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President's Emergency Plan for AIDS Relief (PEPFAR): Remarks

International Health Issues: Remarks at the President's Emergency Plan for AIDS Relief (PEPFAR) 10th Anniversary Celebration

07/03/2013 02:22 PM EDT

Dean Acheson Auditorium
U.S. Department of State
Washington, DC

First speaker, Ambassador Eric Goosby:

Well thank you so much. It’s wonderful to see everybody here today. I want to thank you all for coming. This is a very special occasion. We have this podium up here because Secretary Kerry’s a little taller than me, (laughter) so I’m going to look over the top at you. This is the tenth anniversary of PEPFAR, and we’re really honored to have all of you convened today. I look forward to sharing some of my thoughts about PEPFAR at the closing of the program, but first I have the distinct honor and true privilege of welcoming Secretary Kerry to the podium. The fight that he has been involved with that goes back to the domestic as well as the international fight has been truly one of our heroes from the very beginning. As all of you know, Secretary Kerry has been a tireless champion of PEPFAR from before the PEPFAR days in his early vision and concepts that really led into the legislation that we now call PEPFAR. His vision shaped the program, and it’s his vision that is now inspiring us to move forward. I know that the Secretary has truly an overwhelmingly busy schedule. I pulled him out of three things as I was up there. So without further ado, I’ll allow Secretary Kerry to present.

Sec. John Kerry:

Thank you very, very much everybody. What a pleasure to be here. This is a really great celebration. This is special. And if anybody here – I know you’re here because you are touched by it – but what a wonderful thing to celebrate the 10-year anniversary of this remarkable intervention that represents the best of the human spirit, and also I think in many ways, the best of American leadership. It’s something we can really be proud of, and we can be possibly not prouder at all of any effort by any individual than the remarkable effort, the amazing job of developing the PEPFAR programs and taking on one of the greatest health challenge crises of our time. I cannot thank enough the leadership of Ambassador Eric Goosby, who has been spectacular in this effort. (Applause.) Thank you. Thank you.

And I want to thank Tatu. Thank you so much for being here with us. I couldn’t be more pleased than to welcome you and your daughter, Faith, here to the State Department. I think you are an inspiration to everybody in this room and to everybody who knows your story, which everybody will learn more of. But you’re a living example of the impact and meaning of this program, and we thank you for coming here to share with us.

Also, when it comes to vision and leadership, I’d be remiss if I did not recognize Dr. Tony Fauci. Tony has been there since the very beginning, and he has taught us all that if we follow the science, we can truly achieve an AIDS-free generation. And I’m not sure there would be a PEPFAR today if it were not for the leadership of Tony, and we owe him all our thanks, so thank you very much. (Applause.)

And I know full well after 29 years on the Hill that without the right senators and congressmen and women behind this kind of effort, it doesn’t happen. And when this started up, it started up with a lot of courage by individuals who were willing to step up. It didn’t exactly have the unanimous consent not only of the people in the Congress initially, but in the country. So I want to thank Senators Mike Enzi and Ben Cardin for their leadership, and thanks for being here today; I know you’re going to hear from them. And I also want to thank my good friend and colleague Senator Johnny Isakson and the other members of Congress who are here. We salute you all for coming and sharing in this celebration, and that is what it is.

Everybody knows that as you look at Congress today, not every day produces the kind of exceptional bipartisan cooperation that created the celebration we’re here to enjoy today. This is one issue where I can happily say that partisanship has really almost always taken a backseat. And in fact, the success of this effort shows what can happen when you reach across the aisle and you do wind up working together.

I want to thank Richard Nchabi Kamwi for – he’s the Health Minister from Namibia – I want to thank him for being here with us today. Namibia has been hugely impacted by this disease, but through the Minister’s efforts, and our partnership with his country, we are seeing extraordinary progress.

And to everyone else here, I know that so many of you here are the stakeholders in this effort and you’ve worked hard on it, and I thank you for what you’ve done and I welcome you here at the State Department on this tremendous occasion.

I want to acknowledge one person who, sadly, is not here today, and that’s Michael Taylor Riggs. Michael was a former congressional staffer whose hard work and dedication helped to make PEPFAR a reality. And as many of you know, Michael passed away last month at the age of 42. And we miss him, and we thank him for his leadership. And while we celebrate today’s anniversary, I think all of us are thinking of Michael as well as the millions whose lives this terrible disease touched: the mothers and fathers who lost children, the children who were left orphaned, the friends and loved ones left behind, the communities that were devastated, from San Francisco to Soweto.

I met a number of these young people who were affected by this disease when Teresa, my wife and I, visited the Umgeni Primary School outside of Durban. And I’ll never forget the visit, walking around these mud huts with a grandmother who was coughing badly from HIV infection, and young kids whose – the only – the gap between them was generations wide. And we saw these orphans who were robbed of their parents, who were forced to take on the burden of adulthood at the age of 13, 14, 15, and caring for their younger siblings.

We were heartbroken at hearing what these children had been through, and you couldn’t help but feel this agony and this total disruption of the way life is supposed to be. But we were also inspired. We saw in their faces the amazing resilience of humanity, and it said something about all of us, and to all of us as well. Because when we all looked lost, when this disease appeared to be unstoppable, history will show that humanity and individual humans rose to the challenge. Action was taken. Innovations were discovered. Hope was kindled, and generations were saved.

The success of PEPFAR, as well as efforts by the entire global community, including the great work done by the Global Fund, represents in truth a victory for the human spirit. And with the Global Fund replenishment happening this year, now is the time for all donors to join with the United States to support and strengthen the fund. The fight against HIV and AIDS shows what we can accomplish when we make the effort together, join hands, overcome the ideology and the politics, and really dedicate our hearts to win.

None of this was easy, and frankly it’s really worth remembering for a moment how bleak things looked at a certain point in time. A decade ago, when the world finally began to reckon with the full magnitude of this crisis, many experts thought it was too late, and with nearly 30 million people infected with HIV/AIDS in 2002, an entire generation seemed lost. When I looked at the enormity of the challenge at that point in time, candidly it was hard not to be overwhelmed to some degree, and perhaps even a tiny bit pessimistic.

But I also felt that we had to do something, and so did many of my fellow senators, I am so happy to tell you, especially Bill Frist and ultimately Jessie Helms. I was proud to serve with Senator Frist as a founding co-chair of the bipartisan HIV/AIDS taskforce, a group that was instrumental in helping us to be able to prepare and lay the groundwork and pass the first AIDS legislation in the United States Congress – unanimously, I might add, in the Senate, thank to Jesse Helms’ and Bill Frist’s efforts – so that that was signed by President Bush in 2003. That translated ultimately into PEPFAR.

This landmark legislation created the world’s largest and most successful foreign assistance program, and today a disease that seemed unstoppable is in retreat. Globally, new HIV infections have declined nearly 20 percent over the past decade. In Sub-Saharan Africa, both the number of new infections and AIDS-related deaths are down by almost one-third over the last decade. Last year alone, PEPFAR supported HIV testing and counseling for nearly 50 million people, and while just 300,000 people in low and middle income countries were receiving anti-retroviral treatment 10 years ago, today PEPFAR is directly supporting more than 5 million people on treatment.

Because of these successes, I am honored to make a very special announcement today, an announcement that we could literally only have dreamed about 10 years ago. Thanks to the support of PEPFAR, we have saved the one millionth baby from becoming infected with HIV. That is a remarkable step. (Applause.)

And as you know, preventing mother-to-child transmission has been a central pillar of our fight against this disease, and just this month we reached the truly landmark moment on the HIV/AIDS timeline. Imagine what this means – one million babies, like Tatu’s daughter Faith, can grow up happy and healthy, go to school, realize their dreams, break out of this cycle, maybe even have sons and daughters of their own, free from the burden and the fear of HIV.

That is not the only good news. I’m also pleased to report that in 13 countries, we have now passed a programmatic tipping point. Today, more people are newly receiving treatment than are newly infected. We are at this point, thanks to the combined and coordinated efforts of all partners in the fight of global – against global AIDS. That is what has brought us to this moment.

But in order for more countries to pass this tipping point and keep going in the right direction, we still need to reach those who are at the greatest risk of HIV infection. That’s why last July, the United States announced the creation of a new $20 million fund to support key populations, people who are too often stigmatized, at risk, and neglected. And that means particularly men who have sex with men, it means people who inject drugs, and it means sex workers. And it’s my pleasure today to announce that the recipients of this funding, Cambodia, Ghana, Nepal, Senegal, Swaziland, Zimbabwe, and two regional programs, are going to have the benefit of this going forward.

This has been a decade of remarkable progress, my friends. But obviously, our work is not done. Millions still become infected every year and millions are still dying. But we can now say with confidence something we could perhaps only have dreamed of before, as I said, and that is we can achieve an AIDS-free generation, and that is within our grasp now.

So to get there we’re going to have to stay at it. Under President Obama’s leadership, we have redoubled our efforts. Through PEPFAR, the U.S. now directly supports three times more people on antiretroviral drugs today than we did in 2008.

Where we once saw a situation spiraling out of control, today we see a virtuous cycle beginning to form, with more people receiving treatment and fewer people passing on the virus. Fewer infections means it is now easier to actually focus treatment efforts. And with fewer people sick and dying, we are seeing healthier, more productive populations. That’s the virtuous cycle. The economies of Sub-Saharan Africa are growing at a substantial rate, and a generation is now able to look to the future with hope.

As the progress continues, PEPFAR, over its next decade, will gradually evolve as our fight against this disease evolves, and that is going to happen both by necessity and by design. Achieving an AIDS-free generation is a shared responsibility and it is going to be a shared accomplishment. That is why PEPFAR is working to gradually and appropriately transfer responsibilities to host countries. This means that PEPFAR will shift from merely providing aid to co-investing in host countries’ capacity.

Ten years after this program began, rest assured that the commitment of President Obama, the State Department, myself, this country’s commitment to fighting HIV/AIDS is as undiminished as our work is unfinished. Our commitment has only been strengthened by the progress that we’ve made and the lives that we’ve saved and this story that we are able to tell today. This story compels us to continue.

What has been achieved here is a lesson for all of us. And I think it is, in fact, a lesson that people should believe in humanity. To never doubt what we can achieve is one of the lessons of today, to know that we can do the remarkable, that we can find solutions to what seems to be unsolvable, that we can overcome the insurmountable and we can leave politics and ideology at the wayside in order to choose life and possibilities for people everywhere.

Because of this faith, because of this program, because of your efforts, because a mother like Tatu could live to see her child grow up to change the world – that is why we will continue

Thank you. Thank you, Eric. Thank you, senators and congressmen and women. And thank you, all of you who have worked at this extraordinary effort. It’s a story worth telling. Appreciate it. (Applause.)

Amb. Eric Goosby: Well, thank you. It's now my pleasure to introduce two truly outstanding PEPFAR champions here today: Senator Mike Enzi and Senator Ben Cardin. I'll introduce both of them, but Senator Enzi will be the first to speak. It's difficult to overstate Senator Enzi's role in the global fight against AIDS, but he is a true leader and friend of PEPFAR. I've been grateful to be able to work with him during my time as Ambassador.

Prior to coming to the Senate in 1997, Senator Enzi had a long and vibrant career as a successful small business owner, member of the Wyoming Air National Guard, mayor, state representative and state senator. As a United States senator he has made meaningful contributions to health on multiple committees, including the Health, Education, Labor and Pensions Committee, where he has served as both chairman and ranking member. His thoughtful and measured work has been guided by his visit to Africa, where he's been able to evaluate our programs firsthand.

And millions of lives are better off due to the expertise and input of Senator Ben Cardin. A senior Member of the Senate Foreign Relations Committee, Senator Cardin has been praised for his mastery of public policy, pragmatic bipartisanship and even-keeled determination by the Washington Post, was first elected to the Senate in 2006 but also served for nearly two decades in the House of Representatives and, before then, as Speaker of the Maryland House of Delegates. Senator Cardin has been a supporter of PEPFAR since his tenure in the House and has been a valued voice in ensuring our smart investments are based on sound science and a shared global responsibility. Senator Enzi, if I could ask you to come forward?

[General applause]

Sen. Mike Enzi: Thank you, Ambassador Goosby, friends of PEPFAR. What a great day -- 10th anniversary. Doesn't seem like it's been that long, but we do know that it's been saving lives. I remember being at the State of the Union speech when President Bush said, "We're going to put $15 billion into an AIDS effort." That shocked everybody that was there. Republicans, Democrats -- everyone was shocked. It was a lot of money. It was a lot more money then than it is now.

[General laughter]

Sen. Mike Enzi: So it generated a lot of conversation, but we were able to come together with a bill. And, as the Secretary said, that bill passed unanimously in the Senate and in the House. That's as bipartisan as you can get. Well, after that happened, then they sent some of us to take a look at the problem after we passed it.

[General laughter]

Sen. Mike Enzi: But that was a real eye-opener. One of the first places we went was to South Africa. The Director of Health in South Africa had been educated in Moscow during the Cold War, and she was sure that whatever the United States was doing was going to be adverse to the people of her country, that maybe we were trying to wipe out their population. Of course, in their country the military realized that they had to train five people for every position because four would die before they could take the position over. So the military was willing to let us come in and have a program. It worked, and that showed the population that it wasn't as adverse a program as they thought.

I remember visiting a 3,000-bed hospital, and three people were being treated with antiretrovirals -- three. And they had to sign a contract that, at the end of two years, they wouldn't be able to get it anymore, it would be somebody else's turn. So they'd return to a healthy lifestyle, were able to work and support a huge family knowing that, in two years, that was over without PEPFAR.

I visited a Salvation Army orphanage. At that time the churches were pretty much the only people doing anything with AIDS. I remember visiting this one hut. There were 25 cots around the hut for kids that were under 5. Their parents had already passed away from AIDS. I asked how many were being treated and they said, "Well, five are being treated." I said, "How many need to be treated?" Well, the doctor caught up with me later and he said, "You do know that if they're not treated they won't make it to the age of 5. All of them need treatment. We can only get medicine for five." How would you like to be the person that had to pick the five? You don't have to do that now.

Another thing that was being preached at that time was that if the mother had AIDS and had a child, they couldn't nurse because HIV would go through the mother's milk. Something we've learned since that time, of course, is that if they're on antiretrovirals the baby probably won't have AIDS and they will be able to nurse, which is essential in those really poor countries. That was a discovery, incidentally, by a person educated in Wyoming, graduated from the University of Wyoming and somehow --

[General laughter]

Sen. Mike Enzi: -- had to put that in there --

[General laughter]

Sen. Mike Enzi: -- somehow wound up in Harlem working on the AIDS problem, and found out that if mothers were on antiretrovirals -- and, you know, in the United States we suggest they don't even take aspirin if they're pregnant -- but antiretrovirals help. Lately I've retraced the steps that we had on that first trip . . .

Oh, I should mention that we went to Mozambique, too. We went into the back country and we got to meet with traditional healers. Actually, we call them "witch doctors," but they're "traditional healers" there. We asked them what they had learned about AIDS and they said, "We've learned that we shouldn't bleed two people with the same knife." That's the level of education before PEPFAR.

Recently I got to visit an orphanage -- the Kasisi Orphanage in Zambia -- and got to talk to delightful little Sister Moriole, who runs it. There are five nuns from Poland that run the thing, along with five nuns from Zambia. She was telling us how thankful she was that PEPFAR came along because before PEPFAR they had to bury 18 kids a month that died of AIDS; now they only have to do one a month. And the difference? The mothers are being treated now, and they're getting the kids in a little better condition.

We saw one baby there that had just been brought in, and they weren't sure that that baby would make it because the mother brought the baby in and died the same day of AIDS. So it was a pretty advanced stage. This is one of those things where the help that the United States gives gets to the people -- all of the people, at the lowest level of the people. They know it and they appreciate it, and it's some of the best efforts that the United States have ever made in any of our foreign affairs.

We've also learned a lot from these different places. There's a cervical cancer test now that is done with white vinegar that's saving lives. And, of course, there are the circumcision clinics, particularly in Africa, that are saving lives. So it gets to the people. As the Secretary said, we need to continue this program. And we need to encourage the countries that have found the successes to join us and to participate and to actually take over the program at some point in time. It's their people, but it's their appreciation for the United States. So our work is still cut out for us. There's still a lot we have to do, and we need to continue doing it. I thank all of you for your participation in this great project.

[General applause]

Sen. Ben Cardin: Senator Enzi, thank you for sharing the specific stories. It is so important for us to see what has happened over the last decade. We want to see that village that you referred to, that's gone from 20 burials to one, to go to zero. We have the capacity to make that happen. Tatu, thank you for being here. You've put a face on it. We heard Secretary Kerry talk about the numbers, and they're extremely impressive -- the millions of people who have received help through PEPFAR, the millions of lives that have been directly affected by PEPFAR.

The good news is that those numbers are accelerating. The number under treatment, the number of lives saved, the number of babies that are not infected -- those numbers are increasing dramatically so that we should see continued progress if we continue our commitment. We can win this fight, and that's really the message.

Today we celebrate 10 years. It's a long time. We've seen an incredible change over the last decade. Ambassador Goosby, thank you for your extraordinary leadership in [getting] all the players moving in the same direction. I come from the Congress of the United States. That's not easy to do. We thank you for your leadership in making this a reality.

I want to thank my colleagues on this. Secretary Kerry has mentioned them. Senator Enzi and Senator Isakson are two senators who look at a problem and then try to find a way to find a solution, to bring us together. That's certainly been true on our fight against HIV/AIDS. And I thank both of our colleagues for their very, very positive way that they have worked to make this a reality -- bridging partisan division, bridging the different bodies of the Congress. They made an incredible difference. To Barbara Lee and the Congressional Black Caucus: Thank you for thinking big over a decade ago.

[General applause]

Sen. Ben Cardin: And to Jim McDermott, who was my seat mate on the Ways and Means Committee. At every opportunity he could find to advance the cause of HIV/AIDS, he was there in the forefront, raising these issues at times when it wasn't popular to do that. So Jim, I thank you for your leadership and your help.

[General applause]

Sen. Ben Cardin: One of the great honors that I've had is to serve on a committee that was chaired by then-Senator Kerry and see his drive and his commitment to get things done. On HIV/AIDS he has been tireless in developing strategies that would work. As a senator and now as our Secretary of State, we are truly blessed to have an international leader with credibility, who can bring diverse interests together to work out a way to move forward an issue. He certainly is doing that, continuing to do that on our fight against HIV/AIDS. So to Secretary Kerry: We very much appreciate his continued commitment to public service. Our loss to the Senate has certainly been our country's gain as our Secretary of State.

As a result of the work that we have done, as a result of PEPFAR, hope has replaced despair, life has replaced death, and productive lives have replaced those who were disabled and couldn't work. The numbers speak for themselves -- the progress that we've made. Not only have we affected millions of people; we have changed health delivery systems in places in the world that desperately needed a way to provide health to their people. It represents the best of America.

The best of our values is represented by PEPFAR. It represents our global humanitarian desires and values, what America can do when it leads. It represents a view that if we have a healthy country we have a more stable ally, a country that will not only be our friend but will consume our products and develop a market. It's in our interest, it's in our security interests to work towards healthier countries globally.

PEPFAR represented the best in the bipartisan tradition of the United States, where the President and Congress worked together, where Democrats and Republicans worked together, where government partnered with the private sector to bring about an incredible result. The Secretary already mentioned some of our partners at the Global Fund. I know that Senator Enzi mentioned his Wyoming contacts. I have to mention NIH at John Hopkins University, the University of Maryland Medical Center, and all of those partners --

[General laughter]

Sen. Ben Cardin: -- that have made a huge difference. Thank you very much for all of your leadership. But it represents the best in American politics, the best in what America can do when we truly come together. And, quite frankly, to my colleagues in Congress: I hope we use this model this year to get other issues resolved in the Congress of the United States.

[General applause]

Sen. Ben Cardin: But as Secretary Kerry said, we cannot stop here. We still have the challenge ahead of us. Our goal is an HIV/AIDS-free generation, and it's truly within our reach. Continuing this effort, we can accomplish that goal. We're proud to be partners -- the United States Congress -- and we're proud of the people in this room who have made today's celebration a true celebration for humanity. Congratulations.

[General applause]

Amb. Eric Goosby: Well, thank you to both Senators. Those were really wonderful remarks. I know we all share them. I now want to introduce, really, a friend and a colleague. It's really my privilege to introduce Dr. Kamwi, who is our Namibia Minister of Health. He has been a wonderful public servant in his country and a true leader in focusing his country under President Pohamba on the essential ingredients to turn the epidemic in Namibia towards that AIDS-free generation.

Minister Kamwi has served in this position since 2005 after holding a post in public health from Environmental Health Officer to Deputy Chief Public Hygiene Officer to Chief Health Program Administrator. After receiving his PhD from the University of Namibia in medical entomology, he worked on malarial control strategies. He has been a stunning and aggressive Minister of Health. We don't have time to read his impressive and extensive bio today. I would like to point out that his official bio states that he's been a good partner to the United States -- which he certainly has -- and that he's been a fan of PEPFAR, for which I thank him.

I had the opportunity to visit Namibia a few months ago and witness firsthand the truly extraordinary work that's being done there. It is a country that has changed its trajectory, engaged in strong management and oversight, has targeted key populations aggressively and been at the forefront in tackling gender-based violence both with medical and legal strategies. Namibia is also implementing the B+ -- prevention of mother-to-child transmission -- and increasing its own funding significantly each year. Please join us in welcoming the Minister of Health.

[General applause]

Dr. Richard Kamwi: Good morning, ladies and gentlemen. And thank you to my good friend, Ambassador Goosby, for the warm introduction. I would like to begin by expressing my profound gratitude on behalf of the government of the Republic of Namibia for the privilege accorded to me to attend this historic moment in the presence of Secretary Kerry -- who has just left us -- Senator Enzi, Senator Cardin.

The 10th anniversary of PEPFAR represents a decade of hope and renewed help for victims of HIV/AIDS who, without PEPFAR support, would have succumbed to the deadly pandemic. Our government and the people of Namibia have come together to combat HIV/AIDS, thus making it a top priority for the nation. We have developed and implemented policies, programs and services that have enabled us to prevent the further spread of HIV, treat those who are infected, and care for those who are affected.

But Namibia alone cannot take credit for these hard-won victories. Rather, they have been made possible through the historic partnership between the government of the Republic of Namibia and the government of the United States of America. I would also like to acknowledge the generous contributions the U.S. government has made to the Global Fund which, in turn, has also partnered with Namibia not only in our fight against HIV/AIDS but also against malaria and TB.

Let me share with you the devastating effects of this disease on my country prior to the arrival of PEPFAR in 2004. In 2002 the HIV prevalence in our ante-natal care was 22.3 percent, meaning that close to one in four pregnant women was HIV-positive. Yet only a few of them were able to access services to prevent mother-to-child transmission of HIV, provided only in two major hospitals of the country. Fewer than 400 individuals were on antiretroviral treatment, and all of them were treated in the private sector.

But with the launch of PEPFAR in Namibia, AIDS-related sickness and death began to give way to life and hope. Over the past decade the financial resources dedicated to combating HIV/AIDS, particularly from PEPFAR, have been truly transformational. With support from PEPFAR, the Global Fund and sizable investments by the Namibian government, we have built infrastructure, strengthened our human and institutional capacity to combat HIV/AIDS. We have also made significant gains against TB, which affects people living with HIV at an alarming rate. We are on the threshold of eliminating malaria within our borders.

It is with immense pride that I'm able to declare that we are, indeed, winning the fight against HIV/AIDS. We have passed the crucial programmatic tipping point where the annual increase in adults on treatment exceeds the annual number of adult infections. The 120,000 Namibians living with HIV on treatment represent an estimated coverage of 87 percent [unintelligible] for eligibility a threshold of 350. More than 83 percent of HIV-exposed infants receive an HIV test within six weeks of birth. And our mother-to-child HIV transmission rate at six weeks is less than 3 percent.

[General applause]

Dr. Richard Kamwi: These impressive results are some of the best on the African continent. Ladies and gentlemen, how did Namibia achieve such success? First, we have had an infusion of financial, human, and technical resources at a critical juncture in the epidemic. Secondly, we benefited from the government leadership and commitment from the President down to local constituents, community leaders and NGOs. Thirdly, the Namibian public demanded a response from the government, thereby ensuring that we were held accountable on our promises.

Finally, and perhaps most importantly, we benefit from a truly global partnership linking the U.S. government, the Global Fund, U.N. agencies and numerous other multilateral institutions and international NGOs in a unique alliance. It was the government and the people of the United States who provided the financial resources necessary for Namibia to mount a forceful and effective response to HIV/AIDS. For this my government and our people are eternally grateful.

[General applause]

Dr. Richard Kamwi: What I am describing here is the concept of shared responsibility. The HIV/AIDS pandemic is far too big and complex for any one country to tackle on its own. In the 21st century people are increasingly interconnected. A disease raging in one part of the world poses a threat to people living elsewhere. Both share responsibility and the complementary principle of country ownership, in which countries [assuming] greater responsibility for leading their HIV/AIDS response [is] required in order for the global community to develop and implement a sustainable response to HIV/AIDS. That will see us through the long haul and, certainly, well beyond the [endpoint] of the MDGs come 2015.

I am proud to say that in both policy and practice Namibia is living proof of these principles and, in this way, is part of the global community in working towards the realization of an AIDS-free generation. All of you in this room should be encouraged by and proud of what we have accomplished in Namibia because these gains would not have been possible without your contributions. We are on the verge of malaria elimination, working stringently towards TB elimination. And with the strength of our global partnership, Namibia may be the first country on the African continent to eliminate HIV transmission.

[General applause]

Amb. Eric Goosby: Thank you.

Dr. Richard Kamwi: I would now like to invite to the podium a true heroine in our collective push to achieve an AIDS-free generation. Tatu Msangi, my sister from Tanzania, you have the floor. Thank you.

[General applause]

Tatu Msangi: Thank you. My name is Tatu Msangi, and I'm 41 years old. I'm honored today to stand before you as a living example of the impact of PEPFAR [unintelligible] over the past 10 years. When I became pregnant in 2004, I went to the ante-natal clinic at Kilimanjaro Christian Medical Center in Moshi, Tanzania, known as "KCMC". I was given a blood test and discovered that I was HIV-positive. I was shocked when I learned my HIV status, and I felt scared for my health and the health of my baby.

But the counselors at the clinic gave me hope. They told me there were things I could do to prevent my baby from contracting HIV. I took medication during my pregnancy to reduce the risk of transmission of HIV to my child. I delivered my daughter through Cesarean section, and she received the medication after she was born. I named my daughter Faith, and she is here with me today. She is 8 years old, and she is HIV-negative.

[General applause]

Tatu Msangi: She is happy in health, and my health also is good. I'm also a woman who is helping my country to fight this terrible disease now and for years to come. Several years ago I began working at KCMC counseling women who are going through what I went through and encouraging them to participate in the PMTCT program. I could see how scared many women were when they first arrived. I could hold their hands and tell them it will be okay as long as they learned about HIV and took care of themselves and their families. I told them my own story to reassure them.

Then, in 2011, I earned a nursing degree. Now I work at Kilimanjaro Christian Medical Center as a registered nurse. I am proud to work at the clinic and enjoy working with women, children and families to improve their health. Also, I work hard to make sure my colleagues and other health workers get tested, too. Most recently, I joined the board of directors for the Ariel Glaser Pediatric Healthcare Initiative, known as "[AGPHI]". AGPHI is a locally-run organization that collaborates with the government of Tanzania and partners like PEPFAR and Elizabeth Glaser Pediatric AIDS Foundation to eliminate pediatric AIDS and to provide care and treatment for people living with HIV in Tanzania. As an HIV-positive nurse with an HIV-negative daughter, I feel that I bring a unique perspective and voice to the leadership of these local organizations.

As a nurse, I can also tell you that when the first HIV test is carried out on a baby and it's negative, it is amazing to see the relief and joy on a mother's face. I remember that feeling so many years ago, fighting so hard to keep my daughter [healthy] and free of HIV. Today Faith and I have a bright future ahead of us. Faith enjoys school, and I'm hopeful that she will continue to excel. My daughter Faith is all the proof you need that an AIDS-free generation is possible.

With PEPFAR's help, hundreds of thousands of HIV-positive pregnant women have given birth to HIV-negative children. I am deeply grateful to PEPFAR and the people of the United States for everything they have done for me, my daughter, and all other women and children who need help to save their lives. Thank you, once again.

[General applause]

Amb. Eric Goosby: Well, thank you so much. That was a wonderful series of testimonies coming at it from many different angles to the 10 years that PEPFAR has contributed. I want to thank you all, again, for helping us recognize this 10th anniversary of the creation of PEPFAR. When I took a look at the room, I see faces here that go back for many years, going back to the early '80s for some of the people in this room -- for Tony Fauci, in particular, who has really been a friend and mentor to me in more ways than I can count in more situations than I can recall. But the long-term contribution that the Secretary acknowledged I just want to echo.

I also want to acknowledge Peggy Hamburg -- who's in the room -- Commissioner from FDA, which really typifies a new chapter in the contribution that PEPFAR is moving toward making as a U.S. government effort to bring the ability to approve drug approval to more countries more simply, with a containment of excellence in the evaluation process.

So all I can say is that it's been 10 years, and what a difference a decade makes. Ten years ago AIDS was ravaging countries in Africa, wiping out an entire generation, erasing critical health and development gains, threatening the key foundations of societies as it saturated and blocked medical delivery systems, making them unresponsive or slow in responding to all diseases. Today too many people are still dying -- 1.7 million. But the progress that we've made together is remarkable.

What we have proven with PEPFAR is that when you make significant investments in a problem, you achieve significant results to scale. And when you remain flexible, matching program services to critical human needs, the success continues. When PEPFAR was created, it was an emergency response to an emergency situation.

My colleagues -- many in this room -- and their predecessors, and the teams that they created both in the United States and in country, the extraordinary role our chiefs of mission and embassies have played in orchestrating the USG response through the seven agencies that make up the PEPFAR family -- an extraordinary job in that responding is truly what was created. And we have seen, as the needs of these populations who depend on these services change, an ability to be nimble and responsive.

Today, thanks to new scientific evidence and lessons learned from a decade of implementing the program, we find ourselves at a tipping point in the fight against AIDS -- a tipping point that led our former Secretary of State, Hillary Rodham Clinton, in November of 2011 to make the historic declaration that the world is at the point where an AIDS-free generation is in sight. And while together we are saving millions of lives, PEPFAR's response to the global AIDS crisis is also transforming the health sector in many countries.

PEPFAR's investments strengthen national health systems so they can move effectively and effectively deliver the essential services for all the needs of their people, including the non-HIV needs of people living with HIV. Clinics, hospitals and communities that were once overwhelmed dealing with AIDS now have the systems, tools and capacity to address the broader range of health issues that face people. These focused investments are enabling access to basic health care, often where little or none existed before. In countries with substantial PEPFAR investments -- 36 of them -- we've seen reductions in maternal, child and TB-related mortality -- dramatic reductions. We have seen increased use of ante-natal care and wider availability of safe blood, just to name a few.

And while we are doing this, we are not taking our eyes off the prize. We are not letting up, and are focusing more intently, more specifically on the specific ingredients needed to achieve that AIDS-free generation in this town, in this district, in this province, in this country. We must continue to work on reaching this goal together. As Richard said, it is a shared responsibility. No one nation or donor organization can do this alone. We've come this far together, and everyone in this room knows we can go the distance. Now it's time to come together once again to reach the finish line.

Part of the reason that we've gotten this far is because of the tremendous bipartisan support that PEPFAR has long been fortunate to receive, starting with President Bush and a bipartisan Congress, and continued by President Obama, Secretary Clinton and now Secretary Kerry, but also in working with Senator Gordon Smith as well as Representative Barbara Lee, among others, to lift the travel restrictions once placed on those living with HIV.

I want to thank all of the congressional leadership, the real champions who, over countless fights over many years, are here with us today. Both Senators Cardin and Enzi, Senator Isakson, and Representatives Leach, Barbara Lee, Congressman McDermott and Congressman Waxman and Wasserman Schultz. You each know the individual issues that you have put forward on the table and, most importantly, have kept in front of us. And we thank you for that leadership.

There are so many heroes in this fight. Some of you are sitting in this room. That's why I'm pleased to announce today that, as part of the 10th anniversary commemoration, PEPFAR is launching an initiative that we're going to call "PEPFAR Heroes". PEPFAR Heroes will honor outstanding individuals who have demonstrated extraordinary commitment and passion in serving people and communities affected by this disease around the globe. We will announce the honorees at an event in Washington on World AIDS Day later this year.

As I conclude, I want to leave you with a thought: What would the world be like today without PEPFAR? I truly believe that PEPFAR is one of the great gifts the American people have given the world because PEPFAR gives the gifts of hope and life. Each and every one of you in this room, and so many others who are with us in spirit, should be proud of the work you've done to deliver this gift over the past 10 years. It's truly an honor to serve with you and to look at the opportunities that are before us. So I thank you very much for staying for this 10th-year anniversary celebration.

[General applause]


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