President Bush will be traveling shortly to Africa on a trip where he will want to highlight some of the achievements of his administration. When he took office in 2001, did Africa figure much in his foreign policy?
It really didn’t. He said very little about Africa. The administration’s basic approach coming into office was that it was not going to get very engaged in what was called “nation-building.” He had not said very much about debt relief and in the early days of the administration, what some senior officials said and did in relation to the HIV/AIDS crisis was actually not very helpful. So the expectations at the beginning of the administration were not very high at all. There were not too many new initiatives at that point.
Things began to change early on. There were some signs, even in 2001, that they were going to take debt relief more seriously. The World Bank pushed an initiative to move toward more grants [as opposed to loans]. After September 11, all sorts of things began to change on the foreign policy front. They began to be more interested in Africa for a variety of security and military reasons, but also in terms of fighting poverty. The first manifestation of that was the announcement of the Millennium Challenge Corporation in February 2002, which was clearly an attempt by the administration to launch a new initiative on foreign assistance that would be different from past foreign aid, and which would respond to some of the criticisms of the United States that it was not doing enough in that field.
Would you evaluate the Millennium Challenge today?
The Millennium Challenge Corporation (MCC) has evolved into what I think is an imaginative and creative new way to think about foreign assistance. It has done many things well, in terms of how it is thinking about foreign assistance, but it has also been quite slow in getting off the ground and dispersing money. What it has done well is recognizing that not all countries are the same and that we should deliver assistance differently to different countries. It separates out those that are better governed, countries that have made choices toward democracy, toward better governance, and toward better health and education policies. It gives those countries the responsibility to set their priorities and design the programs. This is a huge change and a huge step forward in how we think about foreign assistance, to actually give the recipient countries much more responsibility.
Who runs this? Is this part of the State Department?
This is an independent entity called the Millennium Challenge Corporation [MCC]. It’s run by a chief executive officer, managed by a board of directors; the chair of the board is the secretary of state. Five board members are from the administration. Four others are independent, who are outside of the government. It is a government entity but it is outside the control of any agency.
They have been very good—they’ve selected about twenty-three countries at this point, signed with what they call compacts with sixteen countries, nine of which are in Africa. Of those nine countries in Africa they have committed $3.8 billion over the next five years. It’s a substantial sum of money for the countries involved. The countries have had the lead in saying what they want the funds to be used for. Most of them have focused on infrastructure and agriculture—infrastructure being roads, ports, and water systems mostly, and then agriculture systems.
Which countries have benefited?
They’ve been very slow to disperse the funds so there haven’t been huge benefits on the ground yet. The African countries that have qualified and have signed compacts include Benin, Cape Verde, Ghana, Lesotho, Madagascar, Mali, Morocco, Mozambique. Those are the African countries that have signed compacts for $3.8 billion, which are beginning to be implemented, but it’s still very early in the day. So far, the MCC has only dispersed $150 million worldwide. So, their disbursementshave been slow. It still remains to be seen if the great promise of the MCC turns into reality in terms of real benefits for people on the ground.
Does it have bipartisan support?
It has very strong bipartisan support. On both sides of the aisle, the Republicans like it because of the responsibility factor that it takes countries with good governance and strong policies and holds them responsible. Democrats like that as well. Both sides like the idea of providing more funds as long as they are used responsibly. It has had strong bipartisan support into the next administration, no matter who is elected.
Another program that I know Bush has pushed has been PEPFAR. Can you explain that?
It stands for “The President’s Emergency Plan For Aids Relief.” It’s actually been overall a very strong success. Some people believe it’s actually the Bush administration’s greatest foreign-policy success. Early in the administration there was not a lot of support for HIV programs but things began to move, not just in the administration but across the United States and around the world, to begin to view the AIDS crisis in Africa, not as a moral failing of the people involved but as a humanitarian issue. [Former] Conservative Senator Jesse Helms [R-NC] shifted his views quite publicly. The administration did as well, nudged along by people like Bono, who had been fighting this fight for a long time.
In January 2003 in his State of the Union address, Bush announced a new program which would provide $15 billion over five years, which was an increase of $10 billion over five years. They pledged to increase it to $15 billion over five years. They are actually running ahead of that amount because as they have made budget requests every year, Congress has actually increased it, so they have more than met their pledge in terms of funding. Most of the funding has gone toward fifteen focus countries that have very high HIV/AIDS prevalence rates. The funding goes directly to programs within countries but it also goes indirectly through some global funds to fight AIDS, tuberculosis, and malaria. Through the direct and indirect support, today more than one million people in Africa are on antiretroviral drugs, where their lives are quite literally being saved by these medicines. They are getting public-awareness programs going, they are supplying large amounts of condoms, which they don’t like to publicize very much but they are.
There has, however, been some controversy about the program. Early on there was controversy about buying the drugs, whether generically or on patent. That’s less of a controversy now because more generic drugs are available and the prices of nongeneric drugs have fallen. Of course, another point of controversy is the focus on abstinence-only programs, where many people in the administration wanted to put a high premium on abstinence-only programs while others say the evidence does not show them being particularly effective. That’s been a controversy as well. Of course, just using condoms has been controversial. But even the administration’s harshest critics give them credit with providing quite a large sum of money on this and getting the money out and making it effective on the ground.
Those are two major initiatives, there is also a malaria initiative, yes?
Yes, which is smaller and more recent. It’s just getting off the ground in the last two years, but it also showing some great promise. Malaria is actually the largest killer in Africa and had been forgotten for many years. The Global Fund was actually responsible, among others, for putting malaria back on the global agenda. The Global Fund was set up in 2001. It’s actually a foundation, based in Geneva, but it looks more like a multilateral. It takes funding both from governments and private organizations, which makes it very different, say from the World Bank. The United Statesis the largest donor. The British, French, and other governments also provide donations. Bill Gates is the largest private funder and there are several other private funders as well. The Global Fund has now become the second-largest funder in the world on HIV/AIDS and the largest on TB [tuberculosis] and malaria in just a few years.
So any new president, is obviously going to keep supporting this?
Yes, the Global Fund will continue to get very strong bipartisan support. In fact, folks on [Capitol] Hill continue to like it better than the bilateral approach in many ways because the Global Fund has been quite successful. It will continue, I think, to get strong support. It has a smaller budget and works in over one countries around the world. So it is a little bit stretched and has a much bigger remit than PEPFAR, so a question will be whether it continues to get the funding that it needs.
The broader PEPFAR program, I think, will also continue to receive strong support. It has had strong bipartisan support. My guess is that the name might change because it’s called the President’s Emergency Plan and it’s a little strange to name a program directly after a president. It’s partly an emergency but HIV/AIDS is going to be with us for a long time. The presidential candidates are all talking about increasing the funding for HIV/AIDS.
Let’s move on to some of the more unpleasant areas. Most Americans right now when they think of Africa they think of Darfur.
Before getting into the unpleasant stuff completely, let me just comment on your point about how most Americans when they think of Africa they think of Darfur, Zimbabwe, or Sudan. It’s true. We think about the bad news that comes out of Africa and there’s plenty of it. But there is less of it than there was fifteen or twenty years ago and most Americans don’t really recognize the progress that many African countries have made. Just one statistic. In 1989, there were only three countries in sub-Saharan Africa that were considered democracies by the international measures of democracy: Botswana, Mauritius, and Senegal. Today there are over twenty. These are measured by Freedom House and several other independent groups.
Let’s talk about Sudan and Darfur.
It’s obviously a very, very difficult situation. The options are difficult for the administration. [Former] Secretary of State Colin Powell finally came out and called this genocide, but there has been less follow-up in terms of concrete actions to push for a resolution there. The administration has not been as active as many people would have liked it to have been. It’s difficult when we’re stretched in so many places around the world. There hasn’t been a clear strategy and a clear concerted effort to move forward.
They’ve paid less attention to some of the crises than they could have and should have, I think, because of the more senior foreign-policy people have been distracted by foreign-policy events in other parts of the world. There are ways they could have done better and still can do better. Hopefully this trip will bring attention to these kinds of issues and will help solidify support for these kinds of foreign-assistance programs going forward.
So would you give them a B or a B+?
I would give them a B, on their stuff on Africa. They deserve credit for the MCC and the HIV/AIDS program, but for the MCC, they get some deductions for being slow to get programs implemented and because they haven’t paid as much attention to some issues as they could have.