TRANSCRIPT: Reforming the WHO: Ensuring Global Health Security and Accountability

A Hearing Hosted by the U.S. Select Subcommittee on the Coronavirus Pandemic

Reforming the WHO:
Ensuring Global Health Security and Accountability
Select Subcommittee on the Coronavirus Pandemic

TRANSCRIPT

WHAT: Hearing titled “Reforming the WHO: Ensuring Global Health Security and Accountability”

DATE: Wednesday, December 13, 2023

WATCH:

https://oversight.house.gov/hearing/reforming-the-who-ensuring-global-health-security-and-accountability/

TIME: 2:00 PM ET

LOCATION:

Committee On Oversight and Accountability, 2157 Rayburn House Office Building, Washington, DC 20515 • Phone: (202) 225-5074 • Fax: (202) 225-3974

WITNESSES:

Loyce Pace, M.P.H, Assistant Secretary for Global Affairs, Department of Health and Human Services | https://www.hhs.gov/about/leadership/loyce-pace.html

John Nkengasong, M. Sc, Ph.D., Ambassador-at-Large, U.S. Global AIDS Coordinator, Senior Bureau Official for Global Health Security and Diplomacy, U.S. Department of State | https://www.state.gov/biographies/john-n-nkengasong/

Atul Gawande, M.D., M.P.H., Assistant Administrator for Global Health, United States Agency for International Development | https://www.usaid.gov/organization/atul-gawande

PRESS RELEASE

Dec. 6, 2023, Select Subcommittee on the Coronavirus Pandemic, Chairman Brad Wenstrup (R-Ohio)
https://oversight.house.gov/release/wenstrup-announces-hearing-on-reforming-the-world-health-organization/

MEDIA

FULL TRANSCRIPT

Chairman Brad Wenstrup (R-OH-02): [00:10:54] The Select Subcommittee on the Coronavirus Pandemic will come to order. I want to welcome everyone here [00:11:00] today. Without objection, the chair may declare a recess at any time. I now recognize myself for the purpose of making an opening statement. Today, the select subcommittee is holding a hearing to examine the future of the World Health Organization and our relationship as the United States with the W.H.O. The World Health Organization is supposed to be the preeminent organization that governs just that the world's health. It played a key role in eradicating smallpox and significantly reducing the cases of polio around the globe. Yet when the world was faced with the outbreak of Covid 19 pandemic, the pandemic, we saw that the W.H.O. does not always serve all of its members equally. We saw it's not an organization that serves all of humankind, but instead perhaps an organization that became beholden to or entrapped in politics when it was most essential [00:12:00] that the W.H.O. be able to step up and help everyone. It seems to have bowed to political affiliations over global public health. When the W.H.O. should have been conducting independent investigations into the origins of Covid 19 and presenting the global community with verified information to help keep them safe, we instead saw that they ignored some facts and parroted back statements that came from the Chinese Communist Party. We saw the W.H.O. deny the Covid 19 was spread via human-to-human transmission based entirely on the word of the Chinese government.

Chairman Brad Wenstrup (R-OH-02): [00:12:40] The W.H.O. delayed naming Covid 19 a public health Emergency of International Concern, a World Health Organization procedure that, amongst other things, would have allowed for the procurement and distribution of scarce supplies, all because the Chinese Communist Party told them the spread was under control. The [00:13:00] W.H.O. delayed serious measures to counter the global spread of Covid 19 because the CCP was only worried about their own bottom line. When the W.H.O. produced a report evaluating the possible origins of Covid 19, it became unquestionably evident that the entire report was nothing. Or but Chinese propaganda. Even Doctor Fauci was worried about the report, stating there was a lot of restrictions on the ability of the people who went there to really take a look. I have some considerable concerns about that. The CCP was so entrenched in influencing the Who's investigation into the origins of Covid that they even contacted me with the unanimous consent I wish to submit for the record an email sent to me by the Chinese Embassy. So ordered. This email [00:14:00] from the Chinese embassy is another attempt to interfere with the investigations of Covid. The letter stated we express our grave concern regarding the Covid 19 origins hearing. We firmly oppose it. This kind of communication and action hardly expresses a clear conscience. The W.H.O.’s lack of independent investigation potentially allowed the beginning of the pandemic to be worse and spread further than it could have been.

Chairman Brad Wenstrup (R-OH-02): [00:14:31] All in all, we saw the W.H.O. more influenced by politics than public health. Not necessarily their fault. There's no denying it. The W.H.O. stumbled out of the gate. This subcommittee is as much about looking back as it is looking forward and preparing for the future. We must be better prepared when the next pandemic surfaces, and a scientifically focused W.H.O. is paramount to [00:15:00] that. It's evident the W.H.O. is in need of some reform, so why not take an opportunity to ask the very people who are in the trenches how we can help them? Why not ask direct sources what we can do right now to equip future generations? Should there be an independent body that is able to conduct oversight? How can the ideal methods of data sharing and development be implemented across the world? What we do know is that the W.H.O. needs to be re-established with raised expectations of transparency, verifiability, and accountability. Accountability amongst its members as well. Running any public health organization in a political manner destroys the organization's credibility. The W.H.O. needs to police its members and not cower behind bullies. The W.H.O. should [00:16:00] have been in a position to tell the world that China was lying if they were lying. The fact that it didn't do so until later is very telling.

Chairman Brad Wenstrup (R-OH-02): [00:16:13] Honesty is always non-negotiable, especially during a once in a generation public health emergency. The W.H.O. is currently drafting a new pandemic accord and new international health regulations that will apply to all its members. These changes must ensure American interests are protected. They must not violate international sovereignty, and they must hold China and others accountable. Further, any accord or treaty must be presented to Congress for approval. Anything else is wholly insufficient, especially in the minds of the American people. Let's use this opportunity to ensure that the W.H.O. can actually protect [00:17:00] the world's global health, and not just the political interests of a few of its members. The United States should be setting the gold standard in incentivizing best practices. And we should be doing everything we can to force the W.H.O. to listen to American interests. And nothing is more important than global public health. And properly reforming the W.H.O. is the first step to that protection, so that our officials and our providers can better care for our citizens and establish best practices not only for here, but perhaps around the world. We're holding this hearing to look at the current circumstances surrounding the W.H.O. and see how we can make it better and stronger for the future. I look forward to a strong on topic discussion today, and I would now like to recognize ranking member Doctor Ruiz for the purpose of making an opening statement.

Ranking Member, Raul Ruiz (D-CA-25): [00:18:00] Thank [00:18:00] you. And I believe, uh, Mr. Chairman, that this is the first time we gather after you made your announcement. So, I think it is absolutely appropriate to congratulate you on your decision regarding your retirement and to show you our full, full respect and full appreciation for the amount of service you have given to our nation, not just as a policy maker here in Congress, but also in your service in our military and as a physician. And so, as a fellow physician. Uh, I'm it's going to be sad to see you leave, but know you're loved and know you're very well respected, and our nation appreciates you 100%.

Chairman Brad Wenstrup (R-OH-02): [00:18:38] And I will miss working with you. And I think we got a few bills we can get passed this year.

Ranking Member, Raul Ruiz (D-CA-25): [00:18:43] We must, we must. It's been a while, my friend. Uh, you know, and thank you to ambassador Nkengasong, uh, assistant Secretary Pace and Assistant Administrator Gawande for your participation today. I must say, Mr. Chairman, I right now, you [00:19:00] probably can't see, uh, or really feel, uh, but inside, I'm like a kid at a candy store. I'm really excited to have all three of you here. All three of you have done remarkable work, have led your profession, and have been thought leaders for our nation and many countries around the globe. So I want to thank you personally, and I also want to give a special thank you to Doctor Atul Gawande. You see, because when I was a third-year medical student doing my general surgery rotation at the Brigham and Women's Hospital, I actually scrubbed in with, uh, Doctor Gawande when, uh, when he was a fellow there. And I really need to thank you for your kindness, because despite you looking like you hadn't slept in seven days, uh, you were still kind and patient in in helping me maneuver around the operating room. So, thank you so much. In the last three years, the world has preserved through a deadly pandemic that [00:20:00] has claimed nearly 7 million lives across the globe. Now, as we reflect on the international response to this public health crisis and look to the future, we must do so with a commitment to advancing global health security. There is no international organization as central to this work as the World Health Organization, which has contributed to monumental advancements in health care access, improvements in population health outcomes, and the defeat of deadly diseases even in the farthest corners of the world.

Ranking Member, Raul Ruiz (D-CA-25): [00:20:33] The W.H.O. has continued surveillance of global health threats, has helped prevent outbreaks of deadly diseases, such as measles from arriving on our shores, and the W.H.O.’s global vaccination programs have helped contribute to an overall 54% percent increase in global life expectancy in the last 70 years and put us on track to prevent 51 million deaths from measles and hepatitis B around the world. So [00:21:00] I want to take the time to emphasize now that our work to prevent and prepare for future pandemics is not in conflict with enhancing international cooperation. Instead, our efforts are strengthened and fortified by it. In our last hearing on biosafety and biosecurity, we all agreed that threats to the American people's health do not end at our borders. So, in order for us to ensure our nation is truly prepared for the next pandemic, we must continue to engage with the international community on work that prevents future threats from reaching our nation. The United States has served as the preeminent leader in global health for decades, and now is not the time to cede that role to another country angling for global influence. No, now is the time to reinforce the United States global health leadership with meaningful reforms to the W.H.O.

Ranking Member, Raul Ruiz (D-CA-25): [00:21:55] that promote transparency and strengthen international cooperation in the [00:22:00] event of future pandemics. Thankfully, after years of volatile leadership under the previous Trump administration, the Biden administration has sought to correct course by re-engaging not only with the World Health Organization, but our partners around the world to advance global health and our interests abroad. You see, when we become an isolationist nation, we leave a void that other countries can come in and easily fill to use public health diplomacy as a way of geopolitical dominance. Taking a lessons learned approach from the early days of the pandemic, the Biden administration has pursued reforms to the W.H.O., and I think we can all get behind reforms that one enhance oversight of member states compliance with international health regulations, to develop an early warning system for public health threats, and three, strengthen investigative capabilities for public health emergencies of international concern. [00:23:00] Exactly what we're working on to strengthen. So, these reforms would not only institute positive change at the World Health Organization, but they would also enhance pandemic preparedness on a global scale and therefore reinforce U.S. influence in international institutions and norms. You see, in many ways, global health is the cornerstone of our diplomatic efforts, and we must continue to find ways that enhance our role in this space on the international stage. The fact of the matter is, when we leave gaps, our adversaries will fill them. So now more than ever, we should work to deepen cooperation with our allies and commit to a collaborative approach to global health security that will ultimately counter the Chinese Communist Party and deter their influence.

Ranking Member, Raul Ruiz (D-CA-25): [00:23:50] Bold investments in global health and pandemic prevention, made through the Consolidated Appropriations Act and the American Rescue Plan, have set the stage for [00:24:00] this work. For example, the American Rescue Plan funds bolstering the Who's Covid 19 vaccination administration efforts helped vaccinate approximately half the world's population for Covid 19 within one year period. With the US vaccines making their way to key regions of the world where we compete with the PRC for influence. Additionally, the Biden administration has complemented these investments with forward looking policies that advance US interests abroad. Notably, under President Biden's leadership, the State Department established its Bureau of Global Health, Security and Diplomacy, with Ambassador at Large Nkengasong at the helm. Ambassador. Uh. Nkengasong. Um, I look forward to hearing from you, uh, today about how the bureau has integrated global health security in our national security [00:25:00] and foreign policy priorities, and how the United States is engaging with W.H.O. to advance that effort. So, there's certainly a great deal of ground to cover in today's discussion. And it is my hope that today we can identify constructive reforms to the W.H.O. that build on the administration's effort to enhance global pandemic preparedness, as well as forward looking policies that further cement America's leadership in global health security. So, with that, thank you, Mr. Chairman, and I yield back.

Chairman Brad Wenstrup (R-OH-02): [00:25:32] Well thank you. Our witnesses today are Miss Loyce Pace. Miss Pace is the assistant secretary of Health and Human Services for Global Affairs. Ambassador John Nkengasong. Ambassador Nkengasong is the U.S. Global Aids coordinator and senior bureau official for Global Health, Security and Diplomacy for the Department of State. He worked as the W.H.O. Special Envoy for Africa during the Covid 19 Pandemic. [00:26:00] And Dr. Atul Gawande. Doctor Gawande is a surgeon, writer, and public health researcher. He is the current assistant administrator of the US Agency for International Development for Global Health, as well as board certified in General and Endocrine Surgery.

Chairman Brad Wenstrup (R-OH-02): [00:26:19] Pursuant to the Committee on Oversight and Accountability, Rule nine, G. The witnesses will please stand and raise their right hands. Do you solemnly swear or affirm that the testimony that you are about to give is the truth, the whole truth, and nothing but the truth, so help you God? Thank you. Let the record show that the witnesses all answered in the affirmative. The select subcommittee certainly appreciates you all being here today. And I'm sorry we had a delay in this meeting, but we're grateful that you are here today and look forward to your testimony. Uh, let me remind the witnesses. We [00:27:00] have read your written statements, and they will appear in full in the hearing record. But please limit your oral statements to five minutes. As a reminder, please press the button on the microphone in front of you so that it is on when you speak, and so that the members can hear you. When you begin to speak, the light in front of you will turn green. After four minutes, the light will turn yellow. When the red light comes on. Your five minutes has expired, and we would ask that you please wrap up your opening statement. I now recognize Miss Pace to give an opening statement.

Loyce Pace, M.P.H: [00:27:41] Good afternoon, Chairman Wenstrup, ranking member Ruiz, and members of the subcommittee. Thank you for ensuring that we identify and implement lessons from the Covid 19 pandemic to enhance our public health preparedness and our national security. My [00:28:00] office leads us engagement with Who and has been working since the start of the pandemic on institutional reforms that improve transparency and accountability, both within the organization. And as you said, sir, across its 194 member states. We work closely with our colleagues at the Department of State and USAID, as well as other federal agencies to build pandemic prevention, preparedness, and response capacities worldwide. Of course, the world has been profoundly impacted by the Covid 19 pandemic. In the US, unfortunately, we tragically lost more than a million lives and nearly 7 million have died globally. We know there's no ocean large enough to protect Americans from a virus that can spread rapidly across the globe. So, we also know that it's only a matter of time before the world faces another serious public health threat. As [00:29:00] it turns out, who has been on the front lines of nearly every global health challenge over the past 75 years, combating, containing and curing some of the planet's most deadly diseases. Currently, W.H.O. is responding to dozens of serious health emergencies, including in Gaza and in Ukraine.

Loyce Pace, M.P.H: [00:29:21] But it takes an effective hoe to adequately guard global health and wellbeing, supporting the safety and sovereignty of America. Frankly, if Ho didn't exist, we would have to create it. That said, the Covid 19 pandemic also revealed major gaps in our global health security architecture, including and importantly, at W.H.O. Working with like-minded member states, the US is leveraging our seat at the table to drive dialogues and solutions required today because unfortunately, we've learned the hard way that this is in our national interest. [00:30:00] So at that table, HHS is leading efforts to update the International Health Regulations to make them clearer, more precise and better fit for purpose. Among other important reforms, we're advocating for amendments that would ensure rapid and transparent information sharing. Enhance, whose ability to assess health threats and improve global implementation and compliance. Additionally, we are actively working alongside State Department colleagues to negotiate a global agreement that seeks to improve international accountability and collaboration on pandemic preparedness and response. Through both of these negotiations, we're advancing long standing U.S. priorities to reinforce regional capacity and reduce risks posed by emerging infections. Ultimately, we're focused [00:31:00] on finding sustainable solutions that break the cycle of pandemic crisis and complacency.

Loyce Pace, M.P.H: [00:31:07] The US is also pushing for reforms within W.H.O. itself with vocal US leadership, the 2023 Executive Board meeting and World Health Assembly approved a set of recommendations and plans for more stringent oversight of Who's budget and business functions. We are closely monitoring progress with W.H.O. leadership and ensuring principles of good governance at all levels of the organization. In closing, I'd like to highlight two of the greatest health achievements of the 20th and 21st centuries the elimination of smallpox and significant progress in eradicating polio. Both are the direct results of a partnership between the US non-governmental organizations, countries around the world and Who. In [00:32:00] fact, the US was one of 59 countries that first signed the treaty establishing a World Health Organization. Since then, we've been party to many of its successes and at the same time have pushed the organization to be better over these last 75 years. You can be assured that the Biden-Harris administration is committed to building on this legacy through our ongoing work in service to the American people, which is our North Star. Thank you again for the opportunity to testify on these important issues.

Chairman Brad Wenstrup (R-OH-02): [00:32:35] Thank you, thank you. I now recognize Ambassador Nkengasong to give an opening statement.

Ambassador John Nkengasong, M. Sc, Ph.D.: [00:32:41] Good afternoon, Chairman Wenstrup. Ranking Member Ruiz and members of the subcommittee. It is an honor to be with you today on behalf of the Department of State, to discuss the US government's commitment to strengthen global health security to protect the American people. We [00:33:00] engage internationally at all levels, bilaterally, regionally and multilaterally with international organizations like the World Health Organization's W.H.O. I come before you today representing the State Department's newest bureau, the Bureau of Global Health, Security and Diplomacy, which was launched on August the 1st of this year by Secretary Blinken. I would like to thank members of the Congress for their support to establishing this bureau. The Covid 19 pandemic left a deep, lasting impact on all of us, with over 1 million American lives lost and at least 7 million globally. One estimate found that the American economy lost more than $14 trillion due to the pandemic, and economists estimate that global GDP contracted by three percentage point in 2020. [00:34:00] The last few years have reinforced that a pandemic is not only a health crisis, it's an economic crisis, and it's a national security crisis. Without the combined leadership of the United States multilateral partners, including the W.H.O. and others, the world may not yet have successfully made it, made it out of the acute phase of the Covid 19 pandemic. The coordinated global efforts required to deploy Covid 19 vaccines around the world was a major demonstration of this lesson. A coalition of countries, including the United States, came together with the Who to support the Covid 19 Vaccines Global Access Initiative, commonly called COVAX. The United States, in partnership with COVAX and bilaterally, has donated close to 7 million safe and effective vaccines [00:35:00] to over 117 countries and economies around the world while simultaneously investing in regional vaccine manufacturing, supporting healthcare workers, and strengthening our capacity to prevent, detect and respond to Covid 19 and future global health threats.

Ambassador John Nkengasong, M.Sc, Ph.D.: [00:35:19] Under Secretary Blinken's leadership, the State Department continues to play a critical role in elevating global health security as a major priority in high level global and regional dialogues. Our team at the Bureau of Global Health, Security and Diplomacy is focused on collaborating across the US interagency community and with Congress to do all that we can to mitigate future threats. Unfortunately, it is not a question of if. A new health threat will emerge. It's a matter of when. The world needs greater cooperation, coordination, collaboration and communication. [00:36:00] A major priority continues to be to be ending HIV Aids as a public health threat by 2030. And in that spirit, I look forward to working with you in continued, strong bipartisan fashion to pass a clean, five-year reauthorization. Despite the challenges he has faced, he continues to play a critical role in advancing global health security priorities by its coordinating roles and responding to emergencies, and in promoting healthy lives worldwide. The Who's leadership in developing evidence based guidelines and policies for combating HIV Aids have been critical for enhancing our own diplomatic efforts when working with partners and countries to advance their respective HIV Aids response. The United States has played a critical continued to play a critical leadership role to ensure the W.H.O. [00:37:00] is reformed to effectively address current and future global health challenges. We have engaged with the task force involved in these efforts and will continue to exercise our leadership in this space. Thank you, Chairman Wenstrup and Ranking Member Ruiz for the opportunity to testify on this important topic. And I look forward to your questions.

Chairman Brad Wenstrup (R-OH-02): [00:37:25] Thank you. Ambassador. I now recognize Doctor Gawande to give an opening statement.

Atul Gawande, M.D., M.P.H.: [00:37:31] Chairman Wenstrup. Ranking member Ruiz. Doctor Ruiz. We're across a different table today. And who knew we would be here from where we were a few years ago? Um, also, members of the select subcommittee, thank you all for the chance to speak about USAID's commitment to global health security, to our partnership with the World Health Organization, and the importance of continuing reform to the systems required to secure our collective protection from international health threats. USAID's [00:38:00] health investments focus on reducing the global burden of mortality and disease, and on protecting Americans from health threats from abroad. We work daily to prevent and respond to emerging threats while also pursuing long tum goals, such as eradicating polio and ending the public health threats of HIV, malaria, and tuberculosis by 2030. Success requires global collaboration. Collaboration for impact on health is what Who has done for 75 years. And that's why Who has been an essential partner and recipient of USAID funding? The Who's leadership of the Global Polio Eradication Initiative is one excellent example who demonstrates its unique convening power and technical capacity in leading polio activities worldwide. USAID has supported polio eradication efforts for 35 years, and now we have only [00:39:00] 12 wild type cases documented worldwide in the last year in a small region along the Afghanistan-Pakistan border. And last week was quiet but persistent diplomacy persuaded the Taliban to finally allow house to house vaccination, reversing its long opposition. Among USAID’s top priorities is strengthening global health security, the capacity to prevent, detect, and respond to infectious threats that can spread worldwide.

Atul Gawande, M.D., M.P.H.: [00:39:30] And our partnership with W.H.O. is critical in this work, allowing us to leverage its global network and technical expertise to help countries everywhere prepare for and manage dangerous outbreaks. For example, in February, an outbreak of Marburg virus, a deadly cousin of Ebola, occurred in Central Africa and Equatorial Guinea. USAID and CDC supported and worked closely with WT to Ho to respond because of their particular relationships and technical [00:40:00] capacity there. Equatorial Guinea had resisted, as often happens, with countries resisted sharing information or permitting foreign involvement in what was happening. But W.H.O. persuaded the government to accept US support that ended up delivering capacity, diagnostic capacity, proper screening, isolation and emergency treatment procedures and PPE from the joint USAID W.H.O. emergency stockpile for front line workers. And that produced a turnaround that ended the outbreak before it spread anywhere else. There is simply no entity in global health other than W.H.O. that has an equivalent mandate, reach or capacity to influence the countries where US aid works and where we don't. And that influence is not, however, foolproof. It is up to countries whether they adhere to W.H.O. recommendations. But as we saw during the Covid 19 pandemic, whose role is vital their systems for safety review, for sharing [00:41:00] technical information for emergency response made vaccines, tests and treatments available globally, saving millions of lives. The pandemic exposed some fractures in our global health security systems, including at W.H.O. With our interagency partners, USAID has pushed for the critical reforms that W.H.O.  needed to increase effectiveness, transparency and accountability in future emergencies and in tackling other health goals.

Atul Gawande, M.D., M.P.H.: [00:41:29] And we see progress in what matters, which is lives saved. For example, historically, Ebola outbreaks have killed thousands. But in the six outbreaks of Ebola and Marburg virus that have occurred since I've started, I've seen the response get faster and better. I was especially concerned about an April 2022 Ebola outbreak in a city of a million people in the Democratic Republic of Congo in 2018, a similar outbreak in that region killed more than [00:42:00] 2000 people and required a two-year, billion dollar global effort to stop it from getting across the world. Since then, USAID, CDC and W.H.O. came together with others to help the country improve its response capacity. So, in 2022, when a man with a high fever arrived in a clinic in Équateur province and died that day, the health worker had the training to recognize this could be Ebola. He had the protective gear he needed. He had the test equipment to make the diagnosis. He alerted contacts and the national health authorities who got a team on site within 48 hours. They identified the contacts and brought newly approved vaccines. And as a result, Ebola claimed just five lives compared to the 2000 lost in 2018. W.H.O. and US investment meant that the outbreak required no emergency foreign assistance at all. I thank the subcommittee and I look forward to your [00:43:00] questions.

Chairman Brad Wenstrup (R-OH-02): [00:43:02] Well. Thank you. That's excellent testimony from all of you. It's greatly appreciated. I now recognize myself for questions. Uh, you really touched on some things, um, that I appreciate greatly. I've been in Vietnam twice in the last year, and I don't know that W.H.O.  was involved, but more our own CDC. And I think the work that we did with our CDC and the Vietnamese government during Covid was a tremendous plus. Not only for the lives of the Vietnamese people, but for our diplomacy. And so, there's great opportunity. So, like I said, I don't know if W.H.O. was involved with that, but the importance of the W.H.O. being trusted comes into play with the example you just gave doctor where they came in and said, [00:44:00] trust the Americans on this, let them work with you. And if and if that's what's needed for that conduit, then they certainly need to be the trusted institution that that we want them to be and that they have been. And make sure that everyone agrees with that. And I suspect everyone here would agree that, uh, politics, getting involved with science can create a distrust among the public at large, just as politics always does. But, um, I guess with your knowledge of what we have now and looking at Covid 19, I ask was, was, in your opinion, China forthcoming and transparent, uh, regarding Covid 19? Um, because the W.H.O. put together a group to study this and go to China. The only American in the group was Doctor Peter Daszak of EcoHealth Alliance. And he maybe should have been somebody [00:45:00] that even recused, recused himself because he was a collaborator with the Wuhan Institute of Virology. And China was deciding who got to go. And so, these are things that raise people's concerns. And Secretary Blinken said, we've got real concerns about the methodology and the process that went into their report, including the fact that the government in Beijing apparently helped to write it. That's not an independent organization, then. So, do you agree with the Secretary's assessment, and what are your thoughts during that time and moving forward? And then we can go down the line.

Loyce Pace, M.P.H: [00:45:41] Thank you, Mr. Chairman, and thank you for your reflections on your travel to Vietnam. I too, have been able to visit the work of CDC and our partnership with W.H.O. there. With regards to your question, it's an important one, especially because we have a lot of lessons to learn regarding Covid 19. And [00:46:00] unfortunately, one of those lessons is the importance of transparency. Um, we're quite disappointed and share your frustration with the government of China not being as forthcoming as they should have been with W.H.O. at the time, especially because, um, getting to the bottom of this crisis is critically important, as you said, not only for Covid, but for any outbreaks moving forward.

Ambassador John Nkengasong, M.Sc, Ph.D.: [00:46:30] Thank you Chairman. We fully agree with your opening remarks about the trust, the trust capital that is required to deal with global disease threats, and that comes with the ability to be fully transparent, to be accountable, to report in a timely fashion and also to cooperate. And all of these elements were lacking in China's ability to cooperate with W.H.O. and the world. [00:47:00] And in when you have a fast-moving respiratory disease like Covid, all of these elements are very important for the global health security. I think, um, the burden is still on China that for the past three years, China has not been forthcoming the way it should be in working with W.H.O., working with us directly so that we just understand what the origin is. So that of the virus is that it can better prepare us for the future. As we've all said, it's a matter of time before we face with another threat. Yes. So, I think I fully agree with you that we need to build a trusting relationship that will enable us to be to respond in a very timely fashion.

Atul Gawande, M.D., M.P.H.: [00:47:49] I'll add only that I'm in complete agreement with my colleagues. China was not forthcoming early on about human-to-human transmission, as we noted that there's a common reluctance [00:48:00] to under SARS, which happened years before W.H.O. pushed hard and was public about that lack of forthcoming behavior in a way that did not occur in this particular instance, however, W.H.O.  got a lot right that were critical to getting vaccines out to the world, getting treatments out to the world. We'll say that we have also seen that history has shown that they are capable of improvement. After Ebola, where response to emergencies were very slow, US pressure ended up creating a global driving the creation of a global health emergencies program that massively improved response on the ground in many subsequent outbreaks. And similarly, after Covid, US pushed successfully for the creation of a Standing Committee on Health Emergencies Prevention, Prevention and Prevention, Preparedness and Response. And that's already giving us and others more real time oversight of handling in in [00:49:00] the case of potential picks for public health emergencies of international concern.

Chairman Brad Wenstrup (R-OH-02): [00:49:07] I think, um, you know, new methodologies coming forward, uh, are going to benefit us all in the, in the future. Uh, I guess my real concern is if a member is not participating in the way that should be expected, not only how do we call them out in a way that might get them to behave as they should? Um, you know, my so my question would be, do we say, well, you can't be part of the W.H.O. if you're not going to adhere to the rules? Or is there some enforcement mechanism? I don't know where to turn on that if it were to happen again in the same way, and I don't know if so, I'd love to hear your ideas. Uh, as you deal with the W.H.O. and the frustration that everyone had.

Loyce Pace, M.P.H: [00:49:56] So I will try and respond to this question. Mr. [00:50:00] chair, again, it's a good one, especially because we need everyone to be good actors around the table. One of the things that we are able to do as board members of W.H.O.  is at least track that very level of accountability and really understand how we all come together to support the work of the organization. As it turns out, we are board members alongside the Chinese government as well as other actors like Syria. And so, it's one of the reasons why we want to remain at the table, if nothing else, to be a voice in that room and ensure that that voice is rooted in science and in the important work of W.H.O., really serving not only America, but the world in ways that we want to see.

Ambassador John Nkengasong, M.Sc, Ph.D.: [00:50:51] Chairman, I agree with my colleague that. We have to be at the table all [00:51:00] the time and exercise our leadership, because it is by being at the table that we rally our friends and allies to put pressure across the board on countries that may not want to cooperate fully. Uh, we know that when we are not at the table, others will take our seat at the table. I think we have to always be at the table and continue to put pressure on it, that the administration has been very clear on this, that we have to work in the area of global health security. We must work with people that we agree with, and we prefer that we do not agree with because we just don't know where the next threat will come from. And the way to do that is the platform for that is W.H.O. I can think of any other platform that we should, that could serve that role. Now the burden is on all of us, the burden of leadership to continue to put pressure on W.H.O. to reform so that it can be more agile, it can be more forceful, [00:52:00] and it can be more accountable in responding to or putting pressure where it's needed, so that countries can be more transparent in their reporting.

Atul Gawande, M.D., M.P.H.: [00:52:10] I'll only add a couple of points to my colleagues. One is that we want respect for our sovereignty. And so, we also limit how much W.H.O. can control or demand things of us. And that is one of the challenges here, that we are protective of our own sovereignty and therefore do not want to have those tools challenged, uh, uh, potentially challenge us or other member states. The second point about possibly well, then could we force out a China that does not adhere and we want China under the tent? Um, once a country starts, pulls out, they become a blind spot in our national security. Currently, China does participate as a network of 129 countries that submit flu and other [00:53:00] illness data. It's the reason we have an effective annual flu vaccine, because we have access to information being supplied through those, through those means. And so, we want to have China continue to be a joint actor in, in this work. And so that leaves us in a space where it's diplomacy. Now, the additional reforms that the US is advocating for under reforming the International Health Regulations are to make a clearer tiered response. Right now, we just have a public health emergency of international concern, and that's the declared level. And we're looking for a three level, uh, set of uh, tiers so that there is an earlier indication that countries have a health issue developing of concern. There are clearer standards about what they what transparency requires and then clear requirements that W.H.O.  has to live up to for reporting, making public and indicating when countries are not adhering to those so that that [00:54:00] set of commitments are a part of what we're aiming to negotiate and produce in strengthening international health regulations and the pandemic accord.

Chairman Brad Wenstrup (R-OH-02): [00:54:09] Well, I would also like to see something where the host nation, in this case China, doesn't get to decide who the United States sends. And doesn't restrict who we send. Because frankly, I'd have been very pleased if any of the three of you were there when that occurred. With that, I yield back and I now recognize the ranking member for questions.

Ranking Member, Raul Ruiz (D-CA-25): [00:54:33] Thank you. As ranking member of the Select subcommittee, I have long called for a forward-looking approach to preventing and preparing for future public health threats. That applies the lessons that we have learned from the Covid 19 pandemic. Emerging public health threats are not bound by our borders, meaning that this objective is as important for our engagement with the international community as it is for our domestic efforts. Reforming the World Health Organization to insulate [00:55:00] it from political pressure and strengthen the international community's response to emerging public health threats is central to this mission. So, I'd like to begin by asking each of our witnesses with respect to the United States global health engagement and reforming the W.H.O., what is the single most important lesson, the single most important lesson that we should take away from the Covid 19 pandemic. Let's start, uh, with you, Assistant Administrator Gawande. Then we'll move to the left.

Atul Gawande, M.D., M.P.H.: [00:55:31] Thank you. Um, number one lesson from Covid, I think, is that in crisis, US leadership is indispensable. Um, first, we are often the first in. And then we bring others along. A case in point is the US providing more Covid vaccines without charge than any country in the world with 700 million vaccines. But then we also supported COVAX as a mechanism that then got other countries to do their share. [00:56:00] We came in early with funding first, but the net contribution of COVAX was even larger in the in the end. Uh, there are multiple other examples in the ways we led on oxygen capacity in building that out in places that didn't have capacity for oxygen in the face of a respiratory virus. Around antivirals being distributed. American leadership works because when we lead, we pull in partners and allies with us. We demonstrate the values of, uh, of, uh, global collaboration and harnessing collective national security. And American engagement with the W.H.O. has been essential to our effective global response as a result.

Ranking Member, Raul Ruiz (D-CA-25): [00:56:46] Thank you. Ambassador. Uh, Nkengasong.

Ambassador John Nkengasong, M.Sc, Ph.D.: [00:56:50] Thank you, Congressman. I think the number one lesson from the I believe, or one of the lessons from the Covid 19 pandemic, [00:57:00] is that it is easy to get anywhere in the world is immediately a threat in the United States. It took only two months. For Covid to spread to 165 days, two months. On January the 4th, they were just about four countries in the world that had reported Covid. But by March 20th, about 165 countries had reported Covid. So, it tells us a story of our common connectivity, a connect, a common vulnerability, and the inequalities or inequities that we have to address in all of this. I think the lesson that follows from there is our leadership is important, our leadership in making sure that we are engaged, proactively engage such that such a threat when it occurs and anywhere that it occurs, is squashed before it becomes a threat in the United States. [00:58:00]

Ranking Member, Raul Ruiz (D-CA-25): [00:58:00] Thank you, Assistant Secretary Pace.

Loyce Pace, M.P.H: [00:58:02] Thank you, Ranking Member Ruiz, for this question. My colleague, Assistant Administrator Gawande, touched on the importance of the International Health Regulations. And when it comes to lessons, I think we can think of it in a couple of different ways. First, as he mentioned, there are ways that we as HHS, are working to amend those International Health Regulations, not only through the alert system or improvement of that system that he described, but also thinking of ways to give W.H.O. flexibility to share the information that they see or receive by other means. So, I believe the chair as well spoke to the limitations with regards to countries if and when they choose to be transparent with us in the event they are less than transparent with W.H.O.  W.H.O. actually has other means to understand the situation, perhaps by other sources or other publicly available information, but they [00:59:00] might hesitate for fear of backlash from that country if they get ahead of them. And then that country essentially retracts and isn't a partner in the response, or otherwise continues to be more opaque in what they share or less than forthcoming. And so, what we're hoping to do also through these amendments is make it so that W.H.O. has permission, so to speak, to notify other countries around the world if and when they give certain actors a chance to provide what they know. And those actors just don't respond. We just essentially don't want to be in the dark. And that's why it's so important to work in this way on these IHRs.

Ranking Member, Raul Ruiz (D-CA-25): [00:59:38] Thank you. The State Department and Department of Health and Human Services have also been representing the United States in the ongoing pandemic agreement negotiations, which are generating recommendations for member states to promote cooperation on preventing, preparing and responding to future pandemics. Ambassador Nkengasong, what steps is the [01:00:00] State Department taking to advance the United States interest in global health leadership in the ongoing pandemic agreement negotiations?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:00:09] Thank you to the State Department is working very closely with our colleagues from the Department of Health and Human Services to support our team negotiating team in Geneva. And it is very clear, as you rightly said, that we need this instrument, pandemic accord or pandemic agreement that would protect us. I mean, if you asked me to summarize that in one line, I would say it is an accord that will do the things that we have been discussing here, which is allow us to detect early, respond early, a threat that will emerge and invariably will emerge, because we all know that we live in an era of of pandemics. So, we are actually looking at ways we could continue to [01:01:00] work with several countries, more than 190 countries around the table negotiating. This is not a fast process, but it's a necessary process. We have to be at the table and continue to show leadership in the way we work with countries to share sequences, share viruses when the threat arises, and share, of course, the medical countermeasures. I think that is central to our ability to protect ourselves. Imagine if a virus or an unknown virus emerged in anywhere in the world where we don't have access to that, to that, I mean, we rely on this kind of an accord or agreement to have access to those specimens’ sequences so that we can develop a diagnostic test, vaccines or therapeutics.

Ranking Member, Raul Ruiz (D-CA-25): [01:01:47] Assistant Secretary Pace, how will the framework of the recommendations in the pandemic agreement apply? Lessons we learned from the Covid 19 pandemic to advance international pandemic prevention and preparedness.

Loyce Pace, M.P.H: [01:01:59] Well, [01:02:00] certainly these potential agreements would do quite a bit to complement what is already in place, such as the International Health Regulations. Um, one of the shortcomings, unfortunately, of the Covid 19 pandemic is it did not allow for, um, a high degree of accountability when it came to accessing innovations in particular. Um, and one of the things we are trying to negotiate as part of this agreement is to ensure that those innovations reach everyone, including Americans, on time. As the ambassador mentioned, that involves sharing samples and data so that we can actually produce or manufacture these innovations, in other words, spur R&D, essential R&D. But then there's a question of how this these innovations reach people around the world. That isn't just a moral question, but it's a strategic one, frankly. Um, [01:03:00] because in the absence of vaccinations, for example, we had the opportunity for variants to emerge and thus kept us in this ongoing fight against Covid. So, it's our hope that, um, the this potential agreement helps to, again, sort of buttress what we are able to do at a more technical level with regards to pandemic preparedness and response.

Ranking Member, Raul Ruiz (D-CA-25): [01:03:25] Thank you. And as negotiations for the pandemic agreement have been underway, there have been some misrepresentations of how this treaty would square with the United States sovereignty. Uh, ambassador Nkengasong, could you please help us understand, correct the record regarding these misinterpretations?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:03:44] Thank you. Congressman. Let me say upfront that that has not at all been a subject of discussion during the pandemic, uh, accord or agreement. We will not [01:04:00] allow such, uh, if ever such a discussion was to occur during the negotiation, I can assure you that we will not allow it to happen. As a matter of fact, uh, when you look at the draft that is circulating the draft pandemic accord agreement or instrument, uh, on article three, section two, clearly, uh, on the principles clearly stipulates and affirm the importance of the sovereignty of the countries, that it is the countries themselves that have the right over their people. I think that is very clear. Article three, section two of that. So, I think, uh, the misinformation or disinformation is unfortunate. It's at all the accord has absolutely nothing to do with, uh, the sovereignty of our country. Thank you.

Ranking Member, Raul Ruiz (D-CA-25): [01:04:52] And now that we have closed the chapter on the darkest days of the Covid 19 pandemic, we must dedicate our efforts to ensuring that the United States [01:05:00] is leading the way, as you have identified, as one of the biggest lessons learned, uh, in preventing and preparing for the future public health threats, which requires an international response that will allow access, transparency and data to contain an emergency virus in the host country with full cooperation of the host country, in order to prevent it from spreading elsewhere. I think that should be our singular focus as a global community, wherever this virus may arise, even if it arises in the United States to really have international cooperation, to prevent, because that's how you're going to prevent the next pandemic. Thank you. And with that, I yield back.

Chairman Brad Wenstrup (R-OH-02): [01:05:42] Now recognize Miss Malliotakis from New York.

Nicole Malliotakis (R-NY-11): [01:05:46] Thank you. Um, I'm sure you all know that the United States stands as one of the World Health Organization's top donors, contributing roughly $700 million in 2020 and 2021, with over 65% being voluntary [01:06:00] above our membership dues. And in December 2021, the Biden administration announced another $280 million contribution aimed at ending Covid 19, bolstering health care health systems and providing urgent relief and ex taxpayers. We want to make sure that our money is being used properly, that there are metrics in place and that, as you say, we have a seat at the table. However, I'm really concerned about what we've seen from the W.H.O. throughout the Covid 19 pandemic. I mean, they denied human to human spread of Covid 19 based solely on CCP propaganda. Uh, it was not until January of 23rd of 2020, the W.H.O. finally recognized that human to human spread was occurring. It was a month after the first warnings the W.H.O. delayed naming Covid 19 a public health emergency. It delayed serious measures like travel restrictions because the CCP told them the spread was under control. [01:07:00] Um, the W.H.O. continued to praise the Communist Chinese Party failed efforts to combat the pandemic despite a globally recognized cover up.

Nicole Malliotakis (R-NY-11): [01:07:10] And then when we pushed for an investigation, um, into the origins, the CCP was given full veto power over inclusion of American scientists. Right? The Communist Chinese vetoed the three Americans put forward by our government to be in that investigative body, and the CCP was given full power to edit and alter the final reports. And so, I'm compelled to ask the question, I mean, how do you justify continuing US support for the W.H.O., given their debatable handling of Covid 19 investigations and apparent compliance with misleading communist Chinese narratives? And I agree, the World Health Organization has played a tremendous role in the history. The United States was one of the founders. And when it came to the Aids epidemic in particular and other, you know, they [01:08:00] have been but it seems to me that they're now corrupted by the Communist Chinese. So, what do we do and why should we continue to fund them if they continue to take their, um, if they continue to do what the Chinese tell them to do?

Loyce Pace, M.P.H: [01:08:17] Well, thank you, Madam Congresswoman, for that question. Um, again, we really do appreciate being able to reflect on some of these very important lessons learned with regards to our support of W.H.O. Um, the leadership is very clear that we expect reforms with regards to the way they do business in the US has worked with W.H.O. over time, particularly in the past several years, towards those types of reforms you had. Assistant Administrator Gawande mentioned the Standing Committee on Health Emergency Preparedness and Response. That committee was established by the executive [01:09:00] board, on which we hold a seat. And the US was supportive for the reasons that you described, particularly because we felt that the board needed to have better oversight over W.H.O. 's response in emergencies and direct them accordingly.

Nicole Malliotakis (R-NY-11): [01:09:16] Yeah. The issue is that even when we have a seat at the table, it doesn't mean that we're seeing actual reforms. And we have this problem with other international organizations as well. It's not just the World Health Organization. The fact that we have so much most egregious violators of human rights sitting on the UN Human Rights Council, um, and, and, and that they're allowed to get away with it. I mean, it's a much larger issue of these global, international organizations that have been infiltrated by these nefarious bad actors, you know, Iran chairing the UN Human Rights Council. I mean, that's disgraceful. Okay, so this is just another example. I mean, the way, the way that here we're seeing communist China having this much influence in the World Health Organization. So, it's a much larger question. I guess my [01:10:00] question to all of you is what can we do as a United States other than send more American tax dollars, uh, to, to these organizations? What else can we do to truly reform them? Because what I hear from the administration is, oh, we've got to elect better actors to the committee. You know, that's why we went back to the UN Human Rights Council after, uh, you know, President Trump removed us was because this administration felt, well, if we were at a seat at the table, we can get more better, better nations, democracies, freedom loving people to be represented on those councils. But it has not happened. So, what really can we do? To change it.

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:10:38] Thank you. Let me provide additional information on what we are practically doing. We, the United States, are part of the Member States Task Force on strengthening W.H.O. 's budget, programmatic and financial and governance. And [01:11:00] as you've heard from us, I mean, they were about 96 actions that were required. And thanks to our leadership, our presence at the table, about 67 of those have been implemented, and we have about 25 or more that by the end of 2025 must be implemented. We are actively putting we put in pressure where we believe it's producing the return on investment in terms of the actions that were required of W.H.O. and what they are actually implementing.

Nicole Malliotakis (R-NY-11): [01:11:34] Well, I appreciate that. It's yet to be seen whether any of this will really amount to anything other than nice words, but again, I, I run out of time so I will yield back. But I think we just got to stop throwing good money after bad until we see some changes at these international institutions.

Chairman Brad Wenstrup (R-OH-02): [01:11:51] Now recognize Miss Dingell from Michigan.

Debbie Dingell (D-MI-06): [01:11:54] Thank you, Madam Chair. I want to build, actually, on what you were talking about, because we are all [01:12:00] worried about what did happen, etc., because in during Covid, how we don't repeat it and how we make W.H.O.  stronger when it comes to preventing and preparing for future pandemics, whether we like it or not, safeguarding global health and our own national security interests are inextricably linked with other countries around the world. That's when we live in this modern world that that's a reality. So, under President Biden, we have the United States has reasserted its global health leadership by re-engaging with the W.H.O.  and proposing substantive reforms to promote transparency and strengthen the international community's position against countries that obfuscate and evade accountability. So, let me start with you, um, Assistant Secretary Pace, and have you elaborate a little more? How has the Biden administration's re-engagement with the W.H.O. helped to solidify America's global health leadership in the wake of Covid 19 [01:13:00] pandemic? And what are you doing? You're not just talking, you're acting.

Loyce Pace, M.P.H: [01:13:05] Absolutely. Madam Congresswoman, thank you for that question. Yes. We want to reassure you that our role as leaders at this table is directly connected to what we view as our national security and those interests. I talked about the executive board, and I'll continue to talk about the executive board, because that governing body really does serve an important purpose in steering and guiding the work of W.H.O. There are 34 members. The US is one, as I mentioned, China, Syria, Belarus are also members of that body. So, what we do is we really take advantage of our seat at the table to ensure that our interests, whether they be in global health security, specifically in biosafety and biosecurity or in other areas of public health are well represented. We've had other members cycle on and off of the board as well. Even in my time as alternate board member, including Russia. [01:14:00] And you can imagine during that time, as we were deliberating as a board around how we respond in Ukraine, for example, in whose work in that space, how important US leadership was again at that table. Finally, when it comes to the reforms that ambassador Nkengasong mentioned, we've been very specific and deliberate with W.H.O. about what we'd like to see. We really need to understand, for example, how they're allocating their funding and ensuring that funding is going towards programs that have a real impact. This might seem basic to us, but we have to remember W.H.O.  was a technical institution. And it's in its in its origination, in its origins. And over time it's had to become more management savvy. And so we as a US government are really helping steer the organization in that direction. And again, having it operate at its highest and best use.

Debbie Dingell (D-MI-06): [01:14:55] So thank you for that. Mr. Ambassador. I'm going to go to you and I'm going to ask you to build [01:15:00] on that and ask you another question. The Biden administration has established the Bureau of Global Health, Security and Diplomacy to lead the State Department's work on preventing, detecting and responding to infectious disease. How has the Biden administration's efforts to integrate global health security across foreign policy, through your bureau, advanced our national security interests and knowing that you all work together, how do we make sure China doesn't lie to us the next time, which is what my colleagues on the other side and we are worried about? How do we not undermine people's confidence in W.H.O., but assure them that we are working and holding those countries accountable for telling us what's going on?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:15:45] Thank you, Congresswoman, for that. There are three goals that are driving the new bureau that was launched. Secretary Blinken launched in August. The first one is to leverage [01:16:00] all the assets that we have domestically and globally, so that we can address the challenges of global health security as a whole. As you know, Congresswoman, through the program, the prep for the president's Emergency Plan for Aids relief, we have footprints in over 55 countries in the world, and we build capacity in those countries. Those assets and public health systems are being used in responding to other disease threats like Covid was very instrumental, especially in Africa when Covid emerged. And we use that for rolling out testing, vaccinations and other PPE there. So, by having such a footprint, we have diplomatic leverage to in countries that we are operating and we have access to the leadership of those countries. We have professional allies, and we have control over what is going on in terms of having the right information [01:17:00] through such a platform. Then secondly, is really to coordinate, I mean, a coordinating. We've said severally during this hearing that and highlighted the importance of coordination. I think one of the things that we is doing will do to advance our foreign policy through the lens of global health security is to coordinate and coordinate everything the assets that we have, both internally and externally. Lastly is to elevate the global health security as part of our foreign policy. During the Covid 19 pandemic, our Secretary of State, Secretary Blinken, established a platform called the Foreign Ministers, a platform which was very instrumental in reaching out other sectors of of the society other than the ministries of health in our partner countries. And that platform was very useful in the way we discussed how vaccines will be distributed in the way PPE were made [01:18:00] available. So, we want to build on that, that those existing platforms and expand on it so that we have regular contacts with foreign ministries across the world to continue to promote global health security as a foreign policy.

Debbie Dingell (D-MI-06): [01:18:14] Thank you, Mr. Ambassador, I yield back.

Chairman Brad Wenstrup (R-OH-02): [01:18:18] Now recognize Doctor Miller-Meeks from Iowa.

Mariannette Miller-Meeks (R-IA-01): [01:18:21] Thank you, Mister Chairman. And I thank the witnesses for testifying before the select subcommittee today. It's no secret that the World Health Organization failed during the early phases of the Covid 19 pandemic. Our leading world health agency ended up being manipulated by the Chinese Communist Party and used to dilute transparency and accountability, especially when it came to investigating the origins of the coronavirus. And since the beginning of 2021, I've stated the origins were necessary to understand because of immediate disclosure of potential pathogens, because of biosafety lab work being done in the appropriate laboratory setting, and the ethics of certain types of research, such as gain of function research. [01:19:00] As a physician and a former state public health director, I value public health and both the mission of the World Health Organization and its done good since its creation in 1948. Since eradicating polio or smallpox in 1980 and working to reduce polio cases worldwide. However, previous achievements cannot be used as a cover for undeniable and costly failures during the Covid 19 pandemic, especially when the United States has historically been the W.H.O. 's largest contributor. During the pandemic, the W.H.O. constantly and adamantly praised China's leadership delayed calling it a pandemic and acknowledging human to human transmission. While many of us in the public health community were saying exactly those things, and it’s clear evidence that the Chinese Communist Party was lying to world leaders and restricting international access to its labs and information, the CCP was given full access to the W.H.O. 's Covid 19 origins Report. Before it was published, the Wall Street Journal reported that the W.H.O. led team sent to investigate Covid [01:20:00] 19 origins had little power to conduct a thorough, independent investigation during that trip, and China initially resisted international pressure for an inquiry and later imposed strict limitations, secured China veto rights over participants, and expanded its scope to encompass other countries.

Mariannette Miller-Meeks (R-IA-01): [01:20:17] As the W.H.O. seeks to alter international health regulations, it's vital that the United States and other member countries not let bad actors hijack the review process, similar to how the CDC lost public trust during its actions during the pandemic. The W.H.O. has accomplished the same, but now has the chance to rebuild its reputation. And let me just comment on several of the things you said, Doctor Gawande. We don't want respect for our sovereignty. We demand to be respected. We demand it, especially from members who are not acting in good faith. And if we cannot be assured of our sovereignty, it is up to members of Congress to have an accord or a treaty, have congressional approval [01:21:00] so that our sovereignty is respected. And Miss Paige. We don't choose to be transparent. The 24-hour disclosure of potential pandemic pathogens is not a choice. It is a violation. And that is where accountability comes into play. So, oversight of the global bureaucracy is vital, as is reviewing investments the United States make is making in global health landscape through its agencies like the US Agency for International Development. In your written testimony, you state that the Biden-Harris administration is working tirelessly to ensure that W.H.O. is effectively delivering on its mission. Do you believe that limiting the influence of the Chinese Communist Party on IHR regulation revision process is important to ensure that the W.H.O. is effectively delivering on its mission?

Loyce Pace, M.P.H: [01:21:51] Thank you for that question, Madam Congresswoman. And, um, yes, it's quite important for us to ensure that in [01:22:00] these deliberations around improving the International Health Regulations that they are. They evolve in a way that serves all countries. And importantly to your point, ensures our highest and best level of prevention, preparedness and response. It's one of the reasons that the U.S. actually took a leadership role in calling for the revisions of the International Health regulations, and introduced the original 13 or a handful of amendments that now other countries have also come in to say, we think this is also a good idea, and we are also willing to come to the table and have a constructive conversation about how this can be improved.

Mariannette Miller-Meeks (R-IA-01): [01:22:41] While I don't support withdrawing from the W.H.O.  or necessarily not funding the W.H.O., I do believe there are other ways to hold the Chinese Communist Party accountable. And one of those is whether or not they have a seat at the negotiating table for the pandemic accords and IHR revisions. Doctor Nkengasong. Excuse [01:23:00] me, Mr. Nkengasong. Ambassador, do you believe that China was transparent during and after the pandemic? And do you think they should have a seat at the negotiating table?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:23:09] Thank you, Congresswoman. As I said earlier, um, China wasn't transparent, uh, in its ability to, uh, to report and be accountable to a serious threat that ended up costing the lives of 1 million people here in the United States and 7 million in the world. Uh, this is the worst crisis that we face in the last 100 years of in terms of a pandemic, a respiratory disease that emerged. And it actually required more transparency, really full transparency of what happened at that time. And we I don't think for the past three years we've had that kind of, uh, we can say that China has been fully cooperative [01:24:00] and accountable both to the W.H.O. and to the rest of the world.

Mariannette Miller-Meeks (R-IA-01): [01:24:04] Uh, thank you, ambassador, I have one last question for Doctor Gawande in relationship to fraud within USAID. And then the request for additional funding. However, due to my time being expired, I'm going to submit the question and ask for it to be responded to in writing. Thank you, Mr. Chair, I yield back.

Chairman Brad Wenstrup (R-OH-02): [01:24:26] Mr. Mfume from Maryland is now recognized.

Kweisi Mfume (D-MD-07): [01:24:30] Thank you, Mr. Chairman. Um. By the way, I didn't know that you were leaving us. So, I will, uh, associate my remarks with the ranking member and say to you that it is indeed a loss for the Congress and for the sense of bipartisanship. Quite frankly, that has, uh, really been demonstrated over and over again by this committee. Um, I want you to know that your decision to voluntarily leave is not new. I did the same thing [01:25:00] 27 years ago and look where it got me.

Chairman Brad Wenstrup (R-OH-02): [01:25:02] So that crossed my mind.

Kweisi Mfume (D-MD-07): [01:25:04] Yeah, you may be back, um, for decades. And by the way, I want to also agree that this is a great panel of witnesses and I appreciate all the work that you've done, all that you're doing, and the many things that we don't know about because we get an hour here with you or two hours there, but, uh, your reputations precede all of you. And I'm glad that you're here today. Mr. chairman, the World Health Organization has helped, as we all know, to build an effective health system and has overseen for many, many years the expansion of health care access across the globe. In fact, 75 years. And through this work, the World Health Organization has markedly increased a number of things, not the least of which is the average life expectancy global from a globally from 47 years to 72 years. It is, of course, [01:26:00] important for countries that are part of the W.H.O., such as the United States, to give critical feedback to the W.H.O. on reforms to help strengthen its mission. I mean, we all have some ideas, I think, of what we'd like to see, and that's why I was actually shocked when I learned that the committee was not going to center this hearing around bringing witnesses from the World Health Organization to testify before us, particularly since the title of the hearing is reforming the W.H.O.. It just seems like we've lost a great opportunity here. And some of the things that have been raised, such as finding a way to reduce, if not eliminate China's influence, finding ways to have greater accountability, and finding ways to make sure that oversight is fixed and set seems to have eluded us. As a result of this, I strongly hope [01:27:00] that the committee will, at some point in the future, consider bringing in representatives from the W.H.O.

Kweisi Mfume (D-MD-07): [01:27:08] so that we might, in fact, be able to get to the heart of some of the things that keep us up at night and trouble us when we think about what we'd like to see from this particular organization. Um. Again, I appreciate the witnesses who are here today. There's a couple of things that strike me as kind of ironic, and I believe, Mr. Chairman, that the horse just got out of the barn, that some of this stuff that we are reacting to, it was really the role of this Congress and the previous Congress to get in front of. And that did not happen. So, we're playing catch up. We're mopping up the floor. In some instances, we are assigning blame. But the real blame, I think, here is in the Congress for not providing the proper oversight from the time that the pandemic hit. And I agree, it was a difficult time for all of us then. [01:28:00] But, you know, we ought to be a little careful about wanting reform without being able to identify the reform that we want. Um, this year, uh, several members of the other side of the aisle are offering amendments that would eviscerate, gut and do away with, quite frankly, the World Health Organization. I have before me, H.R. 1546, to prohibit the use of any and all funds to implement any obligations of the United States, uh, under the World Health Organization Pandemic Treaty. Uh, H.R. 79, a bill directing the president to withdraw the United States from the Constitution of the World Health Organization, and an amendment to the labor HHS appropriation that says none of the funds made available by this appropriation shall be made available to the World Health Organization. I would ask unanimous consent that they be, uh, entered into the record.

Chairman Brad Wenstrup (R-OH-02): [01:29:00] Without [01:29:00] objection.

Kweisi Mfume (D-MD-07): [01:29:01] So this is a very serious situation. Um. I'm going to come to the Assistant Secretary, Mr. Pace, in just a moment, because she said something that struck me, and that is that if there was no World Health Organization, we would have to invent one. And I agree with that totally much. As was the case in 1948, when countries around the world really understood the need to find a way to collaborate together. And I would ask Mr. Pace as assistant secretary, if you had your way in a magic wand, since we don't have the W.H.O. here to talk about reforms that we think and they think might be needed, what would be 1 or 2 of the things that you would suggest for the consideration of this committee?

Loyce Pace, M.P.H: [01:29:49] Well, thank you for that question, Mr. Congressman. I appreciate it because we do want a W.H.O. that is effective and truly in service to [01:30:00] the world. Um, I also want to reflect on what we've offered as highlights on what the W.H.O. has done right or well. Um, it is not just smallpox or polio that are its success stories. In fact, many of its success stories in global health security, as we call it, um, are even seen and heard today. Only they don't make headlines because of their that or that very success. So, whether it's with regards to Ebola or Marburg outbreaks, which we've all experienced and worked with W.H.O. to, to address in the past couple of years, or even in long standing programs such as childhood immunizations or maternal care around the world addressing maternal mortality and other really important issues such as Aids, TB and malaria. This is the work of W.H.O. that even helps to complement long standing U.S. programs. The fact is, we cannot be everywhere as a country, [01:31:00] nor should we be. We cannot be the World Health Organization ourselves. And so we rely on this multilateral institution to work or partner with us and leverage our resources so that they and we collectively can have that much greater an impact.

Kweisi Mfume (D-MD-07): [01:31:16] Thank. Thank you very much. My time has expired. Thank you, Mr. Chairman.

Chairman Brad Wenstrup (R-OH-02): [01:31:21] Um, I just want to point out that the W.H.O. and other international organizations are immune from congressional testimony. That doesn't mean we can't reach out to them directly in. Less official way.

Kweisi Mfume (D-MD-07): [01:31:36] Yeah, because I'd like to know what they think their reforms should be.

Chairman Brad Wenstrup (R-OH-02): [01:31:39] And we're planning.

Kweisi Mfume (D-MD-07): [01:31:39] Okay.

Rich McCormick (R-GA-06): [01:31:40]

Chairman Brad Wenstrup (R-OH-02): [01:31:40] Thank you. I now recognize Miss Lesko from Arizona.

Debbie Lesko (R-AZ-08): [01:31:45] Thank you, Mr. Chairman. And thank you all for being here today. My questions are going to be to the ambassador. Um, ambassador, on January 14th, 2020, the W.H.O. tweeted that, quote, preliminary investigations conducted [01:32:00] by Chinese authorities have found no clear evidence of human-to-human transmission of the novel coronavirus. A National Review article states that the Chinese Communist Party jailed any doctor that disseminated any information about Covid 19 that was not first cleared through their state-run media. A Wall Street Journal article states that the US intelligence sources since discovered that the CCP covered up and lied about the extent of the outbreak. According to the CIA, on January 21st, 2020, China threatened to cease participation in all international Covid 19 efforts if the W.H.O. declared a public health emergency of international concern. Well, guess what? W.H.O. delayed declaring Covid 19 a public health emergency of international concern. By the time the W.H.O. [01:33:00] declared Covid 19 a public health emergency of international concern on January 30th of 2020, the disease infected almost 10,000 and killed 1000 in 19 different countries. Despite declaring Covid 19 a public health emergency of international concern and extensive evidence of transmission through travel, the W.H.O. insisted other countries not restrict travel or trade to China. In fact, the W.H.O. never recommended restricting travel. The W.H.O. routinely praised the Communist Chinese Communist Party's efforts to combat the spread of Covid 19, despite multiple reports that the CCP engaged in a massive disinformation campaign. According to the US Intelligence Community Report, the CCP severely underreported both its total number of cases and deaths caused [01:34:00] by Covid 19. My question, ambassador, do you believe that the W.H.O. relied too much on false information from the Chinese Communist Party?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:34:13] Thank you, Congresswoman, for that very important question. And it is very clear that and I agree with you entirely, that CCP did not, uh, act in this crisis in a way that was, uh, a responsible, responsible in terms of, uh, fighting a threat that had emerged. It wasn't accountable, it wasn't transparent, and it didn't act in a timely fashion. That is very, very clear, I think, who has since become more forceful. There are several pronouncements that W.H.O. leadership had made over the course of, uh, as the pandemic evolved and they've [01:35:00] become more, more critical. But has that enabled and provided the right access for to information? I don't think so. We need to continue to press hard on CCP to have the right information. I think the reforms that are on the way, uh, going on at W.H.O. and the pandemic accord and the revisions of the IHR are all instruments that I believe strongly, so that working with others is the best way for us to be at the table, build a coalition of people that are like minded so that they can put the right pressure on any country that behaves in that fashion, including the PRC.

Debbie Lesko (R-AZ-08): [01:35:43] Well. And so, I think you said something about it. But what other reforms are needed before the US invests more money in the W.H.O.? Because ultimately isn't that the United States leverage is not to invest money until they do the reforms. [01:36:00]

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:36:01] Think that the reforms that  W.H.O.  is currently leading and we are at the table pushing that is in the areas of accountability, country level impact. That is what happens at a in country, because we know that a threat anywhere in the world is immediately a threat. Here in the United States, governance of W.H.O., the human resources, financial resources. So there's a whole set of categories of reforms that we've put on the table for W.H.O. And we are pressing W.H.O. to carry that on. And as I said earlier, of the 96 action items, about 67 have been acted on. About 29 of them will be acted on by two end of 2025, and we will keep an eye on that and continue to press them to change and reform.

Debbie Lesko (R-AZ-08): [01:36:51] Well, thank you. And please continue to press them to reform, because it's a lot of money that we're investing. And I don't want them to controlled by [01:37:00] the Chinese Communist Party. And so, with that I yield back.

Chairman Brad Wenstrup (R-OH-02): [01:37:04] Now recognize Miss Ross from North Carolina.

Deborah Ross (D-NC-02): [01:37:07] Um, thank you, Mr. Chairman. And I, too, want to thank you for your leadership, and you will be sorely missed in Congress. Um, so I want to appreciate first all of the witnesses acknowledging the problems with the W.H.O. and the Chinese Communist Party during the coronavirus pandemic. Um, Mr. Raskin is not with us today. So, I also want to remind the committee that the Trump administration was praising the Chinese Communist Party at the beginning of the coronavirus pandemic and wasn't stepping up to the plate to work with our international partners. The Biden administration came in, recognized many of these problems. And thanks to the good work of many of you. Um, we have become a better [01:38:00] global partner. It does not mean that the W.H.O. should be, um, exonerated for not cracking down on the Chinese Communist Party, but the W.H.O. was not alone in believing the Chinese Communist Party at the beginning of the pandemic, to the detriment of the entire world and to this country. Um, I do want to talk about how we should work with the W.H.O. going forward and the value of all of your leadership and any contributions that we make going forward. So, um, with our guidance and our leadership, the W.H.O. has worked to improve health outcomes around the world, standing up localized responses to public health emergencies and both bolstering defenses against deadly diseases. And we'll talk about some of the ones that Miss Pace has raised. But in fact, [01:39:00] for every dollar we invest in the W.H.O., the W.H.O. generates a minimum return of $35 in public health benefits. Um, Assistant Administrator Gawande, how has US participation in the W.H.O. not just benefited the world, but benefited public health here at home?

Atul Gawande, M.D., M.P.H.: [01:39:25] This is such an important question. There are multiple roles that W.H.O.  plays that leads to them improving health and lifespan of billions of people around the world, including Americans. And there are three central roles. One is that they lead collective action to reduce common killers. And we talked about eradication of smallpox. We talked about polio. But there are many other examples, and one that we rely on here at home is W.H.O.  is essential for our annual flu shot. The global tracking system has a network of 129 countries, including [01:40:00] China, that report on flu. Flu. Flu upticks share specimens and data. And that's the way we end up with a annual effective flu shot here. And it's important that we participate in W.H.O. to maintain that effectiveness. A second example is W.H.O.  coordinates action on health threats in countries that where USAID and our other agencies are and in places that are not. And the and they do that through something called the Global Outbreak Alert and Response Network. And I can attest to from experience on a weekly basis, responding to news of potential outbreaks across the world, whether it's Ebola, Marburg, potentially unknown causes that this information is vital for our early action. Triangulating to other sources when you don't necessarily trust the country source, and making sure that we understand what's happening so we can move quickly to stop, spread and address issues that protect [01:41:00] the lives and economic security of all Americans. And third, we, the W.H.O., brings together global experts for agreed upon norms and standards for treatments and preventions of virtually every medical condition that human beings can face and the results of that benefit us in in a variety of different ways. One example is that we they create the International Classification of Diseases and that system where we all call diseases. The same thing means that our electronic medical record companies have a have a global market for, for their medical record systems. And we're the biggest supplier and, and seller of those of those record systems because of that common framework that are that's negotiated. And there are many examples of these. In addition to that.

Deborah Ross (D-NC-02): [01:41:52] I see my time is about to expire. I'm going to submit a couple more questions for the record, but a couple of [01:42:00] you have mentioned PEPFAR. Could somebody you choose to briefly talk about how important it is that Congress continue to fund PEPFAR?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:42:11] PEPFAR, Congresswoman is, in a collective view, the greatest act of, uh, humanity in terms of, uh, solidarity, uh, to the world. I mean, imagine what Pepper has done over 20 years, saved 25 million lives, prevented HIV infection from occurring in about 5.5 million children in the world. Uh, before Pepper, uh, the face of the devastation that the disease had caused in the world was just a frightening. Uh. In a recent commentary, the former president of Botswana stated that in headline that without pepper, the country would have been extinct by now. We should be very proud of what we we have done. The values that we've [01:43:00] shown, which is the values of our solidarity with the rest of the world that we care for, for, for the rest of the world. And we are leaders in this, the discussion we are having today, which is  leaders in global health and global health security. It has always also provided a huge platform for the ability for countries to detect and respond to, to other diseases. I mean, as I mentioned earlier, uh, platforms were instrumental in being leveraged to roll out, uh, testing for Covid and for the vaccination. And in other countries where Ebola and cholera outbreaks have occurred, there have been used. And by doing that, they enable these infections to be detected early before they become a threat in our own country. So, we are not just helping, uh, countries in Africa and the rest of the world, but we are also protecting ourselves by making sure that PEPFAR continues to, um, uh, be reauthorized. So I'm really counting on working with you all to, in a bipartisan [01:44:00] way to get reauthorized for the next five years so that we get the job done. I think our goal is to bring HIV Aids to an end as a public health threat in six short years, 2030.

Deborah Ross (D-NC-02): [01:44:13] Thank you for your indulgence, Mr. Chairman. I yield back.

Chairman Brad Wenstrup (R-OH-02): [01:44:16] Now. Recognize Mister Cloud from Texas for five minutes of questions.

Michael Cloud (R-TX-27): [01:44:19] Thank you, Mister Chairman. Ranking Member. And thank you all for being here today. Uh, very important topic of conversation. Um, I wanted to start with kind of the lead up to Covid, uh, and what was happening before then? Uh, in 20 1819, I believe the US, uh, contributed about 839 million, China about 80 million. Uh, the Rotary Club actually had more investment in the W.H.O. than China. Does the Rotary Club have a seat on the board? No. Okay. China does. Still okay. Uh, and then some of the items that, that [01:45:00] the resources were being used for in September 2019. Uh, the W.H.O. was working, published a paper on addressing the harmful, harmful masculinities to improve sexual and reproductive health rights. Uh, February 2020. This is right after saying that there's not human to human transmission and then working to correct that. Uh, the W.H.O. was busy addressing the important health issues by holding a conference on road safety. Uh, right now, they're still working on, uh, groundbreaking research series on health benefits of the arts. Um, other, uh, there's resources being spent to shift negative attitudes toward abortion and prevent conscientious objection. Uh, that's regardless of what you think on abortion, even if you think it's right. This is this is if you're if you're working to change people's minds on it. Uh, that's not providing a scientific medical service, which I would you know, I'm pro-life.

Michael Cloud (R-TX-27): [01:45:58] I disagree with abortion, [01:46:00] but this is political action, not medical action. Legal recognition of self-determined gender identity. Uh, and the provision of, uh, gender affirming care. Things that the W.H.O. is invested in. Now, this is not protecting countries against the pandemic. And so, we continue to be by far the largest contributor to the W.H.O., ten times the amount of China leading into the pandemic. But it would have seemed that China had about ten times the influence during the pandemic in having their issues protected and addressed. And I appreciate the ambassador, uh, acknowledging the list that that Miss Lesko so, uh, capably presented of the missteps and misinformation that came from China, the W.H.O. But you kind of shifted the finger to China, which is appropriate. But it was also her point was in getting back to the missteps of the W.H.O. had in protecting it. And so what I wonder at this point is, is why we're not seeing full throated response [01:47:00] to bring China to account. Why is China still on the board? Why do they get a vote? Will the Biden administration stand up to China and have them removed from the board? Why do they get a vote going forward on any of this? Could you speak to that, please?

Loyce Pace, M.P.H: [01:47:16] Certainly. Mr. Congressman, thank you for this question because it is it is important to understand sort of the inner workings of W.H.O.  and how it is, uh, directed or in working in service to its member states. Um, so the way that board elections work or selections work is each region actually puts forth someone from their, um, from amongst their member countries to serve on the board. Now, there have been times when the US has objected to those nominations. However, not being a member of certain regions, we don't have [01:48:00] the say in terms of who they put forward and ultimately nominate to the board, just as they don't have a say in what the America's regions does to put the US on the board as many times as we have. And so, we do in the World Health Assembly object as we did when Belarus was nominated, when DPRK was nominated, because for the reasons that I'm sure you and your colleagues um, uh, agree, there are uh, uh, issues with their engagement. However, um, what we do with their space.

Michael Cloud (R-TX-27): [01:48:34] What we're not seeing, though, is bold, bold, full throated, uh, acknowledgement that we need to, you know, there could be a vote held in the board meeting to discipline China to remove them from it to counteract their influence in what's going on. I think after you've killed a couple of million people, you should not be able to get a vote, uh, on, on the board. Um, and from our perspective, we're continuing to fund this. And so I'll go back to my initial list, which we could [01:49:00] add a number of other items, uh, to, uh, encouraging taxing on sugar and climate change and all these different things. Uh, if, if you are involved in any issue that remotely affects the health of an individual, that seems like a whole lot of mission creep and a whole lot of power that the W.H.O. is asking for, uh, that you're asking us to be the primary funder of, uh, with only 1/34. Influence on the board. And so how do we as the people funding this on the backs of the American people, address those concerns when there seems to be a whole lot of mission creep that goes beyond protecting against pandemics.

Loyce Pace, M.P.H: [01:49:44] Well, if I may try to respond again, Mr. Congressman, thank you again for that question. With regards to Woo's program of work, they do work across the spectrum of public health, not only in pandemics or outbreaks. Importantly, when it comes back to [01:50:00] the benefit of woo for Americans, their work in non-communicable diseases is applicable to us and even justifies our engagement with them, whether it's on diabetes or cancer or other issues that we face here in our country, it is an important partnership that we maintain.

Michael Cloud (R-TX-27): [01:50:17] The vast majority of our input is voluntary, and my understanding is that comes with our ability to earmark what that is for. Uh, and, and we have great concerns. There's a lot of opacity in us getting to where what we're earmarking and what is actually being spent on so we can talk about transparency, uh, the need for transparency of what we're earmarking for. We can't find the information on that. So, it'd be great if you could help us with that. Um, uh, but then it gets earmarked to these very vague categories that when we go to what the with the many of the items I read are under these vague broad categories, uh, on the W.H.O. website. And there are things I don't think the American people feel like they should be [01:51:00] funding when it comes to, yes, happy to work with polio and those kinds of things. A number of these other things, uh, shouldn't be on the backs of the American people. Thank you, I yield back. Thank you. Chairman.

Chairman Brad Wenstrup (R-OH-02): [01:51:12] I now recognize Miss Tokuda from Hawaii for five minutes. Question.

Jill Tokuda (D-HI-02): [01:51:15] Thank you, Mr. Chair for your leadership. And I echo the comments of our colleagues today and thanking you for your service. Sadly, we have heard too often dangerous claims that withdrawing from the World Health Organization would somehow make the world safer for Americans and hold the PRC accountable. Make no mistake, a return to the Trump administration's isolationist approach to global health will undoubtedly put American lives at risk. Calls for accountability and cutting funding or withdrawing from the W.H.O. are not part of any legitimate effort for reform, and they are not part of any thoughtful strategy about how to make us safer and healthier. As our witnesses have shared today, if we aren't at the table, someone else will take our place. And if it's accountability we want, we need China under the tent [01:52:00] versus operating in a blind spot. Republicans repeated attempts to gut global health programs, including domestic programs at the CDC that track the outbreaks of emerging diseases and fight bioterrorism, will not keep Americans safe. In fact, just the opposite. Donald Trump's disillusion of the National Security Council's global health unit, which was monitoring cases of a deadly flu strain in China and an outbreak of yellow fever in Angola just prior to the pandemic, did not keep Americans safe. And in one of the most egregious global health decisions of all, Donald Trump's attempts to halt US funding and withdraw from the World Health Organization were not only a national embarrassment, but also sent a signal to our competitors that the United States was willing to abdicate our global leadership. Ambassador Nkengasong, you previously served at the World Health Organization, including during the pandemic. How did Donald Trump's decision to cut US funding for the W.H.O. and pull us out of the organization, shape perceptions of the United States? And in what ways might this have actually elevated [01:53:00] the PRC's influence and interest within the organization?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:53:05] Thank you, Congresswoman, for that. Um. Statement and the question, I must state very clearly that we always have to have a seat at the table. It's the only way that we can influence and, uh, the issues and protect our interests. It's the only way we can influence the issues and protect our interests. We are not at the table because we want to just be generous, but because we are truly wanting to protect our interests when we, the United States, isn't at the table, others will take our place. Our competitors are waiting for such an opportunity to influence the discussion, the dialogue, and tilted even in their favor. I think we should not and should never accept that to happen. And just for the record, um, Congresswoman, I was, uh, I've never worked at a W.H.O. Uh, [01:54:00] so my comments are totally, uh, transparent. I was UN special envoy for Covid for Africa during the Covid very early days of Covid, uh, until there was a nominated for, for this position. So I've been an envoy but not work at W.H.O. But you're absolutely right. We should always have a seat at the table and use that seat to protect our interests and to advance our interests in global health security.

Jill Tokuda (D-HI-02): [01:54:27] Thank you for that clarification there, ambassador. And I would also argue that we've heard a lot today on this dais about the PRC's elevated influence within the W.H.O. And I would argue that that probably happened as a result of the United States vacating its position upon the W.H.O. So, again, we should always have that seat at the table. Uh, at least someone else take it from us. We're thankful that President Biden has moved quickly to reverse the Trump administration's harmful decision, even if the damage has already been done. Assistant Secretary Pace is a senior official regularly engaged with the W.H.O. [01:55:00] What is your assessment of how our country is still recovering on the international stage from the harmful decision to cut US funding and withdraw from the W.H.O.?

Loyce Pace, M.P.H: [01:55:09] Well, thank you, Madam Congresswoman, for this very important question, because US leadership is quite essential in this space. And just turning back to the negotiations, for example, it took quite a bit for us to bring countries along with our proposal to amend the International Health Regulations. I think to this day, we feel there is quite a bit of skepticism with regards to whether or not the US is entering those conversations in good faith. Honestly, I think we know here our intentions and the importance of improving those existing regulations, but there are still questions about our intentions and our staying power, if you will. An important aspect of those regulations as well, includes [01:56:00] helping build or rebuild the capacity of countries around the world to actually implement them and adhere to them. And so, one important question that countries have and continue to have of us is whether the US will continue to be a part of that technical assistance, even beyond funding the enduring relationships that we've had that my colleagues have described are essential. And so, we have tried to ensure those member states that we are here again in service to Americans, but also in ways that hopefully will benefit the world.

Jill Tokuda (D-HI-02): [01:56:33] Thank you very much. And no doubt we have a lot of work to do to again rebuild that trust and that presence on the global stage. And no doubt, attempted cuts to funding is not helping in ensuring those other member countries that we have the staying power that we should have to ensure safety and security of the health and accountability overall for Americans and others across the globe. So, thank you very much, Mr. Chair, and I yield back my time.

Chairman Brad Wenstrup (R-OH-02): [01:56:57] I now recognize the chairman of the full committee, [01:57:00] Mr. Comer.

Chairman James R. Comer (R-KY-01): [01:57:01] Thank you, Mr. Chairman. During the Covid 19 pandemic, the W.H.O. did not step up to the plate. Instead, it aligned itself with the Chinese Communist Party. On December 31st, 2019, Taiwan sent an email to the W.H.O. that warned about a potential outbreak, particularly human to human transmission. On January 14th, 2020, ignoring this warning, the W.H.O., based on information from China, claimed there was no evidence of human-to-human transmission. This tweet this tweet contradicted even the W.H.O. on experts. Then, in June of 2020, the.

Chairman James R. Comer (R-KY-01): [01:57:37] W.H.O. was still claiming there was no, uh, transmission of Covid 19. So. So this was also false, starting with Miss Pace and going down the line. Do you agree that these statements were not accurate?

Loyce Pace, M.P.H: [01:57:52] Thank you for the question, Mr. Chair. We, of course, are here to really learn the lessons of Covid 19. And [01:58:00] one of the things that we have talked about with W.H.O. is the importance of ensuring that we get to the bottom of its origins.

Chairman James R. Comer (R-KY-01): [01:58:09] Ambassador?

Ambassador John Nkengasong, M.Sc, Ph.D.: [01:58:11] But I fully agree with my colleague. We, uh, W.H.O.  should continue to be reformed, strengthen this reform so that in future they can actually play the role that they've played in the past in protecting us.

Chairman James R. Comer (R-KY-01): [01:58:29] Doctor?

Atul Gawande, M.D., M.P.H.: [01:58:30] And I. And I would agree with your calling out that the Chinese government was intransigent, was not transparent, and had and was behaving irresponsibly. This is a situation which the where the WTO was too credulous. They called out Chinese behavior in SARS and were willing to call out publicly that the that China was not being forthcoming. And in this particular case they did not until [01:59:00] too late. So now there was more they did better. But this was important.

Chairman James R. Comer (R-KY-01): [01:59:05] The W.H.O. also praised China's transparency during the outbreak, even while China was silencing journalists and whistleblowers were going missing. Uh, again down the line, do you think China was forthcoming in sharing data about the pandemic, Miss Pace?

Loyce Pace, M.P.H: [01:59:20] No, sir. Absolutely not. Ambassador.

Chairman James R. Comer (R-KY-01): [01:59:22] No, doctor?

Atul Gawande, M.D., M.P.H.: [01:59:23] No.

Chairman James R. Comer (R-KY-01): [01:59:24] So the flaws of the W.H.O. all culminated in its origins report in 2021, a report based off an investigation that only had one American, Peter Daszak, who was funding the lab being investigated. He was the only American on that had its access to labs restricted by the Chinese Communist Party. And the Chinese Communist Party had final editing privileges of the report. So, it's no wonder the report was bogus. Doctor Fauci said he had considerable concerns about [02:00:00] the report, and Secretary Blinken said, we've got real concerns about the methodology and the process that went into that report, including the fact that the government in Beijing helped write the report. Ambassador, do you believe the Chinese government improperly influenced the outcome of the report?

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:00:19] They did.

Chairman James R. Comer (R-KY-01): [02:00:21] Miss Pace is. It is our understanding. That the US put forward some names to be part of that investigation, and China rejected them. Is that your understanding as well?

Loyce Pace, M.P.H: [02:00:34] Thank you for the question, Mr. Chair. I do know that the US has worked to not just put forward names for that particular investigation, but for the multiple visits or investigations and missions that the W.H.O. was seeking to have.

Chairman James R. Comer (R-KY-01): [02:00:51] So did China reject those names?

Loyce Pace, M.P.H: [02:00:54] I am not aware of why those recommendations were not accepted, unfortunately. [02:01:00]

Chairman James R. Comer (R-KY-01): [02:01:00] But it's our understanding that China rejected those like China was calling the shots. So, the W.H.O. took China's word time and time again. Miss Pace, how can we better ensure that the W.H.O. reports facts, not just what the Chinese Communist Party is, uh, is telling them?

Loyce Pace, M.P.H: [02:01:21] Thank you for the question, Mr. Chair. It is important for us to get to the bottom of this. I just want to take a step back and also note the multiple missions, international missions that W.H.O.

Chairman James R. Comer (R-KY-01): [02:01:33] We know about the missions. We just have a problem with China, or I have a problem with China calling the shots on it. I don't think that turned out very well during Covid 19. My last question for each of you, and you can just answer yes or no for the sake of time, do you believe that the Chinese government ought to be held accountable for the lack of cooperation in the early days of the pandemic? Miss Pace.

Loyce Pace, M.P.H: [02:01:57] Thank you, sir. We do think that the international [02:02:00] health regulations and improving those will make all countries be should.

Chairman James R. Comer (R-KY-01): [02:02:04] They should China be held accountable?

Loyce Pace, M.P.H: [02:02:07] We believe all countries should be held accountable for any violation of those.

Chairman James R. Comer (R-KY-01): [02:02:11] Do you not think China is a little special in this situation, since it, by all accounts, came from China and they completely lied and were not truthful with the world population about the outbreak of Covid 19 that they, you know, had veto power over who America put on boards and rejected reports that we now know, uh, could have been helpful.

Loyce Pace, M.P.H: [02:02:36] I share your frustration with China's lack of cooperation.

Chairman James R. Comer (R-KY-01): [02:02:40] But should we hold China accountable?

Loyce Pace, M.P.H: [02:02:42] Well, that's something that we're trying to do by amending these International Health Regulations and ensuring that violations can't happen in the way that they did previously.

Chairman James R. Comer (R-KY-01): [02:02:51] Ambassador, should we hold China accountable?

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:02:53] I think we've said, Congressman, that, uh, transparency and accountability were [02:03:00] totally lacking. And we hope that, uh, it is the purpose and intent of the IHR reforms and the pandemic, uh, agreement accord that will bring more accountability to any country and not just PRC, but any country in the future when they default.

Chairman James R. Comer (R-KY-01): [02:03:18] Doctor.

Atul Gawande, M.D., M.P.H.: [02:03:19] Yes, China should be called to account. And that and the office of the Director of National Intelligence has indicated that we are still in a world where there's no definitive answer to two viable theories about the origins of Covid, and that in order to in order to resolve this issue, uh, the People's Republic of China would need to be forthcoming about data that can resolve these issues, which they have not been.

Chairman James R. Comer (R-KY-01): [02:03:46] Mr. chairman, my time has expired, I yield back.

Chairman Brad Wenstrup (R-OH-02): [02:03:49] Now recognize Mr. Garcia from California.

Robert Garcia (D-CA-42): [02:03:52] Thank you. And thank you, Mr. Chairman. I want to thank our witnesses for making the time to be here today as well. And for your service to health, not just here [02:04:00] at home, but across the world. We know that the World Health Organization plays a critical role in global response, which impacts, of course, everything that happens here in the US during the pandemic especially. We know that the World Health Organization was a critical partner to everything going on globally, across the world. And just as our own country's response to the pandemic was imperfect and we learned as we went along, we also know that it also was the case for the W.H.O. Everyone across the globe struggled to address this crisis as it happened, and we've lost millions and millions of lives not just here at home, but across the world. I'm grateful for each of you to speak candidly about ways we can improve and in ways we cannot just not just strengthen our partnerships, but also look at lessons learned. I'm also grateful to my colleagues here today for the chance to have a serious discussion about how to prevent and respond to future emergencies, but we should be also very clear. There's a difference between a good faith conversation about ways to improve the World Health Organization and proposals [02:05:00] to slash the World Health Organization, including critical funding or even withdraw from the World Health Organization completely. Now, at our last hearing in the subcommittee, we heard about the importance of international biosafety standards for medical research. We had a great discussion, and everyone agreed that we needed both additional funding and oversight for global biosafety and biosecurity. There was wide agreement on this. Assistant Secretary Pace, if I'm not mistaken, the W.H.O. plays a huge role in safeguarding biosafety and biosecurity in our laboratories. Is that correct?

Loyce Pace, M.P.H: [02:05:32] Yes, Mr. Congressman, that's correct. It's important.

Robert Garcia (D-CA-42): [02:05:35] Thank you. That that's what I understand as well. So so if my colleagues are serious about international biosafety standards, it sure seems that co-sponsoring bills that are titled withdraw the United States from the Constitution of the World Health Organization or another bill that is titled the No Taxpayer Funding for the World Health Organization Act. It would appear to me that bills like this would actually [02:06:00] hurt global health and hurt our health programs here in the United States. Would you agree, um, that that would be the case, assistant Secretary?

Loyce Pace, M.P.H: [02:06:09] Thank you, Mr. Congressman. We would certainly not want anything to hinder W.H.O. 's ability to protect Americans in the world.

Robert Garcia (D-CA-42): [02:06:17] And Assistant Secretary Pace also, and it's not just members of this committee because numerous members of this committee actually co-sponsored these bills that are on this subcommittee. Um, are the former president now, of course, trying to be president again, Donald Trump tried to destroy the World Health Organization and separate the United States from any of its health responsibilities. He quoted it as extraordinarily bad, a threat to all Americans. The US role will be diminished. It's short sighted, unnecessary and unequivocally dangerous. There he is talking about the world's leading health collaborative that brings countries together to take on pandemics. And we know, and at least I believe, that he's also responsible, [02:07:00] in large part for the failures of the last pandemic that led to the death, as we know of over a million Americans. And so, would you also agree that supporting the World Health Organization is critical to the success of American health Assistant Secretary?

Loyce Pace, M.P.H: [02:07:16] Yes. Mr. Congressman, I would agree that it's critical. Of course, we need an effective W.H.O. to do so, but they've done much over the past 75 years to demonstrate their value to Americans and the world.

Robert Garcia (D-CA-42): [02:07:28] Thank you. And finally, I just want to also add that it's also unfortunate that there is so much vaccine misinformation happening just right now and across this country and across the world. Um, and it's happening here in the subcommittee, I think. I mean, just last week, we had a colleague that published a post openly encouraging parents to defy pediatricians and refuse childhood vaccinations, which we know is not advised by the medical science here today. And anti-vaccine misinformation is dangerous and is costing American lives. Childhood vaccine [02:08:00] rates against preventable diseases like measles, polio and hepatitis are declining to dangerously low levels, and we're seeing a resurgence of some of these same diseases in our communities because of declining vaccination rates. And so, while we're having these hearings on the broader pandemic, we must also remember, to be honest, focus on the truth and support organizations that are battling pandemics and trying to keep people safe. And so, with that, I yield back.

Chairman Brad Wenstrup (R-OH-02): [02:08:26] Now recognize Doctor Joyce from Pennsylvania.

John Joyce (R-PA-13): [02:08:29] Thank you, Chairman Wenstrup, for holding today's hearing. And thank you for our witnesses, for your time and for your testimony. Covid 19 was the most devastating global public health emergency since the inception of the World Health Organization. Their flagrant lack of action from the beginning was a primary concern, but their blatant dereliction of responsibility is why there must be reform, why we are holding this hearing. This subcommittee was established in response [02:09:00] to the misguided policies, mishandling and inconsistent guidance that arose amid the pandemic. In the beginning, the Covid narrative was controlled by the W.H.O.   W.H.O.  are corrupted by the CCP, and they ultimately place CCP political interests ahead of their international duties. The CCP steered clear, steered the dialogue, the CCP skewed the statistics, and they fed the W.H.O. information that would ultimately effectively shield the Chinese government from blame. Now, it's almost four years later, and the same organization is calling on member nations to enter a pandemic treaty. Entering a treaty with an organization that refuses to hold bad actors accountable is the antithesis of what was AU's mission, and it is the antithesis of the principles of all Americans. The American [02:10:00] people want. And the American people deserve answers from this committee. They deserve to know that we intend to safeguard our nation and protect our citizens from the next global public health emergency. Ambassador Nkengasong. Article two, section two, clause two of the United States Constitution clearly states the powers of the Executive Office as it pertains to the making or entering of treaties. Nowhere does it grant the W the World Health Assembly that authority. Do you believe that the World Health Assembly will attempt to act unilaterally and circumvent congressional approval and enter the US into an agreement like the Pandemic Prevention Preparedness Response Treaty?

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:10:52] Thank you, Congressman, for the statement. And let me just repeat what I stated earlier before you [02:11:00] arrive, that the pandemic accord, which is still being drafted, if we look at our article three, section two, it talks about sovereignty, which is that the countries and only the countries have the right over the people and themselves to make a determination as to how to manage health issues in the, in the country. So, absolutely, as a principle of that, our pandemic accord treaty, we still don't know how we will call it in the end, but that is we are the accord is what is the word that is being used now, not necessarily a treaty, because we are still early on in the process of negotiation with more than 194 countries or so. So that absolutely we are at the table. We will never allow any language in the accord or treaty that will remotely suggest that our sovereignty will be taken over by the W.H.O.

John Joyce (R-PA-13): [02:11:58] And, and it would never occur [02:12:00] from your understanding, whether you call it a treaty or an accord, it would not occur without congressional approval. Is that what you just stated, sir?

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:12:07] I am stating that we are still early, sir, in the negotiation, and it will still. We don't know how the final outcome will look like, and.

John Joyce (R-PA-13): [02:12:17] The citizens of the United States expect that any treaty would only occur with congressional [approval] by the Senate with congressional approval. Miss Pace, the W.H.O. acted as a bulwark apologist for the CCP, and a few examples include. They praised the CCP's failed efforts to combat the pandemic. Despite a globally recognized cover up, the W.H.O. denied human to human spread of Covid 19 based solely on CCP propaganda. The W.H.O. delayed naming Covid 19 as a public health emergency because China claimed that the spread was under control. The W.H.O. delayed implementing pandemic [02:13:00] stalling measures to protect, trade with and travel to China. With that in mind, how can we ever restore trust public trust in the W.H.O.? You all three of you just stated, you acknowledged when Chairman Comer asked if China was forthcoming with Covid 19. You all said no when? When, chairman Comer continued, and all three of you stated that the People's Republic of China should be held accountable. Isn't that trust permanently fractured with the W.H.O. firm alliance with the Chinese Communist Party?

Loyce Pace, M.P.H: [02:13:41] Thank you for this question, sir. And Mr. Congressman, excuse me. You know, it is, as I mentioned earlier, um, very frustrating and unfortunate that China in particular did not cooperate at such a critical time. It's one of the reasons why we are [02:14:00] working through these International Health Regulations to rebalance things, to make it so that we are not all beholden to the failure of a single actor.

John Joyce (R-PA-13): [02:14:10] But wasn't that single actor? Didn't that fracture your ability to come forth as what you should be doing by your mission statement? Isn't that culpability because of the Chinese Communist Party's undue and over influence on the W.H.O.?

Loyce Pace, M.P.H: [02:14:27] It's one of the reasons we're frustrated. Our hands were tied because we did not receive the information that we needed from them. And so, what we're trying to do through these amendments is unlock that information by other means in the event something like that ever happens again.

John Joyce (R-PA-13): [02:14:42] So my final question is, how would you prepare your organizations for the next pandemic, both in-house and in conjunction with the W.H.O., knowing what you just stated, that that makes it an incredibly difficult situation and a relationship that does not have trust in it.

Loyce Pace, M.P.H: [02:15:00] Thank [02:15:00] you again for this question, because it's so important that we do rebuild that very trust and so that we can be most effective in preventing or mitigating a future pandemic. One of the things that we are doing as a lesson learned is strengthening our not only our multilateral partnerships, but our regional partnerships, and so ensuring that we are working with networks, particularly in Asia, but in other regions of the world, to understand disease trends. This is building on, obviously, decades of relationships and partnerships that HHS has had globally over time. But really looking to not rely again on a single actor to save us is something that we have taken away from Covid 19.

John Joyce (R-PA-13): [02:15:44] My time is closing, and I think you really drive home that the single actor did not save us that single actor. The Chinese Communist Party destroyed so many human lives, and the culpability and the ability to respond is what we have taken [02:16:00] on as a charge for this committee, Mr. Chairman, thank you. I thank the witnesses for being present here today, and I yield the remainder of my time.

Chairman Brad Wenstrup (R-OH-02): [02:16:09] Now recognize Miss Green from Georgia.

Marjorie Taylor Greene (R-GA-14): [02:16:12] Thank you, Mr. Chairman, and thank you to the witnesses that are here today. This is an important conversation. Due to the Covid 19 pandemic response, government lockdowns, forced vaccinations, school closures. Many Americans have lost faith and trust not only in our government, but also in the W.H.O. And it's extremely serious. The W.H.O. colluded with the Chinese Communist Party. In January of 2020, the W.H.O. repeated Chinese Communist propaganda by saying that there was no human-to-human transmission with Covid. The W.H.O. waited several weeks to declare Covid 19 a public health emergency because China insisted they had the situation under control, which was a lie. The [02:17:00] W.H.O. did not impose any travel restrictions, unlike President Trump, to help slow the spread of Covid 19 because China did not want their economy to slow down. The W.H.O. continued to praise China's handling of the pandemic despite a globally recognized cover up. The W.H.O. went along with the CCP's fake claims about the origins of the virus not being from a lab, and our investigations and our own intelligence agencies have told us otherwise. The International Health Regulations. The IHR is a treaty of the W.H.O., meant to usher in a new era of global public health that requires all Member States to cooperate to make the world more secure. The IHR requires only a simple majority to amend it. There have been over 300 amendments proposed, and member States will not be able to see these amendments before they are scheduled to vote. [02:18:00]

Marjorie Taylor Greene (R-GA-14): [02:18:01] At an October 2023 meeting, the working group compiling the amendments for the 77th World Health Assembly in May 2024, was told that they do not have to produce their document before the meeting. Some of the amendments include expanding the ability of the W.H.O., director general to declare public health emergencies, to include regional declarations, as well as intermediate threats, allowing director general to act on information in the public domain without verification from member states and creation of a compliance committee to enforce their rules. I can assure you, the American people do not want the W.H.O. enforcing any rules on their own personal decisions regarding their health. If certain IHR amendments are adopted next year, sovereign countries, including the United States, would be obligated to adhere to the treaty. The Biden administration led the charge for amendments to the IHR, [02:19:00] including a new compliance committee. The treaty would create a conference of the parties, which could call on the United Nations for help in implementing the treaty. There is already talk of that conference of the parties being merged together with the IHR. While the Biden administration wants to entangle the US and more globalist organizations and imperil the health and safety of American citizens, President Trump withdrew the US from the W.H.O. completely, wisely anticipating such precarious mandates as the ones being proposed.

Marjorie Taylor Greene (R-GA-14): [02:19:28] The move toward a global health security state is reliant upon surveillance, which relies on data. Remember China? That's what they did to their citizens and still do the treaty and the IHR call for more sharing of personal health data in the name of safety and outbreak prevention. That's an invasion of privacy for the American people. The next step is to create a digital profile of everyone in the world. And if the W.H.O. [02:20:00] is given binding power, the UN will essentially have the power to restrict any American's movement, access to health care, medicine, etc. I can assure you right now, the American people will never comply with anything like this from a globalist organization regarding their personal health decisions and as a matter of fact, any way they decide to conduct their lives. I think this is extremely dangerous. Um, I have a question. Um, Miss Pace, the working group for the IHR, were told recently they did not have to produce their final draft of proposed amendments to the IHR for the 77th World Health Assembly until the event in May 2024. How can the US, or any member state, have any meaningful way to evaluate and consider the proposed amendments before they are put to a vote?

Loyce Pace, M.P.H: [02:20:50] Thank you very much for the question, Madam Congresswoman. This is a really important issue for us, especially considering our leadership on the international health [02:21:00] regulations, not only in this administration, but I, but also going back to the previous administration. And so, a couple of things in response. One, I want to be certain and assure everyone here that we echo what the ambassador said earlier about the pandemic agreement. That also applies to the International Health Regulations and any negotiations or amendments there. We are not going to accept anything that would undermine our national sovereignty. And in fact, the W.H.O. does not have that authority over our U.S. health policies. And so, I wanted to be sure and reiterate that, um, I think that in addition, um, the one of the things that we are hoping oh, I also wanted to assure you, excuse me, that the U.S. is very much at the table for these negotiations. And so, we do have visibility into the various amendments being proposed and [02:22:00] the opportunity or ability to push back again, as we need to out of respect for our own sovereignty or other national laws and policy. And that is something we are absolutely doing if and when necessary. Finally, with regards to our own amendments, we did feel it was important to revisit the tiered alert system as we described earlier, so that we are not in a position of scrambling in an outbreak, but rather have some intermediate alert whereby we can mobilize resources before we're all in a panic. Also, one of the reasons why we touched on verification of public information is because you had actors like the CCP or the or PRC not providing that. And so, we wanted to provide a sort of alternate, um, um, pathway, again, to protect America and the world in the event countries weren't being forthcoming.

Marjorie Taylor Greene (R-GA-14): [02:22:58] Thank. Thank you, Miss Pace. [02:23:00] Um, I can also assure you, in a future Trump administration, given the way the W.H.O. conducted itself, it could be very likely that we withdraw again from the W.H.O. Thank you, Mr. Chairman, I yield back.

Chairman Brad Wenstrup (R-OH-02): [02:23:13] I now recognize Doctor McCormick from Georgia.

Rich McCormick (R-GA-06): [02:23:16] Thank you, Mr. Chair. Much like, uh, other international organizations such as the World Trade Organization, the United Nations World Health Organization is vying to gain more authority through pandemic prevention, preparedness and response. In my opinion. Uh, this worries me greatly. Let me be clear. The United States should never, ever allow international organizations, specifically the World Health Organization, to impede our sovereignty, which I know you just reaffirmed. With that said, I think that when you designed the World Health Organization, it was intended to be a daddy gatherer, an observer, an informant to nations around the world with the goal of providing interchange [02:24:00] of information, uh, from different health care organizations for emergencies. Uh, however, the Biden administration must ensure the W.H.O. authority is limited to setting public health standards and providing a forum for countries to exchange information, but not to be given greater authority to infringe on our nation's sovereignty. Now, I know we had this debate on world tribunals and other areas where we have world organizations that want to overreach. I think it's really important when we talk about us national interests advanced to these upcoming negotiations in the Pandemic Prevention, preparedness and Response accord, which I believe both of you are involved in. Correct. Ambassador. Okay, so you're both on board. Can you both commit to complete transparency during this process?

Loyce Pace, M.P.H: [02:24:46] Yes, sir. Thank you for the question. We have been.

Rich McCormick (R-GA-06): [02:24:51] Just. Yes, sir. It's fine.

Loyce Pace, M.P.H: [02:24:52] Yes, sir. Thank you, Mr. Ambassador.

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:24:54] Yes.

Rich McCormick (R-GA-06): [02:24:54] Thank you. Uh, can you both commit to making the proposed treaty and amendments public to [02:25:00] any proposal public to allow for commentary and opinion?

Loyce Pace, M.P.H: [02:25:06] We have done so. Thank you, sir.

Rich McCormick (R-GA-06): [02:25:08] And we'll continue to do so?

Loyce Pace, M.P.H: [02:25:08] Absolutely.

Rich McCormick (R-GA-06): [02:25:10] Okay, great. Uh, with that said, one of the things I'm worried about is, uh, we haven't we obviously have been compromised in the past where we have been given misinformation and then propagated that information, which you fully admitted and which we've pointed out probably ten times just today where we propagated Chinese misinformation, if you will, whether it be just through not vetting the process or not thinking it through. We didn't really take the world's opinion. We just took one countries and kind of propagated that. That worries me in the future. My question is how do we get the trust back? And even more importantly, I think what have we done to hold China accountable? Or is there a way? Because I'm telling you, if you look at the World Trade Organization, for example, with China, has been taken to court 27 times and defeated in court, we're still don't have any teeth to actually hold them accountable. How do we keep countries like China and other bad [02:26:00] actors from using the system, from giving us the inappropriate information? And how do we hold them accountable? Because I don't feel like they've been held accountable at all.

Loyce Pace, M.P.H: [02:26:12] Well, I'll try to respond to this question, Mr. Congressman. It's an important one. As the ambassador said earlier, we are quite clear, particularly in multilateral settings, what we expect of all member states, including China, and even in our bilateral engagements. We also have been able to reiterate our expectations.

Rich McCormick (R-GA-06): [02:26:32] With all due respect, Ms. Pace, saying, I expect you to do something and holding somebody accountable is like saying, I expect my kid not to take cookies and then doing nothing when they steal them. What have we done to keep them accountable?

Rich McCormick (R-GA-06): [02:26:47] Mr. Ambassador. I'll give you a shot.

Rich McCormick (R-GA-06): [02:26:49] Yeah. Thank you.

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:26:50] We thank you, Congressman, for that question. I share your concerns with how China conducted itself during [02:27:00] this pandemic and continue to do so. And there are two things that instruments that we are working on, and I see those as instruments for accountability, the IHR and the pandemic accord. And let me be very clear, there is absolutely no room in the pandemic accord that will allow W.H.O. to have an influence or to make any determination over our sovereignty. Absolutely not. As principal article number three, as I've stated repeatedly during this hearing, clearly defines what uh, countries have versus what W.H.O. would have. I mean, they really affirm the leading role of each country over its sovereignty.

Rich McCormick (R-GA-06): [02:27:45] So I appreciate you answering the question you already previously answered, which is we're not going to lose our sovereignty. That's great. But the question that was never answered and the reason we're here is to hold you accountable. The question is, what are we doing to hold them accountable? Which was not answered? [02:28:00]

Rich McCormick (R-GA-06): [02:28:00] No.

Ambassador John Nkengasong, M.Sc, Ph.D.: [02:28:00] I think we answered that in, uh, very quickly in that there are two instruments we are working for, working on the China and the pandemic accord, which are instruments that will, uh, will be used for ensuring accountability.

Rich McCormick (R-GA-06): [02:28:16] Accountability for sovereignty. Yes. But I guess my question is the bad actions, but I'm out of time, so I yield. Thank you.

Chairman Brad Wenstrup (R-OH-02): [02:28:28] I'd like to yield to the ranking member, Doctor Ruiz, for a closing statement if he would like to make one.

Ranking Member, Raul Ruiz (D-CA-25): [02:28:33] I would thank you, Mr. Chairman. And, um, excuse my absence. I was opening a roundtable, National roundtable on health care with the Congressional Hispanic Caucus, and, uh, came back as soon as I could, right in the nick of time. So, thank you again to the witnesses for your testimonies. The W.H.O. plays a critical role in advancing global health security. Throughout today's hearing, we've discussed much [02:29:00] of this vital work improving access to care, surveilling for deadly diseases, administering lifesaving vaccines, and more. And so, before we conclude today, I want to emphasize again, for the record, that our work to prevent and prepare for future pandemics is not in conflict with enhancing international cooperation, but rather our efforts are strengthened and fortified by it. In all of our conversations, both today and going forward, I hope we continue to recognize the value our participation in the W.H.O. brings to our nation's diplomatic, foreign policy and national security interests. In fact, almost everyone in the in the panel today said that one of the biggest lessons learned is that we need to lead in this effort. And so right now, we have the opportunity to not only enhance global pandemic prevention and preparedness, but also cement our nation's leadership in global health. And we can do so by continuing to [02:30:00] foster international collaboration and advance reforms to the W.H.O. Uh, in the International Health Regulations. The pandemic accords are very vital, real time priority instruments and tools to have the influence that we need in this space and that promote transparency, improve surveillance, and strengthen cooperation with standards and norms. So, these matters are of critical importance to global health security, and I hope that we can find ways to work together here in Congress and with our administration partners to pursue constructive reforms that will save lives and reduce harm in the event of a future pandemic. Again, I want to thank all of our witnesses. Um, you are in the front lines. Much respect. Thank you for your hard work. Thank you for your service to our nation. And I want to thank, uh, the chairman and yield back.

Chairman Brad Wenstrup (R-OH-02): [02:30:55] Thank you, Doctor Ruiz. And again, thank all of you for your time today. I [02:31:00] think this has been extremely valuable. Um, you know, the whole situation obviously is frustrating, but this committee remains committed to the shared goal of preparing for the next pandemic. Lessons learned that so that the issues that the W.H.O. had, Chinese transparency, all of these, they're highly relevant to our preparedness here in the United States. My feeling is the more we can set the tone for what it takes to be prepared. Others can as well. And could make an organization like the W.H.O. much stronger if there's cooperation. Like every witness today said, China was not transparent. They weren't forthcoming. All of those things. I can't help but think of Ronald Reagan's line we need to trust but verify. That's what was missing is the verification [02:32:00] and so why not trust you? Assume people are going to be honest brokers you would hope. And when they're not, and you can't check that. I think the lesson learned is. Organization, international organization, or at least [we] ourselves, need to be there on the ground to see what the actual truth is. So, I think that's one of the lessons learned, and I would say here too early on in the pandemic. I said to the administration, America needs to be hearing from the doctors treating Covid patients. That's who they trust. That's what every patient in America person in America can relate to is the one wearing the white coat. That's there to say, I'm going to try and take care of you as best I can.

Chairman Brad Wenstrup (R-OH-02): [02:32:50] Doctor, you know that feeling, and it makes a big difference. You know, we heard some comments today. Again, trusting without verification [02:33:00] is a problem. If the president of one country is telling the president of another country, everything's under control, we got this. Well, we see what that leads to. When you're lied to and don't know you're being lied to. Then you don't give the guidance and leadership that you should. Honesty is the is the lesson learned to me. The W.H.O.  needs full access. And the W.H.O. representing all of its partners, need full access. To be able to do things correctly. Um. We talked about revisions to ours. We need that to be without political influence. You all have testified to that today, and I thank you for your work. I heard things today that I think are really good for us to hear. And we [02:34:00] agree US leadership is indispensable in this process. And I was pleased to hear all of you talking about an agreement that protects the United States is your priority. And that's what we need to have. But I also agree. That we're going to protect the United States. We have to do everything we can around the globe. When we're talking about a pandemic, it can't just be the United States, you know, without data, accurate data, without truth, without honesty. We can't help we can't help fully or quickly, which is key to a pandemic response. So, it became clear to me that the show's success depends on the United States.

Chairman Brad Wenstrup (R-OH-02): [02:34:49] And that the United States is going to have to depend on honest data access and everything else through the W.H.O. So, [02:35:00] um, we can't have a situation where one country gets to deny us from being part of the team. In controlling the situation on the ground. But I see a lot of opportunity here. Um, I do have in front of me the draft, and I appreciate that. This is public and we need to go through it. Uh, we're here to represent the American people and the taxpayer dollars. So, we want to know what the investment is and what it looks like. And so, I appreciate the openness. There is a difference between an accord and a treaty. And that concerns members of Congress, as you can imagine. Um, and I will say so when in Congress, when Congress is frustrated, what's the power they have? The power of the purse. So, we do want to be involved. We want to be involved [02:36:00] with this so we can honestly report what the intent is, where the money is going and how we're trying to make the world a better place. And the health of America in particular. And with that I yield back. And I want to again, thank you all. Uh, with that, and without objection, all members will have five legislative days within which to submit materials and to submit additional written requests for the witnesses, which will be forwarded to the witnesses for their response. And there's no further business without objection. Select subcommittee stands adjourned. Thank you all.

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This transcript is provided by the Sovereignty Coalition as a resource for the public.

See also the Sovereignty Coalition Congressional Briefing hosted on Tuesday, Dec. 12, in advance of the @COVIDSelect hearing.

COVID Subcommittee Must Defend Our Constitution

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