At Tuesday's Senate Appropriations Committee hearing, Sen. Susan Collins (R-ME) questioned Secretary of State Marco Rubio.
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00:00Thank you Mr. Chairman. Let me say first of all welcome Secretary Rubio. I hope
00:08that you look forward to working with us not only because you have to but also
00:13because you want to and I keep wondering how it is for you to be on the other
00:19side of the dais but we're very happy to have you in the position that you are. I
00:26do want to follow up and talk with you about the global health programs. I
00:32obviously share the goal of evaluating programs, reforming them to root out
00:39wasteful spending, reduce overhead costs, even question whether or not a
00:46particular program is achieved is subjective and is no longer needed.
00:51However, I'm also mindful that US international assistance plays a key
00:59role in helping us to respond to humanitarian crises, fight the spread of
01:06deadly diseases like Ebola, and project soft power. And that's why I'm concerned
01:14that the president's budget request proposes a cut of 62% below the enacted
01:23level of 2025 for global health programs. Are you concerned that if we cut back by
01:33that amount that China is going to step in and pick up the terminated USAID health
01:43programs particularly in Southeast Asia? Well let me first say China has no
01:49history in the past or even now. I know that there's been some talk about this but
01:53they really have demonstrated no willingness or capability to deliver
01:56humanitarian aid at scale to anyone. Their aid is largely driven by loans
02:00sometimes low interest or no interest loans but nonetheless loans and other times
02:04interest you know traditional loans to trap nations. They also give you the
02:09money so that you hire their companies to do the work but on the space of
02:12humanitarian they are not a major player as I said even on humanitarian assistance
02:16the United States dwarfs the next nine or ten countries on the list in terms of
02:20what we provide and we intend for that to continue and that as part of this
02:24budget. We'll obviously work with you to find what the number needs to be to
02:27fit the need but I can tell you that one of the reasons why the number is so
02:30stark is because we you know the reductions that happen at USAID transferred
02:34some of these programs over understate and so now we have to accommodate that
02:38within our overall budget and so we'll have to work with the committee to find out what the
02:42right number is to fit the need but I will say that it cannot be in no matter
02:45what I think we are living in a time where it's essential that we recognize
02:50that this is not a time of largesse we are going to have to in my view going to
02:54have to limit how much we spend in general as a government given the fact
02:58that just a few days ago we started downgrade to our debt these are
03:02problematic things and other nations need to step up and do more it is
03:06frustrating to me to see how much money we invest in certain countries albeit on what we term
03:11humanitarian or global health but when you look at the other side of the
03:15ledger all the business deals all the critical mineral deals all the other all
03:20their votes at the United Nations are all aligned with China or Russia or Iran and
03:25so I do think that has to be taken into account here we are humanitarian we
03:29cannot solve all of the world's humanitarian problems there are many we can
03:33contribute and we'll continue to be the largest contributor in the world but I do
03:37think how we allocate the limited resources of our government has to somehow be
03:41viewed through the lens of the benefit to the United States is certainly in the
03:46short till in the mid to long term the administration also included Gavi the
03:53Vaccine Alliance in its list of terminated programs and you've always been a very
04:01strong advocate for that program which has resulted in 1.1 billion children being
04:10immunized and averted more than 18 million deaths and I would point out that the
04:17United States is not the largest donor we actually ranked third behind the United
04:23Kingdom and the Gates Foundation but without the US doing what it's
04:30traditionally done in this program Gavi will be unable to vaccinate 75 million of the
04:38500 million children it traditionally has reached every year and I'm really
04:45concerned that that's going to lead to preventable deaths like tuberculosis and
04:51pneumonia so I think about how the Defense Department always due to our law has each of
05:03these services give us a list of unfunded priorities would that be on your personal
05:13list of an unfunded priority well let me first of all we still are doing vaccines we are still doing
05:18vaccines for malaria for example we're still doing tuberculosis we're still doing AIDS funding as well
05:25what we have done is we are reviewing our relationship with a number of multi-national
05:29multilateral institutions across the board because many of them have strayed from their core purpose the World Health Organization being one of them
05:36which I personally view did a very poor job in the early days of COVID as an example
05:40so we're also closing working closely with HHS to identify alternatives to some of these existing
05:48multilateral organizations that we think could end up helping us provide the aid we provide reach more people for less money in essence in a more efficient way so we'll clearly include that in our work that we're doing I'm not prepared to tell you whether we've identified today what those alternative entities would look like but we definitely want to find one this is the kind of aid we want to continue to provide but not through the existing mechanisms that we have found wanting in many cases thank you
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