Thank you. Good morning. It is truly a pleasure to welcome all of you to the second day of the Africa Health Forum, and I greatly appreciate this opportunity to appear before you.
I want to thank the World Bank and Harmonization for Health in Africa for partnering with the State Department to convene this important meeting and the many distinguished ministers, bilateral and multilateral development partners, major foundations, and private sector leaders for joining us today.
I also want to thank Assistant Secretary for Global Affairs at the Department of Health and Human Services, Dr. Nils Daulaire, and Dr. Ariel Pablo-Mendez, Assistant Administrator for Global Health at USAID, for their support in organizing the U.S. contribution to the forum and for their exceptional work on health systems strengthening and health care finance reform.
Finally, please allow me to extend my deepest gratitude to my friend and colleague, Ambassador Eric Goosby, for his extraordinary lifelong service to public health and his commitment to the treatment and eradication of AIDS here in the United States and across the world.
We gather here today amidst a dramatic transformation of the African continent from a region once defined largely by its problems, to a region defined increasingly by its possibilities… from a region afflicted by conflict, crisis, and impoverishment to a region known more and more for its economic growth, expanding democratic governance, and enhanced health and human development.
Rwanda, a country devastated by genocide less than two decades ago, is today on track to meet many of the Millennium Development Goals - life expectancy has doubled, maternal mortality and annual child deaths more than halved, and deaths from HIV, TB, and malaria have dropped by 80%.
In Ghana, economic prosperity and good governance have not only led to improved health outcomes, but also important innovations in health care delivery and education that are having an impact across the region.
As the continent evolves, and as governments take on greater leadership and responsibility for their own future, the nature of assistance and cooperation from the international community should evolve as well – from a donor-recipient relationship to more of a partnership.
This partnership – based on principles of country ownership, shared responsibility, and mutual respect – allows donors and partner countries to better meet the needs of the country’s population. Where transparency, good governance, and accountability are enshrined in law and in practice – our joint investments will yield more effective, more efficient, and ultimately more sustainable outcomes.
This is why sustainability and shared responsibility are two foundational principles of President Obama’s Policy Directive on Global Development and our global health diplomacy strategy.
Let me say just a few words about each.
First, to ensure that the results and significant investments we have all made to-date are durable, governments – in partnership with civil society and the private sector – should lead, implement, and eventually pay for all aspects of their health system. Partnership between Ministries of Finance and Health are critical and I am very pleased to see ministry representatives from over two dozen African countries here today.
It is this kind of dialogue that has made possible the significant transitions underway in health assistance programs across Africa, from Namibia - where thousands of PEPFAR-funded essential health care workers are now fully financed by the Government of Namibia, to Ethiopia - where U.S.-selected partners are providing technical assistance and cooperation to local partners instead of directly implementing programs themselves.
None of us are under any illusion that these transitions are easy or risk-free. But you have shown that they are possible. And this is why we must be systematic about capturing lessons from recent successful transitions from donor dependence to country ownership, just as we continue to benefit from lessons learned in transitions in family planning that began several decades ago and documented by colleagues from USAID and UNFPA present here today.
Second, the decision to elevate shared responsibility to the core of our policy approach was conscious and deliberate. The only way we can eradicate polio, reach the goal of an AIDS-free generation, eliminate the effects of neglected tropical diseases, roll back malaria, and end preventable maternal and child deaths, is if we do it together.
Our commitment to global health remains strong. Indeed, President Obama’s budget request for a $1.65 billion contribution to the Global Fund in fiscal year 2014 maintains our historically high level of support.
Consider the enormous progress in combating HIV in South Africa.
Over the last decade, the United States provided $3.2 billion to support South Africa’s fight against this epidemic. Through our joint efforts and mutual investments, millions of South Africans received treatment for HIV, and the rate of mother-to-child transmission plummeted to 2.7%. And today, South Africa is increasing its investments so that locally generated revenues are replacing hundreds of millions of dollars in external financing for antiretroviral therapy and other elements of the AIDS response.
This vision of strengthened country capacity, leadership, and ownership, is also driving the signing of more than 20 Partnership Framework agreements that bring together governmental and nongovernmental partners around a strategy to combat HIV/AIDS. And the strategy is working.
In Zambia, when the government introduced an innovative, evidence-based program and doubled its budget for antiretroviral drugs, the United States was able to provide an additional $30 million in funding. And today, through joint investment and collaboration, the number of people receiving antiretroviral treatment each year, exceeds the number of people infected with HIV, putting Zambia solidly on the path to an AIDS-free generation.
We need to sustain and accelerate this positive momentum. To do so, it is vital that we translate the conversations here in Washington into actions in your respective capitals. To better support your efforts, we will be sure to share the results of this forum with our Ambassadors, Mission Directors, and their teams at our missions across Africa.
Like all of you, I have no illusions about the challenges ahead, but I remain optimistic about Africa’s future. The work all of you are doing -- day in and day out -- to deliver improved health outcomes across the continent only reinforces that optimism, and that sense of possibility. I want to thank all the participants at this meeting and our development partners from around the world for all that you do. I wish you every success over the rest of the day, and in the months and years ahead.