We Have the Solution and We Need to Use It: Advocating for the USAID NTD Budget in D.C.

The END7 campaign awarded scholarships to three outstanding student leaders to attend the second annual END7 Student Advocacy Day in Washington, D.C. Read scholarship winner Nicole Spitzer’s reflection on her experience in D.C.:

By Nicole Spitzer, University of Central Florida College of Medicine

I was introduced to the END7 campaign while I was in the midst of planning a Global Health Conference at my medical school, the University of Central Florida College of Medicine. The theme chosen for this year was “The Global Burden of Neglected Tropical Diseases,” which was a topic that, even as a first-year medical student, I knew nothing about. My team and I began to research what NTDs are and how NTDs affect not only those infected, but also their families, the communities they reside in, and the economies of their respective countries. What struck me most while I was learning about NTDs was this question: why is this such a giant problem if many of these diseases are easily treated and cured? My faculty advisor, Dr. Judith Simms-Cendan, who has completed research on the NTD schistosomiasis, pointed my team to the END7 campaign. We decided to donate a portion of conference registration fees to the campaign and invited Dr. Maria Elena Bottazzi of the Sabin Vaccine Institute, home of END7, to deliver the keynote at the event. I became so interested in NTDs at the conference that when it was over and I received an invitation to attend the second annual Student Advocacy Day in Washington, D.C., I knew I wanted to make the trip.

Nicole after a meeting in the office of her representative, Alan Grayson of Florida.

Nicole after a meeting in the office of her representative, Alan Grayson of Florida.

My trip to D.C. was nothing short of a whirlwind, as I was there for only 26 hours! On my flight from Florida to D.C., I was vigorously preparing for the four meetings I was scheduled to attend the next day in order to advocate for funding for the USAID NTD Program. I was delighted to see that my team would be meeting with the staffers of two Florida Members of Congress, Senator Marco Rubio and Representative Alan Grayson. As a constituent of their state, I knew that my team would have their full attention to advocate and raise more awareness for NTDs. I also knew that I would be able to provide a different angle as a medical student and future physician and I looked forward to meeting the other students I would be working with.

Before we headed into a long afternoon of meetings, we were briefed by representatives from USAID, RTI International and Helen Keller International, who provided us many compelling facts we could bring into each meeting. Kalpana Bhandari from the ENVISION project at RTI international shared personal stories that were very touching. Some of her family members live in Nepal, including her aunt, who works as one of the community health workers who lead local mass drug administration (MDA) campaigns. Emily Toubali, a representative from Helen Keller International, shared the details of a plan being rolled out to treat the morbidity and mortality associated with blinding trachoma and lymphatic filariasis, commonly known as elephantiasis. As a medical student, hearing these stories and learning about these programs has inspired me to become more involved in the global NTD effort in the future. From these briefings, we learned many strategies on how to conduct each meeting with a congressional office, highlighting the most compelling reasons for each member to support the USAID NTD Program budget.

Our afternoon of meetings was very successful, as my team consisted of students from a variety of different backgrounds, each offering a new and unique perspective on the effect that NTDs have on the communities that are affected and how the United States can help. As a future physician, my main argument was that we need to care for all human beings, regardless of where they are from. We have the solution and we need to use it. One student in my group, Beza Teferi, is originally from Ethiopia and has seen and experienced the effects of NTDs herself. Another student, Imani Butler, was able to provide the perspective from a research point of view. Her message was that we have a simple solution to these problems, so why not use them. Malvika Govil, a student from Rice University, discussed how the money allotted has a multiplier effect — for every dollar invested in treatment programs, pharmaceutical companies donate $26 worth of medicine. Finally, Sujay Dewan, from the University of Pennsylvania, delivered the request — an increase of the USAID NTD Program budget to $125 million to ensure that the progress of the last decade continues and control and elimination efforts succeed, so we do not lose ground on the work that we have already accomplished.

Our approach really seemed to resonate in the meetings. Senator Lindsey Graham from South Carolina and Senator Marco Rubio from Florida are both proponents for global health and we received very positive feedback from their staffers. The staffers of Colorado Senator Cory Gardner and Florida Representative Alan Grayson had many questions for us, which really allowed us to explain in depth what NTDs are and how they are affecting the world. We finished our meetings confident that we had made an impact and helped build support for the USAID NTD Program in Congress.

Barbara Bush, CEO and co-founder of the Global Health Corps, captured the central tenet of our advocacy best during her keynote our closing reception: “We are all here because we agree on one thing: health is a human right.” She also emphasized that, “great ideas don’t change the world, great people do,” which is why we need to act on these ideas now. As young leaders in our schools and communities, we have the passion and the voice to do so.

Nicole meets Barbara Bush, CEO and co-founder of Global Health Corps, at the closing reception of the second annual END7 Student Advocacy Day.

Nicole meets Barbara Bush, CEO and co-founder of Global Health Corps, at the closing reception of the second annual END7 Student Advocacy Day.

Nicole Spitzer is a first-year medical student at the University of Central Florida College of Medicine. Learn more about her experience at the END7 Student Advocacy Day in this article.

To Helminth It – Let’s Go to D.C.

The END7 campaign awarded scholarships to three outstanding student leaders to attend the second annual END7 Student Advocacy Day in Washington, D.C. Read scholarship winner Cyrus Ghaznavi’s reflection on his experience in D.C.:

By Cyrus Ghaznavi, Rice University

Nearly a year after the first ever END7 Advocacy Day in April of 2015, I was back on a plane headed nonstop to Reagan National Airport. The second annual Advocacy Day was less than 24 hours away!

Over the past year, Rice University’s chapter of END7 has grown significantly. Our general membership and committees have expanded and awareness of our cause on campus has blossomed. We have hosted trivia nights, fundraisers, Super Smash Bros video game tournaments, petition drives, and much more. Consequently, what once started as a relatively obscure club on campus has now gained significant traction within the Rice community.

Bera office

Cyrus (far right) and his group meet with Representative Ami Bera of California on the second annual END7 Student Advocacy Day.

However, though we have worked extensively to advocate for NTDs “inside the hedges,” the Rice chapter of END7 strongly believes that official policy change is needed to successfully control and eliminate the seven most common NTDs. In fact, our mission states that “END7 at Rice is an organization that strives to raise awareness…for our mission with local and national policymakers.” And so, when I was faced with the question of whether or not to attend the second annual END7 Advocacy Day, it was a no-brainer.

The momentous day was kicked off by Senator Roger Wicker, co-chair of the Senate Caucus on Malaria and NTDs, who had invited the END7 group to morning coffee. After socializing and meeting our morning coffee quota, we took pictures with the Senator, who explained that NTDs are an issue very near and dear to his heart. After coffee, we were welcomed by Dr. Neeraj Mistry, Managing Director of the Global Network for Neglected Tropical Diseases. We were then presented with informative presentations by representatives from the U.S. Agency for International Development, RTI International, and Helen Keller International, before grabbing lunch in our small groups.

Last year, I had the pleasure of working with Kathryn McGrath, who works with END7 as a member of the Global Network staff, as the leader of my small group. Perhaps not coincidentally, she was my group’s leader again, so we immediately had a dynamic and strategy for how to pitch our case to the four House Representatives we would be meeting that day. Working with my teammates Antonia, also from Rice University, and Elaine, from the University of Texas at Dallas, we devised a division of labor as to which points we would each hit in our meetings with staff.

Kathryn started each meeting with a brief introduction to END7, after which Elaine jumped in by sharing some of USAID’s most persuasive statistics. One of every six people globally suffers from one of the seven most common NTDs. For every $1 invested into the program, $26 worth of donated pharmaceuticals are leveraged. For a mere $0.50, an at-risk individual can be treated and protected from the seven most common NTDs for a year. So far, 1.4 billion treatments have been distributed to almost 700 million individuals. Antonia would then shift gears and relay some of the more human, emotional aspects of the program and NTDs. She mentioned that children miss school and parents miss work when infected, reinforcing the cycle of poverty. She went over some of the disfiguring and debilitating symptoms of these seven diseases, and wrapped up by talking about the stigma associated with them. At this point, I pounced by synthesizing what those before me had mentioned. I asked if the Representative would support increasing USAID NTD funding by 25 percent instead of allowing it to be cut by 13.5 percent. Additionally, I implored the staffers to encourage their Representatives to join the Congressional Caucus on Malaria and NTDs, if they were not members already. “This is not the time to lose momentum – USAID funding is critical during this watershed time,” we would conclude.

We had four successful meetings with Representative staffers, and even got to meet one of the Representatives in person: Rep. Ami Bera (D-CA), with whom we briefly chatted and took some pictures! He was a very unique case, given that he has an M.D. and can thus see NTDs from both a medical and political standpoint. As a pre-medical student studying both biology and policy, I felt that my interaction with Rep. Bera was particularly meaningful – especially since my group also visited his office during the 2015 END7 Student Advocacy Day!

At the end of the day, we all attended a reception where Barbara Bush, CEO and co-founder of Global Health Corps, and Peter Hotez, president of the Sabin Vaccine Institute, spoke to the END7 advocates. Ms. Bush’s speech was truly moving and inspiring, urging us to global health action. Dr. Hotez recounted the beginnings of END7 and the USAID campaign, putting all of our advocacy into a unique, historical context.

And before I knew it, the day was over. As a group of nearly 50 students and leaders, we had spoken to almost 40 congressmen/women or their staff. Our pitches were not partisan, nor were they communicated out of self-interest: we were all passionate voices in the realm of NTDs, and we were all thrilled to be in the Capital.

Speaking for Rice, I cannot express how proud I am of the growth and commitment I have seen in just one year’s time. Last year, three students, including myself, attended this trip. This year, we had almost 20, comprising the large plurality of the advocates who attended (even compared to the schools in Washington)! I can only imagine how much more growth we will see in the coming years. Here’s to counting down to next year’s advocacy day!

Barbara Bush with student advocates from Rice University at the END7 Student Advocacy Day closing reception.

Barbara Bush with student advocates from Rice University at the END7 Student Advocacy Day closing reception.

Cyrus Ghaznavi is a junior at Rice University studying Biological Sciences & Policy Studies. He represents Rice on the END7 Campus Leaders Council and participated in the END7 Student Advocacy Day in 2015 and 2016.

END7 Student Leaders Speak Out on Capitol Hill for NTDs

Student Leaders on Capitol Hill

END7 student leaders on Capitol Hill

On March 1, student leaders gathered in Washington, D.C., for the second annual END7 Student Advocacy Day. The event brought together 40 students active in END7 programs, from 15 colleges and universities across the country for 39 meetings with Members of Congress and their staff.

The students traveled to our nation’s capital on planes, trains and buses from as far as Texas and Florida to urge their elected officials to maintain U.S. leadership in the fight against neglected tropical diseases by protecting and increasing the budget for the USAID NTD Program.

They met with congressional offices to discuss the devastating impact of NTDs and how USAID has successfully led global progress against these diseases for a decade. After briefing Congressional staff, students answered questions and requested an increase of the USAID NTD Program budget to $125 million. One student participant, medical student of the University of Central Florida, described her group’s approach:

“As a future physician, my main argument was that we need to care for all human beings, regardless of where they are from.  We have the solution and we need to use it. One student in my group, Beza Teferi, is originally from Ethiopia and has seen and experienced the effects of NTDs herself.  Another student, Imani Butler, was able to provide the perspective from a research point of view.  Her message was that we have a simple solution to these problems, so why not use them.”

Malvika Govil, a student from Rice University, discussed how the money allotted has a multiplier effect – for every dollar invested in treatment programs, pharmaceutical companies donate $26 worth of medicine. Finally, Sujay Dewan, from the University of Pennsylvania, delivered the request — an increase of the USAID NTD Program budget to $125 million to ensure that the last decade of progress continues and control and elimination efforts succeed.

END7 students are passionate advocates for the USAID NTD Program. The largest public-private partnership in USAID history, the NTD Program has leveraged more than $11.1 billion in donated drugs over the past decade. Yet, despite the clear impact of NTDs on health and development and the proven cost-effectiveness of treatment, President Obama’s FY 2017 budget proposal only allocated $86.5 million USAID NTD Program – a 13.5 percent cut in funding from the previous three years’ enacted level of $100 million.

Before their busy afternoon of meetings, students participated in a morning coffee with Senator Roger Wicker (R-MS), co-chair of the Senate’s Malaria and NTD Caucus, and received a briefing in the Capitol from USAID, RTI International and Helen Keller International. Students then fanned out across Capitol Hill to meet with, in many cases, their own U.S. Senators or House members. The students were well received and numerous offices expressed an interest in supporting the NTD Program’s funding.

Spitzer reported that her group received positive feedback from Senator Lindsey Graham’s and Senator Marco Rubio’s staff and several offices asked for additional information and indicated they would oppose a proposed cut in funding to the USAID NTD Program.

At the end of the day, the students gathered for a closing reception with Barbara Bush, co-founder and CEO of Global Health Corps. Bush spoke movingly of her commitment to global health and developing the next generation of global health leaders.

Bush said, “It is critical that you continue to advocate and work for change by meeting with your representatives in Congress and amplifying your voice and the voices of other END7 supporters through petitions and op-eds. We have so much at our disposal to achieve great things, and we also have the possibility to reimagine leadership that can accomplish even more, including eliminating NTDs. This is exciting, even if it is a bit daunting. But I know, beyond a doubt, that we are up for the task.”

Neeraj Mistry, managing director of the Global Network, and Peter Hotez, president of the Sabin Vaccine Institute, also shared remarks thanking students for their advocacy and urging them to continue the fight against NTDs.

Tayler McCord, a senior and secretary of END7 at Michigan State University, reflected:

“Attending Student Advocacy Day made me even more determined to help change the outlook for those affected by these debilitating diseases. This event not only allowed me to participate directly in this crucial political process but has also inspired me to continue to make my voice heard to our nation’s lawmakers. I am excited to share this passion with my peers at Michigan State and with members of our END7 chapter on campus. I hope to inspire and encourage others to participate in advocacy for NTD treatment to help make a positive difference in the lives of millions of people.”

We are so proud of our student advocates for delivering a powerful message on Capitol  Hill.

Barbara Bush Addresses END7 Student Leaders

Barbara Bush,  CEO and co-founder of Global Health Corps, addressed END7 student leaders on March 1, 2016 at the closing reception of the second annual END7 Student Advocacy Day.

Barbara Bush

Barbara Bush, CEO and co-founder of Global Health Corps

I am so thrilled to be here with y’all at the Global Network for Neglected Tropical Diseases’ Second Annual END7 Student Advocacy Day. I’m Barbara Bush and I’m the CEO & co-Founder of Global Health Corps. I am honored to be here with you today to celebrate the 10th anniversary of the USAID NTD program, a unique public-private partnership that has successfully leveraged more than 11.1 billion worth of donated drugs and supported the distribution of 1.4 billion safe and effective NTD treatments to more than 687 million people throughout Africa, Asia and Latin America.

It seems oddly fitting and very humbling that I am with you today to celebrate this program that my father launched a decade ago as he was the catalyst for my involvement with global health, an interest that was born rather unexpectedly. In 2003, as a 21-year-old architecture major, I was lucky enough to take 2 weeks off of my fancy Summer internship designing beautiful buildings and clothing in NYC, to be on the ground for the launch of PEPFAR—the President’s Emergency Plan for AIDS relief–in five countries in East and Central Africa, and witnessed first-hand the roadblocks so many people face in obtaining appropriate healthcare to lead happy, prosperous lives.

It was a harrowing image–seeing hundreds of people lining the street waiting for life-saving medicine that had been readily available in the U.S for years. I vividly remember standing with my mother next to a tiny precious girl and her mother. The little girl was lying down dressed in her fanciest white and lavender dress. I didn’t know the details of that child’s life, only that she was too sick to stand, and though she looked like she was 3, she was probably 7. Her mother dressed her up and brought her to the launch, though she probably didn’t live much longer. People’s lives, like that little girl’s, were limited and cut short, simply because of factors beyond all of our control – like where and when we are born.

Yet, these heartbreaking memories were set against inspiring memories, memories of witnessing the commitment health workers, family members, and community members had made to change this unacceptable status quo.

Following that trip, I became obsessed with working on global health issues. And, quickly realized that I was only one of hundreds of thousands of people in my generation eager to fight to make health a human right; a fact demonstrated by the tremendous growth of global health programs on US college campuses, as well as by the engaged minds sitting here this evening.

Global Health Corps is building the next generation of global health leaders who share a common belief: health is a human right. At Global Health Corps, we are motivated by the conviction that great ideas don’t change the world, great people do.

However, our belief that health is a human right is not reflected in today’s reality – millions’ potentials and futures are undermined simply because they do not have access to the healthcare that they deserve. This is a truth y’all know too well as more than 1 billion people are at risk of NTDs’ debilitating effects, despite the fact that they are easily prevented through cost-effective interventions. This inequity of healthcare access persists in developing countries just as it does here in the United States; as it does in this very city.

Yet, right now is an incredible time to be working in global health (and alive, for that matter), we have vaccines that prevent childhood diseases that just a generation – or even half a generation – ago were fatal. In 2016, we actually have the technology, medicines, and interventions to not only save lives, but ensure people everywhere thrive – living healthier, more joyful, and more connected days. In many ways, life today is better than it has ever been. And, yet, millions die from preventable, treatable illnesses such as NTDs. Health systems are weak and we need new leaders to fix them.

The complexity and scope of today’s Global Health problems require people with diverse experiences, including an array of hard skills which are not clinical but still profoundly critical in the health care setting: operations, project management, engineering, communications, and architecture to name a few.

We believe that most powerful lever of change in global health is leadership: exceptional, talented problem solvers who can inspire and collaborate with others, and really move the needle in a new way. Getting the right talent in the right positions in the health system.

In 2009, five other twentysomethings and I founded Global Health Corps, a leadership development institute, to harness the passion, energy, and skill-sets of our generation to confront the world’s massive global health challenges.

Since then, we have been growing the movement for health equity, with many bumps and victories along the way. Six years ago, GHC had two staff members, including myself, and 22 inaugural fellows who took a chance on us. Today our team is ten times that size and our global community of fellows and alumni is nearly 600 strong.

These 600 young leaders have been placed at high-impact organizations in Rwanda, Malawi, Uganda, Burundi, Zambia, and the United States for a year-long fellowship. We partner with organizations on the front lines of health equity, across issue areas including NTDs and WASH and ranging from large international organizations such as Partners In Health to government agencies such as Ministries of Health to small grassroots non-profits such as Nyaka AIDS Project in Uganda. Our partners identify capacity gaps that they have and then we competitively recruit two young leaders, between the ages of 21 and 30, to serve with them for a year to address those needs. In this way, we are seeding the global health field with new talent and fresh ways of thinking and responding to real-time, demand driven needs in the global health field. Our fellows always serve in teams of two—one fellow from the country where they work, partnered with an international fellow—making this a truly global group of young leaders. Throughout the fellowship year, we invest heavily in training, coaching, and mentoring our fellows, ensuring they understand policy-making, advocacy, and intra-and entrepreneurship because we know their year with Global Health Corps is just the launching point for a career as a changemaker in global health.

Our fellows embody a vision of leadership we’ve crafted over the years based on the evolving needs of the global health field. It’s 2015. Post-Ebola crisis, post-Millennium Development Goals, at the dawn of the Sustainable Development Goal era, with Africa rising, we strongly believe that to see the progress we need to see – and to ensure access to healthcare for all – we need a change. We need a cadre of leaders placed in the right gaps in the health system to move us forward. It’s an exciting moment.

But we aren’t focusing on building any leader. In our view, a leader possesses several key qualities: Compassion. Vulnerability. Resilience. Collaboration. Creativity. Commitment to social justice. Business acumen. These qualities have not been automatically linked to leadership in the past – especially traits like vulnerability, compassion, and resiliency.

This past June, we welcomed our 7th class of 134 fellows who are serving at 62 organizations. And quick side note that three-quarters of this year’s class are brilliant, inspiring women. This year we received more than 14,000 applications for 168 positions in our 2016-2017 fellowship class. We will accept less than 3% of these applicants. In short, our fellows are exceptional. From counselling homeless youth on chronic disease management in Newark, New Jersey, to building an electronic medical records system in Malawi, to screening and treating cervical cancer in Zambia, our fellows are positively affecting the health of thousands of people around the world. GHC fellows represent the powerful notion that young people can make an impact in the field of global health now, while gaining necessary skills to be leaders throughout their lives.

You might be wondering what the next generation of global health leaders looks like. Well, they are pretty diverse. They are writers, architects, economists, healthcare practitioners. They have founded organizations, completed other prestigious fellowships, won African Grammies, and given TED talks. You may know some of them – you may one day be some of them.

One of the biggest obstacles to this goal is that a lot of people who want to make a difference in this field are under the impression that they can’t.  They think that only people with medical training—doctors and nurses—can help the sick and suffering.  So part of our work is education—showing people that this simply isn’t true.

The complexity and scope of today’s problems require people with diverse experiences, from a wide range of fields beyond medicine. Finding innovative, sustainable solutions demands skills ranging from education and psychology … to supply-chain management …to computer programming … to engineering and beyond. I’m sure some of these skills can be found right here in this room.

Global Health Corps is working to change this perception. Ameet Salvi, who studied engineering at UC Berkeley and went on to work for the GAP in supply-chain management. After three years in retail, he began looking for a way to use his skills to make a difference in the lives of others. He heard about Global Health Corps, applied, and was accepted as one of our 22 inaugural fellows.

Only weeks after leaving his job, Ameet moved to Tanzania.  His task was to do for the 1 million people living on the island of Zanzibar exactly what he did for GAP.  But instead of working to get jeans into stores, Ameet used his skills to get life-saving medicines to health clinics—and into the hands of the patients who needed them most. Today, Ameet works as the Supply Chain Manager for Partners In Health in Sierra Leone, where he moved when the Ebola crisis hit West Africa. Ameet represents the powerful notion that bright and motivated young people can make a profound and immediate impact working in the field of global health and build skills to become new leaders in the industry.

Our fellows look like Jasmine Burton who is currently serving as a Design Specialist with Population Services International in Zambia. As a product designer, Jasmine wrestled with how products could be designed and created to solve health issues. These questions led her to discover her unique passion for toilets. In 2014, she won the Georgia Tech InVenture Prize competition for her design of an inexpensive mobile toilet. As founder of Wish For WASH, Jasmine strives to bring innovative solutions to the sanitation crisis; a crisis that impacts the spread and prevention of NTDs. Jasmine’s skills as a product designer were turned into life-changing superpowers when paired with her creativity & belief in health equity.

Our fellows also look like Regina Yang and Amelie Ntigulirwa, architects from the United States and Rwanda. These women served their fellowship year with MASS Design Group using their backgrounds in architecture and design to make small and inexpensive changes in the way that air flows throughout health centers so airborne illnesses like TB, which affects a 1/3 of Rwanda’s population, don’t spread to everyone that enters the hospital. Excitingly, the Ministry of Health was so impressed by the drop in TB incidences and the improvement in health outcomes due to these design tweaks that airflow is now a factor in all new health facilities built throughout the country. Both Regina and Amelie remained at MASS Design after their fellowship and are still currently working there, alongside the new generation of GHC fellows. Amelie and Marie are making an impact in the health field now and wherever their careers take them, they will be champions of the global-health cause for the rest of their lives. But we need to recruit many more people like them. As we recruit more people like them to join the global health field, the possibilities for innovative and creative solutions grows exponentially and that is inspiring. And the talented people we have working to solve these challenges, the more lives we can save.

In 20 years, we will see a dramatic improvement in health systems, in terms of quality and affordability of care. This will be the result of an infusion of radical new leadership, a group of leaders that Global Health Corps is working to build. In 10-15 years, young leaders like Sarah Snidal, currently at CHAI with its Global Vaccines Delivery team where she focuses on identifying and mitigating systematic bottlenecks and sharing best practices across regions and stakeholders, will be the Director of the World Health Organizations overseeing that NTDs no longer needlessly rob people of their health and lives. And Marie Amelie, the Rwandan architect at MASS Design Group, will be the Minister of Finance in Rwanda, funding smart clinic designs that stem disease spread. And Estefania Palomino, a Colombian human rights lawyer working on reproductive health in the US, will be the UN High Commissioner on Human Rights ensuring that health as a human right is realized in every way.  And All this while Ameet Salvi, who’s been working on the frontlines of the Ebola crisis will be running Partners in Health. And finally, James Arianaitwe will be Uganda’s Minister of Health, revitalizing infrastructure and empowering frontline workers. These and many other impressive individuals are becoming empowered to advocate and fight for change.

This community of young leaders inspires and energizes me. Knowing that I’m standing in front of a community of equally engaged, thoughtful, and committed individuals eager to improve lives worldwide also inspires me. It is critical that you continue to advocate and work for change by meeting with your representatives in Congress and amplifying your voice and the voices of other END7 supporters through petitions and op-eds.  We have so much at our disposal to achieve great things, and we also have the possibility to reimagine leadership that can accomplish even more, including eliminating NTDs. This is exciting, even if it is a bit daunting. But I know, beyond a doubt, that we are up for the task. Thank you.