Tuesday, December 16, 2008


I came across this article today from Relevant Magazine, a Christian magazine for young people that I believe is progressive, inspiring, and intelligent. This article is about President George Bush's PEPFAR policy to help eliminate AIDS in Africa. We saw PEPFAR's reach in South Africa, as it was a major contributor to the organization we worked with in Cape Town, the Living Hope Community Center. The PEPFAR plan has done a GREAT amount of good in Africa, and this article highlights the heart behind it. Enjoy!


Bush's Unexpected Legacy by Cameron Strong

Two weeks ago, on World AIDS Day, Rick Warren hosted a Civil Forum on Global Health in Washington, D.C. The event was an hour-long interview between Warren and President George W. Bush to discuss the unprecedented work being done in Africa through the President’s Emergency Plan For AIDS Relief (PEPFAR). As Warren said when introducing the president, “No man in history, no world leader, has done more for global health than President George W. Bush.” Not exactly something you hear much about in the media.I actually had the privilege of meeting President Bush that day and was impressed with his compassion and humility. He campaigned in 2000 on a platform of “compassionate conservatism,” and PEPFAR was birthed out of that promise. As our country faces enormous economic challenges right now, it’s easy to overlook the work PEPFAR is doing half a world away. But millions of lives are literally being saved—10 million have been affected since its inception in 2003—and this past summer, those positive results prompted Bush to pledge a tripling of PEPFAR’s funding. When I traveled to Rwanda this past April, I saw evidence of PEPFAR’s work everywhere. Its importance to Africa’s efforts in the fight against AIDS cannot be overstated.Below are some highlights from Warren’s interview with President Bush. It’s a RELEVANT exclusive, mainly because I covertly recorded it in my pocket and I haven’t seen it anywhere online. We’ll post more of the transcript on my blog at RELEVANTmagazine.com.

Warren: I want to talk about the results of PEPFAR in five areas—saving lives, creating new partnerships, building local leadership, encouraging behavior and reducing a stigma. When you first announced this in the State of the Union Address in 2003, you insisted on measurable goals. Most governments are afraid to do that. But you did. So, how are we doing? Tell me about what's happened in the past five years.
Bush: I insisted upon measurable goals because I felt that lives needed to be saved. When we started, 50,000 people were getting antiretroviral treatments in all of Africa. So we set a goal of 2 million people in five years to be getting ARVs. Thank you for setting this up, because today we’re able to announce that we’re over 2 million in less than five years.
Setting! goals is difficult for some. Bureaucracies tend to avoid goal-setting. In all due respect to bureaucracies, foreign governments tend to avoid goals. Nobody really wants to be held to account.
Setting goals also had to change the way we developed aid. In other words, we said to people, "We want to help you." But rather than being paternalistic about our help—which basically says, “We know better than you how to achieve your goals”—we expect [the African leaders] to be a partner in achieving the goals. Which is an attitude change, basically saying to the African leaders, "We trust you. We think we've got the capacity to be a good partner.”

Warren: You once said, "Africa's most valuable resource is not its soil or its diamonds, but it's the talent and the creativity of its people." You insisted that the people who were going to do PEPFAR, that the decisions and the strategy should be don! e by the people on the ground there instead of bureaucracy and centralized back here. So this principal of trusting the local leaders is a pretty innovative thing when you think about it.
Bush: Well actually, it’s the timeless management principal of aligning authority and responsibility. If you disassociate authority and responsibility, you can't have accountability. So we align the responsibility and authority.

Warren: The innovation of trusting leaders at the local level—instead of saying, "We over here are going to tell you what to do”—you've left them to determine the strategy in each country, and that's how you got the 2 million.
Bush: We actually helped them develop the strategy, but when they develop the strategy, it's easier to hold the strategy developer to account. It's not all that profound. The United States believes that paternalism is destructive, and! we believe partnership is constructive. That’s the basis of a lot of our foreign policy.
[We say to our African partners], “We believe that you can do better. We believe in setting high standards and helping you achieve high standards.” That's different from, “We are just going to give you money to make ourselves feel better.” And then the results don't end up accomplishing our objectives.
Warren: That makes me think of the old Reagan statement, "Trust but clarify." Because you did both. You trusted the local leaders but you also made accountability. Now let's look at this partnership for a minute because you brought in a whole new group of partners in PEPFAR. PEPFAR was not just a model for AIDS, but it's a model for all kinds of programs because you invited everyone to the table, including faith-based …
Bush: Especially faith-based. I say especially faith-based, not including faith-based, because I believe that when people join organizations to love their neighbor, it's a powerful incentive for effectiveness on the ground. One of the greatest things about our experience, we've seen people from the faith community in Africa share their stories about what it is to love their neighbor.

Warren: I've heard you say many times that government can't love.
Bush: That's right. Love comes from the heart, a higher calling, from God. So the whole purpose of including faith organizations was frankly to bring some order into that which was already happening. Your church, other churches, synagogues, people from around America who are motivated by faith are involved in the process. So why not bring some order and focus, and that's the proper role of the government in this case. And it's working. When you think about people volunteering in Africa to save lives, they are actually saving their own lives, in many ways.

Warren: Let me talk to you about your own personal motivation behind this. This was the largest initiative ever committed to a single disease. PEPFAR. When I heard about it in 2003, I thought, “Will that ever get voted through?" because it was such an enormous “BHAG (Big, Hairy, Audacious Goal).” From a purely political viewpoint, you weren't going to get a lot of votes for that. So what was it that motivated you to do PEPFAR?
Bush: Well first of all, I believe in this admission: "To whom much is given, much is required."
Secondly, I would hope that when it’s all said and done, people would say, “This is a guy who showed up and solved problems.” And when you have somebody say, “There's a pandemic that you can help,” and you do nothing about it, then you have frankly disgraced the office.
And finally, I am surrounded by people who are pushing hard on these initiatives. People I trust—Condi Rice, Mike Gerson, Mark Dybul. When I was first talking to Condi about being the National Security Advisor, she said, “I want you to make this promise to me, that you will focus on Africa."
I had a group of people around me, people I trust, people whose hearts I came to admire, that pushed this foreign policy as well. We have follow-through people, and it’s been a fabulous experience working with them.

For more of this interview, check out Cameron’s blog at RELEVANTmagazine.com.
Author: Cameron Strang


Allison said...

Hey Sarah,

While PEPFAR surely provides a ton of money that otherwise wouldn't be available and is thus overall a good thing, my colleagues and I found it frustrating. Not only were the levels of paperwork ridiculous (though somewhat understandable), funding was refused for any project that did not have abstinence as a primary focus. In fact, you had to prove in the paperwork that you were teaching abstinence. And abstinence just isn't something that works in Lesotho, and I'd venture to say in sub-Saharan Africa as a whole. I think the money would be more wisely spent if volunteers were allowed to make any form of prevention a focus. This would open many more doors and help many more people. I'm hoping those doors will be opened by the Obama administration.

Casey and Sarah: said...

At this point, there is no way to know what the Obama administration will do with PEPFAR. I've emailed his campaign and nobody ever responded with an answer. The only thing I've heard is that he will shut it down and give the money to the UN instead, which would be a colossal mistake! They will waste it. By the time it gets to the people only 25% will be left! I'm hoping what I heard is wrong or that he changes his mind. Anybody else heard about his plans for PEPFAR?

Allison said...

This is from his official change.gov website, which makes it sounds like he'll do what I hope he's going to do, which is release it from abstinence-heavy preaching (I'm not saying abstinence shouldn't be taught, just that it shouldn't be the only focus):

Reauthorize and Revise PEPFAR: The U.S. has dramatically increased funding for global HIV and AIDS programs through the President’s Emergency Program for AIDS Relief (PEPFAR), but the program has faced controversy. President-elect Barack Obama believes that our first priority should be to implement the recently signed President’s Emergency Plan for AIDS Relief (PEPFAR), legislation President-elect Barack Obama long-supported, to ensure that best practices – not ideology – to drive funding for HIV/AIDS programs.

Allison said...

(the quote above was taken from this page)

Casey and Sarah: said...

Wow, thanks for all that info. I was never able to find that before. I hope that really does end up happening! That's good news in my book.