Remarks by USAID Administrator Dr. Rajiv Shah and President and CEO of ONE David Lane During the Live Webcast: Conversations With America

Thursday, September 16, 2010
The Obama Administration's Work Toward Achieving the Millennium Development Goals

MR. CROWLEY: Hello and welcome to the State Department in Washington, D.C. and thank you for joining us with Conversations with America, a series of video discussions recently launched by the Department of State that enables you to watch and participate in a live discussion between a senior State Department official and the leader of a nongovernmental organization.

I’m P.J. Crowley, the Assistant Secretary of State for Public Affairs, and I’ll be the moderator for today’s program. And on our blog DipNote, we’ve received many questions and comments on today’s topic from around the world, and we have selected some of the questions for discussion during this broadcast.

Today’s discussion will focus on the Millennium Development Goals. These goals are a declaration of the world’s commitment to eradicating extreme poverty and hunger, achieving gender equality, and extending hope and opportunity to millions across the developing world. The eight goals, organized around internationally agreed targets, have provided a framework to translate our highest ideals into concrete actions. They also have helped mobilize unprecedented political support and resources for development.

And we have assembled two experts in this field to help us understand what the development goals are and how we’re doing in fully implementing. First, let me introduce Dr. Raj Shah, who is the Administrator of the United States Agency for International Development, the principal U.S. agency extending assistance to countries around the world that are recovering from disaster, trying to escape poverty, and engaging in democratic reforms. And under Administrator Shah’s leadership, USAID is leading U.S. Government efforts to achieve the Millennium Development Goals. And I’m also joined by David Lane, the president and CEO of ONE, a grassroots campaign and advocacy organization focused on the fight against global poverty and preventable disease. And we’re here to discuss the MDGs.

I suppose just to help our audiences both in this country and overseas fully understand, what are the MDGs and why are they important? Raj.

ADMINISTRATOR SHAH: Well, thank you, P.J., and thanks for having us for this conversation. I think one thing that is important to recognize is that billions of people today still live in extreme poverty and in a condition that we would all consider unnecessarily rough and challenging. We have 9 million kids a year die, many from preventable causes. We’ve known, over the past three or four years, the number of people that go to bed at night hungry has gone up from 860 million to over a billion. So that’s going in the wrong direction and remains a big problem.

And this Administration has been very focused on addressing that. Both the Secretary of State and the President of the United States have made a commitment to addressing the Millennium Development Goals – investing our resources, our technical capabilities, and really expanding our approach so that we are doing this not just for moral purposes, although it is a tremendous moral mission to make the world a better place, but also because tackling the MDGs is fundamentally a part of a strategic vision of bringing the world together, and thereby enabling our own peace and prosperity over a longer period of time.

So it’s exciting to be part of that great effort. It’s great to be here with David, who has been an important leading voice in bringing millions of people together to make the case that the Millennium Development Goals are important, they’re achievable, and we need to put more effort and more intensity into our effort to improve the lot of living conditions for billions of people around the world.

MR. CROWLEY: David, Raj just helped us understand what the challenge is globally. How do the Millennium Development Goals fit into the world strategy in terms of combating these challenges?

MR. LANE: Thank you, P.J., and thank you, Raj, for those nice comments. I really appreciate the opportunity to be here to talk about the Millennium Development Goals from an advocacy point of view especially. Next week is the big gathering. I know Dr. Shah and the Secretary of State and the President of the United States, in fact, will all be in New York talking about where we stand and what we have to do with five years left to try to meet these goals.

And I’m sure when the public thinks UN gathering and then they hear the acronyms that Raj and I will inevitably slip into, fall back on in this conversation, they get a little bit weary and you wonder why somebody would be excited about this gathering next week.

I think first of all, it can’t be underestimated, the importance of the fact – this – the fact of the Millennium Declaration, that 10 years ago, leaders from every country, north and south, came together and affirmed their commitment to promote human progress and human dignity of the world’s poorest. And these are really ambitious goals, but I’m excited about next week because I think there’s a chance really to accelerate the progress, in part with the leadership that Dr. Shah and others are bringing to this with their new thinking.

I think when the public hears progress, they may also wonder what’s beneath that. And I want to say since – just since 2000, when I think 50,000 people around – in poor countries were on AIDS treatment, we now have 5 million people around the world, including 4 million in Sub-Saharan Africa. Hundreds of millions of women and children are sleeping under insecticide-laced bed nets and malaria deaths are reduced by more than half in many countries in Sub-Saharan Africa. I think there are 42 million more kids in school than were in the year 2000, due in large part to debt relief. So there's been enormous progress.

And the important thing about next week is there’s now new thinking. We’ve learned a lot since these goals were put in place, and I think the plan the U.S. Government has put forward, as well as the other thinking we’re hearing from other governments, represents some new thinking on some of the areas that need to be addressed to really meet these by the year 2015.

MR. CROWLEY: Now, how does the process happen? Because you set these global goals, the developed world comes together and says, “Okay, we think these are realistic but ambitious but necessary targets.” And you’ve been struggling with the concept of development – both of you have – and we are doing some new thinking, as David talked about. So is this a matter of trying to impose solutions from above or growing solutions from the ground or a combination of the two?

ADMINISTRATOR SHAH: Well, you know, I think that’s a great question. And the reality is these goals were not crafted by developed countries and presented to the world. They were taken up by the entire UN General Assembly, as David points out. And for all of the world’s leaders and members of the United Nations to come together and say, we will make a quantitative and significant push against eliminating and eradicating extreme poverty and all of its related malcontents, whether it’s unnecessary disease burden, the lack of educational opportunities for children who need that to lead better lives is really a tremendous accomplishment and something that was agreed to by all the countries in the world. So that’s, I think, the first point.

The second, as David points out, is there’s been a huge amount of progress, and we have to give a lot of credit to these goals, but also to the leaders who have mobilized resources to the – and nonprofit organizations and private companies and health workers in Africa and in Asia that have made a huge difference. And it’s important to note, because a lot of times people will say, “Well, most of that progress happened because of economic growth in Asia.” That’s certainly true, that there’s no question that the great economic improvement of large Asian economies really moved hundreds of millions of people out of hunger, poverty, a state of poor health, and low levels of living conditions.

But there’s been a huge amount of progress in Africa. Seventeen – the Center for Global Development just put out a study that shows 17 African countries have made tremendous progress against the Millennium Development Goals and in a way that is even more impressive when you look at their level of economic growth. It’s been a concerted and focused effort.

But David’s also right to point out that, okay, so we’ve had a lot of progress, it’s happened because of great innovation on the ground and a lot of focus and investment and effort. But now, we know what’s left is not the low-hanging fruit. If you look, the problems that remain are concentrated in large and somewhat difficult economies and countries to work in. It is a tougher set of problems and challenges that relate to good governance, that relate to an ability to reach women and girls as part of the fundamental solution to many of these problems and challenges, and it’s part of executing a global effort here that is getting more complicated by climate change and a range of other global economic forces, the financial crisis, that sometimes sets us back.

So going forward, we need to do some things differently, and next week will be a very important opportunity to really discuss what can – what have we learned, what can we do differently, and how can we really carefully marshal these resources so when U.S. taxpayers or anybody else puts resources into achieving the MDGs, we know we’re getting the most value for that money.

MR. CROWLEY: Now, is this about resources? How does that play into this?

MR. LANE: Well, it’s a little bit about resources, but I want to be quick to point out that none of us are so as – are so naïve as to believe that development assistance, foreign aid, ODA alone is going to lift people in mass numbers out of extreme poverty. That is one of the insights. Of course, people understood that when the Millennium Declaration was agreed, but I think we understand more than ever the importance of governance, the importance of trade, investment, private capital, the importance of investing in women and girls, in local capacity.

And I think to your earlier question, if we could pick up a little bit on what Raj said, in terms of how we know, what’s the process going to be as we move forward, I would not encourage your viewers – our viewers here today – to go deep in reading the declaration that comes out of the summit next week. It’s going to be a UN document with all the technical jargon that is often in UN documents. Raj, I know, has seen official versions; I’ve only seen unofficial versions. But I think the way to test the progress of this gathering is the commitments that individual countries as well as non-state actors make to pursue the goals.

In the case of the Obama Administration, they’ve already put forward the Food – Feed The Future Initiative, the Global Health Initiative. There’s a little-noted bit of progress in the nonmonetary realm from just this summer, where the Congress passed an Extractive Industries Transparency Initiative, which says when companies listed on the New York Stock Exchange make payments to foreign countries, they must publish those.

Why is that important? Because if you’re civil society, if you’re citizens in developing countries, you need to know that those payments that are made to your government are addressing the programs that will lift people out of poverty and not lining the pockets of leaders. That’s a nonmonetary initiative in the category of governance. That’s one of the things we mean when we say governance. And there are concrete steps that the governments that are gathering and are represented in New York need to take.

If I can say one other thing. If the declaration is full of – if New York is full of great speeches, and the declaration is full of great rhetoric about the importance of development but then there aren’t concrete steps, we should all be very disappointed. And just as an example, a mere two weeks after the New York summit – next week’s summit, there will be a convening in support of the Global Fund for AIDS, TB, and malaria. This is one of the mechanisms that does cost money, but it’s money well spent that exists right now, that is extremely effective. The U.S. Government has been a major contributor to it. It’s having its replenishment conference.

If, in fact, after great rhetoric in New York next week, we have a disappointing replenishment conference, that will tell us that we’re not doing all the things we need to do to meet these goals.

MR. CROWLEY: David --

ADMINISTRATOR SHAH: Can I build on that?

MR. CROWLEY: You may, absolutely.

ADMINISTRATOR SHAH: Sorry. Look, I think David’s right. And I think this is not about resources, but we know resources are necessary to continue progress. And this Administration, I think, is quite aggressive about that point. You know, we have backed up our commitment to the MDGs with a $3.5 billion commitment to reinvest in agriculture through this Feed The Future effort, which is fundamentally designed to turn the tide on hunger.

But more than that, through effective diplomatic efforts around the world, we’ve tried to mobilize tens of billions of additional dollars for that same goal and that same purpose, because we think it’s important that everybody embrace the challenge and everybody invest in proven ways to achieve success. In health, we’ve invested $63 billion in a Global Health Initiative. So resources are very important, and I look forward to the Global Fund replenishment because I think that’s another opportunity to take this further.

But just as important, it’s important to do things in a more efficient and more effective way, which is why in Global Health we’re actually going through a tough but important process of bringing our programs together and investing in those things that we think are going to be most efficient at saving kids’ lives or saving women who are often suffering during childbirth. And those are the types of things that allow us to get much more outcomes for the money we’re putting in.

MR. CROWLEY: Now, how do we better integrate the efforts of the United States and specific initiatives that Raj has talked about and then what the rest of the world is doing? I know Secretary Clinton has talked about the quintessential problem in her conversations with the Chinese about the Chinese sort of building a road, the United States is building a hospital; it would be nice if the hospital sits next to the road. Is that part of the challenge?

MR. LANE: Yes, it is. And I think, as an observer of the system that Raj is a leader in within our country, the many agencies that work in development, I sometimes get confused about who does what. If we’re confused, imagine what it’s like from the perspective of a leader in a developing country trying to make sense of all this. They get all these different measurements and all these different mandates. It is absolutely our obligation or the obligation of those who lead and manage government programs to reconcile and make those much more coherent.

And in fact, to me, one of the most exciting things about New York next week is I think it’ll represent an acceleration of this trend toward leadership from developing countries themselves. This is not about a rich country obligation or a developed country obligation to developing countries. It always was a partnership. But more than ever I think responsibility and leadership is shifting to those leaders of developing countries. When I say leaders, I don’t always mean government officials. I mean civil society and many others who are impatient with the rate of progress who want to take charge themselves. And I think Raj and many others in his position in developed country governments around the world are working extra hard to be responsive to the government plans. I think you call them country-owned plans. And that’s one of the important things that needs to be reflected in next week’s work.

MR. CROWLEY: Just picking up on that, we do have new concepts like the Millennium Challenge Corporation that was developed under the Bush Administration and then Feed the Future is about taking and supporting plans that do originate with a particular country and then are supported and validated through international contributions. Pick up that thread.

ADMINISTRATOR SHAH: Well, I think both of you are exactly right. Right? We have spent a lot of time listening and learning about how we can do this work better, more effectively. And the number one thing we’ve learned is we need to be more capable of supporting country-owned efforts and building real capacity through our investments around the world. So there are three good examples of this.

One is in Feed the Future in our Global Health Initiative, frankly, across all the rest of the things we’re doing. We are moving much more towards a model a little bit pioneered by the Millennium Challenge Corporation where we’re saying, “We want to see strong country plans, we want to be supportive of those plans, and we don’t want to do things in parallel in a way that’s not visible to and in partnership with country governments, civil society organizations, private sector organizations.” And we’re seeing that make a big difference, especially in Feed the Future in countries ranging from Senegal to Rwanda to Bangladesh.

The second is we’ve implemented, and the Secretary and the President feel strongly about this as do I, a tough but important package of procurement reforms. And you might say, “Well, why is procurement reform important?” And it’s important because if you’re a creative entrepreneur in Uganda starting a small company that could create coffee export businesses and employ people and do unique things like that, our current mechanisms that often lean on U.S.-based firms and contractors may not always be the best way to get resources to those local entrepreneurs and change agents and help them build the capacity to be successful over time. So we are looking carefully at how we can use direct assistance mechanisms. And we’re doing that throughout Africa in programs like the AfriLabs program we created that really targets and supports innovators and entrepreneurs.

And the third is we’ve launched a program we called the Development Innovation Venture Fund. And it’s basically because we know if we keep doing the same things we’re doing, we’re on a certain path of progress, which is a good path, but not sufficient to meet the MDGs. And so to really look for those discontinuous leaps in performance, things like microfinance, or things like SMS text-enabled messaging around nutrition -- and we want to create more space for people in development to take risks and to think differently and to try new things. And so we’ve just piloted this program, we’re very excited about it, and we’ll be expanding it in the years to come. But all of these represent our commitment to really doing things in a different way going forward.

MR. CROWLEY: There’s some – from an NGO standpoint, there’s some tension in what Raj was just outlining, because you’ve got efforts in countries like Afghanistan and Pakistan to try to see if there are partners within those countries who can help, you know, direct this assistance and yet you’ve also got an NGO community that is used to doing things a certain way. So to what extent does the NGO community and the private sector have to innovate and change just as government is changing.

MR. LANE: I would be cautious about trying to speak for the NGO community. (Laughter.) But I’ll say that absolutely, first of all, there’s no one-size-fits-all in terms of applying – approaching countries and Raj could tell us lots about how they adapt their approaches based on local capacity. But none of us believe that ultimately we can get where we need to go without local capacity. I think your recent procurement reforms here at AID are meant to try to transfer and create local capacity so that foreign aid becomes a bridge to something, not some open ended and in itself. So I have to agree with the point that we all need to adapt in support of local country leadership and ownership because that’s the only we’re going to achieve these goals.

MR. CROWLEY: Let’s get a little more concrete. You mentioned earlier that there’s been progress in Asia. But Africa tends to still be the continent where we’re struggling to meet the, you know, MDG goals. Why is that? And perhaps what progress has been made over ten years? But how do we overcome the challenges that still confront us in a region like that.

MR. LANE: Well, if I can start with that, Raj, because my organization focuses on global poverty but has a particular emphasis on Africa, especially for this reason, that Africa lags more than others, the gaps are greatest on the MDGs and, therefore, we want to focus attention. I think it’s fair also to point out there’s been some criticism of the goals that maybe their broad application wasn’t fair because Africa started with such deficits. They have so much further to go. So I think we need to be careful.

I also want to say, it doesn’t need to be said here at the State Department that Africa is many, many countries, 53 countries with an enormous variety. Some of them are resource rich. Some of them are landlocked and resource poor. Some of them have strong leadership. Some of them are conflict states. So we need to be very specific. We shouldn’t miss the fact that Senegal, Ghana, Burkina Faso, there’s a number of countries that have made enormous progress and are going to meet some of the Millennium Development Goals. It’s worth noting that some of those that are furthest away have probably faced conflict in really horrible governance, and I think there’s a lesson there. So when you ask, “What can we do in five years to really accelerate things,” I think focus on governance is very important, building up civil society that can demand more from their governments, their governments ought to be prioritizing these issues with their own resources, not looking to foreign aid as the answer. That’s critically important.

And then I guess the last thing I’ll say is that the role of investment and trade cannot be underestimated. Africa has a woefully small share of global trade. And it's actually declined over time. And nobody believes – the biggest champion of foreign aid does not believe that we can – that aid is going to carry us out of poverty. We know we need private sector job creation and growth. Trade and investment is the answer. We could probably put in place better policies, be more aggressive – those policies that don’t necessarily cost money – to facilitate this. And then I will actually add one other thing. I think those of us who are in the advocacy business have done not a great job – and maybe this is true for those in government as well – letting people know the progress that’s been made – I referred to that earlier – as well as the richness of what’s going on in Africa.

We, our board, went to Africa. In March we went to four countries: Senegal, Ghana, Mozambique, Kenya. We were guided by Mo Ibrahim, who is a tough, tough governance advocate and Ngozi Okonjo-Iweala and John Githongo, the anti-corruption leader and others – very impressive. But everywhere we went, we saw this extremely impatient generation that wants to take charge themselves. They have a vision for Africa, they know what needs to be done. They’re demanding a lot from their own governments and that’s the reason I’m actually optimistic about where this is headed.

MR. CROWLEY: You were involved in the AGOA Conference that the United States hosted earlier this year, the Africa Growth and Opportunity Act Conference, and one of the points I know Secretary Clinton and you have made is that trade is important and there’s a woeful underinvestment in trade among African countries themselves for a variety of reasons which, again, perhaps have nothing to do with money. They have to do with tariffs or laws that inhibit African countries from trading with countries and growing jobs in that way.

ADMINISTRATOR SHAH: Well, you’re absolutely right. One anecdote is in West Africa. We mapped areas where there are food surpluses and areas where there are food deficits and then put the road infrastructure against that and tracked food flows across that region. So this is across maybe eight or nine countries. And sure enough, the food does not get – markets to do not transfer food from food surplus to food deficit areas efficiently. And then you ask, “Well, why?” And it’s trade and transport barriers. Some of them are official barriers and many of them tend to be unofficial barriers, checkpoints and other opportunities to hold things up at border crossings in particular. And some of it is just a lack of infrastructure, trucking businesses, and capabilities.

So one of the things we're doing as part of Feed the Future is a West African transport investment that will help actually alleviate some of these bottlenecks and try and allow for a local economy to effectively transport from surplus areas to deficit areas. And we would hope to see an evening out of food prices, a lessening of hunger, better incentives for local agricultural production and more inter-country trade in that region. So those are exactly the kinds of things we should be doing in taking a really analytical approach to how can we use our resources and on the highest leverage points to make sure we're enabling, you know, especially in Africa the incredible talent and productive capacity of that continent and its people to essentially solve their own problems.

MR. CROWLEY: As we said earlier, we've collected a sampling of questions from around the world. We want to bring in the audience now. You know, Sara in Washington, D.C. has written to us that Millennium Development Goal number 8 calls for a global partnership that makes it incumbent on donor countries to provide funding in a more consistent, transparent and coordinated fashion.

Now I think you alluded to this earlier. How does the United States that has over 26 government bodies that program and plan foreign and development assistance, how do you do that? And what is the importance of raising the level of awareness of the value of U.S. development assistance? That probably is critically important because of, I'm sure, Americans to some extent, hey, we've got our own problems here in the United States and, yet, we're solving problems somewhere else and not here.

MR. SHAH: Well, you know, that's a great question and I appreciate it coming in. I see everyone looking at me. You know, it's true. And you know, there's one of our -- currently our Under Secretary for International Economic Affairs, (inaudible), has developed a sort of famous chart that shows all the funding authorities for U.S. foreign assistance, and it's infinitely complex.

But the reality is we've just gone through a great process that is very close to completion with the Presidential Study Directive on Development and the Secretary's launched a process as well called the Quadrennial Development and Diplomacy Review. These two efforts taken together will essentially bring a great deal of clarity to this system and allow for more standard setting and accountability across the board. And I'd highlight just a couple of things. One is the principle of making investments in a way that are evidence based where we have real evaluations and real knowledge about what kind of impact are we having and what can we learn from successes and failures will be something that I think you'll see much more of across all aspects of U.S. foreign assistance.

A second is transparency. We will soon, and this may be a preview -- I don't know if I'm supposed to say it or not. We will soon have a great website, and I've seen the sort of behind-the-scenes piece that will essentially track U.S. foreign assistance and allow you to click on a country, see where the resources are going to demonstrate which categories of assistance are being provided. And over time, we hope to build that into a platform that also can communicate outcomes, results, projects. In this modern day and age, we ought to have extreme transparency in our foreign assistance system. It's a major part of this President's guidance to all agencies in federal government. And we, in the foreign assistance business, want to take it on really completely and do it in a very significant way.

And finally, and to build on David's point, I think we're going to really focus on finding those opportunities where foreign assistance and development activities can really integrate with trade and investment and so many of the tools we have across the federal government that promote trade and investment so that we can use foreign assistance to build that bridge to a more vibrant and active and diversified economy. And I'm very excited about those aspects of some of these reforms that will be in place for the next several years.

MR. LANE: Raj's -- let me say sympathetically because Raj tries to -- Raj leads very well within a system that's 50 years old. It was designed basically during the Kennedy Administration, and that's why many of us on the outside who want AID to be as effective as possible are eagerly awaiting both the PSD and the QDDR -- there's a couple acronyms for you right there -- the Presidential Study Directive and the Quadrennial Development and --

MR. SHAH: (Inaudible)

MR. LANE: -- we're eagerly awaiting. I should say while Raj is here, he hasn't waited for those things to really push for these things. I mentioned procurement reform, which I'm aware of. I hear from my friends at USAID, that's something I already knew, which is Raj is an evaluation and data nerd and he demands measurement of results. And I think that's also good. But taking the system forward is something we're all eager for.

There was a second part of that question which was about the public support, and maybe I can address that because that's what I'm supposed to -- that's the business I'm supposedly in. I'm in the advocacy world. And I have to say the coalition that has supported this is very rich and very impressive and may not be a coalition that many people fully understand. It includes people of faith from faith communities, it includes the military -- Secretary Gates has been advocating for a bigger development assistance budget. It includes business people. The arguments that persuade people go from moral to practical to national interests.

There's a full span and all of those arguments are about an important -- but one thing I've found that's consistent across the board, and this is actually reflected in poling and discussions with regular citizens, they're willing to support American funding, even more American funding as long as they know it works, as long as they know it works. If they know lives are being saved, it's a pretty easy argument. And that's why effectiveness matters so much. Nobody cares on the outside how the boxes are organized. What they care about is the ultimate delivery of results, which is why this is so important and I think why all of us have a special responsibility when there is success -- because let's face it so much of the news you hear about the developing world is about pirates or corrupt elections or bad things. It's incumbent upon us to be really compelling and really clear about the data and about the stories of success.

MR. CROWLEY: Let me pick up our second question from Migheu in Cameroon and direct it in your direction. You were talking about innovation a minute ago and technology is part of that. How does the introduction of technology in developing countries perhaps make assistance more democratic?

MR. LANE: Well, to me, the most important thing, there's lots of -- it's an economic driver in many ways. I get most excited about the civil society accountability aspect. In fact, I think at the recent election in Kenya there was a use of mobile phones(?) -- it may have been supported by USAID, to monitor election polling sites. Very exciting, eager to hear from Raj on that.

But I mean citizens in the developing world ought to be able to note when the teacher doesn't show up, when the government claims it's building schools and it's not building them. Technology will be incredibly empowering for holding government leaders accountable, and that is extremely exciting.

I shouldn't diminish the economic effects and, Raj, I'm eager to hear maybe you on the innovation plans and that sort of thing, but everywhere you go the mobile phone has leapfrogged our use I think here. I was in Rwanda and just stunned to see a coffee grower -- you know they load up these coffee bikes. They have specially equipped bikes with these special gears so they can carry a lot of beans into the market, and every day that would just carry the beans in and take the price that was available. It could have been a bad price; could have been a good price. To see these farmers texting to find out what the day's price is and saying no, that's not worth it, I'm going to wait until it's up to a certain level and then I'll go, that's incredibly transformative as simple as it sounds. And that's happening across the board, and I think innovation, if I remember, is one of the four planks of the President's MDG Plan.

MR. SHAH: Well, it absolutely is. And David's absolutely right to highlight what just happened in Kenya. You know, it was amazing and I don't think people have as much visibility. We supported programs that used solar powered laptops to essentially create electronic kiosks, and then put in place a system that they called parallel voter tabulation where essentially a polling site would send in their early results by SMS text in parallel to the official system so you had a dual track reporting. And I think the results speak for themselves in terms of the validity and inclusiveness of that process. And really Kenya took a great step forward in taking more accountability for its own future through this process. So technology can be applied in so many different areas.

Another area is in health in particular. You know, decades ago the way you would treat people who had polio was this large mechanical contraption called an Iron Lung, and it was just this huge, big, mechanical thing. And you could only treat so many people because it was hard to deliver and get there. Well, what happened? We invented a vaccine. And today we are literally on the verge of eradicating a disease that has debilitated life for millions of children around the world over the past several decades. And we're seeing a new Rotavirus vaccine, a new vaccine against pneumococcus or pneumonia that would fundamentally change our ability to address diarrhea and pneumonia among children around the world and change the cost structure of solving those problems for the long term.

We're seeing examples like that all over the place. There was just a great research trial that came out of a USAID funded project called the CAPRISA Trial which created a microbicide for women to use to protect themselves against HIV transmission. It would be the first and only powerful preventative tool that women would have in their own hands to protect themselves from HIV transmission and one of the potential breakthroughs to really changing the scale of that challenge around the world.

So whether it's health or elections or mobile connectivity and some of the things we can do in mobile banking in Haiti and other places, the opportunities are really tremendous, and I think they're a big part of changing the rate of progress against achieving the MDGs.

MR. CROWLEY: You sound very hopeful. And Adokiye from Nigeria has asked something like that very question. Is there any hope of implementing the ideas of NGO officials and the actualization of the MGDs especially for African countries where the opinion of the common man, you were talking about this before, is not always heard. You know, so you were talking about the importance of governance, but is civil society rising to do its part in terms of putting pressure and accountability on governments to perform?

MR. LANE: And I know (inaudible) from Nigeria and so I especially want to turn it back because I think, I said this early on, I am hopeful but I'm hopeful because I'm -- because I see this rising generation that's impatient and that wants change. I think for the U.S. Government's part, and Secretary Clinton on her trip last year I believe when she was in Kenya was very forceful about no progress without aggressively attacking corruption. President Obama himself went to Ghana and said the future of Africa is up to Africans and Africa needs strong institutions not more strong men.

Maybe present the -- the part that I'm concerned about, I saw -- I had dinner with a number of entrepreneurs in Ghana last year, and a 30-year-old entrepreneur said, "You know, the thing that makes me crazy is when I see my government is more responsive to the country director from the World Bank than he is to us, than he is to our people." And I'm sure that stories would horrify Raj and his colleagues at AID who do not want to be directing these governments and what their priorities -- as smart as you are, how could you know what they really are.

I think all the instruments that we have need to be constructed in a way that they're responsive to the needs of the people and allow people to be heard. But I'm optimistic because I think they're demanding it themselves.

Secretary Clinton's idea of combating corruption, that is no Western idea. It's -- in the case of Africa, it's Africans themselves who are insisting.

MR. CROWLEY: And Kenya, as one example, has just gone through some significant constitutional reforms that will hopefully preclude the political violence that we've seen there in recent years. And a more stable government, you know, would be a more effective one.

MR. SHAH: Well, absolutely. To build on David's point, the Secretary and the President here hosted a really extraordinary meeting of young African leaders during the AGOA Summit. To see those leaders here, many had created media enterprises, radio stations, nonprofit programs or projects or for profit technology companies that were creating jobs and transforming the landscape. All from Africa. All fairly young. And all really full of kind of hope and enthusiasm about what the future could hold. And the message was just very clear. The message was exactly as David says, you are the future of your community and your continent. We are here to be supportive of that future but not to set policy and or set and direct activities. And the President asked that community, quite transparently, to hold your leaders accountable. Because if we have another round of ineffective governance that stamps out this tremendous entrepreneurial energy that exists in Africa in particular but really all over the countries we work, that would actually set us back.

But I'm confident that that won't happen. I think that the level of technology, the visibility and effectiveness of this new generation of leadership and the fundamental global commitment to achieving the MDGs for both its grand moral purpose but also because it's indispensable to having a world that's safe and secure for all participants will put enough pressure on this system to help people succeed.

MR. CROWLEY: What strikes me is that there -- these goals together are interrelated, they're connected. You know, Ana in Portugal is asking about sustainable development and the fact that global warming will play a significant role in whether a population is able to feed its hungry or ensure the safety of families. How is climate change going to challenge, you know, what we are trying to do and what we will try to achieve in the next five years?

MR. SHAH: Dramatically. And we are seeing right now a flood unfold and is still unfolding in Pakistan that is affecting almost 20 million people, 8 or 9 million in absolute dire need of immediate humanitarian assistance but that has essentially wiped out a quarter to a third of it's agricultural production capability because it's right along the flood plain of the Indus River which, you know, is the source of food and sustenance for millions of people in that country.

So those types of extreme weather events we know we are seeing more frequently and to greater effect all around the world. And so we have to be smart about creating a future that is respectful of that and protective of that. And in my mind it means we need to invest more and we need to think more about how do we build more resilient agricultural systems that can perform in tougher, hotter, drier, more erratic growing conditions. How can we put in place systems of protection, whether that's crop insurance or other types of social insurance programs that can protect people when they have these setbacks.

Because it's one thing in the United States or for a family that's a middle class family to have a setback, that's -- it's very, very tough. But if you're on the verge of survival and you've spent 70 percent of your domestic -- of your income securing food and all of a sudden your income goes away and food prices double in your community, you're now going hungry or your kids are going hungry or you're pulling your children out of school because of school fees. And that's really what sets back countries that otherwise can be on a path of progress.

So we have to take this very seriously and think about it as part of the MDGs and focus on making sure we are responding to the full range of challenges.

MR. CROWLEY: Let me just pause one second (?). You know, there's still a political debate in the United States about climate change. I suspect in Africa there is no debate.

MR. LANE: There's no real debate. We -- certainly about its effects and about the fact that as with many shocks for the poorest of the poor, they are hit first and worst, low lying areas, least able to move, least able to adapt. And so it's extremely important.

I think I heard also, though, in the viewer's question something about the holistic -- the relationship and the sustainability of all these things. And I want to note I think it was a pretty daring thing in the U.S. Government's MDG Plan that they actually didn't go goal by goal by goal. I think they recognized the importance of the eight goals in monitoring them. But I think you were probably making a statement about the relationship between all of them. And just taking on any one issue, whether it's a health issue or a school issue or climate change without understanding the relationship, will not put us in a position to get this done.

And then similarly, the global nature of these problems and the global -- the requirement of a global response. So President Obama a year ago next week stood in front of the UN and called for an aggressive plan. And he actually said, "In our lifetimes we can eliminate extreme poverty." It was an audacious statement. One of my founders, Bono, called them the 36 words and put them in The New York Times and we've been saying, "Where's your plan?"

Raj and his colleagues, the Secretary, the President have come forward with a great plan. But I note it's a U.S. Government plan and the President called for a global plan. So now it gets interesting. Raj and his colleagues and the Secretary go to New York, and how they bring it together with other efforts in a coherent way that links all these issues, that's really the important next step. And I'm really looking forward to seeing how this plan they put forward kind of goes global.

MR. CROWLEY: Well, we've given you a bit of a kind of forecast of what to expect as the UN General Assembly convenes next week, and there will be a summit in New York that highlights the vital importance and the progress of the Millennium Development Goals and what still needs to be done over the next five years.

That concludes this session of Conversations with America. And as events continue to rapidly unfold around the globe from Haiti to Afghanistan, places that both these gentlemen have visited, we will come back to see you and educate citizens here in the United States and around the world about key efforts, key challenges and the efforts of the United States Government to combat them.

Thank you for joining us. This transcript and video will be available on shortly. And we look forward to continuing this conversation in the future.

Gentlemen, thanks very much.

U.S. Department of State, Washington, DC

Last updated: June 01, 2012

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