ROBERT MCMAHON: Well, good afternoon everyone and welcome to this Council on Foreign Relations media conference call. The subject is President Bush's upcoming trip to Africa.
I'm Robert McMahon, the deputy editor of cfr.org. And we are very fortunate to be joined by two Council experts: Laurie Garrett, the Council's senior fellow for Global Health. She's a Pulitzer Prize winner and author of a Council report on HIV and National Security, and is writing a book examining the global impact of infectious disease; and also Tony Holmes, who's the Council's Cyrus Vance fellow in Diplomatic Studies on Africa, and he is a long time veteran with 28 years in the U.S. Foreign Service at the State Department, including in that a number of embassy posts in Africa.
So I will begin with a short discussion with both of them before opening up to questions from those on conference call. And I guess I'll kick it off with Tony on the -- an overview question which is, the trip involves five African nations -- Benin, Tanzania, Rwanda, Ghana and Liberia. Can you start out by saying -- by examining those choices, and why they're significant, or not?
J. ANTHONY HOLMES: Well, I think -- I think they're very interesting choices. And there's quite a contrast with the much larger countries that the president -- the president focused on -- or visited during his July 2003 trip, with South Africa and Nigeria in particular.
But it looks like the administration wants to focus on a number of relative success stories -- countries that have been working hard to resolve their internal problems, to overcome corruption and governance issues, to institutionalize democracy, to liberalize their economies; and countries that -- with a couple of exceptions in the past, one doesn't read about much, particularly in the United States.
So, I mean, while Liberia came out of a dictatorship and, you know, installed the continent's first female president just a couple of years ago; and Rwanda, of course, had the genocide in 1994; Benin and Tanzania and Ghana are relative success stories that has been just plugging away below the headlines, and below the horizon for 15 or 20 years.
MCMAHON: Now, one of the features will be the -- one of the featured items on his visits will be Millennium Challenge Account programs in some of these nations. But this is also a program that he continues to battle with Congress every year on. And this year again Congress is signaling a challenge for this program. It's been under-funded recently.
What are the stakes for this -- are there high stakes for this program? Does this trip need to show, really, demonstrative progress to help press his case with Congress?
HOLMES: Well, three of the five countries have concluded negotiations and entered into compacts with the United States. In fact, the highlight of the Tanzania stop will be the signing of the largest Millennium Challenge Corporation grant to date -- almost $700 million. In Benin and in Ghana the programs were concluded in 2006 and signed then. They are starting fairly slowly. I mean, they're -- all of these programs are focused on infrastructure and they take a while to get off the ground.
But, clearly, the Millennium Challenge Corporation, along with PEPFAR -- the President's Emergency Program for AIDS Relief that Laurie will talk about extensively in a few minutes -- are signature initiatives by this president. And both of them are focused on Africa, while they're global programs. Twelve of the 15 PEPFAR countries are African, and slightly over half of the agreements we signed -- or the Millennium Challenge Corporation he's signed have been with African countries. And, again, maybe 55 percent or so of the funding has been devoted to African countries.
So it's very clear that the president wants to highlight his signature initiatives, attract attention, and to do the best he can to institutionalize them. The Millennium Challenge Corporation, for example, is a little bit controversial. There are some questions as to whether a new administration, particularly if it's Democratic, will keep MCC the way it is, or whether there will be an inclination to fold it into a more unified U.S. government foreign assistance program that would come about as a result of some across-the-board reforms, given the decline in our assistance and the fragmentation of it.
But the government -- the Bush administration sees MCC as quite a success and definitely wants to highlight it.
MCMAHON: Now, Tony one more for you. The trip is threatened to be overshadowed by some really major crises along its fringes, say, in Kenya, for example, or in the Congo region of Kivu. How much, how much is there a danger that this is -- these crises will keep cropping up on every stop the president makes?
HOLMES: Well, I think there will be questions, legitimate questions about what the U.S. is doing; what his positions are; and -- well, not only in Kenya, which is the one closest by, but in Sudan, along the Chad-Sudan border; what's happening in Zimbabwe, and our frustrations and failures there for the entire decade. You mentioned Eastern Congo -- that, actually, has taken a favorable turn in the past couple of weeks; and Somalia in the Horn of Africa is very problematic.
There's no question that there are real challenges and issues out there in Africa, particularly in terms of conflict prevention, and peacekeeping, as well as sort of longer-term, more general challenges of democracy and human rights progress, and economic developments progress, as well as global health.
But, I mean, clearly the desire of the White House is to have a positive focus, to -- I mean, it seems to me that the focus of this trip is legacy, legacy, legacy. They really want to highlight and enshrine what the president has accomplished. And, you know, as well as to get some political points.
The United States is more popular in Africa than any place else in the world, and this trip builds on that positive U.S. image there. You know, the highlighting of the smaller success stories is important and -- you know, so is showing the flag. I mean, showing the American flag in Africa; showing the domestic U.S. constituencies that the U.S. is engaged in helping Africa; and, frankly, to show the rest of the world that the U.S. hasn't forgotten about Africa.
MCMAHON: So, Laurie, as Tony and others have described the trip, it's some sort of a victory lap, I guess, for the president then, in a part of the world which he actually can boast of some serious achievements, especially in the health care realm. But could you put into context what has been accomplished by the administration in the AIDS, and other programs -- health programs in Africa, and what's, what's facing -- you know, what now occurs in the rundown of this administration?
LAURIE GARRETT: I don't think there's any doubt whatsoever that when history books get written the President's Emergency Plan for AIDS Relief, and his commitment to fighting malaria and other key infectious diseases will go down as the major positive legacy of his eight years in office.
And it's been a sort of legacy that built on a series of surprises. If I can take people back in time to the first year of the administration, there was any amount of surprise all over the world when the Treasury secretary -- Paul O'Neill at the time, went to Africa with rock star Bono, where he had a sort of epiphany and announced that he felt that repairing the water systems, and building safe water supplies across the continent was not only a doable goal but probably the single most important intervention that could be done on behalf of the people of Africa.
And we saw a whole series of things billed from that moment, one after another. The big surprise to the entire nation -- and, frankly, to most people in the U.S. government was the president's State of the Union address of January, 2003 when he announced his goal of putting billions of dollars into the fight against HIV/AIDS.
And he initially called for $15 billion over five years. It's ended up being more than $18 billion. Most of it new money -- in the first year or so there was some shifting of old money, from other boxes, into the PEPFAR box but, nevertheless, it's been a fantastic investment, unparalleled in human history by any calibration of currencies from any society ever.
We've just never seen this scale of commitment to global health or to the health of other peoples other than yourselves -- you own nation, your own nationality, at any time. And I think it will, indeed, go down as the positive side of the legacy chart of George Bush.
But I think it's interesting, if that is really the thing he wants to underscore on this trip, that they've selected countries as they have, in the sense that only two of the five countries will -- that the president will be visiting are, in fact, PEPFAR countries, and none of them have particularly high HIV/AIDS rates compared to what we see in many other countries on the African continent. None of them have prevalences above 10 percent of their adult populations, and most of them are below 5 percent. Only Tanzania really has a significant HIV/AIDS problem. And interestingly, it's one of the oldest epidemics of the disease on the planet -- Uganda and Tanzania.
It would have been interesting if they had visited one of the really desperately affected countries, such as Botswana, Malawi, Lesotho, South Africa, Swaziland, Zimbabwe, Zambia, or even Kenya -- countries with much higher prevalences of HIV/AIDS, but that was not what the president chose to do.
On the malaria front, there has been a real shift in the battle against malaria over the last 5 years -- a dramatic shift, not just by the Americans, but across the board. Some major scientific changes, in how the strategic plan of limiting the numbers of people afflicted by malaria and preventing infections, has been formulated and executed -- massive levels of cooperation unprecedented on a global scale, involving World Health Organization; UNICEF; a whole host of governments; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and, of course, the President's Malaria Initiative. Combined, we have seen some really dramatic turnarounds in what had looked like a really intractable, terrible problem, and that's very exciting.
Missing entirely, really, on the agenda are the other longer-term health crises that have proven more stubborn and more difficult to deal with. All the countries that the president is going to visit are ones with very high maternal mortality rates -- the risk of dying in childbirth being among the highest in the world. There are also countries with extraordinary infant mortality rates, and child mortality rates, due to all causes. And they are almost all countries where the percentage of the national gross domestic product spent on health remains stubbornly low.
MCMAHON: So, Laurie, the -- looking at the next president, and whatever -- whoever ends up emerging next year, do they assume, in Africa, in policy -- we haven't heard a lot about Africa on the campaign trail, needless to say, but do they step into an Africa policy that's in sound shape, or are there certain battles ahead that they're -- that they're going to, you know, be caught up in the middle of, do you think?
GARRETT: Well, we have an interesting situation ahead of here in the United States -- that non-Americans may have some vague sense of, but the details of which may escape them, and that is that we are looking at an enormous fight on our Fiscal Year 2009 budget. The White House has sent over their final budget, the last one of the Bush administration, to Congress just about a week and a half ago, and Congress is unlikely, I would say -- beyond unlikely, absolutely will not -- (laughs) -- accept that budget.
There are many, many, many things about the budget that the Democrats oppose. And since the Democratic Party controls both the House and Senate this is going to be a big battle. And for the first time in recent American history -- in fact, I've been trying to find a time, ever, in American history, but maybe one of the reporters on the line will find me wrong on this but we have never really had a situation where two senators were the prime candidates -- one from each party, both seated senators, who would vote in this budget fight. And whether it's Obama or Clinton, the Democrat candidate will be a seated senator, an active senator.
And it looks like John McCain will be the candidate for the Republican Party. He too is active senator. So as this budget fight progresses towards September, we will likely see the parties polarized deeply and rally around their candidate, in terms of deciding where to take the U.S. budget fight. It could get very, very ugly.
So at stake in the middle of all this squabble is the future of PEPFAR. The authorization of PEPFAR was for five years, so the funding, technically, runs out on September 30th, 2008. And a new budget needs to go into effect in our fiscal year October 1st, 2008.
We could very well see this turn into a bloodbath in political terms. The Democrats are favoring a PEPFAR reauthorization on a scale of $50-plus billion, plus a greater focus on tuberculosis than has been the case, and some real significant changes in the PEPFAR language -- the actual guidance, if you will, that's provided to the State Department for implementation of PEPFAR programs.
And, in contrast, the White House is requesting $30 billion -- not a small difference -- (laughs) -- and, of course, wants the language that has guided PEPFAR, for the first five years, to remain intact for the next five years. It's very possible that we could see the whole budget fight -- for a host of reasons, including the Iraq war budget, drag out, leaving us without a set budget until after, in fact, in November, one of the who candidates triumphs and we know who the next president of the United States is going to be.
MCMAHON: That's very interesting.
HOLMES: Robert, I think, though, that -- I mean, what Laurie's just described, in terms of a battle over PEPFAR financing is really an anomaly. I mean, I think that throughout the rest of the budget, particularly the foreign -- foreign affairs, foreign aid budgets, it's going to be a question of stopping the bleeding and, you know, providing minimally-adequate funding for things that should be fairly high priorities, things for which there's a lot of rhetorical support but get chewed up in domestically-focused election year -- and, you know, during which balancing the budget is certainly going to be a major Republican theme, and one that the Democrats have to play at least some defense on.
GARRETT: Well, I would just add to that that there are other areas that will be fought over, that will directly affect Africa. The president's -- the White House proposal for malaria funding is significantly below the figures that the Democrats favor. The White House slashes support for maternal and child survival programs, and, of course, for reproductive health programs. The Democrats in both the House and Senate want both of the -- all those to be increased over previous years.
And I think even on the reproductive health issue, in particular, we're going to see some real battle lines drawn as the Democrats are feeling that, finally, after -- well, since the Reagan years, it may be possible to have a conversation about family planning again, as part -- as a feature of U.S. foreign policy. So I think that, at least in the global health context, there are many, many pieces of the battlefield to be fought out.
MCMAHON: Okay, so we have some very broad and -- as well as specific context here for this trip.
Thank you, Tony Holmes and Laurie Garrett.
I'd like to open it up now to people who've been listening patiently.
Operator, can you please go ahead and open it up for questions.
OPERATOR: Yes, sir. At this time we will open the floor for questions. If you would like to ask a question, please press the star key followed by the 1 key on your touchtone phone now. Questions will be taken in the order they are received.
Okay, our first question comes from Nora Trevarrian (sp), from CBC.
QUESTIONER: Yeah, hi. It's Nora Trevarrian (sp) from the BBC. I apologize for line. I missed the top of that, so apologies if you've gone over this. But my question was, how much do you think AFRICOM is going to be discussed on this trip? And what is the latest on the progress of that initiative?
HOLMES: Okay, this is Tony Holmes. In fact, the word AFRICOM -- you're the first one to raise it since we began 20 minutes ago (laughs). I don't think it's going to be a big issue. It doesn't seem to be featuring as a highlight, or a focus of the trip, for the U.S. government.
And while Condoleezza Rice will be along -- and I presume Jendayi Frazer, the assistant secretary for Africa, and it is clearly an issue in discussion about which there is virtually no agreement within Africa, much less between Africa and the United States, it will likely be discussed privately.
But the U.S. has taken its foot off the accelerator, I would say, in terms of moving forward in placing an AFRICOM permanent presence on the continent. I think the focus now is on internal reorganization, getting the component parts of AFRICOM all together in the same place -- which, you know, is huge because they're coming from three very disparate places, in terms of Tampa, Florida, and Stuttgart and Honolulu.
But there are lots of concerns in Africa. I don't believe that any of the five countries on the itinerary are adamantly opposed to it. I haven't noticed --
QUESTIONER: Liberia's in favor.
HOLMES: Right. Yes.
QUESTIONER: Liberia offered itself as a base.
HOLMES: Right. I mean -- yeah, Ellen Johnson Sirleaf, the president of Liberia, has a very strong interest in trying to attract the headquarters there. The U.S. government is -- I mean, it has clearly noted that. I think there's support for that in some quarters within the U.S. government.
But, at the same time I think the likelihood of a decision has been set back. It's now, you know, cautiously waiting and seeing, discussing, trying to address concerns, making sure that there is a good understanding of what Africa is all about and what the implications are before any decision will be made that, you know, that could well precipitate strong opposition from one or more African countries and, god forbid, the African Union representing all of them.
MCMAHON: Thank you for the question.
Operator, is there another question?
OPERATOR: Our next question comes from Missy Daniel at Religion and Ethics News.
QUESTIONER: Hi. Missy Daniel, from PBS in Washington, Religion and Ethics Newsweekly. Do we know at all if, in any of these five countries, any of his agenda is going to include anything with faith-based initiatives -- either on the disease front, the human rights front? Will he meet with any leaders? Visit any programs?
For instance, Rick Warren, the big mega-pastor in California has considerable stuff going on on the ground in Rwanda for HIV/AIDS. Do we know if this is part of the itinerary or the agenda? The evangelical interest in many of these causes is a big part of the base, and have driven the president's interest in a lot of these subjects.
And do we know who's going with him? Will there be any -- should we expect to see a Bono, or religious leaders, or any other big names?
GARRETT: I'll tackle that. We haven't yet had released -- and you should ask the State Department about this when they hold their Press conference, a detailed list of exactly who the president is going to meet with in every single country, and who may be his invited guests -- outside of the Press Corps, traveling with him.
It would be hard to look at PEPFAR in Rwanda without looking at faith-based groups. It has had such a heavy emphasis on faith-based initiatives, not just Rick Warren, but a wide range of such efforts. And, frankly, in Tanzania and Liberia I think there have been a fair number of faith-based initiatives as well. Whether the president will actually visit any one of them in particular I personally don't know, and I don't know that they've released that list yet.
QUESTIONER: Thank you.
HOLMES: Yeah, I mean, that's definitely a question to ask Steve Hadley at the NSC briefing tomorrow afternoon.
MCMAHON: Thank you for the question.
Operator, is there another question?
OPERATOR: Our next question comes from Cheryl Stolberg at New York Times.
QUESTIONER: Hi, thank you. I guess I have two questions. The first is, when the president went to Africa in 2003 he -- there was a similar trip, he talked about, you know, the United States not forgetting Africa, of us being committed to Africa, and to show that we're a compassionate nation, et cetera. So I guess I'm wondering, five years later, has he lived up to his promises that he made at that time?
And then secondly, you talked a little bit about the budget, and I'm wondering if you could just say has he put his money where his mouth is?
HOLMES: (Laughs.) Okay, I'll start out, and then if you wanted to say anything, Laurie, please jump in afterwards.
I think that the signature initiatives, the Millennium Challenge -- all three of them, MCC, PEPFAR and the Malaria Initiative demonstrate, in the context of a level of U.S. assistance to Africa that has more than doubled during the past seven years, that, yes, he has lived up to his commitment. He has shown a level of compassion. He has put his money where his mouth is in those stovepipes.
I think, more broadly, however, that there is much more that the United States government could do, both itself and in concert with both the multilateral institutions, as well as other bilateral donors. You know, we still give an appallingly low percentage in terms of GDP -- in assistance globally, as well as in Africa. There are many crises in Africa where we're just not quite comfortable because we've got interests on both sides of the issue -- in Darfur, for example.
And the president, in a phrase in the State of the Union message, said that the United States would not tolerate genocide. But, you know, there was absolutely no mention of what we would do to prevent it. In the Horn -- in Somalia, in particular, it's awfully, it has been awfully difficult for the administration to reconcile the short-term imperatives of the war on terrorism, with the longer-term underlying needs for national reconciliation, conflict prevention, and longer-term growth, in terms of democracy and human rights, as well as economically.
So, I mean, there are lots of issues out there. Zimbabwe has been tremendously vexing for the administration. We talk the talk, but we've discovered that our leverage is very limited; that when it comes to prioritizing the expenditure of American resources around the world, Africa still comes very close to the bottom of the list -- with the exception of the global health issues that Laurie's been describing.
And, you know, there's still a lot of frustration that, you know, we haven't been able to do more. And I think there will be great demands on the new administration, regardless of which party forms it, to do more -- both at the macro level, as well as, specifically, vis-a-vis crises points in Africa.
GARRETT: Well, Cheryl, I don't think there's any question that compassion has been more than just a rhetorical theme of the Bush administration, in terms of its commitment to global health. The money has, indeed, been forthcoming -- and on a scale that absolutely dwarfs anything that came out of the Clinton years, or the Bush I years, or the Reagan years.
So we have to dig back an awfully long time to see anything that comes close to the level of commitment that we've seen to -- in particular, HIV/AIDS and malaria, that this administration has put forward. I think the challenge -- going into both the budget fight for 2009, and then into the next administration, whomever it may be -- will be to take this moment of compassion and move it into something that has a less, shall I say charitable edge to it, and more a sustainable, development, long-term, surviving, programmatic response.
And that's going to be really tough, particularly given that we're heading into our own fiscal problems, domestically. I just would point out, for example, that many domestic critics of the White House budget proposal have noted, with no small amount of anger and bitterness, that if the White House proposal goes through, we'll see a reduction in federally-supported services for people with AIDS, domestically.
It becomes hard to imagine how you, on the one hand, cut access to antiretrovirals, or to care and services to poor Americans, and on the other, turn around and double the budget for people overseas. So, I think we're going to see ourselves moving into a more mature discussion, a more sophisticated discussion of implementation of global health efforts, and one that will put the new president, whoever it may be, in a situation of rethink -- how to move the whole PEPFAR agenda, the PMI agenda, the MCC agenda, and resolve them, together with preexisting agencies like USAID, into some new kind of approach that seeks self reliance, long-term control by countries of their own fates, and sustainable approaches.
MCMAHON: Thank you for that question.
Operator, another question, please?
OPERATOR: Our next question comes from Jim Dingman (sp) at the N-World (sp) Report.
QUESTIONER: Yeah, hi. Thank you very much for your very interesting discussion. I apologize -- I missed the first few minutes.
I wanted to ask you what you see the likelihood of a Democratic administration, whether it be Obama or Clinton, extending further the kind of policies that Bush has gotten. Because, as you know, there's a lot of criticism -- even while the AIDS policy and malaria policy have been beneficent, many criticize that it's not spending enough to start with. And I was wondering how you see a possible Democratic presidency extending them out.
And secondly, many talk about how global warming is going to impact on Africa, in particular, very negatively. What thoughts do you have on that?
GARRETT: Okay, well, first of all, both of the lead candidates for the Democratic Party are on record as wanting to see the budgets for -- not just PEPFAR and the Malaria Initiative but across the board for maternal survival, child survival, water development programs, and all the way down the list, increased quite radically above what the White House is proposing for 2009.
In addition, there have been some very interesting debates on-line, between the candidates' websites -- and hosted by the ONE Campaign which favors achievement of the Millennium Development Goals, regarding how one might reorganize all the foreign aid components of U.S. foreign policy, and especially the global health programs, in a new administration.
John Edwards had advocated creating a cabinet level office of foreign aid, moving USAID, PEPFAR, all those programs, into a single department. And, one of the, sort of, under-the-radar-screen things that people rarely take note of, the majority of funding in a lot of these areas, that is actually under the Department of Defense, and, thereby perhaps creating a more coherent program of response that, again, seeks to go towards a very sustainable long-term development set of goals.
President -- I mean, (laughs) interesting, sorry -- Senator Clinton (laughs) --
HOLMES: Freudian slip.
GARRETT: (Laughs.) (God ?), well, there was a president, Clinton. Senator Clinton has favored more of a, sort of, AIDS czar-type approach, writ large, meaning a sort of, development and foreign aid czar inside the White House, as opposed to creation of a whole new department. I think her counter-argument against creating a department is that, look how well the Department of Homeland Security has worked out.
Obama is kind of in between. He likes the way the development institution known as DFID is placed within the U.K. government -- which is quite high, and which answers directly to the prime minister. So I think any way you look at it, we're going to see some reorganization, regardless of who the next president is.
McCain has been less specific. All of his statements regarding global health issues have stated that he cares deeply, that they are very important to him, but he has not offered a lot of specifics, either in terms of what the budget figures would look like in a McCain administration, or the organizational issues.
And on the global warming piece, all evidence indicates that you are absolutely right, that Africa is already taking a real hit from climate shifts, whether they are due to human factor contributions to the overall carbon footprint of the planet or other issues. Certainly the famines, the floodings, the severe weather that has been experienced, particularly in Eastern Africa, is dramatic and worrisome.
One small piece of that -- well, not small for the people of Africa but a small piece of the overall climate change picture -- is the White House support of ethanol and, in particular, of subsidizing corn production in the Midwest for ethanol. There is strong evidence that the outcome has been deleterious for people in poor countries in two ways. One, the quality of corn that's being grown has gone way down, because the intent is simply to burn it, so nutritional content is not necessary. So if Midwest corn ends up being exported for poor people, it tends to be of lower nutritional value now. And the second is that it's driven up the price of food corn rather dramatically, and it's becoming harder and harder to obtain sufficient quantities of cheap corn for use in famine relief and refugee situations.
MCMAHON: This is a question for Tony. I was in Africa in October or November, and one thing I was struck with was when the issue of Africa Command was raised, no one had heard of it, but everybody was opposed to it. And you know, I wonder -- and also questions of governance. They kept on raising the issue with me of, well, look at your own democratic elections in 2000. In particular, they would harp on Florida when I would point out, well, what happened in April in Nigeria itself with the problematics of that election. What thoughts do you have on the whole question of how governance is being treated in this administration or how that Africa Command issue will follow into a next administration?
HOLMES: Okay, well, I view that as largely two separate issues. The promotion of democracy has been a signature initiative of this administration. But the focus, of course, has been far more on the Middle East than the rest of the world. The United States has long had a program to promote democracy in virtually all of the countries of that (sector ?), certainly the ones where we have significant aid programs. But I think there's a very clear understanding on the part of the people working in those programs and throughout the government that we're talking about a long-term process of building institutions, that there's a real -- I mean, this is a generational challenge. This isn't something in which you're going to have glitzy, short-term political payoffs that you can then highlight.
The funding for it has, I think, held fairly steady, but it's not adequate. And it's just something, it's going to be the work of this generation and the next. And it's just something in which there are going to be setbacks along the way and lots of uneven progress. And it's something where we've just got to both keep up our rhetorical support and follow through with the rights kinds of well-financed programs that these countries need.
Now, in all of our major programs except the health-related ones -- the Millennium Challenge account, for example -- there are eligibility criteria related to corruption and good governance and democratization and the protection of human rights. So a gross violator or somebody with a track record that's heading in the wrong direction would not qualify and wouldn't be getting a program.
But I mean, these are long-term engagements that the U.S. embassies just -- and the shoulder's to the wheel, and it's something that needs to be financed significantly better than it has been so far.
GARRETT: You know, one thing I'd add to what Tony just said is if you think back eight years ago and the discussions that were going around about how to give debt relief in Sub-Saharan African, how to get funding to necessary programs in those countries, the constant chorus you heard from Capitol Hill was oh, but they're all so corrupt that if we send money down those pipelines, it will all end up in bank accounts in Geneva. And what we've seen over the last eight years is yeah, there's corruption out there, there's corruption everywhere. But the vast majority of the funds have ended up going where they were intended. And the debt relief funds, by and large to the degree that anybody can track them, have also apparently been used, for the most part, for positive domestic programs in these countries.
HOLMES: Right. And you're seeing a corresponding increase in the financing of health care and education in all of the countries where the debt has been written off.
On AFRICOM, the public largely is unaware of this. But I think the senior people and certainly the militaries in African governments are all aware of it. The issue's been discussed a couple of times in Addis Ababa at the African Union. And I know there have been a lot of internal discussions among African countries themselves.
We got out of the starting blocks without having carefully crafted a diplomatic strategy to sell this and to have thought through what the likely reactions would be and to have diffused those in advance. And so we're scrambling to catch up and to get our act together. I think that we've largely done that. General William Ward who is the commandant, the four-star general in Stuttgart, is coming here to the Council on Foreign Relations at the end of the month and will brief us. It's not yet been determined if he's going to speak on the record or off the record.
But I follow this quite closely, and there is a lot of wariness out there. It's not sunk in, but there is this wariness. We've taken our foot off the accelerator, and we're willing to essentially keep doing the things we've been doing for years and years and cooperating bilaterally and subregionally with African countries and just without the label AFRICOM and a large headquarters staff on the African continent, which really is what has driven the concerns.
MCMAHON: Thanks for those questions.
Operator, next question, please?
OPERATOR: Our next question comes from -- (name inaudible) -- Douglas -- (inaudible).
QUESTIONER: Hi. I have a question for Tony.
Under President Bush's Africa Crisis Response Initiative which was expanded, do you think there would be any shift in policy from any possible Democratic president in the coming years?
HOLMES: No, I don't believe so. This, essentially, it's now got a different name, but it's basically a program to train African militaries to enable them to participate in multilateral peacekeeping initiatives. So there have been many countries. And for example, Ghana and Benin on the president's itinerary next week have been major participants in terms of receiving this training and contributing troops to largely African but not exclusively African peacekeeping operations around the world.
And it's an article (face ?) in Africa as well as in trying U.S. African policy that the African nations themselves need to do more to be able to meet the crises, address the crises that exist in Africa. So the focus of all of the major peacekeeping operations in Congo, in Sudan, in Somalia, previously in Liberia and Sierra Leone all have major African components. And this is just designed to professionalize that, to make sure that some of the misadventures and abuses of the early efforts aren't repeated and to, you know, develop a true partnership with the United States and the rest of the world to help resolve conflicts and to build peace in African countries.
MCMAHON: Thank you.
Do you have another question, please?
OPERATOR: Yes. Our next question comes from Lawrence Freeman at Executive Intelligence Review.
QUESTIONER: Hello. I may be in a minority of one in this call, but I'm having trouble seeing all the progress that's taken place in Africa over the last eight years. I mean, the infant mortality rate is unreasonably intolerable. The death rate's intolerable. In the Congo, you have more people dying per month due to health and food and economic-related issues. The invasion in Somalia has been a disaster. So if you look at the total, you look at the living standards, you look at the poverty, the Millennium Challenge account has been a drop in the bucket. You need tens of billions of dollars in infrastructure just for the Congo alone much less the whole continent.
So I don't see this great legacy example that everyone else does on this call. And maybe you could help me understand it better.
GARRETT: Well, I think that I probably agree with you or at least with the basis for your question. And I would just simply say, look, the legacy is real in the sense of the commitment to HIV/AIDS and, to a lesser degree, to malaria. But what we're seeing now thrashing out on the Hill and thrashing out globally in debate about how to spend resources for health generally is a very lively argument over whether these sort of silo'ed programs are the best way to go. And I think we're going to see this get more heated in the coming year. It already has really picked up steam.
It's hard to understand how we could be so focused on adult mortality to HIV/AIDS and be cutting, slashing programs for infant and child survival and for the ability of women to survive childbirth, all of which are figures that are just not budging. And particularly, maternal survival rates look to be, at this time, the millennium development goal that will be completely defeated. In many countries it's worsening, not getting better. And so we have a real problem on that piece of the legacy.
This is why I was saying earlier what I think is going to happen with the next administration, or at least I hope will happen in the next administration, is this kind of maturing of this whole new response, a kind of more sophisticated approach that's going to have to involve trying to consolidate all the various programs and agencies in some shared mission so that we don't keep having giant, gaping holes in parts of the mission while others are getting a great deal of attention.
HOLMES: Mr. Freeman, I'd like to ask you to step back a little bit, because I think the progress is relative. But I think there are half a dozen things, just right off the top of my head, that I can think of where there's been considerable progress in the past decade.
You mentioned Congo. I mean, 10 years ago or even at the beginning of this administration, there were almost a dozen countries with troops in the Congo. I mean, there were wars, there were other nations illegally mining resources and exporting them. You know, there are still problems. I mean, there's still a long way to go in the (kivu ?) region of eastern Congo. But I mean, you had an election 18, 24 months ago. I mean, the Congo is doing a whole lot better today than it was at the beginning of the decade.
Angola was in the midst of a very severe civil war then. It's at peace now. I mean, they've got governance issues that they need to deal with but, you know, there's a trend in the right direction.
Nigeria, which you also mentioned, was a military dictatorship 10 years ago. Now, you know, we've had a couple of very flawed elections, but I don't think anybody is worried about a military coup. I mean, there has been relative progress, tremendous challenges. But once again, things are moving in the right direction.
In the Sudan, we tend to focus on Darfur which didn't exist 10 years ago as a crisis, wasn't in anyone's consciousness. But we've got a signed peace agreement and some helping steps towards implementation in terms of the civil war between the north and the south that has plagued the country since the 1960s.
In 1998, 10 years ago, Ethiopia and Eritrea were at war with each other. You know, there's a very edgy peace now but, you know, they're not shooting at each other.
And more broadly, in terms of themes of democracy, human rights, economic development, the continent is relatively better off. There are more countries making more progress in all of these areas.
You know, Zimbabwe has been a decided negative, and Côte d'Ivoire in West Africa has been, you know -- things are much worse than they were a decade ago in both cases.
But you know, I think overall, if you take the continent as a whole, there has been relative progress on a number of fronts and, you know, some significant advances as well.
QUESTIONER: May I respond?
MCMAHON: One follow up, sure.
QUESTIONER: Okay. If you look at the Congo, there's now 46,000 people, according to International Rescue Committee, dying a month. There used to be 30,000. It's gotten worse, more people are dying.
HOLMES: Well, you say used to be. What --
QUESTIONER: Well, the last time they did a report in '04, they said 30,000 were dying a month due to non-war-related issues. Now it's 46,000 according to the latest report. So that means you've gotten about 6 (million) to 7 million have died since '98, and it hasn't abated since the end of the war according to their report.
In Nigeria, I was in the Niger Delta. That place is a disaster. And right now, all the conditions are there for escalation of asymmetric warfare due to the horrendous, almost inhuman living conditions.
In Sudan, the Comprehensive Peace Agreement is in real trouble, and many people are very fearful what's going to happen.
HOLMES: And I'm among them. But --
QUESTIONER: Somalia's like a throwback. It's back to 1990, '94. It's going to be turning to (terror incognito ?).
So you say all these things are progress. I guess I don't see it. And I don't see without massive, fundamental change in policy, based on economic development and infrastructure, we're going to turn any of this around. I think all our policies are very far short of what has to be done.
HOLMES: Well, I mean, it's certainly our funding is far short of what's necessary. But I mean, basically what we've been focusing on is conflict resolution. I mean, you can't develop economically unless the conflicts are resolved and you've got real progress towards, you know, peace and stability upon which to base economic development.
MCMAHON: Okay, we're going to --
HOLMES: I'm not sure we really disagree here.
MCMAHON: We're going to go to another question now.
Operator, is there another question?
OPERATOR: Sure. Our next question comes from Kirk Hanneman at Federal News Service.
MCMAHON: Hello? Are you there caller?
OPERATOR: Kirk? Mr. Hanneman, are you there?
MCMAHON: Why don't we try the next in queue if there is one.
OPERATOR: Okay. Our next caller is Derek Zimmerman at Frederick Douglass Academy.
QUESTIONER: (As to defense ?), the budget has been increased dramatically over the last years of the Bush administration, in part, obviously, to the war on terror and the conflicts in Iraq and Afghanistan. Do you see any lack in funds going to become a major issue, especially as there's talk of a recession and as the, you know, the deficit becomes larger? How do you think that's going to pan out in the next several years?
HOLMES: Tony Holmes here. I think it's already a major issue. It's been a major issue for most programs and category suspending throughout the Bush administration the past seven years. I think the global health initiatives that Laurie's described are a real exception. But you know, by and large, we've got a lot of rhetorical support -- I mean, I think it's genuine support -- for increasing U.S. funding for its foreign assistance programs, certainly for Africa.
But I think that in the hardball politics that are going to play out -- Laurie described her view of the upcoming budget battle for the FY '09 budget during the course of this year. But also with a new Congress and a new administration, I mean, the needs are many, and I think the desire is there. But I'm not convinced that Congress feels quite the same way as certainly the Democratic candidates about the need to increase foreign aid beyond a few issues like PEPFAR or fighting HIV/AIDS or malaria or global health where, you know, there's clear bipartisan consensus.
And when you have to trade those priorities off against domestic priorities, you know, the history in this country has been that, you know, the foreign assistance objectives always get shortchanged. And I think it's going to take major, heavy lifting by a new administration to reverse that trend. And we've gotten, I think, some initial expressions of support from the Democratic candidates. We don't know about Senator McCain. I hope he will do the same thing.
I mean -- and you know, this isn't through, you know, just altruism. We need to do this to pursue U.S. interests. We've got real interests in Africa. And we've got a real interest in a progressing, peaceful, stable, prosperous African continent. And we've been shortchanging ourselves by not following through with adequate financing of our objectives.
MCMAHON: If I can just follow on that, I mean, we haven't mentioned another player, a looming player in Africa, which is China. And Tony, you mentioned before showing the flag and also the strong, positive rating of the U.S. among Africans according to Pew surveys and others. I mean, it's just also important, this visit, to just these five countries, but it's important in a symbolic way to show the U.S. is, you know, here to stay in Africa.
HOLMES: I don't think that's in any way behind the trip or driving it. But I think that will be an indirect benefit. And I don't want to exaggerate that. But I mean, China's emergence on the international scene is not (femoral ?). I mean, China's pursuing its interests. It's going to remain in Africa. We need China to make a major, long-term commitment towards, you know, peace and prosperity and good governance and democracy and human rights and economic development rather than just pursuing much narrower interests in terms of petroleum and resource acquisition and, you know, just mercantilism.
We've engaged in a dialogue, we've begun a dialogue with China focused on Africa. We've tried to ensure that they understand the stakes. Clearly, they've responded in Sudan under the threat of, you know, a boycott of the Olympics, not a threat by the United States but of the suggestion of a boycott of the Olympics. But you know, I don't see anything direct.
I mean, China's in Africa to stay. It's throughout the world to stay. We're going to have to deal with it. I think that fundamentally, our interests are very similar. You know, there will undoubtedly be political competition, and there will be times when we differ on issues. But I think that, you know, there is good reason to think that over time China will see its interests converging with ours and that we'll find it increasingly easy to work together to advance our mutual interests in Africa.
Laurie, I had a final question for you, which is the five countries that are chosen also is of symbolic importance perhaps in the leadership of these, and you have President Johnson-Sirleaf and President Kikwete and Kufuor. Are these important symbolically places where you can point to real leaders in Africa to maybe take them through some of these really difficult issues that you've outlined so far?
GARRETT: Well, certainly, Ellen Sirleaf-Johnson (sic) has been an inspiring individual, not just for Liberia or for West Africa but probably one of the most sought-after speakers in the world today, somebody that people from Finland to China to Buenos Aires are all interested in hearing about and from.
And one of the things that resonates in that global imagination is that after years of hideous civil war and atrocities of a grand scale, it was a female leader who stepped forward and said, you boys have to stop fighting. Now, get out of the way and let me run a country. And at least symbolically, it has resonated very dramatically and picked up very favorable ears here in the United States.
MCMAHON: Okay. We might be able to squeeze in one more question if there is one.
Operator, do you have anymore questions in the queue?
OPERATOR: We have no more in the queue.
MCMAHON: All right. Well, that concludes our briefing then, our on-the-record media conference call with Tony Holmes and Laurie Garrett. We want to thank you all for taking part and especially to Tony Holmes and Laurie Garrett, thank you very much.
GARRETT: Thank you all.
HOLMES: Enjoyed it.
GARRETT: Enjoy your trip.
HOLMES: Bye. Okay, thanks, Robert.
OPERATOR: This concludes today's conference. You may now disconnect your phone.
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