[House Hearing, 116 Congress]
[From the U.S. Government Publishing Office]


                  UPDATE ON THE COVID-19 PANDEMIC RESPONSE 
                                 IN AFRICA

=======================================================================

                                HEARING

                               BEFORE THE

                 SUBCOMMITTEE ON AFRICA, GLOBAL HEALTH,
                        GLOBAL HUMAN RIGHTS, AND
                      INTERNATIONAL ORGANIZATIONS

                                 OF THE

                      COMMITTEE ON FOREIGN AFFAIRS
                        HOUSE OF REPRESENTATIVES

                     ONE HUNDRED SIXTEENTH CONGRESS

                             SECOND SESSION

                               __________

                             JULY 30, 2020

                               __________

                           Serial No. 116-128

                               __________

        Printed for the use of the Committee on Foreign Affairs
        
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                              __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
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-----------------------------------------------------------------------------------                          
 COMMITTEE ON FOREIGN AFFAIRS
 
                    ELIOT L. ENGEL, New York, Chairman
 
 BRAD SHERMAN, California             MICHAEL T. McCAUL, Texas, Ranking 
 GREGORY W. MEEKS, New York               Member
 ALBIO SIRES, New Jersey		     CHRISTOPHER H. SMITH, New Jersey     
 GERALD E. CONNOLLY, Virginia         STEVE CHABOT, Ohio
 THEODORE E. DEUTCH, Florida	     JOE WILSON, South Carolina
 KAREN BASS, California		     SCOTT PERRY, Pennsylvania
 WILLIAM KEATING, Massachusetts	     TED S. YOHO, Florida
 DAVID CICILLINE, Rhode Island	     ADAM KINZINGER, Illinois
 AMI BERA, California		     LEE ZELDIN, New York
 JOAQUIN CASTRO, Texas		     JIM SENSENBRENNER, Wisconsin
 DINA TITUS, Nevada		     ANN WAGNER, Missouri
 ADRIANO ESPAILLAT, New York          BRIAN MAST, Florida
 TED LIEU, California		     FRANCIS ROONEY, Florida
 SUSAN WILD, Pennsylvania	     BRIAN FITZPATRICK, Pennsylvania
 DEAN PHILLPS, Minnesota	             JOHN CURTIS, Utah
 ILHAN OMAR, Minnesota		     KEN BUCK, Colorado
 COLIN ALLRED, Texas		     RON WRIGHT, Texas
 ANDY LEVIN, Michigan		     GUY RESCHENTHALER, Pennsylvania
 ABIGAIL SPANBERGER, Virginia	     TIM BURCHETT, Tennessee
 CHRISSY HOULAHAN, Pennsylvania       GREG PENCE, Indiana
 TOM MALINOWSKI, New Jersey	     STEVE WATKINS, Kansas
 DAVID TRONE, Maryland		     MIKE GUEST, Mississippi
 JIM COSTA, California
 JUAN VARGAS, California
VICENTE GONZALEZ, Texas                              
                    
                    Jason Steinbaum, Staff Director
               Brandon Shields, Republican Staff Director
                                 
                                 ------                                

    Subcommittee on Africa, Global Health, Global Human Rights, and 
                      International Organizations

                     KAREN BASS, California, Chair

SUSAN WILD, Pennsylvania             CHRISTOPHER SMITH, New Jersey, 
DEAN PHILLIPS, Minnesota                 Ranking Member
ILHAN OMAR, Minnesota                JIM SENSENBRENNER, Wisconsin
CHRISSY HOULAHAN, Pennsylvania       RON WRIGHT, Texas
                                     TIM BURCHETT, Tennessee
                            
                            
                            C O N T E N T S

                              ----------                              
                                                                   Page

                               WITNESSES

Nagy, Ambassador Tibor, Assistant Secretary, Bureau of African 
  Affairs at U.S. Department of State............................     7
Maloney, Christopher, Acting Assistant Administrator, Bureau for 
  Africa at U.S. Agency for International Development............    12
XXXX.............................................................     4

                                APPENDIX

Hearing Notice...................................................    42
Hearing Minutes..................................................    43
Hearing Attendance...............................................    44

            RESPONSES TO QUESTIONS SUBMITTED FOR THE RECORD

Responses to questions submitted for the record..................    45

 
           UPDATE ON THE COVID-19 PANDEMIC RESPONSE IN AFRICA

                        Thursday, July 30, 2020

                          House of Representatives,
             Subcommittee on Africa, Global Health,
            Global Human Rights, and International 
                                     Organizations,
                      Committee on Foreign Affairs,
                                                     Washington, DC

    The subcommittee met, pursuant to notice, at 1:05 p.m., in 
room 2172 Rayburn House Office Building, Hon. Susan Wild 
presiding.
    Ms. Wild. The Subcommittee on Africa, Global Health, Global 
Human Rights, and International Organizations will come to 
order. Without objection, the chair is authorized to declare a 
recess of the subcommittee at any point, and all members will 
have 5 days to submit statements, extraneous material, and 
questions for the record subject to the length limitation in 
the rules.
    To insert something into the record, please have your staff 
email, the previously mentioned address, or contact full 
committee staff. As a reminder to members, please keep your 
video function on at all times, even when you are not 
recognized by the chair. Members are responsible for muting and 
unmuting themselves, and please remember to mute yourself after 
you have finished speaking.
    Consistent with House Res. 965 and the accompanying 
regulations, staff will only mute members and witnesses as 
appropriate, when they are not under recognition, to eliminate 
background noise. I see that we have a quorum and will now 
recognize myself for opening remarks.
    Pursuant to notice, we are holding a hearing on COVID-19 
pandemic response in Africa. Today, we are hearing testimony on 
the COVID-19 response in Africa and what the international 
community can do, particularly the United States in light of 
facing our own healthcare crisis. We hope the panel today has 
policy recommendations that can help the international 
community slow the spread of the pandemic in Africa, places 
where health institutions and economic systems might never 
fully recover.
    Even though our own country is being hit hard by the 
pandemic, ignoring the continent's plight will affect our 
national security and the ability to trade in the long and 
short term. South Africa is viewed as the best prepared of any 
country in sub-Saharan Africa to battle COVID-19, and yet they 
have more than 400,000 cases. Well over half of the continent's 
total, per the AP.
    Surely it will be a ripple effect for countries with fewer 
resources, weak governance and economic institutions. However, 
several countries have pursued innovative pandemic responses. 
Senegal is developing an affordable, rapid COVID-19 test kit, 
while Rwanda and Ghana pioneered the use of drones to deliver 
medical supplies to rural areas.
    But there are countries, such as Zimbabwe and Guinea, that 
use COVID-19 to restrict press freedoms and free speech, and 
arrest and detain people who oppose the government. Therefore, 
my colleagues and I would like to know how we can deter 
governments from using this very serious pandemic for their own 
political gains, how U.S. foreign assistance can continue to 
strengthen the efforts of countries that are developing 
preventive measures, and what is the long-term impact on the 
United States if Africa does not receive timely resources to 
combat COVID-19?
    I would like to thank our witnesses for taking the time to 
meet with us, especially in person, on this critical issue that 
affects all of us. Unlike Ebola, which only affected certain 
countries within the continent, COVID-19 has spread 
transnationally and so we are all in this together.
    Assistant Secretary Nagy, I look forward to your remarks 
and analysis of what we can do legislatively to ensure the 
continent does not have an economic collapse, but thrives for 
the next generation.
    Mr. Maloney, thank you as well for your time. I understand 
you have led the development of USAID's new strategic approach 
focused on building countries' abilities to plan, finance, and 
implement solutions to develop their own development 
challenges, so I am very interested to hear your thoughts on 
the response to COVID-19 in Africa with its many challenges.
    Many African governments lack resources to stockpile food, 
import medical equipment, and protect their local informal 
economies. This has caused leaders to seek international aid, 
and the most vulnerable seek debt relief. COVID-19 will also 
have an impact on elections in Africa and free and fair 
elections are vital to a strong democracy.
    With scheduled elections coming up for Tanzania, Cote 
d'Ivoire, Burkina Faso, Ghana, Central African Republic, and 
Niger, COVID-19 could impact the perceived fairness and 
legitimacy of those elections. This means that countries will 
have to be transparent with citizens during the electoral 
process.
    My colleagues and I in Congress want to continue supporting 
Africa's health systems, humanitarian needs, encouraging free 
trade, bolstering food security, promoting democracy, and 
countering China's influence. Although the United States has 
pledged more than $400 million to Africa for health, 
humanitarian, economic, and governance assistance to respond to 
COVID-19, we want to make sure there is sufficient funding, and 
that it is being implemented in the right places.
    COVID-19 has caused national lockdowns, border closures, 
and restrictions, which has destroyed the tourism sector, 
ultimately disrupting Africa's intraregional and global 
economy. It will benefit our national security and economic 
interest to support the continent and help sustain its economy 
and health infrastructures, or somebody else will. I look 
forward to hearing your testimony and what Congress can do to 
continue to help millions of people from falling into deep 
poverty from the impact of COVID-19 in Africa.
    I now recognize the ranking member for the purpose of 
making an opening statement. I now yield to our ranking member, 
Representative Smith, for his opening statement.
    Mr. Smith. Thank you very much, Madam Chair. It is an honor 
to welcome our distinguished witnesses, Assistant Secretary 
Tibor Nagy and Acting Administrator Chris Maloney, to the 
subcommittee. Thank you for being here in person to update us 
on the response to COVID-19, a pandemic in Africa.
    The fact that the number of COVID-19 deaths as of July 27th 
in sub-Saharan Africa is nearly 12,000, less than the 15,800 
COVID-19 deaths in my home state of New Jersey alone, may mean 
that deaths are significantly underreported, or that testing 
capacity is limited, or that the pandemic has not hit yet as 
hard as it has in other regions.
    According to WHO, South Africa alone accounts for 57 
percent of all COVID-19 deaths in sub-Saharan Africa, further 
suggesting underreporting in the other nations. But as 
Assistant Administrator Maloney points out, and says with 
concern, we are seeing a worrying acceleration in various spots 
around the continent, including in Nigeria and in Ghana.
    Please update us, if you would, today, on how and why--not 
why, but how the nearly $1.8 billion in foreign aid funding to 
prevent, prepare for, and respond to COVID-19 is being spent. 
Is that money in addition to other resources that were 
reprogrammed or put into the effort? It would be great to know 
what that all looks like and whether or not that is enough.
    And I would appreciate your take on how COVID-19 compounds 
other crises. Part of that is political, where we see a country 
such as Ethiopia, racked by civil disorder amid a health 
crisis, where we see members of governing elites in countries 
in West Africa succumb to COVID, such as the chief of staff to 
President Buhari. We have also seen pretextual crackdowns on 
legitimate civil dissent, justified by COVID-19 concerns, in 
countries such as Zimbabwe and in Nigeria.
    More specifically, however, there is a very real, dangerous 
food insecurity crisis attributable to the plague of locusts of 
biblical proportions looming in East Africa, a response to 
which has been inhibited by the need to check COVID. Yesterday, 
H.R. 7276, a bill which I introduced, joined by Chairwoman 
Bass, was marked up in the full committee. It calls for a 
coordinated response, a strategy in a working group to mitigate 
the desert locust crisis.
    I would point out that Mr. Barsa was here about a week ago 
and gave us an update on how the over $19 million at USAID is 
being spent, again, to affect that crisis and perhaps there 
will be more money put into that pot, but I would appreciate 
any thoughts you have on that and its relationship with COVID-
19.
    What people may not realize is that the scope of logistical 
obstacles to addressing that crisis and others is compounded by 
COVID-19. There has been difficulty in getting assets in the 
air for spraying, in part, because pilots flying planes with 
necessary pesticides have been quarantined for up to 2 weeks 
while en route to staging areas in Kenya and elsewhere.
    We have seen how food supply chains in the United States 
have become fractured and frayed due to COVID-19. Just imagine 
in a continent where the infrastructure is still building out, 
and the roads and bridges are not where they will be in 
sometime in the near future, how much more difficult that makes 
it for them to meet the crisis.
    And, of course, vulnerable, food-insecure people, a number 
estimated to be over 26 million in East Africa, as of now, are 
at heightened risk for disease, including COVID-19.
    So we must focus on combating COVID-19, no doubt about it. 
I do ask that we do not forget the--and I know you will not--
the other ancillary issues that cannot be neglected as we keep 
that focus. Thank you again for being here. I look forward to 
your testimony.
    Ms. Wild. Thank you very much, Ranking Member Smith.
    I will now introduce our distinguished witnesses.
    Assistant Secretary Tibor Nagy, thank you for being here 
today. I hope I said that correctly, Ambassador. You can feel 
free to correct me when you speak.
    Ambassador Nagy is a retired career Foreign Service 
officer, spent 32 years in government service including over 20 
years in assignments across Africa. He served as the United 
States Ambassador to Ethiopia, Guinea, as well as the Deputy 
Chief of Mission in Nigeria, Cameroon, and Togo. Ambassador 
Nagy has received numerous awards from the U.S. Department of 
State in recognition of his service, including commendations 
for helping prevent famine in Ethiopia, supporting the 
evacuation of Americans from Sierra Leone during a violent 
insurrection, supporting efforts to end the Ethiopian-Eritrean 
war, and managing the United States Embassy in Lagos, Nigeria 
during political and economic crises.
    Following his retirement from the Foreign Service, 
Ambassador Nagy served as Vice Provost for International 
Affairs at Texas Tech University from 2003 to 2018. During that 
time, he co-authored Managing Overseas Operations: Kiss Your 
Latte Goodbye, a nonfiction winner of the 2014 Paris Book 
Festival.
    Our second witness is Christopher Maloney, the Acting 
Assistant Administrator in the Bureau for Africa. In this 
capacity, he oversees 47 countries and eight regional programs 
in sub-Saharan Africa with a USAID and U.S. Department of State 
budget of $8.5 billion of assistance in Fiscal Year 2018.
    Prior to assuming this role, Mr. Maloney was the Assistant 
to the Administrator in USAID's Bureau for Policy, Planning, 
and Learning, where he led the development of the Agency's new 
strategic approach focused on building countries' abilities to 
plan, finance, and implement solutions to solve their own 
development challenges, known as the Journey to Self-Reliance. 
He continues to provide overall oversight on this initiative as 
the agency operationalizes this new approach.
    Prior to joining USAID, Mr. Maloney spent 5 years at the 
Millennium Challenge Corporation, MCC, where he was the 
Managing Director for Country Selection and Eligibility. Mr. 
Maloney also spent 5 years with McKinsey and Company in 
Johannesburg, South Africa, and Washington, DC, where he 
focused primarily on agriculture, mining, and pharmaceutical 
clients in both the public and private sectors, including 
consulting on numerous Feed the Future strategies at various 
USAID missions in Africa.
    Prior to McKinsey, he worked with Genesis Analytics, a 
South African economics consultancy based in Johannesburg, as 
well as in the Office of African Nations at the U.S. Department 
of Treasury in Washington, DC. Mr. Maloney holds an MBA from 
the Harvard Business School, an MPA in International 
Development from the Harvard Kennedy School of Government, and 
a bachelor's degree in economics, and African and African 
American Studies from Stanford University.
    I will now recognize each witness for 5 minutes and, 
without objection, your prepared written statements will be 
made a part of the record. Ambassador Nagy, you are recognized 
for 5 minutes.

STATEMENT OF TIBOR NAGY, ASSISTANT SECRETARY, BUREAU OF AFRICAN 
              AFFAIRS AT U.S. DEPARTMENT OF STATE

    Mr. Nagy. Thank you. Chair Wild, Ranking Member Smith, 
members of the subcommittee, thank you for inviting me to 
discuss the United States partnership for the people and 
governments of sub-Saharan Africa working to meet the urgent 
and unprecedented challenges of the COVID-19 pandemic. I am 
pleased to be joined by my USAID colleague, Acting Assistant 
Administrator for Africa Chris Maloney.
    We both rely on the bipartisan commitment of Congress and 
the talented women and men of the State Department and USAID as 
we work toward solutions for this pandemic. Over the past 20 
years, the American people have invested more than $100 billion 
to strengthen public health sectors in sub-Saharan Africa, 
enabling them to respond more effectively to HIV/AIDS, 
tuberculosis, malaria, Ebola, and other infectious diseases.
    Since March, the United States has committed an additional 
almost $470 million COVID-19 specific response funds to the 
region. We have also contributed nearly 20 million in 
humanitarian assistance to combat the decades-high desert 
locust infestation, which is currently impacting eight 
countries in East Africa. These commitments underscore our role 
as sub-Saharan Africa's staunchest ally in promoting the health 
of its citizens.
    Our government, U.S. philanthropists and nonprofit 
organizations, and American businesses invest heavily in 
building a healthier Africa, because a healthy population makes 
Africa and the rest of the world safer and more prosperous. 
This long-term approach stands in sharp contrast to others like 
the Chinese Communist Party whose defective goods, slipshod 
infrastructure projects, predatory lending habits are designed 
more for the benefit of the CCP than the well-being of 
Africans.
    It is no secret that China is by far the largest bilateral 
official creditor to African governments, creating an 
unsustainable debt burden, while the overwhelming majority of 
U.S. foreign assistance comes in the forms of grants rather 
than loans in order to promote transparent, private sector-led 
economic growth that benefits all parties.
    We strongly support the G20's Debt Service Suspension 
Initiative. Public disclosure of official loans helps hold 
governments accountable for their decisions and prevents the 
corruption, fraud, and abuse that siphons off money that is 
supposed to go toward African health and development.
    While strong leadership and early decisive action has 
likely helped many countries delay the harshest impacts of 
COVID, we must be clear-eyed about the situation today, and 
mindful of the difficult days that lie ahead. Soaring 
unemployment, increasing food insecurity, ballooning budget 
deficits are also significant concerns. The secondary effects 
of unanticipated migration flows, declining commodity prices, 
diminished tourism revenues, rising food prices are just some 
of the problems now facing African governments.
    Of particular concern, the COVID-19 pandemic has placed the 
Sudanese democratic transition in an even more precarious 
place. Avenues for international support through international 
financial institutions remain constrained by the international 
community's inability, as well as our own, to proceed with 
heavily indebted poor countries' debt relief.
    We continue to focus on efforts toward rescission of 
Sudan's State Sponsor of Terrorism designation, which would 
help advance this process. Congress could support our goals in 
this regard through the adoption of legal peace legislation as 
part of any COVID-19 supplemental, which would have the added 
advantage of allowing a recently agreed-upon claims settlement 
outline for victims of the East Africa Embassy bombings to 
proceed. Pushing Sudan to provide compensation to these victims 
of the Bashir regime's acts of international terrorism is among 
the Department's highest priorities.
    Finally, I would like to underscore the critical role of 
alumni of State Department exchange programs, such as 
Fulbright, the International Visitors Leadership Program, and 
the Young African Leaders Initiative or YALI. The nearly 20,000 
combined alumni of the YALI Mandela Washington Fellowship and 
the Regional Leadership Centers in Africa and the more than 
650,000 members of the on-line YALI Network represent a new 
cadre of African leaders who are willing and ready to lead 
change. Many are at the forefront of efforts to contain the 
spread of COVID-19.
    Continued commitment to these programs will empower 
Africans to take the lead on charting their future, based on 
pro-U.S. models of governance, innovation, and development. 
Thank you for the opportunity to testify. I look forward to 
your questions and to working together to meet these enormous 
challenges to further advance health, peace, and prosperity in 
the region. Thank you.
    [The prepared statement of Mr. Nagy follows:]

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Ms. Wild. Thank you for your testimony.
    Mr. Maloney, you are recognized for 5 minutes.

      STATEMENT OF CHRISTOPHER MALONEY, ACTING ASSISTANT 
      ADMINISTRATOR, BUREAU FOR AFRICA AT U.S. AGENCY FOR 
                   INTERNATIONAL DEVELOPMENT

    Mr. Maloney. Chair Wild, Ranking Member Smith, and members 
of the subcommittee, thank you for inviting me to testify today 
on the response by the U.S. Agency for International 
Development to the COVID-19 pandemic in sub-Saharan Africa. It 
is an honor and a privilege to testify in front of this 
subcommittee, and I thank you for your bipartisan commitment to 
the countries and people of Africa.
    I am pleased to be joined today by my Department of State 
colleague, Assistant Secretary for African Affairs Tibor Nagy.
    First, a few facts. As of July 27th, sub-Saharan African 
nations have reported close to 713,000 cases of COVID-19, a 
number that has more than doubled since July 1st. As mentioned, 
over 60 percent of these cases have been in South Africa, but 
we are seeing acceleration in various spots around the 
continent including in Nigeria and Ghana.
    But we do not know what we do not know. Testing is low and 
data is weak and incomplete. As a result, it is too soon to say 
how widespread the outbreak could become in Africa. We know 
some places are going to be hit hard and have already been 
hard, while others will get hit less hard. And a wide range of 
factors are at play, from demographics to geography to 
governance. The good news is that despite how complex this 
situation is, the United States is playing a leadership role in 
helping Africans successfully respond to this crisis.
    As of July 29th, the U.S. Government has committed nearly 
$470 million to 45 countries across sub-Saharan Africa to 
respond to the COVID-19 pandemic. The U.S. Government's roughly 
$100 billion in investments in Africa's public health over the 
past 20 years have built deep trust-based relationships across 
the continent and platforms that have allowed our country 
partners to quickly pivot thousands of community health workers 
and related interventions to rapidly respond to COVID-19.
    No other country, certainly not malign actors like the 
People's Republic of China or the Kremlin, can match this 
unparalleled generosity. It is also important to note that we 
are working in two other critical areas, mitigating food 
security and humanitarian needs, and lessening the second and 
third order of effects of the pandemic. Let me provide a little 
bit more detail on these areas of work.
    So, first, on the health side, we know that what happens 
elsewhere in the world can affect us here at home. USAID's 
health assistance in Africa related to COVID-19 focuses on 
saving lives by improving public health education, protecting 
healthcare workers, strengthening laboratory systems, 
supporting disease surveillance, and boosting rapid response 
capacity. For example, in Nigeria, USAID launched a partnership 
with cell phone provider Airtel to provide critical information 
via voice and text messages on physical distancing, safe 
hygiene practices, and other preventive measures to contain the 
spread of the disease. Through this partnership with the 
private sector, we can now distribute the latest public health 
messaging instantly to over one million citizens a day.
    Now, a little bit more detail in how we are responding to 
COVID-19 in the food insecurity and humanitarian needs space. 
Responding to the health challenges alone will not solve the 
crisis. We must proactively and comprehensively address how the 
COVID-19 crisis has eroded food security and worsened 
malnutrition across sub-Saharan Africa.
    The Famine Early Warning System Network or FEWS NET, funded 
by USAID, estimates that 113 million people will be in need of 
emergency humanitarian food assistance this year, which is an 
increase of almost 25 percent over last year. To that end, 
USAID is working with the World Food Programme and non-
governmental organizations to invest over $120 million of 
COVID-19 supplemental humanitarian resources to address 
emergency food needs in over 17 countries in Africa. We also 
are addressing interruptions to agricultural production, trade 
in local markets, the loss of livelihoods, and the 
deterioration of essential social services like water and 
sanitation, while also building long-term resilience.
    And, finally, I want to talk about how we are working to 
reduce the second and third order impacts of the pandemic. 
Before this crisis, the economic growth estimate for the 
African continent for 2020 was 3.9 percent. Now, according to 
the World Bank, Africa's GDP in 2020 could contract by between 
2 and 5 percentage points, the continent's first recession in 
over 25 years.
    One way we are working to push against this decline is 
through Prosper Africa. USAID is adapting existing trade and 
investment tools and creating new ones to help businesses 
address their strategies, protect their investments, and find 
new opportunities in response to COVID-19. As an example, a 
recent $2 million Prosper Africa COVID-19 rapid response 
solicitation received hundreds of applications in a matter of 
weeks.
    We are also very concerned about democratic backsliding and 
have seen how some African regimes are using COVID-19 to 
restrict democratic space and constrain media freedom. We have 
seen severe crackdowns on perceived violators of lockdowns, 
elections getting postponed with little sense of a way forward, 
and serious disinformation campaigns. To push back against 
this, in Mali, for example, we are working with a range of 
stakeholders to counter dangerous misinformation about the 
sources and spread of the novel coronavirus.
    In conclusion, looking long term we remain committed to 
working with governments, civil society, faith-based 
organizations, academia, and the private sector in our African 
partner countries through this pandemic now and into the 
future. No other nation can match our unparalleled generosity, 
our open collaborative approach, or our long-term commitment to 
helping communities on their journey to self-reliance.
    Thank you again for this opportunity to address the 
subcommittee and I look forward to your questions.
    [The prepared statement of Mr. Maloney follows:]

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]
    
    Ms. Wild. Thank you for your testimony.
    I will now recognize members for 5 minutes each, and 
pursuant to House rules all time yielded is for the purpose of 
questioning our witnesses. Because of the virtual format of 
this hearing, I will recognize members by committee seniority, 
alternating between Democrats and Republicans. If you miss your 
turn, please let our staff know and we will circle back to you. 
If you seek recognition you must unmute your microphone and 
address the chair verbally.
    I will start by recognizing myself and my questions are for 
both of you, and feel free to answer as you see fit. We do not 
have a large panel so I think we can probably work it out.
    My first question is to ask you to address the implications 
of the pandemic for U.S. policy priorities and engagement with 
Africa, specifically regarding development responses to 
humanitarian need, health capacity building, security 
cooperation, and trade and investment. And if you could, please 
discuss the administration's approach to addressing an ongoing, 
pandemic-driven, rise in acute food insecurity and extreme 
poverty in Africa. Let's start with that.
    Mr. Nagy. Yes, Madam Chair. On the U.S. policy priorities, 
the overarching policy priorities remain the same. Our long-
term goal, obviously, is for a peaceful, prosperous Africa, 
giving cognizance to the fact that it is such a young continent 
where the population will double over the next 50 years. So 
that remains very much intact. Of course, then you get to the 
point of how COVID impacts that, and in each country the 
situation is totally different. And I also have to add that our 
ability to exercise our policies have also been impacted by 
just the reduction in staffing of the U.S. embassies that we 
had to do in recognition of the COVID and the vulnerable staff.
    At my estimate, our U.S. missions are operating at about, 
in Africa, at about 60 percent of staffing. And as you know 
that U.S. embassies in Africa were the ones who have the lowest 
number of staff and lowest positioning, you know, in the 
various competencies, so that has been impactful, but the 
priorities remain the same.
    And right after the emergency started, I gave our 
Ambassadors kind of an overarching command to, No. 1, look very 
carefully at governments that would use COVID to abuse their 
populations and to restrict democratic place, but also to look 
and see where violent extremist organizations may be using 
COVID to expand their operations.
    Now for the----
    Ms. Wild. Thank you. Before we go to Mr. Maloney, let me 
just ask you a followup question and then I will ask Mr. 
Maloney to address both, also.
    Mr. Nagy. Sure.
    Ms. Wild. What have been the pandemic's effects on U.S. 
security and military cooperation in Africa?
    Mr. Nagy. Actually, the cooperation remains very strong 
because in some other countries it was the militaries who were 
the most effective in responding to COVID. Military hospitals' 
training that they have gotten from the United States, because 
as you know, Madam Chair, a lot of our training is what I would 
call in the soft areas of skills development, community 
outreach, human rights training, law and order, those types of 
things, so they have actually been very helpful in our 
cooperation.
    I have to say--and again, with 51 countries it varies, but 
overall it has been very close.
    Ms. Wild. Thank you.
    Mr. Maloney.
    Mr. Maloney. Thank you. It is an important question and a 
complicated one, so I will try and break it down to its three 
parts.
    Ms. Wild. Do you have your mic on? I just want to make 
sure.
    Mr. Maloney. Oh. Can you hear me?
    Ms. Wild. Yes. Okay, go ahead.
    Mr. Maloney. So let me break it down into its three parts. 
I think from USAID we are looking at this along three lenses. 
The first is the health, the second would be the humanitarian, 
and the third would be the second and third order effects, as I 
said in my testimony. So we have a double whammy on each of 
those three areas, because at the end of the day what COVID-19 
has wrought is a massive risk toward backsliding, right?
    So I am sure you have all seen the press reports that all 
of the investments that the U.S. taxpayer has put into these 
health systems across Africa are now at risk. People cannot 
access services, they are unable to move around, it can be 
difficult to go to your doctor, et cetera. So we need to make 
sure that the work that we are doing in PEPFAR, in the 
President's Malaria Initiative, and in our maternal/child 
health work, all of that can become, as I like to say, COVID-
aware.
    So we have been able to redirect about a little over $100 
million in all of those programs to make sure that they are 
able to build in COVID-aware type things, whether that is being 
able to procure, locally, PPE for healthcare workers or that 
could be making sure that there is just hand sanitizer, that 
there is proper communications, all of those things that we do 
we can to mitigate the backsliding.
    But it is going to happen, it is just how much can we 
protect it from going back too far. So that is a key piece of 
the story, in addition then to all of the COVID work that we 
are doing in response. So that is also, I think, an important 
thing to note, is that the good news is that because we have 
invested so deeply across the continent by developing platforms 
like PEPFAR and PMI and deep relationships with ministries of 
health we have been able to pivot on a dime thousands of 
healthcare workers.
    It was very interesting to me when talking to colleagues in 
Uganda where people, healthcare workers we have trained to 
diagnose malarial fevers can now also look to diagnose COVID-
type fevers as well. So there is a lot of wonderful, deep 
institutional work that we are able to pivot to this crisis, so 
that is what I would say on the health side.
    The humanitarian side is--again, things are going a little 
bit from bad to worse with this. So again, here it is making 
sure that with the very generous and, I would say, the bulk of 
the supplemental that has gone to our humanitarian work is 
making sure that we are ensuring that COVID-19 does not wreak 
havoc in the most vulnerable communities in Africa, so that has 
been a key thing. A lot of the interventions we have been doing 
on the sort of classic health side apply just as much in a 
humanitarian setting, but then also adding food assistance as 
well as necessary, so that has been that key piece.
    But then, finally, the part that keeps me up most at night, 
we can see the health issues, we can see the humanitarian 
issues, the other thing we can point to most directly is the 
democratic backsliding and the second and third order effects; 
that you can point to immediately. One hundred and five 
thousand people locked up in Zimbabwe ostensibly for breaking 
lockdown, it is curious that they are largely urban and so 
therefore mostly aligned to the opposition.
    But even in democratic stalwarts like South Africa and 
Kenya, you are seeing heavy-handedness of police. Literally, 
people have died as a result of violence in the lockdown. So 
how do we think through that? How do we work through each of 
our partners wherever they are in the journey to self-reliance 
to develop the right responses? So empowering civil society to 
counter disinformation, to advocate for the most vulnerable, to 
work with our human rights partners as well, this is all key to 
do across Africa on that front.
    And then, finally, related to that, the other important 
second and third order effect is what is happening to the 
economic growth trajectory that Africa had been so positively 
on over the past 10 years. So in particular agriculture means 
everything in Africa. And whether it is the global supply chain 
interrupting inputs, or the ability for farmers to get product 
to markets on the supply side, the demand side is also quite 
broken. Because now with lockdowns and up to 80 percent of 
people in the informal sectors they have no money to buy food. 
So you have this double whammy on the supply and demand side 
when it comes to the key piece of the economic engine in 
Africa.
    So we are working very hard to think through many different 
types of innovative solutions to work on that supply side and 
the demand side. In speaking with my colleagues, one thing that 
has been very interesting to grapple with is, how do you think 
through urban food insecurity? We kind of know how to do it in 
the humanitarian sense, but how do you do that in a place like 
Khartoum, which is something we are actually thinking through 
right now.
    So it is very multifaceted. It is lot of learning by doing, 
but I think we are really well-placed, now, having learned a 
lot over the past 3 months to keep pushing forward to mitigate 
the backsliding, but also to address where we are right now.
    Ms. Wild. Thank you very much. I may have some followup 
questions after I have given everyone else an opportunity to 
ask questions. I am going to now call on members for 
questioning, starting with Mr. Smith, our ranking member.
    Mr. Smith. Thank you very much, Madam Chair.
    Again, thank you for your testimoneys. Let me ask you. How 
have important programs like PEPFAR and the President's Malaria 
Initiative been impacted by COVID-19? Are ARVs getting out to 
people who have tested HIV-positive, mother-to-child 
transmission, medicines, have they been in any way inhibited or 
delayed? The whole array of response under PEPFAR, has it in 
any way been delayed or even denied?
    Second, on susceptibility to COVID-19 in Africa, do you see 
a break-out as to who is susceptible? We know what the 
underlying conditions are here. We know age is also a 
component. Is it the same there, and what are we finding with 
regards to that and strategies to ensure that people are as 
safe as possible? I know nursing homes are not as prolific in 
Africa as they are here, but half of all the people who died in 
my State were senior citizens in nursing homes. Half.
    So can you also tell us what drugs, interventions, 
therapeutics we are either purchasing or encouraging the use of 
to mitigate COVID-19 as somebody does get sick? Is there a list 
of things? I know remdesivir is probably not available. It has 
saved lives in my district and throughout the country, but I am 
not sure how available it is there. What is available? Is 
hydroxychloroquine being used? I know, you know, you can look 
on CDC's website about how do you deal with malaria and there 
is hydroxychloroquine for country after country. Is it in any 
way being deployed there and is it having any inhibiting effect 
or impact on COVID-19?
    WFP Director David Beasley talked about the hunger pandemic 
coming from breakdown of economies. But also, I--and I get back 
to my first concern that I raised today and that is the 
locusts. You might want to speak to how we need to do even more 
on mitigating that crisis going forward.
    And also, Ambassador Nagy, you did mention bundling removal 
of Sudan from State Sponsor of Terrorism into the COVID 
supplemental. I would respectfully suggest that State Sponsor 
of Terrorism removal is a very complicated issue. We have 
members of the transitional government linked to atrocities in 
Darfur, and I am one of those who went to Darfur more than 
once, like you and so many others.
    We know--I met with Bashir himself. Too bad he never went 
and was held for crimes against humanity at The Hague. But 
Hemeti is still there and there are other very, very dangerous 
people still in that orbit of governance. We also have 
settlements of claims against Sudan by victims of terrorism. 
Not only the USS Cole and embassy bombing, the Granville family 
victims, but also the 9/11 widows who seem to have been 
overlooked by the State Department, and I have many who live in 
my district.
    I have worked on that issue since 9/11 itself, particularly 
trying to help them the day after and days after. Well, they 
are very upset as well. So I just--before I run out of time, I 
would like to yield to you for some answers.
    Mr. Maloney. Thank you, Ranking Member Smith.
    So let me start with the first one in terms of what we are 
seeing on the ground in terms of backsliding. It is real, 
right? So I would say on the PEPFAR front, the main thing is 
that clients cannot really move like they could before, so we 
have been thinking very hard about how we can get to the 
client. So a lot of the work that has been done is training our 
healthcare workers, ensuring they have the right equipment and 
PPE to be able to go out into the field. That has been a main 
thing that they have been working on from that PEPFAR side.
    On the malaria side, a main intervention has been 
developing global guidelines that can be used around the world 
on how to ensure continued implementation of bed net 
distribution, insecticide residual spraying, and, of course, 
continued diagnosis and seeking of care. I made that example 
earlier of the Uganda fever detectors, which is quite 
interesting. So all of that continues.
    I think the main thing is trying to understand the 
dynamics. It is very unique from country to country, you know, 
in South Africa this is more of an urban issue; when you are 
out in different parts of Africa, it is more of a rural issue. 
So how you respond and how you pivot is very, very country-
specific in terms of how that works.
    The final area that is also something of big concern is 
when it comes to vaccine-preventable disease. There has been a 
lot of technical support that we are providing to various 
African governments to restart and also adapt their 
immunization service delivery strategies to figure out how do 
you do that in this environment. And as you have seen, there 
already is quite a bit of backsliding in terms of percentages 
of individuals getting vaccinated, so this is something we are 
also working on quite closely.
    So again, it is this real tension between trying to 
mitigate what is going to be backsliding, for sure, but trying 
to do it in real time.
    Mr. Smith [continuing]. Getting out, you know, malaria, 
diphtheria, pertussis, those kind?
    Mr. Maloney. There has definitely been a big decline and 
this is where we are trying to work. So when I say restart 
strategies, they kind of--all these countries basically seized 
up. That is the way to think about it.
    So after these lockdowns have started to lift in varying 
degrees just like here, it has been thinking through, Okay, how 
do I pivot my strategy to now either catch up, and we will see 
if they can or not, and it is going to be quite difficult, but 
again very country-specific in that regard.
    In terms of the drugs purchases, I would have to defer to 
my global health colleagues on this, but it is important to 
talk about what we actually have been doing specifically in the 
health front. So my understanding is not primarily on drugs. It 
is a mixture of six things. The first is dramatically enhanced 
risk communication and community engagement work. So this 
important factor of knowing what you do not know and making 
sure that we are correcting misinformation is key in Africa.
    Just simple things like face masks and washing your hands 
applies deeply. You can imagine that particularly in an urban 
slum environment in Africa how much that matters. Infection 
prevention and control, support to national lab systems, 
surveillance and rapid response teams, case management and, 
very importantly, coordination. There are many players in these 
games, so those have been the six areas we have been most 
focused on when it comes to the health response more than 
anything else.
    You asked a really interesting question and one that I am 
fascinated by on the demography of this disease in Africa, why 
is it 715,000? Without question, we are dramatically 
undercounting, but there are some important things to think 
about. There is a fascinating study that came out, and that is 
why I put it in my testimony, of three important factors to 
think about and why it is important to think about it at a 
country level and not a continent level, because the experience 
is so different.
    The first is the demography. Remember that in Africa 
something like 70 to 75 percent of Africa is under the age of 
30, so chances are that when they get sick, it is going to be 
that little flu, right? And so we are not going to see that--
they are not going to get tested, or they may be even 
asymptomatic. And this is a horrible thing to say, but when 
Grandma gets sick in a place like Africa, probably the last 
place you are going to go is your hospital, even if there is 
one available. So that is just dramatically going to impact 
your ability to even see where this disease is going overall.
    The second is geography. This is a disease of global 
mobility. Why did South Africa get hurt first, because it is 
the most global of the economies. It is why the Maghreb is 
doing, per capita speaking, much worse than sub-Saharan Africa, 
because it is where the economies are.
    And then the third piece is governance. You talk to 
President Magufuli of Tanzania, COVID disappeared on April 
29th, right, and so this is very important. When you have good 
governance of good case testing and control like Rwanda, you 
can be one of the 16 countries that can fly back to the E.U. 
That is Rwanda right now, right?
    But right next door in Burundi, the President, who arguably 
may have been the first Head of State to die of COVID-19, 
denied it until the very end. Right next door. So it is really 
important to think through these different dynamics, because 
there is no one-size-fits-all because it is playing out so 
dramatically differently country to country.
    Finally, just to address your question on locusts, sir, 
obviously this is something we have been focusing very closely 
on, and in particular with my colleagues in the Bureau of 
Humanitarian Affairs, who are, of course, the ones in charge of 
this at the agency. As I know Acting Administrator Barsa spoke 
to you last week about the use of the $20 million, in my 
opinion, helped us dodge a real bullet, making sure that we 
were able to provide the critical equipment at the right time 
and place, aircraft, vehicles, pre-positioning as needed, et 
cetera.
    The estimates I have seen is that it has been able to avert 
a loss of almost one million metric tons of food. An important 
thing to flag, though, is that in that part of the world it is 
very, very localized and also a moving target, which makes it 
very scary. But so far to date, only about--only is a terrible 
thing to say--only about a million people have been directly 
impacted by the locusts from a food security angle. As you said 
before though, 26 million surrounding those people are victims 
of drought, conflict, and other issues.
    So food insecurity, writ large, remains a tremendous 
problem; locusts are the exacerbator. Where they go next is the 
big question, and I think we dodged a bullet in the spring. We 
need to make sure that as the rainy season comes in--Assistant 
Secretary Nagy knows this part of the world much better than I, 
having served over there, but Ethiopia and Sudan how this plays 
out, that is where we think the locusts are going next.
    It is working closely with the inter-agency, working 
closely with FAO to make sure that we are moving the right 
pieces of equipment to the right places, should this take off 
yet again. So I will leave it at that.
    Mr. Nagy. May I have--mention the SST? Because, sir, you 
absolutely brought up some of the complicating factors in SST 
rescission because we have to recognize the rights of the 
victims at the same time as pursuing SST. That is why I think 
our Special Envoy, Don Booth, has been giving a number of 
consultations with staff, with members who are interested, 
because we recognize that this has to be done right. They 
cannot be done in a vacuum.
    So absolutely, I mean, that is our primary concern is the 
victims. So absolutely. It is very complicated.
    Mr. Smith. Thank you very much, Madam Chair.
    Ms. Wild. Thank you, Mr. Smith.
    I will now recognize members by committee seniority, 
alternating between Democrats and Republicans. As we usually do 
in the subcommittee, I would like to ask that everyone stick to 
the 5-minutes, and then we will go for a second round of 
questioning. Thank you.
    Mr. Phillips, you are recognized for 5 minutes.
    Mr. Phillips. Thank you, Madam Chair. And greetings and 
gratitude to both our witnesses.
    Last week, I had the opportunity to speak with Acting 
Administrator of USAID John Barsa and we spoke about one of my 
passions, the Local Works Program, which advances locally led 
development in countries all around the world. And I love this 
program because I believe it highlights many of ours, including 
the administration's priority of achieving self-reliance, which 
I know you played an integral role in developing, Mr. Maloney.
    So my question is to you, and you have touched on some of 
this already, but how is COVID-19 changing the way that USAID 
delivers assistance, and given the specific challenge and 
difficulties of travel for U.S. officials, you know, how are 
you working to give more responsibility and ownership to local 
entities including local NGO's?
    Mr. Maloney. Thank you very much for that question. I am 
always pleased to meet other followers of the Journey to Self-
Reliance, something that is very near and dear to my heart. As 
former-Administrator Green used to say, ending the need for 
foreign assistance begins with local solutions and local works, 
right? So this has been a key piece of our response including 
even in a time of COVID.
    So a couple of things I would say, obviously the world is 
much more complicated because of movement issues around the 
continent, but in many ways I would argue that our local 
partners that are therefore, almost, more important, in the 
sense that they are the ones who are able to get out, sometimes 
more than our traditional players are able to. These are the 
ones who know the local situations far better than others, and 
so we have been doing all we can to make sure that they are a 
key piece of this story.
    An interesting piece of this, I would say, certainly would 
be on the Prosper Africa front. So you heard me mention earlier 
this rapid response on COVID-19 that we have out of our West 
Africa trade hub. Many of those applicants are small, African-
owned SMEs. We have been able to work with them to do things 
like pivot to production of local PPE. We have been able to 
work with them to get bridge capital, bridge loans, to be able 
to keep workers employed, things like that. So they are also a 
part of the story.
    So it is not just a supply and response angle, it is also 
making sure that we are also thinking through that demand piece 
as well. So I would say that is a core piece of what we have 
been working on, certainly from the local solutions front. 
Thank you.
    Mr. Phillips. All right, very good. And I happen to be a 
small business owner myself. I love ingenuity. I love 
innovation and creative spirit. I am hearing some great stories 
across--all over the world, students finding ways to wash your 
hands without touching any surfaces and fashion designers 
producing masks en masse, cosmetic companies making hand 
sanitizers, and many of these opportunities possible because 
grantors have been giving their grantees flexibility in their 
contracts, creating alternative products to help address the 
pandemic, while still generating revenue to keep the local 
entrepreneurs in business.
    So my question is, you know, what is USAID doing to ensure 
that its grant programs are affording this kind of flexibility 
and how is USAID supporting partners on the ground to ensure 
that products like these are able to adjust and navigate these 
new realities?
    Mr. Maloney. Thanks for that question. A couple things I 
would say, I mean it goes back, I think, first, we said before 
is how important, particularly from an SME front we are making 
sure that when we have pretty flexible mechanisms, like for 
example that request that we had out of the West Africa trade 
hub that allows us to have the degree of flexibility to provide 
the bespoke support that a given SME might need. So that would 
be something I would say is sort of at one angle.
    At the other side of the story though is, I think we have 
been able to find pretty good flexibility in everything from 
our Feed the Future work and others to make sure that through 
redirections we can make sure that we can help make any 
intervention, whatever that might be, whether that is through 
what a SME might be doing or a local faith-based partner we are 
working with on any sort of delivery mechanism that we have 
going on, they can pivot their response in a COVID-aware way. 
And that can be in different forms. I am happy to get back to 
you with some specific examples. I do not have many off the top 
of my tongue, but I know they are out there. But that has been 
a key piece of the story as well.
    One final thing I will also say, which I neglected to 
mention before, is just how important our local partners have 
been in the monitoring and evaluation standpoint. We have 
worked very hard, because they are the ones who are still out 
there, to think through very different types and innovative 
ways of doing the monitoring and evaluation of the work. So 
whether that is through mobile telephony, really thinking 
through different ways of trying to find the right types of 
indicators in these very constrained environments, they have 
been critical thought partners on that side as well. So I just 
wanted to put that point out there too. Thank you.
    Mr. Phillips. All right. I appreciate it. Thank you, Mr. 
Maloney. And I will yield the balance of my time.
    Ms. Wild. Thank you, Mr. Phillips.
    Mr. Wright, you are recognized for 5 minutes.
    Mr. Wright. Thank you, Madam Chair. And I want to thank 
both of the witnesses today for their testimony.
    My questions have to do with Cameroon. As both of you know, 
Cameroon's government and the Anglophone have been in conflict 
for some time. It is my understanding that much of the fighting 
continues, despite the fact that there has been over 16,000 
confirmed COVID cases and 382 deaths due to COVID in that 
region.
    My first question, Mr. Ambassador, do you have any insight 
as to whether the Anglophone region is being hit 
disproportionately hard by COVID-19 and to what extent the 
government is being helpful in containing the coronavirus in 
this region?
    Mr. Nagy. Unfortunately, sir, because of the lack of 
government and NGO presence in much of the northwest and the 
southwest, it is an area of ignorance for us when it comes to 
the statistics. We cannot be sure. We can make assumptions, but 
we certainly cannot be sure of what exactly is happening there 
with the COVID numbers.
    As is true for so much of Africa, you look at some of the 
numbers and the rates and they just make no sense whatsoever, 
from a statistical point of view. And it is even doubly so in 
areas of conflict, such as the Anglophone zones of Cameroon, 
unfortunately. As I have said many times before this committee, 
Cameroon is one of the countries that keeps me up at night 
every night.
    Mr. Wright. I understand.
    Mr. Maloney. And I would just echo everything that the 
Assistant Secretary said. My understanding is that there is 
some very limited PEPFAR and PMI programming in the Anglophone 
parts of Cameroon, but because of the unrest we have had to 
step back quite a bit from that part as well. My understanding 
is there may be some limited DRL and CSO programming, but I 
would defer to the Assistant Secretary on that. And there is 
some humanitarian emergency food and preventive health work 
that has been done, but that would pre-date COVID.
    So everything that the Assistant Secretary said is 
definitely true from the USAID standpoint as well. Our ability 
to operate in that part is quite difficult. But overall, of 
course, we have about 18 million in Cameroon right now in 
health and humanitarian assistance, and we could certainly get 
back to you on where that actually is going.
    Mr. Wright. Actually, my next question was going to be for 
you, Mr. Maloney, and it has to do with that very thing. And 
that is having to do with, how do we ensure that some of that 
18 million is actually getting into the Anglophone region? Is 
there any way we can ensure that that happens?
    Mr. Maloney. It is difficult and it is challenging. It is 
definitely a conversation that I think we should have with 
Ambassador Barlerin. I mean this is something that the 
Assistant Secretary and I would talk about all the time in 
given countries when we have issues like this. So this is 
something I think we can definitely take back and first just 
get a better understanding of where things are geographically 
in Cameroon right now with that supplemental and we can then 
revert back on any sort of next steps out of that.
    But, Assistant Secretary?
    Mr. Nagy. Yes. If I may add, anything having to do with 
Cameroon has to be overlaid with the problem of the conflict 
that is going on. For example, now the Cameroonian government 
is talking about a new U.N. development program for the 
northwest and the southwest. Unfortunately, there is just no 
way to, No. 1, implement that and the Cameroonian government 
seems to forget that the No. 1 desire of the people of the 
northwest and the southwest is to have a say over their own 
affairs.
    It is one thing to talk about development, but at the heart 
of it is their keen desire to have control over their own 
lives. And until the Cameroonian government understands that, 
all these plans are going to come and they are not going to 
succeed.
    Mr. Wright. I agree with that. Thank you. And I yield back 
the remainder of my time.
    Ms. Wild. Thank you, Mr. Wright.
    Mr. Burchett, you are recognized for 5 minutes.
    Mr. Burchett. Thank you, Chairlady. I appreciate it.
    And tell me how to say your name. Is it Nagy, or how do you 
say your name?
    What?
    Mr. Nagy. Tibor.
    Mr. Burchett. Tibor?
    Mr. Nagy. Tibor, my first name.
    Mr. Burchett. Okay. Well, I will just call you T. How about 
that? You can call me Tim. How about that? That is what 
everybody else calls me.
    I got you, Mr. Maloney. We are good.
    You know, as a young man--I probably told the committee 
this before. But as a young man, I remember missionaries coming 
into our church when AIDS was just coming out and getting 
vicious as it was, I mean I lost friends in Knoxville, 
Tennessee from AIDS. But they were talking about whole 
languages were getting wiped out and, you know, it is just hard 
for me to even fathom that as just seeing, you know, like if 
you put that map over Tennessee and just taking counties out.
    And, of course, now with COVID, it just seems history is 
repeating itself because we do not know what is going on. We 
get in there and then, of course, the Chinese Communists, who 
are the most miserable--I do not know, them or the Russians 
right now in my book are one and two. I am not sure which is 
which, but it disgusts me that the communists are taking full 
advantage of this, which they are, and that is in line with 
what my questions are.
    That was not a prepared statement. That was just something 
that--from the heart, right there.
    I know that in 2015, the U.S. worked with the African Union 
to establish the African Center for Disease Control, and China 
is reportedly planning to fund and construct the headquarters 
in Addis Ababa. Did I say that right? I think I got it, with my 
east Tennessee accent. They similarly constructed the A.U. 
headquarters, which was reportedly bugged and the servers were 
hacked. And how can the U.S. push back on this effort, by 
China, to ensure the security of the African CDC?
    Mr. Nagy. Yes, sir. We are absolutely seized with that 
issue. It would be an unmitigated disaster for the Chinese to 
build the Africa permanent CDC anywhere, and that decision has 
not yet been made, actually, as to where the Africa CDC is 
going to be permanently. That is a decision that should be left 
to the member States of the African Union, not a committee of 
the African Union.
    So I understand that a number of African States are very 
interested in pursuing that. There will be an executive meeting 
coming up in a couple of months of the African Union and I 
expect that some of the member States will be asking for that 
to be put on the calendar, because there are a number of the 
member States who are also quite concerned about that, based 
exactly what you said, sir, about the public reports of what 
happens to the data that goes currently through the African 
Union.
    Mr. Burchett. Yes, it just strikes me, again this is not in 
my notes, just how heartless they are and just their ambition 
for world domination. I mean it is just, you know, after the 
Second World War my dad fought in the Pacific, fought the 
Japanese all the way across and then he had to go to China. It 
is not written much, but he went to China and fought the 
communists for a while.
    And they have been at it, dad-gum, they have been at it for 
a long time and they just continue. And I think it kind of 
disgusts me when we get sidetracked with what is going on in 
the world because the Chinese, they are after us and everywhere 
they go. Belt and Road, I mean, you know, I do not believe they 
are ever going to take over Israel, but they built their deep 
port there, for goodness' sakes. I mean, you know, it is just 
amazing that we get so diverted in this country.
    Let's see, I have a minute and 14. Let me go real quick to 
the--how is the U.S. messaging and pushing back on China in 
their influence campaign specifically in the sub-Saharan 
Africa, because in the last 20 years we have provided about $59 
billion--with a B--to sub-Saharan Africa to combat the 
infectious diseases and strengthen health systems.
    Mr. Nagy. Well, you have hit one of my favorite subjects 
and I am sorry I do not have very much time to talk about China 
and Africa because--but I will make it very short. I think 
China gets hutzpah of the year on their pretend response on 
COVID. It is like in the African context, it is like----
    Mr. Burchett. Hutzpah. That is not an east Tennessee term, 
so.
    Mr. Nagy. No. It is not Hungarian either.
    Ms. Wild. I will explain it later.
    Mr. Burchett. Ma'am. Okay, thank you. I think I got it.
    Mr. Nagy. But the example, the African context is the guy 
who shows up in the morning and sets the village on fire and 
then shows up in the afternoon with a bucket of water and wants 
to get credit for putting it out.
    Mr. Burchett. Yes.
    Mr. Nagy. You know. And we have spent, as I said and what 
we both said in our introductory remarks, I think a hundred 
billion dollars on African health systems in 20 years and now, 
all of a sudden, China wants to come in with some PPE 
equipment, much of which does not work, and all of a sudden 
become the savior.
    Mr. Burchett. Yes, they want to go get their prize.
    Mr. Nagy. Like I said, hutzpah of the year.
    Mr. Burchett. Okay. Well, they get my dirtbag of the year 
award, so you do not have to look that up.
    Sorry, Mr. Maloney. I did not have nothing for you, 
brother, but.
    Ms. Wild. Yep. You will get a second round, Mr. Burchett, 
if you want it.
    Mr. Burchett. Yes, ma'am. It's just Tim. Thank you, 
Chairlady, and thank you everybody for your indulgence for my 
questions.
    Ms. Wild. Thank you, Mr. Burchett.
    Mr. Sherman, you are recognized for 5 minutes.
    Mr. Sherman. First, I want to thank the chair for allowing 
me to participate although I am a member of the full committee, 
I am not a member of this particular subcommittee.
    We are spending trillions to deal with COVID. I would think 
it would make sense for us to spend 1 percent of that on our 
worldwide response, and I think it is very important to our 
worldwide response that we also fund research. Less than one-
quarter of 1 percent of our COVID money has gone to research 
cures or the nature of the disease. And, obviously, what we do 
in research helps the United States, Africa, and the world.
    There is one area where I think the Republican bill just 
put forward this week may be better than the HEROES Act. The 
HEROES Act decided to focus exclusively on domestic aspects of 
this COVID crisis. The Senate package provides three billion 
dollars for global health programs, including GAVI, and one 
billion for international disaster assistance. And this is, of 
course, a disaster. We have seen a 135 percent jump in world--
in food insecurity in West and Central Africa, a 90 percent 
increase in southern Africa.
    I realize the administration does not always walk in 
lockstep with the majority in the Senate, but this would be a 
nice time to do so. Does the administration support the three 
billion and the one billion for our international response to 
COVID? And if it is not an official, can you just say nice 
things about it without being official if you are not allowed 
to be official? Do as much as you are allowed to do.
    Mr. Maloney. I would have to get back to you on that, sir.
    Mr. Sherman. That is the best you can do?
    Mr. Nagy. And also I do not know that issue. I would have 
to get back to you.
    Mr. Sherman. Okay. I was in Steny Hoyer's office yesterday 
urging that the Democrats embrace this part of the Senate 
proposal. I will point out that in the House Foreign Ops bill 
we have substantial money to deal with COVID internationally, 
but that bill is not going to become law. It is supposed to 
become law by September 30th. We know it is not going to become 
law until December or January.
    And I will not even ask the question. Do we have to respond 
to this issue now in Africa, or is waiting until January a good 
idea?
    Mr. Maloney. It obviously goes without saying it is----
    Mr. Sherman. I am known for asking the tough questions.
    Mr. Maloney. I appreciate it. The answer is the needs are 
tremendous and the resources as generous as they have been are 
still far short of what Africa needs.
    Mr. Sherman. Okay.
    Mr. Maloney. The backsliding is huge, well beyond the 
capacity of even the United States with a gigantic bill, and so 
our ability to continue to mitigate the backsliding whether 
that is in the health, the humanitarian, or the second order or 
third fronts is key.
    One thing to just going over to Congressman Burchett's 
remarks----
    Mr. Sherman. If I can reclaim my time.
    Acting Administrator Maloney, in your written testimony you 
highlight the success that we have had with PEPFAR and the 
President's Malaria Initiative. You put together your budget or 
the administration put together its budget before the 
dimensions of this COVID crisis was known and suggested a 34 
percent reduction in global health programs.
    Now that we see that what happens there affects us here, 
and now that we see how terrible COVID is affecting there and 
here, do you think we should cut PEPFAR and the Malaria 
Initiative and other global health programs by 34 percent?
    Mr. Maloney. As I said, the needs in Africa are great and 
they are well beyond just the capacity of the United States. It 
is key to think through burden sharing, our other donors and 
also what our African partners can do, and so I think that is a 
key piece of the story. Certainly, as USAID, we commit to doing 
as best we can with whatever is generously appropriated to us 
in this response.
    Mr. Sherman. And I do want to point out that many of our 
allies are providing a much higher percentage of their GDP to 
aid, development aid for Africa and disaster aid to Africa and 
health aid Africa than we are.
    Ambassador Nagy, did you have any comment?
    Mr. Nagy. Yes, sir. If I could just add one point. One of 
the considerations we always have to think about in Africa also 
is the absorptive capacity of various countries because some 
countries can use that money efficiently, others, obviously, 
cannot. And I know that that is one of the considerations that 
went into the formulation of the individual country grants for 
COVID because as much as it would be wonderful to just be able 
to throw money at a problem in some countries, we throw money 
at it and a lot of the percentage is going to end up in the 
pocket of somebody as opposed to where it should go. 
Unfortunately.
    Mr. Sherman. And I would point out that the disaster relief 
in the World Food Program, which I think has done a good job in 
general, makes sense. This COVID crisis is making millions of 
people hungry and perhaps starving, and I do not think there is 
any doubt that the World Food Program can use that billion 
dollars effectively.
    And I yield back.
    Ms. Wild. Apologies for the oversight, Representative 
Houlahan, who is a member of the subcommittee, I now recognize 
you for 5 minutes.
    Ms. Houlahan. Not a problem and thank you, Madam Chair. My 
questions actually follow along Mr. Sherman's questions pretty 
nicely.
    As we all know, the United States is not alone in fighting 
this pandemic and so long as the virus does remain a threat in 
one corner of the world it remains a threat to all of us. And I 
was disappointed to see that the HEROES Act, which we passed in 
May, did not include any foreign assistance or funding which is 
crucial in fighting this pandemic and I am hopeful that the 
Senate version does include some foreign assistance. But it is 
not enough, in my opinion, and so we do not have to have the 
conversation necessarily about whether you are for or against 
it.
    But I would like to know, assuming that we should have a 
foreign assistance response and a large one, what are the most 
important international assistance programs for which we should 
provide emergency supplemental funding in an effort to be able 
to support COVID response globally and in Africa specifically? 
And I leave that to either of you gentlemen to help me answer.
    Mr. Maloney. And, sorry. Just to clarify, which of the--are 
you asking specifically about international organizations?
    Ms. Houlahan. Exactly, assuming that there were funding 
that were decided upon wisely by both the House and the Senate 
in a very short amount of time.
    Mr. Maloney. Exactly. So, first, I would say, I would want 
to get back to you to be very specific to make sure I am not 
giving you an incorrect answer. But I would look again very 
clearly at who our key partners have been along the three lines 
of work, so that again begins with PEPFAR, PMI, and those 
backsliding issues. I think WFP, particularly when we are 
looking at what is going on in the food insecurity piece, they 
are a crucial partner and they have been thinking out of the 
box with us in particularly this urban food insecurity space 
which has been quite important.
    Also, of course, Red Cross and UNICEF, crucial partners, 
and particularly since in numerous cases around Africa we are 
having to do interventions in places where we do not 
traditionally work. A lot of the smaller States where we do not 
have a presence, UNICEF in particular has been a critical 
partner for us too. So again, I would say it is parts of the 
United Nations, certainly WFP, FAO when we are talking about 
the locusts as well, all key with us.
    Ms. Houlahan. And going back to Mr. Sherman's line of 
questioning, you know, I think one of the frustrations as a new 
member of this body that I have is that help us help you. We 
need you to be able to articulate that you need help and that 
dollars matter and that funding matters. And it is very 
frustrating to sit here in my capacity and my position and have 
you not be able to answer whether help would be helpful and 
that is a little bit constricting.
    Mr. Maloney. The help is definitely helpful. I just want to 
make sure we are giving you the very specific results.
    Ms. Houlahan. No, I appreciate that. And I will move on to 
my second question. Obviously, one of the most important pieces 
of our COVID response is the vaccine development, and I am 
definitely disappointed that this administration has started 
the process to withdraw from the WHO or the World Health 
Organization and we are declining to participate in many 
international efforts to coordinate vaccine development, 
production, and distribution.
    So as we are making progress on our COVID-19 vaccine 
response and others around the world are as well, what do you 
view as the greatest barriers to equitable vaccine distribution 
and access across sub-Saharan Africa and how can we build on 
programs that you just mentioned like PEPFAR as we prepare for 
a vaccine?
    Mr. Maloney. The good news is that we have, and we have 
shown through our COVID response, very strong platforms that 
can be leveraged for things like vaccines. So when it comes to 
supply chain, I would argue that the U.S. gets it more than 
many other players in the African health space, so I think 
leveraging those platforms will be key.
    I would have to defer to my global health colleagues 
specifically on the nature of how and then when and if we get a 
vaccine how that would work in the African context. But, 
certainly, watching what has happened in terms of how we have 
been able to pivot these platforms for COVID and how well that 
has worked particularly under the circumstances, I think, gives 
me a lot of hope for when we get to that point.
    Ms. Houlahan. Ambassador, do you have anything to add to 
that?
    Mr. Nagy. Just to add to what Chris said earlier that 
Africa in many respects is a continent of paradoxes. You know, 
you have such a very young population, but because of the 
illnesses that most people have they are still very vulnerable. 
On the other hand, we have some very underdeveloped health 
systems in some countries, but some of those countries have 
done a phenomenal job on Ebola, for example, response.
    So they have the systems in place where logically they 
might not, but they will when it comes to something like that. 
So as Chris said earlier, I think it is very much a country by 
country analysis based on lots of factors, for example, the 
political systems, the availability of local NGO's, conflict 
zones, so it will take careful analysis to make those 
determinations.
    Ms. Houlahan. Thank you.
    And I know I only have 15 seconds. May I ask one more quick 
question?
    Ms. Wild. Take your time, Representative.
    Ms. Houlahan. Okay.
    Ms. Wild. We are going to do a second round and you can 
just go ahead and use yours now.
    Ms. Houlahan. Thank you. I will quickly ask this one.
    I used to run a nonprofit that focused on early childhood 
literacy and had a very strong parental engagement component to 
it. And we have definitely seen here in the United States that 
parents are struggling with children being out of school during 
the pandemic, and I am very concerned not just here in the 
United States but also in the global south that we are going to 
lose a generation of kids who are not going to be able to 
achieve basic education because schools are closed.
    So I was wondering if you could provide an overview of 
existing USAID efforts to address the learning loss that is 
inevitably happening in sub-Saharan Africa and specifically 
that loss for girls and other disadvantaged populations.
    Mr. Maloney. Thank you for that. So my understanding right 
now, I just wanted to get you the specific number, is that the 
pandemic has pushed about 279 million learners out of schools 
across the continent just to give you a sense of the scale. We 
were talking earlier about the redirections that we have been 
able to do with current funding and in education, a large 
amount of that focus has been thinking through how to work both 
with Ministries of Education and our local partners who are 
doing education on how distance learning works in a given 
country.
    Now in the United States we have the beauty of this 
technology. When we are out in the middle of South Sudan we do 
not. So how do we think through that? It has been really 
interesting to engage with my mission director in Juba. We have 
been working on television and radio. We have been doing the 
same thing in DRC.
    So even in some of the most challenging environments that 
we are in, we have been able to pivot and develop curricula to 
at least again mitigate the backsliding. It is going to be no 
substitute for actual in-person teaching, so there is a lot of 
thinking going on. There has been some pivoting going on. The 
work continues, to be frank.
    In terms of getting at the specifics in terms of how this 
is disproportionately impacting girls, it almost certainly is, 
but I would like to get back to you with the specific 
statistics.
    Ms. Houlahan. I would very much appreciate that and very 
much like to be helpful in assisting in that area.
    In my last few minutes, I will ask one last question. So as 
you know, I have been working with my Republican colleagues, 
two of them, on introducing the Women's Global Development and 
Prosperity Act. It is an important initiative started by this 
administration to support women in developing economies.
    How have your agencies been able to make use of the WGDP 
initiative to support COVID response efforts? More 
specifically, how is the U.S. Government leveraging women 
entrepreneurs in its COVID response in Africa?
    Mr. Maloney. Sure. And I will get back to you with some 
even more specific examples, but I can think of off the top of 
my head, I believe, Kenya and Ghana. There is a couple of 
others, one also we have just seen in Cape Town of working with 
women-owned SMEs particularly on pivoting small-scale SME 
production of face masks.
    It does not sound like much--it is critical. Absolutely 
critical. You know, from hand washing to face masks, that is 
really what is going to stop the spread, particularly in the 
urban slum environment, so that has been a key piece of the 
story. Also, of course, just the broad work of what WGDP does 
in terms of removing legal, cultural, and regulatory barriers. 
That is the lens through which all of our support that is being 
done in the SME space is being thought through.
    And so again, it does not matter which sector we are 
talking about, those are the lenses that we will be looking 
through when we are looking at project design. But I will have 
to get you some more stories that we have from the continent in 
that space.
    Mr. Nagy. May I add something on the State Department side? 
For State, one of the programs I mention in my remarks is the 
Young African Leaders Initiative and their very large network 
now in Africa of young leaders. That has a very heavy focus on 
making sure of large participation of women, and many of them 
now are in leadership positions on various COVID response 
projects from the village level to entrepreneurs to leadership. 
So they are very, very much involved in that.
    Ms. Houlahan. Thank you, gentlemen.
    And I yield back the balance of my time and thank you, 
Chairwoman.
    Ms. Wild. Thank you, Representative Houlahan.
    I am going to hold my second round until after the other 
members have had the opportunity to ask their questions.
    Representative Phillips, do you have a second round of 
questions that you would like to ask?
    Mr. Phillips. Yes. Thank you, Madam Chair.
    I would like to direct my questions relative to elections. 
I am concerned about the status of elections in many countries 
around the world. In Mali, the government chose to hold long-
delayed elections in late March and early April. Many voters 
stayed away from the polls not just due to violence, but also 
due to fears of the coronavirus.
    Just before the elections, extremists kidnapped an 
opposition leader in the north of the country. And while the 
ruling government did quite well in the elections, protests 
have erupted in recent weeks as thousands have now taken to the 
streets calling for the President's resignation amid corruption 
scandals and lack of response to the kidnapping about which we 
are all aware.
    So as we look forward, there are a lot of countries with 
upcoming elections--Niger, Cote d'Ivoire. The government of 
Burkina Faso suggested moving their November election to 2021, 
as our President may have suggested today. Elections in 
Ethiopia slated for the end of August have been postponed and 
have yet to be rescheduled. There is a lot of concern and I 
trust we all share it as free and fair and safe elections are 
integral to our mission, the United States of America, 
something that we have to commit to both domestically and 
internationally.
    So my question to you, Ambassador Nagy, is quite simple. 
You know, what are we as the U.S. Government doing 
specifically, and the State Department more specifically, to 
support the efforts around the world to support free, fair, and 
safe elections?
    Mr. Nagy. Super question, thank you so much. That is one of 
the key elements that we have asked each of our embassies in--
around Africa to look at because as you mentioned, sir, there 
are quite a long list of very important elections coming up. 
And obviously, again, this is highly dependent on local 
circumstances.
    Obviously, some governments will be trying to use COVID to 
delay elections unnecessarily or unreasonably, while others 
very justifiably may have to let them slip by a couple of 
months or 6 months so that they can have an environment that is 
conducive to credible elections.
    Our Ambassadors are very much seized with this very issue. 
They are providing reporting analysis. They are engaging with 
their host governments whenever something appears unreasonable, 
and they are working very closely with their USAID missions to 
devise the kind of programs that would be supportive for 
elections in that particular circumstance.
    One just came up within the last week when the very dynamic 
Somali Prime Minister was dismissed by the National Assembly 
because he had been very energized in trying to come to a 
national consensus on the type of elections to be held. So we 
are looking very carefully to make sure that those elections 
now are not unreasonably delayed with an excuse that--of the 
Prime Minister's departure.
    So that, as you said, sir, it is very much a concern all 
around the continent and you can be assured that our embassies 
and Ambassadors especially are very seized with that issue.
    Mr. Phillips. I am glad to hear that, Mr. Ambassador. And 
if you could just also share with me what type of cooperation 
are you seeing from the international community, in particular 
our allies with shared interests?
    Mr. Nagy. Excellent question also. It just so happens that 
last week I had a Quad meeting, you know, over--like this, 
video, with my British colleague, the United Nations, and the 
European Union having to do with Somalia. And we engage very 
heavily with the like-minded groups because what did we say, in 
unity there is strength?
    Mr. Phillips. Yes.
    Mr. Nagy. So, you know, the international community at 
least part of it is very much seized with making sure that we 
have credible elections.
    Mr. Phillips. Okay, thank you, sir.
    With my remaining time, I would like to just address 
misinformation. I do not think it has been covered yet. There 
is a lot of anecdotal evidence that suggests fake news and 
other misinformation is confusing people around the world. I 
know there is a report, a journalist in Burkina Faso said that 
many people he spoke with advised him that they did not think 
coronavirus affected Africans.
    So both to you, Mr. Ambassador and Mr. Maloney, if we have 
a moment, how is the State Department and USAID responding to 
such disinformation?
    Mr. Nagy. I will talk on the State side and leave it to 
Chris to talk about the USAID. Our Ambassadors, actually, have 
been very much in the forefront on going out on Twitter, 
Facebook, local TV, writing local articles about some of the 
correct practices. I remember when the pandemic first started a 
number of our Ambassadors became TV stars for being filmed 
washing their hands, the appropriate way to wash their hands.
    So absolutely, sir, there is a lot of misinformation, but 
our missions through our public affairs offices and as I said 
many chiefs of missions are put to rest some of that 
misinformation.
    And, Chris, anything for you?
    Mr. Maloney. Very, very quickly. We have two programs using 
the COVID supplemental, one in Littoral Africa in a number of 
States and another across the Sahel, where we have noticed this 
disinformation issue on COVID-19 to be particularly profound, 
that are working with local radio stations and local civil 
society groups specifically on this issue. Muslims do not get 
COVID-19 has been a message we have seen in different parts of 
Sahel, things like that.
    Mr. Phillips. Yes.
    Mr. Maloney. So that is something we are definitely working 
on right now.
    Mr. Phillips. Okay, gentlemen. Thank you both very much for 
your time. I am grateful. I yield back.
    Ms. Wild. Thank you, Mr. Phillips.
    Mr. Sherman, do you have a second round?
    Mr. Sherman. I do and thank you so much for going last. As 
chair you could go first.
    And, of course, the President of Madagascar was touting a 
particular local drink as a cure. I assume, Ambassador Nagy, we 
did what we could to respond to that?
    Mr. Nagy. We did. Absolutely.
    Mr. Sherman. Mr. Nagy, the most recent statistics in sub-
Saharan Africa show that 60, almost 63 of the cases, 57 percent 
of the deaths, are all taking place in one country and that is 
the Union of South Africa. Is that because South Africa has 
really been hit harder, or is that because that is the country 
that is doing the testing, reporting the information--is COVID 
a big problem in the countries other than Union of South 
Africa?
    Mr. Nagy. Absolutely. Thank you very much for pointing that 
out. Yes. As was said several times, South Africa is showing up 
on the statistics with having more than half the cases. That is 
because they are doing extensive testing. They have a developed 
world health system, although they still have some developing 
world vestiges left over from the long period of apartheid so 
that is why it is such a mixed bag there.
    But then you look at other countries, South Africa is what, 
I think it is about 60 million people and you look at the 
number of cases, then you look at a country like Nigeria with 
200 million people and the COVID cases are infinitesimal 
compared to that.
    Mr. Sherman. Yes. So I mean to look at the statistics that 
have been reported, roughly 8 percent of ten thousand so that 
is less than a thousand----
    Mr. Nagy. Yes.
    Mr. Sherman [continuing]. Deaths in Nigeria.
    Mr. Nagy. Yes.
    Mr. Sherman. Would you believe there have been less than a 
thousand deaths in Nigeria?
    Mr. Nagy. No. Absolutely not. It is a matter of, you know, 
people are dying. Unfortunately, in Africa people die quite 
frequently from serious diseases. But people die and the cause 
of death is not necessarily----
    Mr. Sherman. So----
    Mr. Nagy. Yes, sir. Absolutely.
    Mr. Sherman. We in Congress want to reflect our values in 
the appropriations but we are not the experts at the program 
level. On the other hand, you work for an administration that 
may or may not share our values, may not have an official 
position. Can you provide us with some what-if guidance, like 
if you are hell-bent on spending five billion dollars to help 
the world, the underdeveloped world, deal with COVID, here are 
the programs? Could you perhaps give us percentages if not 
dollar amounts?
    Clearly, the administration wants us to spend at least ten 
dollars on this so we could divvy up. What guidance can you 
provide us officially unofficially so that when we reflect our 
values and provide the money, we give you the flexibility and 
the allocations that make sense?
    Yes, what percentage, if we are trying to help Africa and 
the rest of the global south, what percentage would go to which 
programs if the focus here is on the health problems and the 
food security problems caused by COVID?
    Mr. Maloney. So if we look at the way the current moneys 
have been split in Africa, and again the numbers sort of change 
a little bit by the day as things get obligated, but, roughly, 
right now, I would say it is about two-thirds on the 
humanitarian front, about 10 percent is in the second and third 
order effects fronts, and the remainder is----
    Mr. Sherman. Ten percent is in the what?
    Mr. Maloney. In the second and third order effects, so 
things like democratic backsliding and economic support.
    Mr. Sherman. Okay.
    Mr. Maloney. Things like that. And then the rest is global 
health, so about 20 percent, a little less.
    Mr. Sherman. So considerably less on global health than on 
humanitarian.
    Mr. Maloney. That is correct.
    Mr. Sherman. Whereas, the Senate proposal is three billion 
for global health and one billion for international disaster 
assistance. That is a different ratio than what you would 
suggest?
    Mr. Maloney. The only thing I would say is that 
humanitarian work is incredibly expensive and it is not going 
to be getting better anytime soon. So it is important to 
understand operationally what is behind those proportions, so 
that is why it is a little bit tricky to speak strictly in 
proportions in terms of what is going behind those figures.
    I would say that in my opinion the economic support piece 
that right now is at about 10 percent is, certainly, in the 
African context, too small, so proportionately I would think 
there should be more in that space. We have talked about that 
before.
    Mr. Sherman. More for economic support.
    Mr. Maloney. That is correct.
    Mr. Sherman. Global health and humanitarian and second 
order. Give me percentages for those four.
    Mr. Maloney. Exactly.
    Mr. Sherman. Please give me percentages.
    Mr. Maloney. Oh. Again, this is off of my top of my head.
    Mr. Sherman. We could only be talking about ten dollars. 
Okay, go ahead.
    Mr. Maloney. The need here is great, right. So I think as 
we look forward I do not think the humanitarian or the health 
issues are going to be going anywhere anytime soon, so just as 
much is needed in those spaces as elsewhere and we take what we 
can have and we can maximize that accordingly. Ten to fifteen, 
20 percent more on the economic growth front, I think that 
would be useful.
    Mr. Sherman. Okay.
    Mr. Maloney. But that of course comes in tradeoffs, right? 
We are going to have tradeoffs in a world of fixed resources. I 
understand that. But if I look at where----
    Mr. Sherman. Health?
    Mr. Maloney [continuing]. COVID-19 is--health, again I 
would put that at least at that same proportion, 20 percent. 
And so again, you would see reductions more on the 
humanitarian----
    Mr. Sherman. Humanitarian?
    Mr. Maloney. And that is where I would take the cuts.
    But again, that is----
    Mr. Sherman. You mean spend less on humanitarian?
    Mr. Maloney. This is what I mean by tradeoffs. So in terms 
of where we see things going----
    Mr. Sherman. OK.
    Mr. Maloney [continuing]. More than anything else. At the 
end of the day though, again those I do not want to see as 
official figures, I am just simply talking about a 
reproportioning of where we are at a very, very high level.
    But if I look forward in terms of where COVID-19 is going 
in Africa, it is----
    Mr. Sherman. I will give you a call.
    I yield back.
    Mr. Maloney. All right, thanks.
    Ms. Wild. Mr. Sherman thinks I was being magnanimous, but I 
do not often get the opportunity to wield the gavel so I am 
going to take full advantage and actually ask the questions 
that I normally do not have time to ask.
    But I would like to start with just--do not even put your 
mask back on, Mr. Maloney. If you could just finish that 
thought that you had that you were expressing with Mr. Sherman 
about where we are going with COVID in Africa.
    Mr. Maloney. So I am just going to go back to my testimony 
and that is where we do not know what we do not know. We know 
certain countries are getting hurt very hard. Just following up 
on that South Africa comment, I think it is important. South 
Africa got hit worse than everyone else because of what it is, 
right. It is the most globally exposed, it has an older 
population and it has the ability to test, so it is a mix.
    Are we going to see a--it is not a second wave--are we 
going to see the wave just pitch later elsewhere in Africa? We 
do not know. We need to be prepared, but I do think that we are 
seeing signs that pieces of the continent may have dodged a 
bullet if they are able to keep things under control. I am very 
worried about--I think it is more about pivoting as the wave 
recedes in South Africa to where it is going to pick up, which 
is primarily Littoral, West Africa, so Cote d'Ivoire, Ghana, 
Nigeria, that area.
    If we can keep everything else under control though, what 
really keeps me up at night are the second and third order 
effects and to some degree the humanitarian effects, because 
the humanitarian issues are always going to be there. The food 
insecurity is going to be there. But at the end of the day, it 
is the global economy as we saw today in the report to the 
United States that is going to hit Africa really, really hard.
    So global supply chains are broken. Farmers cannot get 
their inputs. Farmers cannot get products to market. The urban 
poor cannot buy their products. So the food insecurity piece is 
very real. I saw a report yesterday that said 70 percent of 
households in Africa--this was specific to a Nigerian survey--
are reporting income losses.
    So when you mix all of that together, the real thing that 
we are going to see over the six to 12 months is a profound 
economic crisis, right. And so how that plays out, what those 
right issues are, that is what we are going to have to start 
thinking through which is a little bit different than sort of 
the classic health piece that we have been doing to date.
    So again, it is hard for me to recalibrate the proportions 
so specifically only to say that, you know, and Tibor and I 
worked very closely on this, when we were looking at the 
proposals coming from the field in the second and third order 
space there are an amazing amount of ideas, but not enough 
funding for them. And that is where I think a lot of the long-
term issues are going to come from.
    Ms. Wild. Thank you. Before I get to my next question, go 
ahead, Ambassador.
    Mr. Nagy. Can I answer that? With the secondary effects 
there are other things that very few people talk or think 
about. The large increase in violence against women, you know, 
a huge problem, but again not often talked about. So many 
African countries count on tourism for large portions of their 
gross domestic product. Tourists are not coming. The people who 
are engaged in tourism at these national parks are losing their 
livelihood. So what happens then? They start poaching animals.
    And because we know there is a market for ivory and 
pangolin scales and things, so those could again become 
embedded in the systems. And we have spent such efforts to get 
that out of there, to get people to be park rangers instead of 
poachers, but they can revert very quickly. So there are a 
whole lot of these secondary cases.
    More than official statistics, one of the things I am 
depending on to kind of get a sense of where countries are, our 
embassies overseas follow a phase system kind of like we did 
here, you know, phase 0 to phase 3 is normal, and in Africa 
right now about a third of our embassies are still in phase 0. 
About half now have gone to phase 1 and about a handful are 
phase 2. So our embassies take a really good look at the local 
circumstances and make their recommendations based on that.
    So I look at that a lot more credibly than some of the 
statistics coming out like, you know, Tanzania stopped counting 
on April 29th, so.
    Ms. Wild. So I just need you to explain the phase 0 to 3.
    Mr. Nagy. Phase 0 is basically the embassy is open but most 
people are telecommuting.
    Ms. Wild. Okay.
    Mr. Nagy. And then phase 1 it goes up to more activity and 
more activity and more.
    Ms. Wild. So the lower the number the----
    Mr. Nagy. The more difficult the circumstances.
    Ms. Wild. Got it. That is what I needed the clarification 
on.
    Switching gears, I wanted to talk about how foreign 
assistance funds that are appropriated by Congress, and 
specifically of late under Public Law 116-123 and Public Law 
116-136, how are they being allocated in Africa? Some people 
have alleged, observers have alleged that the bulk of these 
appropriations remain undisbursed and that aid pledges have 
outstripped deliveries.
    So if each of you could just address what bottlenecks, if 
any, may be hindering disbursement in Africa.
    Mr. Maloney. So, first of all, thank you for the question. 
So to get this much money out the door this fast is a mammoth 
task and so I would certainly say in the early days that 
criticism is very valid. I do not have the specific statistics 
right now and I am happy to get it for you. My understanding is 
we have been able to obligate now, I think, about 70 percent, 
and my understanding is of the humanitarian IDA funding it is 
supposed to be all obligated by tomorrow, which is great.
    So at the end of the day though we are trying to balance 
two things. One, the incredible urgency of getting that money 
out the door to real fires and real needs around the world, but 
we have to be responsible to the U.S. taxpayer. We have to make 
sure we are being accountable for that. So all of those 
structures, all of that coordination we need to do with State 
and the rest of the agencies to make sure that we are not 
duplicating efforts, that we are all aligned, that just takes 
time. And I think at the end of the day though, it is 
remarkable how much we have been able to do in two or 3 months, 
4 months at this point, so.
    Ms. Wild. Ambassador, did you want to say anything further 
on that? Okay.
    And then I wanted to ask you about ventilators. You talked 
about financial assistance, but there has also been specific 
pieces of medical equipment. As we move forward, hopefully 
there will be tests developed that will be distributed within 
Africa. In my district we have an excellent company that 
actually has rapid tests for Ebola and HIV that have been 
distributed in Africa. They are working on one now for COVID.
    And so I guess my question to you is--well, let's talk, 
just stay with the ventilators for now. Which countries have 
received or are slated to receive ventilators, if you know? And 
as long as we are--I will ask you the whole question. Also I 
wanted to have you address PPE aid.
    Mr. Maloney. Sure. So to date we have nine countries that 
have been slated to receive ventilators. It is important to 
understand that ventilators are very complicated pieces of 
equipment. So to date deliveries, my understanding, so far is 
really only South Africa and Rwanda, but literally over the 
next coming weeks, this list, the deliveries themselves will 
grow.
    But the nine countries are Democratic Republic of Congo, 
Ethiopia, Ghana, Kenya, Mozambique, Nigeria, Rwanda, South 
Africa, and Zimbabwe. These were all requests between heads of 
State. This was not a process by USAID, this was led by the 
White House as gifts from the United States to these requests 
to these governments in Africa.
    I will say personally having overseen this because USAID is 
delivering these ventilators, we have done a huge amount of 
work to ensure that these ventilators are successes in these 
countries. That is in two fronts. One is, we have been doing 
what are called oxygen ecosystem assessments. So a ventilator 
is one piece of the broader oxygen story, so you need to look 
at where these things can go, the availability of durables and 
consumables, the technical systems of that piece of the story. 
So we are doing full assessments in our countries so that we 
can make sure the wraparound support that USAID can provide is 
there with the ventilators.
    The second piece is what we call facility level assessment, 
so where does the ventilator actually go. That is another piece 
of the story that I have been working closely on so that we are 
working hand in glove with the Ministries of Health on that 
piece of the story, again so that these gifts are a success.
    But I think what is interesting that has come out of this 
is, as we look forward I think there is a real need for 
potential oxygen investments in Africa, so production of 
oxygen, the TA for the oxygen--sorry, technical assistance for 
the oxygen--and again, the sort of durables and consumables 
that go around it like the tubes that would go in your nose and 
that sort of thing.
    I think as we have watched this crisis play out, we have 
learned a lot about the role of ventilators versus oxygen and 
this might be an interesting thing to explore as we look 
forward.
    Ms. Wild. Thank you.
    Ambassador, did you want to add anything to that?
    And you mentioned that these ventilators, have they all 
been gifts from the United States to these countries at the 
request of heads of State?
    Mr. Maloney. In Africa they are gifts, yes.
    Ms. Wild. And do you have any idea what the value of these 
gifts are?
    Mr. Maloney. I would have to get back to you on that 
number.
    Ms. Wild. That is Okay. I just wondered if you did.
    So my last question to both of you, it is going to be kind 
of a simplistic question that I suspect does not have a simple 
answer, but it is something that we in Congress always have to 
answer for and I think it is a very important question. And 
that is, why should the United States taxpayer be concerned 
about what is happening with COVID in Africa?
    Ambassador?
    Mr. Nagy. Can I start? I think that question also is why 
should the United States taxpayer be concerned with Africa?
    Ms. Wild. Of course, yes.
    Mr. Nagy. Because everything--one, as I mentioned, I think, 
earlier, Africa's population is going to double between now and 
2050. It has forever been seen as a problem in our policy, you 
know, since we recognized relations with the decolonized 
countries in Africa. Now I think people are seeing it finally 
as an opportunity. Certainly, our global competitors see it as 
an opportunity.
    With that many young people they could either be--they are 
going to be there. They could either become a tremendous, 
unfortunately, force for global instability, fodder for violent 
extremist organizations, millions migrating to Europe, or they 
could become a tremendous force dynamic for global economic 
growth and they could be billions of customers instead of 
problems.
    And the truth is that African young people have access to 
mass communications and they have exactly the same dreams as 
young people anywhere else in the world--a good job, a good 
home, being able to support their families, opportunities, 
educational opportunities. And the elites who have been running 
Africa, often in a very corrupt way, are on the way out and the 
young people are going to be there.
    And it represents a tremendous opportunity for U.S. 
prosperity and security, frankly, to be engaged there, because 
as I said, if we are not there, the vacuum will be filled up by 
other people. And we also have to remember that in 
international organizations, a country like the Seychelles has 
the same vote as the United States of America and there is at 
least 50 whatever votes that Africa can provide.
    Over to you, sir.
    Ms. Wild. Thank you very much, Ambassador.
    Mr. Maloney.
    Mr. Maloney. Thank you. The way I look upon this is I go 
back to our national security and our national security 
strategy where our key pillar is advancing American influence. 
And it sounds strange to say, but if ever there was an 
opportunity to advance American influence it would be through 
what is happening right now with COVID-19 in Africa.
    And I look upon that in three lenses. The first is the 
American taxpayer should want to protect their $100 billion of 
investments in basically stopping the tidal wave of HIV/AIDS. I 
am just thinking back to grad school 25 years ago and what was 
happening in Africa with HIV/AIDS and where we are today, and 
that is all because of PEPFAR and the American taxpayer. This 
is an opportunity to protect that investment. Second, to 
demonstrate American leadership countering malign influence is 
critical. We have already talked about China with Congressman 
Burchett's comments and I completely second those and this is a 
key opportunity to do that.
    And then, finally, I just want to speak to the moral 
imperative. America stands up for the most vulnerable and there 
is no more vulnerable place in the world, I would argue, than 
the African continent and this is our chance to do that.
    Ms. Wild. Thank you very much.
    Do any members have any additional questions?
    Hearing none, member questions are now concluded.
    I once again want to thank our witnesses for being with us 
today to discuss what I consider to be an extremely important 
issue. As countries--and you obviously have demonstrated your 
tremendous knowledge in this area. I suspect we could have 
continued this conversation for a couple of days.
    As countries around the world grapple with the COVID-19 
pandemic, we want to be certain that the United States is 
playing a constructive role in doing everything that we can to 
address and assist other countries as they respond to this 
pandemic. And we also want to make sure as you referenced, Mr. 
Maloney, that countries do not lose many of the gains made in 
the last few years, many of which have been gains made with the 
assistance of the United States and our investments. So thank 
you very much to both of you.
    This meeting is adjourned.
    [Whereupon, at 2:40 p.m., the subcommittee was adjourned.]

                                APPENDIX
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            RESPONSES TO QUESTIONS SUBMITTED FOR THE RECORD
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