[Senate Hearing 117-797]
[From the U.S. Government Publishing Office]
S. Hrg. 117-797
THE GLOBAL FOOD SECURITY AND COVID-19
CRISES: U.S. RESPONSE AND POLICY OPTIONS
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HEARING
BEFORE THE
SUBCOMMITTEE OF THE
COMMITTEE ON APPROPRIATIONS
NITED STATES SENATE
ONE HUNDRED SEVENTEENTH CONGRESS
FIRST SESSION
__________
SPECIAL HEARING
MAY 11, 2022--WASHINGTON, DC
__________
Printed for the use of the Committee on Appropriations
[GRAPHIC NOT AVAILABLE IN TIFF FORMAT]
Available via the World Wide Web: http://www.govinfo.gov
__________
U.S. GOVERNMENT PUBLISHING OFFICE
54-338 WASHINGTON : 2024
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COMMITTEE ON APPROPRIATIONS
PATRICK LEAHY, Vermont, Chairman
PATTY MURRAY, Washington RICHARD C. SHELBY, Alabama, Vice
DIANNE FEINSTEIN, California Chairman
RICHARD J. DURBIN, Illinois MITCH McCONNELL, Kentucky
JACK REED, Rhode Island SUSAN M. COLLINS, Maine
JON TESTER, Montana LISA MURKOWSKI, Alaska
JEANNE SHAHEEN, New Hampshire LINDSEY GRAHAM, South Carolina
JEFF MERKLEY, Oregon ROY BLUNT, Missouri
CHRISTOPHER A. COONS, Delaware JERRY MORAN, Kansas
BRIAN SCHATZ, Hawaii JOHN HOEVEN, North Dakota
TAMMY BALDWIN, Wisconsin JOHN BOOZMAN, Arkansas
CHRISTOPHER MURPHY, Connecticut SHELLEY MOORE CAPITO, West
JOE MANCHIN, III, West Virginia Virginia
CHRIS VAN HOLLEN, Maryland JOHN KENNEDY, Louisiana
MARTIN HEINRICH, New Mexico CINDY HYDE-SMITH, Mississippi
MIKE BRAUN, Indiana
BILL HAGERTY, Tennessee
MARCO RUBIO, Florida
Charles E. Kieffer, Staff Director
Shannon Hutcherson Hines, Minority Staff Director
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Subcommittee on State, Foreign Operations, and Related Programs
CHRISTOPHER A. COONS, Delaware, Chairman
PATRICK LEAHY, Vermont LINDSEY GRAHAM, South Carolina,
RICHARD J. DURBIN, Illinois Ranking Member
JEANNE SHAHEEN, New Hampshire MITCH McCONNELL, Kentucky
JEFF MERKLEY, Oregon ROY BLUNT, Missouri
CHRISTOPHER MURPHY, Connecticut JOHN BOOZMAN, Arkansas
CHRIS VAN HOLLEN, Maryland JERRY MORAN, Kansas
MARCO RUBIO, Florida
BILL HAGERTY, Tennessee
Professional Staff
Tim Rieser
Kali Farahmand
Sarita Vanka
Paul Grove (Minority)
Katherine Jackson (Minority)
Adam Yezerski (Minority)
Administrative Support
Madeline Granda
LaShawnda Smith (Minority)
C O N T E N T S
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Page
Opening Statement of Senator Christopher Coons................... 1
Opening Statement of Senator Lindsey Graham...................... 3
Panel I: Food Security
Statement of Hon. David Beasley, Executive Director, United
Nations World Food Programme................................... 4
Prepared Statement of David Beasley, Executive Director,
United Nations World Food Programme........................ 6
I. GIntroduction......................................... 6
II. GState of Global Hunger.............................. 6
III. GThe Ukraine Crisis................................. 7
IV. GNeeds and Resourcing................................ 8
V. GImplications for Global Stability.................... 8
VI. GConclusion.......................................... 9
Statement of Tjada D'Oyen McKenna, Chief Executive Officer, Mercy
Corps.......................................................... 10
Prepared Statement of Tjada D'Oyen McKenna, Chief Executive
Officer, Mercy Corps....................................... 12
Introduction............................................. 12
COVID Economic Shocks to Food Security................... 12
Climate Shocks and Stresses.............................. 13
The Ukraine Effect....................................... 14
Recommendations.......................................... 14
Closing Call to Action................................... 17
Statement of Akinwumi Adesina, President, African Development
Bank........................................................... 18
Prepared Statement of Dr. Akinwumi A. Adesina, President,
African Development Bank................................... 19
Panel II: COVID-19 (Briefing)
Statement of Tom Frieden, President and CEO, Resolve to Save
Lives.......................................................... 41
Prepared Statement of Dr. Tom Frieden, President and Chief
Executive Officer, Resolve to Save Lives................... 43
Statement of Atul Gawande, Assistant Administrator for Global
Health, USAID.................................................. 45
Prepared Statement of Dr. Atul Gawande, Assistant
Administrator for Global Health, U.S. Agency for
International Development.................................. 47
Details on USAID's Global Health Response to COVID-19.... 48
A New Area of Focus to Save Lives Now: Test-and-Treat.... 50
The Cost of Inaction: An Urgent Need for COVID-19
Resources.............................................. 51
Statement of Michael Ryan, Executive Director, Who Health
Emergencies Programme.......................................... 51
Prepared Statement of Dr. Michael Ryan, Excutive Directory,
WHO Health Emergencies Programme........................... 53
Additional Committee Questions (Note: No Questions were
submitted)..................................................... 58
THE GLOBAL FOOD SECURITY AND COVID-19 CRISES: U.S. RESPONSE AND POLICY
OPTIONS
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WEDNESDAY, MAY 11, 2022
U.S. Senate,
Subcommittee of the Committee on Appropriations,
Washington, DC.
The subcommittee met at 2:02 p.m., in room SD-124, Dirksen
Senate Office Building, Hon. Christopher Coons, (Chairman),
presiding.
Present: Senators Coons, Durbin, Murphy, Van Hollen,
Graham, Blunt, Boozman, and Moran.
WORLD FOOD PROGRAMME
opening statement of senator christopher coons
Senator Coons. Good afternoon. I would like to call this
hearing of the subcommittee on State and Foreign Operations of
the Senate Appropriations Committee to order. The purpose of
today's hearing is to hear testimony from six exceptionally
experienced witnesses concerning two of the most urgent crises
confronting our world today.
The ongoing destruction of cities and the daily atrocities
committed by Russian forces against defenseless Ukrainian
civilians outrages and offends the sensibilities of all of us,
but we should also be concerned, even alarmed, about the
widening food security crisis that this needless and brutal war
by Russia is causing for hundreds of millions far beyond
Eastern Europe.
Before the war began in Ukraine, more than 50 countries,
including nations like Ethiopia, Sudan, Syria, Yemen, and
Afghanistan were facing acute food shortages due to prolonged
drought and conflict. And today, their circumstances are
markedly worse. As we will hear from our first panel of three
witnesses, the collapse of exports of grain and vegetable oil
from Ukraine, combined with inflation and higher costs for
fertilizer, fuel, and transportation, have caused commodity
prices to skyrocket.
Latest UN information says the total number of people
hungry has increased to 273 million, more than doubling the
number living in hunger in 2019. Millions are at risk of
starvation.
Some estimates are even higher. This food security crisis
is compounded by a second ongoing global crisis, the COVID-19
pandemic, triggering complex humanitarian emergencies on
several continents that threaten economic, social, and
political stability.
Now, while the number of Americans hospitalized and dying
from COVID has declined significantly after Omicron peaked in
January, it is again rising sharply in a number of our States,
and this pandemic is far from over with us.
COVID-19, I will remind you, originated halfway around the
world, and we are no less vulnerable to this pandemic today
from a global perspective than we were a year ago. Roughly two-
thirds of Americans are fully vaccinated, but worldwide
billions are not, and they are concentrated mostly in countries
where the virus continues to spread and in countries with weak
or fragile public health systems that struggle to respond to
this ongoing challenge.
Global campaigns against HIV, AIDS, Malaria, TB, Polio, and
other infectious diseases long led by American funds or
initiatives have stalled or lost ground. And there is a very
real risk to our nation and the world that new COVID variants
will emerge overseas, causing a sudden resurgence of
potentially deadly infections.
That might force another lockdown that would threaten to
once again shutter businesses, schools, public transportation,
and government offices. If we can increase global vaccine
coverage, we can dramatically reduce the spread of the virus
and the incidence of new variants protecting everyone,
including Americans.
As we consider our President's request for emergency
supplemental military and humanitarian assistance for Ukraine
and other countries impacted by the food crisis in Ukraine, our
challenge is determining how the United States can best respond
to these interrelated global challenges.
The President's request initially included about $1.8
billion for food aid, which in my view, fell far short of what
is urgently needed. Senator Graham and I have both called for
at least $5 billion, and I am optimistic, given the action in
the House last night, that that amount will be in the final
supplemental. The President's request for $5 billion in
emergency funding for global COVID response was submitted in
March and has not yet been acted on by this Congress.
Now, as the Appropriations subcommittee responsible for
providing the relevant funding, we are looking to our six
witnesses this afternoon to help us understand what the COVID
virus is doing, what we should most be concerned about, how
other organizations and other donors are responding, and the
recommendations we can make the strongest case to our
colleagues in the Senate.
Any successful global response against the COVID pandemic
requires United States leadership and resources. I also want to
emphasize in closing that we are in a critical global,
strategic situation as well, because dozens of countries and
millions of people were forced to rely on Chinese and Russian
vaccines, which have ultimately proven ineffective against the
Omicron variant.
We have an opportunity, 20 years after the PEPFAR program
was launched, to once again demonstrate that the United States
is a reliable global public health partner, and we should take
that chance.
Before introducing the first panel, I will turn to my
Ranking Member, and wanted to express my gratitude to my
colleague, Senator Graham, who has been a strong partner and
advocate for additional funding to address both these crises,
for any opening remarks he care to make.
opening statement of senator lindsey graham
Senator Graham. Well, thank you, Mr. Chairman. I appreciate
it very much. I think the Committee has done a good job working
together, and one of our witnesses is a South Carolinian, David
Beasley. We are very proud of you at home, former Governor of
South Carolina and the leader of the World Food Program.
Thank you, Ms. McKenna, for coming, our second witness
here. The bottom line is, if you believe in a strong national
security to keep America safe, then you have to be involved in
addressing world hunger.
As you will hear from David here pretty soon, the number of
people that are in desperate straits will lead to mass
migration, will start the cycle all over again--there are so
many conflicts on the globe, it is hard to keep up with them,
then you have got COVID on top of that.
The amount of money that will be in this supplemental for
food and humanitarian assistance is about $5 billion. That is a
lot more than requested, but still not enough. And to the
American people, what does it matter? Well, if somebody is
starving over there, they are not going to just sit around and
starve. They are very vulnerable to terrorist recruitment. I
spent a lot of time in Afghanistan doing reserve duty. There
are a lot of ideologically driven terrorists, but a lot of
people wound up in Afghan prisons because they couldn't feed
their family and $500 bucks sounded pretty good. That is why
they plant the IED. The ability of terrorists to recruit and
sell their cause goes up exponentially as people are looking
for a way to feed their families.
The downside to famine and hunger is so enormous that the
amount of money we are spending, I think, is inadequate to the
task, but we shouldn't be the only country spending the money.
The Gulf Cooperation Council (GCC) nations need to do more, the
European Union needs to do more. But to the American taxpayer,
it is in your interests and our interest that we deal with this
hunger problem not only just from a moral point of view, but
from a national security perspective. One last thought and we
will get to witnesses.
We have a Global Fund to Fight AIDS, Tuberculosis and
Malaria that did a terrific job dealing with AIDS and malaria.
I would like the Committee to think about creating a global
fund for food security to get a new line of revenue from the
private sector. We will put money in, but other countries have
to match, have a multi-national approach to food security and
get more involvement with the private sector.
Elon Musk, who has gotten a lot of attention lately, is one
of the world's richest people. He said, he was asked to give $1
billion, I think, to the World Food Program or some cause, and
he asked, well, tell me how $1 billion will solve world hunger?
It won't. But $1 billion that can be leveraged to get more
money from other people goes a long way to providing the gap in
funding that exists today.
Ambassador Cindy McCain, who works with David Beasley on
the same line of effort at the United Nations, has lots of
plans to teach people to farm and to bring new farming
practices to bear so people can feed themselves. The World Food
Program is a result of people not having food available in
their own backyard.
The goal is to get those people through the crisis and
create a backyard that has food. If you don't understand, after
9/11, how important dealing with hunger and poverty and the
abuse of women is in this war against terrorism and extremism,
you have missed a lot. Thank you.
Senator Coons. Thank you, Senator Graham. Our first panel
of three witnesses will focus on food security. We are very
fortunate to have three witnesses whose combined experience in
this field is unmatched.
First will be the Honorable David Beasley, Executive
Director of the World Food Program, an organization that won
the Nobel Prize in 2020. Ms. Tjada D'Oyen McKenna is Chief
Executive Officer of Mercy Corps, a well-regarded global
humanitarian relief organization. And Dr. Akinwumi Adesina is
President of the African Development Bank.
President Adesina is in Accra, Ghana and will be testifying
remotely. I had the honor of visiting with Dr. Adesina in Accra
a number of years ago, and his leadership of the African
Development Bank is very widely regarded. We welcome each of
you.
I would ask you make opening remarks of up to 6 minutes and
your full written testimony will be included in the hearing
record. Members will then have 6 minute rounds for questioning.
Dr. Beasley--excuse me, Director Beasley, if you would please
lead off, followed by Ms. McKenna and Dr. Adesina. Thank you.
STATEMENT OF HON. DAVID BEASLEY, EXECUTIVE DIRECTOR,
UNITED NATIONS WORLD FOOD PROGRAMME
Mr. Beasley. Senator, thank you very much, and it is an
absolute honor to be here. And I know Democrats and Republicans
fight on a lot of things, but when it comes to strategic
international aid and food security, it is quite a remarkable
thing to see everyone come together recognizing the catastrophe
that we are facing.
Because, as you said, and Senator Graham, as you said, if
you don't have food security, you are not going to have any
other security. And we have seen that firsthand. And I have
been out in the field, and I have heard this many times over,
particularly where ISIS and Al Qaida and extremist groups are,
where women will say, Mr. Beasley, my son, my husband did not
want to join ISIS or Al Qaida or this extremist group, but we
hadn't fed our little girl in two weeks, what were we supposed
to do?
And so if you are not going to--if you are not going to
respond out of the goodness of your heart, because I tell
friends around the world said, so why should I send money down
to Chad or Niger or Nicaragua when we got issues at home? I
say, well, it is going to cost you a thousand times more if you
don't address the root cause and get ahead of it quickly.
And I can give the mathematics expert experientially what
we are talking about, because when we are not there--and if you
are not going to do it out of the goodness of your heart, you
better do it out of your National Security interest. What we
are already seeing, for example, in Central America from just 1
year ago, when you feed 125 million people like we do on any
given day, week, or month, we survey a lot of people. We know
what they are thinking.
We watch their patterns. Five times the number of people
are already talking about migrating from Central America to the
United States. And The Washington Post did an article that
said, on the children that end up at the border in the
shelters, it was something like $3,750 per child per week. For
$1 to $2 per week, we can stabilize the environment in
Guatemala, Honduras, or Nicaragua, or El Salvador. The math is
simple.
Germany just did a study from the Syrian crisis, which is
ongoing. They had a million refugees. We can feed a Syrian in
Syria for $0.50. That same Syrian is up in Berlin, $70 per day.
$125 billion, divide that by 140 and you will get the cost of
what we could have done inside Syria. And we surveyed Syrians
left and right. And what was the response? They did not want to
leave home.
But when they didn't have food security, they would
actually move on average 3 to 4 times inside their country
before they had no other alternative when they couldn't feed
their family and no degree of security, they did what any
mother, any father would do in any country around the planet.
When I arrived at this job 5 years ago, there were 80
million people marching towards starvation. There were 650
million that were chronically hunger. That number is now up to
810 and it will go be going higher now. But that 80 million,
those 80 million that are acutely food insecure, I thought we
could eliminate that.
I was hoping to put the World Food Program out of business,
that we would no longer be needed. We have ended hunger and
created sustainability and resilience, but we had manmade
conflict one after the other, and climate shocks, and that
number went from 80 million to 135 million right before COVID.
COVID comes along, that number went from 135 to 276 million
people marching towards starvation. This is pre-Ukraine now.
And out of that 276 million, you have 48 million of them that
are knocking on famine's door in 43 countries. So I can tell
you which 43 countries are vulnerable to famine,
destabilization, and mass migration by necessity. And we have
an answer to that, and that is food.
If we get the resources we need, just like we did over the
last 2 years, even with COVID economic crippling effect, we
were able to avert famine and destabilization and mass
migration because the United States Government responded along
with countries like Germany that stepped up and others. But we
have many other countries now that need to step up.
And especially with oil prices, the Gulf States need to
step up in a way they have never done before. At least, if they
would pick up the price tag for humanitarian funds of need in
their own neighborhood. So just when you think it can't get any
worse, Ethiopia, then Afghanistan, and then of course, Ukraine.
Why is Ukraine troubling? Because it is the breadbasket of
the world. They grow enough food to feed 400 million people.
That is gone. The ripple effect of that around the world, 26
nations alone depend on 50 percent or more of their grain from
that region. The silos are full. Why are the silos full?
Because the ports are blocked. Why are the ports blocked?
Because Russian forces.
The farmers need to harvest again in July and August, where
are they? They are on the front lines. They need to be putting
out pesticides and fertilizers. Even if they do get a harvest,
of which we expect maybe half the yield, where is it going to
go? If the ports aren't opened, the global ripple effect will
be famines around the world.
And this is why it is critical, and so much appreciated,
that the United States, the Senate and the House is responding
in such a time as this. But we have got to get those ports
open. We have got to get the resources we are talking about out
into the field quickly into the countries that are going to be
very vulnerable in the Sahel and Eastern Africa, in the Middle
East and Central America, and I can go on and on.
But if we get the resources that you are now talking about
appropriated, it will go a long way in stabilizing nations
around the world, which the American taxpayer will save money
because you won't have famine and destabilization and mass
migration. Thank you, Mr. Chairman.
[The statement follows:]
Prepared Statement of David Beasley, Executive Director, United Nations
World Food Programme
This brief is being provided on a voluntary basis and should not be
understood to be a waiver, express or implied, of the privileges and
immunities of the United Nations and its officials under the 1946
Convention on the Privileges and Immunities of the United Nations.
i. introduction
Chairman Coons, Ranking Member Graham, members of the Senate State,
Foreign Operations, and Related Programs Appropriations Subcommittee,
thank you for convening this hearing on the dramatic need for resources
to address the growing threat of starvation around the world.
I want to thank this Subcommittee for your support of the United
Nations World Food Programme (WFP). The United States is WFP's most
generous and longstanding partner. Last year, the United States
provided $3.86 billion in support to WFP, and a considerable amount was
provided through programs under this committee's jurisdiction.
And many thanks are in order in this moment. I commend the Biden
Administration for the recent release of the Bill Emerson Humanitarian
Trust and the chorus of support from lawmakers on Capitol Hill that
made that possible. I also thank Congress for including emergency
humanitarian assistance for the Ukraine crisis in the fiscal year 2022
omnibus spending package signed into law on March 16. We are hopeful
that a considerable portion of those resources can be directed to the
worsening hunger emergency occurring within and beyond Ukraine.
I would also like to thank the United States Agency for
International Development for its excellent cooperation and
longstanding partnership. Despite this generous support, needs are
still outpacing resources. Today, I will outline the state of global
hunger in the context of the Ukraine crisis, provide you with an update
on WFP global needs and resourcing, and a picture of what might
transpire should humanitarian responders like WFP not receive the
resources required.
ii. state of global hunger
It is no secret that the world is not on track to achieve Zero
Hunger. Progress toward this global goal was waning even before the
COVID-19 pandemic produced economic turmoil and eroded food security.
Currently, in the 81 countries where WFP operates, up to 276 million
people are acutely food insecure and in need of urgent food, nutrition,
and livelihoods assistance--in other words, marching towards
starvation. This is a record high, and more than double the 135 million
people living with acute hunger before the pandemic. Refugees,
returnees, asylum-seekers, and internally displaced persons are
particularly vulnerable.
Among the 276 million, there are 48.9 million people living across
43 countries in even graver danger. They presently face severe hunger
emergencies (IPC/CH Phase 4)--just one step from famine. To put the
severity of these numbers into context, people in IPC 4 are in a state
of ``emergency conditions'' where they are acutely hungry and are
liquidating their final assets to do whatever they can to get food.
They are exceptionally fragile, and many die from the impact of their
hunger. Thirty percent of their children are wasting and many are now
permanently stunted, undermining their ability to ever achieve their
potential. This is not just a critical moment of hunger; it is a
generational impact that will have consequences for decades to come.
And finally, there are 730,000 people languishing in IPC 5, a
catastrophic condition of hunger which is the highest number on record
since the 2011 famine in Somalia. About 400,000 of these souls are in
Tigray in Ethiopia, and the others in parts of Yemen, Somalia and South
Sudan. While famine has not officially been declared in these places
because the technical thresholds have not yet been verified, the people
living in them are experiencing the same horrific conditions. The very
real risk that famines will be declared in 2022 is an admission of
failure at a time when the world has enough resources, food and money
to reach them.
While all of this is very bad news, it is about to get much worse.
iii. the ukraine crisis
We cannot adequately speak to the current global hunger crisis
without addressing the conflict in Ukraine and the ripple effects it
has produced across the globe.
I have just returned from Odesa, my fifth trip to the region since
Russia's invasion on February 24. In Ukraine, Poland and Moldova, I
witnessed the same heart-breaking scenes again and again: women and
children who weeks ago led safe, comfortable self-sufficient lives now
suddenly struggling to survive in a world of the unknown--and lack of
food is one of their major concerns. These are families who have never
had to worry about food and did not need the world's help to feed their
families.
That has all changed. Last year, Ukraine grew enough food to feed
400 million people, but now the food they grew is unable to reach its
own population because of this war. Ukraine has gone from being a
global breadbasket to being on the breadlines. About 35 percent of the
remaining population inside Ukraine have resorted to missing meals,
reducing portion sizes, restricting adult consumption to feed children
or borrowing food. To date, 3.6 million people have received help from
WFP and we are preparing to serve 6 million by June, if needed. These
people have every right to expect the global community to respond in
their time of need.
But even greater concerns lie beyond Ukraine's borders. The war is
already causing ``collateral hunger'' all over the world. The tens of
millions of tons of wheat, barley, maize and vegetable oil produced by
Ukrainian farmers, are trapped in ports, silos and warehouses--
threatened by the destruction of the infrastructure to get them to
market and the blockade of ports in the Odesa area of southern Ukraine.
We urgently need these ports to reopen so that food being produced
in the war-torn country can flow freely to the rest of the world before
the current global hunger crisis spins out of control. Unless they are
reopened, Ukrainian farmers will have nowhere to store the next harvest
in July and August. The result will be mountains of grain going to
waste while WFP and the world struggle to deal with an already
catastrophic global hunger crisis. WFP urges all parties involved to
allow this food to get out of Ukraine to where it is desperately needed
so we can avert the looming threat of famine.
In recent years Ukraine and Russia became major engines for feeding
the world, serving as critical suppliers to global markets for wheat,
maize and other food commodities, as well as energy and fertilizer.
This conflict has rocked global food and energy markets as exports from
Ukraine have been halted by this war. Steep rises are occurring in
international prices for basic staples--notably wheat, maize and
vegetable oil--creating a food price environment that resembles the
2008 and 2011 crises. Given heavy reliance on world commodity markets
by numerous countries, prices are rising even in places that do not
source their wheat or maize directly from Ukraine or Russia. So in
truth, instead of exporting food to help feed entire countries, the
conflict means that Ukraine is now being forced to export hunger.
In the case of a prolonged conflict, we should expect the
destruction of the commodities currently trapped in storage, worsening
declines in Ukraine's upcoming grain harvests and severe limits on its
capacity to supply global markets. Countries that rely heavily on grain
imports from the Black Sea, like Egypt, Lebanon and Yemen, will be
greatly affected. To make matters worse, a lack of fertilizer supplies
from Russia and continuously high energy costs will further constrain
yields in many countries far from Ukraine, especially across Africa.
Some 25 countries depend on Russia for 30 percent or more of their
fertilizers.
WFP now anticipates that in the countries where we operate, acute
hunger could rise by 47 million people, from a pre-war baseline of 276
million people who were already in the grip of acute hunger. This means
that up to 323 million people could be facing crisis levels of acute
food insecurity in the coming months.
Let me be crystal clear: Conflict in Ukraine is quickly
transforming a series of already terrible hunger crises into a global
food crisis that the world cannot afford. A crisis of this scale will
destabilize many parts of Africa, the Middle East, Central and South
America and Central Asia.
iv. needs and resourcing
This dramatic turn of events leaves WFP in the position of serving
the greatest number of people in its 60+ year history. In the face of
COVID-19, multiple conflicts and climate-related crises, we aim this
year to assist 147 million people. This is after reaching a record-
breaking 128 million beneficiaries in 2021.
Unfortunately, we are doing this in a time of dramatically
insufficient resources. WFP's assistance this year will cost
approximately US$21.5 billion. To say that our needs outstrip our funds
would be a significant understatement--today WFP faces a funding gap of
over 50 percent. While WFP has historically faced funding shortfalls,
they have not been as great as this in the past or surfaced in such a
complicated environment. As other UN agency and government budgets are
similarly under strain, many responders are forced to cut assistance at
the same time. This makes cuts in WFP's assistance much more painful
for recipients than in prior years.
The Ukraine conflict has further added to the funding gap by
increasing WFP's operational costs and constraining its response at a
time when it is needed the most. While other exporters of staple food
commodities should--at least partially--be able to make up for the
shortfall in supplies from the Black Sea region, these commodities are
higher priced and moving them comes with significantly greater
operational costs; shipping costs are now 4 times what they were in
2019. Buying from farther away means higher transport costs and longer
delivery times--for WFP and everyone else dependent on purchases in
international markets. WFP's operational costs are now $71 million more
per month than they were just 2 years ago, an increase of 44 percent.
This is enough to feed 3.8 million people for 1 month.
Because of these increased costs, we have had to cut rations to our
beneficiaries. In the past month in Yemen we have had to reduce rations
to 8 million individuals who are already in IPC 3 and 4. We are being
forced to make the terrible decision to literally take food from hungry
children to give it to starving children. Those hungry children are now
getting hungrier. This is also true for many of our beneficiaries in
Niger, Chad, Burkina Faso, Central African Republic, Mali, Nigeria, the
Democratic Republic of the Congo, and sadly the list goes on.
v. implications for global stability
We have long known that war produces hunger; that has been true of
every major conflict in human history and the world is seeing this
dynamic unfold in real time in Ukraine today. But we have also observed
that hunger itself can produce conflict and instability, creating a
vicious cycle of deepening hunger fueling increasing conflict. This is
what we should be afraid of today--the further weaponization of food.
In localized cases, we see how food insecurity produces conflict in
a community because of competition over agricultural inputs like land
and water. In other cases, a party will deliberately manipulate food
supplies as a weapon of war. However, one of the most predictable ways
that food insecurity can produce instability is through unexpected,
rapid spikes in food prices or a lack of access to food. As prices of
grains, oils and other basic commodities suddenly spike in countries
around the world it is important that we realize the risks this
portends. Recent history serves to warn us.
In 2007-08, a rapid increase in prices for major food staples
produced social unrest in at least 40 developing and middle-income
countries, and regime change in at least one. A former WFP Executive
Director, Josette Sheeran. referred to this period as the ``Silent
Tsunami.''
We saw food-related instability strike again in 2011 with a second
wave of price spikes linked to the Arab Spring in the Middle East,
which created social upheaval in Tunisia, Egypt, Libya, and especially
Syria. It is not well known that the conflict in Syria was predated by
what some experts have referred to as ``the worst long-term drought and
most severe set of crop failures since agricultural civilizations began
in the Fertile Crescent many millennia ago.'' As a result of that
drought, the southwestern city of Dara'a, situated in one of the
traditionally fertile areas of Syria, saw a large influx of
agricultural migrants and was one of the first sites of social unrest
in the country. From there, the dominoes continued to fall, and Syria
remains in the grip of a crisis that has overflowed its borders. WFP
currently serves over 2 million Syrian refugees in Lebanon, Jordan and
Turkey, along with another 5.8 million beneficiaries inside Syria.
The links between food insecurity and instability often produce
spikes in migration. Food insecurity in Middle Eastern countries during
the Arab Spring led to an increase in refugee flows and asylum seeking
in Europe. WFP's own research into the causes of migration, based on
data from 88 countries, found that a 1 percent increase in food
insecurity fueled a 2 percent increase in migration. More recent
surveys across Central America have produced similar results--a 1
percent increase in hunger leads to a 2 percent increase in migration.
The bottom line is that people do not stand idly by when they
cannot feed themselves or their families. Already in the past month, we
have seen social unrest triggered by food price spikes in Peru,
Pakistan, Indonesia, and Sri Lanka. This is likely just the beginning:
the conditions for food-related instability today are far greater and
the risks of social upheaval are much higher than they were a decade
ago.
First, in 2008, the world was more stable than it is today. Several
major conflicts have erupted since that time. The civil war in Ethiopia
began in 2020, the Yemeni civil war in 2014, the Syrian civil war in
2011; while the conflict in Northeast Nigeria began in 2009 and in
Central Sahel in 2017. Furthermore, we are experiencing exceptional,
persistent droughts across the Horn of Africa, central Asia and the Dry
Corridor, which have already created millions of additional migrants.
The combination of conflict and drought has created fragility in
multiple regions impacting hundreds of millions of people.
Second, the world has still not fully recovered from the ripple-
effects of the COVID-19 pandemic, leaving it ill-equipped to cope with
yet another crisis. In low- and middle-income countries especially,
incomes are still depressed from COVID-19, labor markets are struggling
to recover, and debt is at record levels. Governments around the world
are less economically resilient and unable to respond with fiscal and
monetary measures to help reduce the impacts of increasing food prices
on their populations. With rising interest rates, the costs of credit
further limit the options for governments to respond to these
difficulties.
Third, city dwellers are facing increasing obstacles to accessing
affordable food due to reductions in incomes and closures of informal
markets, combined with price surges due to COVID-19 containment
measures. While hunger has long been associated with rural areas,
COVID-19 has created a growing class of hungry people: city dwellers in
low- and middle-income countries. This matters as food price riots
occur overwhelmingly amongst urban populations, particularly in
relation to food products of cultural significance, and among countries
with a strong reliance on agricultural imports. For example, Egypt, the
most populous country in the Middle East and Ukraine's top wheat
customer, will struggle to maintain existing subsidies on bread--a
staple of the Egyptian diet--in the face of rising global wheat prices.
The combined effects of these factors, exacerbated by the war in
Ukraine, have created a perfect storm that threatens to unleash an
unprecedented global wave of food insecurity and instability.
vi. conclusion
A swift resolution to the crisis in Ukraine appears unlikely.
Therefore, its global repercussions for food security and stability
will become progressively more dangerous in the coming weeks and
months. As humanitarian needs soar our ability to respond is
diminishing due to the lack of funds. While global food supply chains
are stressed, there are enough resources available in the world to feed
everyone; the issue is one of cost and allocation. Because needs have
outpaced funding, WFP is increasingly being confronted with the
impossible decision of who to support--and who not to support. We are
being forced to decide who will live and who will die because we do not
have the resources available to feed them.
Today you have the opportunity to decide whether or not to provide
funds to help save the hungry. The costs of humanitarian inaction are
tremendous, especially for people in need, who in the worst cases pay
with their lives. Failing to mobilize sufficient, strategic, and timely
funds for humanitarian assistance will not spare national budgets. Let
me warn you clearly: if you do not respond now, we will see
destabilization, mass starvation, and migration on an unprecedented
scale, and at a far greater cost. A massive influx of refugees to
Western countries could soon become a reality. As soon as they arrive,
the host governments will start paying the price--literally --for not
having acted earlier. Germany's recent experience of absorbing Syrian
refugees in the aftermath of the civil war is a case in point. It costs
less than 50 cents to feed someone for a day in Syria versus almost $70
a day in Germany to provide a refugee with the humanitarian support
they require.
I therefore urge the members of this body to take decisive action
to prevent a rapidly worsening global food crisis and help WFP and our
partners stabilize the food security of the most fragile countries at
this time of unprecedented need.
At a minimum, an additional $5 billion dollars for food assistance
from the United States will provide WFP and other aid agencies with the
support we need to stem the rising tide of famine. It will also send a
very clear message to other donor nations that they must step up to do
their part.
I do not look to the United States to solve these problems alone,
but I do ask that you show the humanitarian leadership the U.S. is
renowned for and which the world urgently needs right now. We are
counting on you to lead with your actions as much as your words. As the
Washington Post said in an editorial just 10 days ago, ``Whether this
precarious situation turns into a true global famine depends largely on
what the United States, European Union, China and other large and
wealthy nations do now [ . . . ] The United States and other major
world powers have the ability to prevent a global famine. This is as
urgent and morally necessary as sending tanks to Ukraine.''
Senator Coons. Thank you, Mr. Beasley. Ms. McKenna.
STATEMENT OF TJADA D'OYEN MCKENNA, CHIEF EXECUTIVE
OFFICER, MERCY CORPS
Ms. McKenna: Thank you. Good afternoon, and thank you
Subcommittee Chair Coons, Ranking Member Graham, and Members of
this Committee. I want to express my gratitude for convening
this hearing on rising global food insecurity, a problem that
was already acute, but that has already deepened dramatically
in recent months.
My name is Tjada D'Oyen McKenna. I am the CEO of Mercy
Corps. We are an international humanitarian and development and
peacebuilding organization. We operate in 40 fragile countries
facing conflict and hunger, supporting more than 37 million
people. I previously stood up and ran the U.S. Government's
Feed the Future Initiative at USAID in response to the last
global food crisis, and I know how critical it is to respond to
immediate hunger crises while strengthening food systems and
building long term resilience.
A perfect storm is leading to heightened global food
insecurity, worse, much worse than the previous food crises
over the past decade. Food and fuel price hikes resulting from
the war in the Ukraine are the latest shock, undercutting the
ability of the poorest and most vulnerable to feed themselves.
The deepening effects of climate change, conflict in other
parts of the world, and the economic pummeling of the COVID-19
pandemic combined to push those least able to cope towards the
abyss of hunger before the shockwaves caused by Ukraine. I
testified last year in front of the House Foreign Affairs
Committee that COVID-19 was burdening people's ability to feed
themselves through the loss of income and global supply chain
disruptions, and those words continue to ring true.
COVID-19 was not only a health crisis, it is a food and
socioeconomic crisis as well, one which rolled back decades of
hard won poverty reduction and food security gains and
continues to do so today. The drought unfolding in the Horn of
Africa is a prime example of the devastation wrought by a
second hunger driver, climate change. The region is
experiencing its third drought in just a decade.
The current one is the most devastating in a generation,
with over 15 million people experiencing extreme hunger, a 70
percent increase in comparison to past severe droughts. In
Somalia, a recent famine risk assessment clearly signals the
potential for widespread malnutrition and starvation, with
81,000 people already in famine like conditions and over 1.7
million on the brink.
Additional projections indicate the lives of 350,000
children are at risk. The dual challenges of COVID-19 and
climate shocks are now being compounded by conflict. While the
war in Ukraine is responsible for food, fuel, and fertilizer
price hikes, it is not the only conflict undercutting people's
ability to feed themselves.
Conflicts in the Sahel, Somalia, Syria, and Yemen have
decimated food systems, destroyed livelihoods, and led to
widespread hunger. As my colleague, Mr. Beasley said, several
of the most fragile countries reliant on Ukrainian imports find
themselves in serious trouble. The prices of wheat, corn, and
oil--and cooking oil across Africa and the Middle East are
rising sharply. I recently traveled to Lebanon just after
visiting Poland to visit the Ukrainian border.
I saw that the price of some basic food items were
increased already within three weeks of the conflict starting.
In Somalia, basic food items have increased by over 100
percent. Lebanon, which--where I was, which imported 81 percent
of its wheat from Ukraine, faces the fallout from the grain
shortages and higher commodities, it continues to host a very
large Syrian refugee population, and is still reeling from the
Beirut port blast, with a growing proportion of the population
already relying on subsidized wheat.
There is increasing risk that higher fuel and food prices
could drive social tensions, instability, and protest. The
global price of wheat has never been higher, eclipsing the last
highest price, which was just prior to the Arab Spring, which
threatened regional stability in the Middle East. While this
perfect storm may appear unique, it is a window into the types
of multifactor challenges we face if conflict goes unchecked,
climate impacts increase, and new health security challenges
unfold.
In order to tackle this current crisis, Mercy Corps urges
Congress to specifically increase humanitarian and food
security funding this year. Organizations on the front lines
estimate that an additional $5 billion will be needed for the
U.S. to tackle. I know that you all agree, so I will leave
that.
Mercy Corps also recommends that the U.S. Government double
down on efforts to mitigate future food insecurity through a
series of critical actions. First, we recommend that the U.S.
Government urgently make humanitarian aid smarter by
prioritizing the use of flexible cash and voucher programs
complemented by actions to sustain local markets.
Second, we recommend scaling resilient food systems by
doubling investments in Feed the Future countries to shockproof
those communities. And lastly, we recommend tackling the root
causes of hunger by significantly increasing investments in
peacebuilding and conflict prevention in fragile contexts,
reinvigorating the coordination of the R3 bureaus at USAID.
And finally, appropriately layering and sequencing both
humanitarian and development interventions for better outcomes.
We must not only act to address immediate food security
situations, but also to insulate communities to help withstand
future shocks that will be costly in both human resources and
human lives lost unnecessarily.
The U.S. Government exercised leadership in the wake of the
last crisis in standing up Feed the Future. We encourage an
equally bold, and even bolder because the situation is so much
worse than the last one, to address the drivers of the current
crisis and build resilience. Otherwise, I fear food aid needs
will continue to grow and we will continue to have to hold
hearings like this every 10--5, 10, 15 years if we don't act
now. Thank you.
[The statement follows:]
Prepared Statement of Tjada D'Oyen McKenna, Chief Executive Officer,
Mercy Corps
introduction
Good morning, and thank you Subcommittee Chair Coons, Ranking
Member Graham, and members of the Senate Appropriations Subcommittee on
State and Foreign Operations. I first and foremost want to express my
gratitude for convening this hearing on the pressing topic of rising
global food insecurity--a problem that has deepened dramatically in
recent months.
My name is Tjada D'Oyen McKenna, and I am the Chief Executive
Officer of Mercy Corps, an international humanitarian, development, and
peacebuilding organization. Our global team of 5,600 humanitarians
operates in 40 fragile countries facing conflict and hunger, where our
work supports more than 37 million people to improve their lives in the
face of adversity and crisis. In my previous work standing up the
United States government's Feed the Future initiative at USAID in
response to the last global food crisis, I focused intensively on
strengthening global food security and know first-hand how critical it
is to simultaneously invest in smart responses to immediate hunger
crises while strengthening food systems and building long-term
resilience.
Food systems in many of the countries in which we work are on the
verge of collapse. In places like Ethiopia, Kenya, Lebanon, Nigeria,
Somalia, South Sudan, and Yemen, communities are being battered by a
perfect storm of conditions: ongoing economic setbacks from COVID-19,
climate stresses, conflict and skyrocketing food, fuel, and fertilizer
prices resulting from the war in Ukraine. This potent combination of
challenges imperils lives around the world and threatens to fuel
instability and civil strife. While the conflict in Ukraine is
responsible for the recent price hikes, they are only the most recent
factors contributing to global food insecurity. Given this combination
of threats, solutions must, by definition, include bold short-term
relief and medium, and long-term interventions that fortify communities
to cope with and withstand future shocks.
covid economic shocks to food security
I testified in front of the House Foreign Affairs Committee a
little over a year ago and stated, ``Due to COVID-19, global food
insecurity and hunger are on the rise. In part, this is because [at the
time] 114 million people have lost their jobs due to market disruptions
and movement restrictions. Another 141 million people have reduced
their hours, which has led to an income loss of over $3.7 trillion. The
price of basic staples, such as grains and dairy, has inflated
tremendously, triggered by COVID-19's disruption of supply chains.''
That statement is as relevant today as when I first testified and,
unfortunately, the statistics are worse now than then. These impacts
will persist for years to come, pushing those who were already
vulnerable closer to the edge of acute food insecurity.
From the start of the pandemic to today, COVID-19 continues to
drive hunger and poverty and now a global food security crisis is
staring us in the face. The World Bank and the International Food
Policy Research Institute, with analysis from the Pardee Center,
estimates that COVID-19 may cause a persistent increase in extreme
poverty, leading to a six to thirteen-year setback relative to a No-
COVID scenario. Furthermore, at least two-thirds of households with
children have lost income since the start of the COVID-19 pandemic, and
income losses have left 1 in 4 adults in households with children going
without food for a day or more.
In this sense, COVID-19 has not been just a health crisis, but a
food, and socio-economic crisis, one which has rolled back decades of
hard-won poverty reduction and food security gains. This impact means
vulnerable populations such as women, children, and marginalized
groups' ability to respond to shocks and stresses is impaired as we
have witnessed first-hand in many places, particularly the Horn of
Africa.
climate shocks and stresses
The effects of climate change are a primary driving force in the
current global food crisis. Increasing weather risks and the associated
impacts of a dramatically changing climate continue to unfold around
the world, disrupting agriculture and pastoral activity, decimating
livelihoods, and increasing conflict within and between communities
suffering from a diminishing ability to provide for themselves. This is
particularly true in the most fragile places in the world, where
smallholder farmers are reliant on rainfed agriculture for subsistence
farming. Continued crop loss both limits household earnings from
agriculture and causes an increase in food prices.
The drought unfolding in the Horn of Africa is a primary example of
the devastation wrought by climate change. The region is experiencing
its third drought--an event that is supposed to take place every twenty
years--in just a decade. The current one is the most devastating in a
generation with over 15 million people in Ethiopia, Somalia and Kenya
currently experiencing extreme hunger--a 70 percent increase in
comparison to the population in need during past severe droughts.
After three consecutive seasons of failed rains, parts of the
region are facing their driest conditions and hottest temperatures
since satellite record-keeping began 40 years ago. Forecasts suggest
that the situation is likely to escalate further, as a fourth
consecutive season of below-average rains (March-May 2022) is now
widely acknowledged to be occurring. This would be the first occurrence
of four consecutive below-average rains in the region since at least
1981, resulting in one of the worst climate-related emergencies on
record. A fourth season of failed rains could leave a staggering 45-55
million people facing acute food insecurity by mid-2022.
In Somalia, a recent Famine Risk Assessment Report clearly signals
the potential for the drought to lead to widespread malnutrition and
starvation, and indicates food security and malnutrition will
deteriorate ``further and faster'' through June. Based on past drought
responses in 2011 and 2017, we know that the worst is yet to come and
that we should expect heightened humanitarian needs through at least
September. The assessment concluded that as of right now 81,000 people
are already in famine-like conditions, while over 1.7 million are on
the brink. Additional United Nations projections indicate the lives of
350,000 children are at risk of death in coming months.
On top of the urgent threat to human lives, the protracted drought
crisis also threatens livelihoods for millions. Severe water shortages
are leading to crop failures. Over three million livestock have already
died across the region; without access to enough pasture, water, and
fodder, the health of remaining livestock is rapidly deteriorating.
This is greatly reducing people's ability to sell off animals--a key
coping strategy for agro-pastoralists. Mercy Corps is responding to the
drought by protecting lives, assets, and livelihoods in the immediate
term while laying the groundwork for long-term resilience by working
with communities, governments, and the private sector to improve local
capacities and systems.
Prices of wheat, corn, cooking oil, and other staples across Africa
and the Middle East are on the rise due to the conflict in Ukraine. For
example, the price of some basic food items in Somalia has gone up over
100 percent, with three liters of cooking oil going from $3 USD to as
high as $12 USD. A 50-kilogram bag of flour increased by 34 percent.
The impact will contribute to the cycle of compounding and recurring
crises that has eroded communities' coping strategies. While regional
governments and development actors' investments in local systems and
capacities have been crucial in helping lessen these impacts, the scale
of the current drought occurrence, in combination with the array of
other shocks, is overwhelming communities. Women and girls will bear
the heavier brunt of the impacts of the drought, due to prevailing
gender inequality. For instance, in times of crises, affected
households adopt negative coping strategies such as skipping meals or
removing children from school. Cultural norms dictate that women and
girls will be the last to eat or not eat at all, and girls will be the
first to miss out on their education. The displacement that results
from drought can also lead to greater gender-based violence.
The countries in the Horn are far from the only ones experiencing
climate-related shocks. South Sudan, a country known more for its past
as a conflict hotspot and political turmoil, has struggled through
multiple heavy cycles of rains in the previous 3 years. Last year was
the wettest on record, flooding 33 out of the 79 counties across the
country and causing the displacement of 835,000 people. An estimated
800,000 livestock without the ability to graze due to the flooding have
died and the ability of smallholder farmers to support themselves and
their communities has been devastated. Very little water has receded,
leaving these communities at risk of complete inundation in the next
round of rains traditionally starting this month. Beyond lives lost to
the flooding and flood-related hunger, the desperate situation has
fueled increased conflict across the country, continuing the cycle of
violence and misery borne by the people of South Sudan.
the ukraine effect
The dual challenges of COVID-19 and climate shocks are now being
compounded by the conflict in Ukraine and elsewhere. In this globalized
economy, those living far beyond Ukraine's borders are feeling ripple
effects in their daily lives through inflation and increased food and
fuel prices.
The Ukrainian and Russian agricultural sector accounts for roughly
29 percent of the global wheat supply and due to the conflict in
Ukraine the price of wheat is at an all-time high. Disruptions caused
by the conflict, particularly in Ukraine's agricultural heartlands, are
already having a disastrous effect on food prices and availability in
the Middle East and the Horn of Africa. If fields continue to lay
fallow, crops are not planted or harvested, and it remains near
impossible or cost prohibitive to transport critical commodities out of
the country, there will be less food on the global market, driving up
scarcity and prices.
This is compounded by skyrocketing fuel costs, which have added
cost to every link of the supply chain. These challenges will likely
remain far beyond this planting and harvesting season--meaning scarcity
and increased prices will be a feature of global food commodity markets
well into the future. Additionally, fertilizer use will also be heavily
impacted as Russia and Ukraine are both top exporters of three key
fertilizers and crucial suppliers to many countries whose agricultural
sectors are highly dependent on fertilizer imports. Globally,
fertilizer supply continues to drop, and prices have increased fourfold
since early 2020, driving up the cost of agricultural goods and
affecting long-term yields.
Several of the most fragile countries in the world reliant on
Ukrainian wheat and other staple crop imports, or dependent on food
security assistance provided by the World Food Programme and other
actors, find themselves in serious trouble, unable to feed their
populations. A prime example is Lebanon, which imported 81.2 percent of
its wheat from Ukraine in 2020, and as a result faces significant
fallout from grain shortages and the economic impact of higher
commodity prices. The country continues to host a large Syrian refugee
population and is still reeling from the Beirut Port blast in August
2020, with a growing proportion of the population relying on subsidized
wheat as a primary source of sustenance.
I recently traveled to Lebanon and saw firsthand how dramatic the
impact global food and fuel price increases are having on Lebanese
households. The Ukraine-related shortages and price hikes are
increasing pressure on the national government to respond quickly and
forcing families to commit dwindling economic resources to skyrocketing
food prices. There is increasing risk that higher fuel and food prices
could drive social tensions, instability, and protests. Historically,
there is a strong correlation between political instability and rising
international food prices.
Lebanon is not the only country in the Middle East, contending with
this potent mix of conflict and Ukraine-induced food insecurity. Food
prices in northwest Syria--an area wracked by nearly a decade of
conflict--were already up 86 percent, before the conflict in Ukraine
had even started. The Turkish-supported Syrian Interim Government in
northwest Syria and the opposition's Syrian Salvation Government have
both implemented policies to combat the high level of food insecurity
in the region given Turkey imported 69.7 percent of its sunflower oil
and 78 percent of its wheat from Ukraine and Russia. In Yemen, which
imports more than 90 percent of its wheat from Ukraine and Russia, 16
million people do not know where their next meal will come from.
recommendations
While the perfect storm of climate change, conflict, and COVID-19 I
just outlined may appear to have emerged from a unique confluence of
circumstances, we are likely to witness similar combinations of shocks
manifest in the future. The global food security crisis is a window
into the types of multi-factor global challenges we will likely face
repeatedly if conflict goes unchecked, climate impacts increase in
severity, and new global health security issues unfold. The
international community and U.S. government must not only meet this
moment by providing adequate humanitarian assistance to address acute
food insecurity today, but by investing in and reorienting our
assistance modalities to prepare vulnerable communities to weather
these future shocks. As this committee and the broader U.S. government
considers how to respond, Mercy Corps urges the following:
Rise to the Challenge through Adequate fiscal year 22 Funding
Based on new and worsening humanitarian emergencies and increased
food, fuel, and shipping costs, the global humanitarian and food
security assistance funding shortfall in 2022 has increased by 50
percent. We welcome the Administration's recent release of the Bill
Emerson Humanitarian Trust to the Horn of Africa and Yemen, but these
food commodities will take months to arrive, let alone get to people's
plates. The Administration's recent second Ukraine supplemental request
included some international food security assistance, but from our
estimation there is only $1.85 billion dedicated to addressing the
urgent humanitarian needs. Put simply, this is entirely insufficient to
meet the current challenges.
Consequently, we are asking Congress to provide $5 billion in
supplemental funding for international food security programs. The now
323 million people likely facing crisis levels of hunger around the
world cannot afford further delay, nor can U.S. partner humanitarian
organizations continue making impossible choices everyday as to who
lives and who dies because of a lack of funding.
Make Humanitarian Response ``Smarter''
Humanitarian and food security assistance are vitally important
tools in mitigating the impacts of crises and saving lives. First and
foremost, it must be immediately available and provided in sufficient
quantity to actually meet needs around the world. It must also be
provided in ways that promote maximum speed and effectiveness.
Finally--and of critical importance--it must promote readiness for
future shocks and strengthen local systems that people rely on to meet
during emergencies and times of acute stress.
We encourage the U.S. government to:
1. Ensure robust base funding for humanitarian accounts.--While
supplemental funding for unexpected emergencies may be
required, nothing will ever replace the adequate baseline
budget necessary to respond to needs that are clear at the
outset of a fiscal year. We know enough about current needs and
historical spending patterns to set an adequate spending level
for the humanitarian accounts and to provide a State and
Foreign Operations topline number that will accommodate them.
This is essential to make sure U.S. humanitarian offices can
plan and make better choices throughout the fiscal year.
2. Prioritize cash and voucher interventions.--Cash and voucher
interventions support household's ability to purchase food and
farmers' ability to access seeds and fertilizer. These
interventions directly support local market interventions as
part of emergency response and recovery. Evidence suggests that
in most cases, cash is a more efficient and effective mechanism
to reach needy people. It has the added benefit of sustaining
markets and offering people dignity of choice. Where markets
are thin, it should be complemented by direct support for local
businesses and other actors to sustain the marketplace.
3. Universally integrate the use of flexible financing mechanisms
into all existing and new procurement mechanisms across
USAID.--Streamlining the activation of crisis modifiers will
enable bureaus to better pivot quickly to emergency response
while protecting development gains. This flexible funding
mechanism allows USAID to rapidly pass-through new rounds of
funding to current, existing partners whenever a crisis hits,
without the need to go through time intensive new rounds of
requests for applications. This allows crisis response to
leverage existing partnerships and interventions to ensure
response is faster and more effective. Additional flexibility
through procurement reform will also be required to fully
implement smarter humanitarian assistance.
4. Implement peacebuilding and good governance alongside emergency
response.--While emergency assistance is focused on saving
lives, there are ways that it can be provided to promote peace,
improve good governance, and strengthen systems that help
vulnerable people cope. Mercy Corps' Advancing Peace in Complex
Crisis framework provides guidance on how this can be achieved
across a range of conflict types and security conditions.
Invest in Resilient Food Systems
The U.S. recognized the need to strengthen food systems when it
stood up the Feed the Future Initiative after the 2007/2008 food price
crisis. Feed the Future is a ``whole of government'' initiative with
proven results in reducing poverty, preventing hunger, and reducing
stunting. Congressional investments in food systems were successful in
increasing the resilience of households vulnerable to the impacts of
COVID-19 and food systems proved more resilient during the pandemic
than originally expected. Feed the Future has also proven that
investments in fragile areas can increase household resilience to food
security and reduce the need for humanitarian assistance. For example,
in Northeastern Nigeria Mercy Corps is strengthening local market
systems, partnering with input suppliers, buyers, and other local
actors to improve the resilience of food systems and strengthen
livelihoods of households. 80 percent of participants in Mercy Corps'
poultry market interventions have reported improved ability to address
conflict related shocks, while agriculture businesses and farmers
supported with financial assistance in Northeastern Nigeria were able
to generate revenues up to four times larger than the program budget
that supported them. Given these proven results, we would recommend the
following:
1. Invest in Feed the Future Countries.--Despite the increase in
frequency of disruptions, food systems investments at the
country level have remained the same for more than a decade.
The U.S. government must commit adequate resourcing to this
global anti-hunger agenda to ensure it is truly able to ``shock
proof'' global food systems as we head into a future that will
inevitably include more events like those we are currently
experiencing. These must focus on building the resilience of
global and local food systems to more frequent climate and
conflict disruptions. Feed the Future can help mitigate
additional needs by expanding the program into fragile areas to
strengthen food systems for the future.
2. Reauthorize the Global Food Security Act (GFSA).--The GFSA
authorized Feed the Future and sets forth Congressional
expectations on a bold global food security agenda. It must be
reauthorized this year and this process should be used as an
opportunity to incorporate lessons learned and reinvigorate
Congressional support for global food security in light of the
crisis we are currently witnessing. We would encourage Congress
to double the authorized amount for Feed the Future through the
GFSA.
Commit to Proactively Addressing Conflict and Climate Change in a
Strengthened Resilience Agenda
The U.S. and other bilateral and multilateral donors continue to be
stuck in a paradigm of foreign assistance that is reactive. In recent
years, with the passage of the Global Food Security Act, the Global
Fragility Act, and other important pieces of legislation, the U.S. has
begun to pivot toward a more forward leaning and proactive agenda to
head off crises. We must strengthen this posture by squarely focusing
foreign assistance investments on tackling the root causes of conflict,
violence, and fragility, prevent the escalation of crises where we can,
and mitigate the impacts of inevitable shocks. In short, we must
redouble our efforts on building resilience to help communities prevent
or reduce effects of crises.
Conflict, climate change, and COVID-19 are major, intertwined
challenges across the globe. There is increasing evidence that climate
change compounds existing sources of economic, political, and social
risks that drive violence. Climatic shocks like drought are already
increasing the risk of intercommunal conflict in the Horn. Ongoing
conflicts in Ethiopia, Northern Kenya, the Sahel, South Sudan, Somalia,
Syria, Ukraine, and Yemen are exacerbating disparities among vulnerable
communities, destroying livelihoods, and limiting humanitarian access.
Of the more than 161 million people around the world that live in
countries with crisis levels of food insecurity, more than 100 million
live in places where conflict is the main driver of that food
insecurity.
A strengthened resilience agenda should prioritize development
investments and peacebuilding initiatives alongside humanitarian
assistance, which we know all too well cannot solve the underlying
causes of these crises. These different types of interventions should
be thoughtfully integrated and connected for impact. The three USAID
bureaus--for Resilience and Food Security, Humanitarian Assistance, and
Conflict Prevention and Stabilization--were brought together expressly
to ensure a better response to these mutually reinforcing challenges.
We must do more to layer and sequence humanitarian and development
investments in fragile contexts and be more intentional, and bolder in
our efforts to do so.
Our research on this topic in the Horn of Africa demonstrates
resilience programming that better integrates early warning systems,
more shock-responsive social protection programs, and stronger market
systems are arguably mitigating some of the worst effects of the
current shocks--at a fraction of the cost of emergency assistance.
Recent analysis drawn from drought data in the Horn between 2000 and
2015 indicates that investments in resilience and safety nets ``reduces
the net cost of humanitarian response by an estimated $1.6 billion
[USD] over a 15-year period over the cost of a late response.'' When
considering the costs of meeting immediate needs and the benefits to
incomes and livestock, investments in resilience building are estimated
to save $4.3 billion over a 15-year period, which averages to $287
million USD per year.
Put simply, we cannot afford to take any other approach. The
intricate connectivity between climate change, conflict, economic
shocks, and food insecurity demands a more integrated, better
coordinated, and sequenced approach to our foreign assistance
investments. No amount of humanitarian assistance will suffice if this
gordian knot is not untangled.
Mercy Corps recommends that efforts be made to:
1. Increase investments in development and peacebuilding
interventions in contexts affected by recurrent or protracted
humanitarian crises.--Investments in addressing root causes of
these challenges is insufficient. Furthermore, we believe
embedding a conflict-sensitive approach throughout all food
security programming, supporting peaceful migration and
resource sharing makes our humanitarian assistance smarter.
2. Ensure USAID works collaboratively across bureaus.--The
Administration must expand and enhance its focus on working
collaboratively across all relevant parts of our foreign
assistance apparatus with relevant mandates to create an
integrated package of assistance that is mutually reinforcing.
It is particularly important that USAID's efforts break silos
and add up to a greater sum than their individual parts. This
includes ensuring all humanitarian action is conflict
sensitive, and that social and market systems are reinforced
rather than undermined in areas where humanitarian aid is
prolonged. We recommend reinvigorating the ``R3'' concept with
a fully empowered Deputy Administrator role to oversee USAID's
Bureaus for Humanitarian Assistance, Resilience and Food
Security, and Conflict Prevention and Stabilization.
3. Build Resilient Food Systems in Fragile Areas.--The evidence is
clear that resilience investments can mitigate humanitarian
needs in fragile contexts. Through the reauthorization of the
GFSA and the elevation of the USAID Resilience Leadership
Council, we can ensure resources are being targeted in areas of
greatest need and opportunity. Ultimately, food system
resilience must include efforts to prevent and reduce the
impacts of future health, climate, and conflict shocks, among
others, that can impact functioning food systems. Resilience
requires the ability to adapt to the rapidly changing contexts
within which food systems operate, including increasing
urbanization, income changes, complex supply chains, and
natural resource and equity constraints. Adaptive food system
monitoring systems are also needed as part of the resilience-
building pathway.
4. Layer and Sequence Humanitarian, Development, and Peacebuilding
Approaches from the start.--In every context, program
interventions must be layered and sequenced with the full range
of foreign assistance resources, tailored to individual
contexts, communities, and countries. This means that when
responding to a weather emergency or a new conflict that
humanitarian and development funding tools are aligned,
mutually reinforcing and appropriately timed, and sequenced to
give individuals and communities the best opportunity to
survive, cope and thrive.
closing call to action
Taken together, the impact of COVID-19, enduring and escalating
climate shocks, unchecked conflict and now the war in Ukraine are the
perfect storm impacting vulnerable communities' ability to feed and
support themselves. The consequences could be catastrophic--in terms of
lives lost and further global instability--if adequate efforts are not
made to provide immediate assistance at the scale required.
We must also recognize that these interconnected challenges are not
in fact anomalous, but a glimpse into a future where multi-factor
shocks will combine to create significant threats to lives around the
world. Knowing this means we must proceed boldly and strategically,
making dedicated efforts to ensure our humanitarian assistance not only
prevents lives from being lost, but fortifies communities and food
systems to withstand inevitable shocks. It also means better combining
our foreign assistance tools and approaches to promote resilience by
planning and executing assistance that layers and sequences different
interventions. We have a critical window of opportunity to better
prepare for a complex and potentially dangerous future in which global
food security will be imperiled by an array of interrelated shocks,
let's seize it.
Thank you.
Senator Coons. Thank you. Dr. Adesina.
STATEMENT OF AKINWUMI ADESINA, PRESIDENT, AFRICAN
DEVELOPMENT BANK
Mr. Adesina. Thank you very much, Chairman, Senator Chris
Coons. It was great to have you visit us in Abidjan. It is nice
to see you again. Ranking Member, Senator Lindsey Graham, it
was also great to see you in Abidjan when you visited.
Distinguished Members of the U.S. Senate Appropriations
subcommittee office on State and Foreign Operations, and I hope
I will have the opportunity to welcome several of you also to
the headquarters of the African Development Bank that is based
in Abidjan. I very much appreciate the opportunity to testify
about the U.S. response and policy options for a global food
security crisis.
I have dedicated my professional life to realizing Africa's
potential through development. I have served Africa's most
populous nation as Nigeria's agriculture minister, and I am
President of the African Development Bank Group, Africa's
premier and most trusted development finance institution.
And I am also the 2017 World Food Prize winner. So I like
things about food. With an active portfolio of $60.35 billion
in more than 140,000 locations, the African Development Bank is
Africa's only triple A rated financial institution. Our
strategic high five priorities are to light up and power
Africa, feed Africa, industrialize Africa, integrate Africa, as
well as improve the quality of life of the people of Africa.
Today, I would like to focus on feeding Africa and what the
African Development Bank is doing to address the global food
crisis. Africa has an estimated 33 million smallholder farmers.
They are key to food production and the livelihoods of millions
of more Africans whose walk and lives are linked to the
agriculture sector.
The truth is, with America's financing and those of other
80 shareholder members of the bank, the African Development
Banks group actions to boost harvests from Africa's farms are
achieving impressive results.
For example, through our technologies for African
agricultural transformation, which are called T-A-A-T or TAAT,
our support reached 11 million farmers in 28 countries in a
little over 2 years. The program is delivering climate smart
seeds, fertilizers, and technical support, allowing farmers to
harvest high yields of wheat, corn, rice, and other staples.
African food production, as a result of those efforts, has
increased by more than 12 million metric tons. The economic
shocks from the Russian war in Ukraine are causing all of us to
pay more to put food on the table.
The magnitude of food price interests and trade disruptions
caused by the Russia and Ukraine conflict have hit Africa
harder than other developing regions of the world, threatening
to topple the continent's food systems already stressed by the
COVID-19 pandemic. Africa must prepare for the inevitable
global food crisis. Ukraine exports 40 percent of its wheat and
corn to Africa.
According to the United Nations, 15 African countries
import more than half of their wheat and as much of their
fertilizers and oil from Ukraine and Russia. As the Russian,
Ukraine conflict rages, Africa is also dealing with a 30
million metric ton loss of wheat and corn that won't be coming
from Russia nor from Ukraine. The cost of bread is now beyond
the reach of many Africans.
The Russian, Ukraine conflict is a huge factor in
fertilizer prices, hiking upwards of 300 percent. Our analysis
is that America faces a fertilizer shortage of 2 million metric
tons this year. We estimate it will cost about $2 billion at
current market prices to source new fertilizer to cover the
gap. If we don't mitigate this shortage rapidly, food
production will decline by at least 20 percent, and we estimate
in many places by more than 50 percent as well.
This horrific perfect storm will see Africa lose more than
$11 billion in the value of food production according to our
analysis. Without urgent and immediate global action, we may
witness social and political unrest, as we have seen only too
often in the past, as we heard from Senator Graham and also
Senator Coons.
The truth is that the African Development Bank, with your
support, is prepared to meet this challenge and others head on.
Let me share what we are doing to help avert a looming food
crisis. We have developed an Africa emergency food production
plan. A $1.5 billion plan will be used to support African
countries to produce food rapidly. Produce 38 million metric
tons of food, in fact.
The total value of the additional food production is $12
billion U.S. dollars. The Africa Emergency Food Production Plan
will deliver climate resilient agricultural technologies to 20
million farmers, a majority of those will be women farmers. The
$1.5 billion plan intends to source $1.3 billion of own
resources.
With U.S. Government support to reduce the $200 million
financing gap, we can ensure the Africa Emergency Food
Production Plan's success. Distinguished members of the
subcommittee, we are spearheading efforts for African solutions
to Africa's immediate, medium, and long term challenges.
The strong support of the U.S. for the Africa Emergency
Food production Plan will allow Africa to avert the looming
food crisis and use the opportunity to drive structural changes
in agriculture to unleash the full potential of Africa to
become a breadbasket to the world. Thank you very much for the
invitation.
[The statement follows:]
Prepared Statement of Dr. Akinwumi A. Adesina, President, African
Development Bank
Chairman Senator Chris Coons, Ranking Member, Senator
Lindsey Graham, and distinguished Members of the U.S Senate
Appropriations Subcommittee on State and Foreign Operations, I
appreciate the opportunity to testify about the U.S. response
and policy options for global food security crises.
I have dedicated my professional life to realizing Africa's
potential through development. I have served Africa's most
populous nation as Nigeria's Agriculture Minister, and I am the
President of the African Development Bank Group--Africa's
premier and most trusted development finance institution.
With an active portfolio of $60.35 billion in more than
140,000 locations, the African Development Bank is Africa's
only AAA-rated financial institution.
Our strategic High 5 priorities are to light up and power
Africa, feed Africa, industrialize Africa, integrate Africa, as
well as improve the quality of life for the people of Africa.
Today, I would like to focus on feeding Africa and what the
African Development Bank is doing to address the global food
crisis.
Africa has an estimated 33 million smallholder farms. They
are key to food production and the livelihoods of millions of
more Africans whose work and lives are linked to the
agricultural sector.
Truth is, with America's financing, the African Development
Bank Group's actions to boost harvests from Africa's farms are
achieving impressive results. For example, through our
Technologies for African Agricultural Transformation (TAAT)
program, our support reached 11 million farmers in 28 countries
in little over 2 years. The program is delivering climate-smart
seeds, fertilizers and technical support allowing farmers to
harvest higher yields of wheat, corn, rice and other staples.
African food production has increased by more than 12 million
metric tons.
The economic shocks from the Russian war in Ukraine are
causing all of us to pay more to put food on the table.
The magnitude of food price increases and trade disruptions
caused by the Russian-Ukraine conflict have hit Africa harder
than other developing regions of the world, threatening to
topple the continent's food systems already stressed by the
COVID-19 pandemic.
Africa must prepare for the inevitable global food crisis.
Ukraine exports 40 percent of its wheat and corn to Africa.
According to the United Nations, 15 African counties import
more than half of their wheat, and much of their fertilizers
and oil from Ukraine and Russia. As the Russia-Ukraine conflict
rages, Africa is also dealing with a 30-million metric ton loss
of wheat and corn that won't be coming from Russia.
The cost of bread is now beyond the reach of many Africans.
The Russia-Ukraine conflict is a huge factor in fertilizer
prices hiking upwards of 300 percent. Our analysis is that
Africa faces a fertilizer shortage of 2 million metric tons
this year. We estimate it will cost about $2 billion dollars--
at current market prices--to source new fertilizer to cover the
gap.
If we don't mitigate this shortage rapidly, food production
will decline by at least 20 percent. This horrific `perfect
storm' will see Africa lose more than $11 billion in the value
of food production, according to our analysis.
Without urgent and immediate global action, we may witness
social and political unrest, as we have seen only too often in
the past.
The truth is, that the African Development Bank, with your
support, is prepared to meet this new challenge and others head
on. Let me share what we are doing to help avert a looming food
crisis.
We have developed an Africa Emergency Food Production Plan.
Our $1.5 billion plan will be used to support African countries
to produce food rapidly--produce 38 million metric tons of food
in fact.
The total value of the additional food production is $12
billion. The Africa Emergency Food Production Plan will deliver
climate-resilient agricultural technologies to 20 million
farmers.
The $1.5 billion plan intends to source $1.3 billion of our
own resources. With U.S. support to reduce the $200 million
financing gap--we can ensure the Africa Emergency Food
Production Plan's success.
Distinguished members of the Subcommittee, we are
spearheading efforts for African solutions to Africa's
immediate, medium, and long-term challenges.
The strong support of the U.S. for our Africa Emergency
Food Production Plan will allow Africa to avert a looming food
crisis and use the opportunity to drive structural changes in
agriculture, to unleash the full potential of Africa to become
a breadbasket to the world.
Thank you very much.
Senator Coons. Thank you, Dr. Adesina. Thank you, Ms.
McKenna and Mr. Beasley. My colleague had a quick comment he
wanted to make before.
Senator Graham. Yes, Mr. Chairman, we had a huge bipartisan
vote last night in the House. I am hoping we can pass the
supplemental appropriations bill this week and that there will
be $5 billion in the package to help the problems identified by
our witnesses. Governor Beasley's advocacy has been huge.
But I want to also recognize Senator Blunt. He is the
conference Chairman on the Republican side. He has made this a
top issue for the conference for the last three or four weeks.
He laid the groundwork better than anyone, quite frankly, about
why we need to think about paying now or paying later. Governor
Beasley was at the conference yesterday. So Roy, I just want to
let people know that we would not be here on our side without
you, and I appreciate your leadership.
Senator Blunt. Thank you, Senator.
Senator Coons. As a seasoned senior appropriator and a
widely respected colleague, I look forward to your engagement
both on this Ukraine supplemental and on figuring out a path
forward on COVID internationally, domestically. And I also want
to thank you for your friendship and leadership, Senator Blunt.
We have only got 6 minutes, so I will try and touch on a few
main issues.
Across all three of your testimony, it seems clear this is
one of the worst food crises in the world in decades, certainly
in the lifetime of any of us. I would be interested in how you
think we can best maximize the effectiveness of our response.
You have made references to resiliency, to investing in
smallholder farmers, to bringing to market climate resilient
seeds, to unblocking access to the capabilities of Ukraine.
I would be interested in each of the three of you would
simply talk to, given that we may well have a $5 billion
additional contribution from the United States, if and when we
pass this Ukraine supplemental, how do we make it as flexible,
responsive, and effective as possible? Please. First, Mr.
Beasley.
Mr. Beasley. Senator, thank you. And a limited time. But
first thing is get the money out the door as fast as we can
because we do have a crisis. We are already cutting millions
upon millions of beneficiaries down to 50 percent. Like in
Yemen, 8 million have been cut down to 50 percent. In the Sahel
region, Mali, Burkina Faso, Chad. And those are areas that you
will have destabilization and mass migration. It will be
absolute catastrophic consequences. And so we need to move
fast.
We need to make certain that USAID is encouraged to move
the resources out as quickly as possible, and we have got means
and mechanisms to do that. I think what we are facing right now
is a short term crisis and phenomenon that we do need to talk
about the long term of resilience and sustainability because we
have solutions on that too. But right now the house is burning
down, we have got to make certain that we put the fire out
before the entire world is on fire, and that is where we are.
So, and just by the way, just our operational cost increase
of $71 million more per month because of food price increases,
fuel price increases, as well as shipping costs. And what we
are facing right now in the next 8 to 12 months is a food
pricing problem, which creates access issues for those who
can't afford it, which is critical.
But next year, because of the fertilizer and the droughts,
we could have a food availability problem next year. And so we
have got a lot of work to do, and we have got to move fast. And
I think that is critical to stabilize the countries that we are
concerned are at risk.
Senator Coons. Thank you. Ms. McKenna, resiliency. Future,
long term, what should we be doing? We have to address a
crisis, but what else should we----
Ms. McKenna: Yes. Exactly. It would be a grave mistake if
USAID were to err and put, you know, 95 or most of the money in
the current food--although obviously we need the current
commodities. Based on research that we have done in the Horn of
Africa, we have seen that investments in resilience building
are estimated to save $4.3 billion over a 15 year period. So
that averages to about $287 million per year. And what does
that look like?
That looks like the real long term layering of longer term
assistance and mechanisms while doing the humanitarian
assistance. So humanitarian assistance that helps to build and
support local markets like cash and flexible vouchers, support
to entrepreneurs to do import substitution or other things
needed to kind of keep people in place.
Programs that support youth to help prevent them from being
recruited into conflict. Things that promote governments and
their own fiscal stability to provide safety nets so that
doesn't further impair social cohesion. So we would love to see
more of this long term, comprehensive focus on building
systems, more coordination between those three bureaus around
conflict, more support to conflict prevention actors and social
cohesion, and the fighting of misinformation.
We have got to--food, climate, conflict, they all go
together. It is a circle. So we are really making sure that
USAID is thinking about this comprehensively is critical, and
with a lens particularly on conflict affected countries, is
critical.
Senator Coons. Thank you, Ms. McKenna. Dr. Adesina.
Mr. Adesina. Thank you very much, Senator. Firstly I think,
as Senator Graham was saying in his introductory remarks, if
people can produce food in their backyard, they really have
absolutely no resilience at all. So the first thing to do is to
make sure that people can actually produce the food that they
are actually going to grow for their families without having to
check out a boat and beg for food.
So I think the first thing for building resilience is
support people, smallholder farmers to produce the food, and
decouple from such effects that happen so often. The second is
you have got to also focus a lot on making sure that we can
leverage resources. Fantastic to really hear what the Ranking
Member has said about $5 billion, but that can be leveraged a
lot and I think international multilateral financial
institutions like ourselves can use some of those monies and
actually leverage them significantly.
So leveraging matters, as you actually said, Senator Coons,
in your introductory remarks. I think that whatever we do to
ensure effectiveness and efficiencies, the private sector is
critical. Governments are going to have to play a role, yes, in
terms of support. But we have got to make sure that whatever
support is provided does not undermine the private sector, but
rather promotes and enhances and facilitates the private sector
in input markets, in financial markets, and in logistics and
getting food out to markets.
I think we also have to make sure that targeting is done in
such a way that those who actually need based support for seeds
and fertilizers get it. Most of those are actually women
smallholder farmers. And so targeting that, I would say is very
important, and digital technologies can play a role in that.
And finally, at the end of the day, as you all said in the
beginning, both the Ranking Members, the issue of fragility is
important.
Many of these countries, and my other colleagues have
already said it, in the Sahel, in the Horn of Africa, where we
are having what I call a disaster triangle, that has to do with
very high structural poverty, high levels of unemployment, and
environmental degradation makes these areas so highly
vulnerable. So I think that we should target quite a lot of
support to make sure we can stabilize these particular areas.
Senator Coons. Thank you to all three of you. I agree that
we need to move swiftly. We need to be flexible in how we
deliver this aid, how it partners between the private sector,
multilateral development banks, nonprofit partners, and the
largest agencies and entities like the World Food Program and
USAID. I look forward to hearing more of your testimony.
Senator Graham.
Senator Graham. Thank you. Governor Beasley, the demand for
your product is going through the roof, is that correct?
Mr. Beasley. Yes, sir. In fact, we are 50 percent of the
resources we need. We now, because of all the crises that we
are talking about, from conflict, to climate, to COVID, and now
Ukraine, we are about $10 billion short of what we need.
Senator Graham. Okay, so the $5 billion--we are
appropriators so, you know, I am not much of a farmer, but I
want to help people help themselves. That is the whole point of
this hearing. The $5 billion helps, but it is not enough by
itself.
Mr. Beasley. That is correct.
Senator Graham. Okay. What I want to know is what did the
GCC nations give to causes like this?
Mr. Beasley. This year has not been much compared to what
the United States----
Senator Graham. So every time you go to the gas pump--these
folks are getting rich, they are allies in problem areas, too.
I want the subcommittee not only to fill in the gap that
Governor Beasley has with American taxpayer dollars but I want
us as a group, Mr. Chairman, to call our allies and say you
need to help too. In terms of Europe, how do they do?
Mr. Beasley. Germany has really stepped up compared to
where they were about 7 or 8 years ago. They were $300, $350
million. Now they are at $1.4 billion. I have spoken to the
Bundestag on a number of occasions.
Senator Graham. What about the European Union? It
represents all of Europe.
Mr. Beasley. The European Union, in my opinion, has stepped
up, but it can do more.
Senator Graham. Do you know what they give to us?
Mr. Beasley. To us about $500 or $600 million.
Senator Graham. Now they are the same amount of people as
United States, so we are going to visit these other groups and
we will make an argument to the American taxpayer, we need to
spend this money and spend it now for the reasons you said, but
I promise the American taxpayer, we are going to rattle some
cages.
So to the President of the African Development Bank Group,
you have been very impressive in your presentation. How has
COVID hurt the economy in Africa?
Mr. Adesina. Well, thank you very much, distinguished
Senator. COVID situation has really hurt Africa quite a lot, of
course. Economic growth rates actually declined by roughly 1.5
percent as a result of that, the lockdowns, and you couldn't
get trade going, and all of that. And we had roughly about 26
million people that fell further--into poverty as a result of
the COVID-19 pandemic.
And roughly 30 million people actually lost their jobs. So
the impact is beyond just the amount of disease, of people that
actually died from it. Roughly--so that's the impact. But in
the recovery of Africa from that, it has been rather muted
compared to other parts of the world, we project that our
economies will probably go back about 5.1 percent. But the real
issue is how do we ensure that we don't have a divergence in
the growth rates of the developed countries and the developing
countries such as Africa?
The big issue there is access to vaccines. And as you know,
right now we have only 16 percent of Africa's population is
actually vaccinated, I mean fully vaccinated. And if you look
compared to developed economies, countries in the world,
Australia, it is about 83 percent. If you look at the United
States, well--I mean, you have so high here. If you look at
Europe, well over almost 70 percent.
So the issue is--access to vaccine. A lot of work is being
done, distinguished Senator, in terms of local manufacturing of
vaccines in Africa. That ought to be promoted. But I do think
that we have got to make sure that we prepare not only for this
particular COVID situation, but we build what I call Africa
health care defense system, which will have to be predicated in
three factors, three areas.
One is build Africa's pharmaceutical industry, which is
very critical. We import over 80, 90 percent of pharmaceutical
products in Africa, which is not acceptable. The second thing
is to make sure we build local vaccine manufacturing capacity.
And third one, the most critical, is the issue of health
infrastructure, primary healthcare, secondary healthcare, and
tertiary healthcare, especially also diagnostic infrastructure.
I know that when you came, Senator Graham, to Abidjan and
we had a conversation over dinner, the whole issue was around
infrastructure. And this is one area of infrastructure that we
think is critical, infrastructure for life.
Senator Graham. One of the things I learned on the trip
from the Gates Foundation, there was a single mother, I think,
with four daughters, and where the power lines go, everything
changes. As you build the road and build the power system, you
can get products to market better.
Drought resistant seeds were used by this young woman and
her yields were ten times what they were before because she was
using technology. They moved the cow out of the house into its
own place and it improve the health care environment. They were
able to get some disposable income and didn't have to walk five
or six miles a day to get water.
So, infrastructure really is important to economic
development, particularly on the food side. Ms. McKenna, the
Global Fund has been, I think, a good success of where money
has been matched. Do you see a need for something like that in
the food security space?
Ms. McKenna. Absolutely. Absolutely. Multilateral action is
key. And what is concerning is that we have seen some countries
kind of take away aid from places like--from places like Yemen
or Syria in order to support responses in the Ukraine. And the
answer is more, including private sector and other motivations.
It is not less or moving it around.
Mr. Beasley. Senator, can I add real quick? I pulled out
the 2 numbers on like Saudi Arabia and UAE. Three years ago, we
received from both those countries $658 million, primarily in
Yemen. This year we received $6 million from Saudi Arabia and
$0 from UAE.
Senator Graham. Wow. Thank you. That may change next week.
Mr. Beasley. Thank you, sir.
Senator Coons. Look forward to the persuasive effort.
Senator Durbin.
Senator Durbin. Thanks, Mr. Chairman. And thank you to the
witnesses and all of you here today for this critically
important hearing. I am going to ask you some questions that
may be a little bit different. When we talk about food and
feeding people, most of us think in terms of raw foods,
foodstuffs, and I would like to be more specific. In areas of
famine, I have seen, and this goes back a few years, I don't
know if this is still the case, the use of food supplements
like Plumpy Nut, is that still out there?
Ms. McKenna: Therapeutic.
Senator Durbin. It's a winner, isn't it?
Mr. Beasley. Super coffee nut----
[Technical problems.]
Senator Durbin. And also rehydration therapies. When we
talk about food aid through your agencies and such, does it
include these things?
Mr. Beasley. Yes, sir. In fact, there has been a deliberate
effort and a substantial improvement in not just calories, but
the right calories and nutritional added value products. And
that is one of the things that we are really working together
more strategically than we were years ago.
Senator Durbin. When we hear about the increasing cost of
local food producers, I think of how we might help them
directly, but I also think indirectly. Are there microcredit
programs that are part of your effort so that local farmers can
borrow some money to get through the tough times?
Mr. Beasley. We think this is a very critical part of the
success going forward. Not nearly, nearly enough. One of the
things that Congress has done in the last few years is given us
more flexibility with funding. So we now do $2 billion in cash
based transfers, which puts liquidity into the local economies,
which stimulates the local smallholder farmers.
And we are also now buying internally like for Africa to
stimulate farming operations in that regard as well, as well as
we are bringing obviously tremendous amount of quantity of
commodities from the United States into the countries that are
in great need. But these resilience programs are the long term
success.
The charity is never going to be the final solution, as you
well know. It has got to be--we have got to create an incentive
such as you have water harvesting and all the things that you
create the resilience. Because in many of these countries we
are struggling with right now because of this shock from
Ukraine, if we could go in with the right programs to scale
them up, then they won't have these shocks like we are
experiencing.
And that would be--that will save a lot of money, Senator.
Ms. McKenna: May I add, Senator. In addition to
microcredit, which can be difficult sometimes for agricultural
producers to make the frequent payments it requires, we are
also have looked at things like microinsurance to kind of help
protect against crop failures, the things like risk--different
micro savings products to help them plan better. So
comprehensive financial tools are part of the services that we
offer.
Senator Durbin. We know that COVID----
Mr. Adesina. Sorry. Distinguished Senator, may I come in?
Senator Durbin. Sure. Go ahead.
Mr. Adesina. Thank you. I just wanted to make two quick
points about what you said about the importance of
malnutrition. We should make sure that in the interventions
that we do, it is not just calories that matter, it is actually
nutritious food that is also very important.
So, because at the end of the day, if you have children
that are stunted and they are not getting the right kind of
nutrients, it affects actually the capacity of the brain to
function well. So, you know what I call gray matter
infrastructure, we have got to really build that into this. And
one of the things that we will be supporting through this
emergency food production plan is the whole area of bio
fortified foods.
So what I highlighted, maize, sorghum that is actually
fortified with iron, or beans and things like that that are
also fortified, is very important. Nutrition and
supplementation is important. Now, one thing I just wanted to
say is how important these interventions are. We have a program
that we are doing in the Soqota area, which is in Ethiopia,
which is in the Tigray area.
In fact, as part of war in that area, the number of
percentage of kids that were actually stunted was as high as
50, 60 percent. We brought it down to about 38 percent in a
very short period of time. So these focused production things
that are targeted with high nutrient foods does make a
difference very quickly. And on the point of the microcredit
that you said, I think at the end of the day it comes back to
what Senator Coons was saying.
We have got to make sure that $5 billion that we are
talking about here is used to also leverage financial
institutions. Banks don't lend to agriculture in most cases
because of high perceived risk, but when I was Minister of
Agriculture, I got the banks in Nigeria to actually lend to
agriculture, put together a $350 million risk guarantee
facility for them if they lost their money.
And we ran it. We leveraged over $3.5 billion from the
banks into agriculture. And non-performing loans, less than 1
percent. So which means that the passive risk is excessively
high. And so we at the bank, as part of our intervention, are
looking into how we are going to use risk mitigating factors
and risk guarantees to leverage the capital of the balance
sheet of those banks, going to seek companies, fertilizer
companies, logistics, and all of those factors in the
agricultural value chain. This is very, very important.
Senator Durbin. Thank you, sir. I want to ask one last
question, if I can, and it relates to COVID-19. We all know the
death toll in the United States has reached a million, maybe 6
million worldwide. The U.S. has developed very effective
vaccines, but we have struggled to supply them to the rest of
the world.
Now we have a greater challenge in poor countries than just
providing vaccine. We have weak health infrastructures in those
countries, vaccine hesitancy, and other competing basic health
demands. A member of my staff went to West Africa, and I asked
he specifically to look at COVID-19 vaccine supplies. He
reported a surplus of vaccines, but not enough demand. There is
a hesitancy involved in it.
There is a lack of infrastructure to deliver it, and that
has to be part of our conversation. So it isn't just the value
of the vaccine, its taking with it the means of delivery. Can
anyone on the panel comment on that aspect?
Mr. Beasley. Senator, when most of the airline industry
shut down during the height of COVID, the World Food Program
stepped up and began delivering COVID supplies, from PPE,
testing equipment, ventilators, the whole nine yards in 183
countries. So someone said that we were actually the world's
largest operating airline at one time.
That is something that you aren't really proud of, but when
the airline industry shut down, we had to do what we needed to
do. When it came to vaccines, we were and are prepared to step
up and deliver and take advantage of our logistics supply
chain, because we were really very good at it.
But we have really not been asked to do that much in the
supply chain of vaccines. We have been--we have had a very
little role in that.
Ms. McKenna: I would like to echo that. NGO partners like
Mercy Corps and our peers, we are your last mile partners. We
are in these deep communities that are difficult to reach with
deep, long standing relationships. And we reached out several
times kind of trying to get people to work with us to support
that last mile delivery and it just was not something that was
taken up in a huge way.
Mr. Adesina. For Africa, from a--distinguished Senator, the
issue with the vaccine hesitancy that you mentioned, yes, there
is some truth to that, but I will not say that there are
surplus of vaccines in Africa. In fact, what happens is that
there is not enough supply. We have--even well what was
supposed to be delivered to Africa wasn't really delivered. It
came late. Some of them were actually expired vaccines, so they
couldn't really be--doses couldn't be applied.
You have a situation in which as developed countries
actually have, double doses, triple doses or booster shots,
Africa was just basically still struggling to have basic shots.
So I do think that it is not necessarily correct to think that
there is a surplus of vaccines in Africa. There is not a
surplus of vaccines in Africa.
There are structural issues that we must deal with in terms
of making sure that we have the capacity to produce those
vaccines in Africa, and also issues that have to do with
intellectual property rights that can make sure those vaccines
and antigens and things like that, that are needed are actually
available through R&D systems in local pharmaceutical and
vaccine manufacturing industry.
So in Africa right now, a lot has been done in terms of
Johnson & Johnson in South Africa and many other places to set
up vaccines manufacturing. And when they are setting up those
vaccine manufacturing is because there is demand, but they are
trying to deal with the problem of structural bottlenecks that
have made it difficult for Africa to actually access the
vaccines in the quantity, at the cost, and at the timing that
is needed.
Senator Graham. Thank you. We have votes, and I am going to
go vote and we will do the best we can.
Senator Blunt. All right. That means I am in charge until
you get back?
Senator Graham. Means you are in charge--maybe----
[Laughter.]
Senator Blunt. I have got lots of time then. Well, thanks
to all three of you for being here. Ten years or so ago, when I
started talking about the demographic impact on food, which is
highly predictable, and the double in the world food need in a
relatively short period of time--and I was talking to somebody
who runs one of our big agricultural companies, and I said, how
do we--can we do this?
And his answer is, yes, we can do it, but we can't do it
without science, and we can't do it without Africa. That that
incredible population growth in Africa, that what all three of
you are saying, the importance of Africa producing more of its
own food and us helping figure out how to do that is critical.
I do think at this moment, this immediate $5 billion, frankly,
is going to go pretty fast, and go fast to meet the crisis
need.
I as--Governor, you said you bought a lot of--Governor
Beasley you buy a lot of food from Ukraine. What happens as the
Russians move across Southern Ukraine, they have almost
destroyed Mariupol, if not--and probably the port at Mariupol,
I don't know. But they are now focusing on Odessa.
What happens, one, to the rest of the world if those ports
are not operational for some period of time? And then two, what
do you think happens to Ukraine and the food they maybe would
be able to still continue to grow if those ports aren't
available to them or to anybody else, perhaps?
Mr. Beasley. I guess you could actually say goodbye to
Ukraine if you don't get those ports open because the economy
collapses. 40 more percent of their GDP is based upon
agricultural products that are exported through those ports, so
it is critical. And then you talk about the impact that it will
have on global food security, famines around the world, the
pricing that we already see is spiking.
And so over the next 8 to 12 months, you will be--you will
see continued pricing spikes. And here is what is very
frightening. When you look at the Arab Spring in 2011, 2012,
the economic indicators is now are worse than they were in Arab
Spring, because we see food pricing and what it leads to, from
migration to riots to protests to destabilization. Just in the
past few weeks, you have seen Sri Lanka, Indonesia, Pakistan,
Peru.
In the last few months you saw Chad, of course, and Burkina
Faso, and Mali. And so it will only get worse in these places
if food prices continue to spike, and they will, because you
don't have the availability of $400 million--400 million--
Ukraine feeds 400 million people with the food. So if that is
out of the equation, where is that going to come from? You
can't make that up that fast.
So it creates tremendous market volatility, and then you
compound that with the fertilizer problem, and like Ethiopia
and Sudan, 85 percent of their fertilizer comes from Russia and
Belarus. And they are already in very, very fragile state. That
is just two, and I can go from country----
Senator Blunt. But without those ports, could Ukraine even
if it could grow the food, how would the--how would they get
the food--how would you get the food out of Ukraine?
Mr. Beasley. You can't. You can't get enough food out. To
try to truck it out--for example, when an average day at the
ports is 3,000, give or take, train carloads per day, and the
average train carload is 3 to 4 trucks. So do the math.
That would be at least 10,000 trucks per day. And it is not
a one day trip. It is several days. So you could talk about 4
to 5 days' worth of trucking operations, 50,000 trucks. What we
have, and sitting down with the Ukrainian government, a best
case scenario is you could truck and train out about 1 million
metric tons a month.
Now, the problem with that, and that is not much compared
to how much they produce, it is a drop in the bucket. But the
problem with that is pricing spikes with that, because the cost
of transportation will move it up to $120 more per ton, which
prices it out of the market.
Senator Blunt. Right, right. Let me ask one more question
here. You said, and I think Ms. McKenna has also said, we need
to move fast. What can we do to speed up our efforts through
you, through USAID? Are there elements--are there tools we can
better use to get this done quicker? And I want to go next to
Ms. McKenna and ask her if the NGOs have the capacity to do
more, if we will work in a better way. But, David, you want to
answer that?
Senator Blunt. Yes, I do. I think there are several things.
I think first and foremost, I think encouragement to USAID from
the Senate in the House to move these funds quickly. I think
they are in a lot of pressure.
You have got lawyers and all the bureaucracy, and I think
as much encouragement as we can do down to USAID, that would be
very important. Number two, in the past, we have mechanisms
that we can put in place--that we have in place ready to move
quickly. Funds, I mean, cash based transfers, we can move just
like that.
IRA accounts and major tranches for regional areas of the
world. We can move these funds very quickly, so we have the
capacity to handle such. And then we can move funds with our
partners as quickly as possible. But I think it is going to
take a lot of encouragement down the street.
Senator Blunt. Ms. McKenna.
Ms. McKenna: Yes. Thank you for that question. We would
encourage USAID to really work with NGOs to move that quickly,
obviously, but also really leveraging NGOs and leveraging
existing relationships they have to do things like creating
cash consortiums that can be used in multiple markets around
the world like Yemen or Syria to kind of support local markets
while also supporting food production and other things. So we
saw them able to do that a bit with COVID, being able to top up
existing awards to support that, and we would encourage them to
look at that again.
Senator Blunt. Well, thank you. And I have a whole lot of
other questions if the Chairman hadn't returned, but he is back
and----
Senator Coons. Please feel free to ask----
Senator Blunt. No, go right ahead, Chairman.
Senator Coons. We have no other members currently. And I
know two are on their way back.
Senator Blunt. Well, from the African Bank point of view,
what are we--again, the key points to, one, get food out
quickly, and two, to encourage more production.
Mr. Adesina. Thank you very much, Senator. And so back to
your point, you were saying earlier on, it was an excellent
point, on the importance of R&D science models. And I just want
to make two examples of that.
One is, in Africa today, we have actually supported what is
called the water efficient maize for Africa, which is a very,
very drought tolerant maize variety. Interestingly, I was at
that time an associate director of the Rockefeller Foundation,
and I was based in Zimbabwe, where we actually supported the
global setup for wheat and maize cement based in Mexico to
develop those varieties.
And those varieties worked. When we had drought in East and
Southern Africa in 2018, 2019, the African Development Bank,
through this program that I mentioned to you, called
Technologies for African Agricultural Transformation, we
actually got those water efficient maize varieties out to 5.2
million households, and that is why we were able to avoid a
food crisis that there.
The second one is about wheat. As we all know, wheat is a
temperate crop, but with technology right now, we actually have
heat tolerant wheat varieties. And the African Development Bank
was able to provide, and Beasley was talking about the case of
Sudan and also Ethiopia. We provided for Ethiopia--I mean
Sudan, 65,000 metric tons of certified seed of these heat
tolerant varieties and that is about the equivalent of if one
takes an Airbus A380 in terms of passenger cargo and we have a
90 metric tons or 98.2 or so metric tons.
So you are talking about almost 665 A380 Airbus of seed
provided for them. And that allowed them to reduce that import
of wheat, most of you, of course, you know, coming from Russia
and all of those places, by 50 percent.
We did the same also in Ethiopia, where today they were
closing in 2018 to 5,000 hectares of heat tolerant varieties.
They have gone to 400,000 hectares of that today. So technology
actually does matter. And in terms of, you know, the issue of
getting things out, I think just to add to what Tjada was
saying and also to David, is I think that we should get into
what is working on the ground.
To come back to what Senator Graham was saying, produce
food in your backyard. You know, and we have part which
actually brings together the global R&D centers, the national
centers, the regional centers, the private R&D centers, to
actually get technologies to move agricultural value chains all
across Africa.
So put the money where it is working on the ground. The
plan that we have put forward here, distinguished Senators, is
not one we developed in our offices. It is one that is actually
developed from the countries, over 44 countries where we have
been impacting them in terms of access to climate resilient
technologies.
So one of the things we can do with this money, given also
that the Administration, U.S. Administration is big on climate,
as much as we are big on climate, is to make sure that the
money is used for food, but also wins on climate. So we can win
on food, but we also have to win on climate, and R&D is the
best way. And we have--the best way of getting these
technologies out, I would say, is the mobile phones.
We can register, we have to register farmers biometrically,
give them access to technologies, and give them via their
mobile phones, and send them money by mobile phones, that way
we make sure there is inclusiveness, in particular that women
have to be carried along.
I continue to say that because you have to make sure that
women participate and benefit from this because they are the
majority. I have done this when I was Minister of Agriculture
in Nigeria. We got all the farmers registered on mobile phones.
We put them on a digital databases.
I was sending money by vouchers on their on their on their
mobile phones. And I remember walking into one perimeter one
day. The farmer told me, the woman from out there said, well,
thank you, Minister. Now we get seeds and fertilizers in our
villages, and the men cannot cheat us anymore. We have got to
bring transparency and accountability and inclusiveness to the
way in which these phones are deployed for impact.
Senator Blunt. Thank you. Thank you, Chairman.
Senator Coons. Thank you, Senator Blunt. And thank you to
my colleagues who have come to join this compelling hearing. I
believe we will move next to Senator Murphy, then to Senator
Moran, then to Senator Van Hollen, then to Senator Boozman. I
am basing that on the order of when they were here before. We
have another panel following this on COVID, which will be
equally compelling. Senator Murphy.
Senator Murphy. Thank you very much, Mr. Chairman. Thank
you all for being here and for your fantastic work. I just
wanted to have you all take a few minutes to delve a little bit
deeper into the crisis in Afghanistan. This started as one of
the world's poorest countries, and it has descended into what
is really now the world's worst humanitarian crisis.
And I would like you all to give us a little bit of advice
as to how we best unlock the significant amount of money that
the United States currently has in its possession and at its
disposal to try to address this crisis. In February, President
Biden authorized $3.5 billion, that is about half of
Afghanistan's frozen assets to be used, ``for the benefit of
the Afghan people.''
But 3 months later, we have not yet figured out what that
international financing mechanism is. It still hasn't been set
up. And so what advice would you give the Administration? What
advice would you suggest we give the Administration as to how
to push that $3.5 billion? Because it cannot be that we can't
both save lives while also not unjustly enrich the Taliban.
There is a mechanism by which to get this money as directly
connected to the Afghan people as possible. So, I am
certainly--I will start with you, Mr. Beasley, but I would love
comments from all three of our panelists.
Mr. Beasley. Yes, Senator Murphy. I mean, this is one of
the things we have been talking about from the beginning,
because of the lack of funds that we have globally and then in
Afghanistan hit. We were already--right before Afghanistan, we
were talking about the crises that we are facing around the
world. And Afghanistan hit, a nation of over 40 million people,
23 million people are in IPC 3, 4, 5.
I mean, that is just unheard of 8, give or take, 7 million
are knocking on famine's door. So we were like, look, we don't
have enough money. So what we did with the World Bank because
the World Bank couldn't give it to the Taliban, and so we
actually sat down with the Taliban, said, look, no one is going
to give you money. Let it go directly to us without your
fingerprints being on it.
And they, I would say, consented, but didn't matter. But it
worked out with--money came directly to us. Same thing on these
frozen assets. I don't think there is any question whether it
is us or UNICEF and others, that we can work with teachers,
health care providers, and of course, is working with
beneficiaries throughout the country is not difficult to do. We
are reaching about 40 million people right now.
But because of the lack of funding, we are having to cut
back, cut back, cut back and at least try to reach those
knocking on famine's door. But we have got to unleash those
funds, whatever it takes, because otherwise you either got
appropriated more dollars, and if you don't, you will have
famine, you will have destabilization, which means you have
more migration coming out of Afghanistan and you are going to
have an extraordinary amount of recruitment by extremist groups
for terrorist training activities.
Senator Murphy. Ms. McKenna.
Ms. McKenna: Afghanistan is actually our largest--our
longest continuous country presence. We have been operating in
Afghanistan since the 1980s through multiple Administrations.
The Government needs to figure out a mechanism to program that
money to partners like us who are in those communities.
That economy has collapsed. We have seen news accounts of
families selling off young children, young girls for dowry
money because there is just no money coming in. Opium
production is through the roof. We need to be able to start--we
need to that to help starved--save people from starvation.
Senator Murphy. But money coming directly to your
programmings does not enrich the Taliban, in any way, shape or
form?
Ms. McKenna: No, and we have been working with Treasury to
create different rules and such that we can program those
funds.
Senator Murphy. Dr. Adesina.
Mr. Adesina. I will have to take a pass because my mandate
doesn't cover Afghanistan.
[Laughter.]
Senator Murphy. All right. Thank you all. This is long
overdue. In a world in which we are starved for resources, here
lies for the time being, $3.5 billion that is ready to go. And
you have pointed out that the programmings you are running on
the ground right now directly benefits the Afghan people
without unjustly profiting the Taliban.
You are not alone in that club. There are plenty of
mechanisms that will allow us to do both, save lives and make
sure that this money doesn't end up in the hands of the wrong
people. And so my hope is that this Committee can work with the
Administration to expedite a mechanism to get that money
released. Thank you, Mr. Chairman.
Senator Coons. Thank you, Senator Murphy. Senator Moran.
Senator Moran. Chairman Coons, thank you. Thank you to our
witnesses who care so much about this topic. I guess Ambassador
Beasley, Secretary--or Governor Beasley, Yemen. You talked
about Afghanistan. A lot of unsavory individuals who control
most of the populous parts of Yemen. How has the cooperation
been with the Houthis, and what worries you with those
countries going forward?
Mr. Beasley. Senator, I have had some very frank
conversations with the Houthis. I was just there a month and a
half ago meeting with the Houthi leadership. And I know you
probably recall back when I was pretty tough on the coalition
about the blockade in Hudaydah and really was--in fact, 60
Minutes did a story then that helped break up the issue of the
blockade in Hudaydah because we couldn't get food supplies in.
And that is a country that relies on 90 percent--85, 90
percent of all its food comes from the outside. And so when I
was pretty hard on the coalition and that broke apart in terms
of allowing the blockade to be set aside and food came in. The
Houthis were just so excited and patted me on the back, thank
you, thank you, you are our friend.
And I said, look, I am not doing this because I am on your
side. I am doing this because it is the right thing to do. And
I said, and if you cross that line, too--I probably should say
what I said to them here. But anyway, the bottom line, I said,
I am going to kick your rear end. You know that kind of thing.
And they kind of laughed about it.
Well, a couple of years later, we had some serious issues
with regards to many of our provisions in place to move food
out there and neutral impartiality to reach the beneficiaries
with independence. We had significant issues. So I went and sat
down with them and said, let me be very clear.
We don't have enough money right now to feed everybody in
the world. And our donors want to make sure that every dollar
go--is maximized to reach the most people possible. And so when
what you are doing in diverting our aid and creating all these
unnecessary obstacles, there is no way that we can get the
funding we need to help the people in Yemen. And we want to be
able to do it in a neutral, impartial, independent way.
I actually made the decision to cut off all food supplies
for about a million people for about a month. It was a hard
decision, but with diversion taking place--otherwise I would be
participating in diverting food from innocent children over
here to help--you know, and this is what we are facing today.
We are having to take the lack of money, food from hungry
children to give to starving children. That is horrible. So it
was quite remarkable. Houthis didn't think there was anyone in
the United Nations, I think, that would actually do that. We
made that hard decision, and they were at the table within a
few weeks, and we resolved it.
And things have moved incredibly better since then. That
doesn't mean it is all perfect. Anytime you are dealing these
types of places is tough. But the cooperation has been--has
remarkably improved inside Yemen. But there is still a lot of
issues there.
Senator Moran. Is there attention being paid to this, and
this is--perhaps it is to you again, Governor, the attention
being paid to the countries that are enacting protectionist
policies to keep the food they grow within their country? And
is there something that you, the United States of America, the
United Nations, needs to be doing to encourage--it drives up
the cost and makes it more difficult for us to meet the needs
of hungry people elsewhere.
Mr. Beasley. We faced this in COVID in a remarkable way. A
lot of ministers of different governments of economies and
trade were doing lockdown, shutdowns, border controls,
limitations on imports, exports, and it was creating havoc.
So I was on the phone, particularly those first 6 months,
and my teams were on the phone saying, let me explain to you
what is going to happen, you shut down this port right now or
you put this limitation at this stage, and here is what is
going to happen in the next three, 6 months. And so we were
able to really avert a lot of the complications from those
types of restrictions.
Now we are seeing that bubbling again. And I think not just
us, but everywhere we see it, we try to make a phone call.
Explain, please don't do this, here is what is going to happen.
Talking to the secretary general and others in the United
Nations, as well as talking to our friends like in the United
States to say, please call this particular government leader to
minimize these types of issues. And so that is one of the----
Senator Moran. Actions are being taken.
Mr. Beasley. Actions are being taken. But you have got to
be on top of it literally every day.
Senator Moran. Let me quickly, in the last minute or so,
raise the topic of ready to use therapeutic food, RUTF. Two
countries, I think South Sudan and Ethiopia, have already
requested RUTF through the Bill Emerson Humanitarian Trust. Do
you support including funding for RUTF via the Bill Emerson
Trust, the emergency supplemental package, or annual
appropriations to ensure that this lifesaving product gets into
the hands of those who need it most?
Mr. Beasley. Yes, sir. The Emerson Trust is a godsend right
now with the crises that we are facing. If you don't use it
now, I don't know when you would use it. And so we are 100
percent supportive.
Senator Moran. Thank you. Mrs. McKenna, anything to add
or----?
Ms. McKenna: No, nothing to add.
Senator Moran. Thank you, Chairman.
Senator Coons. Thank you, Senator Moran. Senator Van
Hollen.
Senator Van Hollen. Thank you, Mr. Chairman. Thank you to
all of our witnesses. Mr. Beasley, it is good to see you today.
We were together yesterday morning talking about some of these
issues. And thank you for all your passion and the experience
you bring to these critical matters. Yesterday, I was able to
bring you the preliminary good news that we were on the verge
of passing the $40 billion assistance package, including $5
billion for food security assistance.
And I do want to thank the Chairman of our subcommittee for
all his work on making that happen. I am confident that--I am
increasingly confident we will have bipartisan support here. I
want to get to how the $5 billion will help the emergency food
situation around the world. But before that, I have a question
about Odessa and the Russian ports.
And I know it was covered a little bit already, but if you
could dig down more deeply on what will happen to food
insecurity around the world if we don't unblock those ports--
there is some people saying, well, we can use the land routes
and obviously we want to do our best.
But Mr. Beasley, tell us what will happen if that? I think
it is over 30 million tons of wheat is stuck in those Ukrainian
ports. What does that mean for world hunger?
Mr. Beasley. Ukraine normally ships about 60 million metric
tons through those ports on an annualized basis. That is about
3,000 train carloads per day. You can't truck enough out. You
can't do it. You might can truck out about a million metric
tons a month on a good day at best. And even then, you are
talking about $120 more per metric ton. So it puts it out of
the market in terms of pricing.
And so the ports have got to open. Ukraine grows enough
food to feed 400 million people. It is not just availability of
food price--food, it is also food pricing. That is going to do
more harm to the poorest of the poor around the world who
barely can afford it now. As I was saying earlier, we have gone
from 80 million people marching to starvation to 276 right
before Ukraine.
And now that number is going to go up an additional 50
million. So, number one, the Ukraine economy, 40--over 40
percent is export, over 40 percent is agricultural exports. So
it will have catastrophic consequences if another shot is not
fired in the war and the ports are just blocked. I don't know
how--I mean, I am not the economist here. I am just a
humanitarian. But I don't know how you don't have economic
collapse.
Then you have the impact--inside Ukraine--then you have the
agricultural impact on food supplies, particularly in Eastern
Africa, Western Africa, the Sahel, countries that depend on
this grain from this region. For example, Egypt, 80, 85 percent
dependency, Lebanon 80 percent.
Twenty-six countries depend upon Ukraine, over 50--Ukraine,
Russia over 50 percent. And we buy over 50 percent from Ukraine
itself. We assist about 125 million people on any given day,
week, or month. So it is already having a $71 million increase
of operational cost per month on our operations, which means we
will feed 4 million people less as we--right now----
Senator Van Hollen. Yes. No, I appreciate you going into
that. So what I wanted to paint a clear picture of what the
consequences here. I think the world, at least outside of
Russia, knows that Putin is killing people indiscriminately in
Ukraine. But countries around the world need to recognize that
what he is doing in Ukraine and the blocking the ports are
going to result in starvation and food insecurity for tens of
millions of people around the world. Do you know of any ongoing
efforts to address this issue? And I don't mean those of us who
are calling for something to happen. I mean any material
progress in this.
Mr. Beasley. Senator. I know, as you know, I have made
requests straight to President Putin that the world's famines
are in your hands right now and you need to open up these
ports. I do believe there are efforts being made as we sit to
try to create an opportunity to open up the ports.
And it cannot--it can't just be an open of the ports for
humanitarian purposes, because the commercial side is just as
equally on a humanitarian basis. And we cannot use--food can't
be weaponized. It just cannot. And right now, if those ports
stay closed, food would be weaponized.
Senator Van Hollen. Let me in my remaining time here, first
associate myself with the comments of Senator Murphy with
respect to Afghanistan and the situation there. I think, as he
indicated, we can find a way to help people without in any way
strengthening or reinforcing the Taliban government. Thank you
for the efforts you made in Yemen. That remains a really
terrible situation, but your efforts improved it.
And in my final seconds here, maybe if I could just get a
sense of the $5 billion. Maybe, Ms. McKenna, you could tell me,
what will that mean for your efforts around the world, if we
are able to get the $5 billion for food assistance?
Mr. Beasley. The $5 billion, a chunk of it obviously will
go to emergency food relief, and we expect that through our
colleagues at the World Food Program. But what is really
important is that we have a chunk of it that really goes
towards long term resilience and building long term systems so
that these economies can support themselves and that they can
further withstand the shocks that are to come with climate
change, drought, and conflicts.
That is things like supporting farmers long term, like
using cash and vouchers and things to support local markets,
incorporating youth into activities, and really working with
conflict actors. May I add one other point kind of based on
your prior question? Russia is using hunger as a weapon of war,
and Congress is on record kind of condemning the use of hunger
as a weapon of war through the recently introduced House
Resolution 922. And we hope that the Senate will take up a
companion version of that as well.
Senator Van Hollen. Thank you. We will look into that.
Mr. Adesina. Can I comment--Senator Hollen?
Senator Van Hollen. Oh, yes, I was going to ahead, but let
me----
Ms. McKenna: Yes, Akin--
Mr. Adesina. Yes. Right here. On the video, yes. Well, just
on that point, distinguished Senator, on the, what will this
mean? In the case of Africa, I think we need to refocus on what
the problems are. You know, for Africa right now, it is not
just giving food away, it is actually producing food because we
are dealing with a very massive food price inflation at the
market level to bring that down. It has to be something that is
structural, that is scalable, and that is sustainable.
And that is why we have the African Emergency Food
Production plan to actually produce that food. And that is
going to, with the $5 billion, you know, we have put in $1.3
billion of our own money on the line. We have put in our money
where our mouths are, you know, and we need $200 million to be
able to come up to $1.5 billion that we want to be able to help
Africa to avoid a looming food crisis.
What this will do, the $1.5 billion, if we are able to get
$200 million from the U.S. Government to complement $1.3
billion that we are putting down ourselves, it will allow us to
get climate resilient agriculture technologies to 20 million
farmers in Africa. It will allow them to produce 38 million
metric tons of food. And a big part of that will be 11 million
metric tons of that will be wheat. I just mentioned my
experience in Sudan and also in Ethiopia.
We will have 18 million metric tons of corn and we are
looking at 6 million metric tons of soybean--rice and 2.5
million metric tons of soybeans. So it will make a lot of
impact, but we need to also use this crisis to deal with the
structural issues to unlock agriculture potentially in Africa.
And from the African Development Bank, we have a program
that we are also going to see as a relay basically from this
emergency production program, that we are calling 1 for 200
mission, 1 for 200, which is to allow support of African
countries to produce an additional 100 million metric tons of
food that will feed 200 million people.
If we are able to feed 200 million people, that means that
we can actually cut hunger in Africa by 80 percent. I have been
in agriculture all my life. I have never been this confident
that we can actually reach zero hunger, but it will have to be
done via a structural approach, not just only giving food away.
Senator Van Hollen. Thank you. Thank you for emphasizing
that. Thank you, Mr. Chairman.
Senator Coons. And thank you, Senator Van Hollen. Senator
Boozman, for the last questioner of this round. We do still
have three great witnesses for a second panel and about half an
hour left.
Senator Boozman. Thank you. And I will be brief, because I
know we need to move on. We appreciate all of you being here
and we appreciate the great work that you do. Governor Beasley,
congratulations on your Nobel Prize, you and your agency.
That is remarkable. And we are very, very proud of you.
U.S. is a very generous country, and it has really stepped up
in the past. It is stepping up now. Tell us about that. Tell us
about what that means. And then also, how does that help you
when you are dealing with other countries to pony up the way
that they should?
Mr. Beasley. When I arrived, the United States was
appropriating about $1.8 to $1.9 billion. And if you--we had
many of us in this room had a conversation out of concern that
this new Republican Administration would, Trump would zero out
the budget and we would have significant funding problems. And
all of us came together.
It was quite remarkable to see everybody come together--and
actually on both ends of Pennsylvania Avenue on this particular
issue. And so our funding went from $1.8 billion to $3.84
billion. And like I was saying earlier, my goal was put the
World Food Program out of business and funding would go down,
but because of crisis after crisis, war after war, climate
shock, and now Ukraine, Afghanistan, Ethiopia, the needs are
going up substantially. So the United States has led the way
and I have been able to use that.
When I go to Germany, the colleagues in the Bundestag or in
the UK Parliament or the Nordic countries, the EU, and say,
look, the United States is stepping up because usually the
first line of impact is in Europe. And now, Central America's
first line of impact is the United States.
But because of what the United States has done and Germany
and a few other major donors, we, particularly during COVID,
because not many people realize the economic ripple effect that
COVID had on the poorest--on the poor countries around the
world. Had it not been for the United States, the taxpayers of
this country, we would have had mass famine, we would have had
destabilization of many nations, and we would have had mass
migration.
We were able to avert that in the last couple of years
because of the generosity of the American taxpayer, along with
Germany and other donors. So here we are again, unfortunately,
because of COVID recycled--and now in Ukraine, we have got a
crisis within a crisis, that perfect storm.
And so this appropriation right now, as I am sure--I get
some of my friends of South Carolina, why should I send money
down there, you know, and I am like, well, if you don't it is
going to cost you a thousand times more.
I don't say that hypothetically, theoretically. I have
experiential data that proves very clearly when we have
strategic international aid and food security, it saves
taxpayers anywhere from $100 to $1,000 more, a thousand times
more. So thank you, sir.
Senator Boozman. So, no, and again, we have got all of this
going on the--I am very active in agriculture right now. The
increase in fertilizer costs, the input costs are just through
the roof. Part of that being, you know, fertilizer from Belarus
and Russia and, you know, areas. And other countries seeing
this are actually holding their fertilizer. So you have got the
input cost problem.
You have got the high cost of diesel. So as you mentioned
earlier, we are going to have, you know, tremendous commodity
increases, so these countries aren't going to be able to buy as
much. And then the other problem is, you know, Senator Van
Hollen mentioned the importance of opening the ports and all
that.
You know, even if that is done, high commodity prices,
high--because of the high inputs. And then--what I would like
for you to talk about is the potential. Even if we do, ports,
do all we can, are we looking at shortages? How do we plan--
what do you need for us to do? And it is not--you know, with
shortages it is not money.
You know, what do we do to coordinate, to make it such that
we are proactive and see this coming and people like you help
us plan as we go into the future?
Mr. Beasley. Senator, before Ukraine, I was already
declaring to the world we were facing the worst humanitarian
crisis for the year 2022 that we have ever seen since World War
II. And just when you think it couldn't get any worse, then
Ukraine, the breadbasket of the world, a nation that feeds 400
million people.
And so you are seeing fuel costs, shipping costs just
escalate beyond the roof. Food price, you know, commodity was
already doubling and tripling in many, many of the poorest of
the poor countries. And so it was already a problem. Then
Ukraine comes into the scene. So what is critical is to get
those ports operational for a variety of reasons. It will not
eliminate the problems.
It will at least diminish some of the excesses of the
problems we are going to face, because right now, when you look
at the droughts taking place around the world, even in the
United States, and then you get the Horn of Africa and other
places in Central Asia, for example, you are talking about a
dynamic impact on food production. Compound that with the
fertilizer problem.
Countries are not able to get the fertilizers, or the cost
is so high they can't afford it, so smallholder farmers can't
afford it. Now, we are already hearing farmers say they can't
afford the fertilizers. They will be cutting back on
production. And this is not the time we need that. So when--I
have talked with the, about four weeks ago, the minister--
foreign affairs minister for France who called me and when I
went through this scenario, what we were looking at, he
literally was just shocked.
And we brought, got together the G-7 agriculture ministers,
Tom Vilsack and all of us had a very practical conversation.
And I said, let me tell you what we are facing. The question to
me, to you is how quickly can you react in the major producing
countries to offset not just Ukraine, but the crises that we
are facing around the world, from the lands that have been set
aside to fertilizers.
And which has been interesting because like the Green Party
in Europe and in Germany have been very open and pragmatic at
this stage, which is, it is good to see everybody coming
together to understand that we truly have a global crisis
coming before us.
And so the next 8 to 12 months, we will have a food pricing
problem. And I think in the spring--well, I will say the spring
and the fall of next year, we could have a food availability
problem.
Senator Boozman. Very good. Thank you. Thank you, to all of
the witness. Appreciate it.
Mr. Adesina. Senator Boozman, can I make a point on the
fertilizer question?
Senator Boozman. Yes.
Mr. Adesina. Thank you. Just on that fertilizer question,
as I said in my remarks at the start that Africa faces 2
million metric tons of shortage. And if we don't actually very
quickly to close that, it means that even productivity on
existing arable land will decline by anything between 20
percent to 50 percent. Just to let you know, concrete actions
are actually being taken on that.
I called for a meeting of all the global CEOs of fertilizer
companies that meeting is actually tomorrow, you know, to
really look into how is it that we make sure that Africa is not
shortchanged this time around, and we know what happened with
regard to the COVID-19 issue with vaccines. We want to make
sure that Africa's priorities are not at the end, that all the
rich countries of the world take all the fertilizer, and then,
of course, then we have a problem.
So ammonia phosphate are the main issues so we are trying
to see how we can actually deal with some of this issue. Now,
the point on the price, I think of fertilizer. I am right here
in Ghana. I am not based in Ghana, but just came here to see
the President as we are preparing for the annual meetings of
the African Development Bank that is holding here in Accra. But
I was surprised at the price of fertilizers here, you know.
You know the price of fertilizer has gone up about GH cents
65 Ghanian cedis of about 25 Kg bag, you know, to roughly on
the open market, part of the market almost GH cents 220. You
can imagine what this will do. So it is a big issue. If we
don't solve the fertilizer problem, we cannot solve the food
problem. And one of the things I want to suggest to the
distinguished Members of the Senate Committee is that the issue
of trade finance is going to play a very, very important role.
And secondly, guaranteed facilities are going to be very
important to make sure that financial institutions can actually
lend to the fertilizer importers and wholesalers and the
retailers to actually get it out to the end. And in particular
also, maybe I will link it back to the original point, at least
by one of the Senators on efficiency of the use of the $5
billion, you have got to make sure also that we deal with
delivery risks, because if we look at the price of fertilizers
as high as it is, that is not that we are going to have to
subsidize.
But if we have to subsidize, we have to then make sure that
the subsidies are done in a way that are market friendly, in a
way that is well-targeted, in a way that actually uses digital
technologies to redefine the standard. And in fact, I actually
don't so much even like the word subsidy. I like to call it the
growth enhancement support.
Which is we give people what they need to boost their
production and very quickly transition that to a more market
based system. So these, I think, are very important if we are
going to actually have to deal with this. But this fertilizer
question is very important, and we actually have a global
meeting on that tomorrow.
Senator Boozman. Right. Thank you very much. Thank you, Mr.
Chairman.
Senator Coons. Thank you, Senator Boozman. Thank you, Dr.
Adesina. I remember well our visit in Abidjan, and I appreciate
your insightful testimony today. Ms. McKenna, thank you, and
thank you for everything Mercy Corps does around the world. And
I thank David Beasley in the World Food Program. We are now
going to quickly transition to the second panel. We are
awaiting notification of when the next vote will be. A number
of the Members of the Committee are holding, waiting for that
next vote, but I think we should proceed with this second
panel.
I want to thank the witnesses for a second panel today that
will focus on the COVID-19 pandemic, and in particular, its
global impacts and what investments the United States should be
making to address the current status and future risks
associated with this and other potential pandemics.
We have three of remarkable witnesses, physicians with
extensive experience in responding to infectious disease
outbreaks, Dr. Tom Frieden, former Director of the U.S. Centers
for Disease Control and Prevention, and currently serves as
President of Resolve to Save Lives. Dr. Atul Gawande is the
Assistant Administrator for Global Health at the U.S. Agency
for International Development and testifying or speaking with
us remotely today is Dr. Michael Ryan, Executive Director of
the World Health Organization's Health Emergencies Program, who
will be joining us remotely from Geneva.
This second panel is a briefing of the subcommittee for
some technical reasons relating to the World Health
Organization, but it is important that I recognize that. Dr.
Frieden, if you would please start us off, and if there is a
vote that interrupts us, I will inform you. But thank you for
your testimony.
If you can keep it concise, that will allow us to have more
of a discussion. But I appreciate your testimony and your
patience with the first panel and the enthusiasm of our
members.
STATEMENT OF TOM FRIEDEN, PRESIDENT AND CEO, RESOLVE TO
SAVE LIVES
Dr. Frieden. Thank you very much, Chairman Coons, and
Ranking Member, and distinguished Members of the Committee for
the opportunity to testify today. Here is the bottom line. The
U.S. and the world were underprepared for COVID, haven't
responded well, and we are well on our way to making the deadly
mistake of repeating the cycle of panic and neglect. This would
leave us avoidably vulnerable not only to future COVID
variants, but also to future health threats.
I urge Congress to approve the proposed COVID supplemental
request at least the $5 billion for global COVID control, with
funding to both USAID and CDC. Most of the one million deaths
that the U.S. has suffered and most of the nearly 20 million
deaths that the world have suffered did not have to happen.
Pandemics do not stop because of wars. In fact, wars tend to
accelerate pandemics.
That is certainly what happened 100 years ago. With safe
and effective vaccines, as well as stunningly effective
treatment, we can have the upper hand on COVID in this country.
However, this is only true as long as a worse variant doesn't
emerge. We have to face three dichotomies, and in each of these
there is a pull toward one side that would imbalance our
response.
The first dichotomy is the temptation to spend money on
stuff, vaccines, equipment, medications, while neglecting the
need for staff. To increase vaccination uptake, you need health
care workers, you need to focus on vaccinating health care
workers, as well as the elderly and immunosuppressed people who
are not only most likely to die, but perhaps most likely to
have the emergence of variants if they are infected. We have to
support staff on the ground who can do this.
And I will say that in Sierra Leone, my organization,
Resolved to Save Lives, worked with one of the organizations
implementing the tremendous success story of PEPFAR, a
bipartisan program. We approached more than 7,000 health care
workers because health care workers getting vaccinated is a
critical first step to change the narrative on vaccinations in
many countries. 2 percent, 2 percent declined vaccination. 90
percent were double vaccinated. 8 percent got a single dose.
The second dichotomy is the need to focus on both response
and prevention. It is tempting to focus on putting the fire
out, but we have to make our world more resistant to future
outbreaks. This is why it is essential to have at least the $5
billion previously requested for the global health
appropriations supplemental.
I also strongly support the fiscal year 2023 budget
proposal of $88.2 billion over 5 years to allow sustained,
targeted interventions, and investments in public health and
preparedness domestically and around the world, including to
support both CDC and USAID for global protection.
The third dichotomy is protecting the U.S. versus
recognizing that it is in our self-interest to support programs
to fight COVID and other threats around the world. The plain
truth is that it saves more lives and costs less money to fight
outbreaks at their source than fighting them on our shores.
When it comes to access to vaccines and treatment, the right
thing to do ethically is also the right thing to do
epidemiologically.
But that is going to require more money from the U.S. and
from other countries. The CDC plays a critical role around the
world in vaccine planning and implementation, vaccine safety
monitoring, supporting ministries of health. CDC has over 1,000
doctors and other public health specialists who know how to
plan vaccine campaigns, support countries, assess and improve
vaccine administration.
Both USAID and CDC have indicated that they will no longer
be able to continue this work unless Congress approves
additional funding. This funding was cut, unfortunately, from
the recent bipartisan supplemental deal framework. I urge you
to find a way through to provide support for global COVID
control.
Representative Tom Cole of Oklahoma said at the start of
this epidemic, it is just a no brainer to spend millions--to
spend billions on preparedness to save trillions of dollars in
costs. He also predicted years before COVID hit that Americans
are much more likely to be killed by a pandemic than by a
terrorist. He was right then, and he is right today. COVID has
claimed more than a million American lives.
That is more than any in all wars over the past 150 years.
And yet we spend only about 300 times to 500 times less on our
health defense than we do on our military defense. We have to
address COVID now, be ready for the next variant, and protect
against future threats. Fiscal responsibility certainly
includes cutting direct costs when appropriate, but fiscal
responsibility also requires making sound investments to save
money and save lives.
We can't afford not to spend the $5 billion and ideally
more to protect the world and protect ourselves through
increasing global vaccination. We have to be better prepared
for the next threat, and that is why the fiscal year 2023
proposal is so very important. This really is the make or break
year.
This is the world's teachable moment to prevent the next
pandemic. You and Congress have the power to provide the
essential investments to make this possible. Thank you.
[The statement follows:]
Prepared Statement of Dr. Tom Frieden, President and Chief Executive
Officer, Resolve to Save Lives
Good morning. I thank Chairman Coons, Ranking Member Graham, and
distinguished members of the Committee for the opportunity to testify
today. I'm Dr. Tom Frieden. I was CDC Director from 2009 to 2017 and
New York City Health Commissioner from 2002 until my appointment to
lead the CDC. I received my MD and MPH degrees from Columbia
University, with advanced training in internal medicine, infectious
disease, public health, and epidemiology. I am currently President and
CEO of Resolve to Save Lives, a global public health organization that
partners with countries to prevent 100 million deaths from heart
disease and stroke and to make the world safer from epidemics, and am
Senior Fellow for Global Health at the Council on Foreign Relations.
I will give you the bottom-line up front: The U.S. and the world
were underprepared for COVID, haven't responded well, and we are well
on our way to the deadly mistake of repeating the cycle of panic and
neglect, leaving us unnecessarily vulnerable to future COVID variants
and to future health threats. The result: Most of the 1 million U.S.
deaths and most of the approximately 20 million global deaths from
COVID could have been avoided. No war in American history has cost the
lives of one million of our people, as COVID has, and yet we spend more
than 300 times as much on our military defense as we do on our health
defense. Unless we spend more now, COVID and future health threats will
cost us more later--in both lives and money.
With very safe and highly effective vaccines developed in large
part through the efforts of the prior administration and provided in
large part through the vaccination campaigns of this administration, as
well as stunningly effective treatments such as Paxlovid, we can have
the upper hand over COVID in this country--as long as a worse variant
doesn't emerge. COVID isn't over--it will almost certainly be with us,
with ongoing spread and flare-ups in different times and places, for
years. In much of the world, lacking widespread vaccination coverage
and access to effective treatment, COVID continues to be a deadly
threat. And COVID will not be the last health threat our world will
face. Because a pathogen can travel from one part of the globe to
anywhere else within 24 to 36 hours, uncontrolled disease spread
anywhere is a threat to people everywhere.
More than half of deaths in the U.S. and globally were
preventable--first by better and faster public health action, then by
immunization. But even though we've begun to strengthen the global
capacity to find, stop, and prevent disease outbreaks, the world
remains unprepared for and unprotected from epidemics. The United
States must continue to address COVID now, be ready for new variants,
and prepare for future health treats. To do this requires addressing
three dichotomies and avoiding a gravitational pull that risks having
an unhealthy balance in how we address each of the three.
First, the temptation to spend money on stuff while neglecting the
need for staff. This is crucial to help vaccinate the world, which we
must do to reduce the risk of emergence of more dangerous variants.
Today 2.7 billion people have yet to receive their first shot of COVID
vaccine,\1\ with 91 percent of the unvaccinated living in low- and
middle-income countries.
Donating vaccines is essential but insufficient. It's not enough to
airdrop vials of vaccine into countries without supporting the overall
vaccination programs needed to get vaccines into arms. Many vaccines
were delivered too close to their expiration date and some countries
received large shipments of vaccines only to discover that they lacked
the appropriate syringes to administer them.
It will be particularly important to increase vaccination uptake
among healthcare workers in order to maintain essential health
services, as among the elderly and those who are immunocompromised, who
are not only at the highest risk of hospitalization and death from
COVID but are also the most likely to be incubate new variants. To do
this, we must support national staff on the ground who manage supply
chains, organize vaccinations, and get shots in arms.
Early international cooperation can contain a disease outbreak
before it becomes widespread, as happened with SARS back in 2003.
Ongoing cooperation can reduce illness and death worldwide, as
countries around the world are doing, with crucial support from the
United States, in the continuing fight against AIDS, TB, and malaria.
PEPFAR, a bipartisan success story that has saved millions of lives,
has strengthened health systems in more than 50 countries. In Sierra
Leone, my organization, Resolve to Save Lives, worked with a PEPFAR
implementer to reach more than 7,000 healthcare workers and offer
vaccination. Only 2%--2%!--declined vaccination, with 90 percent
getting both doses and 8 percent a single dose. The U.S. has strong
programs to build the capacity of staff in countries around the world,
and doing so is crucial for our collective health protection.
The second dichotomy: The need to focus on both response and
preparedness. Our impulse to fund immediate COVID response risks
overlooking our need to also invest in protection from future
pandemics. Responding to the blaze is not enough; we need to make our
world more resistant to future pandemics. This will not be our last
pandemic threat.
We must prepare for the next health threat while we provide the
resources to fight this one. We need at LEAST the $5 billion previously
requested for global health appropriation supplemental. Protecting the
U.S. against pandemics here without finding and fighting them abroad is
like having a military that only works in the US. That is why I also
strongly support the expanded proposal for $88.2 billion over 5 years
that will enable sustained, targeted investments in public health and
pandemic preparedness both domestically and around the globe, including
the support for CDC and the $6.5 billion which would address the need
for better global protection.
Although the price tag sounds high, the annualized cost for the
Administration's preparedness plan is $18 billion--less than one
fortieth the U.S military budget.
We need transformative investments to protect our health security
as well as our economy. If major pandemics similar to COVID, which has
cost more than $15 trillion, occur every 30 years, the annualized
economic impact on the U.S. would be more than $500 billion per year.
In this estimation, the proposed $88.2 billion over 5 years would
generate a return on investment of approximately 30-to-1.
These investments also need to address equitable access to vaccines
and other products to confront outbreaks at they emerge. Vaccine
nationalism is both ethically unjustifiable and, unfortunately,
politically inevitable. Solutions need to address ensuring quality,
quantity, timeliness, sustainability, and equity of distribution of
vaccines, medications, diagnostics, protective equipment, and other
essential supplies around the world.
The third dichotomy: Focusing on the United States vs. recognizing
that it is in our self-interest to support programs to fight COVID and
other epidemics around the world. The plain truth is that we live in an
interconnected world. A disease outbreak anywhere is a threat
everywhere. It saves more lives--and costs less money--to fight
outbreaks at their source than on our shores. Improving detection and
protection in low- and middle-income countries could save millions of
lives and trillions of dollars. We can't protect Americans effectively
without supporting global progress.
Neglecting preparedness is tantamount to playing with matches and
gasoline. Letting COVID burn unchecked through other countries makes
Americans less safe, similar to a fire burning in building in which
only some rooms have sprinkler systems. We can either fund global
vaccination and control efforts now, or increase the risk of paying far
more later when new, more dangerous variants reach our shores. Failing
to make vaccination programs, testing, and life-saving treatments
available wherever people are at risk of dying is not just a moral
failing, it is epidemiologically dangerous, and will worsen the impact
of the pandemic. When it comes to access to vaccines and treatment, the
right thing to do ethically is also the right thing to do
epidemiologically--but it will require more funds from the U.S. and
other countries.
I'm especially pleased that the Administration's initiative for
Global Vaccine Access (the Global VAX initiative) has worked to build
on the successes and lessons learned from the President's Emergency
Plan for AIDS Relief, better known as PEPFAR, rather than duplicate
them. As you know, this is an all-of-government effort led by both
USAID and CDC. I'll let my friend and colleague Dr. Gawande tell you
more about USAID's activities in this area.
CDC plays a critical role not only in this effort to help vaccinate
the world but also in strengthening health system readiness, vaccine
planning and implementation, vaccine safety monitoring, implementing
evidence-based interventions to reduce vaccine hesitancy, and
supporting ministries of health with which CDC has many close
relationships. CDC must maintain and expand CDC country offices around
the world to strengthen the capacity of those countries to detect novel
diseases and outbreaks, as well as ensure strong ties with
international organizations so they can get the financial, technical,
and logistical support they need. CDC has more than 1,000 doctors and
other health professionals who are experts in planning, implementing,
assessing, and improving vaccination programs, including hundreds who
work in CDC's Global Immunization Division. Both USAID and CDC have
indicated that they will no longer be able to continue this work unless
Congress approves additional funding--at a bare minimum the $5 billion
in the Administration's original request to Congress for global
vaccination. This funding was cut from the recent bipartisan COVID
supplemental deal framework; I urge you in the strongest possible terms
to ensure that the full $5 billion is restored to any future
supplemental appropriations bill.
Someone I consider a friend, Representative Tom Cole of Oklahoma,
the Vice Ranking Republican of the House Appropriations Committee, said
at the start of this pandemic: ``I think it's just a no-brainer to
spend billions [on preparedness] to save trillions.'' He also
predicted--years before the COVID pandemic hit--that Americans are much
more likely to be killed by a pandemic than by a terrorist. He was
right then and he is right today. COVID has claimed more than a million
American lives, more than all deaths in war over the past 150 years in
this country.
We need to address COVID now, be ready for next variant, and
protect against future threats. Fighting the fire of COVID today
requires that we that we help vaccinate the world and invest in global
health security--because you can be certain that there will be more
fires. Funding for pandemic preparedness to ensure our nation's health
defense is just as critical as the 300 to 500 times more that we spend
on our military defense.
Fiscal responsibility certainly includes cutting direct costs where
appropriate. But fiscal responsibility also requires making sound
investments to save money and lives. We can't afford NOT to spend at
least $5 billion--and ideally more--to help facilitate global
vaccination. We must be better prepared for the next pandemic by
passing the proposed pandemic preparedness plan into law. This is THE
make-or-break year to prevent the next pandemic. You in Congress have
the power to make the essential investments to make this possible.
Thank you.
Senator Coons. Thank you, Dr. Frieden. Dr. Gawande.
STATEMENT OF ATUL GAWANDE, ASSISTANT ADMINISTRATOR FOR
GLOBAL HEALTH, USAID
Dr. Gawande. Thank you, Chairman Coons. Here we go.
Chairman Coons, Ranking Member Graham, and Members of the
Subcommittee, thank you for the invitation to speak today. I
lead Global Health at USAID and I get to co-chair our COVID-19
task force. My written testimony I put into the record, so I am
just going to try to hit a few of the high points for you. The
direct and indirect impacts of this pandemic have been
horrendous.
The result is the first reduction in global life expectancy
in a century. It is development in reverse. If it weren't for
the bipartisan support that you and Congress and American
taxpayers have provided, these numbers would be far worse. The
Government, the U.S. Government is providing more than $19
billion in assistance towards the fight against COVID-19. Of
this, USAID has deployed almost $10 billion.
And through the President's global COVID-19 summit last
year and the second one, which will take place tomorrow, we
have also rallied the world to join this fight. And in the
course of this, we have accomplished a lot. We have donated
more than half a billion COVID-19 doses to 115 countries in
just 9 months.
That is a historic accomplishment. We launched the Global
Vax effort to ensure that we are able to get shots into arms
with $1.7 billion in committed funding. And USAID is also
leading the non-vaccine work where we become the global leader
in providing oxygen systems as well as testing and treatment
supplies. But here we are. We are now at a precipice.
As of the first of May, we have approved and, or notified
99.9 percent of the total COVID-19 supplemental funds that we
have received. And we have obligated 95 percent of those funds.
When it comes to the American Rescue Plan Act funds, we have
obligated 90 percent of that. We expect to obligate virtually
all remaining supplemental funds by July. Our work at that
point will begin grinding to a halt. And it is clear that the
fight against COVID is not done. I just want to say, the worst
may not be behind us. I want us to understand that.
The potential outcome scenarios that we face are extremely
wide. I am a cancer surgeon, and I tell my patients that we
will hope for the best, but hope is not a plan. Of more than 10
million vaccine doses administered worldwide, only 1 percent
has been administered in low income countries. We have barely
more than 16 percent of people across Africa fully vaccinated.
Lower income countries face even bigger gaps in access to
the arsenal that we now have been able to count on, that is
they barely have access to rapid diagnostic tests, to oxygen
capacity, and now the new generation of oral antiviral pills
that have proven to be so effective. And that is why the
Administration requested $5 billion to support the immediate
needs of the global COVID-19 response.
That includes $2.55 billion to enable an expansion of
Global Vax to get more shots into arms in under-vaccinated
countries. I pointed out--I will point out, it requested no
money, not a dime for new vaccines, because we are in a
situation of vaccine abundance. We had $1.7 billion in request,
however, to enable us to shrink the gaps in global access to
testing, oxygen capacity, and antiviral treatments.
And then finally, we have requested $750 million to enable
humanitarian assistance. As you heard from the prior panel,
COVID-19 has complicated humanitarian assistance in a number of
domains, made disasters worse, in particular, increasing food
insecurity. We are now facing the cost, potentially, of
inaction.
If the--if no further funds are appropriated, we will have
to end our leadership in increasing vaccinations. We will have
to give up on fighting dangerous variants, even though each
surge of variants has disrupted our supply chains, disrupted
the trade we rely on, and driven inflationary pressures that
are hurting every American.
These recurrent cycles of damage. Have endangered and
continue to endanger the health and lives of all Americans, as
well as people around the world. So I want to emphasize here,
stopping global COVID-19 funding would be a geopolitical
mistake. It would be an ethical mistake. It would be a health
security mistake, and it would be an economic mistake of
historic proportions.
Throughout the pandemic, you in Congress have done what has
had to be done in passed supplemental funding that has saved
the lives of millions abroad and protected hundreds of millions
here at home. And once again, we are asking you to please come
together to continue America's leadership to end the acute
phase of this pandemic.
I am grateful for this opportunity to be here today. I
welcome many questions.
[The statement follows:]
Prepared Statement of Dr. Atul Gawande, Assistant Administrator for
Global Health, U.S. Agency for International Development
Chairman Coons, Ranking Member Graham, and Members of the
Subcommittee, thank you for the invitation to speak with you today
about United States leadership in controlling the COVID-19 pandemic,
the key role played by the U.S. Agency for International Development
(USAID), and the funding necessary to continue this fight to control
the pandemic.
My name is Atul Gawande, and I serve as the Assistant Administrator
for USAID's Bureau for Global Health and as Co-Chair of the USAID
COVID-19 Task Force.
I am grateful to the Subcommittee for calling today's hearing and
for continuing to prioritize the global response to COVID-19. Since the
start of this pandemic, we have lost almost one million American lives,
with the death toll globally now exceeding six million. The effects on
worldwide health, development, and the global economy are like nothing
we have seen in our lifetimes.
Data recently published in The Lancet estimates that total deaths
during this pandemic increased by approximately 18 million
worldwide\1\--most not directly from COVID-19 but from the indirect
effects of its disruptions of healthcare and economies. The result is
the first reduction in global life expectancy in more than a century.
It is development in reverse. It has pushed back the impact of our
decades of bipartisan U.S. global health investments.
Thanks to bipartisan support from Congress and American taxpayers,
the U.S. government has mounted a historic response to this global
crisis. Since the beginning of this pandemic, the U.S. Government is
providing more than $19 billion, of which USAID has provided $9.9
billion in supplemental funding towards the fight against COVID-19. The
U.S. government led the world by donating, in partnership with COVAX
and bilaterally, more than half a billion COVID-19 doses to 115
countries in just 9 months, as part of President Biden's commitment to
donate and deliver more than a billion COVID-19 vaccines.
In December, the U.S. government announced the Initiative for
Global Vaccine Access--or Global VAX--a whole-of-government effort, led
by USAID in partnership with the CDC and other interagency partners, to
turn vaccines in vials into vaccinations in arms around the world
through more than $1.7 billion in funding committed to date. Global VAX
encompasses all of the U.S. government's work with more than 100
countries to accelerate COVID-19 vaccine uptake, and involves a surge
of technical and financial resources to 11 countries in sub-Saharan
Africa where we see the greatest opportunity to increase coverage
rapidly. USAID is also making progress to save lives now through
programs that provide oxygen, testing, and treatments in order to slow
transmission and decrease COVID-19 morbidity and mortality.
But we are now at a precipice. As of May 1, USAID has approved, and
when required notified Congress, of 99.9 percent of the total COVID-19
supplemental funds received since the beginning of the pandemic, and we
have obligated 95 percent of these funds. We expect to obligate
virtually all remaining supplemental funds by July of this year. Under
the American Rescue Plan Act--or ARPA--we have so far obligated 90
percent of the funds.
As much as it may feel like we are returning to normal in the
United States, the fight against COVID-19 is not over. This is
especially acute for those in low and lower-middle income countries
(LIC/LMICs), but as long as COVID-19 continues to persist anywhere,
inevitably more variants of concern will emerge, putting us all at risk
everywhere. Of the more than 10 billion vaccine doses administered
worldwide, only 1 percent has been administered in low income
countries. The result is that although almost 60 percent of the world
is fully vaccinated--including 50 percent of people in low-middle
income countries--barely more than 16 percent of people across Africa
are. At the same time, low income countries have begun to delay vaccine
deliveries, not because they are not desperately needed, but because
the flow of supply is now outstripping their capacity to get shots in
arms fast enough. This is why Global VAX's efforts are so vitally
important, and broader U.S. efforts such as the Global Action Plan and
the COVID-19 Summit to lead efforts to galvanize commitments and
coordinate these efforts, alongside our partners in governments,
international and multilateral organizations, and beyond. Lower income
countries simultaneously face even bigger gaps in access to rapid
diagnostic tests, oxygen, and the new generation of oral antiviral
pills that we in the United States have been able to count on to help
us so markedly reduce the morbidity and mortality of COVID-19. These
gaps create a situation poised to produce further COVID-19 variants
that pose risks to not only to other countries, but also to U.S. lives,
our economy, and our national security.
In March, the Administration requested $22.5 billion in additional
COVID-19 response funding, including $5 billion to support the
immediate needs of the global COVID-19 response. This global funding
would enable a significant expansion of our Global VAX surge efforts to
another 20 to 25 countries and other global COVID-19 vaccination
priorities, including the rollout of boosters and pediatric doses. With
more than 30 countries qualifying as severely undervaccinated, it
remains critical to expand the initiative beyond the 11 surge countries
we currently support. This request will also enable us to shrink the
severe gaps in global access to testing, oxygen capacity, and antiviral
treatments--enabling lifesaving services for more than 100 million
people--as well as enhanced monitoring of potential or emerging
variants.
Failure to continue our supplemental global funding would abdicate
U.S. leadership even as the People's Republic of China continues its
transactional approach to pandemic response and global health; it would
weaken health systems that are crucial to fighting this and future
pandemics; and it would amount to a surrender to the inevitability of
dangerous new variants. Failing to provide supplemental global funding
would also jeopardize our long-term baseline pandemic preparedness,
global health, and health security investments. In sum: it would be a
geopolitical, ethical, health security, and economic mistake of
historic proportions.
The President has repeatedly outlined the stark realities of not
passing a COVID-19 supplemental. Variants of concern continue to
emerge. Each surge has disrupted the supply chains and the trade we
rely on and driven inflationary pressures. U.S. leadership is critical
to keeping political momentum and commitment to clear action. Barring
additional funding, however, essential work cannot launch and many of
our existing programs will begin to grind to a halt in the coming
months.
By not helping lower income countries get shots into arms, and not
fostering adequate testing, treatment and oxygen delivery capabilities,
their populations will be left unprotected and we'll continue to see
more preventable deaths and societal disruptions. New, potentially more
dangerous variants may also be more likely to emerge from a long-term
infection in immuno-compromised individuals who lack access to
vaccination or treatment. That outcome would be disastrous both
globally and here at home, with the potential to claim more lives and
deliver a serious blow to the economic recovery that all countries and
economies seek. We will need additional resources in order to improve
our ability to track variants. We were lucky that Omicron was not more
lethal. The next time, the variant, or the new pathogen, may be more
lethal and may spread even faster; we need to be able to identify the
new organism rapidly and respond quickly.
U.S. leadership has led to significant achievements since the
beginning of this pandemic. But now is not the time to be complacent or
we risk the normalcy and security we are just beginning to experience.
details on usaid's global health response to covid-19
USAID is supporting more than 120 countries to contain, combat, and
recover from this pandemic with more than $9.9 billion in funding. Our
activities align with the goals outlined during President Biden's
Global COVID-19 Summit last year and those that will be discussed at
the Second Global COVID-19 Summit tomorrow--vaccinating the world,
saving lives now, and building back better to prevent future
pandemics--and are driven by USAID's COVID-19 Implementation Plan which
outlines USAID's role in the whole-of-government U.S. COVID-19 Global
Response and Recovery Framework (``Framework''). The global community
came together around last year's Summit, making new commitments
centered around these global response goals. We continue our work to
rally the world to deliver on these goals during the second Global
COVID-19 Summit, taking place tomorrow.
Vaccinating The World
Safe and effective vaccines are one of our best tools to end this
acute phase of the pandemic. President Biden committed to donating 1.2
billion COVID-19 vaccines--more vaccines donated than by all other
countries combined--to the world for free and with no political strings
attached. Completing the job collectively with other nations and donors
is the Administration's and USAID's top COVID-19 priority. As of May
10, the United States, in partnership with COVAX and bilaterally, has
donated close to 540 million vaccines, the result of highly successful
coordination with our interagency partners, and the White House.
But vaccines on tarmacs are not vaccines in arms, which is why the
U.S. government launched Global VAX. This initiative supports countries
to scale up their vaccination campaigns and help with last mile
efforts, including vaccinating the highest risk populations; planning
and logistics; the purchase of ancillary supplies; cold chain
infrastructure; and community engagement and public outreach,
especially to strengthen vaccine confidence and counter mis/
disinformation about vaccines. In the 11 Global VAX surge countries--
Angola, Cote d'Ivoire, Eswatini, Ghana, Lesotho, Nigeria, Senegal,
South Africa, Tanzania, Uganda, and Zambia--the U.S. Government is
surging technical, financial, and diplomatic support in close
partnership with the interagency. And we are seeing results:
1. In Angola, the U.S. government supported vaccination efforts
through ultra cold chain strengthening, logistics support to
vaccination sites, social media campaigns, and vaccination
donations, which contributed to 18.5 million doses administered
as of May 2, 2022. To date, around 11.7 million people received
their first dose, 5.9 million people received their second
dose, and another 440,185 received a booster dose. The U.S.
Government is the largest donor of COVID-19 vaccines in Angola,
providing more than 8.6 million doses of Pfizer and Johnson &
Johnson vaccines, in partnership with COVAX. Of the eligible
population, 64 percent have received at least one dose.
2. In Nigeria, U.S. Government vaccine donations and logistics
support, in addition to other implementation support, improved
the availability of vaccines at the state level and helped
sustain vaccination rates of around 200,000--250,000 doses
administered per day by April--up from 30,000 to 55,000 doses
daily prior to acceleration.
3. In South Africa, Global VAX acceleration plans have built on
existing health platforms to deliver integrated services.
USAID's partner BroadReach integrated HIV testing services via
PEPFAR into a vaccination campaign in February to April 2022 in
the coastal region of KwaZulu-Natal. During this campaign, 57
percent of individuals reached were first-time COVID-19 vaccine
recipients, and 69 percent of individuals were high-priority
populations. BroadReach also conducted 3,000 HIV screenings,
identifying nearly three times more positive cases than usual
community testing programs.
Saving Lives Now by Strengthening Health Systems And Countering
Emergency Impacts
Success in stopping the catastrophic damage of COVID-19, however,
has required more than a vaccination strategy. Omicron makes clear that
we must sustain and expand support for activities that minimize spread
and prevent the emergence of new viral strains, decrease severe illness
and death, and limit the burden on health systems, including health
workers who are on the frontline of this battle. We must save lives now
while we continue our efforts to vaccinate the world.
At the first Global COVID-19 Summit in September 2021, President
Biden emphasized the importance of reducing morbidity, mortality, and
disease transmission. With the constant threat of emerging variants and
many lower income countries still facing low vaccine coverage rates,
increasing global access to COVID-19 testing, therapeutics, and
countermeasures is critical to saving lives among those who experience
a breakthrough infection or who are yet to be vaccinated. Two of our
efforts with greatest impact have been increasing oxygen capacity and
providing resources for emergency response.
Oxygen.--USAID has become a world leader in supporting increased
access to lifesaving oxygen in health facilities that lack it. An
estimated 50 percent of facilities with inpatient services in LMICs
lack reliable access to oxygen--even before COVID-19.\2\ Thanks to more
than $100 million in COVID-19 assistance funding, USAID has built
systems to provide oxygen to facilities in more than 50 countries--
including India, Haiti, and Ghana, to name just a few--and is in the
process of building oxygen systems for facilities in 13 countries
across Africa, Asia, and Latin America and the Caribbean.
When expanding access to oxygen, USAID acted quickly to strengthen
oxygen ecosystems and is currently a leader in bulk liquid oxygen
investments for LMICs, the standard for oxygen delivery in high-income
countries. To promote sustainability, we are exploring market-shaping
opportunities so that oxygen markets can work more efficiently in
LMICs, and lower prices and increase distribution. Our leadership is
also informing other partners' investments, including those of The
Global Fund to Fight AIDS, Tuberculosis and Malaria. All of these
investments have the potential for long-term impact on countries'
health systems--strengthening their capacity to respond to not only
this pandemic, but also other critical health needs, such as child and
adult pneumonia, safe birth, safe surgery, and new infectious disease
outbreaks.
Emergency response.--Since the beginning of 2021, USAID has
supported rapid responses across the world as COVID-19 hotspots
developed. To date, we have provided $429 million to support urgent
healthcare needs and critical commodities (including PPE, diagnostic
tests and treatments) in South Asia, Latin America and the Caribbean,
and sub-Saharan Africa.
COVID-19 has also continued to exacerbate humanitarian crises
around the world by increasing food insecurity, reducing access to
lifesaving services, and fueling a shadow pandemic of gender-based
violence against women and girls. In response, USAID has provided more
than $2.658 billion in COVID-19 supplemental funding focused on
preventing famine and mitigating food insecurity, supporting protection
and gender-based violence programs, and strengthening critical public
health initiatives to reduce transmission of COVID-19 in humanitarian
settings. For instance, in Ukraine, we are supporting the World Health
Organization (WHO) to expand delivery of COVID-19 vaccines to
internally displaced people, and to expand hospital oxygen supply to
improve health system readiness to manage COVID-19 cases.
USAID has also been investing in the capacity of the humanitarian
assistance community to respond to outbreaks. The READY initiative
(currently in its fourth year) has been focused on building and
retaining capacity among non-governmental organizations (NGOs) and
other stakeholders in priority regions and countries to more quickly
and effectively respond to major outbreaks. Risk Communication and
Community Engagement continues to be a priority as well, with USAID
partnering with the International Federation of Red Cross and Red
Crescent Societies (IFRC) in building community trust, social cohesion,
and public solidarity to pave the way for uptake of emerging lifesaving
COVID-19 biomedical measures.
a new area of focus to save lives now: test-and-treat
Recently authorized oral antivirals have been shown to
significantly reduce the risk of hospitalization or death by almost 90
percent among people who are at high-risk for severe disease. These
treatments are becoming a mainstay of treatment in the United States
and limiting the COVID-19 hospitalization rates and risk of death,
especially among the unvaccinated and the medically vulnerable. But
lower income countries have little to no access to the new therapies
and have limited access to rapid diagnostic tests. In collaboration
with other agencies and global stakeholders, USAID is working to
increase the supply, availability, and use of low-cost, generic
versions of these oral COVID-19 antiviral drugs for lower income
countries.
With additional resources, USAID can work to build a ``test-and-
treat'' approach and the capacity to deliver it to those who need it
the most. This work would build on successful test-and-treat approaches
for HIV and malaria and will require educating communities about the
importance of prompt testing (including use of self-testing) and
availability of treatment. It will also require the expansion of health
systems' capacity to quickly identify new infections and initiate
appropriate treatment in high-risk patients. USAID can support these
strategies to ensure that test-and-treat programs are integrated into
existing health infrastructure and community systems. In addition to
reducing morbidity and mortality, these activities would also help stem
transmission and reduce the likelihood of health systems being
overwhelmed by patients suffering from severe disease by promoting
early diagnosis and intervention.
Diagnostic testing remains a critical part of the public health
response, not just for diagnosis of new infections and linkage to care,
but also to help identify emerging variants. The President's Global
COVID-19 Summit laid out ambitious goals of reducing the cost of
diagnostic test kits to $1 per test and achieving global equity for
testing. But rapid diagnostic tests are largely not accessible in many
LMICs. Only five rapid diagnostic test kits have WHO Emergency Use
Listing. When Omicron spread more rapidly than had been anticipated
during the Omicron surge, manufacturers could not keep up with surging
demand, and many countries did not receive the testing supplies they
ordered until after the Omicron wave had passed. Available laboratory
testing can be slow, and extremely costly, with a diagnostic test
costing as much as $99 in some countries. As a result, testing rates in
lower-middle income countries remain low, and low income countries
account for less than 0.5 percent of the tests performed, despite
having almost 8 percent of the world's population.\3\ The WHO has now
committed to accelerating test approvals, but low income countries have
limited capacity to drive demand. For them to effectively roll out new
test and treat strategies, investment in purchases of low-cost, rapid
diagnostic testing is essential.
Much of the world also lacks excess laboratory capacity and is
unable to respond to a dramatic rise in testing need; therefore, we
have invested in laboratory strengthening activities that will pay
benefits beyond the current COVID-19 crisis. To support national
laboratory networks, we have funded sample transport networks to ensure
timely and safe delivery of samples within 24 hours so results can
quickly be returned to individuals. Future surges are likely to
encounter the same challenges without additional financial support.
the cost of inaction: an urgent need for covid-19 resources
We have made huge strides since this pandemic first began, and we
are witnessing the end of the acute stage of this pandemic here in the
United States. But we simply cannot ignore that in many parts of the
world--where countries face low vaccination rates and lack of access to
tests and treatments--this pandemic is far from over. And as long as
that is the reality, we face a world in which new and more dangerous
COVID-19 variants will be able to continue developing and endanger the
recovery we have made so far.
Without additional COVID-19 resources, we will be unable to mount
the response needed to end this acute stage of the global pandemic.
That is why the White House has requested $5 billion to support the
global COVID-19 response, which includes:
--$2.55 billion to resource our efforts to vaccinate the world
through Global VAX programs that are strengthening countries'
vaccine deployment and readiness capacities, including $1.8
billion for USAID and the State Department and $750 million for
CDC. These additional resources would enable us to support an
additional 20-25 countries to get shots into arms; support
multilateral partners providing critical assistance; and
prepare for pediatric doses;
--$1.7 billion to finance our efforts to save lives now, covering
activities that are critical to ensuring adequate global supply
and technical assistance to support COVID-19 testing,
treatments, access to oxygen, personal protective equipment
(PPE), and support for health workers to reduce morbidity and
mortality and mitigate transmission. This would provide
lifesaving testing, treatment, and care for more than 100
million people; and
--$750 million for lifesaving humanitarian assistance as global
humanitarian needs have skyrocketed, with COVID-19 adding an
additional layer of suffering upon the world's most vulnerable.
This humanitarian funding will help us to continue to scale up
to meet new and growing needs, while sustaining our ongoing
complex emergency responses in places such as Ethiopia and
Afghanistan.
Without additional funding, we will be forced to scale back the
expansion of Global VAX into 20-25 countries and our existing programs
will begin grinding to a halt this fall. Many countries that finally
have received the vaccines needed to protect their populations will
risk seeing them spoil on the tarmac because they can't be distributed
in country and/or administered to the population. And at the same time,
we will not be able to expand the critically needed testing and
treatment programs that we would have otherwise been able to support
and continue our leadership in expanding access to oxygen. All the
while, COVID-19 will continue mutating and growing, endangering
populations abroad and the health and prosperity of all Americans.
Throughout this pandemic, Congress has come together to pass
supplemental funding that has saved the lives of millions abroad and
protected millions more here at home. Once again, we are urging you to
come together in support of continued U.S. leadership to control and
end the acute phase of this pandemic.
Thank you for the opportunity to represent USAID. I welcome your
questions.
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\1\ Wang, et al. Estimating excess mortality due to the COVID-19
pandemic: a systematic analysis of COVID-19-related mortality, 2020--
21, The Lancet 399, no. 10334 p. 1513-36 (2022).
\2\ PATH, Oxygen Is Essential: A Policy and Advocacy Primer, PDF p.
7 (2017).
\3\ FIND, SARS-COV-2 TEST TRACKER (2022).
Senator Coons. Thank you. Dr. Gawande. Dr. Ryan.
STATEMENT OF MICHAEL RYAN, EXECUTIVE DIRECTOR, WHO
HEALTH EMERGENCIES PROGRAMME
Dr. Ryan. Good afternoon, Chairman Coons, Ranking Member
Graham, distinguished Members of the Subcommittee. Thank you so
much for the opportunity to speak with you today, as we--this
will be an informal technical briefing.
I am the Executive Director of the Health Emergencies
Program here at WHO, and for over 25 years, I have worked on
the front line in epidemics, conflicts, and natural disasters
all over the world.
I have just returned from Ukraine--I have just returned
from Ukraine, where I saw firsthand the work of frontline
health workers and witnessed the power of resilience in the
face of horror.
This is the same resilience, compassion and dedication that
we have and continue to witness in our frontline workers around
the world against COVID-19, in their determination to protect
communities, save lives, and deliver to the last mile.
COVID-19 has infected billions and killed millions.
However, every single person on the planet has been impacted by
this virus, with health weakened, loved ones lost, future
stolen, and livelihoods destroyed. This virus has ripped
through our communities like a tornado.
And like that tornado remains highly unpredictable in its
course and its intensity. While global reported cases are
declining, the virus continues to evolve and evade, leaving our
inter-linked communities highly vulnerable everywhere,
especially in areas with low vaccination, high rates of people
with underlying conditions, and limited access to health
systems.
Continued major disruptions of vital programs for HIV,
AIDS, malaria, tuberculosis, maternal health and immunization,
and others threaten decades of progress. Intense circulation of
this virus has resulted in many variants of concern, each more
transmissible than the last. All these variants have emerged
outside the United States, and all have reached the United
States.
Yes, testing, sequencing, and surveillance activities in
many countries are falling, blinding us to the potential--to
potentially dangerous new variants. However, in a world of
intractable problems, COVID-19 has solutions. This is thanks to
the scientists who developed lifesaving interventions and the
public health of frontline workers who have delivered them.
This is in great part due to the leadership of the United
States and other countries supporting a global effort led by
WHO and its partners.
But massive disparities in access to vaccines, antivirals,
oxygen and other lifesaving tools and interventions threatens
to undermine all we have achieved in the fight against COVID.
While almost 12 billion doses of COVID vaccines were
administered around the world, nearly 1 billion people in lower
income countries have not received a single dose of vaccine
against COVID. That number includes more than two-thirds of
health care workers and older persons in those countries.
We can end this emergency phase of the pandemic, but we
will not do so unless we deliver these lifesaving interventions
to everyone, everywhere. This will not happen with vaccines
alone. It also requires surveillance, testing and sequencing,
protective gear and therapeutics, and most of all, effective
community engagement and empowerment. It requires that all of
these are delivered to the last mile and administered by well
trained and equipped workers.
The funding you are considering today is critical to help
us to get these lifesaving tools to the people that need them
most everywhere. WHO's strategic preparedness readiness and
response plan details how to achieve this, but it remains
underfunded by $1 billion.
WHO also coordinates the access to COVID tools, our ACT-
accelerator, and is shipping millions of vaccines, test kits,
and therapeutics to lower income countries? The ACT's COVAX
pillar has delivered 1.42 billion vaccine doses so far, 80
percent of the supply for low income countries so far.
However, the ACT is facing a nearly $15 billion funding
gap. This includes--this money is needed to purchase over 700
million tests, treatments for 120 million patients, protective
equipment for 1.7 million health workers, and 600 million doses
of vaccine.
In summary, Senators, as long as this virus is circulating
widely anywhere in the world, we are all at risk. We have to
act now to save lives and enable the global economy to get back
on track. We need to track this virus. We need to vaccinate the
world. We need to diagnose and treat patients quickly and
early, and we need to communicate with and engage our
communities deeply.
We need scale up investments in the solutions that are so
badly needed to end this pandemic. The world has long looked to
the U.S. for global health leadership. It was nearly 20 years
ago that you introduced the PEPFAR Program, a bipartisan effort
which saved the lives of 20 million people from AIDS.
Today, the leadership of the United States is more vital
than ever. The funding you are considering today will be a
major contribution towards ending the acute phase of this
pandemic and making the world prepared for the next global
threat. Thank you, sirs.
[The statement follows:]
Prepared Statement of Dr. Michael Ryan, Excutive Directory, WHO Health
Emergencies Programme
Good afternoon, Chairman Coons, Ranking Member Graham,
Distinguished Members of the Subcommittee.
Thank you for the opportunity to speak with you today. As agreed,
this will be an informal briefing.\1\
I am the Executive Director of the Health Emergencies Programme of
the World Health Organization. Over 25 years, I have worked on the
frontline in epidemics, conflicts and natural disasters all over the
world.
I have just returned from Ukraine, where I saw first-hand the work
of frontline health workers and witnessed the power of resilience in
the face of horror.
This is the same resilience, compassion and dedication that we have
and continue to witness in our frontline workers around the world
against COVID-19 in their determination to protect communities, save
lives and deliver to the last mile.
COVID-19 has infected billions and killed millions. However, every
single person on the planet has been impacted by this virus . . . with
health weakened, loved ones lost, futures stolen and livelihoods
destroyed.
This virus has ripped through our communities like a tornado and
like that tornado remains highly unpredictable in it course and
intensity.
While global reported cases are declining, the virus continues to
evolve and evade leaving our interlinked communities highly vulnerable
everywhere especially in areas with low vaccination, high rates of
people with underlying conditions and limited access to health systems.
Continued major disruptions in vital programmes for HIV/AIDS,
malaria, Tuberculosis, maternal health and immunization and others
threaten decades of progress.
Intense circulation of this virus has resulted in many variants of
concern each more transmissible than the last. All these variants have
emerged outside the United States and all have reached the United
States.
Yet, testing, sequencing, and surveillance activities in many
countries are falling, blinding us to potentially dangerous new
variants.
However, in a world of intractable problems, COVID has solutions.
This is thanks to the scientists who have developed the life-saving
interventions and the public health and frontline workers who deliver
them. This is in great part due to the leadership of the United States
and other countries supporting a global effort led by WHO and its
partners.
But massive disparities in access to vaccines, antivirals, oxygen
and other lifesaving tools and interventions threatens to undermine all
we have achieved in the fight against COVID.
While almost 12 billion doses of COVID vaccines have been
administered around the world, nearly one billion people in lower
income countries have not been vaccinated against COVID. That number
includes more than two-thirds of healthcare workers and older people in
those countries.
We can end the emergency phase of this pandemic but will not do so
unless we deliver these lifesaving interventions to everyone
everywhere.
This will not happen with vaccines alone. It also requires
surveillance, testing and sequencing, protective gear, and
therapeutics, and most of all effective community engagement and
empowerment. It requires that these are delivered to the last mile and
administered by well trained and equipped workers.
The funding you are considering today is critical to help us to
getting these lifesaving tools to the people that need them the most
everywhere.
WHO's Strategic Preparedness, Readiness and Response Plan details
how to achieve this but remains underfunded by over $1 billion.
WHO also coordinates the Access to COVID Tools (or ACT) Accelerator
and is shipping millions of vaccines, test kits, and therapeutics, to
lower income countries. The ACT 's COVAX pillar has delivered 1.42
billion vaccine doses so far. However, the ACT A is facing a nearly US$
15 billion funding gap. This money is needed to purchase nearly 700
million tests, treatment for 120 million patients, protective equipment
for 1.7 million health workers, and 600 million doses of vaccine.
In summary:
As long as the virus is circulating widely anywhere in the world,
we are all at risk. We have to act now, to save lives and enable the
global economy to get back on track.
We need to track this virus, we need to vaccinate the world, we
need to diagnose and treat patients quickly and we need to communicate
with and engage our communities deeply.
We need scaled up investment in the solutions that are so badly
needed to end this pandemic.
The world has long looked to the United States for global health
leadership. It was nearly 20 years ago that the U.S. introduced the
PEPFAR program, a bipartisan effort, which saved the lives of 20
million people from AIDS.
Today the leadership of the United States is more vital than ever.
The funding you are considering today will be a major contribution
towards ending the acute phase of the pandemic and making the world
better prepared for the next global threat.
Thank you.
---------------------------------------------------------------------------
\1\ WHO's attendance before the Subcommittee is on a purely
informal and voluntary basis, and nothing in the briefing should be
understood to be a waiver, express or implied, of the privileges and
immunities of the World Health Organization and its officials. This
briefing is being provided on a voluntary basis as a technical
contribution, and based on available scientific evidence.
In principle, WHO would have no objection to the information being
published provided that it will not be presented as ``evidence'' given
by witnesses, but as technical information given by WHO. In the
interests of transparency and access by its Member States to the same
information, please note that WHO reserves the possibility to publish
any information exchanged within this framework.
Senator Coons. Thank you, doctor. Thank you, all three of
you, for your testimony. If you might, you used particularly
pointed, unsettling, difficult, and memorable phrases about our
being avoidably vulnerable, about the balance between stuff and
staff, about this being a tornado whose course and intensity we
cannot predict.
Let me just first ask of all three of you, if I might, it
is a compound question, but what is the risk of the development
of a variant that is more deadly as well as more transmissive
than what we have seen so far? I am struggling with my
colleagues. One of them said to me memorably, my colleague--my
constituents are done with this pandemic. And I said, sir, with
all due respect, this pandemic is not done with your
constituents. One of our real challenges is one of imagination.
Most Americans and many Senators don't appreciate that as
long as there are billions who are unvaccinated and whose
public health systems in the countries they inhabit are
fragile, and where testing and monitoring is dropping rapidly,
the risk of a new variant emerging that is more deadly and that
can get around the vaccine protection we have already deployed,
I think is significant. But I would be interested in hearing
from all three of you whether there is any real risk of this,
first.
Second, the timing of money matters. We failed to deliver
$5 billion when requested months ago. We failed to get it on to
the Ukraine supplemental likely to pass tomorrow. I don't see
what the timing is or the path forward on getting the
international COVID relief funded through this Committee and
through this Congress. I will try. I raise it every day. I
press it with leadership, with my caucus and the other caucus.
What difference does it make if we deliver this $5 billion this
month, next month, or not until the fall? What would the
consequences be domestically and globally?
And last, what do you think is the right balance between
staff and stuff, between making sure that we are investing in
public health system personnel and resources, as opposed to
delivering more therapeutics, delivering more testing,
delivering more vaccines? What is the right balance? If each of
the three of you in turn would answer those questions, I would
really appreciate it. Dr. Frieden.
Dr. Frieden. Thank you very much. The Nobel laureate,
Joshua Lederberg, used to say that microbes outnumber us
millions, billions, or trillions to one. Our only hope is to
outsmart them. The risk of a variant that is deadlier than the
Delta variant and just as or more infectious than Omicron is
absolutely present, but it is not inevitable, and it is not
something that we can't do something about.
Unlike perhaps a tornado, we are able to reduce the risk by
tamping down spread, particularly in areas of vulnerability and
where there are people with immunosuppression, which is one
theory of how some of the more dangerous variants have emerged.
No one can tell you with certainty that it may or may not occur
or when it may occur. It could have already occurred. It might
not happen for a month, a year, or 5 years.
There is no inevitability about various variants becoming
less vicious. There is an inevitability that variants that are
able to spread better do spread more. And those that have begun
spreading in one area may spread more in that area. But the
virus is only rewarded, if you will, if it spreads faster,
whether that is a devastating variant that causes a high
fatality rate or as Omicron, may be somewhat less deadly,
particularly for people with immunity from either prior
vaccination or prior infection.
What we are seeing with the new Omicron variants is
increasingly the virus is learning about our immune systems and
learning to get around our immunity, either from prior
infection or from vaccination.
And that is why it is so important that we get these first
generation vaccines out as quickly as possible and continue to
develop second generation vaccines, and make sure that if and
when we do have better, broader, longer lasting vaccines that
may be able to address vaccine escape variants, they are
available to the world promptly after they become available, so
we don't have a repeat of what happened this time around. In
terms of the timing, better late than never.
The sooner, the better. But every month that goes by, we
have a greater chance of unchecked spread, leading to a more
dangerous variant. And in terms of the balance of stuff versus
staff, I think that may maybe one way to think about that is to
think about the minimum necessary for staff and to protect or
ringfence those fundamental systems. You need systems to detect
problems when they first occur.
So you need a laboratory network, you need a surveillance
and monitoring system. You also need rapid response capacity so
that the public health staff can go out and investigate
outbreaks when they occur.
There are great new tools, I really am very excited about
them, genomics, artificial intelligence, machine learning, but
none of them are shortcuts to building a system where someone
who feel sick goes to their local health provider, the local
health provider contacts the public health department, there is
a prompt and effective investigation, and a prompt and
effective response.
In fact, that is what we have promoted with our approach
for rapid diagnosis and rapid response.
Senator Coons. I apologize. My staff is telling me that we
are down to very few Senators who have not voted, and the floor
is waiting for me. If I could ask each of the two remaining
witnesses about 3 minutes in answering my question.
Are there any staff or are we aware of any Senator who is
seeking to come back? In the absence of that, I am going to ask
for the two remaining witnesses to speak, and then I am going
to close the hearing and return to cast my vote on this. If you
would, please, doctor, go on. And thank you to all three of you
for really compelling written testimony and in-person
testimony.
I will berate my colleagues for their attendance on the
floor rather than here.
Dr. Gawande. I will say quickly. The risk of development of
a more deadly disease--WHO laid out the best case scenario. The
best case scenario and the worst case scenario. The best case
scenario is that we continue to have what we have had thus far,
which is a contagious, relatively milder form of the variant,
variants that remain amenable to vaccine effectiveness.
However, evasion of vaccine effectiveness or being more
deadly is absolutely a potential outcome. And so we have to be
prepared for the worst case scenario, much as we don't want to
think about it. It is just the reality of what we should be
preparing to do. Time really matters. We already see now, the
production lines for testing is not unlike before Delta last
time. That basically we are at some of the lowest levels of
rapid test production that we have seen.
We have low levels of production on PPE and masks because
the demand for these things have disappeared, and that is going
to cost us. So if we wait, we are not seeding those supply
lines, we are not keeping them, we are not keeping the workers
in place, and so it will be weeks to months to get them back
online.
Then add in the antivirals. If we don't have advanced
market commitments to get production of the new oral antivirals
that so protect us--that is our safeguard so that if a virus
develops, a variant develops that evades the vaccines, then we
have the oral antivirals to work with.
But if production is not happening for the world, we will
find our own countries behind. Finally on staff and stuff, what
I would say is that we have been very good about buying stuff.
It is easier to move out quickly, it is easier to buy.
But when it comes to making these services happen, whether
it is oxygen, whether it is antivirals or vaccines, making it
possible for in the United States and abroad, having more
commitment to the staff so that we are getting the mobile units
out to do the vaccinations or do the treatment or enable the
systems to get into place.
That is what makes these lasting systems. And those systems
are helping us not only for the next variant, it is for the
next possible outbreak, it is for addressing childhood
pneumonia, making safer births. It makes for a better system of
care.
Senator Coons. Thank you, Dr. Gawande, Dr. Ryan and Dr.
Frieden. I am going to want to follow up with you about the
therapeutic procurement in particular, something Senator Murray
has been relentlessly pressing our caucus about. Dr. Ryan, you
are going to get the last word today.
Dr. Ryan. Well, thank you, Senator. In terms of will more
transmissible variants emerge. They are emerging as we speak.
They are emerging on almost a monthly basis. This is a
nonrandom effect. This is pressure on the virus through
transmission and survival. Whether more virulent or more
dangerous, more lethal variants emerge is very much--it is a
random effect.
It can happen instantly, or it may never happen. It is very
hard to quantify that risk. But if we leave millions of people
getting infected who are not getting well quickly, people with
immunosuppression, underlying conditions, with longstanding
infections that we don't either prevent or treat early, those
people produce quantum more virus because the virus stays in
the individual human body for longer and can produce more and
more variants, and those variants become much, much more
dangerous.
In terms of timing, I have said it before, perfection is
the enemy of the good when you are dealing with epidemics.
Speed beats perfection. Speed is what we need. We need to act
now. We need to reduce the number of people on this planet who
are being infected. We need to reduce the number of people who
have longstanding severe clinical infections, who can produce
variants that can go on to infect others and potentially evade
our vaccines.
And in terms of staff versus stuff, we have a big focus on
commodities but to protect communities and to save lives, it is
as it has always been, we need frontline health workers,
frontline community workers, frontline NGOs, frontline people
in the system who can deliver the solutions that we develop
upstream. Just having stuff without the staff makes no
difference in the world, Senator. Thank you.
Senator Coons. Thank you, Dr. Ryan. Thank you, Dr. Gawande.
Thank you, Dr. Frieden. I am grateful for your testimony today,
for your long service to protecting the world and the American
people and advancing public health.
ADDITIONAL COMMITTEE QUESTIONS
We will keep this record open for a week until 5:00 p.m. on
Wednesday, May 18.
[The following questions were not asked at the hearing, but
were submitted to the Agency for response subsequent to the
hearing:]
No questions were submitted for the hearing.
SUBCOMMITTEE RECESS
Senator Coons. And I look forward to working tirelessly
with each of you and with my colleagues to ensure that we do in
fact advance this desperately needed appropriation to ensure
that the world is safer from this pandemic, and I look forward
to working with you on preparations for the next. Thank you,
and with that, this hearing is concluded.
[Whereupon, at 4:06 p.m., Wednesday, May 11, the
subcommittee was recessed, to reconvene subject to the call of
the Chair.]
[all]