Dr. Shah, good morning and welcome.

Your vision is to restore USAID as the world's premier development agency.  As a Member of this Subcommittee, I am committed to making that vision a reality.

I want to elevate and strengthen USAID, and ensure your agency has the authority and resources it needs to focus on long-term development rather than crisis response and contract management. This is an exciting moment for USAID and for global development.

In the past year, President Obama launched two new major initiatives in Global Food Security and Global Health. I applaud these commitments from the President.  Food Security and global health are my highest priorities in global development. Following today's hearing, I would like to talk with you more about both of these efforts.

At last week's hearing, I talked with Secretary Clinton about food security - I would like to discuss global health with you today. Specifically, I want to talk about America's efforts to save the lives of children around the world.

As a physician, a development expert, and a parent you know better than anyone that the most basic measure of a country's development is whether their children survive.

And you know that dollar for dollar, U.S. investments in child survival produce some of the best results because we have simple, inexpensive, and effective interventions.

I am encouraged to see the Global Health Initiative is beginning to rebalance U.S. global health investments.  Child survival and maternal health, neglected diseases, and family planning are finally starting to receive more resources. But the re-balancing must continue. According to the Kaiser Foundation, in the first year of the Global Health Initiative, just 6 percent of the total $8.6 Billion went toward Maternal Child Health - HIV programs received 64 percent.

We need to do more to save the lives of children. Child deaths are now at the lowest level in history - but we still lose 24,000 children under the age of 5 every day.

A September 2009 article in The Lancet found, "The rate of decline in under-5 mortality is still grossly insufficient to obtain the Millennium Development Goal by 2015 - particularly in sub-Saharan Africa and South Asia." Your Global Health Initiative sets a goal of saving 3 million children - but it also states that nearly 9 million children die every year, many from preventable causes.

I am going to challenge you and the President to set a more ambitious goal.  With political will, we can close the gap between 3 million and 9 million child deaths.

This year's budget request includes an increase for Child Survival and Maternal Health.

• Please share with the Committee how this investment will be targeted and what results the funding will produce.

• How do investments to save the lives of children and mothers fit into the overall Global Health Initiative?

• And how will the new focus on "integration" across all global health programs work in practice?

You are a numbers guy - I would like to hear some analysis from you as to the return on investment for saving the lives of children.

I'd like to hear more about how USAID defines "country-ownership" and how you plans to increase "country-ownership" in our foreign assistance programs.

I agree completely that it is necessary to transform recipient governments into partner countries.

The only way to sustain development gains is to invest citizens and governments in developing countries in their own future.

But this is tough work.

I spoke earlier about the importance of saving the lives of children and mothers.  The horrible reality is we cannot want kids and moms in poor countries to live more than their own government leaders.

As a Member of this Subcommittee, I see my fair share of Ambassadors. Still, I have never had an Ambassador come into my office and ask for more funding to save kids and moms in their country.

• How will we change our policies and approach to get more country commitment to development?

• How do we hold countries accountable for making and maintaining their commitments to partnership?

• Explain to this Subcommittee like you were talking to a foreign minister or a health minister what's the value in saving a child's life? What are the consequences for failure?

Thank you.