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Session:110th Congress (First Session)
Witness(es):Helen L. Smits
Credentials:  Vice-Chair, Committee on the President's Emergency Plan for AIDS Relief , (PEPFAR) Implementation Evaluation, Board on Global Health, Institute of Medicine, The National Academies
Committee:Health, Education, Labor, and Pensions Committee, U.S. Senate
Subject:Meeting the Global Challenge of AIDS, TB and Malaria

PLEASE NOTE: After brief opening statements by each witness, the hearing evolved into a roundtable discussion, the audio/video of which can be accessed at the Senate’s Health, Education, Labor, and Pension Committee’s Web site. Along with the statement made below, Dr. Smits submitted to the congressional Committee the Abstract and Executive Summary of the Institute of Medicine report, PEPFAR Implementation: Progress and Promise (2007), in lieu of a written statement.



Statement of

Helen L. Smits, M.D., M.A.C.P.
Vice-Chair, Committee on the President's Emergency Plan for AIDS Relief (PEPFAR)
Implementation Evaluation
Board on Global Health
Institute of Medicine
The National Academies

before the

Committee on Health, Education, Labor, and Pensions
U.S. Senate

December 11, 2007

Good morning, Mr. Chairman and members of the Committee. I am Dr. Helen Smits, and it was my privilege to serve as the Vice-Chair of the Institute of Medicine committee that conducted the Congressionally-mandated evaluation of PEPFAR. I would like to thank my fellow committee members who come from many disciplines and nations for their hard work. Together we visited 13 of the 15 PEPFAR focus countries to talk face to face with the people involved, and we are indebted to all of the people we met for spending so much time with us.

I should also convey to you the overwhelming expressions we heard while in the focus countries of appreciation and gratitude for PEPFAR and the generosity of the American people.

Our report makes 12 recommendations, one of which is overarching and one of which is directed to Congress.

We conclude that, overall, the initiative has made a strong start and is progressing toward its 5-year targets, and our overarching recommendation is to maintain the urgency and intensity that have led to early success while placing greater emphasis on long-term strategic planning for an integrated program in which prevention, treatment and care are much more closely linked, and on capacity building for sustainability.

Our one recommendation to Congress is to shift accountability for the program from a focus on how the money should be spent to a focus on what the money is accomplishing – that is, to eliminate the budget allocations.

Thank you for the opportunity to testify. I look forward to the discussion.

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