and business decision-making. NCBA CLUSA: The Creating an Environment for Cooperative Expansion improves enabling environments, enhances support to cooperatives, and improves business performance of cooperatives, in six countries, building the capacity of more than 15 local support institutions to provide quality cooperative development services, and providing targeted technical assistance to more than 60 agricultural and savings and credit cooperatives. NRECA International: Decades-long relationship with the Philippine rural electric community included assistance in the more recent recovery from Typhoon Yolanda (Haiyan) that has included work to make the Philippines' power distribution infrastructure more storm resilient. 49 rural electrification projects in the Philippines provide power for 4.3 million co-op members. World Council of Credit Unions: In Kenya, WOCCU enrolled over 30,000 new youth members (18-35) in the past year. Over 84,000 Agriculture Loans have been issued, totaling to $8.7+ M. 3,000 orphans of HIV/AIDS received support and 466 scholarships were given for orphans and vulnerable children to attend secondary school. impact of the cdp program Compared with other U.S. foreign aid programs, the CDP program has received a modest amount of funding and yet it has achieved tremendous success as a catalyst in laying an effective base for widespread and sustainable international cooperative development. Among the measures of the CDP program's success over the years are reports of the following impacts: --500 cooperatives and credit unions assisted with a combined savings to members of $495 million. --Provision of health insurance and services to more than 42,000 people in Uganda. --Leveraging of more than $94 million of host government investments for agriculture cooperatives in South Africa. --Increased member equity among cacao cooperatives in Ecuador, Peru, and the Dominican Republic by more than $4 million; and, --Reforms to cooperative law and regulation in Mozambique, Tanzania, Uganda, and Kenya. This is only a representative sample of an impressive track record for the CDP program. The challenge is to use the CDP program to get additional traction for cooperative development that will produce similar impacts in other parts of the developing world. Among the lessons we have learned is that the CDP program is an important resource for demonstrating the positive experience of cooperatives in the developed world that can then be replicated to address the economic and social challenges of developing countries where cooperatives have not had a similar successful history. why cooperatives should be an international development tool In the quest for a more prosperous, democratic, and inclusive world, and amid calls to ``build back better'' post-COVID-19, there has never been a better time to increase U.S. investment in cooperative development. Through a democratic business model, people-centered approach, underlying social justice principles, concern for community, and dedication to equitable economic growth, cooperatives bring a unique set of solutions to today's most difficult development challenges. Cooperatives are a dynamic force for self-determination, and they contribute to creating communities where all people--including women, youth and the most vulnerable--have an opportunity to improve their livelihoods. Cooperatives go where for-profit businesses will not--they provide economic opportunities and services in places that others find unprofitable or too risky. For many poor and isolated people, joining a co-op is the best option to help them escape poverty. U.S. cooperative development assistance has helped develop cooperatives that serve millions across the globe. What results can be expected if a greater investment is made? This testimony provides evidence that a greater U.S. investment in cooperative development will: create jobs and economic growth in low- to middle-income countries--and the united states Cooperatives offer a proven way for people to control their economic livelihoods. --In developing and transitional economies, they create jobs, equitable economic growth and social development. --Cooperatives allow poor people to pool resources and reduce risks, and allow small farmers and businesses to enjoy advantages of greater scale of production. --Cooperative development stems migration by providing economic opportunities for people in their home country. --Co-ops provide opportunity and member services otherwise unavailable in remote areas. Public-sector assistance helps fund the formation of cooperatives in developing economies and, as they grow, these well-managed cooperatives develop vital U.S. linkages with corporate foundations, non-government organizations and American volunteers. This makes U.S.- funded cooperative development a win for jobs in the United States: --Private-sector jobs at companies in the U.S., such as those involved with coffee and cocoa, rely on supply chains anchored by well-organized cooperatives in developing countries. --In turn, successful cooperatives buy U.S. products, which expands export opportunities. further democratization across the globe A cooperative is a ``learning lab'' where members experience democratic governance. Cooperatives are democratically managed through ``one member-one vote,'' and members elect a board that represents their interests and are accountable to them. These lessons spill over from local cooperatives into the broader society. Local cooperative members learn to vote in elections, work democratically to achieve change at all levels of their cooperative organization, and advocate for modernization of laws that govern their co-ops. have large-scale impact Cooperatives overseas that have been initiated and nurtured through U.S. funding are thriving. Additional resources will continue fostering development at this impressive scale. For example, U.S. assistance has meant that: --70 million rural people in the Philippines now have electricity. --46,000 health-care co-op members in Uganda have access to reliable care. --15 million producers sell milk to more than 144,000 dairy cooperatives in India. --Thousands of small farmers in Africa and Central America access global markets through Fair Trade-certified coffee cooperatives. --More than 39,000 credit unions meet financial needs of 38 million members across Africa. --36,000 farmer cooperatives provide fertilizer and other critical services to rural India. --40,000 children in South Asia are learning the basic principles of banking. through a children's cooperative. result in trust, sustainability, and growth Where trust of for-profit companies is low, cooperatives grow. Trust is a basic principle for cooperatives, which are owned, managed, controlled, and patronized by their own members. Cooperative banks and savings and credit cooperatives were not damaged during the financial crisis of 2007-08 and grew in membership because they were seen as more risk-averse, sustainable and trustworthy. Income from premiums in the global mutual and cooperative insurance sector grew by 30% in the 10- year period following the onset of the financial crisis, compared to 17% growth of the total global insurance industry. This growth resulted in a 24% increase in jobs globally from 2007 to 2017. REQUESTED FUNDING: The U.S. Overseas Cooperative Development Council (OCDC) is requesting $18,500,000 for the Cooperative Development Program (CDP) in the FY2022 State-Foreign Operations and Related Programs Appropriations bill, the same as provided in FY2021. REQUESTED BILL LANGUAGE: DEVELOPMENT ASSISTANCE: COOPERATIVE DEVELOPMENT PROGRAM ``Provided that not less than $18,500,000 shall be made available for USAID cooperative development programs within the Bureau for Development, Democracy, and Innovation.'' SUGGESTED REPORT LANGUAGE: ``The Committee has repeatedly recognized the important role that U.S. cooperatives and credit unions play in overseas programs as a means to lift low-income people out of poverty through their own efforts by mobilizing equity and savings for community-based economic growth. The Committee directs the Agency for International Development to increase the budgetary level of the program for the next five-year agreement to include funding for research on the impact of cooperatives on members and their communities. Due to increased demand for the program and the programmatic impact, the Committee intends to budget for not less than $18,500,000 per year for the next five years.'' [This statement was submitted by Paul Hazen, Executive Director.] ______ Prepared Statement of the U.S. Section of the Pacific Salmon Commission Mr. Chairman, and Honorable Members of the Committee, I am Ron Allen, Tribal Commissioner and Chair for the U.S. Section Budget Committee of the Pacific Salmon Commission (PSC). The U.S. Section prepares an annual budget for implementation of the Pacific Salmon Treaty. Funding comes from the Departments of State, Commerce, and Interior. The integrated budget details program needs and costs for Tribal, Federal, and State agencies involved in the Treaty. Department of State funding in support of implementing the Pacific Salmon Treaty is part of the International Fisheries Commissions line item. The FY 2021 funding level was $5,935,000. The U.S. Section recommends a funding level of $5,185,000 for FY 2022, which represents a $750,000 decrease. These costs provide essential support to implement the revised chapters of the annex of the Treaty. The Department of State provides funding for the dues to operate the bilateral Pacific Salmon Commission Secretariat office in Vancouver, British Columbia. The United States and Canada kept the dues constant for eleven years. The U.S. Section recommends a $1,000,000 annual increase in the dues. Canada is expected to match the increase in dues. It is anticipated that the annual increase in dues will be sufficient to maintain operations over the next ten years. The Commission's Finance & Administration Committee works closely with the Secretariat staff to keep costs in check. The Secretariat faced challenges in recent years to ensure the operation of test fisheries necessary for the management of Fraser River sockeye and pink fisheries as outlined in Annex 4 Chapter 4 of the Treaty. Declines in the return of Fraser River sockeye and changes in the Canadian Use of Fish Policy have impacted the viability of the test fisheries. The Secretariat faces challenges regarding funding for the pension liability as the Secretariat staff ages and retires. Our section urges the Department of State to continue covering this liability outside the dues structure, consistent with other International Fishery Commissions. The Department of State provides funding, through an inter-agency agreement, with Department of Commerce, National Marine Fisheries Service, to support United States participation in the annual meeting process and to support staffing of the U.S. Section office. A hallmark of the PSC process is the input from affected fishing interests from Alaska to Washington, Oregon and Idaho. Maintaining the funding at least at current levels is essential to address these challenges. Funding to support activities under the Pacific Salmon Commission comes from the Departments of Interior, State, and Commerce. The U.S. Section can provide an additional budget summary and details to the Committee as required. Adequate funding from all three Departments is necessary for the United States to meet its Treaty obligations. The funds are needed for critical data collection and research activities directly related to the implementation of the Treaty and are used in cooperative programs between Federal, State, and Tribal fishery agencies and the Department of Fisheries and Oceans in Canada. The commitment of the United States is matched by the commitment of the Government of Canada. Mr. Chairman, the United States and Canada established the Pacific Salmon Commission, under the Pacific Salmon Treaty of 1985, to conserve salmon stocks, provide for optimum production of salmon, and to control salmon interceptions. After more than thirty years, the work of the Pacific Salmon Commission continues to be essential for the wise management of salmon in the Pacific Northwest, British Columbia, and Alaska. For example, upriver bright fall Chinook salmon from the Hanford Reach of the Columbia River are caught in large numbers in Alaskan and Canadian waters. Tribal and non-tribal fishermen harvest sockeye salmon from Canada's Fraser River in the Strait of Juan de Fuca and in Puget Sound. Canadian trollers off the west coast of Vancouver Island catch Washington coastal and Puget Sound Chinook and Coho salmon. In the Northern Boundary area between Canada and Alaska, fish from both countries are intercepted by the other country. The Commission provides a public forum to ensure cooperative management of salmon populations. The United States and Canada successfully concluded lengthy negotiations to improve management, building on and adjusting the coastwide abundance-based management regime for Chinook salmon established in the 1999 agreement. The revised Coho Chapter also continues to build on a framework for abundance-based management. The revised Annex Chapters for Chinook, Coho, Chum, Transboundary and Northern Boundary fisheries will be in force for the next ten years. The United States and Canada completed a revised Fraser River Sockeye and Pink salmon chapter in 2020, which will also be in force through 2028. Before the Treaty in 1985, fish wars often erupted with one or both countries overharvesting fish that were returning to the other country, to the detriment of the resource sustainability. At the time the Treaty was signed, Chinook salmon were in a severely depressed state because of overharvest in the ocean as well as environmental degradation in the spawning rivers. Under the Treaty, both countries committed to rebuild the depressed runs of Chinook stocks, and they recommitted to that goal in 1999 when adopting a coastwide abundance-based approach to harvest management. Under this approach, harvest management will complement habitat conservation and restoration activities being undertaken by the states, tribes, and other stakeholders in the Pacific Northwest to address the needs of salmon listed for protection under the Endangered Species Act. The 2018 Chinook Chapter continues these commitments. The revisions to the Chinook Chapter will continue to build on the progress made in previous agreements. The combination of these efforts is integral to achieving success in rebuilding and restoring healthy, sustainable salmon populations. Finally, I ask you to consider the fact that the value of the commercial harvest of salmon subject to the Treaty, managed at productive levels under the Treaty, supports the infrastructure of many coastal and inland communities. The value of the commercial and recreational fisheries, and the economic diversity they provide for local economies throughout the Pacific Northwest and Alaska, is immense. The Commission recently funded an economic study of the fisheries that has determined this resource creates thousands of jobs and is a multi-billion-dollar industry. The value of these fish to the twenty-four treaty tribes in Washington, Oregon, and Idaho goes far beyond their monetary value, to the cultural and religious lives of Indian people. A significant monetary investment is focused on salmon due to the listings of Pacific Northwest salmon populations under the Endangered Species Act. Given these resources, we can continue to utilize the Pacific Salmon Commission to develop recommendations that help with the development and implementation of solutions for minimizing impacts on listed stocks. We continue to work toward the true intent of the Treaty, and with your support, we will manage this shared resource for mutual enhancements and benefits. Mr. Chairman, that concludes my written testimony submitted for consideration by your committee. I want to thank the Committee for the support that it has given the U.S. Section in the past. Please feel free to contact me, or other members of the U.S. Section to answer any questions you or other Committee members may have regarding the U.S. Section of the Pacific Salmon Commission budget. [This statement was submitted by W. Ron Allen, Commissioner.] ______ Prepared Statement of U.S. Voters Organized Under the Banner of NO RIGHTS/NO AID: No Rights for Palestinians, Then No U.S. Aid for Israel Dear Chair Chris Coons and Ranking Member Lindsey Graham: We, the undersigned United States voters, write to urge that our government end aid to Israel now. There is no valid reason for continuing U.S. support for this apartheid regime. This has become an urgent matter for a growing number of U.S. voters, including the undersigned. Here are the facts. Israel controls the entire region of Israel, the West Bank and Gaza and the lives of all who live there. As soon as the most recent slaughter in Gaza ceased, and the world's attention became less intense, Israel launched a campaign of retribution against Palestinians for daring to protest earlier in the month. ``Operation Law and Order'' swept through Israel and into the West Bank making mass arrests of Palestinians to ``settle scores'' and ``close accounts''. And yet, U.S. leadership was, and continues to be, silent as this goes on. How can this be? Israel has been illegally taking Palestinian land for more than 50 years to build Jewish-only settlements while denying Palestinians in the West Bank the right to build or even maintain their homes and other structures. Considering all the aid and geopolitical support given to Israel for decades, the U.S. cannot pretend to not be directly involved in these atrocities. Our country is complicit. Hoping that fear and hardship will cause Palestinians to abandon their land, or perhaps simply out of pure hatred, Jewish settlers in the countryside attack Palestinians and burn their crops and fields causing costly damage, loss of livelihood and the terror of violent harassment. Often this happens with the assistance of the Israeli authorities. How can the U.S. honestly pretend to not see and understand this for the ethnic cleansing that it is? In Netanyahu's final speech to the Knesset as he most recently left office he affirmed Israel's true intentions when he said, ``. . . the second challenge facing us is to prevent the establishment of a Palestinian state that will jeopardize our existence.'' In other words, Israel has no intention of ever allowing the Palestinians to have a state of their own. How then can the U.S. claim, with any integrity, to support a ``two-state solution'' when this ridiculous lip service just gives Israel more time to drive out Palestinians and forcibly make the entire region Jewish-only? Unless the U.S. takes a new course of action right now Israel will continue to expel Palestinians from their longtime homes in East Jerusalem and convert them to more Jewish-only settler housing. Arieh King, a Deputy Mayor of Jerusalem has made it clear this is part of a wider strategy of ``installing layers of Jews'' throughout East Jerusalem. This policy, Mr. King said, ``is the way to secure the future of Jerusalem as a Jewish capital for the Jewish people,'' so that future peace negotiators will not ``try to divide Jerusalem and give part of Jerusalem to our enemy'' (New York Times 5/12/21). This explicit municipal policy in Jerusalem is essentially an explicit national policy as well. Pursuant to Israel's Nation State Law adopted in 2018 Jews alone are recognized as having supremacy over all others. Despite this longstanding history of events, Ranking Member Graham recently announced that in the Senate he will make sure that Israel gets 1 Billion Dollars MORE from the U.S. this year. Senator Graham, you have said that it is good for the United States to do this. Respectfully sir, we strongly disagree. It is not good for the United States and it is manifestly unjust for the Palestinians. Many of the long stated reasons for continuing any aid to Israel are no longer valid. Israel does not need protection. After more than half a century of U.S. military aid Israel now has one of the most sophisticated militaries in the world. U.S. aid also helped Israel build its own domestic military industries such that it now ranks as one of the top global exporters of arms and surveillance tools in the world and Israel is the only country in the region to possess nuclear arms. Moreover, in the decades of receiving U.S. aid Israel has become a wealthy economy, equivalent to several in the European Union. Israel does not need our help. Again, in his final speech, Netanyahu boasted that, `` . . . we turned it [Israel] into one of the 20 wealthiest economies in the world, with our GDP per capita surpassing Britain, Germany and France . . .'' Why then does the U.S. reflexively continue to fund Israel and its abhorrent behavior in amounts that exceed $3.8 billion per year? And now Ranking Member Graham has promised Israel another $1 billion. This makes no sense. Respectfully Senators, it looks to us as if we're being duped. It is particularly striking that the humanity of the Palestinians nevers seems to be part of this foreign aid calculation. It is as if we should pretend that Palestinians do not exist in their homeland and have no human rights. It is as if we should ignore the nightmare that Israel has made Gaza for 2,000,000 people who have no way to escape Israel's violence and the deprivation caused by Israel's blockade. During the recent nightly pounding from Israeli bombs an English teacher in Gaza reported it this way, ``I can't even begin to describe the horrors of last night. In the morning, each morning, I can't believe we made it out alive.'' Many families did not make it out alive. It must be a new day in U.S. foreign policy with Israel. For the sake of honesty, morality and the universal value of human rights U.S. aid to Israel must end. Respectfully submitted by the following U.S. Voters on the next two pages: [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] ______ Prepared Statement of the UNICEF USA Chairman Coons, Ranking Member Graham, and members of the Subcommittee, on behalf of more than 10,000,000 supporters of UNICEF USA, I appreciate this opportunity to submit testimony to the Subcommittee regarding the United Nations Children's Fund (UNICEF). I respectfully ask the Subcommittee to provide a fiscal year 2022 U.S. contribution of $134 million to UNICEF's core funding within the International Organizations and Programs Account, which is the same level that was enacted in the final fiscal year 2021 omnibus agreement. I am President and CEO of UNICEF USA. We are a U.S. nonprofit organization that advances the global mission of UNICEF by rallying the American public to support the world's most vulnerable children. I am proud to say that the American public is generous in its support for UNICEF: we raised more than $600 million last year in donations and gifts-in-kind from U.S. individuals, foundations and corporations. We also mobilize our supporters to engage with their Members of Congress. In fact, several member offices of the State, Foreign Operations subcommittee met with some of our 460 UNICEF volunteers from across the country who participated in our virtual Advocacy Week in March, sharing their belief in UNICEF and their support for the annual appropriation to UNICEF's core resources. This year marks UNICEF's 75th anniversary. Since its creation in 1946, with U.S. partnership and leadership, UNICEF has helped to save more children's lives than any humanitarian organization in the world. I commend this Subcommittee for its bipartisan leadership to support UNICEF, and champion programs that help children around the world. You are making a difference. This partnership between UNICEF and the U.S. Government has achieved positive results for children. UNICEF has helped to cut the world's under-five mortality rate by 58% since 1990. Unfortunately, a year into the COVID-19 pandemic, the world has gone backward across virtually every key measure of child well-being. Up to 1.5 billion children and young people have been affected by school closures, and at least 1 in 3 schoolchildren have been unable to access remote learning while their schools were closed. At least 1 in 7 children and young people lived under stay-at-home policies for most of 2020, leading to feelings of anxiety, depression and isolation. Rates of child malnutrition and food insecurity are on the rise in communities across the globe, and up to 56 million children may suffer from wasting by 2022, not to mention our worry about a looming famine in Northern Ethiopia. Since the pandemic outbreak, UNICEF has quickly acted to reduce the spread of the virus and minimize its impact on children worldwide. UNICEF used its data systems to rapidly assess the pandemic's impact on children and leveraged its extensive presence across more than 190 countries and territories, and its dual humanitarian and development mandate, to play a key role in the United Nations' coordinated response to COVID-19. UNICEF's Supply Division leveraged its logistical expertise to ship half a billion items of personal protective equipment in support of 138 countries in 2020. A few of UNICEF's accomplishments in 2020 include: --Providing leadership in the COVAX Facility, leading on the procurement and distribution of COVID-19 vaccines for 92 low- and middle-income countries, and helping those countries prepare for equitably delivering the vaccine to their populations. --Distributing critical water, sanitation and hygiene (WASH) services and supplies for 106 million people, including 58 million children. --Facilitating training on infection prevention and control for 4 million health workers. --Supporting community-based mental health and psychosocial interventions in COVID-19 response plans, reaching 78 million children, adolescents, parents and caregivers in 117 countries. --Facilitating treatment and care for nearly 5 million children with severe wasting in more than 70 countries. --Supporting more than 301 million children, including approximately 147 million girls, with remote learning. UNICEF's response focuses on countries with existing humanitarian crises--working both to prevent transmission and mitigate the collateral impacts on children, women and vulnerable populations, especially around access to health, nutrition, water and sanitation, education and protection. Without this core support to UNICEF, programs such as polio eradication, basic education, immunizations, anti-malarial bed nets, pediatric HIV/AIDS interventions, and protecting children from violence and abuse would be put at risk. Moreover, the U.S. contribution to UNICEF's core resources is essential to UNICEF's ability to respond effectively to global health and humanitarian crises alike. The pandemic has demonstrated how essential flexible resources are to UNICEF's ability to respond quickly and effectively to such crises and to provide countries and communities with the long-term support that builds resilience. U.S. Government support for UNICEF's core resources ensures that UNICEF has infrastructure and resources on the ground before, during and after humanitarian crises. unicef's humanitarian impact for children UNICEF is a global partner in helping the U.S. Government respond to humanitarian crises around the world. Each year, UNICEF's humanitarian programs provide millions of children in conflicts and other emergencies with a range of life-saving services, including: --In 2019, UNICEF assisted in 281 humanitarian situations across 96 countries. This assistance included treatment for nearly 54 million children for severe acute malnutrition, vaccinations for 41.3 million children against measles and safe water for more than 39 million people. --UNICEF supports initiatives to make schools, health centers, water and sanitation facilities--and other services critical to children's well-being--resistant to current and future climate and environmental shocks. --Every $1 invested in emergency preparedness equals $4 saved in UNICEF's ability to respond to crises faster, save more lives and reduce costs. unicef supplies and cost reductions UNICEF is committed to making every dollar go further to save and improve children's lives. Through innovative procurement, market strategies and partnerships, UNICEF uses its market power to drive down supply prices; in only two years, UNICEF exceeded its projected $670 million in price savings for strategic supplies over the period of 2018-2021 by $44.5 million. --UNICEF is one of the largest buyers of supplies for children, providing the organization with leverage to negotiate the lowest prices. In 2019, UNICEF procured $3.8 billion in supplies including nearly $545 million in U.S. goods and services. --In order to provide long-term protection for children, UNICEF is committed to promoting sustainability and security in supply chains. UNICEF's global supply chain and local presence mean it can get help to where it is needed fast--shipping life-saving supplies almost anywhere in the world within 72 hours. unicef partnerships The U.S. Government, the American people and UNICEF have maintained a strong partnership since UNICEF's inception. Without a consistent U.S. Government voluntary contribution, and the leverage that comes from that support through corporations, foundations and other governments, UNICEF would not be able to maintain its level of leadership in the world for children. UNICEF receives no direct funding from the United Nations-all of UNICEF's funds come from voluntary contributions from both public and private sources. Almost a third of UNICEF's total funding comes from non-governmental sources. UNICEF's efforts around the world embody the compassion of the American people for helping children and families. That is why UNICEF enjoys incredible backing from Americans for its mission of child survival and development, from children participating in ``Trick or Treat for UNICEF'' and ``UNICEF Kid Power,'' to major corporations donating money and products. UNICEF USA is proud of its partnerships with corporations and nonprofits to save children's lives. Among many examples: --Kiwanis International, partners with UNICEF to eliminate maternal and neonatal tetanus (MNT) and iodine deficiency disorders. Between 1999 and 2018, the Global MNT Elimination Initiative has helped to vaccinate more than 154 million women against this deadly disease. --UNICEF procures vaccines for Gavi and buys all vaccines and related items for global campaigns not covered by Gavi. In 2019, UNICEF reached almost half the world's children under five years old with life-saving vaccines. UNICEF is a major partner of the United States in fighting vaccine-preventable diseases in 99 countries, including polio and measles. --Rotary International, in partnership with UNICEF, the U.S. Centers for Disease Control, and others through the Global Polio Eradication Initiative, has helped nearly eliminate wild polio worldwide, reducing polio cases by more than 99.9% since 1988. --With the American Red Cross, UNICEF helps lead the Measles and Rubella Initiative, working with countries, partners, parents and caregivers to create a world free from measles and rubella. --UNICEF is a founding member of the Roll Back Malaria Partnership to support malaria treatment and research, and to expand prevention measures such as long-lasting insecticide-treated bed nets. In 2019, UNICEF procured mosquito nets for 48.1 million people in 33 countries-the highest amount in UNICEF's history-including nearly 1.7 million people in humanitarian situations. --Microsoft and UNICEF expanded its global learning platform, the Learning Passport, which began as way to ensure displaced and refugee children had access to digital remote learning, to help 1.57 billion students affected by COVID-19 continue their education at home. UNICEF's impact is also strengthened by maintaining U.S. support for bilateral foreign assistance programs. In this regard, UNICEF USA supports the fiscal year 2022 funding requested by our partners for Iodine Deficiency and Iodine Nutrition ($3.5 million), Maternal and Neonatal Tetanus ($2 million), Polio Eradication ($65 million), and Gavi ($290 million). Because of the importance of U.S. child survival and health programs, our organization also asks the U.S. Congress to provide at least $984 million under the Maternal and Child Health (MCH) account, at least $240 million for the Nutrition account, and at least $540 million for Water and Sanitation account in fiscal year 2022. Finally, UNICEF knows that education is critical for children, especially now, and can be lifesaving for children in crises. That is why we support at least $1.1 billion for the International Basic Education account, including $150 million for the Global Partnership for Education, and $50 million for Education Cannot Wait. innovation Innovation is at the heart of UNICEF's ability to achieve results for children and young people. UNICEF is a leader in innovative financing or non-traditional mechanisms of raising resources to meet children's needs. --GIGA, launched by UNICEF and the International Telecommunication Union (ITU) in 2019, is an innovative partnership to connect every young person to the internet, by mapping school connectivity, advising on technical solutions and building affordable, sustainable country-specific financing models. --UNICEF has driven and brought to scale numerous product innovations such as portable incubators, accessible latrine slabs for children with disabilities, compressed air for pneumonia, new diagnostic tools, multi-purpose lightweight tents and modular schools. --A Cryptocurrency Fund was launched by UNICEF in 2019-the first of any UN Organization-to fund open-source technology benefiting children and young people around the world. u.s. support for unicef is helping to improve and save lives The U.S. Congress's longstanding and generous support for UNICEF's core resources allows UNICEF to partner with the U.S. Government to make a real difference in saving children's lives: --UNICEF plays a critical role in global efforts to ensure child have access to education, including early childhood development, especially for children in conflict and girls; education helps protect girls from exploitation, child marriage, and abuse. As a result of COVID-19 disruptions, UNESCO estimates that 11.2 million additional girls may not return to school. Girls living in conflict contexts are more than twice as likely to be out of primary school as those not affected by conflict. --UNICEF has been a world leader in immunizations and is the world's largest provider of vaccines for developing countries. In 2019, UNICEF purchased 2.43 billion doses of vaccines for children in 99 countries. UNICEF engages with manufacturers to keep vaccine prices as low as possible, ensuring that vaccines reach even the poorest children and communities. --Malnutrition contributes to nearly half of all child deaths and causes stunting that affects a child's physical and cognitive development. Thanks to UNICEF's provision of therapeutic foods, more children have been treated for severe acute malnutrition (SAM) than ever before. --UNICEF is engaged in water, sanitation and hygiene (WASH) programming supporting 18.3 additional people gain access to safe drinking water services and 15.5 million additional people gain access to basic sanitation services in 2019. conclusion We salute this Subcommittee's has longstanding bipartisan support for the well-being of the world's children, especially for child survival and for UNICEF, ensuring that children are a priority of U.S. foreign assistance funding. We believe that UNICEF is an indispensable partner of the United States on initiatives to save lives and protect vulnerable children around the world. Maintaining the U.S. voluntary contribution to UNICEF's core resources at the current level of $134 million will enable UNICEF to continue saving and protecting the lives of vulnerable children around the world. We thank you for your consideration and for helping to ensure that every child survives and thrives. [This statement was submitted by Michael J. Nyenhuis, President and CEO.] ______ Prepared Statement of the Vaccine Alliance (GAVI) Mr. Chairman, Ranking Member Graham: Thank you for the opportunity to provide testimony to the Subcommittee on behalf of Gavi, the Vaccine Alliance (Gavi). I respectfully request the Committee to provide $290 million as the U.S. contribution in fiscal year 2022 to Gavi as part of a four-year, $1.16 billion commitment (fiscal years 2020-2023), and to provide $984 million for USAID's Maternal and Child Health account. A commitment from the United States at this level will support critical immunization efforts around the world and strengthen global health security. It will also support the prevention of disease outbreaks, foster stability in vaccine markets, and support continued innovation in global health at a time when COVID-19 threatens historic gains in health and immunization. I would like to thank you, Chairman Coons, Ranking Member Graham, and the other members of the Subcommittee for your strong support of Gavi. This Committee has been the leader, since our inception in 2000, in the United States-Gavi partnership. You have been and continue to be an essential part of our success in bringing vaccines to the world's most vulnerable and in helping to keep the world safe from infectious diseases. Your support for our routine immunization work in low-income countries helps protect millions of children from vaccine- preventable diseases every year. a critical time for routine immunization Since 2000, Gavi has driven unprecedented progress in global health through one of the most cost-effective public health interventions available--vaccines. With support from the United States and other donors, Gavi works alongside a range of partners to expand immunization access in low-income countries while also strengthening health systems and building stockpiles of vaccines against infectious diseases like Ebola and yellow fever. In the last two decades, this work has helped immunize more than 822 million children, averting more than 14 million deaths and giving children around the world a chance at a healthy start in life. The efforts of Gavi and its partners have protected millions of children against deadly yet preventable diseases and have been a major factor in nearly halving child mortality since 2000. But these gains are fragile. Fifteen million children still miss out on a full course of the most basic vaccines, and other disease outbreaks as well as increasing fragility and displacement jeopardize the achievements of national routine immunization programs and threaten global health security. Increasing birth rates in Gavi-supported countries also means that a greater number of children must be immunized each year just to maintain the same coverage rates. The COVID-19 pandemic has created new challenges, increasing the risk of disruptions to vital immunization services in the low-income countries Gavi supports and reducing the number of planned immunization programs. Without continued investment and support, disruptions like these could lead to concurrent outbreaks of other deadly infectious diseases, further stressing already weakened health systems and jeopardizing decades of progress in immunization. Despite these challenges, Gavi has set ambitious goals to reach even more children and, with continued support and partnership, is well-placed to reach these goals and make further progress on closing the immunization gap. Gavi continues to play a critical role in supporting routine immunization and preventing global infectious disease outbreaks by expanding vaccine access and strengthening health systems in low-income countries, work that would not be possible without the continued support of the U.S. the alliance's 2021-2025 strategy and the road ahead Gavi began a new five-year strategic cycle in 2021, with a goal of immunizing an additional 300 million children in the 2021-2025 period-- preventing an additional 7-8 million deaths. The USAID-announced pledge in February 2020 of $1.16 billion for fiscal years 2020-2023, subject to Congressional approval, is crucial to ensuring Gavi can continue the programs needed to reach this goal. A $290 million contribution to Gavi in fiscal year 2022 would fulfill the third year of that pledge and ensure Gavi can continue to reach children with critical immunization services. Continued support will also help build strong, sustainable health systems and enable additional countries to transition out of Gavi support and begin fully self-financing their immunization programs, joining the sixteen countries around the world that have already transitioned. Furthermore, continued support from the U.S. will allow Gavi to expand current portfolio of vaccines to as many as 18 diseases and invest in critical emergency stockpiles. the gavi model Gavi's impact draws on the strength of its partners, all of whom play a critical role in the Alliance. This unique model brings together donors, including sovereign governments like the United States; implementing country governments; private sector partners, international organizations such as UNICEF, WHO, and the World Bank; and civil society partners to build sustainable, country-led immunization programs in lower-income countries. Empowering countries to take ownership of their vaccination programs is a core component of the Gavi model. Every country that receives Gavi support shares the responsibility of vaccinating their children and co-finances vaccine costs. As a country's income grows, their co-financing obligation also grows until they reach a specific Gross National Income cap, at which point they begin to transition out of financial support from Gavi. Throughout this process, Gavi provides technical support and guidance to ensure transitioning countries have the capacity to continue implementing sustainable and equitable vaccine programs. Currently, 16 countries have fully transitioned from Gavi support with more expected to transition in the coming years. Building healthy markets is critical to the long-term success of the Gavi mission. Since 2000, Gavi, its partners, and the vaccine industry have been working to improve vaccine market certainty by pooling demand from Gavi-eligible countries. Gavi's purchasing power covers more than half of the annual global birth cohort, enabling it to provide a large and reliable market when negotiating vaccine prices. These market shaping strategies have also helped attract new manufacturers across the world to support Gavi-eligible countries, starting from five firms in 2001 to 17 today. Partnership with the private sector is also integral to Gavi's model. Leveraging the private sector's financial resources, operational expertise, and innovation helps the Alliance to deliver on its ambitious coverage and equity goals. covid-19 response In addition to the United States' historic support for Gavi's routine immunization programs, the strong bipartisan support for the $4 billion contribution to Gavi for COVID-19 vaccine procurement and delivery in the fiscal year 2021 Omnibus appropriations bill has enabled us to procure COVID-19 vaccines for lower-income economies and leverage other donors to make contributions to the Gavi COVAX Advance Market Commitment (AMC). Congress' generous support makes the United States the largest donor to the Gavi COVAX AMC, and this funding will help ensure lower-income economies have equitable access to safe and effective COVID-19 vaccines on the same urgent timeline as wealthier countries. Gavi, in partnership with Coalition for Epidemic Preparedness Innovations and the World Health Organization and with support from donors, key implementing partners like UNICEF, manufacturers, international financial institutions, and others, launched COVAX in June 2020. COVAX builds on Gavi's more than two decades of experience in immunization and is the only global initiative that is working with governments and manufacturers to ensure COVID-19 vaccines are available worldwide to both higher-income and lower-income countries. To date, COVAX has shipped over 81 million COVID-19 vaccine doses to 129 countries, including 72 lower-income countries. The U.S.' investment in this work is helping to end the acute phase of this pandemic. U.S. leadership as host of the Gavi COVAX AMC Investment Opportunity launch event in April 2021 further demonstrated the power of the U.S. contribution to Gavi for COVID-19 response. The event, which launched a 2021 resource mobilization campaign for the AMC, raised nearly $400 million in new funding for the AMC and saw several dose sharing commitments. This partnership allows Gavi to continue leveraging the $4 billion contribution through 2022 to raise additional support from other sovereign and private sector donors. Only once COVID-19 vaccines are available to priority populations in all countries around the world will we truly begin to bring this pandemic under control. COVAX aims both to make safe and effective vaccines available globally and to bring this pandemic to an end. This can happen only after billions of doses are made available to everyone. gavi's contribution to global health security Immunization is among the most cost-effective ways to prevent epidemics and is a crucial component of any global health security strategy. As the COVID-19 pandemic has demonstrated, investments in global health security are crucial to protect Americans, prevent loss of life, and protect the global economy. Gavi plays an important role in disease control and strengthening global health security by maintaining emergency vaccine stockpiles to respond to outbreaks of cholera, meningococcal disease, yellow fever, and Ebola. Gavi also works to improve global health security and infectious disease prevention and control by building strong health systems in Gavi-eligible countries. These investments enable countries to better identify, track, and respond to infectious disease threats and to reach more children with routine immunization services. Continued contributions from the U.S. help ensure this work continues in Gavi- supported countries, and in turn, makes the world safer for everyone. conclusion Continued U.S. investment in global health programs is essential to protect people from rising health threats and reducing preventable deaths. These programs complement the impact of Gavi- supported immunization efforts and are crucial to maintaining health security in the United States and around the world. A $290 million contribution to Gavi for fiscal year 2022 as part of the U.S. $1.16 billion commitment over four years (FY 2020--FY 2023) and $984 million for the broader USAID Maternal and Child Health account are critical to maintain Gavi's gains. Continued funding for Gavi will help expand immunization efforts, support country transitions to self-financing vaccine programs, promote program sustainability, and strengthen global health security. We thank this Subcommittee for its long history of protecting global health and other foreign assistance programs. Thank you for your consideration. [This statement was submitted by Marie-ange Saraka-yao, Managing Director of Resource Mobilisation, Private Sector Partnerships & Innovative Finance.] ______ Prepared Statement of the Wildlife Conservation Society (WCS) Chairman Coons, Sen. Graham, and Members of the Subcommittee, the Wildlife Conservation Society (WCS) welcomes the opportunity to provide written testimony on FY22 SFOPS and thanks the Committee for restoring and growing funding in the FY21 Consolidated Appropriations Act (FY21 enacted) for international conservation, combating wildlife trafficking, and global health accounts. WCS appreciates the leadership of Sen.Van Hollen who garnered 25 colleagues in support of these accounts; Reps. Meng and Katko who championed a bipartisan letter of 90 Members; as well as Rep. Espaillat and Sen. Merkley who championed letters in support of FY22 climate finance. The U.S. is currently grappling with biodiversity, climate, and pandemic crises that require an integrated solution. U.S. government investments in international conservation programs increase the capacity of other nations to protect their natural resources and respond to wildlife crimes, extreme weather, and zoonotic disease spillover and spread, thereby strengthening governance in developing nations. This in turn strengthens U.S. national and economic security. As a key implementing partner of U.S. awards, the Bronx Zoo-based WCS operates field conservation programs across 60 countries. Funding international conservation, global health, and climate programs bolster intact ecosystems and help prevent unsafe and illegal trade in wildlife, thereby addressing the root causes of zoonotic disease spillover. USAID Biodiversity.--The U.S. government is a global leader in biodiversity, forest, and marine conservation investments delivered largely through the USAID Biodiversity Program. These programs conserve and protect some of the largest, most at-risk natural landscapes and millions of livelihoods dependent upon natural resources. Maintaining and restoring natural resources enhances U.S. economic and national security interests, reducing conflict over resources and improving the stability of trading partners. FY21 enacted included $320,000,000. The FY22 President's Budget Request (PBR) would cut the program to $217,000,000, while the House mark funds it at $400,000,000. WCS recommends $500 million for USAID Biodiversity to support increases to regional wildlife conservation programs in Central Africa, the Amazon, Guatemala/Belize/Honduras, and South Sudan/Ethiopia. USAID Central Africa Program for the Environment (CARPE) is one of the largest biodiversity and combating wildlife trafficking programs in USAID's portfolio. The WCS-USAID-USFWS CARPE partnership is exemplified in the 20+ years of investment in the Republic of Congo's Ndoki National Park where park rangers conduct SMART patrols by plane, boat, vehicle, and on foot. This has resulted in increases in ivory trafficking convictions and sentencing. Elephant numbers in Ndoki Park have remained stable since 2006, even while they have plummeted across much of Central Africa. WCS values the Social Safeguards in National Parks and Protected Areas language included by the eight corners of the SFOP and Interior Subcommittees in FY20 and FY21. As you know, previously frozen FY18 CARPE funds transferred from USAID to the Department of the Interior (DoI) through a 632(b) interagency agreement have been successfully awarded with social safeguards terms and are being implemented on the ground by partners. FY19 and FY20 CARPE funds subject to the 632a transfer to DOI have been secured but await USAID internal budgeting clearances that often take 12-18 months to award before investments hit the ground. Additional funding to establish and implement safeguards programs separate from existing protected area management funding would be beneficial. FY21 enacted included $43,000,000 for CARPE and $10,000,000 to USFWS. The PBR Biodiversity CBJ includes $43,000,000 for CARPE, while the House mark remains silent. WCS recommends at least $50 million within the Biodiversity Program for CARPE, of which up to $33 million for USAID and not less than $17 million transferred to USFWS, the technical agency with strategic and implementation expertise. Ethiopia and South Sudan share the world's second largest wildlife migration of over a million animals migrating across the border of the two countries, a spectacle rivaling the wildebeest on the Serengeti. South Sudan is grappling with increasing food insecurity, ongoing severe flooding, the COVID-19 pandemic, and persistent insecurity and intercommunal conflict. There has been an increase in lethality of intercommunal conflict due to a lack of access to livelihood opportunities for South Sudanese youth.\1\ The U.S. government has invested $7.6 million to protect wildlife and spur economic opportunities--including ecotourism--in the Boma-Bandingilo landscape. FY21 Joint Explanatory Statement SFOPS included ``continued funding for wildlife conservation activities in South Sudan, and transboundary migration into Ethiopia.'' The PBR includes $2,000,000 in the Biodiversity CBJ for the East Africa Regional Program, while the House mark remains silent. WCS recommends the following DA Biodiversity language: ``Continued funding for wildlife conservation activities in South Sudan, and transboundary migration into Ethiopia's Gambella landscape.'' USFWS global priority species investments have continued to be bolstered to provide technical natural resources support to counter the direct threats they face in the wild. The FY21 enacted included $6,000,000 to be transferred to USFWS including $1,500,000 for migratory bird conservation. The PBR and the House mark remain silent on this. WCS recommends $6 million to USFWS for international wildlife conservation efforts within the DA Biodiversity Program. U.S. Forest Service International Programs (FS-IP) works with more than 50 countries providing valuable expertise to help international partners reduce deforestation and land degradation, promote sustainable forest management, improve forest restoration and reforestation, and enhance the resilience of communities, ecosystems, and economies to climate change. Effective forest management at the global level is necessary to protect American trade interests-such as the ability of domestic timber producers to compete on a level playing field-and to ensure the sustainability of critical domestic and foreign natural resources. By building capacity among partner countries to identify timber sources and determine the legality of shipments prior to export and import, as well as developing a global reference database to help identify timber sources in order to confirm their legality, FS-IP is helping U.S. solid wood and wood products as well as pulp, paper, and packaging product exports compete in growing Asian markets. WCS and others are recovering forest habitats of endangered Siberian tigers with the support of FS-IP. FY21 enacted included $8,000,000. The PBR and the House mark remain silent on this. WCS recommends $20,000,000 million by direct transfer to FS-IP within the DA Biodiversity Program. USAID Global Health Security Programs.--Preventing the next pandemic of zoonotic origins requires addressing the drivers of zoonotic spillover from animals to people and strengthening zoonotic surveillance in wildlife. The drivers of spillover include the legal and illegal live wildlife trade for human consumption, deforestation and land degradation, and agricultural intensification. FY21 enacted included $190,000,000 for USAID Global Health Security, including known and unknown zoonotic virus data collection and analysis. The PBR includes $1,011,686,000 for Global Health Security, including $745,000,000 for USAID Global Health Programs and $250,000,000 for State Global Health Programs as seed funding for a multilateral entity for preparedness and response. The House mark includes $1,000,000,000 for Global Health Security and a directive that ``Global Health Programs'' funding may be made available for a contribution to an international financing mechanism for pandemic preparedness. WCS recommends the following language: ``$2 billion to Global Health Security Programs for bilateral and a new multilateral mechanism to prevent the root causes of pandemics of zoonotic origin, including: preventing commercial trade in live wildlife and derivatives for human consumption; halt deforestation and degradation; grow USAID zoonotic spillover surveillance programs; stand up demonstration projects integrating USAID Global Health, Food Security and Biodiversity program that promotes alternative sustainable nutrition programs to reduce zoonotic spillover and spread from wildlife consumption.'' State INL & USAID's Combating Wildlife Trafficking Program.-- Wildlife trafficking, illegal logging, and IUU fishing are transnational organized crimes linked to drug, weapons, and human trafficking, and pose similar threats to national security, economic prosperity, the rule of law, and the environment.\2\ With field conservation programs in 20 of the Focus Countries and all six of the Countries of Concern identified by the Department of State Report to Congress on Major Wildlife Trafficking Countries,\3\ WCS works in partnership with USAID and State INL to implement anti-poaching, law enforcement, and capacity building programs around investigations and border patrols, prosecutions, and convictions from source sites to trafficking bottlenecks to demand countries. Use of small plane aerial surveillance, Wildlife Crime Units, and tracking of financial transactions are successful strategies that need further investment. FY21 enacted included $100,664,000, of which $50,000,000 to INL. The PBR includes $92,700,000, while the House mark includes $125,000,000. WCS recommends $200,000,000 split evenly between State INL and USAID. Northern Triangle's Central America Conservation & Security.--The region is experiencing severe weather events and its worst fire season, decimating forests, wildlife, and livelihoods of local communities. Drought is leading to widespread crop loss. These events are contributing to increased irregular migration to the U.S. as livelihoods become unsustainable. Narco-ranching accounts for 90% of recent deforestation. This is driven by criminals taking land from Indigenous Peoples and communities to launder drug money through illegal cattle ranches.\4\ The FY21 enacted DA Biodiversity Program included $6,250,000 for this region, of which $2,250,000 to DoI. The PBR Biodiversity CBJ for Guatemala includes $6,100,000, while the House mark remains silent. WCS recommends the following DA Biodiversity language: ``At least $7,000,000 for Selva Maya tropical forest conservation in Guatemala, Belize and Mexico to support increased border cooperation to halt smuggling, address threats from fires, and to support the renewal of existing and development of new community forest concessions in the Maya Biosphere Reserve (MBR), of which $3,000,000 is directed to DoI. The Committee does not support funding for logging activities or the construction of roads in national parks or the MBR, except for community forest concessions in the MBR and temporary road construction in support of such concessions.'' Drug trafficking through Honduras has increased recently, as smugglers lean more heavily on routes across illegal roads from the coastline through the rainforest and northward into Guatemala and Mexico. An illegal road is being cut through the Rio Platano Biosphere Reserve in Honduras, a UNESCO World Heritage Site, as well as Indigenous territories. This will facilitate land invasions into the biosphere and is likely to be used as a drug-trafficking route.\5\ In FY21 enacted the INL section ``notes the importance of the Maya Forest areas of Guatemala, Belize, and Mexico and the Moskitia Forest region of Honduras. The Committee recommendation includes funds to support the comprehensive strategy to support activities to strengthen security and governance in these areas that was developed pursuant to the directive in H. Rept 116-78, including funds for support of scientific investigation, heritage conservation, law enforcement, and sustainable tourism.'' WCS is pleased with INL's NOFO for narco-ranching in the Moskitia and recommends INL report language: ``The Committee is concerned with the increase in jaguar poaching, timber trafficking, unregulated cattle, narco-ranching and narco-roads in the Honduras-- Guatemala--Mexico border forest regions and directs $5M for increased border cooperation for anti-poaching and counter-fire regimes. The Committee recommendation includes funds to support the directive in H. Rept 116-78, and H. Rept 116-444 for a comprehensive security, governance and conservation strategy for Central America.'' USAID Sustainable Landscapes mitigates the drivers of deforestation & land degradation in the world's largest & most biologically diverse tropical forests. Forests cover 30% of the planet's land area, house up to 90% of all terrestrial wildlife species, mitigate severity of storms, and directly sustain the livelihoods of 1.6 billion people worldwide. The U.S. commitment to reducing deforestation & land conversion through sustainable management practices is vital to protecting essential storehouses of biodiversity & carbon in intact forests, as well as the essential goods & services intact forests provide people globally, including in the U.S. U.S. government support gives developing countries the ability to address the drivers of deforestation and degradation, halt illegal logging, and restore degraded lands. U.S. jobs are protected by stopping products from illegal logging from flooding U.S. markets as unfair competition, which costs the U.S. timber industry $1 billion annually. FY21 enacted included $135,000,000. The House mark proposes not less than $202,500,000 for Sustainable Landscapes. Consistent with the PBR Climate CBJ, WCS recommends $232,305,000. USAID Adaptation programs build resilience to climate-related risks, such as floods, storms, droughts, and sea level rise, including by supporting climate-resilient development and improved access to climate and weather data and tools. Extreme weather-driven natural disasters are a growing risk for communities around the world, and amplify existing stresses and vulnerabilities such as famine, floods and fires. Loss of natural defenses, including wetlands, mangroves, forests, and reefs, also increases vulnerability to and amplifies the impact of storms and floods. Weather-driven natural disasters have a disproportionate effect on developing countries with fewer resources to respond and recover. USAID Adaptation programs reduce human migration and social conflict as communities become adaptation-ready and build resilience to these risks. FY21 enacted included $177,000,000. The PBR Climate CBJ includes $221,928,000, while the House mark includes not less than $294,200,000 shall be made available for adaptation programs, including in support of the implementation of the Indo-Pacific Strategy. Consistent with the House mark, WCS recommends not less than $294,200,000. Global Environment Facility (the GEF).--America's investment in the GEF through the U.S. Treasury, unites 30+ donor countries with recipient countries, U.S. corporations and NGOs to support projects in 170 countries. For every dollar America invests in the GEF it generates another $40 from other countries and partners. The GEF has supported the improved cooperation and governance of one-third of the world's large marine ecosystems. The GEF support has also been critical to placing 12 percent of the world's terrestrial area under protection, resulting in 3,300 protected areas spanning 2.1 billion acres containing at least 700 globally threatened species. Consistent with the PBR and the House mark, WCS recommends $149,288,000 for the Treasury's fourth and final installment to GEF-7 and to pay arrears. Green Climate Fund leverages global contributions to support developing countries in transitioning towards low-emissions, climate- resilient development and amplifies U.S. development funds. The U.S. made a multi-year pledge to this institution, mobilizing global support to address the impacts of climate change. This pledge has not been completed by the Treasury International Programs. As the U.S. government restores its leadership role on the global stage, it must complete its multi-year pledge to this important institution, which is catalyzing climate finance and supporting the implementation of adaptation and mitigation programs in the most vulnerable of locations. The PBR includes $1,250,000,000 split between State/USAID and Treasury. Consistent with the House mark, WCS recommends $1,600,000,000. --------------------------------------------------------------------------- \1\ USAID, South Sudan--Complex Emergency Fact Sheet #2, February 10, 2021. https://www.usaid.gov/sites/default/files/documents/ 05.07.2021-----South_Sudan_Program_Map.pdf. \2\ U.S. Department of State, 2020 END Wildlife Trafficking Strategic Review, Oct. 26, 2020, https://www.state.gov/2020-end- wildlife-trafficking-strategic-review/. \3\ U.S. Department of State, 2020 END Wildlife Trafficking Report, Oct. 26, 2020, https://www.state.gov/2020-end-wildlife-trafficking- report/. \4\ Radachowsky, J. (2021, April 10). To confront the U.S. border crisis, save Central America's forests. Scientific American. https:// www.scientificamerican.com/article/to-confront-the-u-s-border-crisis- save-central-americas-forests/ \5\ Mukpo, A. (2021, May 13). In the Honduran Rio Platano Biosphere Reserve, an illegal road for cattle and drugs. Mongabay.https:// news.mongabay.com/2021/05/in-the-honduran-rio-platano-biosphere- reserve-an-illegal-road-for-cattle-and-drugs/ --------------------------------------------------------------------------- [This statement was submitted by Kelly Keenan Aylward, Executive Director.] ______ Prepared Statement of the World Learning Dear Chairman Coons, Ranking Member Graham, and distinguished Members of the Subcommittee, I am pleased to submit testimony on behalf of World Learning, an education and exchange focused non-profit organization based in Brattleboro, Vermont and founded in 1932. At World Learning, we believe in the power of diversity, the importance of an intercultural perspective, and fostering understanding and belonging. Through people-to- people exchange, international development, semester-long study abroad, graduate education, peacebuilding, and certificate programs, we prepare individuals to be effective leaders and community builders in an increasingly globalized but polarized world. On behalf of World Learning, I respectfully urge you to: 1. Support a strong and effective approach to U.S. diplomacy and development in FY2022 with $69.1 billion or the highest possible funding level for the State, Foreign Operations, and Related Programs bill. 2. Increase funding for the U.S. Department of State's Educational and Cultural Exchange Programs to $1.1 billion or the highest possible funding level in FY2022. 3. Ensure that Basic Education receives $1.050 billion or the highest possible funding level for FY2022. As the world begins to reopen and rebuild following the devastation caused by the global pandemic, the United States should take a leadership role in this effort and help bring people across the globe back together. This means appropriately investing in the U.S. Department of State and the U.S. Agency for International Development. what do we know about investing in u.s. citizen diplomacy? U.S. Department of State exchange programs are a proven and cost- effective way for the United States to share our values, remain internationally relevant and competitive, develop American leaders, and promote American engagement critical to our prosperity and national security. Grassroots exchange programs are an intercultural force for good that builds our global reputation and leadership. Exchange programs such as the Fulbright Program, the Kennedy-Lugar Youth Exchange and Study (YES) Program, the Congress Bundestag Youth Exchange (CBYX) Program, and the Future Leaders Exchange (FLEX) create transformational opportunities for our young people, helping them not only to develop the critical skills they need to succeed in a global marketplace, but also to serve as ambassadors of American youth around the world. As U.S. Secretary of State Blinken said during his testimony before this committee on June 8th: ``One of the best investments we make . . . are in our exchange programs, particularly those focused on young people.'' These programs also provide opportunities for Americans from communities of color to study abroad and diversify the pipeline to our foreign service. An increase in funding would enable greater progress to this important end. Programs including the International Visitor Leadership Program (IVLP) and the Young African Leaders Initiative (YALI) bring talented leaders from a variety of fields to the United States to expand their professional skills and networks and often to solve real problems. For example, during the pandemic, World Learning implemented two virtual programs within IVLP that had extraordinary results. In one case, a program enabling collaboration between a non-governmental organization in Utah and authorities in Costa Rica to rescue victims of human trafficking led to the arrest of 11 traffickers and the recovery of two survivors. Another virtual program that focused on democracy and good governance enabled Venezuelan activists to network with their American counterparts and to share best practices on engaging youth and underrepresented communities in democracy promotion and the political process. Without the leadership of the Bureau of Educational and Cultural Affairs and their true partnership these results would not have been possible. ECA deserves high praise for moving rapidly to encourage innovative ways to maintain and build networks during the global pandemic. U.S. Department of State evaluations repeatedly show that these and other participants who visit the United States through exchange programs leave with a better impression of our country, the American people, and our values. U.S. ambassadors consistently rank exchange programs among the most useful catalysts for long-term political change and mutual understanding. An increase of $360 million in funding for Educational and Cultural Exchanges for FY2022 would enable the exchange community to further expand exchange opportunities to include new and often marginalized voices from the United States and internationally. It would also enable the exchange implementer community to maintain and build upon the virtual platforms we have utilized due to the global pandemic, and which have demonstrated significant impact and value. what do we know about covid-19 and the global learning loss? An estimated 26% of the current world population is under the age of 15. Undoubtedly, the future development and prosperity of any country and the entire world depends on children and youth obtaining the skills needed to work together to solve the national and global challenges of our present and future. We know that one additional school year can increase an individual's earnings by up to 10%. We know that every extra year of a mother's schooling reduces infant mortality. We know that people who are literate are more likely to participate in democratic processes. According to UNESCO, the global pandemic disrupted the education of over 90 percent of the world's children and youth. This means 1.6 billion youth experienced learning losses due to the pandemic, which could have generational consequences for countries around the globe and result in less resilient populations, lower productivity, and worse economic prospects. The QITABI (Quality Instruction Towards Access and Basic Education Improvement) 2 Program, funded by USAID and implemented by World Learning aims to improve reading, writing, and social and emotional skills for more than 300,000 students in public primary schools across Lebanon. Many of these students reside in under-resourced rural areas and include Syrian refugees who have struggled with getting to and staying in school to learn basic skills. Importantly, QITABI 2 is designed to build the Lebanese public education system's institutional capacity to promote greater sustainability and self-reliance for better education outcomes. During the pandemic, the program pivoted to provide Lebanese youth with individual educational boxes and free online learning materials. World Learning and other dedicated implementers continue to work in partnership with USAID to do all that we can to address substantial learning losses resulting from COVID-19. USAID should be commended for its efforts to pivot in response to the pandemic to support continued learning in over 50 countries and reaching over 24 million students. An increase in Basic Education funding at this time will enable USAID and its implementing partners to reach more vulnerable children and youth, rebuild education systems, and counter learning losses exacerbated by this pandemic. For these reasons, we strongly believe that now is the time to reinvigorate and expand the investment in U.S. foreign assistance, and specifically in Educational and Cultural Exchanges and Basic Education to build a more peaceful and just world. Thank you for your ongoing support for these vital programs which enable and demonstrate American leadership, and for your consideration of this request. CAROL L. JENKINS Ex-Officio Trustee President and CEO, World Learning, Inc. Carol Jenkins is the CEO and President of World Learning Inc., which encompasses three distinct brands: The Experiment in International Living; School for International Training which includes SIT Study Abroad and SIT Graduate Institute; and the nonprofit global development and exchange programs of World Learning. Jenkins has served in multiple positions at World Learning over more than a decade. She first joined in June 2007 as senior director of international programs after a 16-year career in humanitarian aid and development. Under Jenkins's leadership, World Learning's development portfolio has seen revenue increase by 14 percent with continued anticipated growth. She oversaw the merger of World Learning's three development and exchange offices into one location, leveraging the assets of more than 100 staff members. She was named CEO in February 2018. Prior to joining World Learning, Jenkins was director of program development for International Medical Corps, where she managed a team of technical business development professionals to improve the quality of field programs and expand the coverage to project recipients. She also previously spent 12 years working for World Vision, including a period during which she was posted in Southern Africa. Jenkins holds a bachelor's degree in political science from Messiah College in Pennsylvania. She was a fellow at the Luskin School of Public Affairs at University of California, Los Angeles, in 2012 and a participant in the Leadership Program at the International Civil Society Center. Jenkins is the Chair of the Board for the Alliance for International Exchange and serves on the Board of InterAction. [This statement was submitted by Carol L. Jenkins, CEO and President.] ______ Prepared Statement of the World Vision US Chairman Coons, Ranking Member Graham, and members of the Subcommittee, I am submitting this testimony on behalf of World Vision, one of the largest faith-based organizations working in humanitarian relief and development. Specifically, I ask that the Subcommittee seeks to fund programs within the State, Foreign Operations and Related Programs appropriations bill at no less than FY2021 levels, provides at least $4.2 billion for Development Assistance, $5.2 billion for International Disaster Assistance, $4.1 billion for Migration and Refugee Assistance, and $1.2 billion for Feed the Future. World Vision also requests the following amounts for additional accounts that are within the State, Foreign Operations and Related Agencies appropriations bill: --USAID Operating Expenses: $1,530,000,000 --Water and Sanitation: $540,000,000 --Gender-Based Violence: $200,000,000 --Combatting Child Marriage: $30,000,000 --Maternal and Child Health: $984,000,000 (including $290,000,000 for Gavi, the Vaccine Alliance) --The Global Fund for AIDS, TB and Malaria: $1,560,000,000 --Family Planning and Reproductive Health: $665,000,000 --Displaced Children's and Orphans Fund: $35,000,000 --Basic Education: $1,100,000,000 (including $50,000,000 for Education Cannot Wait and $150,000,000 for the Global Partnership for Education (GPE) --Complex Crisis Fund: $60,000,000 First, World Vision appreciates Congress' continual commitment, on a bipartisan basis, to support foreign assistance and secure the hard- won gains around the world in maternal and child health, education, HIV/AIDS, food security, gender equality, and economic empowerment. This is even more important as COVID threatens these gains and the progress that has been made spanning decades of international development work. We hope that the Subcommittee will once again put forward a bill that provides funding in line with global need as well as with the leadership the United States has long provided. We also hope that the Subcommittee will prioritize programs that impact the most vulnerable and marginalized populations, with a focus on children. Development is hard work--seeing results takes time. But by increasing investments in children, as well as strengthening collaboration across U.S. government programs and agencies, we can impact the next generation in a dramatic way. This must include programs that improve household incomes and resilience, parenting skills, and early childhood development. At World Vision, we have seen the impact the provision of health services such as vaccinations and newborn health initiatives can have and how brave and committed community health volunteers work tirelessly to save the lives of mothers and children. We have seen how quality, safe, and inclusive education--from pre-primary through secondary supports children's development of foundational reading, math, and social and emotional skills and helps prepare youth for successful careers. We have seen how child protection programs-especially the prevention of and response to violence against children -can support child well-being, promote healthy child development, and even help mitigate the harmful effects of migration, displacement, or family separation. We have seen how peacebuilding and youth empowerment programs supported by the U.S. government prevent conflict and disillusionment, particularly among young men. All these investments serve a purpose and are in the best interests of the United States and the American taxpayer. But they also serve as a recognition of the dignity and value of every human life, regardless of birthplace or economic status. The current need for assistance is at critical levels, and COVID-19 has exacerbated the fragility of many vulnerable communities and populations. World Vision estimates that as many as 30 million children are at risk of disease and death because of the indirect impacts of the COVID-19 pandemic, such as deadly diseases like malaria, a lack of immunization, or increased malnutrition. Catastrophic natural disasters, mass atrocities, violence against marginalized populations, and protracted armed conflict have driven crises to never before seen levels, resulting in increased numbers of forcibly displaced persons. Children are often most impacted by conflict--one in four of the world's children lives in a conflict or disaster zone--without access to adequate shelter, protection, and education, and at high risk of experiencing physical, sexual and psychological abuse. In 2021 alone, UN OCHA estimates that 235 million people need humanitarian assistance and protection, which amounts to 1 in 33 people worldwide. We cannot abandon the next generation in their time of greatest need. Women and girls are also especially vulnerable in times of conflict and crisis and face an increased risk of gender-based violence, child, early and forced marriage, and maternal mortality. Additionally, we know there are incredible development and global health challenges, many that have been exacerbated by COVID-19. Every year 5.2 million children under the age of five still die from preventable or treatable causes, and 2.1 billion people lack access to safely managed drinking water services and 4.5 billion people lack safely managed sanitation services. Prior to the COVID-19 pandemic, an estimated 258 million children and youth around the world were not in school, and nearly 40 percent of primary school age children are not acquiring basic literacy and numeracy skills. Now, the United Nations estimates that nearly 11 million primary and secondary school learners worldwide are at risk of not returning to education at all after school closures due to COVID-19. Additionally, as a result of the COVID-19 crisis, World Vision estimates that up to 85 million more girls and boys worldwide may now be exposed to physical, sexual and/or emotional violence. While we can look back and celebrate the success of U.S. foreign assistance investments, we must be vigilant in reaching the most remote corners of the world and the most vulnerable with life- saving and life-giving support. COVID-19 has also further exacerbated the already complicated contributing factors of irregular migration from Central America. We affirm the Biden Administration's request of $861 million in assistance to this region and ask the committee to work in a bipartisan fashion to support foreign assistance funding to address the many challenges-- violence, poverty, lack of educational and economic opportunities--that are driving irregular migration. As we look ahead to needs for Fiscal Year 2022, we ask for at least $4.2 billion for Development Assistance (DA). More and more we are seeing poverty being driven to fragile states--places that face conflict, inadequate governance, frequent disasters, and other issues that lead to instability and a lack of resilience. The Development Assistance account is vital in these contexts to move countries from fragility to resilience, addressing the drivers of conflict, and seeking long-term, sustainable solutions. Development Assistance should also be increased overall to allow for greater flexibility and improve the ability of USAID to respond to unanticipated development needs. DA funding has traditionally been very prescriptive. Our goal of community and country-led development requires us to rethink this approach. Within the development assistance account, we request $30 million be made available to combat child marriage globally consistent with section 1207 of Public Law 113-4. We recommend $5 million of this funding be dedicated to the joint UNICEF and UNFPA Global Program to End Child Marriage. Child marriage is a form of gender-based violence and a violation of girls' human rights and happens across cultures and contexts. With the global spread of COVID-19, we are already seeing increases in child marriage due to related containment measures, including school closures, limited livelihood opportunities, food insecurity, restrictions on movement, and disruptions to essential protection and health services for girls. In fact, 2020 saw the greatest surge in child marriage rates in 25 years. We also ask for the subcommittee's continued support for global health programs. These investments save the lives of mothers and children and support families to ensure their children are healthy enough to attend school, enabling them to gain an education that leads to employment in adulthood, and enable women to be more productive in the household and earn a livelihood as well. These programs are not handouts; they are investments in the long-term economic growth of countries that can become U.S. trading partners and develop economies which better provide for their own people. Saving lives through health interventions, including immunizations, family planning, nutrition, and water, sanitation, and hygiene, as well as strong support of the frontline health workers delivering so many of these services, is the smart and right thing to do. USAID's Global Health Program funding for the vulnerable children account is provided via the Displaced Children and Orphans Fund (DCOF), which delivers financing and technical assistance for the care and protection of vulnerable children, particularly those who have been separated from their families or are at risk of separation. USAID has given particular attention to children who are outside family care, those affected by conflict, or those living and working on the street, as well as children with disabilities and other highly vulnerable children. This funding also supports the implementation of the Global Child Thrive Act, passed in 2020, which ensures that early childhood development interventions will be implemented in all foreign assistance programs aiding vulnerable children and their families. With many current conflicts and hardships displacing children around the world, this funding is vital to the U.S. response to protect vulnerable children. Additionally, World Vision requests the subcommittee's support for the implementation of activities to address gender-based violence in both conflict and non-conflict settings. Gender-based violence occurs in many forms including intimate partner violence, child, early, and forced marriage, rape, sexual assault, trafficking, female genital mutilation/cutting, and so-called ``honor'' killings. In humanitarian emergencies, gender-based violence is known to increase as chaos and tensions grow within households, communities, and society, impacting early one in five women. Given the prevalence of gender-based violence in humanitarian emergencies, as well as the predicted impacts of COVID- 19, we request a portion of this appropriation be focused particularly to support programs to address GBV in humanitarian contexts through the Safe from the Start program at the State Department and USAID. Feed the Future is another critical and successful U.S. government program that has invested in areas where an estimated 23.4 million more people are now living above the poverty line, 3.4 million more children live free of stunting, and 5.2 million more families no longer go hungry. With nearly 690 million people in the world today are facing hunger, and with a growing global population, Feed the Future is working to improve agriculture production and markets, while also working at the household level to give families the tools they need to lift themselves out of poverty. This is especially important as COVID- 19 has severely disrupted livelihoods, incomes, and food supply chains, with the World Food Program currently estimating more than 270 million people face severe hunger--this is double the pre-pandemic figure. These efforts to work with smallholder farmers are critical not only for the families and communities where the programs are implemented, but also for our own economic growth, which depends on our ability to reach emerging markets overseas. We also ask for the Subcommittee's support for U.S. Basic Education programs, including funding for Education Cannot Wait, a multilateral partnership dedicated to education in emergencies and protracted crises. In addition to providing children and youth with valuable life skills, education serves as a force multiplier in the pursuit of comprehensive, sustainable development outcomes. Unfortunately, shocks from COVID have led to widespread school closures, and in sub-Saharan Africa alone, this disruption has led to increases in teenage pregnancy by 62%, with an estimated 1 million girls in this region blocked from returning to education due to pregnancy as schools re-open. In addition to the benefits that children themselves receive from access to a quality education, strong national education sectors and programs are also essential for global economic growth. Education is not only the right of all children, but it will help bolster partner countries towards self-reliance and economic prosperity. In light of the COVID-19 pandemic, I would also like to highlight the need for increased resources for direct pandemic response. World Vision is deeply concerned about the vulnerability of displaced and refugee populations to COVID-19, particularly in places with dense populations and a lack of health services. Because many of these populations are less mobile, the availability of tests to stem the spread early, strong contact tracing, and equitable distribution of vaccines will be essential to avoid massive infections and deaths. In addition, greater support for essential health services and learning lessons from past pandemics about the need for community mobilization, health worker support (including through the supply of PPE), and faith community engagement must be a part of any response. We hope that any spending to respond to the pandemic globally doesn't come at the expense of existing programs but is designated as emergency spending, especially as the full extent of the indirect impacts resulting from COVID-19 have not yet been realized and there is the potential for additional waves of the virus. Thank you for this opportunity to offer testimony to the Subcommittee and for your bipartisan leadership in supporting a strong foreign assistance budget. [This statement was submitted by Robert Zachritz, Vice President for Advocacy.] ______ Prepared Statement of the World Wildlife Fund Thank you for the opportunity to provide written testimony on the Fiscal Year 2022 (FY22) budget. World Wildlife Fund (WWF) is one of the world's leading conservation organizations, operating in nearly 100 countries to ensure a future in which both people and nature can thrive by helping to conserve our planet's biodiversity and the natural resources upon which we all rely. With the support of over one million members in the United States and over five million globally, WWF's unique approach integrates global reach and local impact with a scientific foundation, promoting innovative solutions to meet the needs of people and nature. WWF asks the subcommittee to fund global conservation accounts at the following FY22 levels: --$500 million for Biodiversity Conservation within the U.S. Agency for International Development (USAID) Development Assistance; --$50 million for the Central African Regional Program for the Environment (CARPE) within USAID Development Assistance for Biodiversity Conservation --$5 million to stop illegal timber trade within USAID Development Assistance for Biodiversity Conservation; --$150 million for Combating Wildlife Trafficking programs within USAID Development Assistance and State Department International Narcotics Control and Law Enforcement; --$149.3 million for the Global Environment Facility (GEF) as appropriated in Multilateral Assistance, International Financial Institutions; --$200 million for Sustainable Landscapes within USAID Bilateral Economic Assistance; --$20 million for the Tropical Forest and Coral Reef Conservation Act within Multilateral Assistance, Debt Restructuring; --$268.5 million for Clean Energy Programs within USAID Bilateral Economic Assistance; --$265.5 million for Adaptation Programs within USAID Bilateral Economic Assistance; --$540 million for Water and Sanitation programs; --$75 million to address ocean plastic pollution within USAID Development Assistance; --At least $2 billion for the Green Climate Fund. We thank the subcommittee for past support of international conservation and climate programs and urge continued support for these programs in FY22 as an essential component of U.S. foreign assistance. Increased U.S. investments are needed to respond to a set of intertwined challenges--the crisis of global biodiversity and nature loss, the global climate crisis, and the global health and economic crisis due to the COVID-19 pandemic. All of these crises have roots in the loss, degradation, and over-exploitation of nature, and conservation investments are among the clearest and most cost-effective solutions to addressing them. These programs also support improved management of natural resources in developing countries, which are highly dependent on these resources for economic growth and the livelihoods of local communities. They prevent scarcities of water and food, which can exacerbate poverty and instability and contribute to conflict, and help to combat illegal trade in natural resources and transnational criminal organizations that drive it, reducing corruption, financing for illicit activities, and threats to American security interests in strategically important regions. We urge the subcommittee to consider the significant impact that these modest investments have in supporting developing communities and fostering stability and sustainable growth, combating transnational organized crime, building U.S. competitiveness in overseas markets and demonstrating U.S. leadership to tackle global challenges. The conservation of tropical forests and other carbon-rich and biodiverse ecosystems is also key to slowing and reversing global climate change and to preventing the spillover of new zoonotic pathogens that can cause future pandemics. For these reasons, U.S. investments to promote global conservation should be supported and increased as essential elements of our foreign policy and national security agenda. biodiversity conservation USAID delivers the largest share of U.S. foreign assistance for on- the-ground conservation through its robust portfolio of Biodiversity Conservation, Combating Wildlife Trafficking, and Forestry programs. These programs protect the largest and most at-risk natural landscapes and the livelihoods of millions who depend directly on natural resources for survival and economic prosperity. By maintaining and restoring the natural resources that supply fertile soil, clean water, food and medicine, these USAID programs play a critical role in long- term U.S. foreign policy objectives, promoting stable economics and societies around the world. By combatting illegal trade in wildlife, timber and fish, they combat transnational criminal organizations and prevent unfair global competition from undermining U.S. companies and workers. By conserving and restoring tropical forests and other carbon- rich and biodiverse ecosystems, they also play a critical role in efforts to address climate change and prevent the spillover of zoonotic diseases. We request $500 million for biodiversity conservation within USAID's Development Assistance Account in FY2022, an increase of $180 million over the FY2021 enacted level. Of these funds, WWF requests that $50 million be directed to support the Central Africa Regional Program for the Environment (CARPE), an increase of $7 million over FY2021, and that $5 million be directed towards USAID and Department of State efforts to support implementation of the Lacey Act, an increase of $1 million over the FY2021 enacted level. combating wildlife trafficking Wildlife trafficking is a transnational organized crime that generates up to $23 billion annually in illegal profits, fueling a poaching crisis while financing criminal syndicates, armed insurgencies, and groups with terrorist ties and corrupting rule of law in the developing world. Trafficking in species that can transmit zoonotic pathogens also heightens the risk of future pandemics. In 2016, Congress passed the END Wildlife Trafficking Act and since 2014, Congress has funded Combatting Wildlife Trafficking Programs at the State Department Bureau of International Narcotics and Law Enforcement (INL) and USAID to support strengthening law enforcement, reducing demand, and expanded international cooperation. Additional funding is needed to expand programs into Latin America and support efforts to address trade involving high-risk species for zoonotic spillover. We request $150 million for Combatting Wildlife Trafficking Programs in FY2022, an increase of $49.3 million over the FY2021 enacted level. global environment facility The Global Environment Facility (GEF) partners 183 countries with international institutions, civil society, and the private sector to enhance environmental governance and fight unsustainable depletion of natural resources that lead to food and water shortages, population displacement, and other drivers of instability that can result in conflict and radicalization. The GEF provides many direct benefits to the U.S., including providing economic stability for U.S. jobs and supply chains. Every U.S. dollar invested in the GEF leverages an additional $40 from public and private partners. With 4,400 projects in 183 countries, the GEF is the single largest financier of conservation investing nearly $20 billion dollars with $92.7 billion in co-financing over 27 years. We request $149.3 million for the GEF in FY2022, level with the President's request and an increase of $9.3 million over the FY2021 enacted level. tropical forest and coral reef conservation act The Tropical Forest and Coral Reef Conservation Act (TFCCA) is a highly successful program that allows eligible countries to relieve debt owed to the U.S. Treasury in exchange for commitments to protect tropical forests and coral reef ecosystems using local funds. In 2018, Congress reauthorized the program and expanded it to include coral reefs. TFCCA agreements protect globally important ecosystems while strengthening civil society, building local conservation capacity, and supporting public-private partnerships in developing countries. They have generated nearly $300 million for tropical forest protection in over a dozen countries. WWF requests $20 million in FY2022 for the TFCCA, an increase of $5 million over the FY2021 enacted level and $5 million more than the President's request. usaid sustainable landscapes Through its Sustainable Landscapes programs, USAID supports efforts to halt deforestation and forest degradation, promote sustainable and responsible forestry practices, and prevent illegal logging in the world's largest and most biologically diverse and carbon rich forests, including the Amazon, Central Africa's Congo Basin, and tropical forests of Southeast Asia. The large-scale landscapes supported by these programs are essential to the livelihoods of local communities and Indigenous Peoples, as well as national economies, and play a critical global role as massive storehouses of carbon. The destruction and degradation of forests due to encroachment by human development and agriculture is also a major driver of the spillover of zoonotic diseases that can cause pandemics. With deforestation continuing at high rates in many regions, including a spike in Brazil's deforestation rates and worsening wildfires, WWF requests $200 million for Sustainable Landscapes in FY2022, an increase of $65 million over the FY2021 level. green climate fund The Green Climate Fund (GCF) is the largest international fund financing efforts in developing countries to enhance resilience to climate change and reduce emissions, working with public and private partners and using grants, loans, equity, and guarantees and a country- driven approach to provide innovative climate solutions in over 100 countries, particularly Least Developed Countries and African and Small Island Developing States. The GCF is unique in its ability to engage directly with both public and private sectors in climate-sensitive investments and bear significant climate-related risk. In 2014, the US pledged $3 billion in initial funding to the GCF, only $1 billion of which has been provided. Fulfilling this pledge will be critical to the U.S. securing international support for high climate ambition, including under the Paris Agreement. WWF requests at least $2 billion for the Green Climate Fund in FY2022, $750 million more than the President's request. No funds were appropriated for the GCF in FY2021. usaid adaptation programs USAID Adaptation Programs help communities in less-developed countries to access and use climate and weather data and tools and to build their resilience to climate variability and risks, whether from sudden events such as floods and storms or from slower-moving events such as droughts and sea-level rise. Such extreme weather is increasing in severity, posing rising risks to security, stability and economic growth in many parts of the world. By helping communities build resilience and capacity to adapt, we help alleviate social tensions that can give rise to conflict. WWF requests $265.5 million for Adaptation Programs within USAID Bilateral Economic Assistance in FY2022, an increase of $88.5 million over the FY2021 enacted level. usaid clean energy programs Worldwide, 1.1 billion people still lack access to energy, and many more suffer from unreliable service, suffering frequent and long power outages. USAID works with developing countries to create policy, legal and regulatory frameworks in order to attract private investment in clean energy, increase energy efficiency, and expand energy access. USAID Clean Energy programs work across all aspects of the energy sector to build strong energy systems in order to improve energy access and power global economic and social progress in the developing world. WWF requests at least $268.5 million for Clean Energy Programs within USAID Bilateral Economic Assistance in FY2022, an increase of $86.5 million over the FY2021 enacted level. ocean plastic pollution Each year, roughly eleven million metric tons of plastic pollution enter the world's oceans, equivalent to a truckload of plastic every minute. Congress has recognized the increasing global threat from ocean plastic pollution and directed the Department of State and USAID to redouble diplomatic and programmatic support for regional and global efforts to address the problem, including through grants, technical assistance, and new multilateral mechanisms. Increased funding is needed to implement this mandate and work with developing countries to improve waste management systems and reduce the amount of plastic waste making its way into our oceans. WWF requests $75 million from within USAID Development Assistance be directed in support of these efforts in FY2022, level with the FY 2021 enacted level. global water strategy Water-driven stresses undermine economic productivity, governance, and social cohesion. Poor management and overuse of freshwater stresses food and energy resources, fuels conflicts within and between countries, and undermines U.S. development investments. The first Global Water Strategy, mandated under the Water for the World Act, was submitted to Congress in November 2017 with new strategic objectives on water security, including on water resource management and governance. The U.S. Department of State and USAID and other relevant Agencies, should direct funding to improve water resource management, improve cooperation over shared waters, and build resilience to extreme weather and disasters. WWF requests $540 million for Water and Sanitation programs in FY2022, an increase of $90 million over the FY2021 enacted level. [This statement was submitted by Will Gartshore, Director, Government Affairs And Advocacy.]