I would like to welcome Ambassador Goosby and Ms. Batson before the Subcommittee today to discuss the fiscal year 2012 request for Global Health programs.

The President's Global Health Initiative was announced almost two years ago and will encompass all global health funding under this Subcommittee's jurisdiction.  It totals $8.7 billion in fiscal year 2012 - an increase of $887 million from the enacted fiscal year 2010 levels.

Almost 70% of the Global Health Initiative (GHI), or $5.9 billion, is for HIV/AIDS programs under Ambassador Goosby's office.  Therefore, I hope both witnesses will be able to comment on the implementation of the GHI.

First, let me state that I support the goals of the President's Global Health Initiative. If the GHI will achieve better health for adults and children in the developing world and provide a long-term plan for delivery of health services led by the countries themselves, then I can support the Administration's efforts.  However, given that there is no authorization for this program and no clear goals, I must admit that I am skeptical.

To date, your track record is not very good.  In the fiscal year 2010 House report, the Committee included language at my request directing the Administration to provide a report on global health programs so the Subcommittee knows how effective they have been at meeting their objectives and goals.  Here we are two years later, and we have nothing.

In addition, it is still unclear who is providing the leadership for the GHI.  In the last week, I learned there is a new executive director.  And while the QDDR states that GHI will fall under USAID after certain benchmarks are met, it is unclear what this means in the interim.  I will be raising a number of questions today that I hope our witnesses can answer.

I also have concerns about the operations of the Global Fund to fight AIDS, TB and malaria, specifically the Administration's large multiyear commitment – something that, if fulfilled, would most likely have to come from offsets to your bilateral HIV/AIDS program.  I know this is not your intention, Ambassador Goosby, but it could well be the reality of today's budget climate.

Let me close by saying that while I have concerns about the direction this budget request takes us, Americans should be proud of the many milestones U.S. global health assistance has achieved in the past 10 years.  Many Americans enter careers in global health to provide care that otherwise would not be available to the poorest of the poor. But more money alone is not the answer.  In the current fiscal environment, our government will have to deliver services more efficiently, without destructive competition between agencies and with open books to ensure ample auditing and transparency.

Additionally, both USAID and the Global AIDS Coordinator have large pipelines of previously appropriated funds that are unobligated and unexpended.  I hope you can provide more details about those funds for the record.

Thank you both for appearing before us today.  I look forward to hearing more about your work.

 I will now turn to the Ranking Member, Mrs. Lowey.