It is such an honor and privilege to be with you and your delegations again, to continue our discussions around promoting access to health care for the migrant population in the Mekong region.

After a very successful meeting in Mandalay at the end of March, we now have a critical mass of champions who are highly committed to moving the agenda on migrant health care further along, in whichever way we can, with whatever resources we can muster, the key operative word being partnership. Partnership between health, labor and social security, partnership between public and private sector, between government and civil society, and between the countries, to develop shared solutions to a common and complex health area. Also, partnership among development partners; we have a large group of external agencies who have come together to demonstrate our friendship and support for the cause. This meeting is a joint effort between IHPP Foundation, USAID, UNDP and the Bill and Melinda Gates Foundation.

We have now gained the attention of ASEAN, thanks to our friends at the Senior Official Meeting earlier this month, and I hope we’ll hear a read-out of the discussions there. It touched my heart that the Mekong now leads the way across South-east Asia on this issue, demonstrating solidarity and sharing ideas on what needs to be done and how it can be done. All very truly inspiring.

Just to give an overview of why USAID is involved, the main reason is because we value human rights, including the right to health. Plus the right to migrate. And the United States does have a lot to share, from our own struggles with our domestic situation. As I mentioned in the first meeting, our country was built by migrant labor. And we continue to thrive on migrant labor. In 1962, during the Kennedy Administration, the Migrant Health Care Act was established to fund health and related support services for migrant and seasonal farmworkers and their families. Two years later, federal funds were appropriated and in 1965, the first Migrant Health Centers were established. Now we have migrant health centers in all 50 states, through 150 networks that operate over 700 satellite centers.

In California alone, there are over 300 such centers. One of the enduring principles of the program is to empower patients and communities in the operation and direction of health centers. In the last meeting we discussed the need for “migrant-friendly health services”; this meeting we should discuss how to get their input and how to involve them in developing services and service delivery systems. The Migrant Health Care Legislation Act in the US requires that 51 percent of the majority on the governing board is represented by consumers of the services.

Some factoids to share about migrant farm workers in the United States: 7 out of 10 are from Mexico, which means across the border, similar to what we have in the Mekong region. One out of three cannot speak English, pointing out the need to be sensitive to language and cultural barriers. Globally, migrant labor fuels multi-billion dollar industries including garments, manufacturing, agricultural, poultry and fishing, hotel and service industry. One could question how much they enjoy its rewards. The World Bank estimates that international migrants from developing countries will send over $500 billion in remittances to their home countries this year, far exceeding official development assistance flows.

In 2013, remittances in Southeast Asia increased by 4.8 percent to reach $112 billion, with vigorous growth in Thailand, Vietnam, and the Philippines. With free mobility of highly skilled workers across the Association of Southeast Asian Nations (ASEAN) countries in 2015, remittance flows may exceed $148 billion by 2016. Their contribution to the economies of both sending and receiving countries are significant, now is the time to discuss how to invest in their basic needs and advance their human rights. And in doing so, we need to figure out how to mobilize the contribution from their employers and industry partners.

My dear colleagues, the next few days provide incredible opportunities for us to discuss more deeply how to make the Mandalay Statement become real. USAID is not here to impose any particular agenda, we are here to learn from you and take your guidance on how we can partner in this important area. We value your engagement and ideas. Collectively, together with the other development partners around the table, we are a formidable force with tremendous energy and incredible creativity.

Major thanks go to our friends from the International Health Policy Program for bringing us together, especially the team who worked day and night on the logistical arrangements. In closing, I share a quote from the book called “The Human Cost of Food: Farmworkers’ Lives, Labor and Advocacy” by two anthropologists, Charles Thompson and Melinda Wiggins. "The hands that feed us are often invisible hands, hands of people who work in the shadows of a multi-billion dollar industry without enjoying its rewards."

Let’s come together for the people who harvest our food; who build these skyscrapers, who assemble our laptops, our cars; whose labor we benefit from every day. Let’s try to understand their sense of identity, their challenges, their pride and culture. And turn the page for their health care, with acceptance, gratitude and social change.

I wish you all a wonderful, productive two and a half days, thank you very much for your contribution.