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- 02/06/12: Remarks by Donald Steinberg, Deputy Administrator, US Agency for International Development - Beyond Victimhood: The Crucial Role of Marginalized Groups in Building Peace
- 02/02/12: Statement of Dr. Sarah E. Mendelson, Deputy Assistant Administrator for Democracy, Conflict, and Humanitarian Assistance, before the House Subcommittee on Africa, Global Health, and Human Rights - U.S. Policy toward Post-Election Democratic Republic of the Congo
- 01/20/12: Remarks by USAID Administrator Dr. Rajiv Shah at the Environment and Security Conference, Washington, DC
- 01/19/12: Remarks by USAID Administrator Dr. Rajiv Shah at the Brookings Institution, Washington, DC - U.S. Aid and Transparency for Global Development
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This is an archived USAID document retained on this web site as a matter of public record.
Remarks by Andrew S. Natsios, Administrator
U.S. Agency for International Development
World Health Day
April 22, 2005
Thank you very much, Dr. Roses for those fine words. You're welcome to this important event to commemorate World Health Day, and, more importantly, the opportunity for USAID to reaffirm our commitment to work in partnership with all of you to save the lives of millions of women and children who die each year from preventable causes.
We've had several decades now of intimate partnership together and we expect to have them in the future.
Now since everybody's been talking about their families this morning, I will add a story myself. There's another family anniversary that's about to take place. Within a few weeks, we will celebrate exactly 100 years in the United States. My grandfather immigrated to Ellis Island from Greece exactly a hundred years ago, in April 1905.
I mention that because he came from a province in Greece which is now a part of Greece but at the time was a part of the Ottoman empire. There were no public health ministries, there were no public health offices when he was born. He was born in a family of nine children, a third of whom died before they were five years old.
So we had a mortality rate in my grandfather's village, in our family, of 33 percent. This was in the late 19th Century in rural Greece, a rural part of an empire which is in central Greece.
In 1963, my parents, who were born in the United States of course, took my sister and I, my mother, we went back to the village for the first time, we'd never been to the village before, and it was very poor.
My grandfather was five foot two. My father was six foot two. A foot taller. And it was not from different genes. It was because my grandfather did not eat very well as a child. They were very poor family. Now, all of the family members in my generation are over six feet tall.
When we went, we were very impressed, because in the villages people were still very sick, and very ill, and there were eye infections, and I remember my sister, who was only nine years old, becoming very depressed, and she would not actually talk to us, my parents and I, for a whole week during the trip, because there was a funeral of infants in the village.
They carried, in those days, the body of the infant child in an open casket, through the village with the priest in front, and after a week we finally said "you refuse to talk to us, why are you so upset?" She said "I don't understand why a child would die; why a child would die. I thought only older people died, not children. We had to explain to her in poor countries, like in 1963, Greece was still a very poor country, why that happened.
I visited with my children, fourth generation now, the same village, in 1994. There were no donkeys carrying people around or donkeys pulling the carts in the village. There were only cars and tractors, and there was no one short, in the village, from malnutrition, and there were no funerals.
And I looked at the tombstones in the church my grandfather was baptized in, and I could not see any young dates. The peoples ages were in their 80's or 90's. You see how long they lived. Why? Because there was a public health ministry in Greece that could be modernized, as happened in the rest of Western Europe, in Southern Europe, and there's been a dramatic change in those health statistics from 1963 to 1994, just a 30-year period.
And I asked the villagers why, why did this happen, and they said, well, we modernized our agricultural system and our family incomes went from $300 a year to $16,000 a year. 300 dollars to 16,000. None of us are ill now from preventable causes. We have a health clinic in the village in this remote area and the world has changed for us in three decades.
So when people tell me that development does not work, I get very angry, cause I can tell you from personal experience, economic development, development of social services and education and in health do work. It does not happen in a year or two, it takes several decades; but it does work.
One of the greatest successes of USAID is the dramatic decline in maternal and child death rates all over the world, and particularly in Latin America. Now they're still too high, Dr. Roses has mentioned, but if you look at what they were in 1950 compared to now, there's been a huge shift. And why is that? Because of foreign assistance.
So this day is very important to me personally but it's also important to our two organizations and future collaboration. Most of the deaths of mothers during pregnancy and childbirth, we all know are preventable. More than half of the 4 million deaths of babies each year who die in the first month of life could be saved with simple measures such as cutting umbilical cords with sterile blades, prescribing antibiotics for pneumonia, and keeping newborns warm.
We have succeeded, in many areas, in preventing and treating childhood illnesses through research and investment in oral dehydration salts and in zinc, the newest research now, of course we all know is in zinc. We just did some field tests in Bangladesh and we're doing in Africa now, and that is a new therapy that we realized may be extremely effective against diarrheal disease.
In fact there's some initial indications it actually may slow down the onset of people who are infected with HIV/AIDS. It doesn't prevent the disease but it may actually extent the person's life, because we think it may affect the immune system first.
And so there's still promising research being done that can have a profound effect on people's health. We all know the effect of vitamin A therapy on children. We are preventing birth defects, blindness [inaudible] children. We are supporting delivery of life-saving routine vaccines for diseases such as pertussis and measles and making significant progress toward the eradication of polio.
We will continue to work on these together. We've worked with the Center For Disease Control, Public Health Service, and HHS, look forward to collaboration with Secretary Leavitt.
Despite this progress, we have formidable challenges in illness and injury. And injury, I might also say, among young people from violence. There is a serious problem, I would call it an epidemic level of gang violence in the developing world. We know that young men are unemployed. I have an 18-year, 22-year old sons. I keep them as busy as possible studying, because you know when young men are studying, the testosterone levels are so high they sometimes get into trouble. Even in the United States, in wealthy families, this is a problem. There is no difference whether you're in the North or South. We have a problem with an epidemic of gang violence and that is a serious problem that we must face, and I believe it is not just a security and police problem; it's a public health problem. It's an economic problem as well.
One of the most serious looming health problems in the world now is the avian flu, the potential for a major avian flu epidemic, if the disease mutates and begins to spread between people instead of just from poultry to people, and we've organized in AID a interagency process in the U.S. Government, we're beginning to write a large-scale planning for what we're going to do to prevent this as we look forward, although we haven't had--I don't think there have been any instances in our hemisphere of avian flu. We need to be very cautious because this could be a deadly disease.
We worked, for example, with the government of Nicaragua, training doctors and nurses and supporting local health care systems to upgrade the quality of maternal and newborn services.
USAID is increasing and making new investments in neonatal health, in the repair of fistula and in the prevention of hemorrhaging after delivery for mothers, which is a leading cause of death in the aftermath of pregnancy.
The Pan American Health Organization is taking the opportunity, in collaboration with our partners, to spend a week focusing on the issue of newborn care in the region, analyzing successful country case studies and are beginning to formulate their regional response.
Progress in public health depends on research, innovation and application, and as I said before, we are continuing at AID, not just to do the application of the work in the field but to do the field testing and the research with our university systems in the United States.
President Bush's national security strategy was announced several years ago -- the three Ds are the central part of American foreign policy -- Diplomacy, defense and development. Development is the central part of the foreign policy of the United States. If you read the document, you'll see that third D in the document throughout, and that is reflected in our official development systems level.
In the year 2000, our ODA was $10 billion. Figures will shortly be announced for calendar year 04 and our ODA has gone from 10 billion to $19 billion, and there are five or six reasons why it's increased so much. There's been a huge replenishment of the banks, the regional banks and The World Bank. There has been a Millennium Challenge Account that the president has announced. The Global Fund to fight AIDS, TB, and malaria, which we are the largest donors to. We've already contributed more than a billion dollars and our pledge is in excess of $2 billion between now and 2008. That's from the president's announcement of this huge new effort to combat HIV/AIDS.
Without global health and our family planning programs, there are still challenges. There are areas of Latin America that have not been reached yet. There is a broad disparity between urban Latin America and rural Latin America.
There's disparity between different ethnic groups in the indigenous populations in many of the rural areas that do not have access to health care and their rates, child mortality rates and maternal mortality rates, as you know, are remarkably different than the urbanized populations.
We must deal with these disparities. We must recognize also the emergence of the private for-profit sector and nongovernmental sector, in addition to our public health ministries as partners in making a different in these public health issues.
We can't, without getting into competition, understand that in many countries half of the health care system--the developing world--half the health care system is in fact private, it is not public, part of the ministry of public health.
We need to work in an integrated fashion with all our partners that do work in the health care sector to ensure certain standards are kept and that we have comprehensive approaches.
The president has proposed many new broad initiatives in foreign assistance. One of them is called the Global Development Alliance. We've put a billion dollars into 300 alliances with nontraditional partners and corporations and foundations and universities that do not typically work in development assistance, and these private institutions have put $3 billion--we put a billion, they put in $3 billion. There are 300 of these alliances. I'm sure you've heard of the Gates Foundation. But the Gates Foundation is not one of the old foundations like Rockefeller and Ford.
Their public health budget for the developing world is larger than almost any other donor in the world except for AID. That's how much money they spent. The notion that they're not part of the foreign assistance program doesn't make any sense. We need to rethink how we look at foreign aid in that context.
But it is important we break out of the limitations of the past where we have certain steps or partnerships. We need to broaden those partnerships, if we're going to be successful.
We also want to understand, while we need to strengthen the ministries centrally, we also need to strengthen the health clinics at the village level. Community-based care is critically important to the success of our programs.
We're making progress in many of the childhood illnesses but there's more work to be done.
We have begun, as I said, an effort to plan for avian flu, and I hope you can work with our partners on some preventative measures so that this doesn't get out of control.
Thank you very much and congratulations.
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