Mr. Chairman, Ranking Member Lugar, Members of the Committee,

It's a privilege and an honor to appear before you this morning, seeking your consent to serve as the United States Representative to the Executive Board of the World Health Organization. I am deeply honored and grateful for the confidence the President, Secretary Clinton, and Secretary Sebelius have placed in me.

My parents, who were immigrants to America, raised me with two basic principles: to give back to this country that had given them so many opportunities, and to make the most of an education that neither of them had been able to afford.

I took their guidance seriously and have devoted my career to service. I discovered my calling working in healthcare in low income countries as a medical student, and have worked in global health continuously for the past 35 years. My assignments have included service on behalf of the United States government in more than two dozen countries, as well as on the front lines of child health programs in places as varied as Nepal, Bangladesh, Mali and Haiti.

I have seen the importance of WHO – and the strengths and weaknesses of WHO – both on the ground and at the global level. I have been a member of the U.S. delegation to the World Health Assembly, both as a government official and as an NGO representative, over half a dozen times and have been part of the U.S. government's team at numerous international negotiations.

Through these experiences, I have concluded that without an effective WHO the world would be a more dangerous place. Global coordination related to pandemics and other outbreaks of infectious disease would be less effective; efforts to assure the quality, safety and efficacy of drugs and vaccines would be weakened; and national interests and ideologies rather than science and technical merit would guide how the world dealt with health threats.

Understanding the critical role that WHO plays, I intend to be a force for change and modernization of WHO – an institution formed more than sixty years ago that in many ways still reflects an earlier world. WHO needs to focus its activities on a few core elements of its mission. It is the world's lead technical agency for health, setting norms and standards for the classification of disease, convening experts to develop evidence-based guidance, and translating and disseminating data and information as the foundation of sound policy-making at the national level. It is also the lead UN body for health security, including coordination of the implementation of the International Health Regulations which work to protect all of us from disease outbreaks.

To be effective in these roles, WHO needs 21st century financial management and personnel systems, and, given the global economic situation, WHO's budget and program need to be more results-focused, fully transparent, and reflect the priorities established by its Executive Board and the World Health Assembly. Activities that are not core to its mission will need to be trimmed or eliminated.

If confirmed, I pledge to make sure that the resources the United States devotes to WHO are used to maximum benefit to address such pressing public health issues as pandemic influenza, the control and elimination of global infectious diseases such as polio, the prevention and control of non-communicable diseases such as diabetes, cancer and heart disease, and the strengthening of health systems in low-income countries.

It would be an honor to serve in this position. If confirmed, I look forward to working with Members of Congress and this Committee, as well as colleagues throughout the Administration, on these critical issues.

I appreciate the Committee's time and will be happy to address any questions you may have.

Last revised: April 15, 2011

The delegations agreed to explore ways to advance joint research on vaccine development and on multiple-drug resistant and extensively drug-resistant tuberculosis diagnostics and treatment. They also discussed the future of regulatory cooperation and possible ways to improve the structure of the existing health relationship between the two countries obtain the best public health outcomes.

Currently, HHS cooperates with Korea on vaccine-preventable and other infectious diseases; multi-drug and extensively drug resistant tuberculosis; pandemic influenza; chronic diseases; epidemic investigation and surveillance; public health emergencies; gender and global health; environmental and occupational health; and Public Health Law and quarantine practices.

Last revised: April 05, 2011

For more information:

• News Release from HHS: U.S., Russia Partner to Eradicate Polio Around the World:
  http://www.hhs.gov/news/press/2011pres/01/20110127a.html
• You Tube Channel: USA and Europe: USAID Administrator Rajiv Shah on US and Russian partnership to eradicate polio:
  http://www.youtube.com/USAandEurope#p/u/21/e5lS_LlU_a0 (YouTube)

Last revised: February 08, 2011

Within the structure of the Health Working Group of the U.S.-Russia Bilateral Presidential Commission, the United States Agency for International Development (USAID), the United States Department of Health and Human Services, and the Ministry of Health and Social Development of the Russian Federation (collectively, the Participants, and each, individually, a Participant), seek to work jointly and in collaboration with other partners to eradicate polio globally.

1. Recognizing the human, social and economic costs of preventing and combatting polio, acknowledging the need to accelerate global efforts to eradicate the disease, and building upon an already rich tradition of collaboration in the health area, in accordance with the Memorandum of Understanding of July 6, 2009, as well as decision taken at the World Health Assembly in 2010, the Participants declare their support of the Global Polio Eradication Initiative (GPEI) and the goal of stopping transmission of the disease by the end of 2012.
2. Participants also declare their support for the Millennium Development Goals.
3. The Participants intend to work jointly and in collaboration with other partners, as may be further arranged, in areas that may include:
   • Providing technical assistance for polio surveillance: Collaborate with participating country counterparts to support national laboratories and build capacity for polio surveillance (and possibly other infectious diseases) in third countries, with a strong emphasis on laboratory-related surveillance activities.
   • Participating in and monitoring of polio immunization campaigns: Support of national immunization days in third countries and other special immunization campaigns that supplement and strengthen routine immunization services. Support could include consultative assistance in the sphere of advocacy, communications, social mobilization, planning, and the logistics of delivering oral polio vaccine under temperature-controlled conditions. Experts may take apart in the World health Organization "Stop Transmission of Polio" missions, and provide support in monitoring the qualify of mass immunization campaigns.
   • Providing technical assistance on polio clinical diagnosis, case management and rehabilitation: Train counterparts on rehabilitation of polio-affected people.
   • Advocacy and resource mobilization: Identification and support of activities that should mobilize additional resources from the broader donor community (governments, international and regional organizations, non-governmental organizations, private businesses, and foundations) until the world is certified polio-free. Participating in national and international forums like the G8, G20, and regional or global health meetings to keep polio visible.
   • Such additional areas as may be mutually decided upon by the Participants.
4. Each Participant is to be fully responsible for expenses incurred by itself relating to activities undertaken in connection with the programs described herein, and all such expenses and activities are subject to the availability of funds to each Participant. Nothing in this Protocol of Intent is intended to be constructed as superseding or interfering in any way with any contracts or any other agreements entered into by the Participants, either prior to or subsequent to the signing of this Protocol of Intent. The Participants acknowledge that this Protocol of Intent does not constitute either an expenditure or an obligation of funds, nor does it constitute a legally binding commitment by any Participant or create any rights in any third party.
5. Additions and/or modifications may be introduced into or appended to this Protocol of Intent as needed upon the written mutual consent of the Participants.
6. Activities under this Protocol of Intent are to commence upon the date of signature and continue for three (3) years and may be automatically extended for three (3) additional years unless a Participant notifies the other Participant in writing of its desire to discontinue this Protocol of Intent. The Participants may discontinue cooperation under this Protocol of Intent at any time, and intend to endeavor to provide the other Participant with three (3) months' written notice before such discontinuation.
7. This Protocol is not an international agreement and will not create any right or responsibilities under international law.

Signed in Geneva on this 27 day of January, 2011 in three copies in the English and Russian languages.

For the Ministry of Health and Social Development of the Russian Federation
/Dr. Veronika I. Skvortsova/

For the United States Agency for International Development
/Dr. Rajiv Shah/

For the United States Department of Health and Human Services
/Dr. Nils Daulaire/

Last revised: February 03, 2011

For more information:

• Joint Statement on U.S.-China Healthcare Cooperation
• Press Release: United States and China Launch Public Private Partnership on Healthcare

Last revised: January 19, 2011

Recognizing the positive efforts from multiple agencies and organizations involved in furthering bilateral healthcare cooperation to promote health sector development in both countries;

Recognizing that the United States and China have conducted practical and effective cooperation in the fields of health policy, infectious disease prevention, biomedical research and personnel training;

Recognizing the importance of health to the U.S. – China relationship and to both countries' economic and social development and human welfare;

Recognizing the necessity of expanding health cooperation between the United States and China to promote improvement of the provision of health care in both countries; and

Recognizing the important contributions of both the public and the private sector to advancing the quality and management of healthcare.

The Agencies herein have reached the following understanding:

The United States and China seek further cooperation consistent with both countries' laws and regulations to strengthen exchanges in the areas of health policy and the improvement of the provision of effective and economical health care;

The United States and China intend to bring in strengths from different areas, including resources and specialized techniques from the private sector, to promote both countries' healthcare cooperation;

Both governments intend to support the establishment of a U.S.-China public-private partnership on healthcare (PPPH)composed of companies and organizations to support jointly agreed upon activities including a Healthcare Professional Personnel Exchange Program with potential funding from USTDA, studies/consultancies, training, pilot projects and related project development as identified in consultation with all stakeholders.

Under this new PPPH, the U.S. and China intend to continue strengthening cooperation in fields such as rural healthcare, emergency response, personnel training, medical information technology, and management systems; and explore ways to support other fields such as integrative and traditional Chinese medicine. This should enhance both sides' knowledge of best practices, management, technological developments, and other healthcare-related topics.

The relevant agencies from both the U.S. and China intend to provide policy guidance and technical assistance to support cooperation on health, and intend to have cordial consultations on specific mechanisms and projects.

Last revised: January 19, 2011