If we truly want a world defined by economic opportunity and security – and not by division, inequality and conflict – then we must embrace the whole world, says Bill Clinton. Nowhere is this need more pressing than in Africa, the most misunderstood and underestimated continent of all. Africa matters. We ignore it at our peril.
When I got out of office, I was too young and too restless to retire. So to be useful, I set up a foundation to work on the things that I cared most about as president. I’m interested in economic empowerment of people in poor communities in America and around the world; in religious, racial, tribal and ethnic reconciliation; in citizen service and competent government in emerging democracies; in AIDS; and in education.
I returned from an amazing trip to Africa in September. We went to Ghana, Nigeria, Rwanda, Mozambique and South Africa. In Ghana, I joined with the great Peruvian economist Hernando de Soto to launch a new initiative to implement his plan to grant title to the poor in their businesses, farms and homes so that they can use it as collateral for credit.
When he did this in Peru they had double-digit growth three years in a row, before Fujimori’s government went bad. We gave him a little tax money when I was president to do his work, although not as much as I now wish I had. I have been very impressed with the work he’s done in Mexico, Egypt and elsewhere.
We wanted to see if we could do this in Africa where there are special problems because so much of the land is held in common and under the jurisdiction of tribal chieftains. So we now have a Foundation for Building Capital for the Poor in Ghana that he and I are working on with president Kufuor.
In Nigeria, I met with about 500 political, educational and other leaders and urged them to continue to try to modernize the government that they have, to continue the fight against AIDS, and not to allow that woman to be stoned to death who has been sentenced under the Sharia law for bearing a child out of wedlock.
In Rwanda and Mozambique, I visited AIDS clinics. I visited the war memorial in Rwanda and tried to help them with some of their economic issues. In South Africa, president Mandela and I celebrated his work with an organization called Lovelife, a group of young people committed to working with other young people to prevent the spread of HIV and AIDS. We also worked to advance the cause of citizen service.
I spent a lot of time on Africa when I was president; I spend a lot of time on Africa now. Why? Because I think it is important to our future, because they have enormous problems and enormous promise.
Three hundred million Africans still live on less than a dollar a day, 30% of all those who do in the world. Life expectancy, thanks to HIV and AIDS, is 48 years and falling. More than a third of the children are malnourished. Nearly half are out of school.
Twenty-nine percent of the people are living with HIV and AIDS – about 70% of the total in the world. For millions of people there, in spite of our best efforts to end the conflicts in Burundi, between Eritrea and Ethiopia, and elsewhere, war is still a daily fact of life.
Africa’s challenges are also compounded by widespread ignorance about Africa in the developed world. A lot of people still see Africa almost as a country instead of a continent. They really don’t understand the variety of conditions that exist in the nearly 50 nations, both within and across national lines.
There is almost a kind of continental profiling that goes on. When something bad happens in one place in Africa, we transpose it to our judgements about the whole continent. We don’t know that a lot of the good things are happening.
I’ll just give you one example. Before the terrible floods hit Mozambique, for three years in a row, Mozambique ranked in the top five countries in the world in percentage of economic growth.
About a decade ago, before anybody developed any AIDS medicine, Uganda had the highest AIDS rate in the world: 16.6%. Within five years, through prevention only, Uganda cut its infection rate in half. Most people don’t know that. Senegal also turned the tide. I could give you lots of other examples. Now, unfortunately, the highest rate in the world – in Botswana – is more than twice that.
This problem of ignorance of Africa is one that the world will pay dearly for if it is not corrected. On the other hand, there is a lot to be hopeful about. More and more people are recognizing that Africa matters. The African continent was at the centre of the world’s concern when we had the global debt relief initiative in 2000.
More and more world leaders are going there with what I would call non-crass colonial objectives, trying to help the nations of Africa develop in a modern, open and hopeful way.
When I was in office, we did our best to fundamentally alter the nature of the United States’ relationship with African nations. We worked to expand trade, relieve debt, train peacekeepers, triple overseas AIDS assistance and help bring an end to Africa’s most brutal wars.
We didn’t get everything right in Africa. I have no doubt we did make some mistakes. But at least we showed up in Africa, something that America had not been doing on any consistent basis ever before.
But we cannot minimize the challenges. We know from our own bitter experience in the last year and a half that no country is invulnerable to the world’s forces of disintegration.
We know that the fact that we are interdependent doesn’t necessarily guarantee a good outcome, because whether it is disease or terror, open borders and easy access to travel and immigration, information and technology, the inter-dependent world is a vulnerable one as well as a potentially prosperous one. In every continent you see this struggle being played out between the forces of integration and the forces of disintegration.
The central point is that, especially for the United States, if we want the world I believe we do – one defined by economic opportunity, not division, inequality and poverty; one in which our security is not threatened by the spread of violent conflict; one in which terrorists and criminals have no place to hide; one where disputes are resolved by force of argument, not force of arms – if we want that kind of world, Africa has to be part of it. And we have to have a commitment to making Africa a part of it.
There is a lot to be hopeful about. There are a lot of good leaders in Africa, and more democracies than ever before. President Mbeki of South Africa has taken the lead in developing the first ever home-grown economic plan for Africa: NEPAD, the New Economic Plan for African Development.
It is a classic Third Way document. Why? Because it defines mutual rights and responsibilities. It says that Africans have a responsibility to root out corruption, to give us good government, to give us competence, to eliminate human rights abuses and to overcome tribal and other tensions.
In return, the developed world has a responsibility to give the right sort of assistance that we know will work, not just write a cheque and walk away. In all the years I’ve been following this, NEPAD has the best chance of making a difference to the future of Africa because the Africans ask something of themselves before they ask anything of us. They ask us only to do what works, not what might be most pleasing in the short run.
There is something else interesting about NEPAD. The Africans are not only talking about individual responsibilities of nations, not just about good governance because the donor nations demand it, they are actually talking about assuming collective responsibility to see that all of Africa performs according to certain human rights, governmental and economic standards.
Africans have made it clear that their continental forums are no longer open to those who would overtake democracy through the barrel of a gun. Leaders there are working to end the conflicts on the continent themselves, not waiting for someone else to ride to the rescue.
President Mbeki, for example, has done a lot to move the Congo closer to peace, and West African leaders are trying to end the latest crisis in the Côte d’Ivoire. President Mbeki and president Obasanjo of Nigeria have also done their best to try to deal with the situation in Zimbabwe. This is a particularly difficult one for some of us to understand because, from the African point of view, it involves not only bad governance, but also the legitimate issue of land reform.
It involves not only president Mugabe as he appears today, as an enemy of democracy, but also as the African people remember him – as once a champion of ordinary people. So it is a particularly stern test for the African leaders, but one they will have to meet if they expect the rest of the world to take them seriously.
There are four or five things that I think need to be done. First, AIDS can destroy all of Africa’s promise. Botswana is the richest country in sub-Saharan Africa and 38% of the people are HIV positive. The Gates Foundation has spent an enormous amount of money there, and is doing a really good job. But the prime minister came to see me the other day to tell me that he still didn’t have enough health care infrastructure to deal with all the villages, to test all the people who need to be tested, and to try to make sure we protect those who can still be protected. There are companies in Botswana and South Africa that are actually hiring two people for every job because they know that one of them is going to die before long.
There was a story in the press recently about how agriculture is being ravaged in some African nations because the farmers are too weak to farm the land because of HIV. We have lost 25 million people to this epidemic. If present trends continue, we’ll lose another 65 million over the next 18 years, and before that, there will be a hundred million people who are HIV positive in the world.
Now, this is not simply an African problem. There was a stunning article in the New York Times recently on Chinese orphans who have lost one or both parents to AIDS. India has the third fastest growing AIDS rate in the world, and sometime in the next two years will have more cases than in South Africa. One third of the people in Bombay are homeless. You can only imagine what is going to happen in India unless an aggressive effort is made there.
The fastest growing rates of AIDS are in the former Soviet Union, at Europe’s back door. The second fastest growing rates are in the Caribbean, at America’s front door.
But in Africa, the numbers show us that we will not be able to sustain these democracies and all the progress that’s been made unless we do more about AIDS.
AIDS is 100% preventable – there is medicine that turns it from a death sentence to a chronic illness, and there is other medicine that prevents mother to child transmission. You have example after example – from Cambodia to Senegal to Uganda – of poor countries that have turned it around. Brazil has cut the death rate in half, and the hospitalization rate by 80% in three years with medicine and prevention. I wish that every person could see the long lines of mothers holding their infant babies waiting to be tested at clinics in Rwanda and Mozambique, as I’ve seen.
We still have people with money saying: “Well, there is just so little money to go around, so we really can’t afford this medicine. What we really ought to do is spend all of our time on prevention.”
That is not right. Do you know why? Forget about the people whose lives you could save. The reason it’s not right is that all these young people won’t get tested if they think all they’re going to find out is “you got it, you die”. They would rather not know. The medicine gets people to the laboratory to be tested.
In 2001 there was the court settlement in South Africa where the drug companies said: “We’ll make deals with poor countries. They’ll pay what they can, the international community will have to pay the rest, but we’ll give a big discount.”
We pay $13,000 each year of the American people’s tax money for the anti-retrovirals that are given to people at my neighbourhood AIDS clinic in Harlem. Eighty-five percent of the people in a tough caseload – former prostitutes, former drug addicts – take their medicine properly. It’s not any better than that in Beverly Hills, or any place else.
Poor people can do this. In Brazil, where most of the people in the rainforest don’t even speak Portuguese, 70% of the infected people are taking their medicine on time and properly. All this talk about how these people are too dumb and uneducated to do this is just an excuse to avoid doing what we need to do.
We have to ask ourselves whether it is worth it to save African democracies. Once you get an infection rate of 30%, you are going to hit a period of time when there is nobody in middle age. There will be a lot of young people, a lot of old people, everybody else is missing, and it is very difficult to sustain an economy.
In the southern part of Africa, we already have shortages of teachers and factory workers as well as farmers in the countries with infection rates near 30% and higher. So we need to contribute our full fair share to Kofi Annan’s fund to combat AIDS, TB, and Malaria. Then we need to let him spend the money.
We also need to accelerate the search for an AIDS vaccine. I proposed in my last year in office to give a 25% tax credit to the drug companies to do this, because they know they’ll be in the same fix with the vaccine as they are with the medicine.
Of course, once a drug or vaccine has been developed, generic substitutes become possible, as we see in India, Brazil and Thailand. But first, somebody has got to develop the vaccine, and we ought to provide a very generous tax credit to do this.
Third, we have got to actually hammer out these drug deals in each country and get the drugs out there. We’ll never get these kids tested unless they know that if they find out they’re positive, they can stay alive.
I know you should want to be tested so you can keep other people alive. You should. But we have evidence that indicates that only the availability of medicine will do it. So, if you care about Africa, you’ve got to deal with this.
The second thing Africa needs is another round of debt relief. The relief we did in 2000 has already gone to 25 countries. It will soon go to 32. Many of them are in Africa. Let me remind you what that debt relief did.
We had everybody from Bono to the Pope to Jesse Helms for it. Why did the debt relief work? Because it said the countries could get it only if they could prove they were spending all their savings on education, health care, or economic development. Now there has just been a study of 10 countries in Africa showing that, in education, spending has gone from being less than what the countries were paying to foreign creditors, to more than twice that. Spending on health has jumped by 70%.
This debt relief is saving people’s lives, and not just in Africa. In Honduras, they went from six years of mandatory schooling to nine.
The problem is that the debt relief initiative is only open to the poorest countries in the world and doesn’t take into account that you can look like you’re not that poor, but be in a terrible fix if 25% or 30% of your people are HIV positive.
So, we need another round of debt relief and we need to include all countries with infection rates 15% or more, as long as they put all the money into health care.
One of the biggest problems, from the Caribbean to Africa to the former Soviet Union, is building the infrastructure of health care. One of the reasons that the former Soviet states have such a terrible AIDS problem is that they had the simultaneous infusion of drugs, prostitution and the collapse of the public health system.
We therefore need another round of debt relief targeted to the countries with high HIV rates and high growth rates, with the savings going to investments in proven health care initiatives.
We can make some improvements in our foreign aid. There is more of it now, but it needs to be better coordinated. We can do more with trade. Africa’s share of world trade is only 1.2%.
I signed the Africa Growth and Opportunity Act in 2000 with broad bi-partisan support. It has had an astonishing effect. Since it was enacted, African exports have increased by more than 60%, from some countries by 1,000%. Eight billion more dollars in trade income to Africa, one billion more in accompanying investment. It’s just the beginning.
What is the problem here? The bill expires in 2008. We ought to take it out until at least 2020, by which time I hope we’ll have a global trading system that will render its provisions irrelevant. Now that we know it’s working, we should extend it.
Africa is getting more and more competent people to work on the economy. The economic aide to the president of Nigeria is a Nigerian guy who lived in America, spent his entire business career with JC Penney, putting JC Penney stores all over the world. Unfortunately, he put them in Latin America and Asia, not in Nigeria. So, he’s gone back home to figure out how to bring in investment. The education aide to the president of Rwanda taught physics at Clark Atlanta University for nine years. Talented people are beginning to go home. We’ve got to help them.
Finally, let me just elaborate on what Hernando de Soto is trying to do, and what we were doing in Ghana. According to de Soto, most poor people in the world have assets but they’re dead capital. Why? Because they have no title to them that they can immediately produce and take to a bank and use as collateral for credit. But the poor have five trillion dollars in assets – more than we could ever give them in trade, aid, or investment. De Soto goes in and analyzes why these assets are not in the legal system. Everywhere he has checked so far, it is not because poor people don’t want to pay taxes, it is because they either don’t understand how to, or they can’t afford the time or money necessary to legalize their assets.
For example, I saw his map of Cairo, where 85% of the small businesses are outside of the legal system. Why? Well, if I moved to Cairo tomorrow and wanted to open the Clinton bakery and sell bread and rolls every morning, it would take me seven hundred days to legalize our bakery.
Now, maybe I could afford to wait. But if I had come in as a poor person from Alexandria, I couldn’t afford to wait. So what would I do? I’d start baking and selling rolls. And when the taxman showed up, I’d give him a little, and he would go away until next year.
And maybe my income would get a little better because I’d sell a few more rolls. But I could never go to the bank and say “here is my bakery, here is my title, give me a loan. I want to open a second bakery in another part of town”. It is a simple idea with profound potential. I think the US should strongly support it.
The third area in which we should do more is education. There are 130 million kids who aren’t in school. We know how to get them there. This is not rocket science, and it’s not very expensive.
In Brazil, there is a programme that gives women in the poorest 30 percentile of families something that looks like a credit card. Then, they get a form from the school every month that they can go to the nearest lottery office with and get $15 for every child who goes to school 85% of the time or more. Brazil’s enrolment in elementary school is 98%.
We got $300 million in my last year as president to offer a hot meal to kids, but only if they would come to school to get it. In most of the countries where we implemented the programme, enrolments exploded. This is cheap. Every year of schooling that a young boy or girl gets in a developing country adds an average of 10% or 15% per year to their income for life.
The fourth area we should do more for is in supporting democracies, not only supporting elections, but supporting democratic infrastructure as well. When we were finished with our African tour, I asked all the people who went with me: “Tell me what you felt about every country we visited. What did you feel good about, what did you feel bad about?”
I won’t go through the details, but I will just say this: every person noticed the same thing. Some countries had much better systems than others. Some countries had much deeper teams of gifted people than others. I don’t know how many days as president I was made to look like a genius because there were hundreds of people out there doing what they did, and I just got to make the announcement.
But, if I’d been in the White House all alone, it wouldn’t have mattered how hard I worked, or what I knew, or how smart I was. What made it work was a team, systems, and people coming in and out all the time who could fulfil roles and get things done. There is no inequality of intelligence around the world; it is pretty well evenly distributed. But education and organization are not evenly distributed. So, when I think of democracy, I think not only of honest, clean elections, but also of making democracy work.
There is an enormous role here for foundations, for the private sector, for retired politicians, for all kinds of people to do something to help to implement these systems. I can go to a country over a two or three-year period and see dramatic differences if they just get one or two people who are really good and who know what they’re doing.
Africa may be able to teach us something. I think about all the tensions in the Middle East. I think about my mother’s people, the Irish, out there rioting in Belfast again as if they hadn’t learned one darn thing from all the benefits of peace. It’s amazing how we all seem to be in the grip of fighting over our differences.
Yet in Rwanda, where just eight years ago more than 10% of the country was slaughtered in 90 days, mostly with machetes, I want to tell you what I saw.
A couple of miles from a memorial to the genocide, there is a little village called Ndera that is officially designated as a “reconciliation community”. President Kagame is a Tutsi. It was his tribe that was mostly slaughtered.
He sent out word to all the Hutu soldiers who had gone to the Congo to live that they could come home if they weren’t involved in planning and leading this atrocity. They would be tried in a local community court, in which they would have to stand up and say what they did, and the community will decide what should happen. But they won’t be killed or sent to prison. So, the soldiers started to come home.
Also, in this little village, I went into the home of this Hutu woman who has adopted two Tutsi children, one of whom has a very rare and fatal illness. She is caring for him.
I also met a young Hutu soldier who said he was in the Congo and he came home because he believed his government when they said they wanted him to come back. He was ashamed of what he had done, and he wanted to go on with his life. He didn’t want to spend it out of his country.
Then, the governor of the state where the village is located took me to see this ceremonial dance where all the boys are dressed up in animal skins and have spears and the girls are in long, beautiful, brightly coloured dresses.
The girls were mostly, but not exclusively, Tutsis. The boys were mostly, but not exclusively, Hutus. She said: “They want to do this dance for you. This is the first time our children have danced together since the slaughter in 1994.” So these kids are dancing, and they start smiling, and they’re beginning to look young again, and beginning to trust again.
The Africans have a lot of wisdom, and we have something to learn from them. They do not believe they have to live in fear or anger or war. Every time they give in to tribal slaughter, it is because some lousy politician tried to make money out of it or get power out of it.
One tribe in Africa has the following greeting. When we run into somebody, we say hello. You know what their response is? “I see you”. Think about it. I exist in relation to you. It’s a central lesson the world has to accept in the 21st century.
We have a phenomenal opportunity in Africa and we have a phenomenal responsibility to Africa. We ignore them at our peril; we will be rewarded if we embrace them. I hope all of you will push that message.
This essay is an excerpt of edited remarks delivered by William J Clinton, 42nd president of the United States, at the Woodrow Wilson Centre for Scholars. For more information about the William J Clinton Presidential Foundation, visit: www.clintonpre*****ialcenter.org
New editor’s note: After Bill Clinton‘s association with Jeffrey Epstein, we no longer support the Clinton Presidental center, and choose not to link to it.