 Good. I'd like to ask everyone to please find a seat. We're going to get startled. Oh, you did? Welcome today to the launch of the final report of the CSIS Commission on Smart Global Health Policy, a call for a healthier, safer, and more prosperous world. And thank you all for joining us here on this beautiful spring day. And that includes several hundred people who are joining us online through the live web stream. I'd also like to ask everyone to please turn off your cell phones or put them on mute. I'm Steve Morrison, and together with my colleague Lisa Cardi, we've provided the secretariat for this effort over the last year. John Hamry, my boss, the president and CEO of CSIS, would normally be welcoming you here today. He is also a commissioner and has been a strong advocate of this effort. He's also head of the President's Defense Policy Board, which Secretary Gates has called together today, tomorrow, and John as chairman of that effort, must be there and sense his regrets. I also want to convey the regrets of Congresswoman Kay Granger, another very active member of this commission, who, because of an appropriation subcommittee hearing that begins in about ten minutes, is unable to be with us this afternoon, and she asks that we convey her regrets. We were very ably hated in this enterprise by several very talented and dedicated individuals at CSIS. Suzanne Brundage became overnight the nerve center coordinating the commission's work and was indefatigable and quite indispensable. Daniel Porter, Emily Posner, and Liz Warhouse all made very substantial contributions over the past year, and I want to thank them as well. We have a packed house each day. We have a packed agenda and a very tight schedule. We're going to have to manage our program carefully and keep to our schedule and still enjoy ourselves. We regret that there is not time in the schedule to field questions and comments from the audience over the course of the afternoon. I apologize for that. We did take a preliminary step of reaching out online to our audience on smartglobalhealth.org and solicit questions and comments for input here today. We received 200 or more of those which have been compressed and we'll figure in the panel discussions and some of the other comments. We also wanted to use this as the occasion really to have our commissioners interact and to on the key themes through the panels and to share their thinking in that way. And so we've structured the day with that in mind. We also welcome your comments online and directly to us from today and beyond and we'll do our best to respond and we would certainly appreciate that. In this room today are many, many individuals and many organizations to which we're very grateful for their input and perspective during the commission's work. We go into some detail in the acknowledgement section of our report in trying to be fair and acknowledge those many, many people who gave us so much time and so much insight. We're especially indebted to the U.S. agencies that helped us, the State Department, the U.S. Agency for International Development, the FDA, CDC, NIH and others who were so supportive and generous. After today we'll carry forward with several streams of work that grow directly from the commission and please stay tuned as we unfold those streams. We will continue to be focused on security and preparedness, on maternal and child health and gender issues and HIV AIDS and we will remain very reliant on you, our friends, in carrying this work forward and we are intending that we will be tracking progress periodically as we go forward and we will be doing an aggressive outreach process with the administration and with Congress to try and move this agenda forward. I want now to turn the floor over to our co-chairs to kick this session off. Admiral Bill Fallin, a career naval officer, former head of the U.S. Pacific and Central Commands will open up and be followed by the co-chair, Helene Gale, president and CEO of CARE. So I would like to ask Bill to please come forward and open things up. Please join me in welcoming him. Well, thanks, Steve, and good afternoon. I'd like to thank each and every one of you for coming and those that are tuned in on the web today as we launch this report of the work of the Commission on Smart Global Health Policy. And I am happy to see that we're blizzard-free for those that are not in Washington. It is a beautiful, glorious, sunny day and a heck of a lot more promising than back in February when we had this event originally scheduled. I just intend to speak for a few minutes, quickly explain how we went about our work, outline the Commission's goal, the overall spirit and logic of the approach. And I think this background is important in understanding the product that you have in your hands. Time is tight. You all have the full report. It's available online at smartglobalhealth.org and you can follow along if you haven't already consumed this thing. Later in the program, during several roundtable discussions that we have scheduled to hear from other commissioners about three key themes of the report, maternal and child care, measurement and accountability, and U.S. leadership and partnership with friends and allies. I want to first express my special admiration and gratitude to my co-chair, Elaine Gale, the person of boundless commitment, insight, generosity and leadership in these areas of development and health. She's been a patient guide, always in good humor, and become a good friend in the process. I learned an enormous amount from her that I'll carry with me in the future. Thank you very much, Elaine. I want to thank my fellow commissioners who devoted significant time and energy to our deliberations. And I see that many have gathered here. I'd like to highlight Donna Shalala, secretary. Thanks for your strong contributions. I know we're going to have a few others that are going to drift in over the next couple of minutes, and as we spot them, we'll highlight them for you if you don't already know who they are. There are some commissioners that couldn't make it today. They all remain active and vital contributors. They're listed in the front page, the signatory page. I know we're going to have a few others that are going to drift in over the next couple of minutes, but they're still active and vital contributors. They're listed in the front page, the signatory page of the document. I want to thank members of the Obama administration who kindly provided their input to our deliberations on many points, Secretary Jack Lew, Deputy Secretary of State, Gail Smith, the senior director at the National Security Council, and special assistants of the president, both of whom are going to join us today, and certainly appreciate the tremendous amount of time and effort that they devoted. I'd also like to single out thanks to Zeke Emanuel, Eric Goosby, Dana Hyde, and Jennifer Klein for their contributions. Now the 25 commissioners who began this work almost a year ago are all seasoned opinion leaders accomplished in their respective spheres who think strategically, care deeply for our country, and for the good that we can do in the world. We began with many ideas from our diverse backgrounds and concluded collaboratively and optimistically that the United States can better the lives of the world's citizens and advance our own national interests by investing strategically in global health, and this is a smart choice in our best national interests. The remarkable achievements of the past decade inspire us to recommend doing more in the future. We already have many of the tools to lift and save the lives of millions. We have partnered governments that are serious and ready to do more, and they are very able multinational organizations willing to partner with the U.S. government. These partnerships are crucial to improving the health of the world's people. Our perception of health and its impact on the world has changed. Health matters in new and different ways. It is today a very visible, essential ingredient of economic productivity, the viability of families, and the stability and security of communities and nations. Our understanding of global security has changed fundamentally. We now understand the vital importance that health plays in the personal security of families, be they women, children, and husbands who live in tenuous circumstances. And the links between a safer, healthier, and more prosperous world population to our U.S. global national interests. The goal from the outset was to answer a core question. Can the United States achieve a smart, long-term approach to U.S. health that harnesses all of America's assets and expertise in better and fuller partnerships with our friends and allies? I think we've come up with some good answers. Not perfect solutions, but a coherent, compelling plan of action that people of different political outlooks from diverse walks of life can rally behind. From the outset, our approach was a deliberate experiment. We insisted that at least a third of the commissioners be seasoned professionals and recognized opinion leaders in global health. They were to ground us quickly in the quickly evolving realities of global health and make sense of this world to the rest of us, and they were patient. We also needed leaders from other walks of life, business, foreign policy, Congress, security, media foundations. We needed their independent outlook, their fresh ideas, their critical perspectives. We hoped to leverage their collective wisdom, strategic views, influence, and shared faith in the United States to achieve positive health outcomes outside our borders. Throughout the commission's work, we also confirmed a very powerful point that the United States' contribution to global health has been and remains a bipartisan enterprise, but that significant progress is dependent upon high-level leadership. These factors remain the key to future success. Global health is an enterprise that has the exceptional ability to unite U.S. citizens in collective action. We wanted to demonstrate that reality through the very composition of the commission. We worked cooperatively in our two sessions in countless calls and one-on-one conversations in our travels to Kenya in August and Geneva in November. These interactions cemented friendships enriched our appreciation of the remarkable achievements of those who work in the laboratories, hospitals, and field sites to make this world of ours a healthier place. It also made profoundly clear to me that we are building on a foundation of remarkable achievement in recent decades in science, in research, and in public health. This is a good moment to recognize how much our nation has achieved in global health and to examine how we can best focus our efforts in the coming years to get the best outcomes. We could do so much more if we set our minds to it. We don't want to coast, we're certainly slide backwards, and we need reinvigorated leadership to transcend increasing fragmentation we've seen in the past couple of years within the global health community. We've built our proposals around five core elements for achieving success over the coming years. These are, first, to stay the course in ongoing initiatives to address the HIV, AIDS, tuberculosis, and malaria challenges. These are the bedrock of U.S. achievements in the recent past, and we're going to use them as a springboard as we go forward. Second, this is the moment to move ahead with speed, determination, and a long-term strategy to improve the lives of mothers and children so critical to health, stability, and security throughout the world. Third, we have to operate at a higher level in disease prevention and global preparedness to meet emerging threats. Fourth, let's make certain that we're better organized for success to achieve these goals that we've set for ourselves. And finally, and certainly not least, let's put in place a robust multilateral diplomacy that will be effective in strengthening our partnerships with other nations, international organizations, and NGOs. I'd like to turn at this point and ask Helene to speak in more detail about some of these recommendations and how we can best achieve them. Helene, can you please join me up here? Thank you. It's wonderful to look out and see this incredible audience that has gathered for this and to see so many colleagues and friends who I know have been committing so much of their lives to this effort. I also just want to thank Bill for the kind introduction. It's also been really invaluable for me to work alongside of Bill Fallon over the last year as we've worked on this. He's an incredible individual with a lot of compassion and insight and probably most important, he's an optimist and he believes profoundly in America's role in the world and its ability to do good. He's a man of great honor and commitment to his country and so for me it's really been an incredible opportunity to have this partnership of working together and as he said, we have become good friends, we've enjoyed working together and I think having worked together for the last year we've decided we're going to continue to do that and our next act is a reality TV show called The Admiral and a Doctor. So thanks Bill. I also just want to echo Bill's thanks to our fellow commissioners for all the work that they put into this process. You take people who have incredibly busy lives and ask them to even make a greater contribution to their time but it's really been incredibly rewarding. So let me just as Bill said, touch for a few minutes and elaborate on the five core elements we identified for achieving success over the next 15 years. The first one, the imperative to sustain the progress in HIV, TB and malaria. And we all know that it's very easy oftentimes to go from one issue to the other and feel like that was yesterday's issue and now we're going to move on and do something new but we have to recognize that this, in fact, the U.S. effort to control these three infectious diseases are the foundation of U.S. achievement in global health. We can do more and we must. We can reach the goal of supporting 4 million living with HIV with life-sustaining therapy. We can achieve higher efficiencies. We can continue to make progress on these areas that we've already laid incredible foundation. What's most vital is to preserve a continued trajectory forward movement even in a period of constrained resources and the addition of vital new goals. So that's number one. Number two, improving the lives of women and children. I think this really is the moment. The stars are aligned. There's momentum and support from multiple directions to tackle these complex challenges. We see it in the White House, we see it in Congress, we see it in foundations, in other bilateral partners, other governments, most notably perhaps the U.K. and the role that they've taken. We see the commitment in the U.N. for too long mothers and children have been neglected and I think it's totally unacceptable for us to look at the number of lives a woman dying every minute of every day in childbirth, children dying needlessly of preventable diseases. So we have a historic opportunity to correct this. Let's seize the moment and really put together the tangible solutions that are within our reach, whether it's improved infant nutrition, vaccines for childhood diseases, expanding prenatal care and access to family planning, better emergency obstetrics. We know the things that can make a big difference. We know that these solutions are possible. But they do require an effective integrated maternal and child health program effort and it does require looking at having a functioning health system. But we know that success cannot be achieved rapidly, but it is doable. The third one is the imperative to make prevention and preparedness strategic goals. Prevention is still the most cost-effective way to reduce disease burden and poor health outcomes. Whether it's through changing behavior, changes in norms, attitudes, policies, legal environments, and making sure that the right prevention tools are available. Prevention is the key to reducing the incidence of HIV and ultimately changing the course of the HIV epidemic. It's the key to lowering tobacco and alcohol use, curbing obesity, and dealing with the alarming rise of chronic diseases and premature death and disability that they cause. Preparedness also has risen to the top ranks. H1N1 was a dry run, a mild test fortunately, that reminds us yet that we inhabit an interconnected world that faces a multitude of emerging threats. We've made considerable progress in recent years, but we cannot wait passively for the next major threat. We need to act now to build capacities to detect, respond, and protect populations and build a more transparent, equitable, and predictable global system that shares information, specimens, and narrows the present gross disparities in the divide between the wealthy and the poor. Fourth, the imperative to better organize ourselves and assure adequate resources over the long term. And let me talk a little bit about the long term resources. We need a global health plan that reaches further out in time. We can't keep thinking in terms of short range objectives. We have to set a goal of 15 years at least to 2025. We need to assure the predictability of adequate resources. We think our case is solid for that. If we make the changes we propose, build better and more integrated measurements, focus strategically in the target areas that we've identified, success will build upon itself. Over time, we can imagine our commitments rising to about $25 billion by 2025. Investments in global health clearly remain without a doubt a best buy. They account for a mere 0.2% of the overall federal budget, but have delivered dramatic concrete results over the past decade. PEPFAR, the President's Malaria Initiative, have been the nation's most effective public sector investments in global health and have showcased the American spirit of generosity. The Commission is united in the belief that we should fulfill the administration's goal of committing $65 billion to global health by 2014. It makes sense to begin slowly, ramping up new programs incrementally, and build momentum and credibility. If we follow this path, I think we can be successful. It's equally essential that we better organize ourselves. We propose the establishment of a deputy advisor in the NSC charged with leading the policy and oversight of global health programs and a truly comprehensive senior level interagency global health council to lead on that implementation. The State Department and USAID have huge equities in our approach to global health and have to remain in the center. We've noted that the progress of the State Department has made in advancing the Global Health Initiative and call for that to continue. We also acknowledge that Health and Human Services, which has had a long-standing role in global health, has grown rapidly in its global health commitments through the agencies like NIH, CDC, FDA, and HRSA. Treasury is essential both with respect to the World Bank and other multilaterals, and in making certain that we take our seats at international deliberations and on innovative financing options. The Defense Department is building ties with other militaries and has strong surveillance and emergency response capability. Our intelligence community has the special ability to provide over-the-horizon estimates, so it's clear that this has to be a multi-departmental process that is integrated and coordinated if we're going to have the impact that we want to as a whole of government. We also emphasize that Congress can do more in bridging its committee jurisdictions. We call for a new congressional consultative group for the next three years, comprised of the key party and committee leadership. This is an area where I think Congress can show its ability to transcend divisions creatively to support the Global Health Initiative. We detail how we can do better in measuring results, incorporating business competencies in our approach, and communicating and building support for global health efforts with the American public. We think all of these things are essential to really building our successes in the future. Fifth, and again by no means last, we can be smarter about how we nurture our essential partnerships with friends and allies, whether it's WHO, the Global Fund, the GAVI Alliance, the World Bank, UNICEF, all of these are vital partners to our work in global health. They're not perfect, but our success relies on building and improving these partnerships. Over time, these institutions can and should carry a greater share of the responsibility. We can also do more to accelerate new innovative financing options and mechanisms that could lead to more sustainable sources of funding over the long run. So I think we need to be and we focus on how it's important that the U.S. is more engaged in some of these discussions, pushing to see what we can do that works in this area of new methods of financing. And we also detail how a stronger multilateral engagement can better coordinate efforts, reduce inefficiency, and put a strategic focus on solving some of the most vexing global problems, whether it's health workforce deficits, tobacco control, the prices of commodities. Some of these are just, those are just some of the examples. Finally, one closing appeal. We need to take the high road, take the long view, and remain committed, be united across party lines and other things that often divide us to make sure that U.S. leadership on global health remains strong. We all know that this is a tough moment in our history. We confront a grave fiscal crisis, painful, slow economic recovery, and dangerous fraying of bipartisan ties. We also have many competing priorities in an ever more complicated world. The Commission wrestled with these realities throughout our deliberations, as well as the fundamental issues of how we can afford to do more for the rest of world and our own citizens are struggling with their mounting needs being placed front and center. But at the end of the day, we remain more convinced that ever that a strategic investment in helping build a healthier, safer, more prosperous world, our smart power approach is essential to promote our own national interest and to save and enhance the lives of millions around the world. So, that's where we are. Those are the areas that we wanted to focus on. And now, it's my delight that we have with us this morning the Deputy Secretary of State, Jack Lu. He needs little introduction in this audience. He has an illustrious career. He served as the Director of the Office of Management and Budget in the Clinton Administration. After that, he had a successful stint at the right time on Wall Street. And across those years, he retained a keen interest in development and finding the means to get better results for every dollar that was spent. He is now the Deputy Secretary of State for Management and Resources and has been taking the lead on the State Department's efforts to assure that foreign assistance is strategic and well-resourced. He's been a driving force behind the Global Health Initiative and he's also been an extraordinarily generous in his sharing of insights and wisdom with the Commission throughout its work. And for that, we are immensely grateful. Jack. It's a pleasure to be here this afternoon with so many friends, colleagues, and partners on an issue that's of critical importance to all of us in the nation and the world of global health. I want to thank Helene for that generous introduction and for her leadership, her work at the CDC, the Gates Foundation in care, co-chair of this Commission. She's played an integral role in shaping...