James Hereford: “You write, Tony Blair came to America to beseech George Bush for $25 billion
over ten years in aid to the impoverished nations of Africa,
he got not quite 3% of it – $674 million.
‘I was hungry and you gave me nothing; I was thirsty and you gave me
nothing; I was a stranger and you did not invite me in.’” We
have now reached the point that $674 million dollars is ‘nothing’? Have we completely lost perspective? We have
dumped untold billions of dollars into Africa
over many years and to what end? Is
there a success story we can point to that shows money was the answer? We have made a few individuals very rich
(along with some American and French arms dealers), but the average African is
in the same boat he was in 30 years ago.
Americans are always so quick to throw money at problems (especially
other people’s money), thinking that money is always the solution.”
F I think this
states the view of a great many Americans. Which is why I think the following interview with one of the world’s
leading hands-on economists is so important.
Because it's long, I've highlighted parts to save you time. (Or listen to it here, though
it takes a while to load.)
Telephone Press
Briefing for Journalists with Economist Jeffrey Sachs Discussing the Upcoming
G-8 Summit
June 15, 2005
Dr. Jeffrey Sachs, director of the UN Millennium Project and Dr. Joanne Carter, legislative director
of RESULTS International in Washington, DC.
Operator: Excuse me, everyone, we will now begin the
conference. All lines will be muted during the broadcast. If you should need
operator assistance during the call, you may press star zero, and an operator
will come by to assist you. There will be a question and answer session
following the presentation. Instructions for asking questions will be given at
that time.
At this time, I would like to
turn the call over to Joanne Carter. You may begin.
Joanne Carter: Thanks very much, Operator, and
thank you to everyone for joining us for this conference call briefing with the
economist Jeffrey Sachs, at this extraordinarily important time in advance of
the G-8 Summit in Gleneagles,
Scotland, in
early July. My name is Joanne Carter, I am the legislative director of RESULTS,
which is the organization sponsoring this call. RESULTS is an international
advocacy organization that works to influence the U.S. and other donor country
policies and priorities to ensure access to health care, education, and other
basic needs for people in the world.
We set up this call to provide you with background to the upcoming G-8, the
issues at stake related to poverty in Africa, the opportunities, and a
realistic assessment of where the U.S. stands right now. In a moment
I will introduce Jeff Sachs, and he will make some opening comments and then
take your questions. But I would just say that it is really becoming clear that
this year, and specifically, this year and this year’s G-8 may be the most
important and most opportune moment we’ve ever seen to address poverty — the
poverty that has over 1
billion people surviving on less than $1 a day, with a
particular opportunity to address the severe poverty in sub-Saharan Africa.
Jeff Sachs is going to put U.S.
efforts to date in context by looking at some of the scale-up that we have seen
in USAID’s efforts and the recent agreement on debt.
But also, be clear that the U.S.
is still far behind in providing its fair share by any standards. I would just
point out that when we look at some specific critical areas like the Global
Fund to Fight AIDS, TB and Malaria, we are so in danger of under-funding it
from the U.S. side that the fund won’t even potentially have money to assist in
grants, never mind funding new projects to be approved this fall, if the U.S.
doesn’t do its fair share. Certainly the world and the U.S. have made very little progress to date on
access even to primary education for all children in Africa,
which has an especially detrimental effect on girls and AIDS orphans who are
often kept out by school fees. So I would just say, whatever the United States
chooses to do or not do at this G-8, whether or not we step up to the plate, is
going to have a huge impact on the global momentum and successive global
efforts.
I want to turn this over now to
Jeff Sachs. For those of you who do not know him, Jeff Sachs is currently the
director of the Earth
Institute at Columbia University.
He is the special advisor to UN Secretary-General Kofi
Annan on the Millennium
Development Goals. He is
the director of the Millennium
Project, which in January released a very
important report that’s maybe the most detailed blueprint we
have ever had for cutting severe poverty
in half in the next decade. Jeff is also
the author of the recently released The
End of Poverty: Economic Possibilities for Our Time. So
Jeff, if you go ahead with your comments and then we will take questions from
journalists. Thanks very much.
Jeffrey Sachs: Thank you, Joanne, and thanks
everybody for the opportunity to have a discussion. As Joanne Carter has just
said, this is an extremely important year and a very important moment in our
nation’s decision making. It is an important year because 2005 is in many ways a make-or-break year for
achieving the Millennium Development Goals. These are international
goals that were agreed [upon] by the world’s governments in September 2000, at
the time of the Millennium Assembly at the United Nations. They call for very
significant progress in cutting all aspects of extreme poverty by the year
2015, and they have the advantage that they’re quantified. They are specific goals in the relevant areas of life and
death for the world’s poorest people: income, poverty, hunger, child survival,
maternal survival, AIDS, tuberculosis, malaria, access to safe drinking water,
and so on.
We know that for dozens of the
world’s poorest people[s], we’re not on track to meet the goals, although
happily for hundreds of millions of people, especially in Asia, indeed
for billions of people, there’s
been a lot of progress. It’s the progress that gives us the
realistic hope that that kind of progress can be achieved everywhere, including
the places where it is not being achieved right now. The epicenter of disaster
is certainly sub-Saharan Africa, although places in our own hemisphere, in the
Andean region, which we know is in turmoil again, and in central Asia around Afghanistan, but including places like Kyrgyzstan and Uzbekistan
and other landlocked parts of central Asia,
are also trapped in an extreme poverty trap.
There are ways out of this. In fact, all the recent studies
that have been done, whether by the UN Millennium Project, which I had the
honor to direct, or by Tony Blair’s Africa Commission, or by the Global
Monitoring Report of the International Monetary Fund and the World Bank, have
all come to the same conclusion: extreme
poverty can be reduced, indeed eliminated by our generation. The
Millennium Development Goals can be achieved, but they require a greatly
increased level of investment. That’s the core: increased investment in people
themselves and their health, their education, their nutrition, in the
environments in which they live, the soils, the water, the
habitats and in the infrastructure: roads, power, Internet connectivity, and
telecommunications. With these investments, the poorest of the poor, who suffer from an extremely low level of productivity can have
their productivity enhanced tremendously and they can become productive
members of the world economy.
But all of these studies agree
on the point that for the poorest of the poor, they can’t afford the vital
investments that are needed, even when these are at very low cost. An example
is something as simple as an
anti-malaria bed net which is $7, it lasts for five years, and yet it is
financially out of reach of hundreds of millions of people living
in the extreme poverty of endemic malaria regions. If we help the poorest of
the poor make the investments, not simply send over emergency food aid, but
actually help them to grow more food, and help them to fight diseases like
malaria, as we’re doing with AIDS, if we step up this effort, this kind of
extreme poverty can be ended.
Now all of these studies found
the same thing; that aid needs to be doubled in the next few years in order to
meet these goals. Our project did the most detailed costing ever done. The
Africa Commission came up with very similar numbers; so did the IMF and the
World Bank in fact in their report. We do need to double overall aid in the
next few years, in particular to Africa, as
Prime Minister Tony Blair has said. We need to
raise aid from about $25 billion a year now to about $50 billion a year within
the next few years, and direct that aid towards high-priority investments:
controlling malaria, helping farmers grow more food, building basic
infrastructure, assuring the children are in school, providing school meals,
replenishing soil nutrients, helping with micro-irrigation and many other very
practical things. If that’s done, extreme poverty can be ended.
Now, unfortunately, we are not
on track, and the United States
is not following through on commitments that the Bush administration made in Monterrey, Mexico
in March 2002 when it, together with other governments in the world, signed the Monterrey
Consensus. That consensus says in paragraph 42
— I’ll quote it exactly — “We urge developed countries that have not done so to
make concrete efforts towards the target of 0.7 percent of gross national product as official
development assistance to developing countries.” Now that goal of 0.7 percent, where we have committed
to make concrete efforts, has become now the commitment of the European Union
as of last month, with a specific timetable to reach 0.7 [percent] in steps by
the year 2015 and to reach 0.5 percent of gross national product by the year
2010. This was the message that Prime Minister Tony Blair brought to Washington last week. The Bush
administration has not agreed to this target,
even though it is part of our commitment, as it is the commitment of all the
signatories of the Monterrey Consensus. It is also part of the need for Africa
to be able to surmount the multiple crises of hunger, and disease, and despair,
and economic isolation that Africa now faces.
Let me put this in human terms
if I can. I was in a village last week in Mali, sitting around a circle on
the ground with a number of the impoverished farmers in the village. I asked whether any children had died in the
village recently and everybody was shocked. A man stood up and said, “But
mister, so many children, so many children dying all
the time”. I see those children dying on each visit to Africa
because I go to the clinics. I see children in coma, in convulsions from
malaria. I know that this is a disease which will kill up to three million
children this year, even though
it is largely preventable and 100 percent treatable, but it is neither being
prevented nor treated. These places are too impoverished to be able to fight
on their own. We have started with AIDS; we have not started with malaria in
the same way. We have not helped farmers grow more food; [instead] we’ve been
sending food aid. There are practical things that are part of Tony Blair’s call
for a doubling of aid to Africa by the year
2010. All of the governments around
the world are sharing in this. The European Union is speaking
clearly. I very much hope — I urge in every possible way for the United States, for the sake of the spirit of America and the sake of American security, to
join in this call of Prime Minister Blair so that the summit in July can be a
success for the world and a success for America. And I believe that all
hangs in the balance still, to this day. Thank you.
Joanne Carter: Thanks very much, Jeff. Why
don’t we go ahead then, too, so we have plenty of time for questions, and then,
perhaps, Jeff, in the context of that, you can give a few more details, and
then we can provide in writing the background note that you put together about
America’s current aid to Africa if that would be helpful. For now, Operator,
will you please let folks know how they can ask questions, and we will get
started with that.
Operator: Ok. We will now begin the question and
answer segment of the conference. If you would like to ask a question at this
time, please press star one on your touch-tone keypad. Again, to ask a
question, please press star one.
And your first question comes
from Lynne Varner with the Seattle Times.
Go ahead, Ms. Varner.
Lynne Varner: I wanted to ask Jeff, what is
the role of politics, of reforming government in many of the poor countries you
are talking about, and are we doing that? Is the U.S. moving toward pushing those
governments to reform?
Jeffrey Sachs: Well, there are many reform
governments in Africa that are struggling to
survive. In fact, President Bush met with a number of those leaders a few days
ago, but we are not helping those places either. So it is not just a matter of
us pushing, because Africa has democratized
all throughout the continent, not every place, but in many many
countries. And yet, those democracies which struggle for survival, with hungry
populations, facing very desperate odds, facing massive disease, are not
getting the kind of help that they need to break out of extreme poverty. So my
suggestion — in fact the suggestion of everyone that looks at this, including
the Bush administration — is to help those countries that are ready for that
help, prepared, and there are many of them, but they are not getting the help.
That’s the basic point. The level of
our assistance right now is really so extraordinarily small compared to the
need and compared to the possibilities of dramatic use of such aid, that all
governments around the world are saying to the United States, it’s time. We can
do a lot more. That’s why Tony Blair came last week, to say we can do a lot
more. So it’s not just a matter of pushing for reform. Reforms have happened,
but we are not backing up the reformers.
Lynne Varner: OK.
Operator: Thank you sir, your next question comes
from Martin Crutsinger with the Associated Press.
Martin Crutsinger: Yes,
Jeff. Could you make a prediction on what is going to happen at Gleneagles? Do
you think that the U.S.
will come part of the way to meet Blair’s request, or is it likely that, that
it will end up in some sort of an impasse?
Jeffrey Sachs: Let me go through a few of the
numbers just to be clear where we are right now. Europe
has committed on a timetable to reach 0.5 percent of GNP in overall official
development assistance by 2010 and to reach 0.7 [percent] by 2015. The United States is second from bottom
of the rankings of aid relative to GNP. (Last year Italy was lower.) The
United States is at 0.16 percent, but even the fact that we are at 0.16
[percent] and Europe is at around 0.4 [percent] now, on its way to 0.5
[percent] by the end of the decade and 0.7 [percent] by 2015, really in a way
understates the issue. The U.S. is at 0.16 [percent] without any timetable,
without any set of clear policies on how it is going to meet the obligation
under the Monterrey Consensus of making concrete efforts towards the target of
0.7 [percent]. So we don’t even have a clear U.S. policy on this of how we’re going to
get to where we have promised to aim. This is what Europe is saying to the United States —
are you going to participate in this process? And the answer is very unclear
right now because basically, the answer so far has been no. The U.S. says we
don’t accept artificial targets — ironically it signed up to making concrete
efforts to 0.7 [percent] so it signed the Monterrey Consensus together with
everybody else. And these are not arbitrary except to the United States. These are life and death targets for the poorest
people in the world.
So, I think that it’s not possible
to answer the question of what will happen right now, because we are in a
situation that I believe is neither in America’s interests, nor is it a
place where I believe we are likely to remain. But, it’s very unclear what the
administration’s policy will be. It has not really explained any policy of how
it’s going to respond to this clear international commitment and to the
repeated findings from all over the world of what can be accomplished right
now.
Martin Crutsinger: Thank
you.
Speaker: Next question, sorry, go ahead.
Operator: Your next question comes from David Francis
with the Christian Science Monitor.
David Francis: Jeff, in Africa
there is still a rapid population growth in many of these countries which, I
imagine, would make the problem of development much harder and more difficult.
And the United States
seems to have some restrictions on population control. Is there conflict here?
Is this a serious issue that should be addressed in the efforts to improve Africa’s situation?
Jeffrey Sachs: I believe that sexual
reproductive health is a vital part of economic development, and I believe that
the opportunity for families to choose family planning is a vital part of that.
What’s also true is that in the
poorest places in the world the population growth tends to be highest, because
impoverished people, seeing their children die in such large numbers, tend to
choose to have very many children as a kind of insurance policy, so
that there will be some surviving children in the old age of the parents. And
what this means is that ironically, it’s in the poorest places in the world,
often the places least able to support a growing population, where you find the
most rapid population growth.
What it also means is that when
economic development begins, starting with child survival itself, fertility
rates tend to fall quite sharply, as do population growth rates. And so I think
there’s a real prospect through a strong development policy of saving children,
of creating more productive agriculture, of empowering women, of having
literacy and girls in school and literate mothers, another huge contributor to
lower population growth. THAT All of these things, in
my view, good development policy, will turn the tide in what is right now an
unsustainably rapid growth of population. And I always find people amazed, but it’s true, that saving children
actually will slow population growth, not speed it, because of the
response of parents choosing smaller families and investing more in the health,
and the education and the nutrition of each of the children that they have.
So yes, it’s very important, but
the main thing that is happening right now is that we don’t have a coherent
development strategy in Africa at all, and I
have not really explained it properly. Our total aid budget for Africa is right
now about $3 billion, total. In other words it is less than a couple of days of
the Pentagon budget, for example. Of that $3 billion about $1 billion is
emergency food aid. About $1 billion is the AIDS program, and about $1 billion
is for everything else. Of the ‘everything else’, almost all of that is
American consultancy salaries, rather than actual investable
funds. What this means is that the image that Americans have, that we push huge
amounts of money into Africa and it somehow goes bad or goes missing, is simply
wrong. It’s simply wrong. It is a misunderstanding — it’s one of America’s great
myths. In fact, we give very small amounts of assistance, most of which are our
own salaries or food aid. What we give to actually invest in clinics,
and schools, and irrigation projects, and soil replenishment is so small, it’s less than $1 per African. No
wonder we don’t find it, we don’t do it! And this is the biggest
misunderstanding in America,
because you can understand American feelings. They say “Well, we give so much
aid, and we see so few results”. If they understood we
give so little and we see so few results, and if we gave more, we’d see more results, there would be considerably more support. And
that’s what I would hope the president would explain to the American people.
The truth about how much more could be done if we would simply make the effort.
We could control malaria. We could
help to promote a Green Revolution for Africa.
We could ensure that all Africa’s children
have a midday meal at their schools. Which would do wonders
for getting the girls and the boys in school. We could enable Africa to drop user fees for primary education and
primary health. These are all practical steps that could be accomplished
quickly, but we haven’t tried them. And I believe the American people would
support such practical results-based assistance, especially if the president of
the United States
would explain this to the American people.
Operator: Your next question comes from Shihoko Goto with UPI.
Shihoko Goto: Mr.
Sachs, I actually wanted to know about how the private sector might fit into
the development precis that you have for Africa. It seems to me that right now the G-8 is more
concerned about immediate relief and aid, food aid, health, sanitation. But, if
Africa is to grow in the longer term there
needs to be a lot of business investment, and specifically technological
transfer. How do you see that sort of private/public partnership developing?
Jeffrey Sachs: I think that the clear sense of
international business, and of Africans and the
experience of development in Asia and elsewhere is that the reason that Africa does not get the investment that it needs for
growth in the private sector is because there’s a lack of basic infrastructure.
Electricity is irregular. The roads don’t exist or are unreliable. The port
facilities are unreliable. The population is hungry, the people are sick and
the labor force is without all of the skills needed. Now, that sounds like a
pretty daunting set of challenges, except that one can see practical solutions
for each of them. It comes back to investment. Investing in
basic infrastructure, investing in health. Which is a series of
straightforward investments right now, such as control of malaria, that are not done yet. Investing in schooling
for children with techniques as simple as ending user fees and promoting midday
meals, using locally-produced foodstuffs.
These steps are what makes a business environment attractive for the private
sector. So with roads, ports, electricity, health and an increasingly literate
labor force, Africa would
have the same kind of development that Asia is
having right now. And in fact, Asia and Africa were in a similar situation 50
years ago, but Asia started
with a Green Revolution to grow more food, feed the population and thereby
escape from the cycles of famine, disease and extreme poverty. Africa has not
had that Green Revolution yet and that’s because the farmers in Africa lack the basic inputs of improved seed, fertilizer
or soil nutrients and small-scale water management. And yet, now, the
scientists have shown in repeated projects that this can be done. This is where
practical investment — for example at the G-8 Summit
— could enable Africa to have a Green
Revolution. That would change the face of Africa,
that would change the business climate, that would
change possibility over the coming generation, for the private sector to invest
in a significant way. It was the trigger for Asia’s
development. It requires financing, right now, the financing which, so far, the
White House has not agreed, but if it did agree would change the prospects. But
the one thing that will not
create a Green Revolution is sending American food aid to Africa. That
will not create Africa’s Green Revolution.
Operator: OK. Just so you know,
there are 10 questions in queue.
Jeffrey Sachs: Yup!
Operator: Next question comes from Dan Carpenter with
the Indianapolis Star.
Dan Carpenter: Hello. When we speak of the
private sector, again, shouldn’t we be holding their feet to the fire more? So
much of the money that is necessary for this investment that you speak of is
already being extracted in places like Nigeria, for example. By
corporations that are not being required to pay taxes, to protect the environment,
or to engage and contribute to local needs. Are we talking too much about
reform of government and not enough about reform of the private sector?
Jeffrey Sachs: Well, again, let me first say
that the first thing we should be talking about is investment and then the
areas of priority again are health, education, nutrition, the productivity of
agriculture, which is an investments in the environments such as soils and
infrastructure.
The question then becomes how to
mobilize those investments. The problem is that in most countries, there is
simply not the domestic resource base of any sort in order to finance the basic
level of investments that are needed. This is true, incidentally, even in oil
countries like Nigeria,
because the costs are simply beyond what Nigeria can afford. It is often
thought Nigeria
is a rich country, it’s not a rich country. It
produces 2 million barrels of oil per day, but it has 120 million people that
are dependent on that.
The point you make is a good
one, though, because when you have resources like oil, even if it’s not that
much per capita — and it isn’t in the case of Nigeria — it is still important to
use properly. At times, the oil has just been stolen by dictatorships like Abacha, but it’s clear that there is a tremendous lack of
transparency about how that oil is extracted by the international industry as
well in these countries. And so there are initiatives for extractive industries
transparency, or the EITI, the Extractive Industries Transparency Initiative,
or the ‘Publish What You Pay’ initiative. And that is extremely important
because I believe that those resources would be used much better
if there were transparency on the international business side as well.
I also believe that the large
oil companies have a much greater responsibility to help the communities in
which they operate than they have met so far. Now there are differences among
them, but I think as a general rule, they should be doing a considerable amount
more. But I don’t want to pretend, and I think it’s a mistake and almost a
cop-out for all the rest of us, to pretend that that can actually solve the
problems, because most of sub-Saharan Africa,
first of all, is not hydrocarbon exporting economy. Most of these economies are
subsistence, impoverished, disease-ridden, agricultural economies and they need
help. And the help is going to have
to come from us, or the people will die. And they are dying in massive numbers
right now — 6 to 8 million a year in Africa
alone. I think reliably, one could say worldwide, that at least 8
million people a year die of their extreme poverty, 20,000 a day. One can say
that 6 million of those can be located in sub-Saharan Africa,
with the nearly 3 million dying of malaria, 2 million of AIDS, half a million
of tuberculosis, and millions more, in fact, of other infectious diseases.
Those places don’t have an easy way out from oil. They need our help, or their
downward spiral will continue. Fortunately,
we have promised, time and again, to help. Unfortunately, we haven’t yet followed
through. And fortunately, the G-8 Summit is the opportunity
when we can finally match our commitments and our actions.
Operator: Thank you. Your next question comes from
Mark Bixler with the Atlanta Journal-Constitution.
Mark Bixler: Dr.
Sachs, as you know, the G-8 finance
ministers recently agreed to cancel the debt of 18 poor countries, mainly
in Africa. Can you give us your sense of how
significant that decision is, and also could you put that into context by
talking about the contributions through the years of faith-based activists,
such as the Jubilee campaign. How significant a player have they been in the
campaign to have some of the African nations’ debts cancelled?
Jeffrey Sachs: Thank you very much. What
happened with the G-7 finance ministers is a step forward, definitely, but it’s
a very modest step forward. As you have all been reading, the cash flow saving that results from this is at most about $1.5 billion per
year. The aid need in sub-Saharan Africa is in
the order of $25 billion per year. Even the headline number of $1.5 billion per
year saving exaggerates the real net gain for Africa,
perhaps by quite a large amount, actually, for somewhat complicated reasons.
What’s happening is that these 18 countries are now being told, “you don’t have to repay that debt. The donor governments
like the United States and U.K. will do it
for you.” And so the U.S.,
the U.K.
and others are sharing that $1.5 billion annual flow, roughly, to repay to the
World Bank and to other creditor institutions, who are the holders of the debt
of those 18 countries.
But, there are several details
in this. One is that the United
States government, at least till now, has said that its share of those payments, which
are on the order of $130 to $180 million a year, that’s all we’re talking about
here, about 30 to 50 cents per American per year, that that amount is going to come out of the existing aid budget.
So if the U.S. pays that
interest, it may cut aid of other kinds. This is extraordinarily worrisome,
because it would say, if that’s
really the case, it’s just a shell game. A certain kind of relief will
be given, but it will be offset by cutting aid of other sorts. We haven’t seen
the end of the story, but if that’s the case, it means that there’s no net
change in what is being offered to the countries that need our help. There is
even concern that when a country that otherwise would pay back to the World
Bank, will not pay back, the World Bank will actually lend or give that country
a lesser amount in response. This is another point that needs to be clarified.
But I think the answer is unambiguous. This is a small step in the right
direction, but it may even be smaller than the small amount that it looks like
on paper, depending on how the deal is actually financed.
Now you asked a very important
and interesting second question, which is, to the extent that we’re getting
movement at all, what is the role of the faith-based community? I think it’s
quite large. I’ve worked on these debt issues for 20 years, saying that these
debts are unpayable. I have constantly been told, “oh
no, they’re payable,” only to see another part cancelled and another part
cancelled. And twenty years ago this was all understandable, but it wasn’t
understood. And by the way, when I was on the Meltzer commission in 2000, we
voted unanimously, [that] the International Monetary Fund, the World Bank and
the regional development banks should write off, in their entirety, all claims
against heavily-indebted poor countries. We already had this five years ago; it
took so long to do the obvious. And that is why it is fine, but what a lot of
effort to accomplish so little when we have so much to accomplish.
Now on the faith groups, the
Jubilee 2000 was definitely propelled and championed by faith groups. The turn
to increased effort to provide anti-retroviral medicines has been championed by
faith groups in this country. I know that an increasing number of faith-based
groups are taking an interest, for the first time — but still, it’s great — in
controlling malaria, which is a tremendous blight, a massive child killer that
we could so easily control if the United States would simply step up to it,
which it hasn’t yet. So I think the fact that it is a deep religious value to
feed the hungry and help the poorest of the poor, to help the least among you,
it is one of the powerful sources of movement in this country. But the biggest
problem, in my view, is that people do
not understand how little we’re doing compared to what we’ve committed, what’s
needed, and what we could so readily afford. It’s those three criteria: what
have we promised, what is actually needed, what can we
afford, where there is massive confusion. Roughly a 30-fold overestimate by Americans of what we are actually
doing. Unfortunately the White House and other political leaders not clarifying
this at all, rather say how generous we are, rather than
explaining the truth of what we should be doing and are not doing right now.
Operator: Thank you. Your next question comes from
Penelope Purdy with the Denver Post.
Penelope Purdy: Dr. Sachs, we had talked a
little bit about the 18 countries, the poorest countries involved in this debt
cancellation. Of those, 3 are in this hemisphere. We have talked heavily about
Africa, but given our region’s connections to the Latin Americas, I am very
interested in what you can tell me about what’s going on in Latin America, and
why are places like Nicaragua, Honduras, and Bolivia remain in such economic
and political turmoil?
Jeffrey Sachs: Yeah. It is of course, of great
pertinence to us. Generally these are societies that are bereft of basic
infrastructure, often divided ethnically and racially in internal politics. In
the case of Bolivia,
notably suffering from a massive geographical problem, which
is, as an Andean landlocked country, being in a position of extreme economic
isolation, with some of the highest transport costs in the world. Now,
because they are in our hemisphere, one might have thought that we would pay
more attention to them. And, unfortunately we tend to view countries too often
through the optic of our immediate interest rather than through the optic of
their long term development as a way to also address our interests. An example
of Bolivia
is very stark— a country that I know very well. We pushed very hard over the
last eight years for coca eradication, and I watched in the late 1990s as the United States
insisted on eradication of the coca crop without alternatives being provided.
And it was very clear at the time that this would create a social explosion
because hundreds of thousands are dependent on farmers that grow coca leaf. And
if you just say that this is a military action, and you provide a trickle of
so-called alternative development funding, but it’s so tiny that it’s really a de minimus sum
compared to what would need to be done, it’s not surprising that you get
uprisings, that you get massive political backlash. And this is exactly what’s
happened. And I am sorry to say that it is predictable, and it’s been predicted
by Bolivia’s own political leaders who warned President Bush, warned the
American leadership, without some help and some realism, we’re just going to
have turmoil, and that’s, unfortunately, what we have right now.
Operator: OK, and your next
question comes from Mark Green.
Mark Green: Hi. Near the end of your remarks you
mentioned that you hoped the United
States would step up to its commitment from
the 2002 consensus, and you said, “for the sake of American security”. I wondered if you would talk more about that.
Jeffrey Sachs: Yes, the security experts in
the Pentagon, the intelligence agencies and in foreign policy circles are
absolutely clear that impoverished and disease-ridden states are those that are
also most likely to become failed states. It is the result of that kind of
chaos that can put us into a terrible security bind. Let me quote. “Poverty doesn’t cause terrorism, being poor
doesn’t make you a murderer, most of the plotters of September 11 were raised
in comfort, yet persistent poverty and oppression can lead to hopelessness and
despair, and when governments fail to meet the most basic needs of their
people, these failed states can become havens for terror. Poverty prevents
governments from controlling their borders, policing their territory, enforcing
their laws. Development provides the resources to build hope and prosperity and
security.”
Those are comments of President Bush, March 2002. I think he had it
exactly right. If we want to face the security challenges in
Africa, which are very real right now, and known to be real, sending military
advisors to train armies in the Sahel,
in my view, is the wrong approach for hungry, disease-ridden, impoverished
countries. If we want to help those countries, we should help them get out of
the cycle of massive disease, despair, and extreme hunger. And we could do this
through practical development approaches. Unfortunately, we have taken an approach based on the military. We have
not followed through on development. We’re pretty good on the
development rhetoric, once in a while, but not on real development programs.
Those are what are missing, and that is where you have to separate the rhetoric
from the ground reality. The ground reality, which I see all the time, is that
we do not have development programs in place. I am told repeatedly by our own
ambassadors in private, there is nothing we can do; we have no aid budgets.
This happens all over Africa, I know it. I see
more and more American security officials around. They are concerned about the
instability, but they cannot solve the problem. It’s development, people getting enough to eat, children surviving, children
in school, societies with hope, that will solve the security challenge for us.
But we have to make investments.
Of all our spending right now, other than the AIDS program, which I like and
think the president has done a good job on, the
emergency food aid, which is not a development program at all. If all the rest
comes to $1 billion dollars, roughly,
and most of that is American consultant salaries (and
what you’re talking about In real investments of the sort that I’ve been
discussing: of helping farmers grow more food; providing safe drinking water
and sanitation; helping to connect the villages with markets, with telecom,
with Internet connectivity; helping children have school meals; helping there
to be the war against malaria, which could be won) if all of that comes to a
few hundred million dollars, it’s shocking, because what we have effectively done is leave hundreds of millions of
impoverished people to die and then we worry about security and then we send
military advisors and we wonder why it’s not working. It
cannot work this way, until we step up to actual development assistance.
Operator: Your next question comes from Richard Knox
with NPR.
Richard Knox: Yes, hi, thanks. You mentioned
that you like what the president has been doing on AIDS, and there has been
encouraging progress in providing anti-retroviral treatment. It is sort of the
spear point of a lot of other issues. I am hearing growing worry, though, about
meeting the targets that have been set. A large part of that worry revolves
around personnel on the ground to deliver care. I wonder what — you know that’s
not something that’s easily and quickly remedied— and I wondered what ideas you
may have about that. If I could also ask a second question that maybe too
complicated, but I am hearing conflicting things about policies by IMF and
World Bank concerning requiring countries to cut back some of their spending in
areas like health care in order to offset new aid, in order to avoid inflation
and currency devaluation. IMF tells me that that’s not the policy. Other people
say that countries think it is. I wondered from your perspective what the
reality is.
Jeffrey Sachs: Well, two important questions.
First, on health personnel, there actually are, believe it or not, it is
amazingly sad but true, there are large numbers of unemployed or underemployed,
trained health personnel that are not being hired now because these
governments, the local communities, the hospitals, cannot afford to bring them
on a payroll. Often a payroll, by the way, where there is a budget ceiling put
on in the context of an IMF program. And Kenya is a case in point where
there are thousands of unemployed nurses — one of the most profound nursing
shortages I have ever seen with my own eyes for years. And I have been saying
this to U.S. officials, to European officials, to the IMF, to the World Bank,
and it would cost some tens of millions of dollars of donor financing to bring
several thousand trained health workers, nurses and doctors, into desperately
understaffed hospitals — and it could be done basically overnight. And it’s a
matter of donor assistance, exactly what we are talking about. It’s all ready
to go and yet the donors have not come through. And we will not be able to
achieve targets for anti-retrovirals and for malaria
control and others if we don’t have these personnel, all hands mobilized — this
is a matter of donor assistance. We are not talking about billions, in that
case in Kenya,
we’re talking about millions, but it hasn’t been done. The United States has
actually helped with some of what needs to be done, perhaps about a tenth of
what needs to be done, but we haven’t gotten anywhere close to the minimum
practical scale to be able to achieve the kinds of goals that we have set.
Now, the IMF and the World Bank
basically don’t block increases in health spending, if donors come forward.
But, I don’t believe they also realize the urgency, and they don’t speak up and
say in public what they say in private. In private they know that there is a silent tsunami, silent holocaust
underway in rural Africa with mass death. They
know that there is not enough budgetary support to hire doctors and nurses and
to keep proper provisioning of the health system. But, they don’t say in public
that the United States
and other donor countries should therefore do more to save the millions of
lives that could be saved. What they say is to the governments, “Well, so sorry
you have what you have; now live and in fact die, within your meager means.”
This is the great fallacy of
these IMF programs. Not that they stand in the way, so much, of increased
spending, but that they watch unblinkingly as millions are dying without
saying, country by country, back to the rich governments, “Come on now, you could save these lives. And you could save them now.
And this is a matter of dollars and cents so help this country.” That’s
what they say in private, not to the U.S. and to others, that’s what
they wring their hands to me. But Ttey don’t say it
in public, and they don’t put pressure on the donors to actually come through
and save the lives. That is why IMF, World Bank programs often have health
systems that have four or five dollars per person per year as the total
spending. That is what you get in an impoverished country if you don’t get
help. You get a few dollars per person per year in the health sector. Compared with our country with more than $5,000 per person per
year. In Africa, it’s a few dollars. It
is one of the most shocking facts on our planet, because in effect it is a mass
death sentence and the IMF and the World Bank should be standing up country by
country and declaring this.
Now, they have stood up last
month and said that they need an overall doubling of aid. That’s what was brushed aside by the White House
last week. Bush just casually said, no we’re not going
to do that, as if millions of lives are not lost as a direct result of such an
attitude. But we need that country by country to make absolutely clear
that it is pure mythology that there’s nothing that can be done. There is so
much that can be done, and can be done quickly with a little bit of financial
help, but the kind of help that so far has been refused by the U.S. government.
Operator: Thank you. Your next question comes from
Nina Tandon with the Austin American-Statesman.
Nina Tandon: Good
afternoon Mr. Sachs.
Jeffrey Sachs: Hi.
Nina Tandon: Could
you talk a little bit about past aid
programs that have been successful in Africa, and how the U.S. could
learn from them to come up with its own effective strategies?
Jeffrey Sachs: Yes, aid works when it is directed towards
development, not towards politics, and when it is of measurable inputs and
measurable outputs based around proven technology. In
other words, when aid is specific, when it’s targeted, when it’s measurable,
when it’s properly audited — when it’s really for development, not for Cold War
purposes or to reward someone in the war against terror or something else, but
actually for development, then aid works. Some examples: the eradication of smallpox, one of the great achievements
of humankind. That wasn’t an eradication in the United States, that was an eradication in every
country in the world, including the poorest of the poor in Africa;
the control of African river blindness; the control of African Guinea worm
which President Carter has championed. The control of polio — and it’s close to
eradication — which Rotary International has championed; the rise of immunizations
among children, which UNICEF in particular championed. All of these have the
same characteristic. They are targeted towards specific outcomes, they are
measurable, you can quantify them, you can measure how much goes in, how much
comes out, you can track them and you can audit them. And
they are development goals, they are not just waving one’s hands, they are
specific targets.
Now another great goal like this
was the Green Revolution itself, which was the spread of high-yield varieties
of food crops throughout India
and the rest of Asia in 1960s and 1970s. And
the hero of that was the Rockefeller Foundation. I raise all of these examples because this is precisely the kind of
program that we ought to have in Africa right
now. We ought to be controlling malaria through targeted means by
the year 2008, insuring that everybody in malaria regions is sleeping under a
bed net, that everybody has access to the new generation of effective
anti-malarial drugs, that every village has the capacity for local diagnostics
and has trained community health workers to control malaria. This is absolutely
achievable, but it requires U.S.
government leadership together with other countries. We could help to promote a Green Revolution for
Africa, which I believe is of fundamental importance for Africa
to escape from this seemingly endless cycle of famine, disease and instability.
Because we know what it would take to triple Africa’s food yields, which
are a third of what other farmers in other parts of the world achieve. It
requires improved seed, it requires fertilizer or other soil nutrient inputs,
and it requires water management technologies. This is not high cost, but it is
beyond the means of the poorest of the poor.
So these are the programs that
work. When we put our mind to it, we achieve them. This is what is happening
with anti-retrovirals also, although it started too
late and it remains under-funded. It’s too small; we should be supporting the
Global Fund to Fight AIDS, Tuberculosis and Malaria at a much larger level. But
it’s why the president is having some success in that one area, which is the
only aid initiative of this administration, the one on HIV/AIDS. Because it’s
measurable, monitorable, targeted, and an actual
development need. And so it’s working, and we should be doing that in many
other areas as a practical approach that’s enabling Africa
finally, once and for all, to escape from this seemingly endless cycle of
extreme poverty. It could be accomplished if we would stop saying no, and roll
up our sleeves and get to doing what we have committed to do.
Operator: Thank you. Your next question comes from
Fran Quigley of the Indianapolis Recorder.
Fran Quigley: Hello, Professor Sachs.
Jeffrey Sachs: Hi.
Fran Quigley: You mentioned that the White
House policies don’t really exist right now to put us in a position to ramp up
to the 0.7 percent commitment. I know you have advised a lot of nations on
economic policy, and then you realize this is currently a reflection of
domestic concern. What kind of options do you think the Bush administration and
Congress have domestically to quickly move up to meet the commitments we have
made in the past years?
Jeffrey Sachs: I have been speaking all over
the country in recent months, and also on a lot of talk shows, and [had] a lot
of chance to sample opinion with Americans. I believe strongly that America
is absolutely prepared, in many ways very eager, to help with these real
life-saving and life-changing interventions right now. Americans tend to be
very surprised to find out how little we do. It’s alarming to many, many
Americans. And this is across the political spectrum,
it is not a left-right division. It is religious groups, it’s
groups across our society, ready to move. And then when Americans hear how
practical it would be to control malaria; how practical it would be for Africa
to have a Green Revolution; how readily children could have school meals; how
readily we could enable impoverished African countries to drop user fees on
schools and clinics, they’re ready to support it.
I said — at the White House
during the first phase of the Bush administration, I advised on a $3 billion a
year program on AIDS, and I remember for the first two years, I was told, well,
that’s politically impossible. In the third year, in January 2003, the
president announced a $3 billion AIDS program, and it’s turned out to be
politically popular, as well as an effective program on the ground. It’s just a
shame that it is the only thing the administration has done in this regard, and
compared to our commitments and Africa’s
needs, it’s a very small step. But it has not been a politically unpopular step, it’s been a politically popular step. So I don’t think
that there is a great impasse. I wait to hear from the president. The speech
about ending extreme poverty, about America’s lead in that, about our role in
the world in fighting malaria, in promoting a Green Revolution and keeping
children in school and promoting safe drinking water and using American
technology. This is a winner politically. It’s a winner in foreign policy
terms. It will increase our security markedly, and in the end it’s going to
save, not only millions of lives, it’s going to save money for the United
States because it’s going to save a lot of grief from insecurity in the planet
and Americans would, I believe, rally to
the president if he would lead.
Operator: Thank you. And your next question comes
from Sara McGregor with the Embassy
Newspaper in Canada.
Sara McGregor: Hi. Canada is one of the few countries
that hasn’t yet committed to the timetable of 0.7 [percent], saying, you know,
that we — the government can’t afford it. I’m just wondering, you were in
Canada recently — what’s your sense if Canada actually doesn’t announce at the
G-8 that it is going to commit to the 0.7 percent timetable, do you think
there’s going to be a reputational problem or any
sort of diplomatic rift because we’re not keeping up our part of the bargain?
Jeffrey Sachs: I think Canada’s friends in the world are utterly
perplexed at Canada’s
inaction right now. We find it completely inexplicable. First the 0.7 percent
goal came from Lester Pearson, no less, in 1969. Paul Martin is in many ways a
political protégé of that era and of Lester Pearson, and we know that he’s an
internationalist as well. I also know that in Parliament there’s extremely
strong support, all-party support, for 0.7 [percent]. Canada has the
budgetary means to announce the timetable to 0.7 [percent]. So I have to say
that we are dismayed and perplexed by the inaction, but I’m
believing that Prime Minister Martin is going to come, through because I
think that it would be one of the great disappointments for Canada and for
himself to look back and to have missed this historic opportunity. Canada seeks to
lead in the so-called L20, or G20. It seeks to have its voice heard in the
world, but if it’s ducking its most basic issue for absolutely no
understandable reason (because this could be accommodated financially, and
after all, your own finance minister signed up to this recommendation as part
of the Africa Commission) I believe that this will be a blight on Canada’s
politics for a long time to come, so much so that I’m looking forward to Canada
making the announcement about 0.7 [percent] before the summit.
Operator: Thank you. Your last question comes from
Nancy Alexander with Citizens’ Network [on Essential Services].
Nancy Alexander: Thank you. In 2002, at the
World Bank — at the U.S.’ leading, the World Bank adopted a private sector
development strategy that makes it the purpose of the World Bank Group, which
leads most of the other donors and creditors, to privatize health care, water,
and education, and this has really caused havoc so that people are out in the
streets of all these countries that we would like to help, demonstrating
against the aid programs that are tied to their privatizing assets. Whether
it’s in Malawi where the
National Seed Agency is being sold to Monsanto, or in Ghana where the donors and creditors withdrew
their money for water until Ghana
agreed to privatize its water and the IMF set the rates. Or in Ethiopia where right now, farmers are really
suffering because subsidies or inputs are being withdrawn and no private sector
response is expected, just as it didn’t come about in Tanzania. So in
terms of privatizing these basic services and the actions on the street, how do
you square going ahead and doubling aid?
Jeffrey Sachs: Oh, I think that public health
is a public issue. Malaria is not going to be controlled by the private sector;
it’s going to be controlled as a public health intervention. It’s going to be
controlled through a free, mass distribution of bed nets, just as we ensure a
mass access to vaccines. And many of the other areas: children’s education,
school meals, basic infrastructure, absolutely depend on government provision
of basic services and an assurance of universal access to life — vital life
needs. So what happens every time there is a call to privatize water without
explaining to the poorest of the poor how they’re going to be able to survive,
you do get great instability. The idea that health could be achieved with the
access of the poorest of the poor through a market basis is absolutely bizarre
when that view is actually held. I know of no African governments that believe
it. They want to ensure universal access of the poorest of the poor.
Now in the United States, in control of malaria for example, we’ve had a
failed policy for many years of trying to sell bed nets to people that have no
money, and it’s been, in my view, a disastrously wrongheaded policy. During
this whole time, the malaria burden has gone up, not gone down. Millions of
children are dying on this administration’s watch for absolutely tragically
inappropriate reasons of our neglect and our misguided policies of trying to sell
things to people that have absolutely no money, and I think
we have to get this right. Now, most of the world agrees that for the most
basic needs, these cannot be sold to people that have no resources or the
result is massive debt and I think that this is the right position. We need to
continue to insist on it. Ironically we end up wasting the aid that we could
otherwise provide in the case of malaria because we try to sell the nets. Then
people don’t buy them. Then instead of
spending our aid on getting nets to people, we actually spend our aid on advertising
bed nets, and this is what was described as in the New York Times and Congressional hearings last week. It’s a
shocking mistake and so when these basic needs are addressed, they have to be
addressed in the recognition that people that have nothing, that are dying of
their poverty, need help. They cannot find their way through market purchases.
They’re just being left to die if we pretend that they can.
Nancy Alexander: Thank you.
Operator: At this point there are no further
questions.
Jeffrey Sachs: I wonder if I could add one
thing, I don’t know if anyone else is on the line but I think it’s interesting
and important that not a single question came up about the Millennium Challenge
Corporation. This was to be the administration’s big initiative. It was
announced in March 2002 at the time of the Monterrey
Summit. It was supposed to disperse $10 billion
over the following three years. I don’t know whether it’s dispersed a penny
yet, but I know that the one program in the first four years of the existence
will be a program for Madagascar
where the first-year disbursements are budgeted at $27 million. So this was a
program that was announced in March 2002 and we have essentially done nothing,
and this I think shows how urgent it is for the United States to do more than
just talk and to do more than just wave away the entreaties of the world for
the U.S. to live up to its commitments. This demonstrates the U.S. has an
urgent role to play that it has not yet played.
Joanne Carter: Thanks. Thanks very much, Jeff,
and just to let folks know that we have available from Jeff a brief analysis on
U.S. foreign investment in Africa and also some background information on the
needs of the Global Fund that we put together on opportunities for eliminating
school fees, and school meals and access for other economic opportunity, so if
anyone is interested in that, they will be posted to our website at results.org, and a transcript of this call
should be available within about 24 hours, again from our office or, as soon as
it is ready it will be posted on our website. And I believe there’s going to
be, you will be able hear an audio version on the Earth
Institute website.
Thanks very much everyone for
joining us and thanks Jeff as well for your time.
Jeffrey Sachs: Thank you very much.
Joanne Carter: OK. It’s really important,
thank you all. Bye.
Operator: Thank you.
F Three
thoughts:
- “There but for the
grace of God go I.”
- “No man is an
island. Ask not for whom the
bell tolls; it tolls for thee.”
- What if the people of Africa were white?
Tomorrow (or soon): Barack Obama’s Commencement
Speech