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This is an archived USAID document retained on this web site as a matter of public record.
Remarks by Don Pressley to the
Arlington, Virginia
Annual Meeting of the Partners of the American International Health Alliance (AIHA)
November 15, 1999
Thank you for that introduction, Jim. It’s a true honor to be here with people who make the term "partnership" a living reality.
I am especially pleased to be here today with so many leaders in the health field and in this region - including the Ministers of Health from Russia and Belarus and Deputy Ministers of Heath from throughout Europe and Eurasia.
You know, when the Berlin Wall fell, almost exactly ten years ago today, it set in motion a transformation not just of Europe, but of the whole world.
By bringing us all closer together it has made us more dependent upon one another. And this interdependence brings with it opportunity - but it also brings responsibility.
And after a decade of work in Europe and Eurasia, USAID has discovered that perhaps nowhere is this more evident than in the health sector.
When we first started our programs in this region, we pretty much thought we knew what these countries needed - serious economic reform and democracy building. Once they had accomplished this, we thought, everything else - environmental problems, unemployment, pension reform, health care - we thought these would then be more manageable issues. So we decided to wait to tackle them.
And so, for a long time, USAID - along with other donors - has targeted most of its assistance to the two areas of economic reform and democracy building.
But, as it turns out, we were only partially right.
Because while the countries of this region did need - and do need - help with privatization, tax reform, and small and medium enterprise development, say, on the economic side, and election reform and civil society and media development on the democracy side, they also need help meeting the most basic needs of their citizens - access to doctors and medicine, education for their children, pensions for the elderly.
While a market economy has many benefits, unfortunately, it also creates new winners and losers. And many of the countries of Europe and Eurasia have had trouble meeting these new challenges.
Before the Wall fell, people had their basic needs met - the health care wasn’t state of the art, perhaps, nor the pensions generous, but certainly some sort of safety net was in place. That net is mostly gone today.
In fact, for all its shortcomings, the former Soviet bloc offered its citizens a reasonable set of social conditions: high literacy and life expectancy rates and low infant and child mortality.
So what happens when all of that is taken away, when life expectancy rates fall and infant and child mortality rates skyrocket?
Well, one thing that happens is that people lose faith in the reform process. Why should we support and elect leaders who talk about regulatory reform when our children don’t have access to doctors or medicine, they think.
Why should we support privatization when that means so many of us will lose our jobs?
And why should we continue to work and sacrifice and struggle, they think, when not only is our life not getting better, it’s actually getting worse?
Well we at USAID understand where they are coming from.
We understand that deterioration of the social sector - and of basic social services - erodes the progress we have made in the economic and democratic sectors.
And that’s why, as and where appropriate, we are broadening our programs to place more emphasis on the social sector.
Those of you that know our programs in this region will regard this as quite a breakthrough, but many ways it is a natural evolution of our programs based on the lessons that we have learned from you and others like you all across Europe and Eurasia.
Now and in the coming years, we will be working to support new laws and reforms that target social benefits to the most vulnerable, moving from a system based on universal subsidies to one based on targeted benefits.
We will work to implement legal and regulatory frameworks that promote fiscal and policy decentralization, thereby allowing public and private providers to address the needs of their local communities. You see, after the Wall fell, the responsibility for most social welfare programs were shifted from central to local governments; however, revenue collection and generation remains centralized, meaning that local governments often don’t have the resources to cover the needs of their citizens.
We will work to ensure that countries - as well as communities - have the financial means to manage and sustain sound social programs. This means working to improve tax collection, for example, and teaching communities how to best use scarce resources.
And finally, USAID will work to strengthen health care institutions and help train health care professionals to deal with the new economic and social realities facing this region. We also hope to make health care more comprehensive. Like you, we want to improve not just access to care but the quality of the care itself - better, cleaner facilities, modern technology, and doctors trained in modern methods.
Now, as you all know, the task before us is enormous. We will need time, hard work, patience, and a willingness to experiment. But I am convinced that working with dedicated and determined people like you, we will succeed.
Which brings me to my next point - how will USAID accomplish the objectives I’ve just laid out? What mechanisms will we use?
Well, one way is through sustainable partnerships.
Those of you that know me know how awfully fond I am of sustainable partnerships - in fact, many of you have probably heard me speak on this subject before.
But partnerships are such an integral part of our vision for the future that I think the point bears repeating:
USAID sees partnerships forming not just between institutions here and in the countries of Europe and Eurasia, but also between entities, institutions, or individuals within the E & E region - like Poland and Ukraine, for example, or Hungary and Armenia.
We are operating on the assumption that the countries of Europe and Eurasia have a lot to learn from each other - but also a lot to teach each other.
And we believe that partnerships are a great way to do both - and taking a look at the work you all do, it seems like you agree with me.
You know, Henry Ford once said that "Coming together is a beginning. Staying together is progress. And working together is success."
Well, under the leadership of Dan Bourque and Jim Smith, USAID and AIHA have, over the years, come together, stayed together, and certainly worked together. Our success, then - our success in supporting all that you do, and the bright future that all of you represent - that success, at least according to Mr. Ford! - cannot be too far beyond our grasp.
And so in closing let me say that I hope we will never stop reaching for a future where partnerships are truly sustainable, where all of our countries find ways to be partners not only in the health care arena but in many ways that bring our peoples together in a new era of mutual cooperation, prosperity, and stability.
Good luck to all of you, and thank you.
This is an archived USAID document retained on this web site as a matter of public record.
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Last Updated on: July 12, 2001 |
