[House Hearing, 111 Congress]
[From the U.S. Government Printing Office]
U.S. ASSISTANCE TO AFRICA:
A CALL FOR FOREIGN AID REFORM
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON AFRICA AND GLOBAL HEALTH
OF THE
COMMITTEE ON FOREIGN AFFAIRS
HOUSE OF REPRESENTATIVES
ONE HUNDRED ELEVENTH CONGRESS
FIRST SESSION
__________
APRIL 23, 2009
__________
Serial No. 111-55
__________
Printed for the use of the Committee on Foreign Affairs
Available via the World Wide Web: http://www.foreignaffairs.house.gov/
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COMMITTEE ON FOREIGN AFFAIRS
HOWARD L. BERMAN, California, Chairman
GARY L. ACKERMAN, New York ILEANA ROS-LEHTINEN, Florida
ENI F.H. FALEOMAVAEGA, American CHRISTOPHER H. SMITH, New Jersey
Samoa DAN BURTON, Indiana
DONALD M. PAYNE, New Jersey ELTON GALLEGLY, California
BRAD SHERMAN, California DANA ROHRABACHER, California
ROBERT WEXLER, Florida DONALD A. MANZULLO, Illinois
ELIOT L. ENGEL, New York EDWARD R. ROYCE, California
BILL DELAHUNT, Massachusetts RON PAUL, Texas
GREGORY W. MEEKS, New York JEFF FLAKE, Arizona
DIANE E. WATSON, California MIKE PENCE, Indiana
RUSS CARNAHAN, Missouri JOE WILSON, South Carolina
ALBIO SIRES, New Jersey JOHN BOOZMAN, Arkansas
GERALD E. CONNOLLY, Virginia J. GRESHAM BARRETT, South Carolina
MICHAEL E. McMAHON, New York CONNIE MACK, Florida
JOHN S. TANNER, Tennessee JEFF FORTENBERRY, Nebraska
GENE GREEN, Texas MICHAEL T. McCAUL, Texas
LYNN WOOLSEY, California TED POE, Texas
SHEILA JACKSON LEE, Texas BOB INGLIS, South Carolina
BARBARA LEE, California GUS BILIRAKIS, Florida
SHELLEY BERKLEY, Nevada
JOSEPH CROWLEY, New York
MIKE ROSS, Arkansas
BRAD MILLER, North Carolina
DAVID SCOTT, Georgia
JIM COSTA, California
KEITH ELLISON, Minnesota
GABRIELLE GIFFORDS, Arizona
RON KLEIN, Florida
Richard J. Kessler, Staff Director
Yleem Poblete, Republican Staff Director
------
Subcommittee on Africa and Global Health
DONALD M. PAYNE, New Jersey, Chairman
DIANE E. WATSON, California CHRISTOPHER H. SMITH, New Jersey
BARBARA LEE, California JEFF FLAKE, Arizona
BRAD MILLER, North Carolina JOHN BOOZMAN, Arkansas
GREGORY W. MEEKS, New York JEFF FORTENBERRY, Nebraska
SHEILA JACKSON LEE, Texas
LYNN WOOLSEY, California
Noelle Lusane, Subcommittee Staff Director
Sheri Rickert, Republican Professional Staff Member
Antonina King, Staff Associate
C O N T E N T S
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Page
WITNESSES
Mr. Earl Gast, Senior Deputy Assistant Administrator, Bureau for
Africa, United States Agency for International Development..... 3
Steven Radelet, Ph.D., Senior Fellow, Center for Global
Development.................................................... 23
Ousmane Badiane, Ph.D., Africa Director, International Food
Policy Research Institute...................................... 39
Meredeth Turshen, D. Phil, Professor, Edward J. Bloustein School
of Planning and Public Policy, Rutgers University.............. 53
Mr. Bill O'Keefe, Senior Director of Policy and Advocacy,
Catholic Relief Services....................................... 66
LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING
Mr. Earl Gast: Prepared statement................................ 6
Steven Radelet, Ph.D.: Prepared statement........................ 27
Ousmane Badiane, Ph.D.: Prepared statement....................... 42
Meredeth Turshen, D. Phil: Prepared statement.................... 58
Mr. Bill O'Keefe: Prepared statement............................. 68
APPENDIX
Hearing notice................................................... 106
Hearing minutes.................................................. 107
U.S. ASSISTANCE TO AFRICA: A CALL FOR FOREIGN AID REFORM
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THURSDAY, APRIL 23, 2009
House of Representatives,
Subcommittee on Africa and Global Health,
Committee on Foreign Affairs,
Washington, DC.
The subcommittee met, pursuant to notice, at 12:07 p.m. in
room 2172, Rayburn House Office Building, Hon. Donald M. Payne
(chairman of the subcommittee) presiding.
Ms. Watson [presiding]. The committee has officially come
to order. Congressman Flake, would you like to make an opening
statement? All right, then I will make mine.
This is a very important hearing that the chairman has
chosen to hold at this time, and this hearing is concerning
United States assistance in Africa, and in regards to global
health. As a nation, we are at a critical crossroads. The
current economic crisis has highlighted the need for measure
effectiveness of every dollar that the government spends. The
American people now demand a more transparent government, and
one that works well on behalf of the people.
Even through the eyes of the government, and even though
they have turned inward in the past few months, we must
remember that economic changes in the United States have
repercussions around the world. Africa is in need of aid now,
as much as ever. Malaria, HIV ravaged the continent, leaving
many adults unable to be productive members of society. The
number of orphans in many African nations is also on the rise.
The demographics of the nation are shifting as well. Unlike
developed nations--we have been able to somewhat control our
HIV and AIDS epidemic--African nations are prominently and
predominantly populated by the elderly, who are taking care of
the orphaned youth. The most productive age group, the young
adults, have been victims of HIV and AIDS. The effect of global
climate change is beginning to show.
The fertile lines at the base of Mount Kilimanjaro for
years have been home to the coffee growers of Tanzania.
However, the recent shifts in temperature patterns have caused
drought in this area for also the last few years. The farmers
that inhabit this region, who were the breadbasket of the
nation and of the region, now require food assistance just to
stay alive. Many are turning to hunting and deforestation for
income, which further exacerbates the situation.
Global disease patterns are changing as well, and as
temperatures rise in the flatlands, malaria-carrying mosquitoes
are moving higher into the mountains. Populations traditionally
not at risk for malaria are now being exposed. These changes
are occurring as we are trying to confront the problems that
Africa faces today, and has faced for many years.
Infrastructure has been lacking in many parts of the continent.
There are no roads or health clinics, and very little
access to quality education. Urban populations, predominantly
living in slums, are facing a dual burden of disease and
chronic diseases, and political strife, still plaguing many of
the nations on the continent. Many different government
agencies, USAID, DoD, and the Millennium Challenge Corporation,
are working to alleviate some of the problems on the continent.
Each of these groups performs a vital task, but their
efforts are disjointed. Perhaps it is time for the United
States to resume a leadership role and provide an overall
vision for the humanitarian assistance community. So we are
very pleased to have Mr. Gast here today.
Okay, Mr. Boozman, do you have any opening remarks?
Mr. Boozman. No, ma'am, just that I am excited to hear the
testimony. Thank you very much.
Ms. Watson. Thank you.
I ask for unanimous consent that the ranking member's full
statement be included in the record.
Now, we are going to have two panels this morning, one with
our representative from the administration and a second panel
comprised of private witnesses. Our administration witness is
Mr. Earl Gast, senior deputy assistant administrator for Africa
of the United States Agency for International Development. Mr.
Gast has served as USAID's senior deputy assistant
administrator for Africa since April 2008.
He is responsible for overseeing operations in the Bureau's
offices of Sudan Programs, East African Affairs, Administrative
Services and Development Planning. This 15-year USAID veteran
has received numerous awards and commendations for his
dedicated service. Most notably, he received the agency's Award
for Heroism in 2004, and in 2003, the Distinguished Unit Award
for his work in Iraq. Prior to his appointment to the Africa
Bureau, Mr. Gast has served as USAID Regional Mission Director
for Ukraine, for Belarus, for Moldova, and as a USAID
representative to the U.N. agencies in Rome in 2004.
Mr. Gast began his career with USAID in 1990 as a Project
Development Officer for USAID Philippines, where he led designs
of major United States assistance projects, including large
infrastructure programs in Mindanao. Mr. Gast received a
master's degree in political science and Middle East studies in
1987 from George Washington University. He graduated summa cum
laude from the University of Maryland in 1984 with a bachelor's
degree in history and criminal law.
He speaks Russian and Arabic in addition to his native
English. So we want to thank you very much for your service. We
commend you for the work you have done in the past. We look
forward to the work you will be doing in the future, and we
would like you to proceed at this time with your testimony.
STATEMENT OF MR. EARL GAST, SENIOR DEPUTY ASSISTANT
ADMINISTRATOR, BUREAU FOR AFRICA, UNITED STATES AGENCY FOR
INTERNATIONAL DEVELOPMENT
Mr. Gast. Thank you, Congresswoman. You know my history
better than I do. And thank you, Ranking Member Smith for your
comments. It is really a pleasure and an honor to be here
before this subcommittee, and I hope that in the future we have
a chance to interact more with the members and also the staff
about USAID programs and development issues in Africa. I will
make a brief oral statement, and we have also submitted a
written statement for the record.
The last 10 years, I have seen an unprecedented flow of
U.S. Government assistance in Africa, in an attempt to help
Africa emerge from poverty. USAID's budget alone for Africa has
more than quadrupled from 2000 to 2008. Last year, our
assistance level was nearly $5.5 billion. The benefits of this
investment are being felt by millions of Africans all across
the continent, but as you correctly point out, very real
challenges remain.
Today, I want to talk to you about what our assistance
programs in Africa are doing, what we have accomplished, and
what we see as some of the major challenges as we move ahead.
Wars in Angola, Burundi, the Democratic Republic of Congo,
Liberia, Sierra Leone and Uganda and southern Sudan, have ended
or have dramatically abated. At the same time, the tragedy in
Darfur has escalated, unrest has wracked Kenya, Somalia remains
ungoverned, and economic mismanagement and political
suppression have brought Zimbabwe to the brink of collapse. But
there are signs of positive change.
Across the continent, child mortality has fallen 14 percent
since 1990, Africa's gross domestic product has grown, on
average, 5 percent since 2005. We believe we are making a
difference, but again, much remains to be done. Let me point
out a few quick examples of the impact of our assistance.
Exports to the United States through AGOA, the African Growth
and Opportunity Act, have increased eight-fold since it began
in 2000.
USAID has put a lot of emphasis on building public-private
partnerships in order to leverage private funding. In Africa,
we have been successful. We have 270 partnerships, and with our
$420 million that we have put up, we have received a five-fold
match from private sector organizations. Our education programs
have benefitted over 61 million students, teachers, education
administrators and community members across 40 countries, and
girls' participation in education has increased an average of
25 percent over the past 10 years.
Ranking Member Smith, you brought up the issue of PEPFAR.
USAID, in partnership with other United States agencies
implementing PEPFAR, have helped to put nearly 1.7 million
Africans on treatment. Since its inception, the President's
Malaria Initiative has cut child deaths from malaria in Zambia
by 30 percent, and the number of children infected with malaria
by half in 2008. In Rwanda, severe malaria cases were
significantly reduced by 64 percent at 19 health facilities in
2007.
Our vision for the future is to capitalize on these gains
and strengthen our African partners so that we can face new
challenges jointly. We are committed to the principle of
strengthening country ownership, and that means enabling
countries to define and advance their own development agendas.
Likewise, we are working to build more effective and inclusive
partnerships among both Africans and other donors.
We work with and through African organizations such as the
African Union, the Common Market for Eastern and Southern
Africa (COMESA), the Economic Community of West African States
(ECOWAS), and the Southern African Development Community (SADC)
to increase the effectiveness of our assistance and to expand
accountability for development results. At the same time, we
recognize that there are ongoing and new challenges that must
be addressed to sustain and expand these achievements. I will
touch on a few of those.
In any society, productivity is inextricably tied to
health. In Africa, people in their most productive years are
often prevented from achieving their potential by acute and
chronic illnesses, such as tuberculosis, HIV/AIDS, malaria and
cholera. Keeping trained medical staff in those countries,
improving the supply chain so that clinics are stocked, and
addressing the acute weaknesses of health systems throughout
Africa, are all urgent priorities for USAID and development
agencies.
Despite gains, extreme poverty continues to plague the
continent. Four in ten Africans, more than twice the developing
world average, live on less than $1 a day, and the 2008 rise in
food prices worldwide further distressed the extremely poor
African households. In order to lift people out of poverty, the
gross domestic product for the continent must consistently
exceed 5 percent. This was starting to happen.
Unfortunately, with the world economic recession, growth in
Africa, according to the latest IMF report, is expected to grow
only by 1.7 percent in 2009. Another challenge that you have
pointed out is the proportion of youth. Right now it
represents, people under the age of 15 represent, 50 percent of
the population, and by using the current growth rate for the
continent, the population is expected to more than double,
reach 1.7 billion, by 2050.
So this rapid population growth will impede the ability of
all sectors, agriculture, health, education, and certainly will
impact on economic growth.
With the approaching demographic challenges, it is even
more important that Africa have strong governance structures in
place, and while in 2009 Africa is home to some promising
examples of new democracies, it also contains some of the more
disheartening glimpses of political stagnation, democratic
backsliding, and state failure. I will just point out very
briefly: The four recent coups in Equatorial Guinea,
Mauritania, Guinea and Madagascar serve as examples.
There are some success stories, however. We are very
pleased with the peaceful transition of power in Ghana and in
Zambia. In Zimbabwe, we continue our efforts to promote a
democratic transformation in the face of dire economic
hardships. While the transition government between ZANU-PF and
the MDC is now in place, it has had limited achievements, and
there remain serious issues to be dealt with, including ongoing
land seizures by the government, the denial of due process, and
a lack of progress on media restrictions and judicial reforms.
The U.S. Government strategy during the transition period
over the next 2 years, leading up to what we hope will be free
and fair and credible elections, will focus on targeted
interventions that build upon our existing humanitarian
programs. I want to state clearly before the subcommittee that
we will not provide any assistance to Robert Mugabe or ZANU-PF
members who have undermined Zimbabwe.
Liberia is a bright spot in Africa where we have seen an
impressive transition from a war-torn society to a promising
developing economy and society. President Johnson-Sirleaf's
strong leadership in moving Liberia's economic and political
progress forward, and in addressing key impediments to
development, is to be commended. We are pleased to note that
they have made sufficient progress on the MCC indicators to
qualify as an MCC threshold country.
Finally, conflict remains a significant challenge that
devastates the lives and livelihoods of the people, and can
destabilize neighboring countries. Two countries in particular
are heavily affected by conflict--Somalia and Sudan. In
Somalia, we are supporting the current transitional Federal
Government, and we believe that restoring the rule of law and
effective governance is absolutely key to the region.
Sudan stands as another leading example of the human cost
of conflict and instability. The signing of the Comprehensive
Peace Agreement in 2005 created an incredible opportunity to
advance Sudan on the road to a peaceful and just Sudan, but
serious challenges remain to the implementation of the CPA. The
conflict in Darfur remains dire, with more than 4.7 million
persons displaced by the conflict, and some 2.7 million persons
living in IDP camps.
We have witnessed the dramatic expansion of U.S. assistance
over the past decade. I have given a few examples of how we
have made a difference, but again, serious challenges remain.
Thank you again for your time, and I welcome any questions you
might have.
[The prepared statement of Mr. Gast follows:]Earl
Gast deg.
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Ms. Watson. We want to thank you for what I consider a very
comprehensive presentation. Just a few questions, and as you
were talking about Zimbabwe and some of the troubles in that
area, how are we coordinating with the African Union, and do
they have the resources to be the overseers or the protectors
in various states close to Zimbabwe, South Africa?
Mr. Gast. Sure. If a State colleague were here, I would
defer to him or her, but let me say that we do have a very
close relationship with the African Union, we do have a U.S.
Mission to the African Union, and we do have an USAID
development professional seconded. So, the African Union is
stepping up and member states are stepping up in providing
troops. More troops are needed, and more funding is needed to
support the peacekeeping troops.
Ms. Watson. I am concerned, as well as the chair and I know
other members, about streamlining the policy and its approach,
as we deal with Africa, and we have been looking at USAID and
how to readjust that, and the U.S. Government's 2006 report to
the OEDC's Development Assistance Committee listed 26 Federal
departments and agencies as implementers of official
development assistance, and this fragmentation is kind of
significant, and it shows the lack of an overreaching strategy
that defines our global development priorities across all
government agencies.
The most recent attempt to consolidate programs under a
single authority, the State Department's Bureau of Foreign
Assistance, has actually only consolidated responsibility for
about half of all U.S. foreign assistance, and can you speak to
the need to streamline United States assistance toward Africa
through a defined, unified policy and goals?
Mr. Gast. I think this is the exception, and that is in the
Africa Bureau, and when I say Africa Bureau, I am talking about
USAID, the Africa Bureau over at NSC, and also the State
Department, some 2 years ago came up with a National Security
Policy Presidential Determination. I believe it came out in
September 2008, and it represented the interagency, the main
players in the interagency on development and diplomacy in
foreign policy coming together and identifying collectively
what the United States goals and objectives are for Africa.
We obviously have a new team in place. We have a very good
team over at State, and I know that they are adding more
political appointees over in the Africa Bureau over at State,
and also in the NSC, and we have been having biweekly
coordination meetings. Obviously, the priorities are
readjusting our policies in Somalia and Sudan and Zimbabwe, but
once we get beyond that, we have a commitment to get together
and identify collectively what our policy objectives and goals
are going to be for the continent, and USAID is a player in
that.
Ms. Watson. Thank you. I am going to go now to Mr. Smith
for questioning.
Mr. Smith. Thank you very much, Ambassador Watson, and Mr.
Gast, thank you for your leadership over the course of many
years, including in places like Kosovo, which obviously needs
it, but especially for your work on Africa. As I mentioned in
my opening statement, the New Partners Initiative was a very
successful endeavor under the Bush administration to bring in
new grantees for PEPFAR funding and to promote sustainable
programming by working with in-country NGOs, especially faith-
based groups in Africa.
Does the new administration intend to continue this
initiative with respect to HIV/AIDS funding, and are efforts
being made to expand this initiative to all foreign assistance?
Mr. Gast. One foreign policy reform that wasn't mentioned,
but was started in the last administration, supported in
Congress and absolutely embraced by the new administration, and
that is the build-up of USAID's human capacity. One of the
things that we are doing is, over the next couple of years,
more than doubling the number of foreign service officers in
Africa, and we are involved in the planning session; we are
coordinating with State and also the NSC on that.
What that will do is actually help us better tailor our
programs to the local needs, to include identifying new
partners. When we have a deficit of officers, we tend to use
these large mechanisms, so to get to your point, which is, will
smaller groups that have very targeted expertise be part of
USAID's programs in the future? I anticipate that to be so.
Mr. Smith. I would obviously strongly encourage it. I met
with Archbishop Onaiyekan from Nigeria, and the Sultan of
Sokoto was also traveling with him as part of Nigeria's Inter-
religious Council, and heretofore, they have been largely
excluded from government funding, global funding, but our hope
is, my hope would be strong, because I find this all over
Africa as I travel, these faith-based groups provide an
enormous network of volunteers, hospitals, clinics, and they
don't get the funding that would enable them to reach out to
additional people. They actually are trying to mitigate the
problem of malaria, where 250,000 cases of malaria, as you
know, and one-fourth of all cases are in one country, Nigeria,
at least according to some estimates. So the more we are able
to bring faith-based groups in and, I think, utilize that
asset, the more we mitigate disease, and hopefully prevent
disease in the first place.
Mr. Gast. Great, thank you for your comment, and
absolutely, our having more officers in the field will allow us
to work with more local----
Mr. Smith. Because very often, that is the hurdle they
can't get over, the ability to write a program request, whereas
some others have that capability. When it comes down to
actually implementing, however, local, indigenous NGOs far
exceed their capacity and capabilities. Finally, what
procedures and policies are being implemented to ensure that
conscience clause protections, enacted as part of the PEPFAR
re-authorization, are continued?
Does USAID have procedures and policies in place to ensure
faith-based organizations are not only protected from
discrimination, but are considered for funding in the context
of the very unique benefits and advantages that they inherently
provide in terms of service delivery in Africa?
Mr. Gast. May I send you specifically what our policies are
on that?
[Note: The information referred to was provided by Mr. Gast
to Congressman Smith during a briefing on Thursday, April 30,
2009.]
Mr. Smith. Okay, but does that continue? Is there a
seamless transition from the previous administration to this
one on conscience, because I would just say parenthetically, I
am the one who offered that amendment on conscience protection,
very contentious in the first go in 2003, but I think it proved
itself enormously, and when we did the 2008 re-authorization,
there was a strong consensus on both sides of the aisle, and
conscience protection was actually increased and made more
durable and more effective. I want to ensure that that is
faithfully carried out, because again, that means buy-in from
others who have heretofore been excluded.
Mr. Gast. I don't wish to misstate it, but I will get back
to you.
Ms. Watson. Excuse me, may I interrupt you for a minute?
Since we have a call on, I will ask Ms. Woolsey to raise her
question, we will recess, and then when we come back, maybe you
can have the manual or something ready for him, or just send it
to us, and then you can respond to her question too. We have a
call on, we have a few minutes left, so Ms. Woolsey?
Ms. Woolsey. Thank you very much, Madam Chairwoman.
Thank you, Mr. Gast. I just returned from the Easter break
from a trip to Tanzania. The focus of our delegation, of our
trip, was to study maternal mortality and how we can, and
should, promote healthy mothers and reduce deaths in the third
world countries, and this was Tanzania specifically, but I am
sure it translates throughout Africa and other third world
countries. Actually, I came back struck by how difficult and
challenging it would be to live in a third world country, but
primarily, how almost impossible it is to be a woman of
childbearing age in a third world country where there is lack
of family planning, where the cost of giving birth falls on a
family if they want to go to a medical facility, how
transportation is almost nonexistent, and expertise in
equipment is lacking, all the way up to but not quite including
the hospitals that are involved.
We learned some shocking facts. We learned that problems
due to pregnancy and childbirth are the leading cause of
disease burden for women in developing countries, that a woman
in sub-Saharan Africa has a 1 in 16 chance of dying in
pregnancy or childbirth, compared to 1 in 3,000 risk in the
United States, and that 40 percent of all child deaths each
year, most of which are preventable, are linked to poor
maternal health.
So my question to you is, how should any foreign aid plan
address the most primary needs of women and infants and
coordinate with other donors to address this worldwide crisis,
and can we do it, and how can we do it without taking away from
the programs that we know are already successful, such as
malaria and TB and AIDS? I mean, I am not suggesting that we do
anything that is going to take away from the existing good
programs.
Ms. Watson. What we are going to do now is recess. There
are four votes on the floor, and we will come back after the
last vote and then you will, we will start off with you
addressing Ms. Woolsey----
Ms. Woolsey. Madam Chairwoman, I can't come back. I will be
on the floor.
Ms. Watson. Okay, can he give you a response it writing, or
do you want to--the chair is----
Ms. Woolsey. I would appreciate that, but I think we have
time----
Ms. Watson. Yes, the chair is here now, so then he can do
it. I am going to leave and go to the floor. Okay.
Mr. Chairman?
Ms. Woolsey. Whatever.
Mr. Payne [presiding]. Yes, we have time for you to
respond, and let me certainly apologize. I was at a special
program, a day of remembrance, and I was asked to be with
President Obama, and survivors of the Holocaust at a program
that just ended, and so I really apologize, but I was unable to
leave that very important event that was in the Rotunda of the
Capitol. So we have enough time for the response to Ms.
Woolsey's question.
Mr. Gast. You raise a very good question. We also are
concerned and we also appreciate your not wanting to take from
other programs, and neither do we. We don't want to take
resources out of PEPFAR, we don't want to take resources out of
the Malaria Initiative, but what we did do was we went back to
Congress and we argued for additional money for maternal and
child health funding, and the good thing was that Congress came
back and said yes, we are giving you additional funding, but we
want a strategy. We want to understand what your strategic
approach is to allocating this funding, and so, we have worked
over the past 6-8 months in coming up with the strategy that
has been submitted to Congress, and what it essentially does is
that it is a matrix in allocating the funding, certainly based
on need, but also based on the ability of the country to
utilize the funds effectively.
Ms. Woolsey. Have we seen the report, and have you gotten
any input back from us?
Mr. Gast. We have identified 30 priority countries, and
there are several in Africa, and I do believe that Tanzania is
getting additional funding. I will have to look at my colleague
in the back. I do believe that Tanzania is one of the 30
countries worldwide.
Ms. Woolsey. Did I see a nod yes? Okay, but I am not only
talking about Tanzania. I am talking about all these countries.
Mr. Gast. Yes, but you picked a priority country.
Ms. Woolsey. Thank you very much.
Mr. Gast. Thank you.
Ms. Woolsey. Thank you, Mr. Chairman.
Mr. Payne. Well, thank you very much. As I indicated, once
again, I apologize for being delayed, but let me belatedly
welcome all of you here. We are certainly pleased to have you
here, Mr. Gast, in your very important role as the senior
deputy assistant administrator. We certainly look forward to
working closely with you. This particular meeting, as you know,
is a look at United States assistance to Africa and a call to
foreign aid reform, and we want to really discuss how we feel
there can be a debate about foreign aid and to determine how it
can be more effective.
We understand there is a recent book out that I haven't had
the opportunity to read yet, talking about the failures of
foreign aid, and I am sure that there are; however, if we look
at what is happening now in malaria where we are almost
eliminating it after a year or 2 of concentrated effort, I am
not so sure that we need to only highlight the failures but
also the tremendous successes that have happened through
foreign assistance. We are particularly interested, though, in
the effectiveness of U.S. assistance to the continent, a
discussion which is inevitable particularly because of the
world global problem, because of the fact that we all are going
to be asked to tighten our belts.
We are all going to have to really scrutinize and evaluate
programs very, very carefully, and so a look at foreign
assistance is very, very important at this time. We have
certainly seen significant increases in aid funding to Africa
in recent years, and I have said on several occasions that I
applaud President Bush's cooperation in programs toward Africa,
particularly the PEPFAR program and the Millennium Challenge
Corporation, where much of the increase in funding to Africa
has come from.
Although we believe these two programs are successful, it
is going to be a challenge to keep them going in addition to
some of the areas where we have fallen behind. There are other
successes, which the USAID witness highlighted in his
testimony, as we have already heard. Certainly, USAID and what
we do make us proud to be Americans as we move around the
world.
However, I also feel that we must be careful and assess
with a lot of scrutiny what our assistance is actually
contributing in terms of long-term, sustainable development,
and that is what a key is, to not simply rest on our laurels.
Even with our PEPFAR funds, we need to see if we are creating
health systems that, when funding decreases, that those
countries that have been privileged to be PEPFAR recipients
will have the capacity to maintain the health system.
That is what the real goal is, so assistance is sustainable
over a long-term period. We also know that it is not enough to
simply increase funding levels, but like I said, we have to be
sure that we have strong institutions. I submit that we have
gotten away from some of the core development work that we have
looked at, and the fact that, as I mentioned earlier, some of
the things that we did before have sort of been lost in the
surge in certain areas, and what we have to really think about
is having a balance in our approach.
We should get back to basics. One is agriculture
development. USAID has explored the whole question of
agriculture--maybe two decades ago--and food security, as we
see, is a very, very important issue today. We can't
continually have food aid. We even have seen it diverted in
certain areas. So we need to get back as we once were in the
development of agriculture assistance toward the health system,
as I mentioned, and consider how we can have a sustainable
education program.
However, if we are not improving higher education, if we
are not improving the capacity of the educational system to
absorb the new students, then we are having a diluted
educational system, and nation development into areas like
science and technology will fall behind unless we have a strong
higher education program.
I certainly commend President Obama's G-20 announcement
that he will double support for agriculture and rural
development to over $1 billion, aimed at helping poor nations
achieve food security. In terms of our assistance more broadly,
I welcome the administration's moves toward increased
multilateralism and greater cooperation with other donors, and
I think that this is very key as we move into the future.
I feel that we must take a more integrated, long-term and
regional approach to our foreign assistance. I feel that these
can be balanced with short-term objectives, but as we deal with
short-term objectives; it should really be based on what we
feel national security and strategic interests will finally
roll out. In conclusion, we must also hold ourselves
accountable to the funding we provide intended for development
in Africa and elsewhere.
We must be able to ensure our taxpayers that the money is
used wisely, and we can do that by ensuring that the intended
recipients of aid actually get the aid as intended to do.
Secretary Clinton spoke passionately about this issue before
our committee yesterday, highlighting that less than 50 cents
on the dollar reaches the people, where the bulk of funds go to
contractors and associated costs, and I think we really have to
take a look at this whole issue.
This does not mean that we eliminate contractors. They are
certainly essential and important. However, it does mean that
we need to strengthen USAID. The fact that we have not expanded
the agency and have depended on contractors tends to leave us
minimizing what we do. Like I said, we are not talking about
eliminating contractors. They are very important; they are
essential. It is just that we need to figure out a way we can
get more bang for the buck by using contractors, but in some
way expand our capacity to do it ourselves.
As you know, our witnesses, and we have already heard our
Acting Assistant Secretary for Africa, Earl Gast; senior fellow
at the Center for Global Development, Dr. Steve Radelet will be
on the next panel; director for Africa at the International
Food Policy Research Institute, Dr. Ousmane Badiane; from the
Ed J. Bloustein School of Planning and Public Policy at Rutgers
University, Dr. Meredeth Turshen; and Catholic Relief Services
senior director for advocacy, Bill O'Keefe.
We will certainly look forward to the other witnesses, and
at this time, I have been instructed to hit the gavel and say
that we are not in recess, and this is a part of the official
transcript so that will be recorded. We reconvened from that
very moment of recess, so we are in real session now for a very
short period of time.
I wonder if I can ask, and I don't know if it is already
been asked, but in your opinion, what are the greatest
strengths and weaknesses of the main United States agencies
delivering foreign aid to Africa--USAID, the Millennium
Challenge, and the Global AIDS Program? To what extent are
their efforts appropriately coordinated in your opinion? What
roles should African governments play in implementing United
States assistance programs?
To what extent do you believe that USAID should follow the
MCC model and provide more funds directly to African
governments to implement aid programs themselves, and even
perhaps the criteria used by MCC on criteria of governance and
so forth. To what extent, if at all, should this include direct
budgetary support? What accountability measures should U.S.
taxpayers expect under such assistance? If you could try to
tackle any part of that, that would be appreciated.
Mr. Gast. Which part?
Mr. Payne. Any of the above.
Mr. Gast. Let me start with your first question, which is
comparing the strengths and weaknesses of the various
development agencies of the U.S. Government, and I may have a
bias, because I come from USAID, but I have worked with MCC and
have worked with PEPFAR, so I do have some knowledge. I would
say that our greatest strength as USAID, and the U.S.
Government's greatest strength is the field presence of USAID.
You know that we have 23 bilateral missions and 3 regional
missions in Africa, and the way that we program resources, some
of the money certainly goes in supporting government policy
reforms at a macro level, but the other strength of the agency,
of USAID, is that we are not encumbered by delivering all of
our assistance through government structures.
We can then work with civil society organizations, so that
they can provide a counterbalance to government. We can work
with independent media. We can work with private sector
organizations, again, so that there is an effective balance
among all the power centers in a country. MCC has a terrific
advantage in that it doesn't come weighted down with a lot of
directives, let us say. They can come in with a large sum of
money, and largely, their compact programs have been on
infrastructure, and we have worked very closely over the years
with MCC to have a coordinated approach.
In fact, my previous job, I was Mission Director in
Ukraine, Regional Mission. Two of my missions were MCC
countries, so I worked very closely with MCC and the government
in shaping the program and in facilitating MCC's entry. We do
that in Africa as well, and in fact, I should say that many of
the MCC country directors are former USAID directors who have
retired from the Foreign Service and have come back to work
with MCC in development.
We, back here in Washington, the Africa Bureau coordinates
with Rodney Bent and his team on a quarterly basis, and we talk
about broad issues and some country-specific issues, to make
sure that we are on the same wavelength and that if there are
any issues that need to be resolved at a senior level, we can
do it at that point. With PEPFAR, PEPFAR is less of an
implementation organization, as you know.
It is one that develops the programs, the concepts and
strategies, and we and other U.S. Government agencies have been
working with PEPFAR in trying to influence strategy, but
certainly carrying out the programs in the field.
Mr. Payne. Let me ask another question that has been
bounced about here on Capitol Hill. Although it has actually
gone into effect under the past administration, the whole
question about civilian and military coordination. You know, we
have the U.S. Africa Command, and I just wonder, what
coordination mechanisms have been created to reconcile
Department of Defense and USAID objectives with respect to
DoD's civilian, humanitarian and development activities in
Africa?
What role does USAID's Office of Military Affairs play in
Africa? Have the presence of USAID personnel and DoD Africa
Command and other USAID OMA improved the conduct of United
States military humanitarian civic actions and reconstruction
projects in Africa? In Africa, what role do Chief of Missions
play in ensuring necessary consultation and coordination
between USAID personnel and DoD personnel in the countries of
responsibility are interacting?
Let me just say that there are people who, some of us, in
particular, me, that have been concerned about AFRICOM, and the
way that it initially was introduced. We felt that there was
not enough preparation done, as it was not only introduced to
African countries, but also to the Congress, we read about it--
at least our committee. Now, maybe Department of Defense
committees had a little more involvement in it, but it
certainly was out-of-hand rejected by 52 out of 53 sub-Saharan
African countries when it was first mentioned.
People felt that we were militarizing USAID. If you are in
the alliance of the willing, then you get money. If you are not
willing to do that, then you don't, and secondly, that USAID,
the image was, would have to go to see the general in charge to
see whether it is permissible to start our new agricultural
program, et cetera. What is your take on AFRICOM?
Mr. Gast. I think the situation has been steadily
improving, that is, the coordination. It is interesting, USAID
has very few personnel. We have about 277 Foreign Service
Officers on the entire continent, yet we have huge monetary
resources. The DoD approach is quite the opposite; very little
on the program side, but a lot of people, and unfortunately, in
the early days, especially with CJTF-HOA based out of Djibouti
wanting to initiate development activities or humanitarian
activities, the human cost of interacting with DoD was
excessive for us, and also for embassies.
What we have done over the last year is gotten an agreement
with CJTF-HOA, and now with AFRICOM, on how activities are
going to be coordinated, and that is that if--and by the way,
we are talking about a small amount of resources. I believe the
amount of money that CJTF-HOA managed last year was $11
million, so it is a very small sum of money, but whenever they
have ideas for humanitarian assistance, they are to come first
to the USAID Mission Director, and if it is endorsed by the
USAID Mission Director, it is then presented to the country
team, and if the country team, headed by the Ambassador, of
course, agrees that it is appropriate for the country, only
then will the activity go forward.
So I think that that is, it is becoming a very effective
coordination mechanism, and it is becoming an effective
mechanism in-country. You rightly point out that we do have
persons seconded over to AFRICOM. We have a Senior Development
Advisor, Senior Foreign Service Officer, and we also have two
others who have been seconded over to AFRICOM. I would say
three USAID persons is not enough, but given the size of our
organization, it is, I think, a very valuable contribution, and
they greatly appreciate it.
Mr. Payne. The rationale is that the Department of Defense
has the robust capability to do things. I have heard this
argument, and of course, because the Department of Defense, you
know, tend to be able to get what they want in appropriations
over the past several years, USAID closed several offices in
Africa during the last administration. I wonder what the Obama
administration intends to do. Is it going to try to make the
USAID more, build it up again, or will we keep it at these same
levels?
Mr. Gast. We, during the last administration, and it is
been endorsed by this administration, and certainly with this
bipartisan support of Congress, is our Development Leadership
Initiative, which aims at doubling the number of Foreign
Service Officers by 2011 or 2012. That has been supported and
endorsed by Secretary Clinton, and we are well on our way to
doubling the Foreign Service force. Definitely, there are
issues.
Space is an issue on the continent, but we are expecting to
open additional missions over the next several years.
Mr. Payne. Well, that is good. I certainly look forward to
a strengthened USAID operation, and I hope that we can have a
balance with the growth of the military. You know, that is how
some countries operate in Africa. In the old days, you know,
the military was the one that dispensed anything and
everything. We really don't want to have it look like they were
doing the right thing when they should have been working
through civilian operations. Thank you very much.
I think I will call this hearing into recess. We have
several other votes coming up, and so I would ask the witnesses
on the second panel if you would remain. We have three 5-minute
votes, one of which I am probably going to miss, which is on
now with 1 minute left. Then there will be two other 5-minute
votes, so that is about 10 or 12 minutes, one vote to recommit,
and then final passing, so it will be between 15 and 25
minutes, 15 minutes at the least.
It is according to whether we have a recommit vote, whether
it will be longer. So the meeting stands in recess. Thank you.
[Recess.]
Mr. Payne. Once again, thank you all, very much. As you
know, this is rather unusual today and so if we invite you back
again, it is not going to be like this, we do not believe. The
hearing will resume and we move on to the second panel.
First, we have Steven Radelet. Radelet is a senior fellow
at the Center for Global Development, where he is working on
issues related to foreign aid, developing country debt,
economic growth and trade between rich and poor countries. He
was, in the past, Secretary of the United States Treasury for
Africa, the Middle East, and Asia from January 2000 to June
2002. In his capacity, he was responsible for developing
policies on United States financial relations with the
countries in the region, including debt rescheduling and
programs with the IMF, the World Bank, and other international
financial institutions. From 1990 to 2000, Dr. Radelet was on
the faculty of Harvard University, where he was a fellow at the
Harvard Institute of International Development, Director of the
Institute of Microeconomic Programs, and lecturer on economics
and public policy. He was also a Peace Corps volunteer in
Western Somalia from 1981 to 1983. He currently serves as an
economic advisor to the President and Minister of Finance of
Liberia. His research and publications have focused on foreign
aid and economic growth, financial crisis, and trade policy in
developing countries, especially in sub-Saharan Africa and East
Asia.
Next, we have Dr. Badiane. I am having a tough time today.
Dr. Ousmane Badiane is the Africa director for the
International Food Policy Research Institute (IFPRI). In this
role, he coordinates IFPRI's work in the areas of food policy,
research, capacity strengthening, and policy communications in
Africa. He is also in charge of IFPRI's partnership with
African institutes dealing with the above. He was a needs
specialist for food and agricultural policies for the Africa
region at the World Bank from January 1998 until August 2008.
He previously worked at IFPRI as a senior research fellow from
1989 to 1997, where he led the institute's work on market
reform and development. While at IFPRI, he taught as an adjunct
professor at Johns Hopkins School of Advanced International
Studies from 1993 to 2000. He received a master's degree and
Ph.D. in agriculture economics from the University of Keil in
Germany.
Next, we have Dr. Meredeth Turshen, professor of the Edward
J. Bloustein School of Planning and Public Policy at Rutgers
University. Her research interests include international
health, particularly African women's health, where she
specializes in public health policy. She holds a second
interest in the impact of war on women. She has written several
books, including The Political Ecology of Disease in Tanzania
and What Women Do in War Time, Gender and Conflict in Africa.
Dr. Turshen serves on the board of Association of Concerned
African Scholars, as treasurer of the Committee on Health in
Southern Africa, as a contributing editor of the Review of
African Political Economy. She holds a position on the
editorial board of the Journal of Public Health Policy. Dr.
Turshen has lectured widely in the United States and abroad and
as a speaker on international health policies, women health in
Africa, and, as I mentioned, the impact of war on women.
Last, but not least, we would like to welcome Mr. O'Keefe.
Bill O'Keefe is Catholic Relief Services' senior director for
advocacy, based at its headquarters in Baltimore. He oversees
efforts to change foreign policy in ways that promote justice
and reduce poverty overseas. This involves lobbying Congress
and the administration on a range of foreign policy issues and
educating United States Catholics about international issues
involving them and public campaigns for policy change. Mr.
O'Keefe received his bachelors of science, cum laude, from Yale
University in 1984 and a master's in public policy from Kennedy
School of Government at Harvard in 1987. He joined Catholic
Relief Services in 1987 as project manager in Tanzania,
designing and monitoring community development projects. And he
has in the past served in various capacities with CRS. He was
appointed senior director for advocacy in 2003.
Let me thank all of the witnesses and we will start with
you, Dr. Radelet.
STATEMENT OF STEVEN RADELET, PH.D., SENIOR FELLOW, CENTER FOR
GLOBAL DEVELOPMENT
Mr. Radelet. Thank you, very much, Chairman Payne. Thank
you for holding this hearing this afternoon. Today, of course,
we face enumerable challenges in Africa and around the world:
Two wars in Iraq and Afghanistan, challenges of terrorism and
piracy off the coast of east Africa, the continued spread of
disease, and, of course, the global economic crisis and
deepening poverty, as a result of that. At times like this, the
world looks to the United States for leadership and it is
tempting for us to turn inwards. But for us to do this at this
point would be counterproductive for us and for the rest of the
world and it would be a terrible mistake to do so. For better
or for worse, the world sees and believes that the United
States caused the global crisis and for us to step back and--
and whether that is true or not is irrelevant--but for us to
step back from that just when people in countries are looking
for our assistance, I think would really be a mistake for us to
do it.
Instead, it creates an opportunity for the United States to
strengthen its leadership role through smart power and other
efforts to create a better and safer world over the long run.
In particular, I think today there is a great opportunity in
Africa. Americans tend to still think of Africa as a place of
African big men rife with corruption, no democracy, no economic
opportunities, and deepening poverty. But, actually, there are
big changes underway and have been underway for the last 10 or
15 years in Africa. By international indicators, in 1989, there
were three democracies in Africa and today there are over 20.
Some are fragile, some are less fragile. I was glad to hear in
the early part of the hearing the mentions of the successful
elections in Ghana and Zambia, among other places, which hardly
get the press that some of the negative news gets. We have had
over 10 years of 5 percent growth across most of Africa. The
poverty rate, according to the World Bank, in Africa has
dropped from 58 percent to 51 percent in the last 10 years,
which is a remarkable change to have that kind of drop in just
the last decade. So, there is a lot of good news across at
least half the continent, if not more, and we have an
opportunity today to help consolidate that progress and to help
create stable and contributing members to the international
community.
But, it will take a full set of our tools of how we engage
with developing countries, not just foreign assistance, but
also changes in our trade policies, our health policies, our
environmental policies, and a range of other policies. Now, all
of those are important. Our focus today is on foreign
assistance, so I will speak about that, but I think it is
important to remember that that is but one tool in our tool
chest of the ways that we can help support development and
poverty reduction around the world.
Our foreign assistance programs are far more successful
than they are given credit for. It is very easy to pick out
failures. But, as we heard earlier today, there are successes
around the world and in Africa, from the HIV/AIDS programs and
other health programs, to helping Liberia get back up on its
feet, to education programs in various parts around the world,
infrastructure and power programs, as well. And the programs
generally do not get as much credit as they ought to get. But
having said that, there are some significant problems. Our
foreign assistant programs are out of date and they are pretty
badly in need of significant modernization and reform and
consolidation across agencies, as you mentioned today.
I want to mention quickly just seven things that I think
are important steps that need to be taken in the near future to
strengthen and modernize our foreign assistance programs.
Number one, it is hard to make progress without a strong
leader. The first key step is for the administration to name a
strong, capable leader as the USAID administrator. You had many
questions this morning about the administration's new approach
and they could not be answered, because we do not have the
strong development leadership in place. The administration
needs to name a strong leader at USAID. I believe they need to
make that person a member of the National Security Council, to
give that voice of development at that table on national
security decisions. They, also, need to appoint the other
leading positions in development around the government, at
OGAC, at the MCC, at Peace Corps, and other kinds of positions.
That is number one.
Number two, we need a development strategy that articulates
our goals for what we are trying to achieve as a country in
developing countries, how we are going to achieve those, what
the modalities are of our approach. We do not have a strategy
for what we are trying to achieve. We need an interagency
strategy led by the NSC, not just the State Department, but
across many agencies that articulates a strategy of what we are
trying to do, how we are trying to do it, in our engagement
with developing countries. That strategy should be developed in
parallel with the National Security strategy, the quadrennially
defense review, and other strategies that are out there. But
right now, the absence of a strategy puts us all over the map
in terms of what we are trying to do.
Number three, we need a much stronger legislative
foundation for our foreign assistance programs. As you well
know, the Foreign Assistance Act, written in 1961 and amended
many times thereafter, is very much out of date, overburdened
with too many amendments, some of which are at odds with each
other and has not been re-authorized in two decades. And there
is a time and an opportunity right now to rewrite the Foreign
Assistance Act, to have a sure vision between the executive
branch and the legislative branch on the roles and key issues
going forward on foreign assistance. It would need to provide
the executive branch with the authorities that it needs to
address key issues on the ground, to have the flexibility to
address the highest needs on the ground, and at the same time
ensure rightful and effective oversight by the legislative
branch. We have to get that balance back and I think rewriting
the Foreign Assistance Act is key to that.
Number four, we need a strong consolidated development
agency. You mentioned earlier today that we have programs all
over the place. By various counts, Congresswoman Watson
mentioned 26 agencies according to the OECD report across the
executive branch agencies that are delivering foreign
assistance. The left hand does not know what the right hand is
doing. They work at odds. There is duplication, there are gaps,
and it is far too many agencies trying to achieve the same
thing. We need to consolidate many of those programs, not
necessarily all of them, into a strong and revitalized USAID or
a successor agency. It needs new staffing. It needs strong new
leadership. It needs the legislative foundation. It needs
strong monitoring and evaluation programs and it really needs
to be made into a strong 21st century development agency. And
we can talk more about how that could be done, as we go
forward.
Number five, in Africa and in other regions, we need a more
differentiated approach in how we work in different countries.
Some countries are very well governed and we ought to be
working very closely with governments and give those
governments much more leadership in setting priorities and
identifying the highest needs, not identifying all those needs
here in Washington. The MCC is the first step in that process,
where it supports countries that are moving in the right
direction and lets them make the decisions, not us, on what the
highest priorities are. In other countries where there is much
weaker governance, we should be working with more NGOs and in
parallel with the government, but being more opportunistic,
working with the Ministry of Health, if that makes sense in
that country, the Ministry of Education in a different country.
It depends on the situation when it is a more poorly governed
country. In situations like Zimbabwe or Somalia, it is much
more difficult to work with the governments, we ought to be
working with NGOs and faith-based groups to help provide
support for basic services. So, we need a much more
differentiated approach with different tools to fit different
circumstances. For far too long, we have had one size fits all
and we need to move away from that.
Number six, we need to much better leverage our bilateral
assistance with our multilateral assistance. The share of our
foreign assistance that goes through multilateral channels have
fallen to 10 percent--10 percent. One out of ten dollars goes
through multilateral channels. And it is a missed opportunity
for us to leverage assistance, use our dollars, and multiply it
by the contributions of other member countries that have really
fallen by the wayside during the last administration and I
think needs to be rejuvenated.
And, finally, all of this will take more money, as well as
making sure that money is better spent. It is not just a matter
of moving boxes. We need the resources to get the job done or
we need to make sure that those resources are used effectively,
not through the bureaucratic channels that we have now, and
tracking those with an effective monitoring and evaluation
program to make sure that the dollars we spend have the impact.
So, it is a long list, but we have the opportunity to do it
and the need to take on these reforms. It will not be easy. I
do not underestimate the challenges at all, either for the
legislative branch or the executive branch and it is even
harder with today's global financial crisis. But, the need is
great and we have the opportunity now to take on these
challenges, to build a better and safer world. It is time to
take advantage of the opportunity to really make our
development programs a strong and effective pillar of both
national security policy and humanity in general. Thank you,
very much.
[The prepared statement of Mr. Radelet
follows:]Steven Radelet
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Payne. Thank you very much. Mr. Badiane.
STATEMENT OF OUSMANE BADIANE, PH.D., AFRICA DIRECTOR,
INTERNATIONAL FOOD POLICY RESEARCH INSTITUTE
Mr. Badiane. Thank you, Mr. Chairman, and thank you for
this hearing, which obviously is of great importance to me, and
thank you for inviting me. I have submitted a written
testimony, so I will make a brief comment here. I will be
talking about the economic development of Africa, agriculture,
in particular, and then later in my testimony touch a little
bit on the United States assistance.
The first question that came up was, what are the key
issues for Africa with respect to short-term and long-term
development? And in starting to answer that question, I would
like us to ask ourselves what do we need to do first to
understand where Africa is today in terms of its economic
performance and what that implies for its future development
outlook. Africa has changed and we need to understand that
change and understand how we are going to build on that change.
It hasn't transpired to many places, although I have heard it
around the table here this morning. But we need to really take
a good look at what is happening in Africa and see how that can
be used to propel us toward much high economic performance and
much faster poverty reduction on the continent.
Basically, what happened in Africa over the last 10-15
years, one would have to go all the way back to the 1960s to
find that level of economic performance. Africa has lost the
1970s and the 1980s and the first half of the 1990s. But,
growth has accelerated since. Somebody mentioned a 5-percent
growth rate over the last 10-15 years. It was projected to go
down to 3 percent and maybe now to 1.7 percent because of the
crisis. But, growth accelerated over the last 10-15 years
before the crisis. It has spread to many more countries. We
have over the last 10 years more countries growing at a much
faster rate than any time in the preceding 2\1/2\ decades
before.
Export performance in Africa has also been equally strong.
For the first time in history, post-independence history,
export growth in Africa has been higher than the world average
from 2002 to 2005, both in terms of agricultural export value
and volumes, unprecedented. Increases of FDIA, foreign direct
investment into Africa, has even been the subject of an article
in Time Magazine recently. When you look further, you see that
macroeconomic indicators in Africa have improved greatly.
Inflation has been down. Fiscal balances improved. Foreign
exchange reserves have gone up. Currency valuation has been
much more consistent.
Now, to look forward as to what we can do and what the
United States can do in Africa, we should ask ourselves what
has been behind this remarkable recovery after 2\1/2\ decades
of stagnation and how can we understand the factors behind it
and, therefore, scale them up. I think that should be a
starting point.
First, what I would say is that we had very strong
macroeconomic and social policy reforms across Africa. You look
at governance effectiveness across many African countries. It
has increased quite sharply. But, also, we have to recognize
that the recent economic recovery, has not compensated for 2\1/
2\ decades of stagnation, from the 1970s, 1980s, to mid-1990s.
We will still have large pockets of poverty across Africa and
while the progress toward the poverty reduction goal,
Development Goal has picked up, it is not going to be enough
for many African countries to meet the Millennium Development
Goal. The real challenge, therefore, that we have, Mr.
Chairman, is how to accelerate and broaden the growth process
that has taken place over the last 10 years and I think that
should be the guiding factor in United States assistance to
Africa in the coming years.
I highlighted the recovery because I wanted to insist on
the fact that it creates a very strong foundation for United
States assistance to Africa. We have today far better
conditions for much higher returns to investment in Africa,
including United States assistance in Africa, then we have had
over the last 20 years, or toward the end of the last century.
We have two things that speak for that and I think that should
not be lost to people deciding on United States assistance to
Africa; the conditions are good for much higher returns in the
future.
While planning and implementation is improving greatly
across Africa, the comprehensive Africa agriculture development
program that has been adopted by the African Union, is being
put in place by the NEPAD, New Economic Partnership for
Africa's Development, and implemented by economic communities
across Africa. African countries are moving toward evidence and
outcome-based planning, peer review, tracking of progress, and
mutual learning and adoption of best practices. I have very
high hope for that program, which could provide a very strong
basis for future engagement in Africa.
As part of that program, African governments have committed
themselves to allocating much more resources to agriculture, up
to 10 percent of their national budget. The last time I looked,
allocation to agriculture has gone up 75 percent from 2003 to
2006. So something is happening that provides a very strong
foundation for future United States assistance to Africa.
Now, how do I assess the effectiveness of U.S. assistance
to agriculture and food security? We all know that the United
States invests quite a lot of money in safety nets and food
emergencies. It is a leading force on the continent and I would
say around the world. It has also invested quite a bit in
raising productivity, in earlier years more than in later
years. But, I do not think that the balance is there. The
investments in emergency and safety nets far outweigh the
investment in productivity.
That may be a problem and here is why; the most effective
way to reduce poverty is to raise the productivity of the
resources that people depend on for their livelihood. And most
of the issues we are tackling through safety nets and social
interventions are the symptoms of poverty. And they are there
because (A) growth is low, economic progress is slow, and the
governments are not generating enough fiscal resources to
supply the services that are needed by their citizens; and (b)
productivity being low, households do not have enough resources
to pay for access to such services. So, instead of focusing
solely on the symptoms of poverty and on social services,
assistance should recognize the importance to invest in raising
the productivity of the poor people, who, in many cases, can be
quite gainfully employed and be productive to improve their
livelihood. So, I think this is very, very important.
I would also at this juncture actually salute a very
critical difference with respect to United States assistance in
Africa. It is just not money that the United States is
providing to Africa. It is also the quality of policy dialogue.
It is the quality of expertise. USAID is doing an excellent job
here. This is an area where I do interface with them. And that
makes a difference. It sets the U.S. apart from other
development agencies. These emphasize resources. The U.S. adds
to it high-quality dialogue and expertise, and I think that
ought to be maintained.
Now, do I believe that reforming aid is necessary? My
answer is yes, Mr. Chairman. As I said before, the imbalance
between emergency and productive investment ought to be
restored and corrected. I think that safety nets and emergency
programs should emphasize productivity effects much more,
because as you said and your colleagues also have said, we are
in a time of crisis. Although there is all the determination to
invest more in Africa, choices will have to be made. But I
think it is very hard to make choices between meeting short-
term social needs and long-term productive needs.
Therefore, the smart thing to do is how to create synergy
between the two, not look at them as alternatives, either or,
but how to maximize synergy between social services investment
and productive investments. And the way to do that, I have
highlighted a little bit in my written testimony. One entry
point is, when we are dealing with health, education and safety
nets, to ask ourselves: How can we maximize the short-term
impact on the productivity of labor in the rural areas and in
the agriculture sector?
Health is a composite. It is not just one service.
Education is a composite. It is just not service. And the
composition of the different health services and education
services do have real implication for the long-term growth in
these economies. So, we do not have to choose between
satisfying social needs and investing in growth, but we have to
target the specific investment in social services that give us
the biggest return in terms of raising productivity.
Finally, Mr. Chairman, here are my recommendations. I think
United States assistance to Africa ought to recognize the
historic opportunity behind the current economic recovery and
the efforts by African countries to improve policy planning and
implementation and invest themselves more in agriculture. We
have the best conditions for the highest returns to investments
since, I think, the late 1960s. I, also, think that the U.S.
should be investing and accelerating and sustaining the
recovery process over the last 10, 15 years. It is important to
think about what we do, but also how we do it. And I think
here, we need a common denominator investing our assistance
resources across the world and that common denominator should
be: How are we contributing to raising the labor productivity
and income at the end of the day. We have to make sure that
emergency programs, therefore, Mr. Chairman, target labor
productivity in the rural areas. While doing that we need to
scale up investment in support of agriculture, of course. And,
finally, Mr. Chairman, U.S. assistance going forward should
align as much as possible with the comprehensive agriculture
development program, as a quality framework for policy and
investment partnership, which is owned and led by the African
Union and its member country. I thank you.
[The prepared statement of Mr. Badiane follows:]
Ousmane Badiane
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Payne. Thank you, very much. Dr. Turshen.
STATEMENT OF MEREDETH TURSHEN, D. PHIL, PROFESSOR, EDWARD J.
BLOUSTEIN SCHOOL OF PLANNING AND PUBLIC POLICY, RUTGERS
UNIVERSITY
Ms. Turshen. Thank you, Mr. Payne. I am very glad to be
here from our home State of New Jersey. I want to thank the
distinguished members of the subcommittee for the honor of this
opportunity to address global health and gender in Africa. And
as my colleague has said, I have submitted testimony, which is
too long to read, and so I am going to read a brief summary.
The title of these hearings appropriately links economic
policy to health issues. The prevailing neoliberal economic
model, known as the Washington Consensus, mandates constraints
that include ceilings on expenditures on health and education
and requires governments to cut services in personnel and to
eliminate food subsidies. Trade liberalization policies have
hurt weaker domestic industries related to the provision of
healthcare. And WTO regulation of private property rights in
medicines has impeded access to affordable drugs. The U.S.
Government imposes many such conditions through bilateral trade
and investment agreements. Applying these economic policies
over the past 20 years, international institutions,
multinational corporations, and bilateral agreements have
transformed global healthcare and, I believe, devastated public
health services by commercializing both supply of and
expenditure on health services. As a result of these policies,
Africans face twin crises, increased poverty, and poor
healthcare delivery systems. U.S. policy should prioritize
poverty reduction and support for public health systems.
Global poverty is concentrated in sub-Saharan Africa. As we
have heard, 40 percent of people live on less than $1 a day and
real income has declined over the past decades, while, in fact,
Latin American countries, the Arab States have registered
modest gains and growth was rapid in East Asia. New poverty
reduction strategies are needed that stress the right to health
as a primary objective and these strategies should be based on
an economic philosophy that promotes government investment in
public health.
The United States subscribes to the MDG challenge of
halving extreme poverty by 2015, but it has no international
poverty reduction policy. As we have heard, the 2007 U.S.
Foreign Assistance Framework, which seeks to align all U.S.
Government foreign assistance into a single cohesive structure,
lacks a focus on poverty reduction.
African public health systems are fragile and under-
resourced. Public health expenditure has stagnated in 20 of 25
countries for which there are data. Eleven sub-Saharan
countries spend less than $5 per person per year on health and
another 15 spend less than $10. WHO estimates that the cost of
a set of social interventions is $34 per person per year, and
they say that most of that would need to be public spending. At
the moment, the percentage of what Africans spend out of pocket
on healthcare is actually greater than what Americans spend out
of pocket.
The fragility of African healthcare systems is largely due
to the failed policies of donor agencies that have undermined
government health services in two ways: From above, by
structural adjustment programs that have hollowed out public
health systems; and from below, by channeling funds to the
private sector, usually through private voluntary
organizations. These and other policies accelerate brain drain,
which siphons health personnel from the government sector.
I think the United States needs to reexamine the migration
of African health personnel, recognizing the role that we play
in this phenomenon. Brain drain takes several forms: The drift
of trained African personnel from rural to urban areas, from
primary to tertiary facilities, and from the public to the
private sector from within their countries. In addition,
personnel are moving from all over the continent down to South
Africa, but they are also moving from their countries to
Europe, Oceania, and North America. Austerity policies that cut
government jobs push personnel out of public health services
and foreign aid policies that channel assistance through
international NGOs attract government personnel to the private
sector. Ratios of physicians to population fell in four
countries, remaining the same in another four. They rose in 16,
but not at the rate of population growth. Proposed legislation,
such as the Nursing Relief Act of 2009 and the Emergency
Nursing Supply Relief Act, would aggravate the effects of brain
drain on fragile African health systems.
U.S. assistance in the health sector has favored large
vertical disease-based initiatives. These eclipse more
traditional conduits of foreign assistance by running around
the United Nations and WHO. These initiatives contributed to a
decline in spending on maternal and child health, which is 22
percent less than it was 10 years ago. I have reported
elsewhere on what has happened to women's health in sub-Saharan
Africa since the 1994 conference on international population
and development, when promises were made to improve sexual and
reproductive health services, and I would ask that my report be
entered into the record. Maternal mortality rates have risen or
stayed the same in 16 of 40 African countries. Two-hundred-and-
sixty-five thousand women in sub-Saharan Africa died during
pregnancy or childbirth in 2005, approximately one in 22.
Skilled personnel attended fewer births in 12 of 31 countries
for which comparative data are available. Family planning is
the one service that has increased in the years since the ICPD
conference in Cairo. At the 10th session of the Human Rights
Council in March 2009, 83 countries signed a statement
expressing concern at the unacceptably high rates of maternal
mortality. The United States was not among them nor has it
ratified CEDAW, the U.N. Convention on the Elimination of all
Forms of Discrimination Against Women.
Our record is no better in meeting Millennium Development
Goals. According to the most recent MDG Africa Steering
Committee report, the continent as a whole is lagging behind on
each goal. Progress toward achieving gender equality and
environmental sustainability remains inadequate. The challenge
of reaching the eight MDGs in African countries is compounded
by the grave long-term risk that climate change poses. The
recent rise in food prices, which is related to climate change,
volatile hydrocarbon prices, and commodity speculation is
putting great pressure on African economies and threatens to
unravel hard won progress in fighting hunger and malnutrition.
The dangers of the decelerating world economy only add to the
challenges that African countries face.
There is widespread agreement in the United States and
abroad and at this table that the United States does need to
change the way that it administers health-related assistance.
It has already been mentioned that according to OECD, the
United States differs from that of other members of the
Development Assistance Committee in that each of the 26
government agencies in the United States conducting aid
programs has its individual approach to planning, agreeing, and
implementing the assistance in consultation with partner
countries. USAID, historically the main agency for implementing
U.S. programs and health education, humanitarian relief,
economic development and agriculture, has seen its share of
foreign aid decline, from over 50 percent in 2002, to under 40
percent in 2005. One cause of this decline has been the
increase in foreign assistance disbursements to the Department
of Defense, up from 5.6 in 2002, to 21.7 percent in 2005. This
shift from USAID to DoD represents, I believe, an undesirable
blurring of the boundaries between defense, diplomacy, and
development. Currently, the State Department, which has limited
expertise in development, is taking the leading role on AIDS
interventions.
There are significant problems in the way the U.S. delivers
assistance. The bulk of the money is wasted, misdirected, or
recycled within our own country. Agencies fail to target the
poorest of the countries. They spend too much on overpriced
technical assistance for international consultants and they tie
aid purchases from our own country's firms. Planning,
implementation, monitoring, and reporting requirements are
cumbersome, poorly coordinated, making the administrative costs
excessive, and disbursements are late and partial. These aid
delivery problems are called collectively the ``phantom aid''
phenomenon. They are significant in almost 90 percent of U.S.
assistance. Changing annual appropriations to 5- or 10-year
budgets would resolve some of the problems of unpredictability.
But, untying 97 percent of U.S. bilateral assistance to the
least developed countries would yield an additional $4.37
billion, according to one estimate.
Re-engaging with the multilateral system would promote
better international coordination. The U.S. share of overseas
development assistance to multilateral organizations is
falling, from 26 percent in 2002 to 8 percent in 2005. We need
to renew our support of U.N. agencies like UNFPA. And here I
disagree with Congressman Smith. I think we need to decrease
the undue influence of religious doctrine on sexual and
reproductive health programs.
If the U.S. Government is serious in its wish to build
public health systems in Africa, then scattered health
initiatives must be consolidated, and I think they should be
channeled through WHO. WHO has the expertise to improve African
health systems, whereas I am afraid the United States has no
viable model to offer. The funds in PEPFAR and the President's
Malaria Initiative should be turned over to WHO. I believe
UNAIDS should be disbanded. I do not think I am alone in this,
and WHO should once again administer AIDS programs, as well as
the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and
the Roll Back Malaria Campaign.
The delivery of aid through private voluntary organizations
should be curtailed in favor of multilateral channels. This
would not only assist African governments in planning their
healthcare and reducing the administrative workload, but it
would also help the private voluntary organizations wean
themselves from dependency on government support. Being more
independent, the PVOs could take a more critical stance as
advocates for their constituents. African people cannot hold
international NGOs accountable for failures of service
delivery, but they can make their government answerable.
Under the current international intellectual property
rights regime, pharmaceutical oligopolies hinder the supply of
affordable medicines to the continent. Instead of putting up
barriers, the United States should encourage African countries
to use the safeguards provided in the 2001 Doha Declaration on
TRIPS, which would allow easier access to generic medicines.
With annual budgets of $1-$10 per person per year, Africans
cannot afford to buy high-priced drugs and vaccines. The World
Bank has a solution for this dilemma, a public fund to purchase
vaccines. It suggests that international development banks
issue contingent loans for vaccine purchases. This does solve
the dilemma for the pharmaceutical industry because it
guarantees them sales. But instead of working toward canceling
the debt of African countries, this plan would increase African
indebtedness and repayment of debt is what has forced so many
countries to spend less on health and education.
The first MDG deadline to achieve gender parity in primary
and secondary education by 2005 was not met. This failure is
particularly disheartening because the deadline was both
realistic and achievable. Not educating girls has special
significance in public health, both because of the high
correlation of educated mothers with healthier children and a
greater provision and consumption of health services by women.
There are more than five nurses and midwives to every doctor in
the African region, a female-to-male ratio of roughly five to
one. Yet curricula often exclude girls from mathematics,
science, and technology, which are precisely the prerequisites
for careers in medicine, nursing, and public health.
Poverty creates competitors for girls' time in school--the
pull of work, paid and unpaid, and the push to early marriage.
Twenty-six percent of African children under the age 14 are in
the labor force. I actually think that is a terrible
underestimate. School fees, which is the same misguided World
Bank policy that demanded user fees in health facilities, keep
many poor children out of school.
So the solution once again is poverty reduction, as Dr.
Badiane has emphasized. But, I hope that the economic crisis is
an opportunity to reform the flawed policies of the Washington
Consensus. Thank you, Mr. Chairman.
[The prepared statement of Ms. Turshen
follows:]Meredeth Turshen
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Payne. Thank you, very much. Mr. O'Keefe.
STATEMENT OF MR. BILL O'KEEFE, SENIOR DIRECTOR OF POLICY AND
ADVOCACY, CATHOLIC RELIEF SERVICES
Mr. O'Keefe. Good afternoon, Chairman Payne, and let me
just thank you for your courage in going to Somalia and the
commitment that that represents for the people of Africa. I,
also, want to thank ranking member Smith for his tireless
advocacy on behalf of human rights for the people of Africa. I
appreciate the interest of all the members of the subcommittee.
Thank you for allowing Catholic Relief Services to share its
views on foreign assistance priorities for Africa and
especially around reform.
Foreign aid does need to be reformed to meet the 21st
century challenges in Africa. Paul Collier documented in the
Bottom Billion many of the poorest people in Africa live in
countries stuck in development limbo. As Congresswoman Watson,
I think, summarized well, major global trends, such as climate
change and the global financial crisis, threaten to keep these
nations permanently locked in this state of poverty. Again and
again our church partners in Africa highlight the growing
problem of underemployed and unemployed poorly educated urban
youth in expanding cities. Finally, the complicated series of
conflict systems on the continent is the Gordian knot that ties
up African development in many places.
Responding effectively to these challenges would benefit
from all the lessons learned from over 60 years of experience
at CRS. Our central conclusion from that experience is this:
Effective responses require local participation and ownership
in their design and implementation. Whether strengthening
agricultural supply chains, improving access to quality
education for girls, or caring for people living with HIV,
people must be the central participants in their own
development. In Africa, faith-based institutions, like Catholic
Relief Services, are well positioned to ensure this local
participation and ownership. This is because of our extensive
grassroots network and the resulting access, trust, knowledge
of local cultures and needs, and respect for local traditions
and religious values.
Linking our on the ground assets to this approach of U.S.
foreign assistance, however, is not always easy and has not
always been easy. U.S. foreign assistance is stuck in its own
limbo. Only 25-34 percent of foreign assistance is directed to
the poorest people in the poorest countries. As Dr. Turshen has
mentioned, poverty reduction is certainly the focus that we
would like to see more of. In response to complex and changing
conditions and the rich diversity of peoples and cultures on
the ground in Africa, funding has been stove piped, inflexible,
short-term, and too often prescribed from Washington.
So how can this committee reform U.S. foreign assistance,
so that the critical elements of participation and ownership
filter all the way down to the rural Kenyan farmer or to the
woman trying to feed and educate her children? There are three
principles from our experience that apply to the range of
legislative initiatives facing this committee from general
foreign assistance reform legislation, to food security reform,
to microenterprise reauthorization.
The first principle is ``do no harm.'' In this case, I mean
preserve the role of faith-based organizations that fill large
niches that few others can. Conscience clauses and other
provisions that mitigate against discrimination in funding and
allow faith-based organizations to contribute their unique
strengths are essential. In no area is this more true than in
PEPFAR. Faith-based institutions often provide the only quality
healthcare, education, agricultural assistance, and other
critical assistance in whole regions of rural Africa. Without
their presence, the most vulnerable would simply go without.
CRS's care treatment and prevention projects are carried out in
partnership with Catholic church agencies and other local
organizations and last year directly helped more than 3.5
million people affected by the disease. Under PEPFAR II, we are
already building on the rural healthcare system strengthening
begun under PEPFAR I. Where aid isn't broken, don't fix it.
The second principle is ``throw out the cookie cutter.''
People are not single sector beings. And in Africa, the
incredible diversity across every variable means participatory
projects owned locally will vary immensely. Faith-based groups,
local NGOs and PVOs need to be able to address hunger as we do
in Ethiopia, for example, where we combine Title II and other
resources to assist women farmers to improve their environment,
increase their yields, address their nutrition constraints, and
engage in savings led microenterprise activities for income.
This holistic approach suggests a wider need to coordinate
development programs appropriately. Staff and country need the
flexibility to propose a responsive country level development
strategy. Over determining sector allocations from Washington
does not promote real development.
The third principle is ``maximize the comparative
advantages of the various actors.'' Pay attention to the
details of the funding mechanisms, so that faith-based
organizations, American PVOs, and local civil society groups
can access funding in ways that allow them to support the
projects that arise from the participation and ownership we
work so hard to foster. As Mr. Gast mentioned, USAID has been
so understaffed that the remaining personnel do not have the
time and support to manage and monitor the kinds of
participatory, locally-owned initiatives that work. To meet
their responsibilities, the remaining staff rely on larger and
larger contract mechanisms with tighter and tighter
requirements and shorter and shorter time frames. The result,
CRS, local faith-based groups, local NGOs and PVOs specializing
in the critical skills and relationships for development
effectiveness cannot participate. CRS has found that some of
the new foundation donors have developed funding mechanisms
that are both predictable, flexible, and yet rigorous. We have
been able to develop agricultural research initiatives led by
women farmers, for example, because we have had the flexibility
and the opportunity to explore over time with those communities
the kinds of interventions that work. Assistance reform must
allow us to innovate.
In conclusion, this bottom up approach, which focuses on
the poorest of the poor, is also exactly what the American
people want and what they all believe our Government should be
doing. It is what we can all be proud of. I would like to thank
you for your attention and I would be very glad to answer any
questions that you might have.
[The prepared statement of Mr. O'Keefe
follows:]Bill O'Keefe
[GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]
Mr. Payne. Let me thank all of you for your testimony. And
as we are looking to see how foreign aid should be reformed, I
listened to your testimony. I know Dr. Turshen, you indicated
that you feel that we should do away with the individual
funding mechanisms and that it should all go to WHO. Why do you
believe that this would be the best way to go and maybe we
might have others comment?
Ms. Turshen. Thank you, Mr. Chairman. In all fairness, I
should say that I am a past staff member of the World Health
Organization, where I worked for a number of years in Geneva,
precisely in maternal and child health and family health unit.
It seems to me that WHO is the organization with the health
expertise. The United States now ranks 29th in infant mortality
rates behind almost every industrialized nation; we saw a rise
of up to 56,000 new cases of AIDS last year and cannot control
the epidemic in our own country. We have enormous problems even
having the expertise to count cases of malaria and to assess
what sort of health benefits would come from malaria bed nets,
apparently the new estimates of lower rates of malaria arise
from statistical errors in accounting, rather than in any
program that we have put forward, including bed nets. It,
therefore, seems to me that the World Health Organization is
the organization that has the expertise. And it is a collective
organization, meaning that it collects its expertise from many
countries around the world, not from any single model of how to
do healthcare. It is an organization, that was preceded its
present form by the Pan American Sanity Bureau, which goes back
many, many years. And so the depth of its accumulated
experience is very great.
WHO has been starved of budget. There has been a move in
Congress since 1980 to deprive WHO of any additional funds. All
additional money has come from extra budgetary sources, which
in the business we refer to as the ``flavor of the day''
approach to giving money. We think that if the base of WHO were
once again allowed to expand, it would be the proper
organization to oversee these programs.
It seems to me that while organizations like CRS have
undoubtedly filled gaps, governments cannot plan public health
services on that basis, because small private voluntary
organizations do not collect the kind of data that governments
need in order to plan health services. They do not get the kind
of feedback from those organizations, which would allow them to
spread services out evenly, to distribute healthcare across the
country. My experience in Tanzania was that organizations tend
to duplicate one another's efforts in the most lovely parts of
the country where the climate is best and where the resources
are best and travel is easiest, and they do not spread it out
to the rural poor and the neediest.
So for all of these reasons, I would suggest that if we are
going to put money into strengthening public health services
and basic health services, the way to do it is through the
World Health Organization. Thank you.
Mr. Payne. Thank you, very much. There are 26 different
agencies or departments according to a U.S. Government report
to the OECD's Development Assistance Committee that are
implementators of official development assistance--certainly
fragment. Perhaps, it is not practical because of the fact that
they are, in many instances, individual countries able to raise
funds or support by virtue of their signature or their appeal
to their own constituents of that country, that is what we are
doing. I think it might be great if we did have this real world
bank and just drop the money in there and let WHO run with it.
But, I am not so sure that we could continue to sustain their
national interest in what they feel they are doing to eradicate
a particular thing. I wonder if any of the other panelists
would like to comment on that. Yes, Dr. Badiane, and then we
will hear from Dr. Radelet.
Mr. Badiane. Just very quickly. Building on my experience
at the World Bank, I think that it is very healthy to have a
diversity of actors, at least at the bilateral and
multilateral. But, I would agree perhaps with Dr. Turshen that
on the multilateral side, on the U.N. side and things like
that, one might want to consider that a little bit. But, doing
away with the bilateral part of the agenda, I think we will
take an opportunity of individual governments in Africa to
engage bilaterally and have a diversity of choices in the way
they would like to move forward.
I think that merging everything into one individual
organization would overwhelm the resources that any given
organization could muster. But, at least on the global side of
the equation, one might want to think about consideration, but
there is room, large room actually for bilateral action there.
Mr. Payne. Yes?
Mr. O'Keefe. Thank you, Mr. Chairman. And if I could just
add that from the starting point where we are, where faith-
based providers and other private healthcare systems provide
such a large percentage of the actual healthcare, particularly
in the rural areas in Africa, I think while strengthening the
government's capacity is a very good idea. I am no expert on
whether the WHO is the best way to do that, but strengthening
the private healthcare system is needed, if we are going to
make sure that the poorest of the poor get coverage. That is
who cares for the poorest of the poor in our country is our
private healthcare system and our faith-based healthcare
system. There is no reason to think that every government is
going to pick all of that up. So, I agree that a diversity of
actors is a wise strategy and in Africa right now, that
includes the faith-based and private structures, as well. They
can be strengthened. We are trying to strengthen them. Other
groups are trying to strengthen them. The public healthcare
system needs to be strengthened and there is a role for the
United States in both.
Mr. Payne. Okay. Thank you. Earlier, I indicated to our
first panelist that there appears to be, someone I think even
mentioned U.S. assistance going through the military increased
from 5 percent to 21 percent, more or less. Would you panelists
like to comment on the increased role of the military in U.S.
assistance and programming? Yes, Mr. O'Keefe?
Mr. O'Keefe. Thank you, again, Chairman Payne. One of the
points that I tried to lay out in my testimony is the critical
development element of participation and ownership. And from
our experience watching the military do its well-motivated
work, these are committed people trying to do the right thing
in Afghanistan and in Ethiopia and in the Transalian
initiative. We observed that they are not well placed, well
trained, in order to negotiate that kind of participation and
ownership. They go for a short period of time. They come in,
they come out. They have a short-term security objective and
those short-term objectives are not consistent with long-term
development. And they are not consistent with building the
community engagement that is going to lead to the ownership
that leads to success.
I will tell you just a quick story. We had in Ethiopia, two
young Marines came into our office in Addis Ababa to consult
about our advice on the country. Our staff was somewhat
confused and asked what they were doing in the country and they
were told this is like Peace Corps with guns. There is no such
thing as Peace Corps with guns. Development needs to be done by
civilian actors in a civilian context. Thank you.
Mr. Payne. Yes?
Mr. Radelet. Mr. Chairman, I think the militarization of
our foreign assistance is not only a concern in of itself, but
it is a symptom of a deeper problem. The roots of this actually
have to do with the weakening of USAID over the last 15-20
years, from one of the premium development agencies in the
world, to what is now a shell of itself and really just a
contracting agency. And as needs changed earlier this decade,
particularly after the attacks of September 11, there was a
need to ramp up and there wasn't the confidence in USAID, I
think. There weren't the resources, both financial and
personnel, and there wasn't the flexibility for them to move
quickly into some new situations. And the Department of Defense
filled the void. They had the resources, both the personnel and
the money, and they have the flexibility in their mandate to
move quickly.
So, I think addressing this problem in the right way is to
go back to fundamentally strengthening USAID, in terms of
giving it the type of senior leadership that it needs with
world development expertise, giving development a voice at the
NSC table, giving USAID the legislation it needs, and the
ability to hire people with the professional expertise, the
financial resources to work with them, and the flexibility to
immediately address challenges on the ground. Too much of our
programs are determined here in Washington, so when needs on
the ground become evident, USAID does not always have the
flexibility to move where the military does have a little bit
more flexibility in that way. So, I think the real solution to
this is to look back at USAID and think about ways to really
build it up and re-strengthen it into a premier development
agency.
Mr. Payne. Yes?
Ms. Turshen. I would just like to add to that, thinking
about the emphasis on poverty reduction and the need for
development, which I think was very well voiced by Dr. Badiane
in his description of both what has been accomplished and what
are the needs to be done in Africa and what other purposes of
the military. It seems to me that there is a contradiction
here. The military, unfortunately, in achieving its objectives,
has been really the source of great deal of destruction, and
the idea of teaching the military to do nation building has
been an arduous process because that is not what their primary
focus is. It is not what they are really gifted at doing. Yet,
it seems to me that USAID has had this kind of expertise and
could once again build it up. And so rather than trying to
transform DoD into a nation-building organization that gives
development assistance, would it not make more sense to go back
to USAID where we could focus on both development and poverty
reduction? Thank you.
Mr. Payne. Thank you, very much. Unfortunately, in the past
decade anyway, appropriations for programs tend to flow more
easily through the DoD. I wish that other aspects of the
Federal Government could just get what they ask for, almost
whether you need it or not. But, that is really not the case,
as we all know.
In regard to agriculture, we talked about finally, I think,
USAID is starting to think in terms of agriculture. But, in
your opinion, do you feel that we can really increase
agriculture to where it perhaps ought to be and even in Africa,
which I believe should be a commodities exporting continent of
food stuff, et cetera, without a change in the U.S. farm
subsidies program? Do you see it being somewhat futile or
difficult with our agricultural policies, which I think tend to
mitigate against countries trying to develop agriculture? Yes?
Mr. O'Keefe. Thank you. We certainly agree that the United
States agricultural price support, at least to the extent that
it serves as a disincentive in cases of African agriculture, is
problematic. But, our analysis on the ground is that so much
can be done within each locale, within each country and
regionally, in order to stimulate market activity. Thus,
enterprise and market development has been a huge focus of ours
over the last couple of years. On Capitol Hill earlier this
week, we had a seminar of our agricultural people from all over
the world, where they discussed in great depth how we are able
to bring localized market development in many situations in
Africa. So, I do not think it is futile. A lot can be done that
would stimulate local, national, and then regional markets for
the benefit of African agriculture.
Mr. Payne. Thank you. Dr. Badiane?
Mr. Badiane. Thank you, Mr. Chairman. In answering that
question, the first thing that comes to mind is to recognize
that we are in a globalized world market. We are not the kind
of--the domestic market in Africa has been separate from the
regional markets in Africa, has been separate from the rest of
the world. So, it is one continuum. And, therefore, whatever
touches that global market also touches African agriculture.
I, also, would like to highlight the fact that U.S.
policies in agriculture would not be looked at just from the
U.S. point of view. I think global policies are all
interlinked. What happens in the U.S. is relevant to what
happens in the other OECD countries, is relevant to what
happens in the emerging economies. And that is where the
problem comes from, I think. If policies in the United States
are not conducive to less protectionistic agriculture policies
worldwide, the implication is that faster growing emerging
economies are markets that African countries cannot access to
anymore. It is just not the U.S. market that they cannot, but
also faster growing emerging markets. They did not excuse to
build tariff walls and protectionist walls. So, when one looks
at the U.S. policy, one ought to have a global understanding of
that and look at the ramifications beyond the U.S. borders.
I do believe indeed that unless we have much more trade
friendly and developing country friendly U.S. policy, it is
going to be very difficult to reap the opportunities for growth
and sustained economic growth in Africa. What is being invested
on the system side probably is going to be curtailed on the
environment, in terms of trading environment side of the
equation. African economies deserve the opportunity to compete
globally and I think global policies are not affording them
that opportunity.
And, Mr. Chairman, if I also may just share you with what
people like me think about that. We ask ourselves sometimes,
Does the U.S. lack the resources, the expertise, and the
legislates? To have policies that address the legitimate social
concerns in the United States rural economy and the rural part
of the country, would that have a detrimental effect on the
global trading environment on African countries? And we think
that it is an issue of looking for the solutions, the
innovative sources, expertise on legislates capacity in this
country, they are the best policy indicator for the social
needs of the rural population without causing the damage that
either directly or indirectly is being imposed upon African
countries, just due to the fact that the global trading
environment is putting this our way because of that. Thank you,
Mr. Chairman.
Mr. Radelet. We do, Mr. Chairman. We do extensive damage
through our farm subsidy programs against many people and
families in Africa. We undermine incentives for production, we
undermine people's incomes, and we contribute to poverty. And
what we do is counter to American principles of working on a
level playing field, of providing opportunities to people, and
giving them the means to help themselves. We preach that we
want people to help themselves and pull themselves out of
poverty and then we kick the ladder right out from under their
feet and do not let them do it. And it runs counter to many of
the other efforts we make through our foreign assistance
programs. That does not mean we cannot do some good even in the
presence of those things and I realize the obstacles are
inherent in changing those policies, but they do a lot of
damage.
In terms of other steps that can be taken to strengthen
agricultural productivity in Africa, we underutilize one of our
other great assets, which is our technological know-how and our
potential to help develop new technologies that can help
agricultural productivity in Africa. We have some of the best
agricultural research universities in the world and they helped
along with research centers around the world in the green
revolution 40 years ago and we need to redouble those kinds of
efforts toward improved technologies for Africa.
And then, finally, I will just mention the role of the MCC
in helping support agriculture through building roads and
markets, which is what countries have been asking for. The MCC
does not push this down people's throats. This is what they ask
for and people are smart. If you ask most people out in rural
areas the one thing they want, they want roads, because it will
improve their agricultural productivity, they are able to sell
more things, they are able to get girls to school, they are
able to access health clinics to women do not die in
childbirth, they are able to do a lot of things. And so, the
things that the MCC are beginning to do can help in this fight
against rural poverty and agricultural development, as well.
Thank you.
Mr. Payne. Yes, Dr. Turshen?
Ms. Turshen. If I could just add something with a slightly
different perspective, which is that of healthcare and health
problems and to say there has now been a lot of questioning of
the efficacy of the green revolution, especially in India,
where it is discovered that the thirsty and oil-consuming
approach to agriculture is both poisoning the land and perhaps
poisoning people. There has been a suggestion that we need a
green revolution in Africa whereas there are many people in
Africa who are questioning whether that is the best approach,
whether, in fact, it will bring better health. So, when it
comes to a question of transferring United States expertise,
one has to ask whether, in fact, there is enough assistance to
African universities to develop their own expertise in
agriculture and agricultural innovation based on a much closer
knowledge of their land and soil and water systems than we
could have at a distance; and whether agriculture for better
health rather than agriculture for export of non-nutritive
commodities is what African needs in the short-term; and
whether in the long-term, by building better food security
within African nations, we might, in fact, achieve better
health. Thank you.
Mr. Payne. Thank you. Yes?
Mr. Badiane. Just on the connection between education,
health and agriculture and also on the global relation subject,
when we talk about the global relation, we might want to look
at difference between Africa today and Asia of the fifties and
sixties. The biggest concern that Asian agriculture faced then
was a technological problem. If you knew how to produce, then
you solved the problem 60, 70, 80 percent.
That is not the reality in a globalized economy. It is
technological. It is markets. It is infrastructural. It is the
value chain development. So it is much more complex than just
focusing on the technology side.
I think though there are areas we use and certainly can
make a great contribution. Let me share with you a number here.
The projections that urban and regional markets in Africa--the
demand in those markets is going to grow from $50 billion right
now to about $150 billion in about 25 years from now.
If you do not have the value chains, the infrastructure,
the logistics, the modernization of the trading systems,
African farmers and African agribusiness people are not going
to be benefitting from that.
So what I think is important is to get the investment going
on infrastructure, as he said, and agribusiness development; so
that the $100-plus billion in demand can also generate income
and create wealth within Africa.
Regarding health and education, as I was saying in my
statement, and I give a little bit more for that in my written
testimony, we need a common denominator between the three
things: Growth, public reduction on one side; health and
education and safety nets on the other.
The common denominator has to be the contribution to labor
productivity of the poor people; and it is possible to achieve
that. Living health, I think that not all health programs are
created equal. Some health services contribute to labor
productivity more than others. But it can be dealing with
diseases that are also very important.
I would imagine--and I am not a health specialist--but I
could imagine that if you had a health program that targeted
the seasonal diseases that could curtail labor availability
during the peak labor season in rural areas, you will raise
productivity of the rural laborers. You will achieve your
health goals, and you will make people in their areas much more
productive.
Similarly in education, if you would for once think beyond
primary tests and secondary; and think about vocational
training, and think about work force development for
agribusiness, that is all education, the image and impact on
productivity will be far greater than the longer term impact of
conventional and traditional education.
So I think that is where we have to be a little bit more
innovative and create bridges between growth, productivity
enhancements, and social services investment. That will allow
us to get the kind of general evolution we want, which is
diverse enough, good for productivity, strong for market excess
and competitiveness; but also good for health and education at
the same time. Thank you, Mr. Chairman.
Mr. Payne. Thank you very much. The question of access to
markets, by road and transportation, you know, it is kind of
difficult to have roads built. You know, it is not what someone
would like to save a child with some medication. It is not
glamorous, it seems, about building roads.
And we have actually attempted to have the MCC look at
regional projects that would just fall out of the realm of a
country's project; but as you know, there is no way you can get
to Goma other than flying. There is just no road through the
Congo. Roads are really a hurdle, if we really want to see
agriculture develop like it has the possibility.
Secondly though, and maybe Dr. Badiane might handle this
one, since some of our brothers--Nigeria, for example, are
countries that probably could be number one in agriculture.
However, agriculture is not a main priority in countries like
Nigeria. I guess oil was discovered, and everything sort of
focused on that.
Do you have any suggestions on how we can try to have our
leaders in African countries deal with agriculture in a big
way? Some countries could have two crops in a year or even
perhaps three you could squeeze in. We are here in the U.S. We
do one crop a year, and make it successful.
Any suggestions you have for trying to impress upon maybe
the AU, just as a subject about the focus or maybe to re-focus
on agriculture. One time, Sudan was the bread basket of Africa.
They almost produced enough food for the whole continent.
Today, they are the biggest recipients of food aid. So maybe
you can elaborate on that for a minute.
Mr. Badiane. Just actually the other very exciting
development in Africa which, Chris, what I am hopeful
personally because I am very closely involved in that, in the
effort to develop what they call the Comprehensive Africa
Agriculture Development Program, under the auspices of the
Africa union, and coordinated by the NAPA secretary in
Johannesburg.
By the way, USA is playing a great role in there, as a
partner, and also as an advocate for the leadership on the
African side on the agenda among the development community.
That program CAADP, the acronym, is actually an African
union program. What they are trying to do in that program, and
I highlighted it a little bit in my written testimony, is to do
two things: Help African countries raise the profile of
agriculture, by helping premises of agriculture get much better
programs, better budget planning execution and reporting.
During my 10 years at the World Bank, I had noticed
actually that a big program Ministers of Agriculture had,
Ministers of Agriculture had to execute the budget that was
being allocated to them. It was not enough. But if they got 60
or 70 percent, that was great.
I think that this is not a reflection of how poorly
equipped the Ministers of Agriculture are; but how complex
agriculture is: Planning it, designing it, and implementing it.
It is not a public sector program like education and health
where you can program and budget and execute. You depend on the
private sector; and that is very difficult. You depend on the
farmers, and that is also very difficult.
So what they are trying to do is, it is, therefore, to help
countries move toward evidence and outcome based planning and
implementation, so they can track and document and report on
it, and hopefully implement better and, therefore, can consume
more sources.
Also, by implementing better, they will get better results.
This is actually coming from way up the Africa union. It is
being coordinated by the regular economic communities, like
ECOWAS and COMESA; and the U.S. had provided a lot of resources
to support the implementation process and the progress that has
been made so far.
There are now about 20 countries, Mr. Chairman, who are
working systematically, trying to achieve the objectives that
the African union has laid out in that program which are: One,
raising productivity to achieve a 6-percent growth rate in
agriculture, and allocating at least 10 percent of the budget
to the agriculture sector.
My institution is looking for that, which is what got me to
get out of the World Bank, to lead this work with them; and
thirdly, they put putting together what they call inclusive
platforms for dialogue and partnership, giving a voice in the
farmer's organization.
So agriculture is coming back. I do hope it is going to
stay that way for the near future. If the 20 countries that are
involved in that are successful in turning things around, I
think it is going to catch fire, and you will see good progress
around agriculture on the continent.
I am hopeful. But there are a lot of risks out there. I
hope they are going to be handled well, and categories are
going to become a success story; thank you.
Mr. Payne. Thank you very much. I did have an opportunity,
right after the new President in Ottawa was elected in Nigeria.
I suggested that agriculture would be something that they look
at on my recent visit to Nigeria.
I thought that if the world economy was continuing to go
like it was a couple of years ago, food commodities with a
growing income, places like China for example, would be
starting to develop housing. In a country where the income
increases, people want to have better housing or a little
larger housing.
As China increases their investments, they may start to use
land, previously used for agriculture, for industrial plants
and housing. A place like Africa, however, has plenty of land
and could really take advantage of that land for economic
growth. Similar activities can be occurring in places like Asia
and in other parts of South America.
But because we have a downturn, so many of the things that
were applicable a couple of years ago may not be, temporarily.
But I think that is the kind of global thinking that we need to
have.
Dr. Radelet, you mentioned about democracy, and although
this is basically, you know, how should we reform foreign
assistance, and part of our foreign assistance does deal, as
you know, with democracy and supporting democratic
institutions. For example, we supported the election in the
Democratic Republic of Congo, the run-off elections, and the
counting, and the delivery of ballots, and printing. The cost
was close to $1 billion that the U.S. supported for that
election.
I just wondered if you had thought, in your opinion, how
elections in Africa have been going. As you know, we have had a
number of elections, at least since the fall of the Iron
Curtain.
We had a good wave going at one point; and then we have had
Zimbabwe and Nigeria, Kenya--less positive elections. Although
in Ghana, we saw the President, whose party was defeated,
invite the President-elect to the Presidential palace and show
him around, which is really the way you like to see it.
In your opinion, how have elections been in Africa in
general, if you could sort of characterize them?
Mr. Radelet. Thank you; I think one of the most striking
changes in the world in the last 15-20 years that often goes
unnoticed is the shift toward democracy in sub-Saharan Africa
and in other low income regions around the world.
Twenty years ago, the most prevalent idea was that low
income countries could not support democracy at all. The only
significant democracy among low income countries was India, and
the view was that it was not doing all that well, thank you
very much. There were a few others. But the idea, of course,
was that benign dictatorships were the way to go.
In the last 15 years in Africa, we have seen the shift from
three democracies: Botswana, Cape Verde, and Mauritius in 1989,
according to international indicators, to over 20 today. As far
as I am aware, never in the history of the world have we had so
many low income countries become democracies in such a short
period of time.
You are correct that there have been some cases of back-
sliding; some countries that showed promise. Zimbabwe never
actually made the ranks, according to these indicators, by
Freedom House and by the University of Maryland, as a
democracy. It showed promise that way. It has slid back, of
course, with Kenya and others.
But we have had the great successes of Ghana, which hardly
made news, when there was a very successful election; and an
opposition candidate won; and there was a peaceful transfer of
power. It was not in the newspapers, and it was a great thing
to celebrate.
There was great nervousness when the President of Zambia
passed away, about what would happen there, and there has been
a remarkable transition there. But places from Mozambique,
Lesotho, Namibia, Tanzania, Ghana, Benin, Mali and Senegal,
there has been tremendous progress.
So I am quite hopeful. It is beyond elections. You
mentioned elections; and elections are, of course, a step. But
an election is not democracy. It is deeper than that. You need
accountability to the citizens. You need transparency for
government operations. You need government officials that are
honest and are adhering to the rule of law.
And those are harder. Elections are hard. But in some ways,
they are the easiest part. So some of the things we can do are
continuing to support non-government organizations that are
working toward transparency and accountability; toward a free
press and an active voice, an active debate.
Sometimes the press seems a little too free and a little
out of hand. But that is the first step towards, I think,
strong institutions.
As you know, I work closely with the Government of Liberia;
and you know, the change just in the last few years is just
hard to describe. It is still very fragile. The future is, of
course, unknown. But there have been remarkable strides from
the first kind of authoritarian government to a very promising
democracy, in its deepest sense, in just a few years.
So I am optimistic. I think most of the effort, of course,
must come from Africans themselves; African governments,
African citizens and other institutions. We can play a
supporting role. We cannot lead the charge, but we can help
support this move, and hopefully see it continue to grow and
evolve in the years to come.
Mr. Payne. On that note, I know that recently in the last
day or two, it was announced by President Johnson Sirleaf about
the fact that Liberia paid off $1.2 billion of foreign debt.
I know you have been very involved in there. As a matter of
fact, they said 97 percent I think--sort of--I do not know, it
sounded tricky to me. [Laughter.]
No, I am sure that there was really a lot that went into
it. I just wonder if you might touch on that, because it was
quite a great achievement, and congratulations on your
assistance to Liberia.
Mr. Radelet. When the new government was inaugurated 3
years ago, they inherited a debt of $4.9 billion, which with
the economy collapsing during the war, translated into a debt
export ratio of 2,300 percent; by far, the highest in the
world, by far, higher than any other HIPC country. In fact, it
was seven times the HIPC average.
The HIPC program, as you may know, aims for a debt export
ratio of 150 percent. Liberia's ratio was 15 times higher than
the target; so by far, the most heavily indebted country in the
world.
About a quarter of that debt was owed to commercial
creditors; originally banks. A lot of that had been traded to
investment funds, hedge funds, distressed debt funds, and a
variety of other actors over the years, at ever steeper
discount.
It took about 2 years to track all these people down, and
find out who owed the pieces of debt. There were legal cases
all around the world.
But when the government got everybody into the room and sat
down with them, they recognized that the government had very,
very limited resources; made the offer of three cents on the
dollar, of today's legal claim. So it was three cents on the
dollar, including penalty and accumulated interested.
The government recognized that that was a real liability.
After tough negotiations, the creditors realized that that was
the best deal they were going to get. Their only choice was to
go to court, and they did not want to go to court against Ellen
Johnson Sirleaf, frankly; many of them.
So several donors put together the $38 million, which was
necessary to buy back $1.2 billion worth of debt. The World
Bank put in half the money. The United States put in $5
million. The Governments of Germany, Norway, and the United
Kingdom each also put in $5 million to give a $38-million fund,
and that fund was used to buy back the debt.
The deal was closed last week; and has been completely
finalized. So the debt has been extinguished, and it was done
at no cost to the people of Liberia.
So all of those legal cases are now gone, with the
exception of two small creditors that collectively held about
2.5 percent of the debt; $20 million out of the $1.2 billion
that did not participate. The government is continuing to
negotiate with commercial creditors. But with those two small
exceptions, the rest of the debt has been completely, legally
extinguished at this point.
So that takes care of about a quarter of the debt, along
with some other debt forgiveness. The debt has been reduced
from $4.9 billion to $1.7 billion; and when Liberia reaches the
HIPC completion point next year, most of the rest of that will
be extinguished; not quite all, but most of it; thank you.
Mr. Payne. Well, that is a good story. We hear so many;
and, we have heard some horror stories with the vulture funds
that have come in and have actually caused the reverse,
granting awards that unfortunately are very damaging to
countries. We really appreciate that success. Yes, Mr. O'Keefe?
Mr. O'Keefe. Thank you; I just wanted to follow-up on Dr.
Radelet's point about openness and accountability and
transparency as it relates to elections.
The list of successes, the notable absences, are the
countries that have large oil resources. There is a reason for
that, as the committee and the chairman are familiar with--the
specific and particular economic and political problems that an
excessive over-reliance on extractive industries, particular
oil, creates.
So as the reform effort and looking at assistance to Africa
continues, attention to transparency and openness and
requirements that will move countries and support them toward
more transparency and openness, and companies as well, of
course, would be very helpful in moving the democratization
process forward.
So I just wanted to put that one point on, Dr. Radelet's
excellent summary of the Democratic status and progress going
on; thank you.
Mr. Payne. Thank you. Dr. Badiane, also, there is a
substantive body of thought, and I am sure that the panel would
agree, that progress in the social sectors has a substantial
impact on growth and productivity.
Your testimony acknowledges this by suggesting that we
should better focus our assistance on health, education, and
social safety nets in order to improve growth and productivity
of labor. I would just wonder if you would expand on that a
little bit more.
Mr. Badiane. Thank you, Mr. Chairman, for the opportunity
to do that. I think that when we look at health and education,
we look at them as a monolithic service. You have better
health. You are more productive, which is correct.
But if you are a country with limited time, because you
have a large share of your population that lives in poverty,
and you have extreme constraints as to the resources
availability, I think that what you ought to do is to maximize
the return from every dollar incentive invested in terms of
growth.
So we should not be just satisfied by knowing that health
contributes to growth or education does contribute to growth.
What we should be doing basically, just to do what we did for
infrastructure. Nobody thinks about infrastructure as just on
monolithic service. But we distinguish between highways, tracks
and trails, and bridges and secondary roads; and they all have
different implications for local development.
I do believe again, because I have been an expert, that
education services that target primarily vocational training in
the rural areas and work force development in the agribusiness
sector, and health services that target diseases that are
seasonal but chronically seasonal and, therefore, really are
not seasonal any more, which have a huge impact on the level of
labor availability to raise productivity--those diseases and
services targeting them ought to be, I think, a priority in any
health program.
Here is the example we use to illustrate it. You have an
economy and a measure of health--and I have health experts here
that can correct me--has $100 to invest in health. Investing
$100 every year in health, that focuses on hospitals and
clinics and management and the like of 10 years, or taking
those $100--you say, I am going to allocate $20 to the kind of
seasonal diseases I am talking about.
You run those two programs over 10 years. Your productivity
levels in the rural areas are going to be much higher in the
second case than in the first case; and they are both health
programs.
You do the same thing with education--$100 on education for
all, or girls' education. I am not saying that it is important.
I am just saying that if you want to maximize the short term
impact on growth, you have to look at what gives you the
biggest return, faster and sooner.
So $100 on general education issues or $100, including $20
on vocational training and work force development over $10
years, puts you also somewhere else on the gross horizon.
So these are the kinds of issues that we ought to be
looking at. Now why is it important? It is not from the growth
point of view. Currently, we have a lot of competition between
Ministers of Agriculture and Health and Education. The dollar
going to health education is seen as being lost to agriculture,
and this should not be.
If they can find out the composition of health services and
education services that maximizes growth in agriculture, then
what they discuss and negotiate about is not going to the other
sectors; but the use of the money is going to the other
sectors. You have a totally different ballgame.
I think both in terms of budget negotiation and in growth
outcome, you will be in a much better position. That is how we
can maximize the return we get from the dollars we invest; not
just investing in health because it is good, in education
because it is good. So nobody is going to disagree with.
But can you get health and a little bit more growth? Can
you get education and a little bit more growth? And you get to
the safety net, I will tell you that those education services
and health services that give me the biggest return in terms of
growth, as well.
Mr. Payne. Yes.
Ms. Turshen. I understand and appreciate Dr. Badiane's
argument. But it seems to me that once again this kind of
instrumental use of health services to achieve other goals is
the same sort of thing we saw in family planning. If you reduce
population growth, you will have better distribution of income;
or if you take care of the AIDS epidemic, you can also release
the productive age group to once again participate in
development.
And I must say, Dr. Badiane, I know exactly what you are
talking about. Because I remember distinctly in Tanzania, going
into a village which grew sugar cane; and the crop was ready
for harvesting. The mill nearby was ready to process it. The
entire village was down with malaria. So I know exactly what
you are speaking of.
But if you are talking about a long term investment, this
kind of short term, instrumental use of healthcare, I think,
will not achieve it. Because what we need are basic health
services that deal with all diseases, and not targeting
specific diseases for another vertical program, which will just
look at malaria, which is one of the examples that would be
used; thank you.
Mr. Payne. Yes?
Mr. Radelet. I think that it may look like an instrument
promoting health, and maybe it does a little bit.
But what is the philosophy behind that? I think the
approach to health services and social services, in general, in
the context of a developing country should be very different
from the approach in the context of a developed country.
The reason being that in the context of a developed
country, there are enough resources basically to look at
services from their general point of view and entitlement point
of view.
In a developing economy, where you do not have enough
resources to grow the pie and sustain the supply of the
services, you have to link services to expanding the pie;
unless you have an external sources that can allow you to
supply the services and sustain the supply. Unless the pie
grows, you are not going to be able to supply the service in
the long run.
So, yes, it may look like an instrument to use a bit. But
it allows you to sustain your health services in the future.
Unless you do it, you need a general term, and you will end up
having lower levels of services in the future.
I think that as long as we are dealing with health, we
should be happy and satisfied. Nobody is talking about taking
the resources from health; but targeting health a little bit
better, so that you grow the pie and will be able to even offer
more services in the future.
Mr. Payne. Yes?
Mr. Radelet. If I can add to that briefly, I think that Dr.
Turshen raises an important point and is correct; that in the
long run, what we need to do is build health systems. I do not
think there is any question about that.
What that runs up against is that I think the political
reality, that individual people--taxpayers in the United States
and in many developing countries themselves, and Members of
Congress--find it much easier to identify with very narrowly
defined, very specific diseases.
We put 2 million people on antiretrovirals. People
understand that, and they can envision and they can support
it--so many bed nets, so many people, so many people immunized.
That approach does not lead to good health systems. But it
does engender, I think, some support for funding and for
programs. So there is a clear tension between those.
I think that perhaps the way forward is to use the support
for specific initiatives as a gateway to building the support
to strengthen health systems more broadly. To take advantage of
the support that people do have for malaria programs, or TB, or
HIV/AIDS, or whatever it is--but make sure that those programs
are defined broadly enough and allow the flexibility that that
becomes a way to provide support for strengthening health
systems and building that capacity in the long run.
It is not a clean approach, and I realize that there are
some compromises there. But I do think that the importance of
building the health systems runs up against what I think is the
political reality of people understanding and wanting to
support more narrowly defined goals.
Mr. Payne. Yes, Mr. O'Keefe and then Dr. Badiane.
Mr. O'Keefe. Thank you, and I am going to agree with Dr.
Radelet on the political point, and just add that I think that
Dr. Badiane questions conceptually are very important and we
should all be thinking about them.
But what I am not comfortable with is that at the level of
governmental donors, we would be answering them; and that these
are the questions that rural people, urban people, citizens of
countries in very diverse, changing, complicated situations
need to be asking.
Then we need to be helping to develop comprehensive, cross
sectoral responses that in each of those situations are going
to leverage progress in a particular sector in order to get
labor productivity gains or other gains.
We can ask those questions; but we are not the ones to
answer them. We have got to help people locally answer them.
Because if we try to come up with a cookie cutter answer here,
it is just not going to work; so thank you.
Mr. Radelet. Yes, Mr. Chairman, I was just going to clarify
that the concept that I was discussing does not go against
building health systems. Because laying infrastructure in the
rural areas to be able to deliver those services ought to be a
part of the health system in general. It is just how you target
the services you deliver, and you build the system that you
need for it.
But the fundamental idea behind this is that in planning
social services, heath, or education, or safety net, you ought
to ought to also certainly consider the entitlement and needs,
but go beyond it and look at growth and productivity.
If you are a developing country, you have no time. You have
no resources. You are just going to be focused on entitlement
and need. You really have to go beyond that. That does not have
to be a conflict. But you cannot have it in a way that you can
have all of those three things; thanks.
Ms. Turshen. It is fun when you have an argument among your
witnesses. [Laughter.]
I am possibly the oldest person on this table, and I would
to say that I have heard this argument from the World Bank
many, many times over the years.
What happens is that the short term objective always pushes
aside the longer term investment. The longer term investment in
healthcare returns for 40 years, even after you decrease that
investment.
That has been true all over Africa, as well as in the
National Health Service in Great Britain. You may think that
this is expensive to do a long term investment now, when there
are so many short term needs. But if you are looking at the
long term, the investment can be for 40 years. So it really is
important to do it; thank you.
Mr. Payne. Well, I think that certainly, one of the
problems is the lack of adequate funding for healthcare and
other social needs in developing countries.
I believe that the argument that President Thabo Mbeki in
South Africa, when arguing about the devastation of HIV and
AIDS, was really saying we need to have a whole health-care
system, that is no worse than the rest.
Of course, it was certainly having an impact on Botswana,
right across the border. The life expectancy went from 61-39
years of age. So, I mean, you do have to deal with some
immediate goals, in addition to the fact that we certainly need
to have a health-care system.
At one time, it was inoculation, and children did live
longer. We had one time a concentration on oral re-hydration,
when UNICEF, back in the seventies, found that salt and sugar
put together for about a dime, could really save a child from
dying from diarrhea.
So I think that we certainly need them both. I would hope
that as the world becomes flat, and developing countries are
finally able to benefit from the wealth that they have in their
country. For example, assisting the country for diamonds to
make the people in the Congo better off, rather than people in
Belgium. I think those countries will be able to start to
invest in health systems, along with, you know, the so-called
donor countries. I call them partner countries, and just
hopefully, we can get that gap closed.
But the fact that you are really able to save a life, you
know, a child dies every 30 seconds from malaria. You cannot
say, Let us not get all the bed nets we can and put them up
immediately. Because that will be a very inexpensive way, with
other things that spring so forth, until we can find a vaccine
perhaps to prevent malaria.
Ms. Turshen. Mr. Payne, there was a study done in Latin
America many years ago, where they undertook a survey of child
mortality in nine countries; and then did a very high coverage
measles vaccination campaign, because measles was found to be
one of the major causes of death.
Then they went back and re-did the mortality survey, and
they discovered fewer cases died from measles. But guess what,
mortality levels had not changed.
So, yes, you may save a child from dying of measles. But
that does not mean that you have actually changed the death
rate among children.
What will change the death rate is if there are enough
health services. What will change death from malaria is
development. So we come back to the issue of poverty reduction,
which is really the basis of all of this.
Mr. Payne. There is definitely no question about it. If we
could ever get close to poverty reduction goals for 2015, we
will do a whole lot.
One thing that is unknown is that even though the mortality
rate may have been the same, had it not been for that specific
measles vaccination, the mortality rate may have been higher.
So that is the unknown that we do not know.
Let me just kind of get one or two last questions in. We
have not spoken much directly about women; and I just wonder
quickly, we cannot talk about health and all this without
really, you know, highlighting the problems of women.
I wanted the panel's opinion on what are the critical ways
of ensuring a U.S. approach, and ensuring in our approach that
activity includes and promotes women across the continent in
terms of economic powers.
We are talking about women within the household,
involvement in microenterprise, small businesses, access to
health services and educational services, all of which we say
protect women against violence. Yes, Dr. Turshen?
Ms. Turshen. Well, I am going to encroach on some of my
colleagues' expertise, and I hope that they will pick it up.
But I would like to start with the question of land ownership,
and talk about women's need to have rights to land, as being
one of the critical issues right now in Africa.
We know that women farmers are the backbone of agriculture
in Africa, and that most of them are losing out with transfer
of titles usually to the head of household, which means men;
and that as people move to cities and family structures are
reorganized into more nuclear forms, women are also losing
their rights to access land which often came from either
fathers or husbands.
So this question of how women are going to access land is
really critical to food security and critical to basic
malnutrition problems, which are the causes of so much death.
The second question I want to address is general
legislation to protect women against all forms of
discrimination. I would highly recommend that Congress, once
again, re-consider ratifying CEDAW; and also might re-consider
ratifying the United Nations Convention on Economic, Social and
Cultural Rights.
You know, they split the convention on the declaration of
human rights into two. We ratified the political rights, but we
never ratified the economic, social, and cultural rights; and
it would be really of great help in the fields of health and
education, if we had ratified that convention and stuck to it.
The third issue I would raise is direct healthcare for
women. I think that your staff are very well aware of this
problem, as are many committee members; there has been
absolutely no progress made in lowering maternal mortality
rates in Africa, and there is no reason for this; in the sense
that we know very well what the causes are, and we know very
well what the answers are. The answers are, more personnel, and
particularly more personnel to assist women in child birth.
That does not call for very high, expensive technology for
hospital births. It really requires very broad based services
with perhaps provincial clinics, where women in serious
difficulty can go for delivery assistance. I think that if we
could start looking at that, we would get very far.
There are some other issues. You speak of the malaria
vaccine. We have had a vaccine against neonatal tetanus since
1981, but we still have hundreds of thousands of African
children dying of neonatal tetanus every year. It requires one
shot during pregnancy, to make sure the baby does not get
neonatal tetanus and die from it.
So there are examples like that of, not a broader
technology, but rather broader based health services focused on
women's needs, which really could accomplish a lot; thank you.
Mr. Payne. Thank you. Mr. O'Keefe?
Mr. O'Keefe. Thank you very much; two points--the first is,
I think in terms of the basic health needs of women that Dr.
Turshen has laid out, it is a question of resources. The models
are there. Faith-based groups, government groups, other local
groups have successful programs to improve material health,
child health, maternal mentality.
Also, we need to integrate into a comprehensive program,
microenterprise, to work on livelihoods, and agriculture; it is
a question of getting the resources to those programs so that
they can scale up.
The second point is, in Eastern Congo, CRS is supporting
some of the healthcare of the women who have been terrorized by
the sexual and gender-based violence. I would just say that the
most important thing that we feel our Government can do is
invest the diplomatic energy in ending those conflicts.
For a number of years, we have felt that our nation has
been distracted and taken its eye off the diplomatic ball, in
Sudan and Africa, and has not been able to engage at the
highest level.
We would urge Secretary Clinton and the President to make
sure that these conflicts do not fall off their diplomatic map.
Because otherwise, there is not much that can be done
unfortunately for the victims of this kind of violence, once it
has happened. It needs to be prevented, and the conflict that
drives it needs to be prevented.
Mr. Payne. Thank you. Yes, Dr. Radelet?
Mr. Radelet. Just quickly, to add one more and then
underscore two other--to add to the list, of course, is girls'
education from primary school throughout, and to really create
the focus and provide the opportunities for girls to have
educational opportunities throughout.
That is a complicated issue, because it gets to issues
around poverty for the family and their own income
opportunities, which will allow families to allow their
children, girls, to go to school for a longer period of time.
It has to do with roads and other kinds of safe venues and
methods of transportation, so girls can get to schools safely.
It is a complicated issue. But I think it is central to
providing the educational resources and, therefore, the
economic opportunities for girls.
I just want to underscore Dr. Turshen's point on land
access, which is often under-estimated and not underlined
enough. But this is crucial to provide women with the economic
assets necessary for agricultural productivity in farming.
Then Mr. O'Keefe's point on gender-based violence, we
really can do more, I think, in simple ways of shedding light
and opening up the dialogue, through things like billboards and
newspaper advertisements, and radio talk shows, to force the
issue out to be discussed more.
Too often and, of course, you know again, in Liberia,
during the war and the aftermath, this was just all too
prevalent a problem. But a big step forward is to get people
stop whispering about it, behind closed doors, and to get it
out in the open. It is painful and it is hard. But that is, I
think, a first big step. With relatively small steps, I think
we can help support those efforts to bring that more out into
the open.
Mr. Payne. There is just question about domestic violence
and all kinds of issues related to women, such as trafficking--
even here in this country--and in many of the new areas that we
are hearing about. Dr. Badiane?
Mr. Badiane. Mr. Chairman, I was just going to comment on
that issue. I normally do not work on that. It is a very dicey
field for me, because there are a lot of preconceived notions
about gender and gender issues in Africa.
And as an African male, if I start speaking, I lose my
legitimacy somehow, of being objective. So I avoid it as much
as I can; but I will talk about it here.
First of all, I think the issues are very clear in area of
maternal and child health. I mean, as Mr. O'Keefe said, we know
the issue. It is an issue of resources and scaling-up, I do
believe. That is very, very simple.
There does not tend to be clear education; much less
os deg.than in health, but somewhat. It is more
complicated in agriculture. I think that you often hear that 70
percent of African farmers are women, and they are the pillar
of African agriculture. It may be true in some countries. It is
growing in a lot of our other countries.
So I think that the approach here ought to be on a case-by-
case basis, and really tailored to the realities of the
individual countries and societies. There are many countries in
many sectors where female farmers are not even present.
But one thing is clear, that 50 percent of the population
at least are women, and they are key economic actors, and each
and every actor ought to be creating the role and the scope for
them to excel just like their male colleagues would do.
But we cannot approach that with preconceived notions and
sometimes actually perhaps not realistic. So it has to be based
on real things and real obstacles on the ground so we can have
real solutions to what is happening.
Mr. Payne. Mr. O'Keefe?
Mr. O'Keefe. I have just a very quick point which is, as I
mentioned in my introductory statement, our partners are
constantly calling our attention to the unemployed male urban
youth.
I think one of the things, in terms of stability, that is
going to create the conditions where we do not have this kind
of sexual and gender-based violence, conflict driven, is
getting at this problem of employment of the growing number of
uneducated young men.
So we have to look at, the gender lens has two sides to it,
and we need to look at both sides, for the benefit of both men
and women; thank you.
Mr. Payne. Well, I wanted to mention that also just in the
next to area that I wanted to touch on. I did not think we
should leave without specifically dealing with women as gender.
The urban problems, you raised it, and I think that 70
percent of slum dwellers make up 70 percent of African
residents; and you have places like Cabetta in Nairobi, where I
just wonder, how do you penetrate the concentration of people,
the lack of health services, the lack of adequate living
conditions?
Does anyone have anything they would like to mention? We
always talk about rural areas. We talk about access to roads.
We talk about the inability of people to receive services. What
about the urban problem, as one that has been touched on with
the urban youth and the lack of employment. Would anyone like
to make a quick comment on that? Yes, we can go right down the
line.
Mr. O'Keefe. I yield to Dr. Turshen.
Ms. Turshen. Thank you, Mr. O'Keefe. I would like to say
that obviously you have hit on a crucial problem that we are
going to be facing very quickly. Because Africa is transforming
rapidly into an urbanized continent, from being so long with
more people living in rural areas.
The slum situation has really grown to epidemic
proportions. The lack of planning of cities, the lack of
sanitation, the lack of infrastructure--not just roads, but
sanitary infrastructure and, of course, heath clinics, is a
critical problem that the cities will have to address. It seems
to me that part of the problem of building basic health
services is precisely to do something in the slums.
One of the experiments I saw in Zimbabwe, which I thought
was extraordinarily successful, was the medical school taking
first year medical students out to the slums, assigning them a
family to follow throughout their medical education, so that
they became totally familiar with the problems in the slum
areas that people were facing in their day-to-day lives.
Another experiment in Zimbabwe was with very innovative
systems of latrines called the Blair Toilets and that this was
a system that was developed in Zimbabwe. It answered the
conditions of urban Zimbabwe, and could also be expanded.
So I think that there are both problems on the horizon, but
solutions within the countries, which lead to solving them;
thank you.
Mr. Badiane. Mr. Chairman, urbanization is bringing two
problems with respect to poverty, actually. One is, poverty is
becoming more and more of an urban phenomenon. It was not so 25
years ago. It was primarily and almost exclusively rural.
At the same time actually, urbanization is dismantling the
traditional social protection systems in Africa, which were
family based. The more people in the urban areas, the less
actually they invest in those family-based social protections.
Yet, the African states do not have really a lot of
experience or a good track record in social protection. Now you
are having a larger number of poor people in areas where they
should need social protection. But the fact that they are
increasing in numbers in those areas are tearing down the
social protection fiber of this society.
So I think the next crisis in Africa, a base one to come in
the next 15 years or so, is going to be social protection.
African countries have no experience, like the American
countries have done or Asian countries have done. We were lucky
that we can rely on the family systems to that. But that is not
going to work in the 10-15 years.
So if there is anything, I think, a smart African
Government would do right now, it is to try to think about how
to develop the social protection policies to tackle poverty,
which is going to be an urban phenomenon, to a large extent, in
the next 15 years or so.
Mr. Radelet. Let me, if I can add to that a little bit,
part of addressing the urban problems is creating better rural
economic opportunities, which gets us back to our earlier
discussion about agricultural productivity and roads and
everything else.
One reason people leave the rural areas is because there
are not the economic opportunities. So that is one piece to
this.
But that is not going to make it go away. The problem is
here to stay, and it is part of what has been the process of
what we call economic development over the last 200 years. It
happened in Europe. It happened in the United States, and will
continue to happen, I think, in developing countries.
So you want to try to address it, and try to minimize some
of the problems that Dr. Badiane and others have mentioned.
Part of this is infrastructure, which we talked about
before, and creating solid urban infrastructure of roads and
ports; the water systems and power and other basic needs that
people need.
We are not all that well suited, as a bilateral aid agency,
to do this. I think this is an important role for the multi-
lateral development banks, the World Bank, and in particular
the African Development Bank.
I actually believe that if the African Development Bank
became just an infrastructure bank, it would really help in
many ways.
You mentioned earlier, politically, it is a little harder
to get people excited about infrastructure projects, and that
is true, I think, for bilateral agencies. But I think that
lends itself to multi-lateral agencies to really focus on that.
So part of this is an infrastructure issue.
But then finally, to complement the social services, we
need to think about economic opportunities for urban dwellers.
The classic solution to this, over the last 30 years, is
manufacturing; and particularly, manufacturing exports, which
is what the Asian countries have done with a range of products
of shows and textiles and footwear and toys and everything
else.
That has had some downsides, along with the upsides of
literally creating millions and millions of job for people and
bringing them out of abject poverty.
The world is changing right now. We do not know, in the
aftermath of this crisis and the rise of China and India,
exactly what the right economic opportunities will be for
Africa.
I suspect it will be in more services and using new
technologies of the Internet; of data entry, of call centers,
of cell phone use, and other kinds of things that we cannot
quite yet imagine that would create economic opportunities for
the urban dweller.
So I do not want to suggest that I know the answers; or
that the answers were what exactly that Asia did 30 years ago.
But I do believe that a big part of the solution has to be
creating economic opportunities for low skilled workers, to
begin with, and over time to create new opportunities as those
skills rise.
So it is going to take a combination of the infrastructure,
the basic services, and the economic opportunities, to address
this problem.
Mr. Payne. Mr. O'Keefe?
Mr. O'Keefe. Just very quickly, I appreciate Dr. Radelet's
comment on strengthening the rural sector as part of limiting
the growth of the urbanization and the problems that we have
discussed.
Just quickly, the faith institutions can play a role in the
social protection in urban areas. The rapid changes and the
systemic changes that Dr. Badiane talked about are things that
are above our pay grade, so to speak. But I think that we can
play an important mediating role in creating the conditions of
social protection to more people than would otherwise be.
Finally, we are trying to adapt things like microenterprise
to be more successfully used in those urban environments; and
there are some very creative efforts by CRS and by many other
groups to do so, and those will help, as well. They are not
going to be able to soak up all that excess labor. But they are
going to be able to help thousands and thousands of people to
find opportunity and to make a livelihood and, therefore, to
care for their families.
Mr. Payne. Finally, I just wonder if anyone has any ideas
about education in general. We are looking at a higher
education bill to try to see if we can assist tertiary
education.
We know that many countries have said that they will open
up their schools to the girl child. Many of the first women in
Africa, and President Museveni's wife and others, have stressed
the girl child and education.
In addition, in some instances, the classroom had twice as
many students and still the same number teachers. So we have
not seen the growth, you know, in a planned manner.
What are your ideas about just education in general--
elementary, secondary, and higher education? If the U.S. could
be of assistance, what do you think would be the best way to
go--school buildings? Would anyone like to tackle that? Yes,
Dr. Turshen?
Ms. Turshen. Congressman Payne, I would like to give an
example of a country which achieved remarkable changes in
girls' education, and that is Algeria.
With the nationalization of the oil resources, Boumedienne,
who was head of the country at the time, decided that he would
invest in secular co-educational programs, free of charge, from
primarily school through tertiary education, with enough
resources from the income from oil to meet basic needs of
families. So the need to put children out to work, as one finds
in Morocco, with 3- and 5-year-old girls in the marketplace
working, in Algeria, they all went to school.
They went to school with their brothers' boyfriends, and
they continued their education through law school, medical
school. They became the journalists, the doctors, the judges,
et cetera, in quite high proportions. I mean, I am speaking of,
maybe half the doctors are women. Maybe half the lawyers,
certainly a third of judges, a significant proportion of
journalists, are all women in that country today.
So there are precedents, in Muslim countries, where people
had been reluctant to send girls to school, where this can be
accomplished.
So, as I said, the tug of war between, on the one hand, the
push to early marriage, and the pull of helping out in work,
either paid or unpaid, at home or in the factory, must be
resolved by some poverty reduction, free education--and in this
case, Algeria also offered free healthcare, by the way--which
allowed girls to continue their education and then delay
marriage.
So the average age at marriage became upwards of 25, 26,
27, 28. It is just an example of how a government can invest in
educational services and be successful; thank you.
Mr. Payne. Yes?
Mr. Badiane. Mr. Chairman, I think that we have both a
problem of supply and quality in the education sector. I think
the U.S. can help expand the education infrastructure, reaching
into the rural areas; but also in the urban centers, where the
numbers of school children in classrooms are just skyrocketing.
There is also an issue, particularly in Anglo and Eastern
Africa. School costs too much for families. Elementary and
secondary schools--I think if there is anything you can do in
terms of policy, dialogue, and diplomatic moves to get those
governments to understand that investing in childhood education
ought to be actually something that the government ought to be
doing and looking at it as a priority.
Asking poor families to pay for the little boy to go to
elementary school, I think, does not make sense. I do not know
how much money they save in the budget that can legitimize
doing something like that.
At the tertiary level, I think it would be good to have a
program that facilitates joint venturing between United States
education, institutions of higher learning, and African
universities.
You could have funding for scholarships for education,
based in Africa, for example; having somebody come over here.
If I look at my case, I did not study in the States. But it
takes a lot of time. By the time you leave your country, to
learn a new language, to get used to the area, to go to school,
to get a Ph.D., it is about 10 years.
If you had an Africa-based program that facilitated access
to the same kind of faculty and teachers here, you can get the
same outcome within 6 years, okay? The scholarship and the
money, one would have to spend here to go to a university here.
Probably with that 1 percent, you get four or five students
trained.
So I think there is scope and room for that kind of joint
venturing between universities in the United States and
universities in Africa. Particularly at this stage, private
universities are thriving very well in Africa. A synagogue is
developing into a regional learning center. Nobody believed it
15 years ago, when the first professor started constructing a
private university.
But I also think that we have to go beyond primary,
secondary, and tertiary. I really do believe that vocational
training and work force development, in support of agriculture
and agribusiness is going to be important.
You were asking, Mr. Chairman, is Africa going to be a
major player in the global agricultural commerce in the next
years to come. Looking at the trends in China, in India, and
others, I think unless we have the work force development and
the vocational training to raise productivity levels and
competitiveness in African agriculture, it is going to be very
difficult to be a major global player.
China is going to have a problem competing down the road.
Water is getting more expensive. Land is getting more
expensive. The seller is getting higher, and India, the same
thing.
So I think that Africa does have an opportunity to be a
major player in global agricultural commerce. But investments
in technology, in infrastructure, in agribusiness system are
going to be required for them to do that. If that is done, they
can play a major role in these markets; thank you.
Mr. Payne. Yes?
Mr. O'Keefe. Our experience is more in the most remote sort
of rural areas in terms of education, where we find that the
building or the physical infrastructure is not so much the
constraint as is the qualified teacher, and the organizational
support through some sort of organization that allows for
parents to take ownership of the education of their children.
That is point number one.
Point number two is just that the documentation between the
increase in education, particularly for girls, and agricultural
productivity seems fairly clear; that the more investment in
agriculture in girls who end up being farmers, the greater
their productivity in terms of their agriculture. So there are
complimentary benefits in education of girls in rural areas;
thank you.
Mr. Payne. Right, and vocational education--does anybody
have any specific comments on that, the trades and, you know,
that whole crafts area; yes?
Mr. Badiane. I was just emphasizing that. Because the way
it is being handled in Africa there is a project based
vocational training project in one part of the country. Five
years later, it is in the northern part of the country; 10
years later, down in the center. There is nothing systematic
about it. It just does not make sense.
Second, agriculture is being really a knowledge-based trade
in the 21st century. Bio-technology, modern practices of saving
the environmental, cultural practices--all those things are
changing, developing practices.
One good way to really cut corners and make quick progress
is to upgrade the skills of the African farmers; especially
small holders. What it does for you, it makes agriculture cool
again for the younger generation.
You saw some of the rural urban migration that you have. So
I think that vocational training ought to be mainstreamed and
become part of the regular education ministry's job; that the
way they plan for primary, secondary, and tertiary education,
they ought to be planning systematically for vocational
training and education.
There are examples, and unfortunately there are not many in
Africa; but outside of Africa. There are a lot of examples that
can be brought to bear.
I am just facilitating now a learning mission to Germany,
led by the Federation of Farmers Organization in Africa. We
asked some of our staff members to go and look at Germany's
experience in vocation education training and work force
development.
It is an advanced agriculture system; but they have that
across the country, and it is private sector based. Certainly,
the governments can help develop that. But I think there is
room for it, and it ought to part of the education systems;
thank you.
Mr. Radelet. Mr. Chairman, I am glad that you have raised
the issue of education. I was a high school teacher for 4 years
myself; 2 of which were in an all girls school in a tiny
village, in a little island in the middle of the South Pacific.
So I am very conscience of the importance of these issues and
how they have been neglected over time.
I applaud, in recent years, the beginning of a shift toward
a focus on tertiary education. But I do so with a bit of a
concern. That dates back to our history 30 years ago, when the
pendulum was on the other side; when there was a big focus on
tertiary education, very little on primary, and there were
problems with funding for tertiary education going for the
elite and for children of government officials, and not really
for the poorest members of society. It was not an equal access,
open opportunity.
Then the pendulum shifted back toward basic education, and
for good reasons; because we were not getting kids and we were
not getting girls into primary schools.
But in the intervening 30 years, the quality of
universities and colleges in Africa has just completely
diminished. So many schools that were great universities 30
years ago, missionaries and others, are just a shadow of what
they once were.
So we need to find that better balance; and that balance is
going to be different in one country from the next. We do not
want to move resources into tertiary education at the expense
of primary education, and we have got to find that balance.
There are several ways we can do it. Dr. Turshen earlier
reminded us rightly, that as we look for new technologies and
work with universities in the United States, that we need to do
that partnering and building the capacities of university
research centers in Africa, both of the tertiary and also for
of primary.
For primary, one of the things I think the United States
should be focusing--I not sure we should be focusing on
building schools, per se. Again, I would actually thing the
MDBs, the multi-lateral development banks, are a better place
to do that. But I think we can focus on teacher training, on
curriculum development, on those kinds of issues.
One of the big problems is teacher quality and pay, and the
incentives for teachers. There are so few well trained
teachers, and they do not have the incentives; because they are
paid lousy amounts, and they are not given the resources, and
it is not a particularly rewarding career path.
So working with countries to devote the resources necessary
so that teachers are well trained and are well paid to make it
a profession that will attract good people I think is just as
important as building the schools, et cetera, and I think it is
a place where the United States can be helpful.
Mr. Payne. Well, let me thank all of you first of all for
your patience and indulgence. Of course, I might try this every
time, because I have all the time, and I do not have to share
it with my other colleagues. So you can really have a pretty
thorough and efficient hearing, not that they do not add to it,
but if they do add to it, then it is less time for me.
But I really appreciate all of your indulgence. I think
that what you have stated has been very, very helpful. I just
had an opportunity to be able to focus on Somalia, where all of
these things regarding assistance have been neglected, and
people wonder why there is anti-social behavior on the part of
the population.
So all of the things that we have mentioned here need to
start, starting right at Mogadishu, and going throughout
Somalia. When you abandon and neglect a place totally, then you
get a certain result. Hopefully, we will be able to re-engage
Somalia, but also expand our programs, as you have mentioned
throughout the continent.
So I thank all of you for the years of work that you have
done on the continent, and we will keep the pressure on. With
that, this hearing stands adjourned. Thank you.
[Whereupon, at 4:46 p.m., the subcommittee was adjourned.]
A P P E N D I X
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