 Let me start with some figures that I think you will find as startling as I did. The U.S. global health investment skyrocketed between 2003 and 2010, rising from $1.7 billion a year to $8.8 billion a year, reaching over 30 percent of our total foreign assistance. So Dr. Frieden, let me just ask you, how is it that we have come to spend this much money and what are we getting for? I think you have to divide that into two things. Why do we do it and what do we do? So first to start with the why. First off, it's in our interest. We can't build a moat around the country. We're all connected by the air we breathe, by the water we drink, by the food we eat, and we're increasingly interconnected. So whether an infectious disease like measles starts and spreads this country or drug-resistant organisms develop and spread here, it's in our self-interest. Second, it's in our self-interest also that our trading partners are productive, that they are stable, and what we know is that if you increase exports from this country 10 percent, you increase jobs 7 percent. So most of our growth and our most dynamic growth in exports has been to developing countries. If we can help them be more stable, more productive, that's in our own self-interest as well. It's also a wonderful form of soft power. I wish American taxpayers could come with me when I travel around the world and talk to women in Nigeria who say, my baby is born without HIV because of American assistance. This is so powerful in our self-interest as a country, but ultimately it's who we want to be as a country, that there are literally millions of lives in the balance. We're not responsible for the whole world, but we can make a huge difference and with leadership of Representative Granger and her colleagues, we've been able to change the world in dramatic ways. Where are we now? Obviously there are going to be great pressures to cut the budget. People always want to cut foreign aid, which actually is a very small percentage of the budget. What is it something? One percent. One percent. Although not this audience because they know better, but I do this all the time and other members of Congress in front of an audience, they'll say, well, if you just stop foreign aid, stop sending that money to other countries, we could balance our budget. It's always asked the audience, well, how much, how much, what percent do you think it is of the spending? And it always is between 20 and 30 percent, about evenly divided people that say it's 20 percent or 30 percent. I said, no, it's one percent. But it's still, you've got to use it right. But this part of it is a pretty good, good, pretty good part of that one percent, isn't it? That's what surprised me. Right. So how's it going to, how's it going to, how's it going to survive in the current atmosphere? It will survive, but it's, it's like everything else in this time where we really have to cut the spending. It's being cut in every department and every, every type of funding. That's my job because I chair that, that subcommittee does the funding. It was really important to me that it not be an across the board. We're just going to cut by this amount because if you do, we lose all of our flexibility and all of our, you know, the ability to respond to, to emergencies that have been huge, Haiti, for instance. And so I really fought for that. I had great help because it is bipartisan, but it was how do we preserve this, particularly these programs that are so important, but we have to be more innovative because the need hasn't lessened. It's just the funding that's lessened. And that's what we've got to really be aware of. And so Raj Shah and I have long conversations. He's wonderful. We talk and communicate how we can do this in a time of less fun. Well, I think we have so much to reflect on that is positive and really to celebrate. And that, frankly, is a journal interested in chronically not just the challenges that we face in global health, but the successes that we faced and learning from those. We like to focus on those. I was just in preparation for today. I was assembling what would be on your list of the top five triumphs. Well, more than half the countries around the world are, in fact, lowering maternal and child mortality and are on track to meet millennium development goals four and five. All of the people that we now have on treatment and HIV AIDS that was unthinkable, unthinkable 15 years ago that we'd ever get to this point. 33 million tested around the world for HIV last year alone under PEPFAR funding. You just sort of go down the, today, WHO notifying us that tuberculosis deaths are falling. We have a long way to go, but we have just one success after another, demonstrable successes. Not just as a consequence of some of these so-called vertical programs like PEPFAR, but clearly because of the success in health systems strengthening that has gone on as a consequence of the investments in these vertical programs. So we have a ton, a ton to celebrate and should not lose sight of that at this point in time. Now that said, we face all the challenges that the Congress and others have already discussed, and we also face some opportunities to stretch our dollars farther. I think that Raj Shah would be the first to say, we know we could do an even better job in procurement under PEPFAR, for example. We know we still have a lot of overhead going to U.S. and other entities that probably we could squeeze out. We know that as Tom Frieden said, the embrace of countries and partnerships with countries can go even farther. We know from some research that has been done by the Institute of Health Metrics and Evaluation that a consequence, an unintended consequence of us giving more money for these global efforts is that some countries have reduced their own spending. So we know we can encourage them to be better partners in this effort and spend some more money. So it isn't just the large donor countries that are spending it. So we have all of these challenges. There's no doubt about it, but we have enormous successes and we have some room for improvement, even within existing budgets. And I think obviously for the next year, we're going to have to push as hard as possible on that piece of it to get more bang for our bucks.