President and Mrs. Bush's work in Africa began with the fundamental principle - all life is precious. They continue their work building a health infrastructure and implementing sustainable solutions through PEPFAR and Pink Ribbon Red Ribbon.

In April, President and Mrs. Bush led their seventh Bush Center delegation to Africa since leaving office. After their return from Botswana and Namibia, they spoke with Catalyst Editor William McKenzie about the roots of their shared commitment to Africa, the challenges they see in developing democracy and a strong middle class across the continent, and the reasons they are bullish about Africa’s future. Let’s start with this question: How did you all get interested in Africa? President Bush: Condi [Rice] was very instrumental. At one point in the run up to the 2000 election, she said I hope you take an interest in Africa. I hadn't had much experience in Africa and wasn’t very well-steeped in African history. I viewed Africa as a source of great potential, and I knew it had been viewed in Cold War terms prior to the end of the Cold War. But, like many people, I viewed it skeptically. That’s because of what I viewed as corruption and exploitation of natural resources that worked not to the benefit of the people but for the benefit of rulers.

I assured her that I would take an interest in Africa but I wasn't certain what that meant. My mind was specifically focused on Africa right after my election when Condi was telling me about a pandemic destroying an entire generation of people. I thought that might be a little bit of hyperbole, so she wisely brought experts to the table and I became convinced there was a pandemic. I decided to do something about it, based upon the principles I had articulated: that all life is precious and that we’re all God’s children. The idea of a pandemic destroying an entire generation of people was something the United States ought to seriously consider doing something about. That was my focus. I had a general desire to help Africa based upon advisors. Colin [Powell] probably talked to me about it, too. The AIDS pandemic really focused my attention on a massive problem, and therefore developing a solution. "My mind was specifically focused on Africa right after my election when Condi was telling me about a pandemic destroying an entire generation of people. I thought that might be a little bit of hyperbole, so she wisely brought experts to the table and I became convinced there was a pandemic."

--President Bush Mrs. Bush: And there was a solution in the U.S. People with AIDS were on anti-retroviral (ARV) medicines and they were living. But in Africa, ARVs were really too expensive. They didn’t have the health infrastructure to make sure people all got on ARVs and stayed on them, which is what you need to do to control AIDS. One of the great results of PEPFAR [President’s Emergency Program for AIDS Relief] was that it built up a health infrastructure in all PEPFAR countries. That’s why we can do what have done now with Pink Ribbon Red Ribbon. A health infrastructure is established and we can add the cervical cancer piece to it.

President Bush: When you’re analyzing a problem, the questions are, what are the solutions and then what are the benefits? Obviously, saving human life is a benefit, but so is the development of a health infrastructure that would enable these countries to deal also with other problems. About that time, we were reevaluating our foreign aid program. I remember going to meetings like the G-8, and people were talking about donations as a percentage of your nation’s GDP. My attitude and the attitude of others, including in the State Department, was we ought to focus on results, not on a formula. Giving money based upon a percentage of your GDP, or a percentage of your budget, smacked of paternalism, of handing out money so we can feel better. The real question is, are the people any better? The Millennium Challenge Corporation came to be in 2004, and its leaders said we will do some big projects with people primarily in Africa but they have to meet certain criteria, such as having non-corrupt governments, marketplace economies, and investments in women and children.

I mention that because one reason PEPFAR became successful is that, in partnership with the affected countries, we developed plans tailored to each country to deal with the three-pronged issue of prevention, anti-retrovirals, and orphans. Each nation developed a plan with our help, but it was their plan. "One reason PEPFAR became successful is that, in partnership with the affected countries, we developed plans tailored to each country... Each nation developed a plan with our help, but it was their plan."

- President Bush Shifting to today, Africa is home to the world's 10 largest populations of young people, which suggests a growing workforce. How can Africa best capitalize on this asset? President Bush: Education is first. That means using tools now available, such as distance learning or internet-based education, to educate young people so they can take advantage of economic opportunities as they arise. Secondly, Bill Clinton got Congress to pass the African Growth and Opportunity Act, which we extended. The best way to eliminate poverty is through trade. Hopefully, the trading regimes then will provide opportunities for a better-educated workforce. In some cases, all that is set back with corruption, young kids who have lost their parents from AIDS or are battling disease themselves, or exploitation of resources by entities who really are more interested in satisfying their own domestic needs. I am thinking of China satisfying their own economic needs without consideration of how to advance opportunities for young Africans. Mrs. Bush: We also founded the Africa Education Initiative, which went along with PEPFAR and the President’s Malaria Initiative. Malaria was also such a serious problem along the Equator, especially in Africa. We did all of those together in an effort to not just treat AIDS, but also to leave something better behind, where people are more educated, know what AIDS is, know what malaria is, and know how to protect themselves. "We did all of those together in an effort to not just treat AIDS, but also to leave something better behind, where people are more educated, know what AIDS is, know what malaria is, and know how to protect themselves."

- Mrs. Bush According to UNESCO, illiteracy in Africa is down from the 1970s, but about 40% of Africans are still illiterate. About two-thirds of those Africans are women. How do you expand education, particularly among young girls? President Bush: We’re talking about a continent where it’s a very rural environment in many parts and the infrastructure isn’t that good. Mrs. Bush: When they are not in school, girls spend their time walking to get water because they are working for their families or somebody else.



President Bush: We’re talking about a long-term project. Our attitude was, let's deal with the big issue first, which was whether or not there would even be young girls around. What PEPFAR has done is create new hope in many parts of Africa where there was no hope. The question is, will that be capitalized upon? Laura and I were recently in Botswana, which is a huge country with people dispersed all across the nation. This creates enormous problems in terms of infrastructure, including educational infrastructure. On the other hand, the government of Botswana is committed to, as best it can, educating all people, young girls included. You’re dealing with a culture that is slowly but surely adjusting to the needs of the 21st century. "Our attitude was, let's deal with the big issue first, which was whether or not there would even be young girls around. What PEPFAR has done is create new hope in many parts of Africa where there was no hope. The question is, will that be capitalized upon?"

- President Bush Mrs. Bush: One of the things we’re doing now is the African First Ladies Initiative, where I’ll host first ladies in New York this fall right before the United Nations General Assembly. We’re working with African first ladies because they really are using their platform to work on issues. Of course, a lot of first ladies worldwide specifically work on issues that have to do with women and children. So that’s what we’re doing today in working with first ladies from Africa. President Bush: We also recently went to a high school in Namibia where some of the seniors were getting ready to go to college. Maybe some of the better students were going, but they all had aspirations and dreams. That was a hopeful sign. I doubt it would have been that robust 20 years ago, so there is progress. It seems to me the role of the United States is to establish relations with governments based upon trust so our aid program and embassies can help a willing country develop an education program for girls. We need to be engaged, but it’s not engagement from a paternalistic point of view, where it is, "Here’s the money, do it this way." Rather, the engagement is, "What can we do to make it easier for you to educate your girls?"

What impact might Africa’s growing number of young leaders have on political parties? President Bush: The hope, of course, is that African leaders honor their constitutions, which basically limit power. There’s a certain sense of indispensability among some African leaders. They get in power and say, "This country needs me; it’s not ready for change." That discourages young people, who might wonder whether anything will ever change. Some countries are very good. In Ghana, my friend [John] Kufuor left power peacefully. But [Yoweri] Museveni in Uganda decides he’s indispensable and stays for life. It seems to me that, as the U.S. and our allies engage, we ought to develop relationships where we can have frank discussions with leaders without rupturing relations. I would hope America's diplomats would say, "Look, we want to help you but one of the things that I think you need to do is honor the limitations of power in your constitution." One of the real issues is inspiring young people. A way to do so is to show a political system that is responsive to people, and where power doesn’t become centralized. What can the U.S. do when people are elected but then won’t step down? President Bush: I don’t want to name this person, but there was one leader who thought he was indispensable. One of our diplomats was going to tell this leader he shouldn’t be running again, and the diplomat said, "I want you to back me." The leader was upset, but I backed the diplomat and the leader didn’t run again. I’m not sure he didn’t run because of what we said, but it was important that we had a trusting relationship. If an African leader thinks that you’re not a friend, and that you have stepped in without engagement and started lecturing, that falls on deaf ears. On the other hand, if an African leader has worked with and befriended a U.S. president, it makes discussions a lot easier. It’s just a matter of personal diplomacy. I spent a lot of time with African leaders and had very good relationships with them. The Arab Spring was driven by young people but now governments in places like Egypt see them as threats. And some young people turn to extremism when no one pays them any attention. That’s why I used to tell people PEPFAR was a national security issue as well as an issue of conscience. Imagine, for example, East Africa, where Al Qaeda was quite active. There were bombings in Tanzania and Kenya. And there were orphans that people ignored. Those orphans wonder whether or not there's a family for him or her, and some of these extremist groups show up and say, "We’re your family." Then, they propagandize and convert them to child soldiers. Africa is a continent that is extremely wealthy in resources and extremely wealthy in people but it's got enormous problems: The Lord’s Resistance Army, Boko Haram, corrupt governments, and now real problems in South Africa. On the other hand, the potential is significant and it's in our national interest that we engage.

It takes a while to work out the long-standing problems, but it’s not going to happen unless there's active engagement by the U.S. in a non-paternalistic, partnership way. You mentioned PEPFAR being a national security tool. Is a new way to think about foreign aid that it also is a national security investment? President Bush: I think so. One of the underlying themes of 9/11 was that conditions elsewhere matter to our national security. Therefore, we have to worry about stability and whether or not democracy takes root in parts of the world. Part of that means a foreign aid component. Our military would tell you that a good diplomacy makes their job easier. We can’t solve every problem, and people need to understand that most of our budget goes to the United States and the people of the United States. But it makes sense, for long-term security and economic security that foreign aid can help develop markets and develop a middle class that becomes consumers of U.S. goods as well as proponents of peace. Mrs. Bush: We’re in this time where people say foreign aid doesn't matter, let's just pay attention to our own problems. But foreign aid, which is only 1% of our whole budget, does matter. If nothing else, it matters to our conscience. As a very wealthy nation, and a diplomatic nation, which we are, it’s a really bad example for the world to act like everyone else's problems are their own problems and we don’t care. "We’re in this time where people say foreign aid doesn't matter, let's just pay attention to our own problems. But foreign aid, which is only 1% of our whole budget, does matter. If nothing else, it matters to our conscience."

-Mrs. Bush What do you all see as the drivers of Africa’s emerging middle class? And how can the U.S. help it grow? President Bush: The drivers have got to be education and economic opportunity. The U.S. can help through effective trade and education programs, such as through USAID [the U.S. Agency for International Development]. The middle class can’t be ravished by disease. Nor can any class. Being ravished by disease is going to debilitate hope and optimism.

Africa is very rich and deep in commodities like minerals and oils. But if you are so dependent upon them, you’re at risk of being subjected to jolts in prices. How do you diversify? As you know, Texas, faced a similar question in the past because of all its energy reserves. Mrs. Bush: Non-corrupt governments are really important when a country is rich in natural resources but no one benefits except a handful of people. President Bush: Yes. Exploitive countries benefit, too. First, I think natural resources should be viewed as a catalyst for change, not as a curse. Take food. Africa ought to be an exporter of food to the world. Africans have a fantastic opportunity to do that. On the other hand, [Zimbabwe’s Robert] Mugabe has in essence ruined the economy and the food capacity of his country. And now South Africa, which used to be a net food exporter, is a food importer. A middle class can’t grow without food, so some basics have got to be looked at first. Forms of government matter, too. China also is an interesting phenomenon. China has this gluttonous appetite for raw materials, so the question is, when the Chinese come sweeping into these African countries, do they leave behind something for the people? I saw Chinese work camps on a trip to Ethiopia, so I said to the Prime Minister that I noticed there are a lot of Chinese. "Oh, yes," he said. "They are building infrastructure for us." And I said, "Are the Ethiopian people working? Are they able to take advantage of this big infrastructure program?" He said, "Of course, they are." But they weren't. "Non-corrupt governments are really important when a country is rich in natural resources but no one benefits except a handful of people."

--Mrs. Bush Should China’s involvement be a challenge to the U.S. in Africa? In other words, is it a challenge for the U.S. to stay involved? President Bush: Prior to the Cold War, Africa was really viewed as a theater for the Cold War, with Cubans in Angola, for example. The U.S. supported different leaders based upon whether or not they were pro-U.S. or pro-Soviet, not upon whether they were for democracy. At the time, that was how foreign policy was developed. Let’s promote stability above all, regardless of the nature of the governments. After 9/11, I reassessed that it didn’t work. Stability was the cornerstone of foreign policy but it looked to me like the world wasn’t very stable. Therefore, we ought to try something different. We decided we would advance democracy, and that’s what we’re doing here at the Bush Center, advancing democracy. We’re helping Tunisian women advance democracy. We’re helping young Burmese advance democracy. We’re helping develop leaders in the United States to advance democracy. "Stability was the cornerstone of foreign policy but it looked to me like the world wasn’t very stable. Therefore, we ought to try something different. We decided we would advance democracy, and that’s what we’re doing here at the Bush Center, advancing democracy."

-President Bush And that’s what we ought to be doing in Africa. That was the whole basis of the Millennium Challenge. That’s why I’m a friend of Bono’s. Not only was he a big advocate for the Millennium Challenge, he is also a big advocate for PEPFAR and its antecedent: Pink Ribbon Red Ribbon.

Women are emerging as entrepreneurs in Africa, so how do we help expand their opportunities and grow more women entrepreneurs? Is that access to capital? Easier access to education? Something else? President Bush: That’s a problem in every country; we’re having that debate in the United States. How do you give women a chance to have an equal voice in the public square? How do you give women a chance to use their talents to develop markets? One thing is for certain, it’s going to be very difficult for women entrepreneurs to succeed unless there is robust trade. Trade develops markets. While Africa has worked on developing trade with the United States through the African Growth and Opportunity Act, Africa is not doing a very good job eliminating tariffs within Africa. There are trade barriers to moving goods and services across borders, but the internet is changing that. The internet is now helping young women find opportunities outside the borders of their own countries. The internet is going to be a very useful tool for reform-minded African leaders to make sure women are given better opportunity. How do we in the West deal with the realities of famine in places like South Sudan? President Bush: So far, the response for the last 10 years is do nothing. I feel a special kinship with South Sudan because my administration was the one that negotiated the plebiscite that allowed them to become an independent nation. I’ve been very disappointed that the leaders have not honored that commitment to the people. One good thing about America is that private sector groups are intensely focused on places like South Sudan. Mrs. Bush: And there is the World Food Programme, meaning there are a number of big international programs that are on the ground with famine. There are ways the U.S. government can support them. Like George said, there are lots of faith-based programs in the U.S. that direct their energies toward famine. President Bush: The cumulative effort of Americans is pretty significant. Government's one thing, but the private sector is pretty darn significant.