Delegation Briefing Table of Contents

DELEGATION BRIEFING TABLE OF CONTENTS

3 THE CLINTON FOUNDATION IN AFRICA

4 DELEGATION SCHEDULE

8 SOUTH AFRICA 9 COUNTRY OVERVIEW 11 CGI VISIT: CITY YEAR SOUTH AFRICA

12 MOZAMBIQUE 13 COUNTRY OVERVIEW 15 CHAI VISIT: MAPUTO HEALTH FACILITY 15 AGOA VISIT: MAPUTO

16 RWANDA 17 COUNTRY OVERVIEW 20 CGI VISIT: OPENING OF BUTARO CANCER CENTER OF EXCELLENCE 20 CDI VISIT: SOYCO LTD 21 CHAI VISIT: HUMAN RESOURCES FOR HEALTH PROGRAM

22 UGANDA 23 COUNTRY OVERVIEW 26 CGI VISIT: BUILDING TOMORROW ACADEMY 26 CHAI VISIT: NATIONAL MEDICAL STORE AND RX DISTRIBUTION CENTER

27 DELEGATION INFORMATION 28 PRESS GUIDELINES 29 DELEGATION LIST AND BIOS 36 FOUNDATION STAFF 39 “AFRICA: A CONTINENT READY TO FULFILL ITS POTENTIAL” BY PRESIDENT BILL CLINTON, LONDON EVENING STANDARD 40 “CHARITY NEEDS CAPITALISM TO SOLVE THE WORLD’S PROBLEMS” BY PRESIDENT BILL CLINTON, FINANCIAL TIMES

CLINTON FOUNDATION BRIEFING: AFRICA 2012 1 CLINTON FOUNDATION BRIEFING: AFRICA 2012 2 THE CLINTON FOUNDATION IN AFRICA

President Clinton made his first trip to Africa in 1998 – the longest, most extensive trip made to the continent by an American president. During this trip, he launched a number of initiatives aimed at education, economic empowerment, and peace and reconciliation. He forgave debt so nations could reinvest in health care, education, and poverty alleviation. He increased funding and research for lifesaving vaccines. And he signed the African Growth and Opportunity Act (AGOA) into law, which helped strengthen economic ties between the United States and Africa. President Clinton has continued to build upon his longstanding commitment to Africa through the work of his Foundation, and has traveled through Africa many times since leaving the White House in 2001. Today, the Clinton Foundation’s programs in Africa are enabling sustainable development for families and communities; strengthening health systems and expanding access to lifesaving treatments for HIV/AIDS and malaria; helping cities develop sustainably through alternative waste management and clean transportation initiatives; and preserving and regrowing Africa’s forests. Through the Clinton Global Initiative, President Clinton has also advanced innovative partnerships between the public and private sector that have brought new investment and opportunity to the continent. President Clinton continues to visit locations that have left an indelible mark on his life along with new places where the Clinton Foundation now works. Each country, city, and village has its own unique story, its own challenges, and its own opportunities. And each has hope that, with a hand up from the global community, they can lift themselves out of poverty and share in the positive benefits of our global interdependence. The Foundation continues to work directly in line with communities, providing them with the tools they need to secure their futures. Our ultimate hope for the communities where we work is that our programs will become self-sustaining, relying on local resources and enterprises rather than foreign aid. To address climate change in a manner that is both economically and environmentally sustainable, the Foundation has helped farmers plant trees that generate income through the sale of carbon credits on the international marketplace. In Malawi, the Foundation’s Anchor Farm Project has achieved increased yields and improved quality of inputs for over 10,500 smallholder farmers, increasing profitability by 567 percent since 2008. In Ethiopia, the Foundation has recently helped to accelerate the introduction of the new vaccine for pneumonia – the pneumococcal vaccine – by two years, saving the lives of an estimated 23,000 children. And throughout the entire continent, we have reduced prices up to 90 percent for key HIV drugs and up to 80 percent for HIV diagnostics. In total, we have helped more than 4 million people gain access to lifesaving antiretroviral medications around the world. Inspired by President Clinton’s commitment to Africa, Clinton Global Initiative members have made 759 of their own commitments that are already improving lives across the continent. With a total estimated value of over $27.8 billion, these commitments are focusing on the prevention and treatment of HIV/AIDS, conflict resolution, improving the wellbeing of women and children, improving water and sanitation, fostering agriculture, and improving nutrition. This year, President Clinton will travel to South Africa, Mozambique, Rwanda, and Uganda, where the Clinton Foundation’s programs are expanding and changing lives each and every day. Through these programs, we hope to spur more economic progress, build sustainable communities, and improve health and education for entire populations.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 3 DELEGATION SCHEDULE

CLINTON FOUNDATION BRIEFING: AFRICA 2012 4 AFRICA 2012 TENTATIVE DELEGATION SCHEDULE

FRIDAY, JULY 13, 2012 EARLY MORNING Fly From New York (JFK) To Johannesburg, South Africa

SATURDAY, JULY 14, 2012 AM TBD Arrive Johannesburg, South Africa PM TBD Downtime in Johannesburg, South Africa Attire: Casual RON Johannesburg, South Africa

Weather in Johannesburg, South Africa Scattered showers/wind | 60° high, 35° low | Sunrise: 6:55 am, Sunset: 5:33 pm

SUNDAY, JULY 15, 2012 3:00 PM Visit to City Year South Africa Location: Soweto, South Africa Attire: Business casual PM Downtime RON Johannesburg, South Africa

Weather in Johannesburg, South Africa Partly cloudy | 53° high, 35° low | Sunrise: 6:54 am, Sunset: 5:34 pm

MONDAY, JULY 16, 2012 8:00 AM Depart the hotel 9:00 AM Fly From Johannesburg to Maputo, Mozambique (1 hour) 10:00 AM Arrive Maputo, Mozambique 10:20 AM Drive time to CHAI site outside of Maputo 11:00 AM Walking tour of Health Facility/Pediatric Unit NOON Foundation Press Announcement Attire: Business casual 12:30 PM Greet with CHAI Mozambique staff 1:00 PM Drive to Maputo/lunch 3:00 PM Hold for AGOA Stop/Maputo Attire: Business casual 4:15 PM Drive time to Maputo Airport 5:00 PM Wheels-Up Mozambique en route Johannesburg (1 hour) 6:00 PM Arrive Johannesburg, South Africa 7:00 PM Arrive hotel RON Location: Johannesburg, South Africa

Weather in Johannesburg, South Africa Sunny | 59° high, 37° low | Sunrise: 6:54 am, Sunset: 5:34 pm Weather in Maputo, Mozambique Sunny | 76° high, 52° low | Sunrise: 6:35 am, Sunset: 5:17 pm

CLINTON FOUNDATION BRIEFING: AFRICA 2012 5 TUESDAY, JULY 17, 2012 AM TBD Depart the hotel en route airport AM TBD Wheels-Up Johannesburg to Cape Town, South Africa AM TBD Arrive Cape Town, South Africa AM – PM Down day in Cape Town, South Africa PM TBD Wheels-Up en route Johannesburg, South Africa PM TBD Arrive Johannesburg, South Africa RON Saxon Hotel, Johannesburg, South Africa

Weather in Johannesburg, South Africa Sunny | 62° high, 40° low | Sunrise: 6:54 am, Sunset: 5:35 pm Weather in Cape Town, South Africa Sunny | 64° high, 46° low | Sunrise: 7:48 am, Sunset: 5:57 pm

WEDNESDAY, JULY 18, 2012 7:30 AM Wheels-Up Johannesburg en route Kigali Rwanda NOON Arrive Rwanda 12:30 PM Drive Time to Butaro, Rwanda (2 Hours/Paved Road) 3:00 PM CGI Visit: Opening of Butaro Cancer Center of Excellence with Paul Farmer and Jeff Gordon Location: Butaro, Rwanda Attire: Business PM TBD Helo To Kigali, Rwanda PM TBD Arrive Kigali, Rwanda Note: Downtime RON Kigali, Rwanda

THURSDAY, JULY 19, 2012 10:00 AM – 11:00 AM Depart Hotel en route Soy Factory 11:00 AM Arrive Mount Meru Soyco Ltd Construction Site 11:05 AM – 11:45 AM CDI: Soyco site visit Attire: Neat casual NOON – 1:00 PM Drive time to Kigali, Rwanda 1:00 PM – 3:00 PM Downtime/lunch Attire: Neat casual 3:15 PM – 4:15 PM CHAI Visit: Speech highlighting the HRH Program Attire: Business 5:30 PM Fly to Kampala Uganda (1:15 + 1) 7:45 PM Arrive Kampala, Uganda RON Kampala, Uganda

Weather in Kigali, Rwanda Partly cloudy | 81° high, 62° low | Sunrise: 6:05 am, Sunset: 6:07 pm Weather in Kampala, Uganda Cloudy | 80° high, 65° low | Sunrise: 6:52 am, Sunset: 7:00 pm

CLINTON FOUNDATION BRIEFING: AFRICA 2012 6 FRIDAY, JULY 20, 2012 9:00 AM Travel to Building Tomorrow Academy 10:15 AM CGI Visit: Building Tomorrow Academy Attire: Business casual 11:15 PM – 12:15 PM Drive time to Kampala, Uganda TBD CGI Visit: Starkey Foundation Fitting Attire: Business casual 2:45 PM Travel to CHAI Site in Entebbe, Uganda 3:15 PM CHAI Visit: National Medical Store/Rx Distribution Center Attire: Business casual 5:30 PM Fly Entebbe, Uganda to TBD 10:30 PM Arrive TBD RON TBD Note: The Morocco portion of the trip has been replaced with TBD

Weather in Kampala, Uganda AM clouds/PM sun | 80° high, 64° low | Sunrise: 6:52 am, Sunset: 7:00 pm Weather in Entebbe, Uganda AM clouds/PM sun | 79° high, 65° low | Sunrise: 6:53 am, Sunset: 7:00 pm

SATURDAY, JULY 21, 2012 AM – 5:00 PM Downtime in TBD Attire: Casual TBD Delegation goodbye lunch or dinner in TBD PM TBD Wheels-up en route TBD (1:30/0) RON TBD

Weather in TBD

SUNDAY, JULY 22, 2012 AM TBD Wheels-up TBD to New York, NY Attire: Comfortable PM TBD Arrive New York, New York (JFK) Weather in New York City, U.S.A. Sun and clouds | 89° high, 69° low | Sunrise: 5:43 am, Sunset: 8:22 pm

CLINTON FOUNDATION BRIEFING: AFRICA 2012 7 SOUTH AFRICA

CLINTON FOUNDATION BRIEFING: AFRICA 2012 8 SOUTH AFRICA

CLINTON GLOBAL INITIATIVE (CGI) CGI members have made 138 commitments that include South Africa in their geographic scope, with an estimated total value of $4.2 billion. The largest portion of these (39.9%) represents commitments in the field of Economic Empowerment, and the largest specific area of focus is youth (39 commitments). Of these 138 commitments, 30 target South Africa exclusively, with an estimated total value of $197 million. CLINTON HEALTH ACCESS INITIATIVE (CHAI) CHAI first began working in South Africa in 2003, when the government asked for assistance to develop a plan to significantly scale up HIV services and access to antiretroviral therapy (ART). In 2009, CHAI was invited back to partner with the South African Government to help improve the response to HIV and TB, which laid the foundation for the most aggressive expansion of HIV testing and treatment ever attempted in the world. In addition to the CHAI HIV/AIDS work, CHAI also supports the National Department of Health (NDOH) with efforts to eliminate malaria.

CHAI team members are embedded at the Department of Health and National Health Laboratory Service (NHLS) to provide support at multiple levels – policy formulation, implementation planning, and monitoring and oversight of implementation. TREATING HIV/AIDS • Prior to 2011, South Africa was purchasing HIV drugs above internationally competitive prices. CHAI helped achieve a 53% price reduction for ARVs, allowing the NDOH to realize an estimated savings of $700 million over two years, and putting hundreds of thousands of additional patients on life-saving treatment. • CHAI worked with the government to develop implementation plans for testing and treatment and to select facilities for ART scale-up. From April 2010 to March 2012, the number of facilities providing ART increased from 495 to over 3000, and in the last year close to 430,000 people started treatment. Since April 2010, nearly 20 million HIV tests were conducted in South Africa. • By 2013, CHAI intends to help the South African Government provide treatment to 2.3 million people, up from 800,000 at the beginning of 2010. ERADICATING MALARIA Over the past 10 years, the number of malaria cases has decreased in South Africa by a remarkable 85%. To build on this success, CHAI partnered with the NDOH in 2012 to develop a strategy to move from malaria “control” to “elimination” by 2018. EMPOWERING NURSES In an effort to effectively integrate HIV/AIDS treatment into primary care, CHAI and the NDOH have been working to train additional health workers, especially nurses, to get more patients on treatment. Since 2010, more than 10,000 nurses have been trained to get more South Africans tested and treated for HIV. STRENGTHENING DIAGNOSTIC SERVICES In addition to supporting the scale-up of HIV testing, CHAI has been supporting the NDOH and the National Health Laboratory Service (NHLS) to scale up HIV and TB diagnostic services. In 2011, the Minister of Health announced the large-scale implementation of the GeneXpert TB diagnostic platform—a test that provides rapid test results within 90 minutes. With CHAI support, South Africa now has the largest GeneXpert program in the world. FUTURE PLANS: 2012 AND BEYOND CHAI is proud of the role it has played over the past nine years in South Africa, and the NDOH’s leadership continues to foster an environment in which CHAI can work efficiently and effectively with all who have rallied to support the government’s efforts. CHAI will continue to support the NDOH scale up testing and treatment for HIV and TB at the national and provincial level. This work, in addition to eliminating malaria and increasing effectiveness of health spending, will be central to strengthening South Africa’s health system to combat—and eradicate—the HIV epidemic in the future.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 9 C40 – CCI CITIES The City of Johannesburg was a founding C40 city and serves as a Steering Committee city. With assistance from C40-CCI and a consulting firm, Johannesburg worked to develop a greenhouse gas emissions inventory in order to establish a baseline and ultimately a Climate Action Plan. Johannesburg is targeting a 30% emissions reduction by 2025. ENERGY EFFICIENCY IN MUNICIPAL BUILDINGS In Johannesburg, C40-CCI worked with the city government to develop a project to retrofit its municipal buildings. The city government has received the results of the investment grade audits of 16 buildings, which indicated a variety of savings opportunities ranging from simple lighting retrofits to more complex systems replacements. C40-CCI supported the review of investment grade audits, finalized the scope of the project, and identified financing solutions. ALTERNATIVE WASTE MANAGEMENT C40-CCI worked with Johannesburg to modify its existing solid waste by-laws to establish a governing framework that supports the development of alternative waste treatment technologies such as anaerobic digestion and gasification. In addition, C40-CCI worked with the city government to explore a small project to remove 20,000 tons of organic waste from city parks. CLEAN TRANSPORTATION In partnership with the Institute for Transportation and Development Policy (ITDP) and the International Council on Clean Transportation (ICCT), C40-CCI assisted the city government of Johannesburg with the development of a new bus rapid transit (BRT) system, the Rea Vaya. Rea Vaya was the first BRT system to operate in Africa. Today the BRT system runs 66 buses per day, and will expand in 2013 to 807 buses running 75.8 miles of routes and serving 434,000 passengers per day. Overall, the project is expected to reduce carbon dioxide emissions by 1.3 million tons by the end of 2020. C40-CCI also helped Johannesburg procure several low-carbon buses to test on its new BRT system. Ethanol and compressed natural gas (CNG) buses were used to transport fans from parking lots to and from the 2010 FIFA World Cup. The project provided an important opportunity for cities throughout Africa to collect data on emissions, maintenance, and fuel economy on a range of next-generation buses. Additionally, C40-CCI helped the Johannesburg city government identify and mobilize funding for 3.7 miles of bicycle and walking paths that are tied into BRT stations, schools, and museums. This project made it easier for underserved residents and communities to access the BRT system and dramatically reduced the number of road fatalities in the area. Approximately 1.8 miles of paths have already been completed. CLIMATE POSITIVE DEVELOPMENT PROGRAM Two Climate Positive projects are underway in South Africa. • The first project, Old Mutual Zonk’izizwe, is a 543-acre site in Midrand, halfway between Johannesburg and Pretoria. This project will serve a new town center connecting Pretoria and Johannesburg. CCI is currently engaged with the developer and city governments to assess technical needs. • The second project, Menlyn Maine, is located in Pretoria. Menlyn Maine is a new 3,304,520.4 sq ft, privately- owned, mixed-use development. This development seeks to become the first green city in Africa. When completed in 2020, it will accommodate 21,000 people.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 10 CLINTON CLIMATE INITIATIVE (CCI) • CCI has updated its MoU with the Department of Energy to develop the first Solar Park in South Africa, built on the pre-feasibility study completed in 2010 and the success in India. • CCI Transportation is in the process of submitting final documentation for its Fleet Greening Project in Johannesburg. Results have shown that all fuel options analyzed for the city’s bus fleet have a five-year lifecycle cost within 10% of the diesel baseline, and that ethanol and renewable gas will each reduce greenhouse gas emissions by 70-80%. City officials are digesting the conclusions as they work toward a mid-term technology direction for transit buses and other city fleets.

CGI VISIT: CITY YEAR SOUTH AFRICA During this visit you will tour the City Year project, meet with City Year members and have an opportunity for a question and answer session. Since its inception in 2005, members of the Clinton Global Initiative (CGI) have made 2,100 commitments in 180 countries, valued at $69.2 billion. CGI members have made 138 commitments including South Africa in their geographic scope, valued at an estimated total value of $4.2 billion. This visit is an opportunity to see how one CGI member – City Year – is directing resources to a community in need. With the help of City Year service members, Freedom Park Primary School runs programs that serve food to approximately 300 children and care for approximately 200 ill or elderly people in their homes. Building on President Clinton’s longstanding efforts to encourage civic engagement among youth, this City Year commitment engages young people of diverse backgrounds in a year of full-time service in South Africa.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 11 MOZAMBIQUE

CLINTON FOUNDATION BRIEFING: AFRICA 2012 12 MOZAMBIQUE

CLINTON GLOBAL INITIATIVE (CGI) CGI members have made 70 commitments that include Mozambique in their geographic scope, with a total estimated value of $2.3 billion. The largest portion of commitments (37.1%) was made in the field of Global Health. Of the 70 commitments, 4 target Mozambique exclusively, and are valued at $24 million.

CLINTON HEALTH ACCESS INITIATIVE (CHAI) CHAI mobilizes technical and operations expertise to improve the management and organization of health systems, allowing developing countries to maximize resources available to them. In each area of its work, CHAI seeks to have an immediate and large-scale impact while ensuring sustainable solutions that can be owned and maintained by government partners. MATERNAL CHILD HEALTH CHAI Mozambique expanded its focus in 2011 to more comprehensive support to strengthen health systems and key areas in Maternal Child Health. The areas included Prevention of Mother-to-Child Transmission (PMTCT) and Emergency Obstetric and neonatal which, along with the current Pediatric HIV/AIDS program, addresses over 60% of the causes of Maternal Mortality rates in Mozambique. CHAI’s scope of work will include reducing incidences and mortality rates related to pneumonia, diarrhea and malnutrition for children. Specific program activities include:

1. Prevention of new Pediatric HIV infections Continue national scale up Point of Care CD4 devices to sites that will improve early identification and treatment of HIV+ mothers and reduce vertical transmission. By end of 2012, these technologies will be placed in locations that provide health services to over 50% of the country’s population. By end of 2013, it is estimated that 25% of the population will have been initiated on treatment via Point of Care CD4 technology.

2. Early identification of HIV-positive and Malnourished Infants • Continue technical assistance/coordination of the National Early Infant Diagnosis program, focusing on testing children at 2 months and early initiation on treatment. In 2011, over 42,000 DNA PCR tests were performed, covering 55% of the need. • Increase entry point for screening of HIV and malnutrition by screening during the vaccination program and integrating child services at health facilities.

3. Early initiation of treatment for PCR infants and malnourished children • Evaluate and scale up new Point of Care DNA/PCR device for Early Infant Diagnosis to deliver quality care in rural areas, in progress. • Provide tools to empower patients and families and improve adherence. Includes SMS to mobile pilot, with national scale up if successful.

4. Reduce Maternal and Neonatal mortality during birth • Provide equipment and materials necessary for safe childbirths at health centers. • Support national distribution of misoprostol for rapid treatment of hemorrhaging. • Evaluate and test point of care diagnostic for screening of pre-eclampsia.

5. Improve U5 survival rates • Support rapid preventative solutions for Child malaria (potential vaccine, trialing in Mozambique).

6. Improving information systems and results to patients • Develop and implement national connectivity system that expands on the current platform of the EID system. The system includes integration of testing for CD4, PCR, TB into national databases, transmission of results via GPRS to health facilities and SMS to mobile for patient information and alerts.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 13 7. Develop a regularized transport system at provincial level for medicines/commodities and sample transport system from provincial level to health facilities • In partnership with the Ministry of Health, implement efficient and regular warehousing and supply chain system at the provincial level. • Leverage transport network to carry medicines downstream and samples for laboratory testing upstream. PREVENTION OF NEW PEDIATRIC HIV INFECTIONS CHAI’s support in this area includes the introduction of point of care testing devices that provide rapid CD4 test results and the ability to initiate women on treatment in the early stages of ANC for greater prevention of transmission and reduction in lost to follow up rates. POINT-OF-CARE TECHNOLOGIES In order to decentralize HIV related health services into rural and peri-urban areas where the majority of the population live in many parts of Africa, new diagnostic technologies are needed that are easier to deploy closer to patients. Concerns have been raised over the high cost of current conventional treatment and efforts are underway to find cost effective approaches that allow more patients to be treated while improving the cost effectiveness of treatment. The cost of diagnostics is a major contributor to overall costs of ART delivery, comprising a significant proportion of national budgets. More efficient deployment of diagnostics may help reduce these costs while enabling wider access to testing. PMTCT The Point of care technologies are providing a solution to improving access and faster initiation rates for HIV+ pregnant women. Initiating women earlier on treatment can reduce the Pediatric infection rate by leveraging the new technologies such as the POCT CD4 that is being scaled up nationally in the country. In some pilot sites, as many as 50% more women were initiated from the PMTCT program. EVALUATION OF POINT-OF-CARE DEVICE FOR EID AND VIRAL LOAD The aim of this technical evaluation is to assess the new cutting-edge Point of care testing devices for Early Infant Diagnosis (EID) and Viral Load (VL). This evaluation is a joint initiative of the National Institute of Health (NIH) in collaboration with the Clinton Health Access Initiative. A total of 5 health centers close to the national referral conventional testing center in Maputo were selected to participate in this technical evaluation phase. The goal of the protocol is to enroll approximately 100 HIV+ babies at Child At Risk Consultation services. EARLY IDENTIFICATION OF HIV+ INFANTS In 2011, 55% of the number of infants whose mothers received PMTCT received Early Infant Diagnosis testing and of all exposed infants in need of testing, 40% received EID. The national program was 100% funded by CHAI-UNITAID for diagnostics and ARV’s including national distribution. There were 40,622 PCR samples processed in 2011, an increase of 17.4% over the prior year. In the first quarter of 2012, there were 13,286 PCR samples processed, a volume 25% greater than the same quarter in 2011 and an indication that the 2012 annual volumes will be over 53,000. SMS PRINTER SYSTEM The national Expedited Results System was implemented in 2010 and its goal is to meet a turnaround time of 28 days from sample collection time to results at the health facility. The target for 2012 is to return 60% of samples in under 28 days. In 2011, only 32% of samples were returned in under 28 days. In Q1 2012, 43% of samples were returned in under 28 days. By April, 60% of results were returned in under 28 days. Twenty-five new printers are being prepared for installation, which will bring the number of sites with SMS printers to 397 by Q2. CHAI is working with the MoH to integrate delivery of TB results to the Expedited Results System as per the MoH’s request. CHAI will plan to implement delivery of TB results first to centers, which already have an SMS printer. The implementation is planned to begin by the start of Q3 2012.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 14 EARLY INITIATION OF TREATMENT FOR PCR+ INFANTS For the period ending December, a total of 23,049 children are now on ART, which represents 79% of the new target for 2011. This target was revised in August 2011 to 29,166 from the original 24,764 children on ART goal as part of the Government of Mozambique’s commitment to improve Pediatric HIV/AIDS post the high level UNAIDS meeting in July 2011. The new targets for 2012 onwards represent a significant increase from the current 30% coverage of Pediatric HIV/AIDS needs to 80% coverage by 2015. SCREENING PILOT DURING ROUTINE PEDIATRIC SERVICES During Q1 of 2012, CHAI Mozambique launched a new Health facility-level initiative designed to identify more HIV-exposed infants during routine child growth monitoring and vaccination days. It is expected that this new entry point for screening will result in an estimated 15% more children identified for treatment and care. IMPROVING INFORMATION SYSTEMS AND RESULTS TO PATIENTS Expansion and improvement in communications technology and point-of-care technologies have presented the opportunity to improve delivery of health services at the point of care whilst monitoring those services and outcomes on a national level. CHAI is currently working with the MoH and various technologies partners to develop a connectivity infrastructure which would enable digitized data collection at the site and remote monitoring for programs including: EID, epidemic and disease surveillance, and Point-of-Care technologies (POCT) for EID, Viral Load, and CD-4. MCEL, a local telecommunications provider, continues to support the connectivity program by providing SIM cards and transmission free-of-charge for the SMS Printers and the POCT devices.

CHAI VISIT: MAPUTO HEALTH FACILITY You will participate in a short walking tour of the Polana Canhico Health Facility and will have an opportunity to meet the medical staff after the tour.

A centerpiece of CHAI’s work has been the reduction of HIV/AIDS transmission from mothers to babies, a preventable phenomenon that has been virtually eliminated in the U.S. and developed countries, but still takes the lives of many newborns in the developing world. The Polana Canhico Health Facility tour, where President Clinton will also deliver remarks and meet with local families, will showcase this “PMTCT” work. AGOA V ISIT: M APUTO Reflecting President Clinton’s tireless work to provide a hand-up and not just a handout, one of his crowning Africa-related achievements as President was the successful passage of the African Growth and Opportunity Act (AGOA) in 2000. AGOA is up for U.S. Congressional renewal in 2015, and discussions already have begun in Washington regarding AGOAs’ future. This visit will highlight the benefits that AGOA has generated for business in Uganda. AGOA has generated an estimated 300,000 jobs for Africans, and current U.S. exports to Africa (totaling $21.3 billion) support about 100,000 jobs in the U.S.. Just from 2009 to 2011, Uganda’s exports to the U.S. increased 500%; today Uganda’s economy is among the fastest growing in the world.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 15 RWANDA

CLINTON FOUNDATION BRIEFING: AFRICA 2012 16 RWANDA

CLINTON GLOBAL INITIATIVE (CGI) CGI members have made 115 commitments that include Rwanda in their geographic scope, with a total estimated value of $2.3 billion. The largest portion of these (40%) represents commitments in the field of Economic Empowerment, and the largest specific area of focus is jobs (27 commitments). Of these 115 commitments, 19 target Rwanda exclusively, with a total estimated value of $146 million. The largest portion of these Rwanda-specific commitments (31.6%) represents Education, and the most prominent subtopic area is youth (4 commitments).

CLINTON HEALTH ACCESS INITIATIVE (CHAI) In the 18 years since the genocide, the Government of Rwanda has achieved great success in revitalizing its health system. Immunization rates are among the highest in Sub-Saharan Africa (97%) and HIV prevalence has declined to under 3%. Maternal mortality levels in Rwanda were among the highest in the world in 2000, but have decreased by 10% per year and are on track to reach the Millennium Development Goals (MDGs) by 2015. However, many challenges persist to enable Rwanda to establish a sustainable health system not dependent on foreign aid, with Human Resources for Health being the main obstacle towards this goal. HUMAN RESOURCES FOR HEALTH (HRH) PROGRAM Despite many accomplishments in the health sector, maternal and child illness is still too high in Rwanda, and the burden of poorly treated diseases is substantial. To make further progress, Rwanda must improve its health workforce. Currently, Rwanda has only 633 physicians for a population of over 10 million people. There are only 6,970 Rwandan nurses, about 90% of whom have the lowest level of nursing training available (A2).

The Human Resources for Health (HRH) Program aims to build the health education infrastructure and health workforce necessary to create a high quality, sustainable healthcare system in Rwanda. The HRH Program addresses the most challenging obstacles to high quality healthcare in the country:

• Critical shortage of skilled health workers • Poor quality of health worker education • Inadequate infrastructure and equipment in health facilities • Inadequate management of health facilities

CHAI was uniquely positioned to support the Ministry of Health (MOH) in achieving its objectives in HRH. Together with the MoH, CHAI drafted the 8-year proposal that was submitted to the U.S. Government (USG) for funding in June 2011. CHAI continues to work closely with the MoH to implement the program and provide overall program support.

With CHAI’s support, the government of Rwanda has convened a consortium of 13 US-based institutions of medicine, nursing/midwifery and public health. Each of the participating institutions has agreed to recruit and send full time faculty to Rwanda on a long-term basis to build the capacity of the Rwanda health system and Rwandan Institutions. They have also agreed to a set of exemplary principles that are in line with the recent emphasis of increasing the efficiency and effectiveness of Aid from the US Government. This program will build the capacity of local institutions and ensure they develop sufficient capacity to train health professionals without foreign support by establishing a critical mass of well-trained teachers and mentors.

The HRH Program’s Academic Consortium will be by far the largest cooperative global health effort ever undertaken between universities in the developed and developing world.

The principle goal of the HRH Program is to build a sustainable, high-quality health workforce capable of providing the citizens of Rwanda with world-class healthcare. To achieve this vision, the HRH Program will accomplish the following goals within the project’s eight-year time frame:

CLINTON FOUNDATION BRIEFING: AFRICA 2012 17 • Increase the number of trained physicians by 500 in the specialties of internal medicine, family and community medicine, obstetrics and gynecology, pediatrics, surgery, and anesthesiology • Dramatically advance the skill level of nurses/midwives by increasing the number of nurses/midwives with A0 credentials from 104 to 1,011 and the number of nurses/midwives with A1 credentials from 797 to 5,095. These actions will increase the overall number of nurses/midwives from 6970 to 9178, or over 2000 nurses and midwives • Introduce the role of ‘health manager’ into the Rwandan health system and increase the number of trained health managers from 7 to 157 • Build the institutional capacity of the medical, nursing, health management schools and clinical teaching hospitals in order to sustain high quality health education DEVELOPING A LONG-TERM SUSTAINABLE HEALTH FINANCING STRATEGY One of the key priorities of the Rwandan government is to reduce its dependency on foreign assistance over the next few years. This is now particularly relevant in the context of diminishing global health funding. CHAI is working closely with the health financing unit to draft a long-term financing plan that will enable the ministry select the best strategies to reach their financing goals for the health sector. CHAI has already helped setup a resource tracking system that all partners in Rwanda have to complete, which provides the MoH with the visibility over all potentially available funds in the country, as well as their geographic or programmatic allocation and cost category.

The Resource Tracking Tool has been a key source of information in providing unprecedented levels of transparency for all funding for health in Rwanda. This information was vital for MoH to be able to redirect some of the funding towards a government priority like HRH.

As part of this work, CHAI will continue to support a flagship MoH costing and health system management system (DHSST), which is used by all district health facilities in the country to identify system gaps and establish plans to fill them. This tool was for example used in calculating the HRH gap described above and will be key to identifying other areas that may require support throughout the country. TOGETHER WITH PIH, BUILDING A SUSTAINABLE COMMUNITY HEALTH MODEL Rwanda has about 60,000 community health workers (CHWs) distributed across its 30 districts. They constitute the first line of access to the health system for most people in the country and offer a broad range of basic primary care and preventive services. While PIH focuses on clinical care and training, CHAI has supported all CHW cooperatives in one pilot district to develop an income-generating activity. Today after only two years, all the CHW cooperatives in the district of Burera are profitable and support CHWs and their families. CHAI will now explore how to support the MoH to establish well-managed CHW cooperatives in all districts. CLINTON DEVELOPMENT INITIATIVE (CDI) CDI is active primarily on four major projects in Rwanda: A soy and sunflower oil manufacturing business; a project funded by the Alliance for a Green Revolution in Africa to scale up production for soybean farmers; the development of a coffee factory that will roast and package Rwanda’s high quality coffee for local, regional and international markets; and distribution of fruit tree seedlings. MOUNT MERU SOYCO LTD Mount Meru Soyco is a modern, large-scale, fully integrated edible oil processing plant producing quality edible oil and de-oiled cake for both local and export markets. The project, located in Eastern Rwanda, is on 32 acres of land within Kayonza district, and represents a $15 million investment.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 18 Soybeans grow well in Rwanda but have not been widely adopted, primarily because of a lack of domestic demand. Mount Meru Soyco will create demand by buying more than 45,000 tons of soybeans and sunflower annually at full capacity (200 tons per day), producing 9,000 tons of oil and 36,000 tons of soy and sunflower cake per year. The new business will procure soybeans through a large out-grower program, in which approximately 30,000 farmers (55% women) will be contracted to grow soybeans for Mount Meru Soyco with input support and extension services provided by the business. The processing factory itself will employ around 120 permanent staff. In 2010, CDI partnered with the Alliance for a Green Revolution in Africa (AGRA) to scale up soy inputs to 20,000 farmers across Rwanda over three years. The training provided to farmers is targeted at boosting their yields through access to improved seed and better agronomic practices. Improving smallholder soya yields will increase the impact on their income generated by having the Soyco processing facility as the contract purchaser of their crops.

Progress to Date • Mount Meru Soyco has obtained land titles for the factory site (14 hectares). • The Mount Meru Soyco board has finalized the recruitment of the CEO, who has already been active by following up on all of the activities related to the construction of the factory. • The Mount Meru Soyco board has given Mount Meru Group the responsibility of dealing with the manufacturers of the plant equipment. • Construction work for the factory has started, and shipments of equipment have begun to come in. It is estimated that factory construction will be complete in the next eighteen months. AGRA CDI and the Rwanda Agriculture Research Institute (ISAR) received US $733,338 from the Alliance for a Green Revolution in Africa (AGRA, chaired by Kofi Annan) to scale up the production of inputs for soybean farmers over three years. The funds will be used to:

• Repair and commence production at the inoculums production facility managed by ISAR (Inoculum is a bacteria that enables soybeans to fix more nitrogen from the atmosphere, reducing fertilizer needs) • Conduct trials of soybean varieties with different types of fertilizer applications in rotation of maize of inputs to determine which are best suited for Rwandan soy farmers • Create and initial soybean seed stock sufficient to scale-up the production with involvement of 20,000 farmers in three years

Progress to Date • CDI commenced work with thirty mother trials across three districts in Rwanda to test yields for different soybean varieties under different types of fertilizer application levels last season. • RAB is working with CDI and AGRA to identify appropriate seed varieties, fertilizer combinations and inoculum levels to scale-up in the following season. CDI has been able to reach close to 12000 farmers for the scale-up. • Initial results are as follows: For maize, the combination of DAP+UREA+OM has given better yields—close to 4.1 tons/hectare for an open pollinated variety. For soybeans, the combination of phosphorus and organic manure has produced close to 2.1 tons/hectare. RWANDAN FARMERS COFFEE COMPANY Coffee is one of Rwanda’s leading exports, consistently among the top five foreign exchange earners and generating $53 million in export earnings in 2011. With close to 400,000 coffee farmers, this sector is also a significant contributor to Rwanda’s rural economy, injecting $38 million into the rural areas in 2010. In the last five years, Rwanda has gained an international reputation as an origin of some of the finest quality coffees, mostly due to the country’s determination to shift from ordinary coffee production to premium, fully washed coffee processing. Beginning with only one coffee washing station in 2001, Rwanda now has close to 200 washing stations, and has been the only country in Africa to host the Coffee Cup of Excellence - a rigorous coffee quality competition hosted by a select group of coffee producers worldwide.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 19 CDI has been involved in Rwanda’s coffee sector since 2006, initially providing marketing support to coffee cooperatives and eventually toll roasting Rwandan coffee for direct placement in international supermarkets. Now, working with the Rwandan National Agricultural Export Board, CDI plans to set up a world class factory that will roast and package Rwanda’s high quality coffee for local, regional and international markets. The goal is to capture maximum value from Rwanda’s coffee within Rwanda, and return as much of that value as is possible to Rwandan coffee farmers. Rwandan Farmers Coffee Company Ltd (RFCC) was formed to implement this business, with joint investments by The Hunter Foundation (51%) and NAEB – National Agriculture Export Board (49%).

Progress to Date • $800,000 in equity has been committed by the investors • $1.3 million has been committed as debt financing yb FINA Bank Rwanda • A site for the factory has been secured at the NAEB compound in Kigali • An architect and construction supervisor has been selected • An initial design of the factory has been approved by the RFCC board • Bids for the roasting equipment have been received from three suppliers, with Real Contractors winning the bid to build the factory • The building contract has been signed, and construction is expected to begin the week of July 1. • RFCC worked with eight coffee washing stations this past season, moving six of them from non-operation to profits • A Director of Coffee is expected to be hired soon; he will oversee the roasting of the coffee, product development, purchasing of raw material, and procurement and installation of equipment FRUIT TREES PROGRAM CDI has initiated a program on fruit-grafted seedling production in the Eastern Province. Until now, they have been able to produce and distribute more than 100,000 fruit seedlings of avocadoes, mangoes and citrus. This program has had a large impact in terms of generating income for farmers and improving the nutritional value of produce.

CGI VISIT: OPENING OF BUTARO CANCER CENTER OF EXCELLENCE WITH PAUL FARMER AND JEFF GORDON You will attend the opening of the Butaro Cancer Center of Excellence and receive a tour of the hospital.

The Butaro Cancer Center, created as a 2011 CGI commitment made by Partners in Health and the Jeff Gordon Children’s Foundation, is Rwanda’s first Cancer Center of Excellence. The Center represents President Clinton’s longstanding assistance to the Government of Rwanda’s efforts to scale-up national systems of health. The Center is building a pathology lab, training clinicians in oncologic diagnosis, treatment and care, and expanding the Partners in Health supply chain to include chemotherapy treatment. CDI VISIT: SOYCO LTD You will visit the Soyco LTD construction site, which is currently in progress, and will meet with plant representatives.

As part of CDI’s efforts to expand economic opportunity for farmers and their families in Sub Saharan Africa, and building on CDI’s work directly with farmers to expand access to inputs and improve access to markets, CDI has joined local partners to establish a soy processing facility in eastern Rwanda. The Mount Meru Soyco Ltd. edible oil processing plant will provide sustainable local and export marketplaces for local soy farmers and help increase Rwanda’s GDP.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 20 CHAI VISIT: THE HUMAN RESOURCES FOR HEALTH (HRH) PROGRAM You will attend a speech highlighting CHAI’s work surrounding the Human Resources for Health program in Rwanda.

Although foreign assistance is essential for many developing countries, the global economic downturn has constrained many donors’ capacity to give. Using every aid dollar as effectively as possible is therefore more important than ever before. In alignment with President Kagame’s ongoing efforts to reduce Rwanda’s reliance on international aid, the Government of Rwanda is reconfiguring its use of international aid, and this visit will highlight the Government’s work to enhance the capacity of local institutions to train local health professionals by establishing a critical mass of well-trained teachers and mentors, with initial input from several international faculty but eventually requiring less input from foreign donors.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 21 UGANDA

CLINTON FOUNDATION BRIEFING: AFRICA 2012 22 UGANDA

CLINTON GLOBAL INITIATIVE (CGI) CGI members have made 152 commitments that include Uganda in their geographic scope, with a total estimated value of $5.0 billion. The largest portion of these (38.8%) represents commitments in the field of Economic Empowerment, and the largest specific area of focus is youth (29 commitments). Of these 152 commitments, 12 target Uganda exclusively, with a total estimated value of $46 million.

CLINTON HEALTH ACCESS INITIATIVE (CHAI) When the CHAI Uganda office opened with two staff members in 2007, the focus of in-country work was on pediatric HIV and managing the UNITAID grant. Since then, CHAI has expanded to 15 staff and has greatly increased its scope of work, partnering with the Ministry of Health on projects spanning HIV/AIDS, malaria, and diarrhea treatment. AREAS OF WORK Access to HIV Medicines CHAI manages UNITAID donation for pediatric and second-line ARVs and lab commodities; supports Ministry of Health (MOH) drug forecasts and quantifications; and conducts analysis to drive Ministry of Health policy on drug selection. Laboratory Work CHAI develops and supports a new MOH early infant diagnosis (EID) lab and sample transport network. CHAI also pilots technologies (e.g. SMS for EID results, Point-of-Care CD4 testing for HIV patients) and supports their national rollout. Systems strengthening CHAI conducts facility-level reviews of systems in pre-ART care, PMTCT to EID, pediatric HIV care, and lab services to drive policy recommendations. CHAI also develops national training programs (PMTCT-EID, Point- of-Care testing, HIV patient monitoring) to address facility systems challenges. Malaria CHAI provides country support for the Affordable Medicines Facility for malaria (AMFm). CHAI also supports logistics, uptake and adherence monitoring of rapid diagnostic tests (RDTs) and works to scale up optimal medicine for severe malaria (IV artesunate). ESSENTIAL CHILD MEDICINES CHAI strengthens both supply and demand for correct treatment (zinc and ORS) for diarrhea and ensures the availability of this treatment in the public and private sector. CHAI also promotes a conducive policy environment for increasing uptake of correct drugs. ACCOMPLISHMENTS TO DATE CHAI’s support has enabled the Ministry of Health to create transformational impact for Ugandans affected by HIV/AIDS, malaria and childhood illnesses. CHAI’s approach has been to work hand-in-hand with Ministry of Health on the introduction of new programs, drugs, and technologies. The strong partnerships CHAI has fostered and its analytical approach have allowed the MOH to achieve many accomplishments, including:

1000% scale-up of infants tested for HIV (from 6,000 to >60,000 in five years) • Before 2011, access to testing for Early Infant Diagnosis (EID) of HIV was limited, expensive and slow – 8 NGO- run labs provided testing services at great expense to the MOH, taking an average of 25 days in the lab to process results. Patients at many health centers were not able to access testing due to limited sample transport. • CHAI worked with the MOH to develop and secure funding for a national MOH-run HIV Early Infant Diagnosis (EID) laboratory. The lab, opened in 2011, now runs over 90% of the national testing load and is forecasted to save $3.7m over four years. In-lab turnaround time to results has decreased to 3 days, meaning that caregivers receive infants’ results faster and they are less likely to be lost.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 23 • CHAI coordinated a donation from Hewlett Packard for a data center that will compile data from the EID lab and allow the MOH to identify all HIV-positive infants not accessing treatment. This will help improve coverage of pediatric ART, currently at only 26%. • CHAI also worked with the MOH to develop, pilot, and scale Uganda’s national Prevention of Mother-to-Child Transmission of HIV – Early Infant Diagnosis (PMTCT-EID) Strengthening Program, which has scaled to over 1400 facilities, leveraging over $2 million in partner funds. A recent CHAI/MOH review showed an increase from 8% to 40% retention of mother-infant pairs from PMTCT to early infant testing. • CHAI/MOH developed and piloted a lab sample transport system now covering 19 districts that expands access to EID testing and other lab work. CHAI introduced SMS technology that allows for faster transmission of results to facilities. Both of these pilots are now rolling out nationally with CDC and other donor support.

400% scale-up of HIV+ children receiving life-saving ARV treatment (from 6,400 to 25,000 in five years) • Access to pediatric ART has long been a challenge, and one with significant implications – 50% of HIV- positive children will die before age two without treatment. Previously, access to drugs was extremely limited, and most HIV-positive infants were not identified due to low access to testing. • CHAI’s efforts in testing access and the PMTCT-EID strengthening have increased the number of positive children identified. • CHAI also helped the MOH develop its first national pediatric ART strategy, and seconded the department’s first staff member. • Managing the UNITAID grant, CHAI provides procurement and supply chain support to ensure drugs for pediatric HIV are available nationwide. • Using data from the centralized Early Infant Database, CHAI developed patient tracking tools that allow the MOH to identify HIV+ infants that are not enrolled in treatment by name so they can be followed up and put on treatment.

Introduction and uptake of optimal medicines: • CHAI drove the country’s transition from using bulky, expensive syrup formulations to treat HIV+ infants to using fixed dose combination drugs which are easier to distribute and store and easier for infants to take and adhere to. CHAI worked with the MOH to change policy and conduct trainings and worked with the MOH to identify facilities that were still ordering syrups. From 18% utilization in 2009, over 99% of infants are now accessing optimal pediatric formulations, leading to better adherence, a simplified supply chain, and significant cost savings. • At the invitation of the MOH, CHAI conducted analysis to inform ARV drug optimization. Based on this analysis, CHAI secured buy-in to introduce a new drug (ATV/r) into the HIV treatment policy guidelines. This is expected to save Uganda $7 million over five years, while enhancing adherence for thousands of second line patients through lower pill burden and reduced side effects.

Piloting and scale up of innovative diagnostic technologies • Access to the HIV diagnostic tools was very limited, with CD4 testing available at only 138 of 450 facilities providing ART in 2010. These tools increase timely access to antiretroviral therapy by identifying patients eligible for ARV treatment. • In 2011, CHAI and the MOH piloted the use of Pima Point-of-Care CD4 diagnostic technology to expand access to CD4 testing. • Based on the pilot results, the Ministry of Health procured 250 diagnostic machines and rolled them out nationally in 2012 to health centers that previously had limited access to this diagnostic. CHAI supported logistics and planning for the national rollout in addition to developing the national training curriculum.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 24 Access to optimal malaria drugs through the Global Fund’s Affordable Medicines Facility-malaria (AMFm) • CHAI supported the signing and implementation of the Affordable Medicines Facility – malaria (AMFm), which has resulted in a $29 million grant from Global Fund and access to 32 million subsidized low-cost malaria treatments. This is expected to generate $48 million of savings via antimalarial subsidies. • CHAI helped the MOH coordinate marketing efforts, brought together private sector stakeholders to set pricing targets, and supported the national antimalarial quantification.

Quantify ARV and antimalarial drug needs and develop systems to improve the supply chain through relationship with National Medical Stores • CHAI supports the quantification of ARV and antimalarial drugs and helps proactively identify drugs that may stock out and locate emergency stocks where needed. • Through active order monitoring and follow up with partners supporting facilities, CHAI has helped increase (from 60% to 80%) the number of facilities ordering ARVs, meaning more patients are able to access a continuous supply of drugs. • CHAI is working with the MOH and partners to reduce the number of ARV supply chains from 5 to 3. The new simplified supply system, approved in January and transitioning now, is expected to increase accountability amongst donors, create efficiencies in drug storage and delivery, and simplify the ordering process for health care workers. FUTURE PLANS: 2012 AND BEYOND In addition to continuing to support and expand the above programs, in 2012/2013, CHAI hopes to focus on the following:

Rapid Scale Up of Effective Diarrhea Treatment • Despite the existence of effective and affordable medicines for diarrhea, more than 14,000 children in the country are still dying each year from this easily treatable illness. • CHAI is working with MOH to drastically increase access to correct treatment (oral rehydration salts (ORS) and zinc) by generating demand and awareness and by increasing availability in the public and private sector. CHAI supported the development of the MOH’s national strategy to scale up diarrhea treatment, the “Protect- Prevent-Treat Implementation Framework for Diarrhea and Pneumonia”, which is nearly finalized. • Reaching 80% coverage of ORS and zinc treatment throughout the country can save the lives of almost 20,000 children by 2015.

National Uptake of Rapid Diagnostic Tests (RDTs) for Malaria • Malaria can be diagnosed inexpensively and accurately through a simple pin-prick test, yet Uganda currently uses presumptive diagnosis, which leads to the waste of millions of dollars of expensive malaria drugs for those who do not actually have malaria and does not address the actual illnesses. • CHAI will support MOH to roll out ~60m RDTs over the next five years, to fundamentally change the way that fever is managed in Uganda and provide optimal care for the estimated 3.6 million people who are misdiagnosed annually.

Introduction of the Optimal Severe Malaria Treatment, Intravenous Artesunate (IV AS) • CHAI supported the MOH to update the national malaria treatment guidelines, and is now working to integrate IV AS into the public supply chain and develop a national training strategy to effectively rollout the product in the public and private sector. • The introduction of IV AS is expected to save an additional 14,000 lives per year in Uganda.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 25 CGI VISIT: BUILDING TOMORROW ACADEMY You will visit the Clinton Global Initiative’s Building Tomorrow Academy and meet the academy’s students and teachers.

In 2011, Building Tomorrow made a CGI Commitment to launch BT 2.0, an initiative which plans to enroll 15,000 primary-level students annually in 60 Building Tomorrow Academies by 2016. It is one of the many commitments made by CGI members that are lowering the barriers to quality education for students in Africa and beyond. This particular Academy is the eighth in Uganda and the first in the Mpigi District. In addition to Nyomero, the Academy will serve the villages of Jjanya, Ziwugwe, Lwanga, Kalagala and Mpigi town. Currently, students wishing to attend primary school in and around Nyomero often have to walk at least five kilometers. CHAI VISIT: NATIONAL MEDICAL STORE AND RX DISTRIBUTION CENTER You will visit the national medical store and prescription distribution center and tour the facility. Afterwards, you will attend an event to learn more about the medical store as well as CHAI’s partnerships and commitments.

Diarrhea claims the lives of 1.5 million children globally each year – yet these deaths could be prevented through the use of simple and low-cost treatments such as zinc and oral rehydration salts. With this groundbreaking event at Uganda’s National Medical Store, where all medicines procured for the supply of public sector health facilities are stored and inventoried, President Clinton is sparking a new global effort to reduce the number of childhood deaths due to diarrhea. Uganda is a leader in this effort, and CHAI is assisting their efforts to raise public awareness of the possible treatments, expand their production and availability, and calibrate public policy to elevate and achieve Uganda’s goals. If successful, this program would avert the deaths of 41,000 children in Uganda.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 26 DELEGATION INFORMATION

CLINTON FOUNDATION BRIEFING: AFRICA 2012 27 PRESS GUIDELINES

As members of the Clinton Foundation Africa Trip Delegation, you will be traveling with members of the press.

Please note the below:

• You will be sharing a plane and accommodations with members of the press. Please be aware that press may be present at all times.

• Never speak with members of the media on the record. If you speak with them, it is best to clarify that your conversation is off the record, as the assumption is that all conversations are on the record.

• If you have questions about talking to the press, please check in with Valerie Alexander, Director of Marketing and Communications, and Matt McKenna, President Clinton’s spokesman, before speaking with them.

• Please note that photographers and videographers will attend most site visits. Be aware of them, and try not to block any shots.

• You and other members of the delegation should not be the focus of any photographs or videos taken by members of the press.

• Note that members of the media are a part of their own delegation, and may separate from your group. Please remain with your delegation at all times.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 28 DELEGATION BIOS

SUZIE BERRY President, Whisky Productions Suzie is the President of Whisky Productions, a small company that specializes in presenting exclusive events throughout the world, particularly developing countries with a focus on the Caribbean. She is fascinated with cultures and became aware through her world travels that cultural events, including entertainment, speaking engagements and gourmet events that North Americans and Europeans frequently enjoy, were not easily accessible in developing countries. Suzie has successfully been able to bridge this gap and as a result, world class events by Whisky Productions have been presented and continues to be presented to the Caribbean people. Suzie was born in Kingston, Jamaica and lives in New York.

NISHA BESARA General Manager, Swedish Postcode Lottery Culture Foundation Born in Istanbul, Nisha moved to Sweden in 1980 and studied political science from 1998 to 2002 in Stockholm, where she has lived ever since. Since 2011, she has served as General Manager for the Culture Foundation of the Swedish Postcode Lottery. The Culture Foundation donates a portion of the lottery’s profit to cultural projects with a social impact. Prior to joining the Postcode Lottery, Nisha worked at Arenagruppen/The Arena Group, a progressive think tank based in Stockholm. Arenagruppen has a publishing house, produces several magazines, reports and other publications and is an active part in the public political discussion in Sweden. Previously, Nisha was an editorialist and columnist for Scandinavia’s biggest daily newspaper, Aftonbladet, and served as Political Adviser to Jens Orback, Minister for Gender Equality and Integration in the Social Democratic Government of Prime Minister Göran Persson.

ANDREA CATSIMATIDIS COX The Red Apple Group Andrea is a recent graduate of New York University’s Stern School of Business. At NYU, she was selected as one of the 15 most influential students on the NYU campus in 2010. Long interested in public affairs, she was the subject of a 2010 Wall Street Journal profile piece about her political activities. In addition, Andrea has appeared numerous times on Fox News, has been interviewed by the New York Times, the WSJ and the New York Post. In the fall, she will start working directly for the chairman of the Red Apple Group, a privately held company with interests in refining, grocery stores, aviation and real estate.

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CHRISTOPHER NIXON COX Managing Partner, OC Global Partners, LLC Chris is a managing partner at OC Global Partners, LLC, a New York City investment bank focusing on mergers and acquisitions and capital raising for private equity firms. In recent years, OC Global has advised a Fortune 50 company on a $20 billion acquisition, a sustainable PE fund on raising a $1.5 billion fund and a leading LED lighting company on raising $90 million. Prior to founding OC Global in 2006, he was an associate at the New York City law firm of Weil, Gotshal & Manges. Chris has made numerous appearances on Fox News, BBC, the Today Show and WABC radio commenting on politics and public policy. A graduate of New York University Law School and Princeton University, Chris is the grandson of the 37th President of the United States, Richard M. Nixon.

RAJ FERNANDO CEO & Founder, Chopper Trading, LLC Raj is chief executive officer of Chopper Trading, a Chicago-based trading firm he founded in 2002. Prior to Chopper, he held a variety of trading positions at both the Chicago Mercantile Exchange and the Chicago Board of Trade, where he worked on the floor from 1996-2003 and has been a member since 1997. He serves on the Board of Directors for the American Security Project. In addition, Raj is an active participant with the National Democratic Institute and their international pursuits; most notably with their Egyptian Election Mission in November 2011. An advocate for a broad range of philanthropic efforts in Chicago and across the country, he is a governing member of the Chicago Symphony Orchestra and a member of the Chicago Council on Global Affairs. Raj graduated from Beloit College in Beloit, Wisconsin, with bachelor’s degrees in economics and history.

TINA FLOURNOY Executive Assistant to the President, American Federation of Teachers As executive assistant to the President at the American Federation of Teachers, Tina has more than 30 years of experience in management, government relations, and legislative matters in both the private and public sectors. She has held legal and political positions with the Democratic Party, including serving as the head of Governor Howard Dean’s Democratic National Committee transition team, traveling chief of staff to 2002 Democratic vice presidential nominee, Senator Joseph Lieberman, finance director for the Gore 2000 Presidential Campaign, deputy to the campaign manager in the 1996 Clinton-Gore Campaign, and chief counsel in both the White House Office of Presidential Personnel and the 1992 Clinton-Gore Presidential Transition Office. Tina earned her juris doctorate at Georgetown University Law Center in 1984. She graduated from Georgetown University in 1978 with a bachelor’s degree in American Studies. In 2011, Secretary of State Hillary Clinton appointed her as Commissioner of the United States National Commission for UNESCO.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 30 DELEGATION BIOS

ERNEST GREEN Managing Partner, Matrix Advisory As a managing partner of Matrix Advisory, Ernest works to finance the needs of states, cities, municipalities, and government authorities through public-private partnerships. Prior to Matrix Advisory, Ernest was a managing director of Public Finance for Lehman Brothers’ (now Barclays capital), has served as Assistant Secretary of Labor for Employment and Training during the Carter Administration, and serves as chairman of the Historically Black Colleges and Universities Capital Financing Advisory Board and of the African Development Foundation. Following the 1954 U.S. Supreme Court Decision in Brown v. Board of Education declaring segregation illegal, Ernest and eight other black students were the first to integrate Central High School in his hometown of Little Rock, Arkansas. Ernest received a Bachelor of Science degree in social science and a master’s degree in sociology from Michigan State University, and honorary doctorates from Michigan State University, Tougaloo College, and Central State University. He was presented with the “Congressional Gold Medal” by President Clinton in 1999 for his bravery during the inauguration of Little Rock Central High School in 1957.

GABRIEL GUERRA-MONDRAGON President, Guerra Associates As the head of Guerra and Associates, a New York-based international consulting firm, Ambassador Gabriel Guerra-Mondragón advises U.S. companies that want to pursue business in Latin America and the Caribbean, and vice versa, and advises foreign governments on which U.S. firms they should link with in order to advance mutual interests. In 2001, he was appointed by President Barack Obama to the J. William Fulbright Foreign Scholarship Board. Previously, he served as United States Ambassador to Chile during the Clinton Administration, as President of TKC International, Inc., an international government relations firm in Washington, D.C, and as a U.S. foreign service officer at the U.S. State Department. He was also Special Assistant to the U.S. Ambassador to Mexico and afterward, Political Officer at the U.S. Embassy in Mexico. Ambassador Guerra-Mondragón was born in San Juan, Puerto Rico. He attended Fordham University, the school of Advanced International Studies at the Johns Hopkins University, and the University of Puerto Rico Law School.

JOE KIANI Chairman & CEO, Masimo Corporation As the founder, chairman, and chief executive officer of Masimo Corporation, a global medical technology innovator credited with revolutionizing pulse oximetry and noninvasive patient monitoring, Joe Kiani has been a beacon for patient safety and innovation in healthcare for more than 20 years. Under his leadership, Masimo has grown from a “garage start up” into a successful publicly traded company, employing more than 2,000 people worldwide. Since 1989, Joe and Masimo have helped to solve the “unsolvable” problems plaguing patient monitoring while building a substantial intellectual property portfolio with more than 575 issued and pending patents worldwide. In 2010, Joe created the Masimo Foundation for Ethics, Innovation and Competition in Healthcare to encourage and promote activities, programs, and research opportunities that improve patient safety and deliver advanced healthcare worldwide—fostering access to innovative medical solutions for those who may not otherwise benefit from their lifesaving capabilities.

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JONATHAN ORSZAG Senior Managing Director, Compass Lexecon, LLC Jonathan Orszag is a senior managing director and member of the Executive Committee of Compass Lexecon, LLC, an economic consulting firm. Prior to entering the private sector, Jon served as the Assistant to the U.S. Secretary of Commerce and Director of the Office of Policy and Strategic Planning and as an Economic Policy Advisor on President Clinton’s National Economic Council. He also serves as a Senior Fellow at the Center for American Progress and a Fellow at the University of Southern California’s Center for Communication Law & Policy. He is a member of the board of directors of JMP Group, Inc.; a member of the board of governors of the Tiger Woods Foundation; and a member of the Ambassadors Council for Grassroots Soccer, which uses soccer to educate, inspire, and mobilize communities to stop the spread of HIV. Jon received a Master of Science degree from Oxford University, which he attended as a Marshall Scholar. He graduated summa cum laude in economics from Princeton University.

CHRISTOPHER RUDDY President & CEO, Newsmax Media Christopher Ruddy is a noted journalist and entrepreneur. He currently serves as chief executive officer and president of Newsmax Media, one of the nation’s leading news media companies. In 1998, Chris founded Newsmax Media, a multimedia publishing company that publishes online and offline content in the fields of news, politics, health, and finance. Newsmax.com is consistently ranked as one of the country’s most visited news websites. Chris is a member of the board of directors of the Financial Publishers Association and the American Swiss Foundation. Chris holds a Bachelor of Art degree in History and graduated summa cum laude from St. John’s University in New York, and a master’s degree in public policy from the London School of Economics. He has also served as a Media Fellow at the Hoover Institution on War, Revolution and Peace at Stanford University.

KIM SAMUEL-JOHNSON Chair & President, The Samuel Family Foundation Kim is President of The Samuel Family Foundation, which actively engages in a number of collaborative partnerships directed toward global poverty alleviation, global environmental sustainability and conservation, youth empowerment, human rights advocacy, preservation of traditional arts and wisdom, disability rights and family support. She conducts research, writes and lectures on the subject of isolation as a critical experiential and measurable component of multi-dimensional poverty, human dignity and human rights struggles everywhere. Kim serves as Chair of the External Advisory Board of the Yale Center for Environmental Law and Policy, founding member of the Global Philanthropists Circle; Policy Advisor to the Oxford Poverty and Human Development Initiative; Director of Synergos Institute, Quincy Jones Music Consortium, and the Temenos Academy; Member of the Dean’s Council of Harvard Kennedy School, Africa Advisory Committee of Human Rights Watch, Chairman’s Council of Conservation International and Advisory Board Member of Fair Trade USA and TakingItGlobal. She also serves as Owner and Director of The Samuel Group of Companies, her family’s business founded in 1855, which comprises a network of operations across North America, engaged in the processing, manufacturing and distribution of steel and other metals.

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BARBARA J. SEZNA A Washington, D.C. native, Barbara attended Marquette University in Milwaukee, Wisconsin, for undergraduate and graduate school. She holds a Master of Science degree in speech and language pathology. She has worked in Special Education in both the public school system and in private consulting, teaching children with speech and language delays.

DAVIS G. SEZNA President, La Quinta Resort & PGA West Davis joined Pyramid Hotel Group as President of La Quinta Resort & Spa and PGA West in October 2007. In addition to his position as President of La Quinta Resort & Spa and PGA West, Davis’ mission for Pyramid is to assist in the development, implementation and operation of PHG destination golf resorts. He has over 30 years in the hospitality management industry, developing, owning and operating restaurants, golf courses, and resorts. In 1997, Davis founded Tandem Hospitality, which consults with private clubs, hotels, and resorts. He has assisted world-class clubs and destination golf resorts such as Merion Golf Club, Winged Foot Golf Club, Oakmont Golf Club, Aronomink Golf Club, Pine Needles, and The Cloister at Sea Island Resort & Spa. Davis is especially proud to be hosting President Clinton’s annual Humana Challenge, voted Sports Illustrated’s 2012 Sporting Event of the Year, at La Quinta Resort and PGA West.

EVA STRUVING International Charity Director, United Postcode Lotteries Born and raised in the Netherlands, Eva graduated from the Fashion Institute of Technology and then started her career in public relations at a textile company, later joining Ketchum Public Relations. In 1991, she joined Novamedia, the founder and operator of 5 charity lotteries in the Netherlands, the UK, and Sweden, as their International Project Manager. After serving as Head of Communications and Head of Charities, Eva was appointed in 2001 to her current position as the Concern Director International and Charities of Novamedia. Eva was responsible for the acquisition of BingoLotto (Swedish televised charity lottery) and subsequently the establishment of the Swedish Postcode Lottery in 2005. Her current portfolio includes the Swedish organization, new applications of lottery licenses, international cooperation across the Novamedia Concern, as well as relation management with international charities such as WWF, Red Cross and Unicef. She is a Trustee of the People’s Postcode Trust in the UK and was recently appointed as Board member of the Foundation Future for Nature.

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NIMA TAGHAVI Chairman, Solutions 2 Go, LLC Nima is the founder and current chairman of Solutions 2 Go, LLC (S2G), a distributor of video game hardware, software and accessories. Prior to establishing S2G in 2009, he served as chief executive officer of Crave Entertainment Group (CEG). By 2005, CEG had become the largest privately held video game company in the United States; late in 2005, CEG was sold to The Handleman Company and Nima continued on as CEO for CEG and assisted with the transition of CEG to The Handleman Company through the end of 2006. During his tenure as the chief executive officer of CEG, Nima was honored as a regional finalist for Ernst & Young’s Annual “Entrepreneur of the Year” award on three separate occasions. In 2005, Nima formed the Taghavi & Ghazi Foundation, a nonprofit public benefit corporation in an effort to share his good fortune with others via various charitable organizations.

CECILIA PICÓN TORRES Co-Chair, Torres Picón Foundation Born in Merida, Venezuela, Cecilia is a journalist who has acted as Editor and Publisher for several women-focused publications, including “Mujer- Mujer”, a magazine which she founded and ran for several years. She is a strong supporter of women’s rights and has begun to focus her efforts on promoting gender equality and stopping violence against women in all its forms. Cecilia is currently a member of the Board of Trustees of the José Limón Dance Foundation.

PEDRO JOSÉ TORRES Co-Chair, Torres Picón Foundation Pedro was born in Caracas, Venezuela. At a young age, he inherited a portfolio of real estate assets which he grew into a large and diversified enterprise spanning finance, real estate, consulting and other businesses. Pedro is a strong supporter of many initiatives related to the reestablishment of democracy in Venezuela, his home country. He is currently a member of the Board of Trustees of the Brooklyn Academy of Music. Since 2009, Pedro and Cecilia have been living in New York City where they co-founded the Torres Picón Foundation to considerably expand their family’s philanthropic activities in education, entrepreneurship, racial and gender equality, and economic empowerment. The Foundation’s activities are mainly focused on Latin America, but it also contributes to projects elsewhere at the discretion of the Board.

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PEDRO TORRES PICÓN Director, Torres Picón Foundation Pedro is an entrepreneur and angel investor from Latin America, based in New York City. He has been actively investing in early stage technology companies for the past eight years and has made over 40 investments in various areas such as: real estate, construction management, digital and out of home advertising, home maintenance, mobile commerce and several others. In 2010 he created Quotidian Ventures, an early stage Venture Capital firm where he serves as Managing Director. In addition to his investment activities, Pedro sits on the Board of Directors of the Torres Picón Foundation, the philanthropic vehicle for the Torres Picón family which supports social projects in education, entrepreneurship, racial and gender equality, and economic empowerment. The Foundation is mainly focused on Latin America but also contributes to projects elsewhere at the discretion of the Board.

RUMI VERJEE Founder, Rumi Foundation Rumi is a highly successful entrepreneur and the proprietor and chairman of Thomas Goode & Co, based in London’s Mayfair. He founded Domino’s Pizza in the United Kingdom and is the Chairman of Brompton Capital Limited and Ipanema Properties in Brazil. His success is entirely self-made: a fourth-generation Indian born in Uganda, much of the Verjee family’s assets were seized by Idi Amin’s regime. Rumi studied law at Downing College, University of Cambridge where he is now an Honorary Fellow, and after the expulsion of the Asian population from Uganda, made the UK his home. He has always shared his success and knowledge through philanthropic work. He is a Member of the Young Presidents’ Organization, a member of the Advisory Board of the British Olympic Association, and in 2009 was awarded the Commander of the Order of the British Empire (CBE) for charitable services.

JEFFREY WRIGHT Founder/Chairman, Taia Lion Resources/Taia Peace Foundation A critically acclaimed actor and winner of Tony, AFI, Emmy, and Golden Globe awards, Jeffrey has appeared on Broadway in such plays asAngels in America, Topdog/Underdog, and A Free Man of Color and in such films as Basquiat, Angels in America, Syriana, Shaft, Broken Flowers, Casino Royale and Ides of March. Later this year, he’ll be seen on film in Broken City and A Single Shot. He is founder and Vice Chairman of Taia Lion Resources, a mineral exploration company currently operating in Sierra Leone, and co-founder and Chairman of Taia Peace Foundation, Taia Lion Resources’ not-for-profit social development arm, which focuses on building a replicable model for extractives that focuses equally on mineral rights and human rights. Jeffrey earned a Bachelor of Arts degree in political science from Amherst College in 1987 and, in 2004, received an Honorary Doctorate of Humane Letters from his alma mater. He serves on the board of directors of Resolve, the Tribeca Film Institute and on the Governing Board of St. Albans School for Boys. He is also a member of the advisory board to the United Nations Democracy Fund for 2012-2013, and, in 2011, he was made an honorary Paramount Chief of Penguia Chiefdom, Sierra Leone.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 35 FOUNDATION STAFF

VALERIE ALEXANDER DR. ROGER BAND DENNIS CHENG Director of Marketing President Clinton’s Doctor Director of Development and Communications and Philanthropy

JUSTIN COOPER JON DAVIDSON AMI DESAI Special Assistant Trip Director Foreign Policy Adviser to President Clinton to President Clinton

OMAR FAROUL COREY GANSSLEY JULIANNA GUARIGLIA Helpdesk Engineer Assistant Director Special Assistant to of Scheduling the CEO of CHAI

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BARBARA KINNEY BRUCE LINDSEY BARI LURIE Photographer Chief Executive Officer Chief of Staff to Chelsea Clinton

IRA C. MAGAZINER MATT MCKENNA JACK REYNOLDS Vice Chairman and Spokesperson for Videographer Chief Executive Officer of the President Clinton Clinton Health Access Initiative

HANNAH RICHERT HELEN ROBINSON Senior Advisor and Assistant Director of Administration to President Clinton

CLINTON FOUNDATION BRIEFING: AFRICA 2012 37 CLINTON FOUNDATION BRIEFING: AFRICA 2012 38 AFRICA – A CONTINENT READY TO FULFILL ITS POTENTIAL

BY PRESIDENT BILL CLINTON June 27, 2012 London Evening Standard

We are living in the most interdependent time in history. The evidence is all around us. Wealth and talent now cross borders that are more like nets than walls but so do less positive forces. The financial crisis that started in the United States and swept the globe proved just how deeply our social and economic fates are intertwined — we can’t escape each other any more. The good news is that we have more power than ever to build a world of shared values and shared opportunities — and nowhere is this clearer than in Africa. During my first term as President, when we started looking at ways to support Africa and to build stronger partnerships, it was apparent to me and to my Secretary of Commerce, Ron Brown, that while aid — including debt relief — was important and necessary it would never be enough. So we tried to fashion a policy in which aid, trade and investment could reinforce one another, and in the process build the capacity of our friends in Africa to grow and develop on their own. Behind all of this was the idea that if prosperity were shared more broadly, Africa and the US would both benefit. So 12 years later, where are we? Thanks in part to policies in the US and internationally that linked trade initiatives and debt relief to good government practices, six of the 10 fastest growing economies are in Africa. The average life expectancy in Sub-Saharan Africa is five years higher, the extreme poverty rate has declined sharply, and the increase in African exports to the US alone has helped create hundreds of thousands of jobs that support millions of people. A lot of the work I do now with my foundation is based on the idea that while intelligence and hard work are evenly spread throughout the world, opportunity is not. Basic systems that you and I take for granted just aren’t available in many of the places we work; either the government can’t provide these services or the average person can’t afford to buy them from the private sector, and consequently there’s no market. So like many non- governmental organizations in the 21st century, we spend much of our time trying to fill that gap. One example is the work we do with smallholder farmers in Africa to help them become self-sufficient in agriculture so they can preserve their culture and their right to farm the land. We found that many of the farmers live in remote rural areas without a working transportation system — there aren’t any good roads, and even if there were, most people still couldn’t afford an animal-driven cart much less motor-driven transport. These farmers, even when they have a successful crop,spend half their income just to get the food to market. So we help these farmers overcome their lack of strong systems by giving them good seeds and fertiliser, and by getting their crops to market. We’ve seen dramatic boosts in both production and income. One individual we worked with — a widow with one child — increased her income fivefold and was able to send her son to school for the first time. Technology is also playing an increasing role in providing the systems poor countries need. In 2010, a UN report said that the emergence of wireless technology as a common medium has done more to lift people out of poverty than any other technological advance in history. In the poorest countries in the world, every 10 per cent increase in cellphone penetration tends to add almost one percent a year to GDP growth. One of the members of the Clinton Global Initiative started a company which allows people in Africa to use their cellphones to text a code to see if their medication is counterfeit or not — addressing a huge problem in Sub-Saharan Africa. Around the world, cell phones are being used for banking, helping refugees find lost relatives, and allowing small producers such as fishermen find the prevailing market prices for commodities. When governments, businesses, and non-governmental organizations work together to share expertise and forge creative solutions, everyone can win, not only the people in developing nations but also the corporations and philanthropists involved, by diversifying their businesses, growing their markets, training more potential workers, and, for NGOs, expanding their impact. That’s why I’m grateful to the British Government for maintaining its foreign development assistance even in these difficult times.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 39 This model of creative co-operation also works in well-developed nations in need of reform. The major constraints on growth are instability and inequality. The threat of global warming clouds our future. Constant conflict and a “winner-take-all” philosophy may work in politics, but in the real world success will come, sooner or later, to those who pursue inclusive societies of shared responsibilities and shared prosperity through networks for creative co-operation.

CHARITY NEEDS CAPITALISM TO SOLVE THE WORLD’S PROBLEMS

BY PRESIDENT BILL CLINTON January 20, 2012 Financial Times

Charity alone will not solve the world’s problems. Capitalism can help and at the same time put people back to work. There has always been a gap between what the government can provide and what the private sector can produce, a gap charities have long helped to fill. But as our world and economies evolve, we have an opportunity and a responsibility to reconsider how to fill this gap – to rethink the relationship between economic and social challenges, so that benefits and opportunities are available to more people. First, this rethinking is necessary because people are demanding it. From Zuccotti Park to Tahrir Square, people are standing up and saying that for too many citizens the current systems are not working. Second, the financial crisis has made plain that the path we were on was unstable and unsustainable. While our global economic system has brought benefits to many, it has also exacerbated inequalities, both within and among countries. Too much inequality not only hurts the poor and stifles the dreams of the middle class, it also hinders productivity and growth. Finally, our increasing interdependence strengthens the link between our prosperity at home and prosperity abroad. It is hard to sell things people cannot afford to buy. Also, economic privation breeds political resentment with all its costly consequences. We therefore have a vital stake in the fates of others – a stake that extends beyond compassion to political stability and economic security. How do we change course, to merge social and economic progress? Haiti offers us some lessons. Earlier this month, when I travelled there to mark the second anniversary of its devastating earthquake, I could feel a palpable change in the country. Much of this has to do with the focus and drive of the new government. But a lot of it is also due to the approach of Haiti’s friends and partners – an approach driven more by empowering people and communities than by imposing external solutions. My good friend Denis O’Brien and the Digicel Group not only employs 70,000 Haitians, they also rebuilt the famed 19th-century Iron Market bazaar, one of the capital’s landmarks, to create jobs for others, and give charitably to education to ensure that there will be a better educated, more employable workforce. Another example from Haiti is an innovative fund set up by the Carlos Slim Foundation and Frank Giustra to invest in entrepreneurs – giving them a hand up, not a handout. We are starting to see the success of this new approach in other countries and sectors as well, in the approach of the Bill and Melinda Gates Foundation, in companies such as Walmart, Google and Procter & Gamble that have shifted their corporate culture from promoting social responsibility to increasing shared value. This is the lesson that we learnt while working to solve the Aids crisis, when the pharmaceutical industry moved from being a low-volume, high-margin business to a low-margin, high-volume one with guaranteed payments. Today, this system is providing millions of people around the world with lifesaving HIV/Aids treatments at much lower costs while also improving the profitability of the companies involved. Similar lessons were learnt from our work with farmers in Africa: by helping them access the fertilisers, seeds and markets they need, we could provide them with a fundamentally more sustainable way to lift their families from poverty than we could ever hope to achieve through traditional charity. The lessons of this work and the benefits of boosting productivity are clear.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 40 The common thread through all this evidence is that private wealth can effectively advance the public good when governments, businesses and non-governmental organizations work together to share expertise and implement lasting solutions. When our bottom line is more about strengthening the future than maintaining the present, and when our financial interests are aligned with our social ones, we will be closer to the kind of world we want all our children to live in. One of the ways in which I have been trying to support the work of leaders around the world as they rethink our approaches to global problems is via the vigorous discussions and diverse commitments that are generated through our Clinton Global Initiative. To date, members of CGI have made more than 2,100 commitments that have already improved, or are now helping, the lives of nearly 400m people in 180 countries. Many of these commitments reflect the new approach to problem-solving by better aligning the interests and objectives of private corporations, governments and non-governmental organizations. Beyond their specifics, the goal of these projects is to work ourselves out of a job – not to generate perpetual aid dependence. These efforts benefit both the communities they target and the corporations and philanthropists involved, diversifying their businesses, expanding their markets, training more potential workers and helping to create a culture of prosperity. All this enhances profits, increases economic inclusion and gives more people a stake in a shared future. Because of these developments, and in spite of current economic conditions, I am hopeful for the future. The problems we face are solvable: we have the means. What we need is innovation, imagination and commitment. The most effective global citizens will be those who succeed in merging their business and philanthropic missions to build a future of shared prosperity and shared responsibility.

CLINTON FOUNDATION BRIEFING: AFRICA 2012 41 The Clinton Foundation works to improve global health, strengthen economies, promote healthier childhoods, and protect the environment by fostering partnerships among governments, businesses, nongovernmental organizations, and private citizens—leveraging their expertise, resources, and passions—to turn good intentions CLINTONFOUNDATION.ORG into measurable results.