You have the refugee crisis triggered by Syria. That's got a lot of costs associated with it. Domestically, budgets are incredibly tight because the economy's not generating the growth that makes for easy trade-offs.
Bill GatesPresident [George] Bush made the U.S. absolutely the leader, between its own PEPFAR, and it's been by far the biggest Global Fund donor. That's a legacy.
Bill GatesPrograms today get very fat; the enhancements tend to slow the program down because people put in special checks. When they want to add some feature, theyโll just stick in these checks without thinking about how they might slow the thing down.
Bill Gates