VULNERABLE POPULATIONS: INTERNATIONAL COMMUNITY RESPONSIBILITIES

Humanitarian Symposium Proceedings October 31, 2005

World Meteorological Organization Geneva, Switzerland TABLE OF CONTENTS

VULNERABLE POPULATIONS: INTERNATIONAL COMMUNITY RESPONSIBILITIES

EXECUTIVE SUMMARY 7

OPENING COMMENTS Steven M. Hilton, President, CEO and Chairman, Conrad N. Hilton Foundation 14

Ralph Begleiter, Distinguished Journalist in Residence, University of Delaware; 15 former CNN World Affairs Correspondent—Symposium Moderator

Martine Brunschwig Graf, President of the State Council of the Republic and 17 Canton of Geneva

SYMPOSIUM KEYNOTE ADDRESS

“International Cooperation in 2005: Half Full or Half Empty Glass?” 18 Ernesto Zedillo, Ph.D., former President of Mexico and Director, Center for the Study of Globalization and Professor in the Field of International Economics and Politics at Yale University Q & A 22

MORNING SESSION: DELIVERING A FUTURE THROUGH THE MILLENNIUM DEVELOPMENT GOALS

“Gender and the Millennium Development Goals” 24 Mayra Buvinic, Sector Director, Gender, Development, Poverty; World Bank

“Reaching the MDGs for Water and Sanitation: Targeting the Poorest and Most Vulnerable” 26 Vanessa Tobin, Chief of Water, Environment/Sanitation Section; UNICEF

“Injecting pace and rhythm to the Millennium Development Goals” Jim Yong Kim, M.D., Ph.D., Director, HIV/AIDS Department, World 28 Health Organization Q & A 31 LIVE VIDEOCONFERENCE Jeffrey D. Sachs, Ph.D., Director, The Earth Institute at Columbia University and 34 Special Advisor to the UN Secretary-General on the Millennium Development Goals Q & A 40

“The Millennium Challenge Account and the Millennium Development Goals” 42 Richard Morford, Managing Director, Millennium Challenge Corporation

“Harnessing the Positive Potential of the Private Sector” 45 Ambassador John Maresca, President, Business Humanitarian Forum Q & A 49 AFTERNOON SESSION – OPENING COMMENTS

Pierre Muller, Administrative Councillor and member of the Executive Council, 53 City of Geneva.

AFTERNOON SESSION – ASSURING A FUTURE FOR THREATENED POPULATIONS

“Responsibility to Protect: The End of Ambiguity?” 54 Louise Arbour, LL.L., United Nations High Commissioner for Human Rights

“When Theory Meets the Janjaweed” 56 Colin Thomas-Jensen, International Crisis Group, Africa Program “From Rwanda to Darfur: The Past Repeating the Present?” 59 Paul Rusesabagina, Founder, Hotel Rwanda Rusesabagina Foundation

“Sudan — A Nation in Turbulence in Search of Itself” 61 Francis M. Deng, Ph.D., J.S.D., Former UN Representative on Internally Displaced Persons; Former Ambassador from Sudan to U.S., Canada and Scandinavian Countries

“Why is Gender still not on the Peace and Security Agenda in Africa?” 64 Bineta Diop, Executive Director, Femmes Africa Solidarité

“Ending Wars Against Children” 66 Olara Otunnu, Former UN Special Representative for Children & Armed Confl ict; Former UN Ambassador from Uganda

“North Korea: An Unseen, but Vulnerable Population” 70 Melvin L. Cheatham, M.D., FACS, Samaritan’s Purse Q & A 73

CONRAD N. HILTON HUMANITARIAN PRIZE PRESENTATION 81

Welcoming Remarks Walter Fust, Director-General, Swiss Agency for Development and Cooperation 83

Keynote Address 84 Paul Rusesabagina, Founder, Hotel Rwanda Rusesabagina Foundation

Acceptance Speech 91 Dr. Paul Farmer, Founding Director, Partners In Health

LIST OF SYMPOSIUM ATTENDEES 95 Vulnerable Populations: International Community Responsibilities Executive Summary of the Symposium

“…I identify myself with those who propose that international cooperation, while certainly important for ethical, altruistic, and humanitarian reasons, is also critical for attaining the strict self-interest of the parties that happen to be more on the giving side of the cooperation equation. Any person whose own well-being is connected in one way or another to the well-being of people in other countries, close or far away, will fi nd that cooperation to address common challenges is in his or her own best interest. This has been the case for a long time, but never to the extent that it is now. Whether we like it or not — and I believe it’s a very good thing — interdependence among the peoples and the countries of the world has reached an unprecedented degree in human history….We must accept that war, confl ict and terrorism; extreme poverty and social polarization; fi nancial instability and trade wars; global pandemics; and abrupt climate change are risks to all, and therefore collective action to address them is indispensable.”

—Ernesto Zedillo, Ph.D., Former President of Mexico and Director, Center for the Study of Globalization and Professor in the Field of International Economics and Politics at Yale University

This international symposium in Geneva was hosted by the Conrad N. Hilton Foundation in conjunction with the tenth annual presentation of the Conrad N. Hilton Humanitarian Prize. The 2005 Hilton Prize was awarded to Partners In Health at a dinner following the day-long gathering. Paul Rusesabagina, former manager of the Mille Collines hotel in Kigali, Rwanda, whose heroic story was featured in the movie, Hotel Rwanda, was the keynote speaker at the Prize ceremony. Partners In Health is an American-based organization dedicated to providing high quality medical services to impoverished people and communities throughout the world. For 25 years it has been providing health care and training to the poorest members of society, from Haiti to Peru, Russia and Rwanda, while transforming beliefs and practices of the world’s health care establishment.

“Vulnerable Populations: International Community Responsibilities” brought together 193 participants — leaders, policymakers and activists in the fi elds of humanitarianism and human rights. They represented governments, non-governmental organizations (NGOs), foundations, corporations, multilateral institutions, and the media.

Ernesto Zedillo set the theme for the day in his keynote address “International Cooperation in 2005,” responding to his own question: Is the glass half full or half empty?

The year 2005 was a critical one for measuring accomplishments in peace and security, development and trade, Zedillo said. As planned, the world’s heads of state came together at the United Nations in a summit to assess the fi v e-year progress of the Millennium Development Goals (MDGs) adopted in 2000; the Hong Kong Ministerial Meeting was scheduled for December to attempt to move the mostly failed Doha Round of trade talks further; the conference for the Parties to the Climate Change Convention was also scheduled for December in Montreal; the UN was grappling with a serious reform agenda that included taking on the restructuring of the Security Council. To those challenging scheduled events, as was noted throughout the day, came the natural catastrophes of the Asian tsunami, the Kashmir earthquake, and the unnatural, ungodly events of Darfur, terrorist acts and ongoing confl icts. Heading toward the end of 2005, a year full of so much promise, Zedillo declared the glass one-third full, two-thirds empty—saying success in Hong Kong and Montreal could raise it to one-half.

The symposium was divided into two sessions, with the Millennium Development Goals providing the framework for the morning discussion; followed by a closer look at situations involving vulnerable populations, specifi cally minorities, women, and children who suffer from abuse by their oppressors—often their countrymen—and inadequate protection from the international community.

7 The sessions included the following topics:

MORNING SESSION –DELIVERING A FUTURE THROUGH THE MILLENNIUM DEVELOPMENT GOALS • Gender and the Millennium Development Goals • Reaching the MDGs for Water and Sanitation: Targeting the Poorest and Most Vulnerable • Injecting Pace and Rhythm to the Millennium Development Goals • Millennium Challenge Account and the Millennium Development Goals • Harnessing the Positive Potential of the Private Sector

VIDEOCONFERENCE • Jeffrey Sachs, Special Advisor to UN Secretary-General on Millennium Development Goals

AFTERNOON SESSION – ASSURING A FUTURE FOR THREATENED POPULATIONS • Responsibility to Protect: The End of Ambiguity • When Theory Meets the Janjaweed • From Rwanda to Darfur: The Past Repeating the Present? • Sudan – A Nation in Turbulence in Search of Itself. • Why is Gender Still Not on the Peace and Security Agenda in Africa? • Ending Wars Against Children • North Korea: An Unseen, but Vulnerable Population

Steve Hilton welcomed participants, wishing them a productive day and reiterating the day’s focus: “Today we discuss vulnerable populations, those threatened by extreme poverty, disease, violence, war and confl ict, discrimination and oppression. But we focus not so much on their plight as on their resilience—what we can and must do to help them claim their future. We have a set of goals to guide our actions and our discussion today—the Millennium Development Goals. In 2000 the United Nations adopted a set of eight practical goals to be reached by 2015. They are attainable if only we will all—governments, organizations, agencies, individuals—make the commitment and work together.”

It had been seven years since The Conrad N. Hilton Foundation held its fi rst humanitarian symposium on the eve of the Millennium and looked toward it with the theme “Humanitarian Aid: Challenges in the New Millennium,” aware already that the post-Cold War era was shaping itself into something different. By 2000, the Foundation came to Geneva, the city of humanitarianism and internationalism, to host “From Confl ict: to Peace, Justice and Reconciliation.” By then, people acknowledged that increasing globalization did not mean increasing similarity, but increasing diversity, divisions, clashes and needs. There was also increasing awareness, and this presented both challenges and opportunities.

The foundation returned to Geneva to mark the 10th anniversary of the Prize in 2005. If anything was clear, it is that we are decidedly on the other side of the Millennium now. We are living in a world that has seen such cataclysmic events in the past few years that at times the receding memory of the 20th century seems rosy by comparison—this for the century that coined the word “genocide” and then saw it repeated in the Balkans and yet again in Rwanda. There was no humanitarian symposium in 2001, scheduled for September in New York and cancelled by terrorism. The threat, and frequent realization of terrorism is now our constant companion, especially to those who engage in humanitarian work. And now come natural disasters of a magnitude that seems more properly the domain of blockbuster movies but are all too real. At the same time, of course, we have brought the problems of the 20th Century with us into this new world, and genocide, the threat of nuclear annihilation, poverty and the widening gap between rich and poor, are all of part of our shrinking, interdependent world and time.

If the Hilton gatherings are any indicator, the humanitarian community is a resilient one. The very globalization and technology that have brought us so uncomfortably close and interdependent provide us a way out. It will cost,

8 but the international community has the means and the ability to do it. If we will rise to the occasion, summon our political will, commit our resources, and use our common sense, we can achieve the millennium goals, and go beyond them. The symposium participants have been rising to the occasion and if anything they left seeming renewed in their resolve.

The symposium speakers covered a wide range of issues, but in their presentations and the remarks of participants in the audience, several themes kept emerging:

The debate about sovereignty versus international responsibility is over, but the resistance to it is not, and the reluctance to follow through continues. Just a few years ago, whether or not the international community had responsibilities to vulnerable communities was a subject of debate—especially since a growing number of situations involved abuses of a population within sovereign countries. Just as the argument that domestic violence is a family matter has been dismissed, so has the claim that the international community has no business intervening in a sovereign state when violations of vulnerable groups are occurring. Yet many sovereign states resist, even reject, this concept and fi ght its application elsewhere lest it be used later against their state’s actions in the future. And many in the international community, especially other states, are reluctant to acknowledge severe abuses are occurring in other states, because it would require a response on their part. Olara Otunnu described this reluctance in situations of genocide: “We have said before, “Never again” after the Holocaust in Europe, and “Never again” after massacres of children and women in the Balkans, and “Never again” after the genocide in Rwanda, but each time this has been after the fact.”

The lines between pragmatism and altruism are blurring. Perhaps because of globalization and the pace of events, people are coming to regard humanitarian action as a pragmatic response to crises brought on by confl ict and nature and conditions bred by poverty and injustice. Moral responses are not discounted or rejected, but lofty ideals of justice and compassion are being overshadowed by an international community increasingly acting out of a sense that its own survival is at stake. The shift refl ects an urgent, healthy awareness that one must act out of self-interest. Not to act invites real peril that will reach us sooner rather than later. No one expressed this more directly than keynote speaker, Ernesto Zedillo: “For people in the rich world, elementary self-interest is at stake. In the global village, someone else’s poverty very soon becomes one’s own problem.”

The goals of the MDGs are achievable and we probably won’t achieve them. Several speakers criticized the goals for their limitations, especially the lack of specifi c targets and dates. Yet all considered them important, not only for their ultimate value but for the light they shed on problems, and the impetus they can give nations and the international community to mobilize and plan. Progress has been made along the way, but not of a scale necessary to reach the goals by 2015, and not universally. What is missing is political will, commitment, resources and innovation.

The world has the means to go much further than the Millennium Development Goals. For all of the frustration and doubt expressed in reaching the goals, the participants clearly believed the international community, governments, donors, and practitioners, could do much more. Jeffrey Sachs put it most forcefully: “The Millennium Development Goals are but a halfway station to the goals that we really should have. Our generation, if we put our mind to it, can banish extreme poverty entirely. We have 20 years in which we could put an end to the killer conditions of famine, of chronic hunger, massive under-nutrition, killer disease pandemics that continue to ravage our planet. It is within our means, with the modest effort of less than one percent of the income of the rich world, to rid the world of extreme poverty, and to make it secure for us all.”

9 MORNING SESSION SUMMARY – DELIVERING A FUTURE THROUGH THE MILLENNIUM DEVELOPMENT GOALS

Millennium Development Goals One: Eradicate extreme poverty and hunger Two: Achieve universal primary education Three: Promote gender equality and empower women Four: Reduce child mortality Five: Improve maternal health Six: Combat HIV/AIDS, malaria, and other diseases Seven: Ensure environmental sustainability Eight: Develop a global partnership for development

In 2000, the member states of the United Nations adopted the Millennium Development Goals as a set of shared international objectives whose achievement they determined to be both important and feasible. In September 2005, a UN World Summit of heads of state assessed progress towards their achievement by 2015, or ever. As did the world leaders in September, the panelists at the Hilton symposium in Geneva agreed none of the goals were likely to be met within the time frame set, and in some cases, at least parts of the world were falling behind. Nevertheless, all of the goals could be met, but it will take political will and commitment, investment of resources, a setting of interim targets and dates, a resetting of overall target dates, and some new innovative approaches to get the job done. The consensus was that the international community of organizations and the general public must create the demand and political pressure necessary. Also, the global partnership for development that is envisioned must include the private sector—its expertise and resources, especially its capital, are needed to create the economic growth that will eradicate poverty on a sustaining basis rather than charitable infusions of cash.

Overview of the Millennium Development Goals Jeffrey Sachs, Director, The Earth Institute at Columbia University, and Director of the United Nations Millennium Project

The MDGs are the only shared international objectives we have concerning extreme poverty, disease and hunger. They are achievable, but the necessary follow-through is lacking. We need careful diagnoses of the conditions that are preventing people from escaping poverty and its consequences and that are impeding progress in some parts of the world. The stereotypes are getting it wrong: It can’t be globalization per se; trade per se; corruption per se; mismanagement per se. The rich and powerful often blame the poor themselves; the poor and their champions often blame the IMF, the World Bank, and other monetary policies. The evidence rejects all of these explanations. The correlations are not there. One explanation for the relative progress in Asia and stagnation in Africa is the Green Revolution of superior technology for growing grains that increased yields, freed people from famine, allowed for agricultural diversifi cation and non-agricultural activity in Asia. Only recently has similar technology been developed to suit African seed varieties. Africa has also been impeded by its dependence on rain- fed agriculture rather than irrigation, and lack of infrastructure to support transportation to and from the interior.

Rural, sub-tropical sub-Saharan Africa needs its Green Revolution. It needs both government and the private sector to make the right, practical investments. The know-how and technology are there to make it happen. Suffi cient money is not yet there. It is time to mobilize whatever kind of help—public, private, individual, foundation—it will take. And time to stop blaming the poor and start working with them.

(Note: Jeffrey Sachs spoke from New York via a two-way videoconference)

Gender and the Millennium Development Goals. In pursuit of Goal Three, countries agreed, in 2000, to set of target of eliminating gender disparity in primary and secondary education by 2005 and at all leve1s by 2015. The goal is important in and of itself, but also is of instrumental value to the success of the other goals. Educated women are empowered and have a positive impact on health, leading to reduction of child mortality and improved

10 maternal health. Their empowerment also serves as a deterrent to the spread of HIV/AIDS, enabling them to better negotiate their sexual relationships. They also are in a better position to contribute to the economy and help reduce poverty. While there has been progress in education, with some countries achieving parity in primary education, in general achieving parity in education is unlikely, as are prospects for the health goals and poverty reduction.

Reaching the MDGs for Water and Sanitation: Targeting the Poorest and Most Vulnerable. One of the targets of Goal Seven is to reduce by one-half the proportion of people without sustainable access to safe drinking water. While it is true that 82% of developing countries have improved access, only 42% of the people have access to a household tap. In many countries, success is defi ned as access within one kilometer. The statistics for sanitation are worse. And yet, WHO estimates that more than 80% of diseases in the developing world are caused by contaminated water and poor sanitation. All this at a time when water is becoming scarce worldwide. And rural to urban migration continues, demanding that the pace increase in the next few “make-or-break” years.” In addition to resources, innovative and collaborative approaches will be needed.

Injecting Pace and Rhythm to the Millennium Development Goals. If the goals are to be met, it is necessary to inject pace and rhythm into our response. Targets need to be set, not just for the long range, but for next week, next month. At WHO a target was set for Goal Six: reach three million people for HIV/AIDS treatment by 2005. WHO took a risk. The goal will not be met, but it is likely that it will be met by the end of 2006—an extraordinary achievement. More than 50 countries followed WHO’s lead and set targets. Against great odds, the targets are transforming the morale of health workers, giving them hope; transforming the attitude of the public; increasing willingness to be tested; and to some extent, changing behavior. Targets are critical but they must be time-limited and provide vision, focus, pace and rhythm, so that they change the way things are done next week. Set bold targets and do what it takes to reach them.

Millennium Challenge Account and the Millennium Development Goals. The Millennium Challenge Corporation (MCC) is funded by the U.S. Congress to eliminate poverty and promote economic growth through long-term economic development. It was not set up to provide a humanitarian response to emergencies; it does not help fragile, failed states; and it was not established to support the Millennium Development Goals. Nevertheless, if the MCA is about anything, it is about poverty reduction, the number one MDG. The MCC seeks to work with countries that fi t three criteria—in governance, in willingness to invest in their people in terms of health and education, and in creating conditions that lead to economic freedom. Such countries are invited to take the lead by submitting proposals for funding that are assessed on three questions: Does it reduce poverty? Does it increase growth? Is it broadly supported in the country? Directly or indirectly, invariably the proposals work toward the Millennium Development Goals.

Harnessing the Positive Potential of the Private Sector. The MDGs cannot be achieved without the engagement of the private sector—there is not enough international assistance funding available without it. The private sector has vast resources and it can be engaged, but it cannot be engaged against its interests. Its interests are in the direction of the MDGs. With the proper strategies the business community can be engaged to help local entrepreneurs who need equity partners and the know-how to fi nd them. They need help in writing a business plan, presenting their businesses, dealing with fi nancial institutions. Local entrepreneurs need fi nancing beyond micro-fi nance. To grow their businesses they need loans in the $100,000 to $1 million range. It is time for the donor community to get rid of their lingering hostility and suspicion of the business community and offer fi nancial incentives to private equity investors when they go to risky places where their investments are needed.

11 AFTERNOON SESSION SUMMARY – ASSURING A FUTURE FOR THREATENED POPULATIONS

In the post-Cold War era, the regional and civil confl icts have been numerous, savage and have transformed the nature of war to one of war against civilians where terror, torture, humiliation and abuse are weapons of choice. The world has come a long way in confronting this new reality—on paper—redefi ning responsibilities, criminalizing abuses, establishing institutions, structures, laws and protocols to deal with them. Theory and reality have yet to come together however. The crucial test, implementing these agreements and taking action, is yet to come. It will take constant demand, pressure, monitoring and interaction on the part of the international community and the media on member states and international bodies to make it happen.

Responsibility to Protect: The End of Ambiguity. The UN World Summit in 2005 produced an Outcome Document that may prove to be the roots of a legal revolution with repercussions in international law, politics and practice. The nations of the world agreed that it is the responsibility of states to protect their populations from genocide, crimes against humanity, ethnic cleansing and war crimes. This means they agreed to prevent such crimes including their incitement. If a nation fails to do so, it is the responsibility of the international community, through the United Nations, to intervene by using all peaceful means to protect the vulnerable group, and failing that, to be prepared to take collective action through the Security Council or other bodies. How this will be carried out is unknown, but that 191 nations agreed to the responsibility to protect and intervene signals a new era.

When Theory meets the Janjaweed. The World Summit Outcome Document of 2005 turned the concept of state sovereignty on its head, but theory and reality are not the same—Darfur in Sudan being a case in point. The government of Sudan does not protect and in theory it is the responsibility of the international community to do something about it. In fact, the atrocities continue. The veto structure of the Security Council and the necessity to build consensus, is one reason. The weakness of other likely respondents such as regional organizations—in this case the African Union—is another. And a third is the lack of political will. The international community passed the responsibility for Darfur to the African Union, overlooking the fact that it lacks the capacity to do the job, a fact that African policymakers refuse to admit. NATO assistance to the African Union could help, but, to date, all concerned are deaf to the suggestion. Possible remedies include a Code of Conduct to guide the Security Council; the international community and regional organizations must agree to work together, and political constituencies must hold policymakers accountable to act.

From Rwanda to Darfur: The Past Repeating the Present? In 1994 in Rwanda one million people, about 15 percent of the population, were slaughtered by their fellow citizens, at the rate of about 10,000 a day for 100 days. The whole word stood by, watched and did nothing. After the fact, several months later, the world, meeting at the Untied Nations, called it a genocide. In the upheavals and confl icts that followed and spilled over into the Congo region, another four million have been killed. And now there is Darfur. Two million displaced; militias armed by the government killing thousands and committing other atrocities. It is time to go beyond the governments to the people. African dictators depend on the support of the Western powers that support and maneuver them. Remove the support and the governments, factions, and people will be forced to come to the table and deal with each other for a real peace.

Sudan—A Nation in Turbulence in Search of Itself. Sudan is undergoing an acute crisis in identity—a common thread between the war that has concluded in the south, often considered to be the African south against the Arab- Islamic north, the current turmoil in Darfur, and the occasional outbursts in Nubia in the east. These wars are all about marginalization. Historically the north was assimilated into the Arab-Islamic world, and people began identifying themselves as Arabs, enjoying the status and privilege that being part of the ruling group gave them, regardless of their actual ethnicity. The south remained African, as did parts of the north under Arab-Islamic infl uence. The British came and ruled the south and north as one. In the tumultuous years that followed British departure, the idea of “secession” by the African south has given way to “transformation” to a country where there will be no more marginalization but unity. This is a clear case of state sovereignty, with the state bearing the responsibility to protect all its citizens.

12 Why is Gender Still Not on the Peace and Security Agenda in Africa? Confl icts in Africa now increasingly target civilians. Psychological warfare aimed at humiliating and terrorizing includes amputations, rape, torture and slavery, with women suffering in distinct ways because of their position in society. Women are even more vulnerable when they are internally displaced or refugees. Regardless of their victimization, women are needed in the peace processes in Africa, yet peace negotiations still seem to include just the ones holding the guns. Men become the negotiators and facilitators, and in the transitional government, it is the elites that share the power, leaving women out again. African women, seeking to change this, targeted the Organization of African Unity which later became the African Union. They succeeded in gaining gender parity on the commission, with fi ve men and fi ve women. A woman heads the Pan-Africa Parliament and a Protocol on Women’s Rights has been adopted. Now it is the African women’s struggle to bring the changes happening at the top level down to the grassroots level.

Ending Wars Against Children. The United Nations has succeeded in putting the protection of children in situations of confl ict onto the world’s agenda in a set of protocols, conventions and standards that apply to confl ict, and post-confl ict reconstruction, healing and rebuilding. But the gap between the formal agreements and their application is huge. To address this, the Security Council in July 2005 has endorsed a historic resolution identifying, naming and shaming— publicly and offi cially—offending parties who are abusing children; establishing a system of monitoring and reporting the conduct of parties of confl ict; from the community level to the national level. Time bound action plans will be required to address the violations and a standing committee of the Security Council will assure implementation. Without outside pressure on member states, none of this is assured. At the same time that these remedial systems are being put in place, genocide has been unfolding unimpeded in northern Uganda for 20 years. It is the worst place in the world to be a child. It is happening with the full knowledge of the international community, and it will be the fi rst test of the seriousness of that community to take on the newly defi ned “responsibility to protect.”

North Korea: An Unseen, but Vulnerable Population. The entire population of 22 million is vulnerable to the whims, neglect and abuse of a totalitarian regime. This secretive, isolated, closed society is home to people who are unseen and unheard to the outside world and whose suffering is usually unknown. A country of monuments, palaces and people in poverty, it is a place where the construction of show-off displays of pomp continued in the mid ’90s—a time when two million citizens were allowed to starve to death. Only when the crisis continued to worsen did it drop its façade just enough to let in humanitarian food aid. North Korea continues to be a great threat—of nuclear weapons, of massive migration of people fl eeing starvation, of continued dictatorship. It is a challenge to the good will and common sense of the international community which must continue constant diplomatic and humanitarian efforts.

13 Symposium Opening Comments

Steven M. Hilton, President, CEO and Chairman, Conrad N. Hilton Foundation

Steven Hilton has worked in the fi eld of philanthropy for more than 20 years and was appointed Chief Executive Offi cer of the Conrad N. Hilton Foundation in 2005. The grandson of hotel entrepreneur and founder, Conrad N. Hilton, he joined the foundation in 1983 and was named vice president in charge of programs in 1989. In this capacity, Hilton directed the foundation’s grantmaking activities and had primary oversight of programs for the multi-handicapped blind, mentally ill homeless, international water development, and early childhood development. Prior to joining the foundation, Hilton worked for fi ve years in hotel management in Alabama, Georgia and California with Hilton Hotels Corporation and was involved in aquaculture (fi sh farming) businesses. A graduate of the University of California at Santa Barbara, Hilton earned his Masters of Business Administration (MBA) degree from the University of California at Los Angeles (UCLA). Hilton serves on the boards of both the foundation and the Conrad N. Hilton Fund. In addition, Hilton is a board member of St. Joseph Center and Southern California Grantmakers.

It is a pleasure to welcome you today as we discuss “Vulnerable Populations: International Community Responsibilities.” And we hope to see you again this evening as we honor this year’s recipient of the Conrad N. Hilton Humanitarian Prize, Partners In Health.

We welcome you and, at the same time, thank the government of Switzerland, and the Canton and City of Geneva, for welcoming us back. On this, the tenth anniversary of the Hilton Humanitarian Prize, we have returned to this beautiful international city, a symbol of humanitarianism and globalization at its best.

Although the Hilton Foundation is an American-based organization, our mission is worldwide, as is the community of people, organizations and agencies represented here today. My grandfather, Conrad Hilton, would have been proud of this event and pleased to see it taking place in Geneva. He too was a humanitarian and an internationalist. Long before most Americans were even allowing themselves to dream of a trip abroad, my grandfather was building his hotels in Istanbul and Cairo. In this regard, he was a visionary. He took a leadership role in advocating for U.S. participation in the World Bank and International Monetary Fund, and was a strong supporter of the United Nation’s goals of world peace and economic prosperity.

“World Peace through International Trade and Travel” was more than a motto for his hotels. It was his fi rm belief. He was convinced that increased contact would bring increased understanding among peoples, ultimately leading to peace. At his death in 1979, he left virtually his entire fortune to the foundation he created in 1944 with the mandate that grants should be international as well as domestic since his fortune came from a worldwide hotel empire. Honoring his wishes, one-half of Hilton Foundation grants today support international programs without regard to territory, religion or ethnicity. Likewise, recipients of the Hilton Humanitarian Prize are headquartered in seven countries and serve all races, cultures and religions in every corner of the world.

The Hilton Foundation was founded to alleviate human suffering. At today’s symposium we discuss vulnerable populations, those threatened by extreme poverty, disease, violence, war and confl ict, discrimination and oppression. But we focus not so much on their plight as on their resilience—what we can and must do to help them claim their future. We have a set of goals to guide our actions and our discussion today—the Millennium Development Goals. In 2000 the United Nations adopted a set of eight practical goals to be reached by 2015. They are attainable if only we all—governments, organizations, agencies, individuals—make the commitment and work together. Hopefully, by coming together today, we can sharpen our focus and strengthen our resolve. It is a privilege to have you with us.

14 Ralph Begleiter, Distinguished Journalist in Residence, University of Delaware, and former CNN World Affairs Correspondent

Ralph Begleiter brings more than 30 years of broadcast journalism experience to his appointment at the University of Delaware, where he teaches communication, journalism, and political science. During his two decades with CNN, Begleiter was the network’s most widely traveled correspondent (having visited some 91 countries) and covered the U.S. State Department, hosted a global public affairs show, and co- anchored CNN’s prestigious “International Hour,” aired daily on CNN International. In 1998, Begleiter wrote and anchored a 24-part series on the Cold War. He covered many historic events of the 1980s and 1990s, including virtually every high-level Soviet/Russian-American meeting; the Persian Gulf Crisis in 1990 to 1991; the Dayton Bosnia Accords; Middle East peace efforts; and the aftermath of the assassination of Israeli Prime Minister Rabin. He has received numerous press awards including, in 1994, the Weintal Prize from Georgetown University’s Graduate School of Foreign Service, one of diplomatic reporting’s highest honors. Begleiter has moderated each of the previous Hilton humanitarian symposia.

Welcome to all of you. We’re in a wonderful location—not only the city, but also the building, which is wonderful. It’s really a pleasure to be back with all of you again this year and a real pleasure to return to Geneva itself. This year I think, more than any other since the Hilton Prize Foundation began holding these symposia, events around the world have unfolded coincidentally so close to our theme, which is “Vulnerable Populations: International Community Responsibilities.”

Humanitarian issues generally, and vulnerable populations in particular, erupted to the worldwide forefront of attention in 2005. In a few cases they were predictable; in other cases they were completely unpredictable. In Niger, crop failures last year were perfectly apparent to anyone who was paying attention, but when the United Nations fi rst asked for help late last year, almost no one responded. The crop failures and the food shortages there developed rapidly, and the UN cried out again last spring. Not a single pledge of aid was received. The G-8 did nothing about it at their summit in Europe. Suddenly, when the food crisis began appearing on international television in June and July, pledges of about 10 billion dollars emerged. In Sudan, the human rights crisis continues—the United States calls it genocide. It’s not a new problem: the UN is engaged, but hundreds of thousands of people have died and none of the world’s major powers is involved.

Some of the vulnerable population crises of 2005 were completely unexpected, but not unpredictable. These were natural disasters, which in some cases exacerbated already festering problems on the political side. And what a crop of them we had in the past year, beginning with the terrible tsunami spawned in the Indian Ocean last December, which wiped out low-lying areas around Indonesia. That disaster was so sudden and so awful that television caught on almost immediately, unlike the other situations I mentioned. The world sped to the rescue immediately. Just in the last couple of months, we’ve seen the ravages of the marriage of Katrina and Pontchartrain, a marriage which—embarrassingly—exposed not only the failure to heed the predicted fl ood and collapse of fl ood control systems, but also exposed the well-known vulnerable populations of the Gulf Coast in the United States to the rest of the world. Everyone in this room, I suspect, has experienced the warm glow of television lights which called attention to the populations of Aceh and New Orleans and helped generate mass relief operations in both cases. More recently even, the same phenomenon drew attention to the biblical scale of the earthquake disaster in Kashmir. But Kashmir is also an example of something else that everyone in this room is well aware of—how cold it gets when the TV lights swing around someplace else. Last week, the UN was once again reduced to pleading with the world not to turn away from Kashmir so quickly. Winter snows are upon the vulnerable populations caught in the political crossfi re between India and Pakistan, even as the earth continues to rattle beneath those people, and we all have an international responsibility.

15 Last year at this time, we were anticipating the results of the U.S. presidential election and soon after the Hilton symposium, the U.S. president was boasting about all the political capital he would be spending following the election. Today…well, let’s just say a lot can change in a year. It would be wrong, I think, not to take note of the successful series of steps toward democracy achieved in Iraq—the painful birth of a democratic-style constitution, including a democratic referendum that narrowly endorsed that document. But still uncertain in Iraq, very uncertain, are humanitarian questions about the future of Iraq’s ethnically and religiously divided people.

Tonight, we will celebrate the winner of the Hilton Humanitarian Prize, an uplifting moment that reminds us of the accomplishments of you, the humanitarian community. And we’ll hear from a man whose personal initiative turned him, somewhat by surprise, into an overnight, true humanitarian hero during the darkest moments of the genocide in Rwanda. But fi rst today, we’ve got an extraordinarily full day of exploration of the challenges of the world’s most vulnerable populations. This morning, as Steve mentioned, we’ll begin with overarching goals, those set by the United Nations for the world community. This afternoon, we’ll focus on a few key places— Sudan, Rwanda, North Korea—and a few key issues—children, women, and justice.

Five years ago, we convened here in Geneva for the fi rst time and it’s a great pleasure to be back. As Steve mentioned, this city has been known worldwide as a humanitarian headquarters, for decades. The UN and many other organizations have offi ces here and with very good reason. Without further ado, please welcome Madame Martine Brunschwig Graf, President of the State Council of the Republic and Canton of Geneva, one of our hosts, here in Geneva this year. Madame Brunschwig Graf is head of the Departments of Finance and Military Affairs.

16 Madame Martine Brunschwig Graf, President of the State Council of the Republic and Canton of Geneva

Mr. President of the foundation, dear members of the foundation board and jury, dear guests, ladies and gentlemen. We are very pleased that the Conrad Hilton Foundation chose to hold its symposium and the tenth Hilton Prize ceremony in our city. The concern of the foundation for the alleviation of human suffering all over the world is your concern and ours. The Hilton Foundation has been very generous and active in this fi eld since its creation more than 60 years ago. Millions have been distributed by the Foundation for charitable projects throughout the world. This is because alleviating the suffering of the world’s most disadvantaged is more than a huge task, as you very well know. Nowadays, there is a consensus regarding the necessity of achieving this objective.

The Millennium Declaration was adopted fi ve years ago, and the recent world summit held in New York has been an opportunity to renew the commitment of governments to achieve the Millennium Goals. The continuous renewals of commitment to reaching these goals are a source of hope and offer the best perspective of a better future for those who suffer, as we will discuss today. For now, the goals are supposed to be attained within a decade. There’s still a long way to go, and not an easy one. Some countries on the African continent are, unfortunately, far from achieving these goals, and many actions still have to be undertaken. Therefore, we want to encourage and congratulate you for all of your work and dedication. I will take this opportunity to single out Paul Rusesabagina, in particular, for his work in the Rwandan confl ict and to applaud his courage, which saved hundreds of lives.

As you know, Geneva has maintained a humanitarian tradition in promoting ideals which are essential to freedom, peace, democracy, development and alleviation of human suffering. Geneva is proud to continue to deliver its contribution as an international forum which offers opportunities for dialogue and fruitful meetings in these fi elds. Geneva is very keen to be one of the places where these challenges are addressed with the aim of preparing a better future for new generations. The name of Geneva and Switzerland is known all over the world. It is a name to which a feeling of peace, hope, and action is attached. May this feeling inspire your work. I want to conclude by renewing my thanks on behalf of the Government of Geneva for your humanitarian concern and wish you a very fruitful symposium.

Begleiter. Thank you, Madame Brunschwig Graf. We are all delighted to be back in your city. We begin our work this morning at the macro level of humanitarian issues with a progress update on the United Nations Millennium Development Goals—you will hear them referred to frequently today as the MDGs. I am pleased to introduce Ernesto Zedillo, former President of Mexico who now leads Yale University’s Center for the Study of Globalization. After President Zedillo’s six-year term in offi ce, he chaired a UN panel on fi nancing for development. He’s well equipped to survey the scene with us, because he served just last month as Secretary-General Kofi Annan’s special envoy for the UN Summit on the Millennium Development Goals that was held in New York.

17 Symposium Keynote Address

Ernesto Zedillo, Ph.D., Director, Center for the Study of Globalization, Yale University

Ernesto Zedillo is the Director of the Center for the Study of Globalization and professor in the Field of International Economics and Politics at Yale University. He was President of Mexico from December 1994 to December 2000. He earned his undergraduate degree at the National Polytechnic Institute of Mexico and his master and doctoral degrees at Yale University. After leaving offi ce, Mr. Zedillo became Chairman of the UN High Level Panel on Financing for Development and was a Distinguished Visiting Fellow at the London School of Economics. He served as Co-coordinator of the UN Millennium Project Task Force on Trade and was Co-chairman of the UN Commission on the Private Sector and Development along with Prime Minister Paul Martin of Canada. He is currently Chair of the Global Development Network and Co-chairman of the International Task Force on Global Public Goods. In April he was appointed by the UN Secretary-General to serve as his Envoy for the September 2005 Summit in which heads of state and government reviewed implementation of the Millennium Declaration. Mr. Zedillo is a member of the Trilateral Commission, serves on the International Advisory Board of the Council on Foreign Relations and the Board of Directors of the Institute for International Economics, and is a trustee of the World Economic Forum.

International Cooperation in 2005: Half Full or Half Empty Glass?

Madame President, Steve, ladies and gentlemen. Let me fi rst congratulate the Conrad Hilton Foundation for organizing this very interesting and timely symposium on a crucial aspect of international cooperation: the protection of vulnerable populations.

Other than my own work for the Mexican government, I am not an expert on this specifi c topic, but I am a deep believer in international cooperation. In fact, I identify myself with those who propose that international cooperation, while certainly important for ethical, altruistic, and humanitarian reasons, is also critical for attaining the strict self-interest of the parties that happen to be more on the giving side of the cooperation equation.

Any person whose own well-being is connected, in one way or another, to the well-being of people in other countries, close or far away, will fi nd that cooperation to address common challenges is in his or her own best interest. This has been the case for a long time, but never to the extent that it is now. Whether we like it or not—and I believe it is a very good thing—interdependence among the peoples and the countries of the world has reached an unprecedented degree in human history.

I have never tired of repeating what we said in the High-Level Panel on Financing for Development Report delivered to the UN Secretary-General in June of 2001. I quote myself: “For people in the rich world, elementary self-interest is at stake. In the global village, someone else’s poverty very soon becomes one’s own problem: lack of markets for one’s products, illegal immigration, pollution, contagious disease, insecurity, fanaticism, terrorism.”

More recently, the High-Level Panel on Threats, Challenges, and Change could not have said it better. “In the 21st century, more than ever before, no state can stand wholly alone. Collective strategies, collective institutions, and a sense of collective responsibility are indispensable. Today’s threats recognize no national boundaries, are connected, and must be addressed at the global and regional, as well as the national levels. No state, no matter how powerful, can, by its own efforts alone, make itself invulnerable to today’s threats. And it cannot be assumed that every state will always be able or willing to meet its responsibility to protect its own peoples and not harm its neighbors.” We must accept that war, confl ict and terrorism; extreme poverty and social polarization; fi nancial instability and trade wars; global pandemics; and abrupt climate change are risks to all, and therefore collective action to address them is indispensable.

18 Those of us who believe that international cooperation is a win-win situation wanted 2005 to be a year of great strides in the three key aspects of peace and security, development, and trade. Our ideal 2005 would have been one in which the now thick catalogue of good ideas to improve the system and the long journeys of negotiation and diplomacy endured in the previous months could have crystallized in a September World Summit that would have delivered serious agreements by world leaders to address Mr. Annan’s “In Larger Freedom” agenda — an agenda that I don’t have to repeat here because I am sure all of you are quite aware of it.

Needless to say, believers in international cooperation were also hopeful that great progress would be made to honor the commitments established in the Doha Declaration of 2001, with the aim of achieving a successful WTO ministerial conference in Hong Kong this December as a defi nite step to conclude a truly development-oriented Doha Round next year.

Well, the year is not over, but it is already possible, when speaking about international cooperation, to assess how close the real 2005 is proving to be to the ideal 2005 that I think we all wanted. Let me make a very brief review of how we are doing.

On aid for development, there is good but also bad news. The good news is the G-8 decision for 100% debt cancellation to highly indebted poor countries, while ensuring that the fi nancial capacity of the international fi nancial institutions is fully preserved. Also good news is the European Union’s commitment to reach a little more than 0.5 percent of its gross national income (GNI) in aid by 2010, with a view to achieving 0.7 percent of GNI by 2015, as stipulated at the Monterey Conference of 2002.

The bad news is that the biggest donor countries in absolute terms but the smallest in terms of their national income— the U.S. and Japan—have failed to commit additional aid resources, with the result that a large aid shortfall to fi n ance the Millennium Development Goals remains. As I am sure my friend Jeffrey Sachs will tell you later in the day, there is a very serious risk that most poor countries will continue to be off-track in achieving their Millennium Development Goals.

Disappointment is also to be found on the United Nations reform front. If not a total failure, the September summit did not deliver the needed results. Embracement of the responsibility-to-protect principle, which will be commented upon and discussed here later in the day, and the decision to create a Peace-Building Commission were the only two clear points on the score card. The agreement to create a Human Rights Council is still too shallow to make it real news. On terrorism, non-proliferation, and Security Council reform, it is better to acknowledge failure now rather than later, and open the space to start anew.

Frankly speaking, the United Nations has been left again without the proper means to perform the mission that its members mandate it to execute. The Security Council, for one thing, will continue to be the Gordian Knot that impedes the functioning of the international system in its most sensitive aspect: that of peace and security. Admittedly, the options on the table for Security Council reform, by solely focusing on the issues of enlargement, were inattentive to the problem of its effi ciency. Unfortunately, this was never the issue throughout negotiations. Sheer parochialism and a lack of visionary leadership from the key UN players were the real causes of failure.

Enlargement by itself would not have overcome the unpleasant verdict given by bargaining theory: veto gives high power; no veto gives nil, or very little, power. Whenever statesmanship fi nally prevails, reform must be attempted urgently simply on the grounds that the present arrangement is unsustainable.

I just hope that when the opportunity for real Security Council reform arrives, the possibility of deeper reform will not be dismissed again too soon. Enlargement alone will not bring together the Council’s resolutions, and, without better resolutions and their enforcement, the Security Council will not prove effective, and, without effectiveness, whatever legitimacy is provided at fi rst by enlargement will eventually be lost.

19 On trade, it is fair to say that the Doha negotiations have been a tale of failure to reach agreement on most issues on the agenda. It seems that countries came to these talks with the aim of creating loopholes to avoid obligations, rather than undertaking serious trade liberalization.

Regarding agriculture, the major stumbling block all along and a critical issue to support the aspirations of developing countries, trade negotiators have deadlocked on issues such as products to be exempted from reform, formulas to avoid effectively lowering tariffs, and opaque schemes to preserve subsidies. With rich countries unwilling to deliver farm reform, and developing countries remaining reluctant to open up their own markets, it is no surprise that progress is practically nil on the other topics under discussion.

Except for a few rare moments, the leadership needed to move the route forward has been absent. One of those rare moments occurred on October 10, when the United States fi nally broke apart from what I have called “the Alliance for Perpetual Agricultural Protectionism,” which the U.S. had sealed with the European Union (EU) in August of 2003. If not fl awless—for it contains a number of escape routes which could still allow for huge agricultural protection—the proposal for agricultural reform put forward by the United States Trade Representative did inject some life into the until-recently-practically-defunct Doha talks, and this has happened, unfortunately, just a few weeks before the Hong Kong Ministerial Meeting.

The jury is still out on whether this move by the U.S. government will not prove to have arrived too late to save, fi rst the Ministerial in Hong Kong, and next the whole Round. But at least it has led the EU representatives to recognize, albeit implicitly, what some of us have argued since the announcement of the Common Agricultural Policy reform and the publication of the EU-U.S. farm proposal in 2003. What we have been saying is that the European proposals were designed to avoid signifi cant changes in relative prices, production levels, and effective support to its most protected and distorted agricultural products. The 2003 European offers were, in climate change terminology, pure hot air. With the U.S. initiative, and now the proposal tabled by the European commissioners just last Friday, the talks just got where they should have been well before the Cancun meeting of 2003, had the original Doha work program been punctually observed.

The task to be completed before the Hong Kong meeting—due to take place in December—if the Ministerial is going to succeed, is truly Herculean. Now that the U.S. and the EU proposals are fi nally on the table, the real negotiations must begin. Other countries interested in farm trade reform must now step strongly into the negotiations. The American and European offers must fi rst have their “hot air” defl ated. It is technically possible, and I say this as a trade economist, that a combination of the American and European proposals could result in a regime which could still leave world trade in farm products highly distorted for a long time, and deny agriculturally competitive countries the access they rightly demand to reach other countries’ markets. We would also have to take into account the Japanese and other rich countries like Switzerland’s pretense of keeping their barriers on what they call “sensitive” products untouched. I think this would be disastrous for developing countries.

Of course, a good agreement on agriculture alone, if possible at all, will not in itself provide a happy ending. Poor developing countries—which are yet to acquire a capacity to export agricultural products, and that could have their trade preferences and fi scal revenues eroded as a result of the Round—must be brought on board. A good Doha outcome requires that poor countries be supported in generating the sources of revenue needed to compensate for losses incurred as a result of lowering import duties, building the human and physical infrastructure they need to benefi t from increased market opportunities and adjusting to erosions of existing trade preferences that result from multilateral negotiations.

As argued in the Trade for Development Report of the Millennium Project, greatly increased international technical and fi nancial support for reform and adjustment by developing countries is needed to ensure achievement of the trade liberalization targets. A temporary “aid for trade” fund commensurate with the size of the task, or signifi cantly ramped- up contributions through existing channels are needed to support countries in addressing adjustment costs associated with the implementation of a Doha reform agenda.

20 Once the rich countries get really serious about opening their farm markets and agree to support poor countries in doing likewise, developing countries will have to become more ambitious reformers at the Doha Round. It would be very unfortunate if the defensive position exhibited by developing countries so far were to prevail through the end of the Round, considering that in most cases the biggest gains from trade liberalization come from a country’s own trade liberalization.

Tariff reductions primarily benefi t the country undertaking them. The costs of protection are paid for by the domestic economy—by its households which pay more for the goods and services they consume, and by its fi rms which pay more for the protected goods they use (consume) as inputs. Protection creates a bias against exports by raising the costs of inputs; that is, protection on imports reduces the competitiveness of exports. It distorts the allocation of resources in the domestic economy, encouraging investment in the most protected sectors—not the most potentially effi cient ones. In sum, protection creates an unfriendly environment for implementing development and poverty reduction strategies.

While trade in goods, and particularly agriculture, commands the most attention on the Doha agenda, the potential gains from successful services liberalization may be much larger—by a factor of fi ve by some estimates. Signifi cant barriers remain, particularly in areas of great interest to developing countries, such as the movement of natural persons to supply services under Mode 4 of the GATS (General Agreement on Trade in Services).

Developing countries must not ignore, on the other hand, that services are fundamental for development, in terms of both the effi ciency and growth potential of the economy as a whole, as well as access to basic services to improve the lives of the poor. Done right, services negotiations offer developing countries an opportunity to act in their own economic interest and get paid for it.

Dear friends, ladies and gentlemen, we can now say with all confi dence that 2005 was not the “dream year” of international cooperation that would have resulted if only the country members of the international community, particularly the rich and powerful, would have acted as I have argued in their own enlightened, long-term interests. Various precious opportunities to make a leap forward have been wasted.

Nevertheless, can we speak of an empty 2005? Not really. As of today I would suggest that the glass is one-third full and two-thirds empty. A good Hong Kong outcome that would put the Doha Round on track for a successful conclusion would lead me to speak without hesitation about a glass half-full, which is not that bad after all, considering all the animosity and bashing that the multilateral system—particularly the United Nations organization—has endured in recent times. But whatever happens in Hong Kong—and actually also in Montreal at the end of November when the Conference of the Parties to the Climate Change Convention takes place—must not lead us to retreat in our demands for stronger international cooperation. 2006 will be another good long year to keep pushing. Thank you very much.

21 Symposium Keynote—Question and Answer Session

Begleiter. We have a few minutes for questions for President Zedillo. I’m going to ask you one fi rst to get started. You had a litany of the glass being two-thirds empty, and Europeans being full of hot air—Americans too full of hot air—you said the September Summit was not a total failure, which is a slightly veiled way of saying it was pretty close to a total failure. But look at the rich and powerful nations you referred to in their current political situations and give us a thumbnail of whether you think that Japan and the United States, particularly, are in positions to make the kinds of commitments in 2006 that you think are necessary. Are they in a political position to be able to do that?

Zedillo. If rich countries act in their own self-interest, not only in 2006 but in any year, they should be willing to enhance their participation in the international system. I know that in the U.S., in Europe, and in other rich countries, local politics tend to dominate national and international politics and this is very unfortunate, because it runs against the interests of those countries when a local constituency, a small constituency—like the cotton lobby in the U.S. or the sugar lobby in Europe—dominates, overwhelms the interests of the majority of the population. The question will always be whether political leadership will have the stature and the statesmanship to overcome these circumstances. I don’t know whether it will happen, but we are on this side of the table and I think our obligation is to keep putting pressure.

Q. Daly Belgasmi, World Food Program. Thank you, Mr. President. During your excellent presentation you referred to the Doha agenda. This is also an opportunity to remind all the participants that food aid has been and is still in negotiations, under which traders are looking to discuss new disciplines, hopefully in favor of the implementation of one of the most important MDG goals: to halve chronic malnutrition by 2015. In the last fi ve years, food aid has dropped from around $11 million to $7.4 million. 852 million people are suffering today from chronic malnutrition, 24,000 die per day and traders are talking about life and death without taking into account one of the most important millennium goals: to halve chronic malnutrition. Thank you very much.

Zedillo. Maybe you were not very explicit about your concern, which is very legitimate: countries are demanding a stop to the dumping of agricultural products in world markets and this might have, in some cases, an unintended consequence on the availability of some food aid provided by countries like the United States. Some people have said you have to be clever enough to meet the two objectives. On the one hand, I think it is highly desirable to stop this dumping of agricultural products that is creating great damage, particularly in poor countries, which have lost their capacity to produce agricultural products because of the effect, among other things, of this protectionism and this dumping of agricultural products. And on the other hand, you have to continue support for food aid, and what has been said is that it should be given in the form of economic resources and not through this agricultural dumping. So yes, we have a dilemma and a solution must be found, but I think it is important that dumping of agricultural products is not allowed.

Q. Susan Crowley, Merck, Sharp & Dohme Inc. I’d like to respectfully pose a question to President Zedillo regarding his observation about commitments to overseas development assistance by the U.S. versus other rich nations. I would suggest that offi cial overseas development assistance is not a full measure of a nation’s generosity, and, in the case of the U.S., private overseas giving—by entities such as the Hilton Foundation and my own company, the Merck company’s foundation, and other forms of private remittances abroad—actually accounts for more than our offi cial overseas development assistance. That is often not taken into account, and it is really the measure that should be looked at. Thank you.

Zedillo. I think private contributions are very important, very useful. They do make an enormous difference in the world, but when countries and governments speak about these issues they are speaking about offi cial development assistance (ODA). When the Millennium Development Goals were fi rst offi cially discussed and agreed upon at

22 the Millennium Summit in September 2000, and then further specifi cs were proposed at the Monterey Conference, it was agreed that in order to achieve the Millennium Development Goals, ODA would eventually have to reach 0.7 percent of the Gross National Income (GNI). I think the two issues have to be separated. Nobody is saying that the United States as a nation is not generous, because we have these important private contributions. What is being discussed is the government—the contributions that are channeled through government. Despite signifi cant increases that have been provided since 2002, the U.S. is still, relatively speaking, the smallest contributor to offi cial development assistance. That is a fact, and I don’t think the consequences of this fact should be tempered by another fact, which is that there are very important and very generous private contributions coming from American citizens, which is also the case in Europe where there is a huge amount of resources being channeled through civil society organizations.

Begleiter. You are now teaching in the United States. Presumably now, and you’ve probably known this for a long time, you’ve discovered that if you ask most Americans about American aid abroad, their perception of what American aid is abroad is exaggerated by comparison with actual U.S. contributions abroad. What can you do or what do you think should be done to try to educate the citizens of the U.S. to recognize the actual percentage of its contributions?

Zedillo. When we published the Financing for Development report, one of the proposals was to create a sort of awareness campaign in the U.S. and in other rich countries about two aspects. One, the importance of giving aid from a strictly self-interested position, which we believe is the case, and second, how little, relative to the national wealth and income, is now given away. However, we stipulated that this campaign could not be an offi cial campaign. Some people asked why we did not have the United Nations leading this campaign, but that would not have credibility. What we would like to see is altruistic organizations getting together and spearheading this kind of campaign, so this gives me a great opportunity to express that wish. Perhaps organizations like the Conrad Hilton Foundation, linked to other altruistic organizations, could spearhead a campaign like this, to explain to the American people—speaking of the U.S.—why ODA is not just a nice thing to do for altruistic reasons, but that it is also in the national strategic interests of the United States to be more engaged in supporting the development of other countries. I wish this idea could one day crystallize.

Begleiter. There is your fi rst recommendation from the fi rst panelist of this group. Now we are going to take a closer look at three specifi c areas of the Millennium Development Goals: women, water, and HIV/AIDS.

23 MORNING SESSION SUMMARY – DELIVERING A FUTURE THROUGH THE MILLENNIUM DEVELOPMENT GOALS

Mayra Buvinic, Sector Director for Gender and Development, World Bank

Mayra Buvinic is Sector Director for Gender and Development, PREM Network (Poverty Reduction Economic Management), World Bank. Between 1996 and 2004 she was Division Chief for Social Development at the Inter-American Development Bank (IDB), where she oversaw work on the social sectors, including health, urban development, labor markets, early childhood development, social inclusion and violence prevention, and both the Women in Development Unit and the Indigenous Peoples Unit. Prior to working at the IDB, Ms. Buvinic was a founding member and President of the International Center for Research on Women (1978-2004). She is past President of the Association for Women’s Rights in Development (AWID) and member of a number of non-profi t boards, including the International Water Management Institute, Sri Lanka, and the International Institute of Tropical Agriculture, Nigeria. A Chilean national, her published works are in the areas of gender, poverty and development; health and reproductive health; violence prevention; social inclusion and social cohesion; and project and program evaluations.

Gender and the Millennium Development Goals

First let me tell you what a great pleasure it is to be here in the city of Geneva with the Hilton Foundation and honoring Partners In Health. I’m going to talk about Goal Three of the MDGs, and for those of you not familiar with the MDGs, you have a booklet and it has a list of the eight goals. Goal Three is to “promote gender equality and empower women,” and the target for this goal, which all the countries agreed to in 2000, is to eliminate gender disparity in primary and secondary education by 2005, and at all levels at least by 2015. First, I will talk briefl y about why this goal is important to our future; second, where we are in achieving it; and third, what else needs to be done.

First: why is it important? Goal Three has intrinsic importance—it is good, obviously, for everybody to empower women—but it also has instrumental value, and this I want to expand. The fate of most of the other goals actually depends on achieving Goal Three. Two hundred thousand children under fi ve die of disease, and 10,000 women die giving birth every week in developing countries. Educating and empowering women, Goal Three, leads to educated and empowered women who do not die giving birth, or die less often in childbirth. As you will see, Goal Five is improving maternal health, so Goal Three is directly related to Goal Five. Further, educated and empowered women have children who do not die, and, in fact, another goal—Goal Four—is reducing childhood mortality.

Further, educated and empowered women and adolescent girls tend not to contract HIV/AIDS, and HIV/AIDS is another of the Millennium Development Goals. Nowadays, 68% of those infected with HIV/AIDS in sub-Saharan Africa in the 15 to 24 age group are female. It used to be the case that everybody thought that HIV/AIDS was a male disease. Many of us in the women’s movement already in the early 1990s were telling the health community that this was not the case, and to exercise caution. Well, as you know, they did not, and today the HIV/AIDS epidemic is becoming feminized, to a large measure because of the powerlessness that women and adolescents have in negotiating sexual relationships.

The other and less obvious instrumental reason for empowering women is that empowering women and educating women is central to economic growth and poverty reduction. Poverty reduction is Goal Number One and the most important goal. You must all know by now that growth is a principal deterrent of poverty. We can do a lot, but if countries do not grow, it is very hard to cut back on poverty. In fact, and this is something that few people know, women are critical to promoting shared growth. There is emerging evidence from studies sponsored by the World Bank that shows, for instance, that in India, states with greater gender equality, in terms of women’s participation in the labor force, are also the fastest growing states in India, and those where growth is more effective in reducing 24 poverty. In sub-Saharan Africa, if you give women farmers the same access to agricultural inputs and agricultural machinery that men farmers have, agricultural output would increase by 20%. In Latin America and the Caribbean, a study that we carried out when I was at the Inter-American Development Bank shows that the impact of domestic violence on women’s earnings translates into a reduction in GDP growth in two countries of around one to two percent In the region where this study was carried out, the GDP average growth of these countries was one or two percent per year, so if they really had cut back on domestic violence, this would have had a signifi cant impact on these countries’ GDP growth. So, the instrumental argument is that investing in women is really investing in the Millennium Development Goals.

Now, the second question: where are we in terms of achieving the gender equality Millennium Development Goal? There has been progress, and the gender gap in primary education rates has gone from an 18% difference between girls and boys in 1990 to a 10% difference in 2003. Some countries, notably in Africa, have doubled the number of girls in primary school in this period. For instance, Guinea, Benin and also Bangladesh, Morocco, Nepal, and Yemen have all achieved that. However, overall, gender parity has not been achieved by 2005—and the goal was to achieve gender parity in primary and secondary schooling by 2005. That goal was not achieved, and the prospects for achieving this goal for all levels of education, particularly tertiary education, by 2015 are bleak. In fact, by 2015 if we go at the pace we’re going now, only 10% of developing countries will have parity between girls and boys in tertiary education. Furthermore, it is very unlikely that the health goals in this declaration will be achieved by 2015. And third: even if some of the Millennium Development Goals are achieved, that does not mean that all women will benefi t. The Millennium Development Goals are average goals, and achieving parity in averages may still leave many, many women behind. This is particularly a problem in the middle-income countries, like Latin American and other middle-income countries, when in fact you can have reached the goal but you will have poor women, minority women, ethnic women, black women that are still going to be far behind.

So now what do we need to do? What will it take to empower women, to expand their ability to make informed choices? We really know what needs to be done and we have to scale up all the things we are doing. The Millennium Development Goals had a task force on women, which determined seven strategic priorities. I’m not going to name all of them, but just let me name two important ones. One is property and inheritance; the other one is employment. President Zedillo was talking of trade and liberalizing services; this should be an important avenue to increase women’s employment. We need two things to scale up implementation. First we need high-level leadership and political commitment. Without high-level leadership and political commitment in the international community, scaling up will not happen. The United Nations, furthermore, should set a new date for the failed target of gender parity in 2005 and move it to 2007 or 2008 and, hopefully, through rational arguments, if not persuasion and shame, convince countries that they really need to invest in women to meet the MDGs.

The second and last thing that I will say is that aside from leadership and commitment, we need fi n ancial resources. We were talking here today about offi cial development assistance. Actually, offi cial development assistance in 2003 in total U.S. dollars was $69 billion. Of this $69 billion, roughly only $2.3 billion went to women and girls, so we are talking about only 3.6 percent of all offi cial development assistance. I have just come from a meeting in Bangkok where a study was presented—a recent survey of foundations and private-sector organizations giving to women—and the proportion of money going to girls and women from foundations and private-sector organizations is 7% of all funds available, and women’s organizations are reporting that in the last fi ve years these amounts of money have been substantially cut back.

So, dedicated fi nancial resources are needed to fulfi ll the Millennium Development Goals, and they are important, because under-investment in women is under-investment in the future of all of us. Thank you.

25 Vanessa J. Tobin, Chief of Water, Environment and Sanitation Section, UNICEF

Chief of the Water, Environment and Sanitation (WES) Section of UNICEF since May 2001, Vanessa Tobin has enjoyed 25 years of successful service and visionary leadership in international development. A national of the United Kingdom, Ms. Tobin obtained a BSc. in civil engineering from Birmingham University in the UK and a M.Sc. in Public Health from the London School of Hygiene and Tropical Medicine. She earned a Master of Public Administration degree from Harvard University in 1999. In her seventeen years of service to UNICEF, Ms. Tobin has been stationed in Nepal, Pakistan, Egypt and New York. Prior to her appointment as Chief of the WES Section, Ms. Tobin served two years as Senior Adviser for the Health Section in New York. Before joining UNICEF, Ms. Tobin was a civil engineer for the British Government, working as a sanitary engineer in the UK and in Nepal; served as a consultant for the NGO ACORD in Southern Sudan and as a Technical Cooperation Offi cer for the British Government (DfID) in Lesotho.

Reaching the MDGs for Water and Sanitation: Targeting the Poorest and Most Vulnerable

I would like to thank the Conrad Hilton Foundation for inviting me here today to talk regarding an area which is a focus for the foundation itself. I would like to touch on three areas with regard to water supply and sanitation: fi rst, a quick snapshot of the situation with respect to the Millennium Development Goals; second, a look at emerging trends that will make the task more diffi cult but must be addressed if we are to reach the goals; and third, a few guiding principles in going forward to take this challenge up in a sustainable way.

The Millennium Declaration, as very well described this morning, commits governments around the world to a clear agenda for combating poverty, hunger, illiteracy, disease, discrimination against women and environmental degradation. However, we are now a third of the way to reaching the end year of 2015 and many of the goals are not on target to be achieved. Target 10 of Goal Seven is to reduce by one-half the proportion of people without sustainable access to safe drinking water and basic sanitation. A recent assessment of progress towards the MDGs produced mixed results.

Approximately 1.1 billion people do not have access to any type of approved drinking water facility. Coverage trends indicate that the world is likely to achieve the Millennium Development Goal for water, except for sub-Saharan Africa unless a concerted effort is made. And let us not forget that although 83% of the developing countries have access to an improved drinking water source, only 42% of fortunate people have access to a household connection or a yard tap. In many countries, the defi nition of access is an improved water source within a distance of one kilometer, with a quantity of 20 liters per person per day. And we still have the challenge of ensuring that the water provided is safe, since in many developing countries there is still insuffi cient attention given to regular water quality monitoring and improvement measures. Most probably, there are an additional one billion people who lack access to safe water, free from both microbial and chemical contamination.

There are 2.6 billion people, nearly half the world’s population, without access to sanitation. With 10 years to go when the proportion of people in the world not served with basic sanitation is supposed to have been halved, the world is still lagging far behind the progress needed to reach the MDG. Even if the MDGs are met in full by 2015, we still have 850 million people without water and 1.85 billion without sanitation.

Such basic and essential services are obviously of integral importance for the survival and development of children. Every 15 seconds, a child dies from a disease related to unclean water and lack of sanitation. There are billions of cases of diarrheal diseases, and that burden, both physically and economically, upon children and upon mothers is enormous. More than 80% of diseases in the developing world, according to WHO, are caused by contaminated

26 water and poor sanitation, and millions more children are suffering from parasitic worm infections, which obviously impacts on malnutrition and anemia and ability to learn. A recent cost benefi t by WHO showed that with every dollar spent on water, we can save between three and 34 dollars in terms of the energy, time savings, and the economic benefi ts that will accrue. Total offi cial development assistance to the sector is approximately $3 billion per year—less than half what is required, with the bulk going to Middle Eastern countries, while only 12% goes to those countries in which less than 60% of people have access to improved water sources. Obviously, the focus on sub-Saharan Africa is not on track in terms of achievement of either water supply or sanitation. A clean environment at home and in schools will support the battle on HIV and AIDS. In Africa, the lack of access to basic water and sanitation services is the norm, and poor basic personal and food hygiene practices exacerbate the situation. Home water treatment using simple technologies is a cost-effective way of reducing water-related diseases for HIV-affected households and can be adopted immediately in the homes of poor families. Poor families also need water for a range of small-scale productive activities—for livestock, vegetable gardens and various small businesses.

So what are the critical trends and what do we have to consider in order to go forward? We obviously have to consider the growing scarcity of water. While we are planning for water supply and sanitation services, we must consider the ever-increasing competition for water that affects the poor the most—scarcity at local levels, which causes confl ict within households, within communities and between water-scarce countries. Obviously, any plan in terms of water supply and sanitation has to take into account the broader perspective in terms of water resources management. Emergencies are becoming increasingly complex. There’s been a fi ve-fold increase in emergencies in the past fi ve years. Now one in four children in the world are living within a confl ict situation and, as we can see in the South Asian earthquake, this demonstrates the growing importance of a more rapid response and improved coordination on behalf of the donor community and all partners involved in relief efforts.

Lastly, the rural to urban migration obviously has to be considered: by 2025, urban populations in developing countries will have doubled over today’s fi gures. This means that six out of every 10 children will live in urban areas, and sanitation and water programs have to gear up to keep pace with these shifting and growing populations. In terms of guiding principles that can help us in moving forward on behalf of the United Nations, my own agency UNICEF, and the donor community in general, we have to go beyond rhetoric if we are really going to take these goals more seriously, and the next fi ve years are the “make-or-break” years in terms of their achievement. Talking about a rights- based approach in programming really means nothing if we’re just considering the right to life, but not the right to develop it; the right to an adequate standard of living; and the right to health, which supports the decentralization processes to achieve these goals.

My colleague talked about bridging the gender divide. Women should not simply be participating, but have to be involved in the decision-making processes if we are really going to take it forward and do something about the statistics that were just quoted a few minutes ago. The pro-poor approaches—meeting the rights of the poor to basic services— are at the heart of the mission. Advocacy for the rights of the poor; the development of approved poverty-specifi c approaches; improved monitoring and mapping to identify where the populations that we need to target are located to ensure that the programs are designed using the best available information and knowledge, and that advocacy is based on rigorously analyzed evidence. And, lastly, working closely with partners, innovation is still exceptionally important. We have to promote moving forward on innovation and leveraging resources to approaches that are proven to work. But we cannot stagnate merely in terms of the status quo, in terms of the approaches that we know, that we’ve tried and tested—we have to go forward on innovation. Obviously my own agency works with a number of agencies, foundations, development banks, civil society organizations. The complexity of working within water and sanitation is that integrating those interventions with health and other interventions needs strategic program approaches. Working alone is not an option. The decade of Water for Life was launched by the UN in New York in March. The decade calls for a commitment to action in order to halve the goal. However, this present decade will repeat the mistakes of the past if development aid is not restructured, targeting populations most in need in a way that decreases dependency, builds capacity and continuously interacts with communities to support their development efforts to better themselves. Thank you.

27 Jim Yong Kim, M.D., Ph.D., Director, HIV/AIDS Department, World Health Organization

Jim Yong Kim, Director of the HIV/AIDS Department of the World Health Organization (WHO), is a physician-anthropologist and Founding Trustee of Partners In Health (PIH), a Harvard University-affi liated non-profi t organization that supports health projects in poor communities in Peru, Mexico, Guatemala, Haiti, Russia, and the U.S. Dr. Kim is on leave from his position as Associate Professor of Medicine and Medical Anthropology and Director of the Program in Infectious Disease and Social Change at Harvard Medical School. He has also served as Chief of the Division of Social Medicine and Health Inequalities at Brigham and Women’s Hospital, Boston prior to joining WHO. He was the founding chairperson of the Green Light Committee for second-line tuberculosis drugs and also served as chairperson of the WHO Working Group on DOTS-plus for multidrug-resistant tuberculosis. His edited volume, “Dying for Growth: Global Inequality and the Health of the Poor,” examines the socioeconomic forces that impact health outcomes of the poor throughout the world. Dr. Kim was a recipient of the 2003 MacArthur “genius” fellowship and was a contributing editor for the World Health Report 2003 and the World Health Report 2004.

Injecting Pace and Rhythm to the Millennium Development Goals

Thank you very much. I just want to make some very simple points so that we can get on with what is surely to be an outstanding discussion. I’m sure you’ve heard it again and again: are we on track to reach the Millennium Development Goals? Clearly, we’re not. And for six of the eight Millennium Development Goals—reduction of poverty and hunger, universal primary education, gender equality, child and infant mortality, maternal health improvements and combating AIDS and other diseases—the pandemic of HIV/AIDS has a moderate or large negative impact. Quite simply, we will never reach at least six of the eight Millennium Development Goals unless we dramatically scale up our response to the epidemic.

What does “scaling up our response to the epidemic” mean? We’ve learned a lot here at WHO in the last three years. For much of the 1990s and up, until about 2002-2003, the debate raged on: “Should we focus on prevention or should we think about providing treatment? Should we do one or the other?” Be careful about treatment, it was said, because it will take attention away from prevention. I’m a physician, an infectious diseases physician, but I’m also an anthropologist. Let me tell you what I’ve learned in my anthropological study of our AIDS response since coming to WHO. The notion that talking about treatment will take away from prevention was in fact incorrect; incorrect on two counts. First, in making that statement, one got the feeling that prevention was moving forward at a great pace and we were preventing infections left and right. In fact, that’s not the case. There was no, what I would call, pace and rhythm in the response. In fact there was no target, and we still have no target for prevention.

PMTCT—preventing mother to child transmission—must be one of the most clear moral imperatives we could ever imagine. And yet, less than eight percent who need PMTCT have access to it, while in the First World we give triple therapy and whatever else is necessary to these women early on, before they deliver. We do have an intervention, a single pill that can be delivered very easily and will effectively prevent transmission from mothers to children. Why is it that only eight percent of the women in the world are getting it? When I came to WHO, what I tried to do was in some way inject pace and rhythm into our response to HIV/AIDS. We didn’t have a target for prevention; we didn’t have a target for treatment when we got here other than President Bush’s extraordinary commitment to treat two million people in 15 developing countries by 2008. The rest of the world didn’t have a target. In thinking about what to do, I spoke with a hero and mentor of mine, Don Berwick, who is the master of quality improvement in First World healthcare systems. The fi rst thing he said to me was: “What is the target?” If you do not have an aim, how can you know where you are going and what you are going to do? The key is that not

28 only do you want to know what you are going to do this week, but what you are going to do next week, next month, and next year. He leaves every meeting asking, “So based on this meeting, what are you going to do differently by next Tuesday?” We did not have a next Tuesday, we did not have a next Tuesday of next month. There was no pace, there was no rhythm, there was no urgency in the response. We talked about it a lot. We got it on the agenda of high-level meetings and higher-level meetings and really high-level meetings. Leaders from all over the world declared their commitment to it, but commitment to what? We felt that the world needed to do something and do something quickly, so we announced the target to reach: three million people on treatment by 2005.

I think the history of public health will show that there has probably never been a more criticized target than the “3 by 5” target. Most people said it is unrealistic, it is impossible; forget about it, countries do not want to do it. You talk to ministries of health and they tell you they do not have the infrastructure; they do not want to treat. In fact, what we have seen is that although we are not going to reach the three million by the end of 2005—in fact we’ll be somewhere between 1.5 million and 2 million—we are hopeful that we will reach it sometime before the end of 2006, in which case we will call it “3 by 5 and-a-half.” I think that we will look back historically and see that there are few targets that missed by a year or so—most of them we missed by decades. What did we learn from this “3 by 5” target? I personally learned how one is supposed to announce these targets in polite circles, as opposed to the way we did it. The more we talk to people, what we hear is, “you should have done a consultation.” How long do consultations take in setting global targets? About two years, which would have taken us all the way to 2005 and we still would not have had a target. So one of the things I learned is that, once in a while, you just have to take a risk, and in this case we did.

In December of 2003, there were three countries that had a target at all for anti-retroviral treatment. There were four countries that had a plan for anti-retroviral treatment. Today there are more than 50 with a target and a plan—52 countries have more than doubled the number of people on treatment in the last 18 months. Countries that we would never have guessed would respond, have responded. Malawi—which has been called the “perfect storm” of development disasters—now has upwards of 40,000 people on treatment, starting from almost none in 2003. What are these countries telling us? They are telling us it is diffi cult. The infrastructure problems and human resources problems are severe, but in place after place that I visit, what I see is a complete transformation in the morale among health workers. Think about what they were doing prior to “3 by 5.” They were basically standing by and sending people home to die, watching their hospital rooms fi ll up with people dying from HIV/AIDS. Now there’s hope.

Of the other things that we are seeing, are fantastic increases in the willingness to be tested. Counseling and testing is not everything, but it is a great start. We are really excited about a recent trip to Lesotho, where we spoke with the Minister of Health who committed to offering every single citizen in Lesotho a voluntary test for HIV—every citizen in Lesotho. What might that mean, to have every single person in the country know their HIV status? It has got to be voluntary; we have got to protect human rights, but what could a testing program like that mean? Well, our hope is that there will be some group of those people who will change their behavior, and that behavior change will have an impact on others. Have we had targets for voluntary counseling and testing? Sure, the targets were, “Let’s test more people.” Everyone know your status. But when you have a target like that, how do you know how to go backwards from the target and be specifi c in your planning? How do you know how to budget? So for the fi rst time in history, on the continent of Africa, our team at WHO is now working in Lesotho with the Ministry of Health to set a concrete plan to offer a voluntary HIV test to every person in Lesotho—2.2 million people. If you look at the numbers in terms of all the people who have received VCT [voluntary counseling and testing] for HIV in the last 18 months: 50% of those tests are positive. This country, along with Swaziland, Botswana and others, are countries that are at risk of dying of HIV. We have to do something bold, and we cannot do it without pace and rhythm.

29 Let me, then, leave you with three points. I missed one point earlier. The point about the testing and counseling is that we now have to bring the same kind of momentum, vision, focus, and especially pace and rhythm, to prevention that “3 by 5” did for treatment. We know that targets can have that impact. Any industry in the world will tell you that a clear target that is time-limited is vital. What if Ford were to say, “We are really going to focus and put making a new car at the top of our agenda.” What does that mean? The Hilton Corporation, I’m sure, does not run their hotels in that way. Facing the worst pandemic in history, how can we think it’s OK to work in that manner?

So, three points. Targets are critical, but the targets must provide vision, focus, pace and rhythm. And I would argue that the Millennium Development Goals right now do not do that. They are too vague, there are no interim targets, and they do not change the way we work by next Tuesday. I think that is an important test. Secondly, if we are going to meet the MDGs, and I think we can, we have to begin acting like we are serious about reaching them, and let me just say, we are not even close to being there. Finally, one of the things Mr. Begleiter didn’t mention is that I am one of the early converts to the Partners In Health mission, and I congratulate the Hilton Foundation for giving this award to Partners In Health. What I have just told you, I learned at the feet of Paul Farmer and Ophelia Dahl at Partners In Health, and the method is very simple. Set a goal that will serve you for eternity. The goal of Partners In Health is absolute global health equity. You don’t want a goal that will serve you until 2015; you want an overarching goal that will serve you for eternity. They have a goal that will serve them for eternity. The method is to set bold targets toward that goal, and to do whatever it takes to get there. Finally, the last part of the method is that they avoid the niceties of “global development speak” and tell the truth while bearing moral witness to the suffering of the poor. We do not often get enough of that, and they do that better than any group I know.

I have said some very negative things about the Millennium Development Goals, but let me end with a quote from the Italian philosopher Antonio Gramsci. Gramsci talked about a pessimism of the intellect but an optimism of the spirit. Often what you get with development experts is a pessimism of the spirit. If we go forward as leaders in development with a pessimism of the spirit and say, “It cannot be done; it is not possible; there is no infrastructure,” then surely that will be the case. An optimism of the spirit is our moral duty, and it is what Partners In Health represents more than any other group I know. Thank you.

30 Panel One—Question and Answer Session

Begleiter. Jim, fi rst I’m going to put you on the spot. You were not here when President Zedillo spoke, but I’m sure you’ve heard speeches like his in the past. He lit into the nations of the United Nations for propounding a lot of hot air on the MDGs and not really meeting the targets they had set, and so on. You’re at the other end of the spectrum, saying not only are the MDGs—that these governments have not met—not specifi c enough, but you think they have to be even more targeted and more specifi c, more specifi cally paced, etc. That’s a nice goal and sounds great, but we are living in a world in which politicians have to negotiate these things, not one in which scientists and doctors and do-gooders who are all in this room say, “Here’s what we’re going to do and we’re going to do it by next Tuesday.” How do you reconcile your demand, really justifi able demand for a specifi c action by a specifi c time, with the realities of the politics in a world in which specifi c nations have elections or do not have elections, or do not change governments and do not change their minds very quickly?

Kim. We have had some really interesting experiences in the HIV response, and let me put it this way: it became very popular for a while among donor countries to give money to the Global Fund; its popularity has waned a bit, which is of great concern, but why were they doing that? My own experience is that, especially with President Bush’s declaration that he is going to give $15 billion and save two million lives, and with the explosion of interest in the Global Fund, what the donors kept asking in various forms was, “How many lives will we save with this money?” And in my mind, my response would be, “How many lives do you need to save?” What the donors seem to be saying is, “We are facing a set of political realities at home and we want to maintain, basically, pace and rhythm in our ability to raise money for this kind of endeavor.” What I realized was that among those of us in HIV and global development, I didn’t detect a really enlightened conversation about how to service the donors. What do they need? In this case, what they needed was a clear sense that they are saving lives.

We learned from the tsunami that in response to disasters and under the banner of saving lives, there are literally billions of dollars ready to fall out of people’s pockets in very short order. I think what we haven’t done well enough in the development world is to understand that advocacy; really understand what makes donors tick. In this case, politicians are in offi ce for a very short time and need to be able to give a compelling picture of what they’re doing with ODA (offi cial development assistance). I do not think we provide that. So the AIDS response is a very instructive one, the fact that activists were willing to show up at Al Gore’s political rallies, for example; the fact that they were willing to show up at the doors of parliamentarians in the UK and, literally, their homes, and make noise, has altered the equation. But we cannot do that all the time. There has to be a multi-pronged approach, working on many fronts at once, applying pressure with advocates but also showing that we are doing something; something quite revolutionary that is transforming the lives of people. The companies understand this. Look at the drug industry and how many fronts they work on at once in order to push forward their interests—all the way from lobbying to commercials to everything else that they do. If we are serious about development, we will have an industry that is at least as sophisticated as that, and we are not there yet.

Q. Anthony Whitehouse, Maitland Group, Geneva. A lot of what you are talking about was true in the United Kingdom a hundred years ago, with the exception of AIDS. You had child labor, you had corruption, you had an infected legal system. One of the things that forced the development of the English political system in society was the fact that people could not leave—or very few of them could. Surely part of the problem today is that in a lot of Third World countries the people with talent simply leave rather than staying behind and assisting with their own country’s development. Isn’t that a problem that we have to address?

Buvinic. Actually, and I’m sure that President Zedillo here can add a bit more, today this is not really so much a problem as a solution. It is not only that talented people migrate, but migration these days, international migration, is of all people, not only of talented people. Remittances are dwarfi ng anything that is ODA. These days, remittances that labor migrants send back to their countries, to countries all around the world, are substantial and signifi cant enough to improve the livelihoods of poor families. This is something that is beginning to be

31 recognized. The World Bank and Inter-American Development Bank and the international fi nancial institutions are starting to study how much money labor migrants are returning to their home countries and what the development impact is, and it’s huge.

Questioner. Isn’t the problem that money does not solve the problem? It is political will and development as a society that solves the problem.

Kim. Let me just give you a very concrete example of what we are talking about. Lesotho has 150 doctors in the public sector. Of those 150, ten are natives of Lesotho. So, facing a clinical crisis of epic proportions, trying to treat all these people with HIV in Lesotho, there are very few doctors who speak the language in Lesotho. And yet, as of today, there are 100 medical students in school, paid entirely by the government of Lesotho, studying in South Africa. The government of Lesotho thinks that they will be very lucky if over the next fi ve years more than a handful come back to serve in their country. So, what is the nature of the problem? It’s a very complicated one. What she talked about in terms of remittances, it’s true — that’s part of the issue. The other part is that people would rather live in South Africa, in this case. So this is not brain drain from Lesotho to Manchester — t hat is another issue, where it is said that there are more Malawian physicians in Manchester in the UK than in Malawi. What do we do about this? Some people argue that on a very basic level, South Africa should repay Lesotho for paying for the education of all the people who then serve the South African health service. There is a group right now in the midst of studying this and there are many ways of approaching the problem. It seems unrealistic to say that we are going to take all these physicians and force them to come back to these areas. I think what we need to do is build health systems with some sort of opportunity for intellectual advancement so that the people of Lesotho will want to come back to something that will be meaningful to them. That is one of many possible solutions. The problem is that we have done a great analysis of the problem, we have done a great assessment of what can be done, but very few are really taking action. As far as I know, we do not yet have any targets for solving the human resource crisis. How are we going to get things moving to fi x the problem? We still have not answered that question. One thing that I would like to add though is that money can be very helpful in solving this particular problem, by increasing the salaries of physicians and other health personnel in the poorest countries.

Q. Dr. Andrew Seim, Health and Development International. First an observation, and then a question. The observation is to Dr. Kim. I think that this is wonderful. One of the things that is wonderful is that it is introducing at a much higher level than most of us can manage to do, the observation that disease eradication programs or even disease elimination programs, like river blindness in Africa, for pittances — less than a dollar per person per year — have a huge impact. Seventeen million people able to be fed from the land reclaimed, six million children no longer blind. And there are lots of these very focused initiatives, and they have all got one thing in common — which you have termed pace and rhythm. The question is to Mayra Buvinic. One of the fascinating things that came out of some study in the United States was that one of the most effective ways to stop racism is when white people stop tolerating jokes and comments in their social circles — at family parties and picnics and wherever else. You are asking for leadership and for commitment. With all respect and all the need for leadership and commitment of bright, well-educated committed women, perhaps one could use that same experience about racism to deal with anti-women issues. Would it be easier to get some key well-respected men to no longer tolerate negative things about women, which tend to be tolerated in lots of settings?

Buvinic. That is very interesting and I think it would be worthwhile trying, but in terms of the international development community, which I think is the fi rst group of people that really have to take up a lot more leadership on this, I have always believed that rational arguments are the things that work — showing that empowering women is not only good for women, but good for societies. Hopefully, that argument should do it — it has not done it yet, but there is always hope. As more evidence is presented, I think empirical evidence can convince people.

32 Q. Kristine Pearson, Freeplay Foundation. My name is Kristine Pearson and I have spent the better part of the last seven years in some pretty deep and isolated rural areas across sub-Saharan Africa. I agree with Dr. Kim that there has been an astonishing transformation of the approach and the reach of the attitude around HIV/AIDS and the actual presence of anti-retrovirals in some areas where you just wouldn’t expect it. I run an organization and one of the things we do is distribute self-powered radios to child-headed households across Africa. These are children that have been orphaned by disease or confl ict and the numbers vary, but it’s probably about 40 million across sub- Saharan Africa. Let me use Rwanda as an example. There are between 65 and 70 thousand child-headed households in Rwanda—75 to 80% are headed by teenage girls. When you ask these girls, when you ask these children, what they want to listen to on the radio, it is very different from teenage children you and I would be familiar with. They say, “the news”. They want to feel connected. The second thing they talk about is HIV and AIDS. They say things like, “I want to learn how to behave better.” What they’re really talking about is rape. They are raped at an alarming rate. I spoke to a group of about 60 child-headed households last week, and the fi rst fi ve I spoke to had been raped. One had had a child. They are petrifi ed of getting AIDS and don’t know what to do. I think, in a coordinated response, one of the areas that I see is woefully under-catered is the area of rape—the protection of girls and making anti-retrovirals available to young girls. I think of it almost as a black hole in the development community. We think of education as a basic human right, but surely access to critical information has to be as well.

Kim. If there is any problem that will batter your will to optimism, it is the area of rape and exploitation of women and girls. But in taking this issue on, I will go back to pace and rhythm. Are there any examples anywhere where an intervention has actually reduced the incidence of rape? Let me give you a really exciting program that I just visited a few months ago. In one of the toughest squatter settlements in the Cape Town area, they noticed huge numbers of rapes of young people, and a conviction rate of between 10 and 20%. In other words, a conviction rate that didn’t really dampen the incidence of rape. So what they came up with is, in several of the clinics they put together 24- hour rape crisis centers. I looked through these places with great care. They have doctors on call 24 hours. I asked them, “How do you know they’re going to stay? Don’t they leave the premises to do other jobs?” The director of the clinic had a very clear algorithm how she keeps them on the job. She watches them, and the pay is commensurate so that they actually do the work. Doctors are there 24 hours a day, with nurses there to provide care. There are places where they can sit and have a cup of tea and sort of calm down a bit. And then, a room where the woman can sit and speak with a policeman, and in that room every single form that the policeman needs is already stocked so that not having a form cannot be an excuse for not fi ling a report. When I was there they had measured their conviction rate and it was over 90%. So, in that particular community, that worked, and they saw rapes going down. It’s not the answer for every community at all, but it’s a pretty decent answer. Now what they are trying to do is to scale up that particular intervention…but you need to have a clinic and you need to have doctors, you need to have all kinds of things. All I’m saying is that you need to fi nd those things that we can intervene with, and then we have to hold ourselves to a very high standard of getting those things in place as quickly and as effectively as possible.

Q. Kristine Pearson. Dr. Kim. I am South African, I live in Cape Town and I know exactly what you mean about the Kailicha clinic. It is great for an area where you have resources to combat this, but what do you do for the millions of girls living in rural areas that are vulnerable? Information could come across via radio, but not everyone is going to hear because they do not have money to buy batteries; certainly children do not. There has to be a coordinated response around this, because of the knock-on effect…you know, it is nothing if it operates in isolation. So that is one good example, but it does not really account for the majority of places where these children live across the continent.

Kim. I simply say we have to redouble our efforts to fi nd something that might work, because people would have said before that there’s nothing you can do in these urban areas, and here we have something that certainly seems quite surprisingly effective.

33 Jeffrey D. Sachs, Ph.D., Director, The Earth Institute at Columbia University and Director of the United Nations Millennium Project

Jeffrey D. Sachs is the director of The Earth Institute, Quetelet Professor of Sustainable Development, and Professor of Health Policy and Management at Columbia University, and a research associate of the National Bureau of Economic Research. He is also special advisor to United Nations Secretary-General Kofi Annan on a group of poverty alleviation initiatives called the Millennium Development Goals. Prior to joining Columbia, Sachs spent more than twenty years at Harvard University, most recently as director of the Center for International Development. Sachs became internationally known in the ’80s for his work advising governments in Latin America, Eastern Europe, the former Soviet Union, Asia, and Africa on economic reforms. He is co-chairman of the advisory board of The Global Competitiveness Report, and has been a consultant to the IMF, the World Bank, the OECD, and the United Nations Development Programme. During 2000-2001, he was chairman of the Commission on Macroeconomics and Health of the World Health Organization, and from September 1999 through March 2000 he served as a member of the International Financial Institutions Advisory Commission established by the U.S. Congress. He is author or co-author of more than two hundred scholarly articles, and has written, co- written, or edited over 25 books. A native of Detroit, Michigan, Sachs received his bachelor of arts, master of arts, and doctorate degrees at Harvard University, all in International Economics.

(Two-way videoconference with a Question & Answer session)

Let me thank the Hilton Foundation for the opportunity to join this important conference. I am especially delighted to join because the Hilton Foundation is honoring Partners In Health, which to me exemplifi es how the Millennium Development Goals can actually be achieved. Partners In Health is a remarkable organization, both in concept and in practice, and I want to say a few words about why it is the point of truth to achieving the Millennium Development Goals. I will come back to that in a moment.

I do want to start though, by picking up on something Ambassador Maresca said a moment ago because I think it bears clarifi cation; it is important. The Millennium Development Goals are not the United Nations Goals. They were not set by the United Nations; they were set by the member governments of the United Nations. They are goals of the world, they are not goals of an organization, and they were reconfi rmed by the member governments of the United Nations, by civil society that participated at the UN, by companies. They are goals that are internationally promulgated and internationally shared. President Bush, when he opened the General Assembly just a few weeks ago at the World Summit, said the United States is committed to the Millennium Development Goals. So did 160 other world leaders who spoke. This is important because these are the shared international objectives, not technical goals, but the only shared international objectives that we have with respect to extreme poverty, disease and hunger.

Now these goals are utterly achievable, but they are not being achieved right now. That is another point, and that is because on the one side it is easy to state goals, I suppose, and that is what world leaders do, but it’s quite another thing to make those goals operational and actually to put them into practice. The fact that the Millennium Development Goals are not being achieved in dozens of countries is in no way a demonstration that they are beyond achievement. What it is, is a demonstration of the lack of follow-through, even fi ve years after these goals were fi rst adopted by the world’s governments in September 2000. They are a demonstration only of the fact that we have not taken the practical steps both to diagnose the issues and to follow through on their achievement — more Partners In Health, fewer words, more achievement of the Millennium Development Goals, to put it very succinctly.

34 I think that the starting point for operationalizing any objective has to be a diagnosis. One has to ask the question: what is leading to a blockade of extremely poor people in the world not able to escape from their poverty? We have claims galore about this, but we do not have many careful diagnoses. I am delighted and was very honored that I was asked to help coordinate a worldwide team of scientists, over 360 development practitioners working in all parts of the world over a three-year period to understand in depth what is impeding some progress in some parts of the world, seemingly in a paradoxical way, when other parts of the world are surging ahead more dramatically than ever. After all, one cannot say that globalization per se or world markets or trade per se are the barriers to achievement of economic progress in the poorest parts of the world when we see the kinds of dramatic progress being made in India and China, just to give two remarkable examples. We have throughout Asia half of the world’s population achieving dramatic economic progress, but at the same time we have seen 750 million very poor people in Africa fall farther behind during the past generation. We have seen other parts of the world—the Andean region in the Americas—fall further behind while Asia surges. This requires a diagnosis, it requires careful thinking if we are going to have an approach that makes sense in response.

I believe what is usually said about these issues, my colleagues and I—the scientists, the agronomists, the public health specialists who work together on this diagnosis for the world community in the Millennium Project—we believe that the usual stereotypes that are propounded about this duality of rapid progress in some places, and further decline in other places has gotten it, to an important extent, wrong. Let me explain why, very briefl y. As I heard from many governments, including my own repeatedly, the problem is obviously within the poorest regions themselves: they are not governing properly, there is so much corruption and mismanagement in Africa. If Africa would just do what Asia has done, for example, the escape from poverty would be straightforward. The problem must lie in the problems of the poor themselves. They are acting in a manner that is not conducive to attracting private investment; they are acting in a manner that is not conducive to proper management of resources, this is the tragedy, supposedly, and this is what needs to be fi xed. This view that the problems of the extreme poor lie mainly with the extreme poor themselves is a quite popular view. I would say it is taken as the norm, in fact, in most rich and powerful places in the world. It is a vision or a diagnosis on the poorest of the poor themselves.

There is an alternative, perhaps one could say at the opposite end of the spectrum, that I think is equally mistaken and that is the view that the poorest of the poor are poor because the world’s system prevents them from developing, that it is globalization which blocks the progress of impoverished places in sub-Saharan Africa or in the Andes or in Central Asia. After all it’s a ranked trading system or unfair fi nancial practices or the IMF or the World Bank that keep the poorest of the poor in their tethers. Actually, both of these views we have found overwhelmingly miss the essential points. It simply is not true, for example, that African governments are systematically more corrupt or more failing in governance than their counterparts in low income countries in Asia. A list was just published by Transparency International, again for 2005, on perceptions of corruption. A large number of slow- growing African countries ranked much better on that list than a large number of rapidly growing Asian countries. You would have to look in an awfully distorted way to see from that list any correlation of economic performance and the perception of corruption levels. The fact of the matter is the Asian countries almost uniformly are growing rapidly, the African countries, whether well-governed or not—and I am certainly in favor of good governance, don’t misunderstand me—are growing much less rapidly and in many cases, many well-governed countries have been trapped in stagnation for years, indeed for decades. We need something deeper than just assigning blame, whether it is blaming the poor themselves, or their governments, or the rich. We need to understand economic development a little bit more substantively and thoroughly to see the point.

Let me give my understanding, which is maybe the wrong way to put it; let me give the understanding of this group of participating scientists, agronomists, hydrologists, public health offi cials, who through their experience and their on-the-ground knowledge, their close interaction with each other in recent years, saw something rather distinct from this ping-pong battle of “your blame, our blame, your blame” played in recent years. I will be brief. The story actually starts 50 years ago, with Asia itself seemingly trapped in extreme poverty. It wasn’t so long ago that the things that are said about sub-Saharan Africa today were said about India. I indeed remember in my

35 early days of studying economic development, in my fi rst books as a student, the question was whether India could ever feed itself. Could it ever escape from the cycles of famine, despair and confl ict, and the answer by many was felt to be no, that India was absolutely condemned to an ongoing struggle of famine. That was India’s fate—it was called the Hindu growth rate from time immemorial. And now of course we have one of the booming economies of the world, still poor, but decisively climbing out of any kind of trap of poverty.

Similarly, China was in upheaval and had faced mass famine during the Great Leap Forward and was certainly nobody’s candidate for a dramatic and dynamic breakthrough to the fastest growth rates in history. What is not remembered adequately right now, but what absolutely is at the center of that liftoff, was the Green Revolution. Regions which had struggled with famine and deep, pervasive, chronic hunger starting in the 1960s and 1970s escaped on the basis of the mass diffusion of a package of superior technologies for growing food, and ultimately for many undertakings in agriculture. Until the 1960s, Asian farmers were getting one ton or even less of grain for each hectare of arable land. By the 1980s, they were getting three tons per hectare. That technical difference was the difference of extreme poverty and hunger on the one side, and a farm family that could not only feed itself and bring grain to market, but have a margin for diversifi cation into milk products, dairy cooperatives, into tree crops or into non-agricultural activities altogether. The Green Revolution was the fi rst booster that enabled a freeing-up of Asia’s vast populations for the second part of Asia’s economic revolution, the revolution of manufacturing and service sector international competitiveness, the revolution that Asia and the world are living through right now, and which makes possible seven or eight or nine percent per year growth and the doubling of living standards every decade. Green Revolution, manufacturing and service sector revolution, almost like two boosters of the jet that has put the Asian economy into orbit.

Now let’s go back to Africa. The stunning reality of Africa, until today, is that farmers are getting one ton or less per hectare in their grain production, just as Asia was 50 years ago. Why is that? Complex reasons, but extremely important to understand. First, the improved genetic varieties of plants that came to Asia were not available to Africa for 20 years after the start of the Asian Green Revolution. The science had not been done. The science had been done largely for wheat and rice and a few other strains coming from the U.S. and Japan into Asia, but they were not appropriate yet for African conditions. It took 20 more years, but it has been done now: there are improved seed varieties that make sense for Africa. Second, Asia had a huge natural advantage that is recognized very infrequently, even though it remains important today. Africa has predominantly rain-fed agriculture in areas subject to the risks of drought. Asian agriculture, by contrast, is overwhelmingly irrigation and monsoon-based, with typically ample rainfall and water control potential through irrigation or other water storage means. So African farmers have a much more diffi c ult time managing basic water, and when the rains fail, as they have in Rwanda, in Malawi, in Niger, in Mali and other places, there is famine.

Now the third point is that Asia had a much more developed, articulated transport system than Africa at the end of the colonial period. The British Empire had built one of the great railways networks in India, but in Africa there are fewer spurs of rail built by imperial powers than any place in the world. So when Africa became independent, with most of Africa’s population living in the interior of the continent, and most of Asia’s population living on coasts and near railways and roads, the conditions could not have been more different. Africa’s rural areas were isolated, facing huge transport costs. Asia’s populations were near navigable riverways, on coastlines or in rail service access such as the Punjab in India. Norman Borlaug, the father of the Green Revolution of India, together with his colleague M.S. Swaminathan, says that the decisive advantage for the Punjab in the Green Revolution was the rail service which brought the fertilizer in and brought the crops out to the rest of India. Africa, in short, lacked three conditions—seed, water and transport—to make its Green Revolution at the time that India did. This resulted in rural populations that continued to live in poverty, populations that continued to expand, populations that lived in economic isolation where no private investor could fi nd a motivation for going in. Impoverished countries were being blamed for all of this rather than being helped.

36 One can say the same thing about disease burden, which is intimately linked to the success or failure of the food revolution. Africa has by far the highest infectious disease burden in the world. Part of it is the result of chronic food insuffi ciency; part of it is the result of intrinsic ecological factors such as the mosquito vectors, temperatures, and breeding sites of Africa, which make it uniquely vulnerable to the killer pandemic disease of malaria. Part of the disease burden, of course, is the result of poverty itself, because the weight of poverty means that impoverished countries are simply unable to fi eld a most basic health service to address massive killer diseases that cannot be overcome without at least a modicum of resources.

Let me go back, therefore, to the Millennium Development Goals. What does all of this mean? All of this means that if we are to take a serious approach, not a slogan approach, not a casual approach, not an amateurish approach, but a serious approach to overcoming the mass death and suffering of impoverished places such as rural, tropical, sub-Saharan Africa, we had better be able to mobilize the right kind of diagnosis, the right kind of responses, and the right kind of leadership to get the job done. It requires a mix of commitment and expertise. I am coming close to Partners In Health, because no other organization I know mixes the commitment and the expertise to get the job done like Partners In Health.

What Africa desperately needs is its Green Revolution. The things that have held back its Green Revolution until today are all potentially solvable at low cost if we just care to mobilize expertise and human commitment to get the job done. Africa’s farmers could triple their yields. They could, like Asia’s farmers, diversify from subsistence into commercial agronomic activities. African economies could diversify from agriculture per se into manufacturing and services, but it requires knowing what to do, and it requires making the investments to do it. Despite the sloganeering, Asia’s Green Revolution was carried heavily by government. It was a package of technology—high-yield variety seeds, small-scale irrigation, and transport—to a large extent publicly subsidized and provided to small farmers for many years until those farmers could stand on their own. It was not the rhetoric that markets are going to solve all the problems; it was the rhetoric that well-directed technologies appropriate to local circumstances, and helped by public investments in seed, in water management and in transport, could enable impoverished people to make it out of extreme poverty and thereby afterwards to join the market economy. But the idea was not that the poorest of the poor had to pay their own ticket, and that the only problem of the poorest of the poor was getting government out of the way, or moving the private sector in, because it was properly understood that the private sector activity was complementary to the investments in the public sector which could make good on meeting basic needs, raising farm productivity, fi ghting disease, spurring education, achieving a voluntary reduction in fertility rates, and thereby making the transition from extreme poverty into economic development.

We need an investment strategy. This is the practical point of achieving the Millennium Development Goals. We need to help the poorest people in the world to become empowered, to grow more food, to fi ght disease, to have their children in school, to fi ght gender inequality, and to live in an environmentally sustainable manner. The beautiful thing, ladies and gentlemen, is that the practical investments that are needed are known. In a world that often recoils from expertise, that expertise is vital here. The agronomic community, the Consultative Group for International Agricultural Research, the research institute that brought the Green Revolution to Asia, has identifi ed the kinds of seeds, the kind of farming system strategies, the kind of small-scale water management, and the kinds of improved transport networks that could triple Africa’s food production, but who listens to expertise now? We have slogans and lectures about how the poor are to blame rather than how the poor can be helped. The public health community has said repeatedly what can be achieved. They point out that 10 million children die every year of diseases that are largely preventable, sometimes entirely treatable, but they die because the public health system lacks even the most rudimentary resources to fi ght these killer diseases. Take the case of malaria, for example. It will kill up to three million children this year. Three million, and yet this disease is largely preventable and it is 100% treatable, but the public health community has not been listened to. What the public health community has said is, distribute insecticide-treated bed nets into the villages of Africa on a mass basis for free and make available improved fi rst-line medicines, and the malaria burden can be brought down by

37 70 or 80% through those two means alone. What do we have instead? We have our aid agencies trying to sell bed nets. We have micro-fi nance trying to sell bed nets to people who have no money whatsoever, and every time I’m in the clinics and the villages, I see children dying before my eyes for the most ludicrous reason—that they have not been availed of the bed nets that would last fi ve years, that would sleep two children, and that would cost $7. That means 70 cents per child per year, and we have not been able to organize from the rich country side the mass distribution of this most basic technology.

Now let me fi nally turn to Partners In Health, the recipient of this wonderful award. Partners In Health is based on precisely the combination of commitment and expert delivery of real services that actually turns the tide. Partners In Health did not say, when it moved to Haiti, “We are going to make a business.” Partners In Health said, “We are going to provide a service,” and as an economist I would say, “Provide an investment in the future,” because health is not only a wonderful, life-defi ning condition, it’s also an investment in basic economic development in every dimension. Partners In Health did not say, “We are going to recover our cost from user fees.” Partners In Health did not say that the poorest of the poor should pick themselves up and get on with it, because Partners In Health saw the reality both through the heart and through the head. What Paul Farmer and Jim Kim and Ophelia Dahl and others in Partners In Health knew is that the poorest of the poor were too poor to be able to afford basic health services in the central plateau of Haiti, but also that there were practical, low-cost investments that we could afford that could save lives. Partners In Health took an absolutely radical idea — it is the most radical idea on the planet — Jesus and many others enunciated it. It’s that the poor deserve their life and their dignity as well as the rich, whether you can afford to pay or not. And so Partners In Health took the basic philosophical stance that the poor deserve to live, to earn a living, to change this world, and that this can be provided with the right knowledge.

What I love about Partners In Health is that it did not ask for permission; it did not go to the donor governments and say, “Can we please do this?” It just used its commitment, its heart and the great minds that it embodies to get the job done. This has been the stunning breakthrough—just do it, because the proof of what you can do can then spread throughout the world. A lot of the revolution that we’re living through today and that we need to foment around the world—a revolution of heart, commitment and brains—started in Haiti in the central plateau, by just doing it. Of course, the story is legendary and that’s why Partners In Health is receiving today this most remarkable honor from the Hilton Foundation. It started to treat those with TB, discovered that many of them had multi-drug resistant TB, did not ask for permission, just scrambled anew to bring proper, life-sustaining, and disease-curing treatment to those who needed it, even if the conditions were harder. And then when the AIDS pandemic reached Haiti in the middle of the 1990s, Partners In Health did not read the journals and did not listen to the speeches in Washington and elsewhere which said, “It’s too hard to treat the poor for AIDS.”

Partners In Health took the basic radical position that the poor deserve to stay alive just as the rich do, and began scrambling like mad, begging, borrowing and stealing—and I think, literally, all three as I understand it—to get those AIDS medicines, to keep people in the community alive. By doing so, Partners In Health proved for the world this critical point: the anti-retroviral medicines that hitherto had been available only in rich societies could work beautifully, indeed in some ways even better, in the poorest of the poor settings of the world. The poorest of the poor could adhere, utterly, to the treatment regimens even when there were many pills many times a day, and of course when there is one pill in the morning and one pill in the evening as is the case today. And that revolution, facing what needs to be done, understanding how to do it technically, and proceeding to do it by mobilizing whatever kind of help—public or private, individual or foundation; help from AIDS sufferers in the United States giving their medicines to AIDS sufferers in Haiti or in other impoverished regions—is the point of getting the practical job done. Do not blame the poor. Understand their condition, work alongside them, and take practical steps until the ghastly burden of killer poverty is lifted.

The Millennium Development Goals have ten years remaining. There is no excuse and not a single serious analysis which shows that these goals are not utterly achievable if we put even modest effort toward achieving

38 them. The United States and others have signed on to these goals. We have pledged both offi cially and within our private sectors to be partners in this effort. George Bush in Monterrey, Mexico pledged together with other world leaders that the United States, and I quote, “would make concrete efforts toward the target of 0.7% of gross national product as offi cial development assistance.” Europe is honoring that pledge. Europe has set a timetable of 2015 to meet the 0.7 goal. If the United States were to do the same, we would have another extra $60 billion per year available for Africa’s Green Revolution, for its disease control, for getting basic transport and infrastructure. This is what would make the United States and the developed world truly safe in a dangerous and crowded world.

I want to leave with one fi nal thought. The Millennium Development Goals are but a halfway station to the goals that we really should have. Our generation, if we put our mind to it, can banish extreme poverty entirely. We have 20 years in which we could put an end to the killer conditions of famine, of chronic hunger, massive under-nutrition, and killer disease pandemics that continue to ravage our planet. It is within our means, with the modest effort of less than one percent of the income of the rich world, to rid the world of extreme poverty, and to make it secure for us all. Let me congratulate Partners In Health, and let me thank the Hilton Foundation for choosing such a remarkable honoree for your most remarkable award, and I thank you for allowing me to join you today.

39 Jeffrey Sachs — Question and Answer Session

Begleiter. I think we have time to take two questions. Are there two questions in the hall for Jeffrey Sachs?

Q. Amina Wali, Webster University. Basically, they say Africa has a lot of corruption and bad governance, but with aid coming late to Niger, and aid coming very fast to the tsunami, and the rich countries saying to Africa, “Come up with development strategies, we’ll help you.” And then when they get the money, they say, “We don’t know where it’s going to account.” Basically, what I want to ask you, is what faith does Africa have in the international community? What can we as individuals expect from the international community?

Sachs. Should we take the two questions and then I will give the responses?

Begleiter. OK, that’s fi ne. Second question?

Q. Musimbi Kanyoro, World YWCA. I am from Africa and I want to thank you for articulating many things that some of us who come from that continent would like to see articulated, but really hear it, say it in those words, because what you have said inspires hope of what can be done. My question is: why is it that although we know that the cost of doing what needs to be done in Africa is not very expensive, that it is not possible for us to make it a priority in the Millennium Development Goals and focus on this problem, because the African continent has all of the issues that have been mentioned—and this morning all of the examples of where the problems that need solutions are have come from Africa—why is it not possible to focus? Why did we not have the buildup on what Prime Minister Blair was doing? Why is it that there are so many players and everybody is planting their small mushrooms, doing small things, and when they are reporting in these kinds of forums, they only report about what is wrong and not what is working? So there is really nothing to build on? Can you make some comments on that?

Sachs. During the Millennium Project for the UN, I often said that Africa was two-thirds of the Project. The Project and the Millennium Development Goals are worldwide, but Africa as a priority is absolutely clear, because Africa is the region of the world uniquely trapped in extreme poverty—both stuck with massive burdens of hunger, disease and poverty, and not seeing the light of day right now because the conditions are getting worse. And yet, the practical solutions exist.

The world has let Africa down tremendously. Let me speak about my own country just for a moment. The United States’ aid to all of Africa runs to about $3.5 billion a year. Let me put that in perspective. Over one billion of that is emergency food aid—that is American grain at very high transport costs being shipped, too late and too little anyway, to famine-ridden areas. This does not help African farmers to grow the food, it simply sends them American grain. Half the cost of that $1 billion food aid is transport costs. It is shocking. Another billion dollars plus is actually American consultants’ salaries. It is called aid, but it is American consultants that are going on the bill of USAID and others, to Africa to give speeches, run workshops and so forth. What is actually given to Africa to help make practical investments in growing more food, in anti- malaria bed nets and so forth is well under $500 million a year in recent years. This means less than one penny out of every hundred dollars of U.S. national income—let me say it again, because it’s hard to imagine—less than one penny of every hundred dollars of U.S. national income has been directed toward enabling Africa to make practical investments in growing food, fi ghting disease, digging bore holes, getting safe drinking water, building sanitation systems, paving roads, and extending electricity to rural areas. And then we blame Africa, despite commitments we have made. We have promised to give 70 cents—that is to make concrete efforts toward 0.7 percent; that’s 70 cents out of every hundred dollars—for development aid, but for Africa it is less than one penny out of every hundred dollars that is going to the practical investments that could enable Africa to escape from poverty.

40 And then we are told that aid does not work, that it is down the drain, that it is stolen. This is nonsense, because when aid is actually delivered, when it’s delivered to fi ght specifi c diseases like river blindness or trachoma or leprosy, in each of these specifi c cases when a disease has been attacked, when Rotary has taken on polio, there has been a tremendous success, just as there was more than 30 years ago with the eradication of small pox. This could be done, but the scale of our effort is so shockingly small. So the problem is that we have not tried, not that we have tried and failed as in the public’s mind, and this misunderstanding persists because our politicians never speak of it. They never help the public understand what it is we do, and even much more important, what it is we’re not doing.

I want to give you just one example, because some of you will be interested. If you do practical things, like Partners In Health in the central plateau of Haiti — take any place in Africa and do practical things — the results are startling. In our Millennium Project we have a project called the Millennium Villages to bring the practical investments down to the village level. This year I went to the harvest festival in a village in western Kenya, where in one growing season the village produced four times more food than in the past—actually 3.96 times more food—because the farmers, with a tiny bit of help, were enabled to plant with improved seed varieties and with fertilizer. All it took to enable this village to escape from chronic, massive undernutrition, was a little bit of investment, and this village now has enough to eat, school meals for all its children, a local clinic that’s operating, children sleeping under the bed nets, and malaria coming down, all because of a tiny amount of practically undertaken investment. So all these big slogans, or this idea that the private sector is somehow going to solve the problem without this complementary investment, has been holding us back.

Now the fi rst question was: what can Africa expect? Africa needs to state clearly, “You promised, you told us, you said you would follow through. We are prepared, as are so many parts of Africa, to govern properly, decisively, in a timely way, but we need your real help.” Fortunately, the European Union did step forward. There was good leadership this past year from Prime Minister Tony Blair and UK Chancellor Gordon Brown and Secretary of State for International Development Hilary Benn, who together decided to put the United Kingdom and the European Union on the side of Africa. Now they have promised that the EU will double aid to Africa by 2010. The G-8, basically with the EU commitment, said that overall aid to Africa would double by the year 2010.

We need everybody involved, fi rst to keep our own governments honest and directed, second to insist that this aid not be only our consultants’ salaries, not be expensive workshops, but rather the practical investments—the seed, the water, the soil nutrient replenishment, the road grading, the clinics, the medicines, the bed nets—that can make the defi nitive difference. This is what Africa deserves. This is what the world has promised. This is the agreement that the Millennium Development Goals represent. Goal Eight is the goal on global partnership—that the private sector, civil society and government step forward, recognizing that this is something utterly within our reach and utterly necessary if we are ever to have a safe and secure planet. This is our choice, and it’s our time to do it. We are running out of time, and time I want to insist, ladies and gentlemen, is not merely a matter of convenience. If we fail the Millennium Development Goals, we will be a world without goals. We are close enough to that already. This world can be—and I hate to say it—tragically even more dangerous than it already is if we fail to act on our highest aspirations.

And fi nally, delay is not a mere loss of time. Time is money, we say in the rich world. But in the poor world, time is death. Every delay means thousands and thousands of children dying every day, for reasons that are fundamentally absurd and fundamentally threatening to us all. It is utterly within our grasp to end extreme hunger and pandemic disease. It is a matter of our choice and it is the kind of commitment of the Hilton Foundation and of Partners In Health that can make all the difference. So I thank you very much.

41 Richard A. Morford, Managing Director, Donor and Multilateral Relations, Millennium Challenge Corporation

Mr. Morford is Managing Director for Donor and Multilateral Relations at the Millennium Challenge Corporation (MCC). Since September 2002, he has been active in the effort to develop and realize the Millennium Challenge Account, an innovative U.S. foreign assistance initiative. Prior to joining MCC, Mr. Morford was a member of the U.S. Senior Foreign Service with the State Department. He served as Deputy Permanent Representative at the U.S. Mission to the Organization for Economic Cooperation and Development in Paris, Economic Minister Counselor in Seoul; Principal Offi cer in Fukuoka; Petroleum Offi cer in Jakarta; Trade Center Director in Osaka, and Political/Economic Reporting Offi cer in Singapore. He has held various positions in the State Department, including Director of the Offi ce of European Union and Regional Affairs, Senior Advisor for Economics on the Policy Planning Staff, Senior Advisor for Asia in the Economic Bureau, Deputy Director of the Japan Desk, Deputy Director of the Offi ce of Business Practices, and Trade Policy Offi cer for the East Asia Bureau. Mr. Morford graduated from Wabash College in 1971 with a degree in economics and received a Masters in Public Administration from Harvard University in 1978. He attended the State Department’s Senior Seminar during the 1994-95 academic year. Mr. Morford is a native of Indianapolis, Indiana and currently resides in Vienna, Virginia. He is married and has two children.

Millennium Challenge Account and the Millennium Development Goals

Thank you very much. It is a pleasure to be here and I would like to thank the Hilton Foundation for this opportunity. I represent a relatively new organization. We were founded in January of last year, so we are about 20 months old. Before I go further, let me give you some disclaimers. First, the Millennium Challenge Corporation is a corporation, but it is a government corporation, so indeed we are the federal government; our money comes from the U.S. Congress. Second, despite the term “millennium”—it is the same word in both the Millennium Development Goals and the Millennium Challenge Corporation—we were not set up just to address the Millennium Development Goals. We go a little bit beyond that, looking at long-term development.

Third is the challenge part. Our challenge is, as I said, not humanitarian response to emergencies. In fact, we were set up to have only one mission. We are not supposed to help fragile, failed states. We are not supposed to deal with tsunami victims. We are not supposed to deal with emergencies of health care. We are supposed to be dealing with long-term economic development. In fact, our mission is elimination of extreme poverty and promotion of economic growth. We have put that all down into a single phrase. We talk of “reducing poverty through growth.” What that really means is we are after sustainable poverty reduction. We want people to do better on their own, so they do not need a continuing infl ux of money.

Let me talk a little about the MCC and the Millennium Challenge Account and then talk a little bit about our relationship with the Millennium Development Goals. As President Zedillo said earlier, the Financing for Development Conference is really where the idea for the MCA, the Millennium Challenge Account was born. The idea was to provide greater resources for countries that are taking greater responsibility for their own development; and to do that we decided to have a new aid instrument, the Millennium Challenge Account, which would be in addition to everything else that the United States was doing. The U.S. is doing a lot to address the Millennium Development Goals. You have heard about the HIV/AIDS fund and many other things. This is a separate extra fund aimed at reducing poverty through growth.

As we thought about what we would do with this new fund, we decided that we did not just want to give more money; we wanted to accomplish a few more things. So one of the things we looked for was how to do this in a way in which we really get the incentives right so that countries want to adopt policies that support growth and

42 poverty reduction. How do we get it so that they will adopt pro-growth policies? Second, how are we going to do this in a way where we give the country the lead — not just the government — how do we give the country the lead? And third, how do we do it in a way that we can measure the results? We want to take something to the American taxpayers and say, “See, it’s working.” Of course, that is if it is working, because it is still early — we do not know how this experiment will turn out, but if it is working we want to be able to show that. So how do we go about doing this?

First we decided on three areas important to development. The fi rst is governance, which we call “ruling justly,” and that is both government effectiveness—no corruption, rule of law, that type of thing—but also the question of the participatory nature of the governance; the democratic nature of the government and their support for human rights. Second, for development you really do need a government that invests in its people, mainly in health and education. So that is the second set of measures we used. And third, we think it is very important that there is “economic freedom”— does the government create conditions so that everybody has the opportunity to get ahead, for themselves and their families? So it is economic opportunity. Then we went and looked for the best indicators that we could fi nd that are not issued by the U.S. government. They came from the World Bank Institute, Freedom House, WHO, all kinds of places, and we put them together in a package. If you go on our website — www.mcc.gov — you can fi nd a list of the 82 poorest countries in the world. Each has a sheet which has 16 different measures. We do not measure them against us, or against Denmark, we measure them against each other. If you are above the median, it is green; if you are below the median, it is red; and if you are above the median on half or more, then you are a good candidate to be an MCA country. That’s why we came up with that measurement: a) We wanted to work with countries that have relatively good policies, because that is where our aid would be most effective. b) We wanted to reward the countries that are doing relatively well. c) We wanted to create an incentive so that the countries that do not qualify will have an incentive to change their policies so they can qualify in the future.

So that’s the fi rst part — selecting good partners. The second part of what we do is going to the countries and saying, “Congratulations, you have qualifi ed for the MCA. You have won the opportunity to get recognized and you have the opportunity to give us a proposal. It is your proposal, not ours. Tell us when you have one.” We do not give any assistance on this, and we tell our ambassadors they should not get involved. We tell our aid missions not to get involved. We do not tell the countries what to do. We tell them to look at their biggest obstacles to development, to look at where their poorest people are and what they can do, and then get back to us. We give them really a blank slate to write on. We have 17 different countries that have qualifi ed; we have proposals from them all. Some of them are very, very good; some of them are not so good. They can keep working on them.

We say we will assess them on three things and three things only: a) Does it reduce poverty? b) Does it increase growth? c) Is it broadly supported in your country? And the latter means that they have to talk to people; they have to talk to the people who will be affected, to the opposition, to civil society, to the business sector. They have to talk. That is the second part of how we operate.

Once we actually have a program that we think meets those three tests, then we are authorized to go out and work with them. We can do feasibility studies, we conduct due diligence, and when we get to the point where we have a fully developed program, and we have such programs now with fi ve countries, we sign a compact. The compact includes not only how much money we are going to give, but it has very specifi c targets, the kinds of things that Dr. Kim was talking about earlier. Very specifi c targets, such as outcome goals, for example, a fi ve percent increase in agricultural productivity in these four areas, an increase in school graduation rates by x or an increase in attainment test levels. These are the ultimate aims of the program, but we also have very specifi c steps along the way to meet them. These measures are in the compact, and that’s how we make sure it’s the results we’re measuring and not just how much money we are spending.

43 Where are we now? As I said earlier, we have fi ve compacts. The compacts are with Madagascar—which was our fi r st compact—Cape Verde, Georgia, Honduras and Nicaragua. There are 12 more countries that we are working with. We expect to have maybe another three compacts by the end of the year and then it will keep going forward. We also have a threshold program with another 13 countries, the idea being that some countries came close to qualifying but just missed by one or two indicators, and if they come in with a proposal to address where they fell short, we will give them some money to help them out. That program is being administered with USAID.

I said we both have the term “millennium” in our names, so how do we relate to the Millennium Development Goals? First of all, if you are going to halve the number of people with incomes under $1 per day by 2015, you are going to need economic growth unless you just transfer a whole bunch of money. Our focused mission of reducing poverty through growth in the poorest countries in the world addresses that fi rst MDG directly, but actually growth is really needed for all of the other MDGs.

We provide an incentive also in our indicators for some of the MDGs directly. For example, one of our indicators is girls’ completion rates for primary school. This gets to the discussion we had earlier about gender, and also to the goal about universal education. We challenge countries to do better than the median on this indicator, and in that way we push countries to make progress. We also ended up helping in our threshold program in Burkina Faso with $13 million because they fell short on girls’ education rates from primary school, so we have a $13 million program in Burkina Faso to make the schools girl-friendly and to address some of the reasons why they are not able to go to school.

Some countries are using MCA money directly to address MDGs. For example, in our compact with Madagascar, it has a land-titling element. Roughly half of our proposals have had land-titling elements that the countries have given us. What this means is, instead of running down the land until you cannot use it anymore, and then going out and slashing and burning, they actually will invest in their own land. Thus we are addressing Goal Seven on the environment in the MDGs. Mozambique has given us a proposal for developing water and sanitation in 23 towns in the northern four provinces, which is the poorest part of Mozambique. Again, that is Goal Seven, and obviously if you look at water and sanitation you’re also addressing some of the health goals—child mortality, etc. Finally, with regard to a lot of our investment, we found when we asked countries what they wanted to do with this extremely fl exible, untied, grant fi nancing, that they have come back to us and proposed a lot of work in the rural areas on poverty reduction. A lot of the proposals we are seeing are on infrastructure, particularly things like rural roads that will not only let crops get to market but will also improve the access of rural people to health care and education. So, there are a lot of direct and indirect ways in which we work toward the Millennium Development Goals. But we do not insist that each of the proposals deal directly with a Millennium Development Goal. That would undercut the country’s ownership and, frankly, we believe countries should know what they need better than we or world bodies do.

In the end, we believe that what our partners do is key to reducing poverty — what they do in terms of their policies and their institutions, in terms of the priorities that they identify, in terms of the programs they develop, in terms of how they implement their MCA program. We are now working in 30 countries with about 400 million people— we anticipate that will grow. Our board — we do have a board, as we are a corporation — will meet November 8 and select additional countries. We do not know how many, but that is something to look into. There will probably always be humanitarian crises and a need for humanitarian assistance. Our goal is to make our aid effective so that some day we may not have a need for this type of aid. We want to reduce poverty and improve lives and help move toward the day when extreme poverty no longer exists and countries no longer need our assistance. Thank you.

44 John J. Maresca, President, Business Humanitarian Forum

John Maresca was a career American diplomat, and Ambassador to several multilateral organizations and negotiations, as well as a confl ict mediator in the Caucasus and Mediterranean regions. He negotiated a number of landmark international agreements, including the Helsinki Final Act and the Charter of Paris for a New Europe, and was sent as Special Envoy to open U.S. relations with the newly independent states from the former USSR. Maresca served as an Assistant Secretary of Defense, and was chief of staff for two Secretary Generals of NATO. After leaving the Diplomatic Service, Maresca was Vice President of a major worldwide energy company and President of an international research institute. He is currently President of the Business Humanitarian Forum (www.bhforum.org), an international non-profi t association based in Geneva, Switzerland, which brings business support to humanitarian work and facilitates private sector investment in post-confl ict and developing regions. Ambassador Maresca has published widely on issues of international relations, confl ict prevention, economic development and corporate social responsibility. He is a frequent visiting lecturer and has been a featured speaker in more than thirty countries. Maresca was born in Italy and educated at Yale University and the London School of Economics.

Harnessing the Positive Potential of the Private Sector

Any discussion of the Millennium Development Goals should start with recognition that the UN has done all of us a great service in establishing these goals. I think we are fortunate to have a world organization which can identify the collective goals of the human race. This is true whether or not we are able to reach them, by the way. It is good to have goals, so one has to recognize the achievement of the UN in establishing these goals for us.

I would add that it’s a humbling experience to discuss these goals. They are enormous, and the means we have for achieving them are so limited, really very limited. Furthermore, each of us in this room is like the blind man and the elephant. We are touching this huge challenge, each of us in a different place, and there are very few people who can put together all aspects of the challenge and see it as a whole. Much of what we do is just this sort of touching of the elephant.

I am going to talk about the ways in which my own organization is touching this elephant, and it may seem a narrow view. It is a narrow view. We do not provide emergency assistance, nor food aid or education. We have deliberately set out to work with entrepreneurs, to set up individual, locally-owned enterprises, usually in post- confl ict environments and in the poorest countries of the world. Some people ask me, how do you do this? And I say we do it one by one. It is the only way; business is like that. So ours is a very micro approach; it’s not a macro approach at all. It is tough work, by the way. There are very few existing organizations that are prepared to really help with this type of work; I mean national or international organizations or fi nancial institutions. Very few organizations are really prepared to help.

What about the private sector? As I told the UN General Assembly last June, the MDGs cannot be achieved without the active and positive engagement of the private sector. There just is not enough international assistance funding available to bring about such dramatic changes. To get anywhere near these world goals, we need a new strategy, new methods, and signifi cant additional resources. The private sector has vast resources. More than half of the world’s 100 biggest economies are companies. These are not countries at all, they are companies. The private sector is the world’s greatest employer, its greatest wealth producer and, therefore, its greatest poverty reducer. It has very effective methods and is very effi cient in doing its work. The private sector must be engaged in helping to meet the MDGs, but it cannot be engaged against its interests. It has to be engaged in ways that it sees as positive for its own interests.

45 But the interests of the private sector largely parallel the goals of the MDGs. Vulnerable populations need sustainable jobs, and these can only be provided by the expansion of the private sector. If heads of families, whether male or female, have jobs, they can overcome many, even most, of their problems. But jobs are not being created where they are needed most because investors are not normally attracted to business in such risky areas. This is the aspect of the situation where new structural approaches are needed to encourage investment and development of local entrepreneurship.

I am not proposing a simplistic, magical solution here, nor even a one-size-fi ts-all solution. Obviously, business investment works better in some situations than it does in others. For example, it’s diffi cult to create businesses where most people are living as subsistence farmers. What I am arguing is that the private sector has a lot to contribute, and it has not been used well up to now. The international community has not found creative and effective ways to engage the private sector. It is all very well to say that the private sector is signed up to the Millennium Development Goals or the Global Compact, but companies will sign up to anything that gives them a good reputation. That is not the point. The point is to engage them in ways that help the development process in the places where it is needed most. Those are the places where businesses, on their own, are not inclined to go.

So creativity is needed in fi nding ways to attract businesses to help in places where they are not inclined to go. And if we are going to do that, we have to do it in such a way that it attracts them; they cannot be forced. Businesses will not do things that are against their interests. But there are ways to engage businesses, and that is what my organization has set out to do. What I am talking about here today is based on our direct experience. Just to give you an example, we are in the process of building a generic medicines production plant just outside of Kabul. It is about a $4 million project and will be an Afghan-owned production facility which will produce medicines directly for the Afghan market. We are doing this with very little help from any offi cial organization, but rather with help from several private sector business entities.

What I have learned, and what I am arguing here, is that we need new strategies to help local entrepreneurs, by supporting them with technical and advisory services and assistance so that they can make their businesses more attractive to equity partners, because most of these entrepreneurs, at some point, need some funds. The only way that is open to them now is to go to a bank for a commercial loan, which will very likely put them out of business early on because of the high interest payments. So what they really need are equity partners of some kind, and they are not fi nding them because they do not know how to present their businesses. They do not always know how to write a business plan, for example. They did not go to Harvard Business School. If they can fi nd help in writing a business plan, that will take them a huge step forward. There are many international agencies in the fi e ld who can write business plans, whose employees did go to business schools. All they need to do is to sit down with these local entrepreneurs and help them, but that is not happening.

In our experience, the international business community is generally ready to help. We get donations from big companies to help local entrepreneurs. But on their side, UN agencies, fi nancial institutions and NGOs need to encourage private sector business development much more actively than they do now. There is a kind of lingering hostility, a kind of suspicion or disdain toward the business community which has no place in these areas if what you are doing is trying to help local societies develop. Helping local entrepreneurs so that they can offer people jobs must be a part of that effort. In the short term this can be done through what I call the three “Fs”—facilitation, fl exibility, and fi nancing. Let me take them one by one.

Facilitation means help in writing business plans and other documentation that is needed by local entrepreneurs in order to be able to present their projects to local banks, to equity partners, wherever they need to present it. These are clever business people, but they do not have the experience of dealing with fi nancial institutions. International organizations can help.

46 Flexibility means that international organizations and lenders should work with the ideas that these people have and not try to impose their own. Lots of times, these local entrepreneurs know better than anyone else what will work in their societies, and they certainly know what they can do well. So it pays to listen to what they would like to do rather than having a list of priorities of what the country needs which is imposed from outside.

And fi nancing — fi nancing on a scale between $100,000 and a million dollars is what local entrepreneurs typically need — not micro fi nance. Micro fi nance has become very popular but it is smaller, it is necessity fi nance and not opportunity fi nance, and it is not of the scale needed to start a business. Business fi nancing currently has to be found, basically, through commercial lending. Sad to say, international fi nancing for local entrepreneurs is like something from another planet in most of the poor countries of this world. They just cannot fi nd it; they do not know where to go to get it. So new fi nancial vehicles are needed, with imaginative criteria and active marketing. Banks typically do not market their products, but in these societies they need to be marketed so that local entrepreneurs will know that it’s possible to go to some fi nancing organ in order to get someone to fi nance their business.

In the longer term, we need a new strategy that includes the private sector, not one that separates the private sector, but includes it. This kind of a strategy should be designed to encourage and help local entrepreneurs. Local entrepreneurs are the ones who offer jobs in their cities and towns. This does not mean that foreign direct investment is bad, because foreign direct investment will also provide jobs that stimulate economic activity. But the local entrepreneurs are the ones that need help.

We should also offer fi nancial incentives to private equity investors if they go into places where their investments are needed. Right now, that is not happening, so most equity investors will not go into the risky areas, and that is exactly where they are needed. They are needed now; they are not needed 10 years from now, for job creation reasons.

And we should open up our markets. This is an obvious point, one made by economists all the time, but it is also something that is not happening. To pick up on a point that Jeffrey Sachs was making, too often national aid programs are directed specifi cally to individuals and companies from that country, so that if you are a company from country X, you have access to the assistance programs from that country. That is not what we really need. What we really need is assistance programs that are open to local entrepreneurs, and not just to those from the country that is sponsoring the aid program. For such a strategy to work it needs high-level leadership, and this is where the integration and cooperation between international organizations, national aid programs, the private sector and leading NGOs is needed. If the private sector is not included, it cannot play a positive role.

I will conclude with a story from my own experience in the private sector, trying to work with the public sector. A company I was working with was about to build a two-and-a-half, to three billion dollar project in a country. As many companies do when they go into a very poor country, they like to surround such an investment project with all kinds of good works, just to get the good will of the people. They build clinics or add to the schools and typically have an aid program of their own, in order to surround their investment with benefi cial works. In our case, we had allotted about four or fi ve million dollars for such works, and since we had an aid program of four to fi ve million dollars we were at the same scale as many of the countries that had offi cial aid programs in that country.

So I called up the chairman of the donor group of aid-giving countries and asked if we could sit in on their meetings as an observer, just to understand what the priorities were, and what programs were already being done, since we did not want to duplicate things. We wanted to be in step, basically, with the international community and its priorities for that country. The chairman of the donor group said he would check around, and he later called me back and said no, we could not participate because we were a company. And I just thought that was dumb, really dumb. We were as big an aid program as any of the donor countries, and yet we were artifi cially excluded from knowing what the priorities of the international community were for that country. That kind of dumbness doesn’t help when you’re trying to address problems of the scale of those that are set up in the MDGs.

47 Often, when I come to conferences like this one, the private sector is somehow considered an alien group among the organizations and NGOs that are represented. That is why we started the Business Humanitarian Forum: so there could be a better dialogue and better cooperation between humanitarian organizations and members of the private sector. So I welcome this opportunity to explain my views. Thank you very much.

48 Panel Two—Question and Answer Session

Begleiter. Thanks very much. I want to take your questions, but I’d like to give both panelists the opportunity to respond to something that Jeffrey Sachs said. John, you touched on it just now but I would like to put it more starkly, and I think, Dick, you would like to respond as well. The accusation is that when American businesses, particularly American businesses, but I think this is true for some other countries as well, get involved in these types of projects, a lot of the money that is publicly portrayed as being offered to the recipients actually ends up in the pockets of companies that originate in the countries that are giving the aid. He portrayed this as a very dramatic problem. I do not think he put quite enough emphasis on the public education aspect of this, and I would like you to comment. Do we really understand the extent of this problem or do you think it is not as big a problem as he portrayed it?

Maresca. It is true, that is the way aid programs work. If you go to any country and start looking at the regulations for a project, almost inevitably, you will fi nd something about companies from that country. Even if it is not written down, it is easier for companies from that country. Let’s talk about the so-called beltway bandits around Washington. Beltway bandits, for those who are not used to this Washington jargon, are companies that seek aid contracts or government contracts in general, and operate in the Washington beltway because their targets are U.S. government agencies that have contracts to offer. It is just easier for them. They are credible to the agencies they go to see, they’re often ex-employees of those agencies so they know exactly who to go to. They may have been the previous boss of the offi cial that they go to see, and all of that helps. And that’s true of just about any country, whether it be…well, I won’t name countries. It is not totally bad. In some cases it works quite well because of the fact that there is an easy coordination and easy understanding between the two. But it is very true also, as Jeffrey said, that the way this works in the fi eld is that you have consultants who are under contract and being paid higher wages than locals, who are often not as well qualifi ed as some locals, and who are there pontifi cating about what should be done, and not really participating in the hard work. So that happens too.

Morford. Yes…it is true that a lot of U.S. aid is tied—not all, but a lot. The U.S. gave $19 billion in aid last year and $3.2 billion of it went to Africa, which was three times what was given to Africa in 2000, and the amount given all around the world in 2000 from the United States was roughly $10 billion, so we’re up roughly 90% in roughly four years. That number will increase because it does not include anything from the Millennium Challenge Account yet. We just began disbursing this year; we are new. It does not include much of what was in the AIDS account, some, but not up to the amount that is going to be distributed through the HIV/AIDS program at the State Department. So the U.S. numbers will grow. Regarding tied aid, Congress gave us some really lovely things. Why they wouldn’t give it to USAID or the State Department or a lot of other agencies, you would have to ask them. I cannot speak for Congress, but they were nice to us. They gave us untied money. They gave us no-year money, which means at the end of September, the end of the fi scal year, we don’t give back the money if we do not spend it. Thus, they gave us a billion dollars the fi rst half-year, a billion-and-a-half the second year. We have not reached our targets for this coming year, but that whole two-and-a-half billion dollars is in the Treasury in our bank account. We have now committed roughly a billion of that to the countries that we are working with. They also gave us one more thing, and we did not even talk about this, but this is the “earmarks” that are in so much legislation. We are “un-earmarked,” so we can actually go to countries and say, “What is it that you really need”?

How will the procurement be done for our Account? Procurement will happen in the country. Does that mean that American companies cannot compete? Well, we will certainly give them every opportunity to compete, but all procurement will be done on international tenders so that the whole world will be able to compete for these contracts. In this sense, we are actually doing what we said. I hope that all of you will support this approach because I would hate for it to be taken away from us. It really does allow us to operate in this new way.

Begleiter. No political limits on spending?

49 Morford. There are no political limits; there are some things that we cannot do. We cannot give money to militaries. We cannot do things that will endanger people’s lives or the environment, and we do have the famous Mexico City language regarding reproduction. That is it.

Q. Joe Riverson, World Vision. I want to thank Ambassador Maresca for his very positive comments about the role of the private sector. My name is Joe Riverson from World Vision and I come from the country of Ghana. I thought that it is important for the political environment in a particular country to be attractive, welcoming and encouraging to the private sector in order to encourage local and private entrepreneurs to do their bit in helping develop the country. I come from a country where, for nearly 50 years the head of state looked on private entrepreneurs and private businesspeople as opponents of his government and therefore did not give them virtually any leeway in doing anything. We have a government now that is encouraging the private sector to be part of the development of our country, and fortunately my country is one of those that have benefi ted from debt relief and debt cancellation, and together with the private sector in Ghana they are doing a lot to try to improve the lot of the people. Thank you.

Begleiter. Do you want to comment?

Maresca. Just a brief comment. You know, there’s a Russian joke that goes like this: a businessman is someone who is temporarily out of jail. Actually, in Russia these days they tend to be in jail more than out, but this represents the views of many people in this world. And it is not always incorrect. There are many unscrupulous business people. But there are unscrupulous people everywhere. There are unscrupulous people in universities, in religious institutions, in the UN, and so forth, so it is not unusual that there are also unscrupulous people in business. By and large, the business community is useful. In any case, it has to be used, because it is the only way we have of generating real jobs and all of the other things that come with business development.

Begleiter. Dick, did you want to comment?

Morford. No, except to say that Ghana—just recognition where recognition is deserved—is one of the MCA countries I had a chance to visit recently, and they are working very hard on their MCA proposal, which is quite an ambitious one, actually.

Questioner. Thank you. All three of you have made very positive contributions but I was quite struck by the tone and the power of what Jeffrey Sachs said, and the question I have to the panelists and maybe even later in the afternoon to some of us who participate, is that given this clear message, given his [Sachs] own position in the country—which means that he is heard by many, including policymakers—and I am sure he is not the only one, what are the obstacles to heeding that message and acting upon it?

Begleiter. I guess the simple answer to that is that he has not been elected to anything. Would you care to comment?

Maresca. Jeffrey is heard. I think he has a lot of infl uence. Even people who criticize his comments and some of his phrases, nevertheless respect his views, and I think he has had a lot of infl uence. I would respond to you in this way: the Millennium Development Goals are so huge that I do not think anybody really understood what was being taken on, and I would suggest to you that 10 years from now, or starting even about fi ve years from now, politicians will be scrambling to try to identify why these things are not going to happen, because they are going to be held accountable. People will start saying, “Why did we not reach these goals?” and there will be analyses. Professors will be writing books about why this goal was not reached, or why that goal was not reached, and the real answer is that they are simply very hard to reach. How do you deal with some of these problems? Nobody really has a magical answer; these are huge problems and the world has faced them for a long time. There is no reason to think that suddenly, during these 15 years in particular, we will make huge steps forward toward reaching them. Actually, the amount of money that is available for humanitarian aid is going down in real terms. By one

50 statistic I read, it is going down in real terms by about 12% per year. In any case, it is not going up, whereas the problems are getting bigger and bigger. The amount of water is the same size, but the populations are growing, so the problems get bigger and bigger, and yet the resources we have available to deal with them are getting smaller and smaller. That is why we have people like me, looking around and wondering if there is something else we can use here. Maybe the private sector can help, maybe something else will help. Everybody needs to fi n d new ways of achieving these goals, because the old ways visibly are not getting us there.

Morford. I would like to take us back, in a sense, to what the international community agreed to in Monterrey when the question came up of how do you reach these MDGs? They really came up with a three-part solution and the fi rst part was each country has primary responsibility for its own development through good governance, sound policies and the rule of law. It is tough to make progress without those things. You can make some progress but it is tough to make it over the long term. Secondly, that all resources need to be tapped to fi nance development, particular domestic resources, sustainable debt fi nancing, investment and trade. When you look at how much money is out there—two trillion dollars in domestic savings in developing countries, over nine trillion dollars, according to Hernando de Soto and the report from President Zedillo, in unrecognized—in other words out of the legal system—assets in developing countries. You realize there’s a lot of money out there. You also realize very quickly that what happens in trade and investment just dwarfs anything that is happening as far as foreign assistance. The third leg of it, though, was that aid is an essential complement. Aid is really a catalyst; it can allow all these other things to happen sometimes. It is very important. It’s not that it is unimportant because it is smaller; it is very important. But how we use it is critical, and that is where, I think, some people wonder whether Mr. Sachs has got it all right. There is a certain amount of let’s do it all, let’s do all right now and there are concerns. There are concerns about the capacity on the ground. Wouldn’t it be better to step it up over time so that you actually have the capacity?

Failure is not a very good option, obviously, because then all of the excitement, all of the additional resources will disappear. Aid is actually going up, and it is going up very fast, and it should be going up considerably more over the next fi ve years—you’re going to see fairly large volumes of aid. How we spend it is going to be critical. If we spend it wrong, then where are we going to be 10 years from now? People are going to be back saying, wasn’t that a waste? We do not want that to happen, we want it to be used well and that is really critical. So I think the question people have is, yes more aid is necessary, but how do we do it in a way where we mobilize the resources, where we have the kind of governance where the aid will be used well, and where we end up with the result that is sustained over time and not one of these up and down kinds of periodic excitement—try hard, not reach, disappointment, and aid levels go down like they did at the end of the 1990s—that is not what we want.

Begleiter. The last question, please.

Q. Liv Ullmann, founder, Women’s Commission for Refugee Women and Children. Mr. Morford, you told us about the three limitations you had and one was the reproduction issue, and you said, “That’s it.” For me, that is very diffi cult to understand, that you said “That’s it” like it is just a minor thing that your limitation has to do with the reproduction issue.

Morford. When I said, “Yes, that’s it,” that was a response to someone from the audience. It is not little; but it is not large in the totality of what is needed. I am not going to say anything about it, particularly, because it is forced upon us by our Congress. These are things that are in our legislation just as they are in USAID’s legislation. However, if you look at the number of earmarks that USAID has, which is more than 270, we have very little in our legislation that restricts the ability of a country to come to us and say what they would like to do, and that includes all kinds of health issues, including reproductive health issues that do not go beyond that line. But that is the restriction we are stuck with. We would prefer to have none at all.

51 Q. Susan Wyly, Partners In Health. I just wanted to clarify. Are you saying that it is a restriction imposed by Congress, or that it is a restriction imposed by this President?

Morford. It is in our law. It is in our law, in the founding legislation we have.

Q. Susan Wyly. Reinstated by President Bush.

Morford. I can read you the law, I can show it to you later and you can see what it is. The Bush Administration did not have it in our original bill.

52 AFTERNOON SESSION – OPENING COMMENTS

Pierre Muller, Administrative Councillor and member of the Executive Council, City of Geneva.

Madame High Commissioner for Human Rights, your Excellencies, distinguished guests, ladies and gentlemen. First, I think I will introduce this gentleman beside me, because I am sure you are wondering what I am doing with this colorful guy standing beside me. These are the colors of the Geneva fl a g and when we go out on offi cial visits, we are always accompanied. I do not know how to translate the term — i n America you wear a sash, but here in Geneva you get a gentleman, who is far better to talk to than a sash.

I am truly honored to welcome this prestigious gallery of guests and speakers who represent the intellectual and practical work force of the humanitarian world. As the cradle of humanitarian world, the City of Geneva is particularly pleased that on this occasion — on the 10th anniversary of its Humanitarian Prize — the Conrad Hilton Foundation has chosen our city to hold its symposium and ceremony.

Our world is at the crossroads of a complex web of evils, when natural disasters and geo-politics mix. In their midst, a great number of humanitarian organizations are often caught between states and dollars and the need to assist vulnerable populations. Indeed, it takes the skills of a diplomat, the competencies of a doctor and the dexterity of a carpenter to unravel the intricacies of international humanitarian assistance today. Our country, Switzerland, is politically committed to the applications of instruments that protect civilian populations, in particular women, children, the elderly and the handicapped. As you very well know, Switzerland works through diplomatic intervention and public appeals to advocate for respect for international humanitarian law, human rights and international refugee law, and works actively to further develop these areas and their many aspects. Concomitantly, the Swiss government is actively involved in the pursuit of the Millennium Development Goals, which of course includes the protection of the vulnerable. You must have certainly discussed the Swiss government’s position on this matter this morning, and so I will refrain from going further.

The City of Geneva participated in the recent Millennium Campaign at the Millennium Summit in New York. As a member of the organization United Cities and Local Governments, we put up our banner in front of the city hall to show our commitment to the MDGs. The banner iterated each MDG and was accompanied by the slogan, “2015 — No Excuse, the World Must Be a Better Place.” In 2000, the City of Geneva passed a regulation incorporating humanitarian assistance and human rights that particularly deals with governance, participation, and sustainable development. The measures needed to implement this regulation can take different forms, such as the logistical support in the City’s fi e ld of competence, investment in the infrastructure, reconstruction and subsidies. All these actions seek not only to save human life when it is threatened and to alleviate suffering, in particular in populations that are victims of confl ict and natural disasters. These are also meant to give local communities the means to develop themselves in the most peaceful and effi cient way, incorporating common projects while exchanging very specifi c universal experiences.

More specifi cally, the City of Geneva regularly supports the Swiss Red Cross in its humanitarian missions. For example, we have provided fi nancial support to the lifesaving effort during the earthquakes in Iran and Morocco, and to sustaining emergency humanitarian projects to protect Sudanese refugees in Chad, as well as the vulnerable population in Darfur. More recently, our Executive Council approved an emergency fund for the victims of natural disasters in Kashmir, Honduras and El Salvador.

I salute Partners In Health, the 2005 Hilton Humanitarian Prize recipient. Allow me to pay a vibrant tribute to your work and unswerving dedication and untiring effort under, most certainly, diffi cult conditions, to alleviate suffering and to bring back the dignity of countless human lives. I am sure that the fi nancial part of the award will further immensely the work that you started in 1987. Let me say to the organizers of this conference that I wish them a lively and fruitful discussion with the participants. Ladies and gentlemen, you can count on the steadfast support of the City of Geneva in all your undertakings. A most pleasant day to all of you. Thank you. 53 AFTERNOON SESSION – ASSURING A FUTURE FOR THREATENED POPULATIONS

Louise Arbour, LL.L., United Nations High Commissioner For Human Rights

Louise Arbour was appointed UN High Commissioner for Human Rights in 2004. Ms. Arbour, a Canadian national, began a distinguished academic career in 1970, culminating in the positions of Associate Professor and Associate Dean at the Osgood Hall Law School of York University in Toronto, Canada. In 1987, she was appointed to the Supreme Court of Ontario (High Court of Justice) and in 1990 she was appointed to the Court of Appeal for Ontario. In 1995, Ms. Arbour was appointed by Order-in-Council as single Commissioner to conduct an inquiry into certain events at the Prisons for Women in Kingston, Ontario. In 1996, she was appointed by the Security Council of the United Nations as Chief Prosecutor for the International Criminal Tribunals for the former Yugoslavia and for Rwanda. After three years as Prosecutor, she resigned to take up an appointment to the Supreme Court of Canada. Ms. Arbour completed an LL.L (with distinction) from the Faculty of Law, University of Montreal in 1970. Following the Quebec Bar Admission Course, she was called to the Quebec Bar in 1971 and the Ontario Bar in 1977. Ms. Arbour has received honorary doctorates from twenty- seven universities and numerous medals and awards. She has published extensively on criminal law and given innumerable addresses on both national and international criminal law.

Responsibility to Protect: The End of Ambiguity

Thank you very much, Mr. Chairman. What I would like to address at the opening of this very distinguished panel is what I believe may be the roots of a small, legal revolution—or at least, the beginning of the end of ambiguity. I refer to the fact that the fundamental concept of the responsibility of states to protect their populations has now been enshrined in the Outcome Document of the World Summit that was held in New York in September. I would like to just take a few minutes to tell you why I believe that this could actually signal the beginning of a genuine revolution, if not in international law, at least I hope in international politics and in international practice.

This responsibility to protect is actually worded in the Outcome Document of the Summit as containing three parts. The fi rst one is the unambiguous assertion that each individual state has the responsibility to protect its populations from genocide, crimes against humanity, ethnic cleansing, and war crimes. This responsibility, it says, entails the prevention of such crimes including their incitement, and 191 member states of the United Nations, 162 of which were represented in New York by their heads of states and governments, stated unequivocally, “We accept the responsibility and will act in accordance with it.” Now that is the fi rst component of this responsibility to protect, and I believe that this is actually almost nothing short of a revolutionary commitment, if we take it to what I hope will be, eventually, its extension.

The second part of that assertion in the Outcome Document of the Summit is that the international community, through the United Nations, also has the responsibility to use all peaceful means to protect populations from these crimes. So if states fail in discharging this responsibility, the document asserts that the international community has the responsibility to use all peaceful means. And I can assure you that I run an offi ce that disposes of a lot of peaceful means, and we intend to live up to, and to take full advantage of this broad scope of action for us.

Finally, and it may be the most critical part, the document provides that, if there is failure by a state to meet these responsibilities in a timely and decisive manner, the international community is prepared to take collective action through the Security Council in accordance with the UN Charter, in particular Chapter Seven: “Should peaceful means be inadequate or national authorities manifestly fail to protect their populations from such crimes.” Protection by peaceful means; protection of very vulnerable populations from genocide, crimes against

54 humanity, war crimes, ethnic cleansing — up to now, I think the most visible peaceful means has been recourse to international criminal justice — personal criminal responsibility of offenders. This is an area that I am very familiar with, having been associated with it, but historically it contained its own limitations. I believe it is in the process of fi nding its full scope of action. The ad hoc tribunals for the former Yugoslavia and Rwanda, and similar ones in Sierra Leone, one also about to be launched in Cambodia, a serious war crimes unit in Timor—all these were essentially after-the-fact specifi c forms of intervention. The creation of the International Criminal Court is obviously a major step in the right direction. I understand that the 100th ratifi cation was deposited in New York, I believe by Mexico just last week, so it has a very broad base of international support despite not just a hesitance, but a hostility, of the United States against this institution. I am also a very big fan of the extension of the concept of international jurisdictions in national states, whereby crimes of this order of magnitude committed anywhere in the world can be prosecuted if the offender is found on the territory. We have seen it happen in Spain, Belgium, and now Canada has recently activated these provisions. I think it is a very welcome development, to use peaceful means to enforce the international community’s responsibility to protect when states fail. Less peaceful means range from sanctions to military intervention, and that is basically for the Security Council.

Traditionally, I think we can anticipate three forms of action. The best one is the Security Council, because it is vested very explicitly in the UN charter with these powers of intervention. If the Security Council is unwilling or unable to act either by use or threat of use of the veto, or lack of consensus, the question is whether unilateral action or coalitions of the willing are an appropriate alternative. That carries a lot of diffi culty. What I would like to propose, for those jurists in the room who are interested in this question, is the suggestion in background documents on the responsibility to protect of reactivating the role of the General Assembly of the United Nations if the Security Council is unwilling to discharge its responsibility. There is a 1950s resolution called the Uniting for Peace resolution, which permits the General Assembly to deal with matters of threats to international peace and security when the Security Council is unwilling or unable to act. I hope that we will see in the future maybe a renewed recourse to that United Nations-based collective action that I think would be a much more appropriate substitute than unilateral action or the forming of coalitions.

Allow me to make two points to conclude my remarks. The fi rst one is that the Outcome Document of the Summit also provides for the expansion of the scope of intervention. The genocide convention, which invites the responsibility to prevent and to punish genocide, is of course limited to the crime of genocide, and we all know it has led to a lot of reluctance on the part of member states to label a situation a genocide, so as not to trigger this particular responsibility. The Outcome Document now imposes or acknowledges the same responsibility for crimes against humanity, so the somewhat odious debate is still taking place as to whether or not the events in Darfur amount to genocide or mere crimes against humanity—and that is offensive enough, to refer to crimes against humanity as “mere” crimes — in a sense, that debate is over. The responsibility to protect, to intervene, should be equally triggered whether it is actually genocide—technically, legally defi ned genocide—or whether we are witnessing ethnic cleansing, war crimes, or crimes against humanity. That is a very welcome development.

Finally, if I am correct, these are the roots of a revolution. I believe that, in maybe fi ve or ten years, rather than merely assert a responsibility to protect civil and political rights, which is what we are currently doing, we will then also see an expansion of acknowledging states’ responsibilities to protect their populations in the fi eld of economic, social, and cultural rights. It seems to me that we should exert exactly the same responsibility to protect populations from genocide and war crimes. We should exert the same responsibility to protect populations from starvation, disease, and uphold other social and economic rights, where states cannot be allowed to be willfully blind or in fact, to be complicit in predatory practices against their own populations on this basis. We are not there yet, but I believe that the erosion of the concept of state sovereignty as a shield against responsibility and accountability has now been extremely well expressed in that document, and I think we can only see progress in the legal infrastructure and the political climate that will permit us to assert with more confi dence that this will never happen again, at least not on our watch. Thank you.

55 Colin S. Thomas-Jensen, Advocacy and Research Offi cer for Africa, International Crisis Group

Mr. Thomas-Jensen is based in the International Crisis Group’s offi ce in Washington DC, where he has a roving brief of advocacy and research responsibilities across Africa. He joined International Crisis Group from the U.S. Agency for International Development (USAID), where he was an information offi cer on the humanitarian response team for Darfur. Earlier, he served as a Peace Corps volunteer in Ethiopia (1998-1999) and Mozambique (1999-2001). He has traveled extensively in East and Southern Africa. Colin received his Master’s Degree in African Studies at the University of London’s School of Oriental and African Studies (SOAS) in 2003, with a concentration in the history of Islam in Africa, African politics, and Islamic family law. He graduated from Pomona College (California) in 1997. Mr. Thomas-Jensen has authored commentaries in the Boston Globe, Business Day (SA), the East African, and elsewhere.

When Theory Meets the Janjaweed

Thank you very much, Ralph, and thanks to the Conrad Hilton Foundation for hosting this event. I have been asked to talk about Sudan, and with Francis Deng sitting so close to me, it is a bit intimidating, but hopefully I can say a few words to spark some debate.

The fi rst time I visited Darfur was just about this time last year when I was part of the U.S. government’s disaster assistance response team. My job was to make sure that the right information from the fi eld was getting back to policymakers in Washington. I spent most of my time in and around Geneina, which is the capital of West Darfur, and if you look on a map of Africa, it is almost exactly the center of the continent. A United Nations security offi cer, who was South African, briefed me upon my arrival in Geneina. He summed up the situation there quite succinctly, and I quote, “This is a sorry, depressing place, mate,” and proceeded to tell me about all the places I could not go.

But there were places I could go; security was safe enough and I was able to travel south. My driver Ibrahim and I spent a lot of time on the road south of Darfur—and “road” in Darfur is a loose term, for anyone who has been there. Roads are anywhere you can get the car through. We traveled south; we saw burned villages; we saw livestock roaming freely on abandoned farms; and every so often we saw a guy with an assault rifl e on a camel. For the fi rst time, I had seen the notorious Janjaweed militias that I had heard so much about. And it was, as I had been forewarned, pretty depressing.

Ibrahim and I went to a town called Habilah, where thousands of displaced Darfuris sought refuge in late 2003 and set up shelter outside of town. In the center of Habilah there is a large tree, and under the tree, when we drove into town in our clearly marked U.S. government vehicle, there were about 25 men with assault rifl es and their camels, just milling about and going about their business. The fear and anger in that town were palpable. One woman I spoke with told me that she did not think she was ever going to be able to go home.

So the time I spent in Darfur taught me a lot about responsibility; it made me do a lot of thinking. When these types of crimes occur—when governments turn against their own citizens—who is responsible for protecting the victims? It says a good deal about where we are, that one of the few things that was not controversial at this year’s World Summit was the idea that Judge Arbour so eloquently outlined of the responsibility to protect. This is basically a concept that turns the debate over humanitarian intervention, and indeed the whole notion of state sovereignty, on its head. In a remarkably short time—the report that put this idea out there was fi rst published in 2001—this concept has gone from the “good idea” stage to what is really now a broadly accepted, normative framework for responding to these types of crimes. In theory, it paves the way for the international community to respond collectively to genocide and atrocity crimes while they are occurring. However, as we are all aware, theory and practice are rarely harmonious, and in Darfur, theory has run into a brick wall.

56 A brief outline, for those of you who are not familiar with the situation. Civilians in Darfur have been under direct attack since early 2003, and I think many researchers and people who know the area would say that they had been under attack for a great deal longer than that. The situation since the 1980s has been described by one French analyst as “ethnic cleansing on the installment plan.” The government of Sudan’s gloomily predictable security clique in Khartoum has orchestrated a counter insurgency campaign that targets the civilian populations it accuses of supporting the rebellion. Government forces and their proxy militias—the aforementioned Janjaweed— attack civilians with impunity. Their atrocities are well documented by the United Nations, individual member states, human rights groups and humanitarian NGOs. To put it mildly, the government of Sudan is failing in its responsibility to protect, and in theory this responsibility has now fallen to the international community. Why then, are the atrocities continuing, and in fact, over the past month getting a lot worse, more than two-and-a-half years since these crimes have come to light? I’m going to propose three reasons.

One is simply the structure of the Security Council and the veto. Two is the capacity of regional organizations to respond to these types of crises when the Security Council cannot. And three is that ever-important question of political will, and that is obviously the toughest.

So, what is wrong with the Security Council? Well, the theory says that the United Nations, through the Security Council, should take action to protect Darfuri civilians; it is quite clear. In practice, the permanent fi ve have the veto, and building a consensus for intervention, military or otherwise, that infringes on Sudanese sovereignty has met with stiff resistance from some members, perhaps most notably, China. The Chinese are keen to protect their substantial oil interests in Sudan, obtained through deals with members of the Sudanese government who are currently responsible for these crimes and accused of these atrocities. The Chinese shield their business partners from trouble to keep the oil fl owing, and a cynic like myself—don’t let my age fool you here—might also suggest that the Chinese are not only indifferent to Darfur’s agony but also benefi t from it. Sudan’s continued pariah status in the West makes doing business there unattractive for Western companies, and currently, for U.S. companies, impossible because of U.S. sanctions against Sudan, thus shielding China from unwanted competition.

I have singled out China here because I am speaking about Darfur, but other states with the veto can and do protect their own interests, and shirk their responsibilities with that veto at the expense of human lives. One country’s intransigence makes it easy for other states to cry foul, when in reality a united Security Council could just as easily fail to act. In the absence of strong Security Council action, the theory suggests that regional organizations, acting within their own region—and the obvious choice here would be the African Union—can and should intervene where atrocity crimes are occurring, yet, both practical problems and political ones have prevented the African Union from fulfi lling our collective responsibility. The African Union should certainly be commended for their efforts and their sacrifi ce in Darfur—they recently lost four troops who were killed in an attack—but we also need to be honest about this organization’s current capacity to respond to crises of this magnitude. Even with NATO and the European Union providing some assistance, the simple facts on the ground are that the African Union force lacks the mandate, the troop strength and the operational capacity to do the job. And I think here, Khartoum’s rather half-hearted objections to African Union intervention are an indication of how good their prospects were from the beginning. In fact, I think the African Union efforts to date have a lot in common with our responsibility to protect as a whole—well-intentioned but completely inadequate.

If the international community has failed Darfur by passing the buck to the embryonic African Union, then African policymakers have also failed by refusing to acknowledge the African Union’s defi ciencies. For the most part, African policymakers have argued that Darfur is an African problem demanding an African solution, dismissing suggestions of increased non-African involvement as meddling in the continent’s affairs and thereby providing the international community with a convenient excuse to do nothing. Regrettably for many of the two-and-a-half million displaced and vulnerable Africans in Darfur, this African solution looks like a death sentence, and the African Union’s failure could very well hurt the organization’s credibility in peace support operations in the future.

57 What about non-African, non-Security Council intervention, leaving aside whether or not Africa would accept it? Well, the theory says that if the Security Council fails to discharge its responsibility in conscience-shocking situations like Darfur, then concerned states, a coalition of the willing, can intervene to stop the slaughter. In practice, hundreds of thousands of African lives in the balance is simply not enough to generate the necessary political will.

What makes this lack of intellectual courage and political fortitude so disturbing in Darfur is that there are policy responses available. My organization, the International Crisis Group, is in the business of coming up with reasonable and realistic policy responses. We published a report in July, after much deliberation, in which we argued that a NATO bridging force could assist the African Union in meeting Darfur’s civilian protection needs. The responses in Washington and in European and African capitals to this proposal were tepid. Of course, there are elected offi cials and civil servants around the world who are committed to preventing the types of atrocities taking place in Darfur, but even speaking collectively, those voices cannot match the deafening silence, and indeed the active opposition of others. The international community is a bit like the alcoholic who always says he’s going to quit tomorrow. We have identifi ed what is unacceptable, we have a framework for response, but we have not taken appropriate actions to protect vulnerable populations in Darfur, and we have got a lot of work to do if we are going to take it from theory to practice.

So what are the next steps? I have three. First, the permanent fi ve Security Council states must agree to a Code of Conduct to prevent Security Council action designed to stop or avert a humanitarian crisis like Darfur, and the Code of Conduct is pretty simple—you just do not use the veto to prevent a response to a humanitarian crisis. Second, the international community must use the diplomatic and the military capacities of regional organizations like the African Union to respond to these crises in their back yard, and at the same time, regional organizations must accept the necessary assistance from the wider international community when that capacity is lacking. Third, and I think most important, policymakers must have the political will to respond, and they must be held accountable when they do not by political constituencies that will not tolerate acts of barbarism by any government against its citizens. This of course is the toughest one to attain, and I think that building this constituency at the grassroots level will be a long and frustrating process.

To conclude, the last I heard, Habilah, the little town I visited, is completely cut off from humanitarian assistance right now because of relentless Janjaweed attacks in that area. The Janjaweed are responsible for some of the worst atrocities in a decade. These guys do not read theory, they do not attend UN summits, and as long as we fail to respond to their crimes, they and others like them will continue to go about their business, operating with impunity in that gaping divide between international norms and meaningful action. Thank you.

58 Paul Rusesabagina, Founder, Hotel Rwanda Rusesabagina Foundation

Paul Rusesabagina, the former manager of the Mille Collines hotel in Kigali, Rwanda, was born in 1954 at Murama-Gitarama in the Central-South of the country. After fi n ishing school, he was employed by Sabena as a front offi ce manager in their new Hotel Akagera in a national park, where he discovered the tourism and hotel industry. In 1980, he pursued this fi eld at the Kenya Utalii College in Nairobi, where he studied hotel management until his graduation in 1984 in Switzerland. Upon his return to Rwanda, he joined Sabena again, as assistant general manager in the Mille Collines in Kigali until 1993, when he was promoted to general manager at the Diplomate hotel. When the Rwandan genocide began, he returned to the Mille Collines and remained there for almost the entire span of the 100-day genocide. He took over as general manager after many of the hotel’s staff had fl ed, opting instead to shelter over 1,200 people threatened by the Hutu-led Interhamwe militias who were slaughtering the Tutsi population. Rusesabagina, a Hutu, chose to stay with his wife, a Tutsi, and their children, using his position and ingenuity to shelter orphans and refugees in the hotel. In 1996, he and his family went to Belgium as refugees and have lived there since. In 2004, his story was adapted for the big screen and was released as “Hotel Rwanda.” He recently set up the Hotel Rwanda Rusesabagina Foundation to help survivors of the Rwandan genocide. In June 2005, he was awarded the United Nations World Refugee Day Humanitarian Award.

From Rwanda to Darfur: The Past Repeating the Present?

Good afternoon, everybody. Once again it is a pleasure to fi nd myself in Geneva for this special opportunity, for the Conrad Hilton Foundation’s Humanitarian Award. Today, I’m going to talk about the Rwanda issue and compare it with Darfur.

In 1990, a war broke out from the eastern side of Rwanda and that war immediately started the killing of civilians. As the rebels were advancing, civilians started fl eeing the occupied zones. Within the country, many political parties opposing the regime came up, frightened by both the rebels and the opposition. The then-president created a militia, but the militia also started killing civilians—Hutus and Tutsis together, all of us threatened, all of us scared. Many people decided to leave the country and went away as refugees, but a peace agreement was brokered by the United Nations and the United States. That was on August 4, 1993. To make it more reliable, to implement the peace agreement, the United Nations came in to protect us and assure our security. All those people who had decided to leave the country came back, gathered in schools in churches. When things became very tough, when both presidents were killed, the United Nations ran away. They simply closed their eyes and ears, turned their backs, and left us—a whole nation—to thugs, to thieves, to gangsters.

The result was the genocide of about a million people. After the genocide of a million people in one hundred days ended in July 1994, that is when that same international community sat down in New York in November and called the genocide by its name. I do not know where it came from, but maybe people sat somewhere and said, “What was happening was a genocide.” And yet a million people out of 7.5 million—that was about 15 percent of the whole population—were killed in a hundred days. An average of 10,000 people were killed each and every day. The whole world stood by, looked, watched and never said anything. We saw churches, all the churches together, keeping quiet and their silence was complicity. After that, did we have peace? Had we learned from the past? No. That is why, more than two years later, most of us had to go away as refugees. As we were leaving the country, another war broke out in the Congo. Since that time—1996 up to 2005—many millions of innocent people—the United Nations talks about four million people—have been killed. What have we done? Have we been talking about it? Have the media been talking about it? In Rwanda, I had seen people, a million people displaced within their own country, without food, without water, without shelter, without clothes, without any goals, without objectives, without schools for their children—for four years.

59 A few months ago, I went to Darfur. When I arrived in Darfur I saw that about two million people were displaced within Darfur. Many people had been killed. A gang of militia armed by the government was killing people, who were fl eeing completely burnt villages destroyed by government helicopters. There are so many ghost cities. When we were crossing the border, there was a small city which used to have 48,000 people…when we were there, there were only 200 people left. What shall we call that? Is it really a city, a ghost city? How can we qualify that? One of the few people who had made it was sleeping again in the Sahara sun, without food, without shelter, without any hope for future generations. What made us very angry were the children. When they saw us, about 2,000 kids gathered in about 15 minutes. They had a big blackboard on which they had written, “Welcome to our guests, but we need education.”

Ladies and gentlemen, today I am telling you that children and women are almost always the victims. They need an education. Thank you to those of you who provide education to those who need it, but how long shall we keep on providing people with food? How long shall we keep on helping people to eat? How long shall we bring fi sh to people? Are we ready to show people how to fi sh? What Africans need, I believe, is also to learn how to fi sh. How to learn how to fi sh is not to turn to European super powers, but to tell them the truth so that you can sit around the table. What we need in African countries is a round table, and to get all of us around that table to talk. We should not support the Khartoum government or the Kigali government or the Kampala government. We need to support all the Ugandans, all the Rwandans, all the Sudanese, the Darfurians with the Khartoum government…sit around the table and come up with the real decisions. I know that in the West you can do it; you can help us do it, because behind each and every African dictatorship, there is always a Western superpower maneuvering everything. Until all of us, as humanitarians, join our voices and tell all our leaders in the West to please leave those dictatorships alone, we will be forced to come around the table and deal, if no one supports us. Thank you.

60 Francis M. Deng, Distinguished Visiting Scholar at the Kluge Center of the U.S. Library of Congress

Francis Mading Deng is a Distinguished Visiting Scholar at the Kluge Center of the Library of Congress and Research Professor of International Politics, Law and Society and the Director of the Center for Displacement Studies at the Johns Hopkins University Paul H. Nitze School of Advanced International Studies (SAIS) in Washington, D.C. From 1992-2004, Dr. Deng served as Representative of the United Nations Secretary-General on Internally Displaced Persons and was concurrently a Senior Fellow of the United States Institute of Peace during 2002-03. He also has served as Human Rights Offi cer in the United Nations Secretariat, as Ambassador of Sudan to Canada, the Scandinavian countries and the United States, and as Sudan’s Minister of State for Foreign Affairs. Dr. Deng co-founded the Brookings (now Brookings-SAIS) Project on Internal Displacement and was a Distinguished Professor at the Graduate Center of the City University of New York. He has authored or edited more than 20 books and two novels. He holds an LL.B (Honours) from Khartoum University and an LL.M. and J.S.D. from Yale University.

Sudan — A Nation in Turbulence in Search of Itself

Thank you very much. Colin spoke of being intimidated, but I must say I’m the one intimidated by the insights they have already given, and by the powerful speeches of our distinguished guests here.

I want to say that Sudan is a country of paradoxes. At the moment, we have just witnessed what we hope will be lasting peace in the southern part of the country, while at the same time, as we have just heard, Darfur continues in turmoil. Other regions of the Sudan, eastern Sudan, and even possibly Nubia up in the North, are organizing opposition to the central government. I want to say that these issues should not be seen in isolation. These crises are all part of a chain of what the country is going through, and that chain of what the country is going through is what I call a nation in turbulent search of itself. I want to ask three questions. What was the war in the south—and now the wars we see going on in other parts of Sudan—about? How has the agreement in the south addressed what were the underlying causes of the confl ict? And what are the prospects for Sudan actually achieving a comprehensive peace?

Sudan is a country that has been experiencing an acute crisis of national identity. Now, if you ask people what the wars are all about, one word is very prominent, and that is “marginalization.” Marginalization was initially thought to be against the African south by the Arab-Islamic north, and as a matter of fact, it is the result of a long history in which the north was assimilated into the Arab-Islamic mold where people identifi ed themselves as Arabs. If you became a Muslim and you were Arabic-speaking, culturally Arabized, and you imagined you had Arab blood in you, you were elevated to a very high level of dignity. But if you were black and a heathen, you were not only denigrated, you were a potential slave. You were a legitimate target for slavery. What the north did, what the Arab-Islamic system did, was to allow people to pass so that—with these elements that I mentioned—you began to imagine yourself and see yourself as Arab, whatever your color of skin, whatever the factual realities evident on you. The south, on the other hand, became the hunting ground and the area of resistance. The British found this country and ruled it as two parts in one, and our assumption was that the country was divided in two—the Arab-Muslim north and the African south. The thing is, the north was not entirely Arabized. There were pockets of the north that remained African but were subsumed under the Arab-Islamic mold. And so you see the Nuba Mountains, the southern Blue Nile, Darfur, the Beja in the east, even Nubia in the extreme north, were all assumed to be part of the north that was considered to be Arab and Islamic. The south was kept as African, and Christianity was introduced to it; all the elements of today’s Africa were in the south.

When the British left, having developed the north more than the south, they decided to leave the country as a unit. That’s when the war started, because southern Sudanese began to fear that the whole situation of slavery was

61 going to return, and it did indeed return eventually. So the fi rst war, for 17 years, was a war of southerners not only resisting the north, but wanting to secede. In the end, that war was compromised by autonomy for the south. The agreement that gave the south autonomy was abrogated ten years later and the war resumed, but this time, instead of the southerners fi ghting to secede, they wanted to fi ght to transform the country on the assumption that the identity of the country that was discriminating against the non-Arabs, non-Muslims, was a distortion of the realities of the country. Even the so-called Arabs were actually an integration of Arab and African. Not only were the northern Sudanese not all Muslims, but even those who were Muslims had a religion that is like any other African Islamic religion on the continent, where there is a great deal of tolerance of other elements of different religions—that is true of most parts of the north. And yet, the central core, which is the core that calls itself Arab with orthodox Islam, wanted to impose their identity on the whole nation and become a basis for discriminating against others, and essentially against a signifi cant aspect of their own identity.

So the idea from the south was, “We are not seceding, we are not separating from the north. We are transforming the country to let Sudan become what it really is, not what it has been distorted to be.” That message was heeded by some people in the north by the people of southern Blue Nile and the Nuba Mountains. They joined the war in the mid 1980s. When other areas of the north also began to heed the message—in 1991 and 1992 the Darfurians rose up to join the south in transforming the country—they were crushed. Ten years later, they rose up again and that is the war we hear about now. The terrible reaction of the government is that this whole thing is just dragging on and on. The black groups of the country are rising up against what is, in effect, a minority that has been dominating the country. And so what you see is that terrible reaction against Darfur, as was indeed the case against the south. I would argue that the rise of Islamic fundamentalism in the Sudan is at least in signifi cant part, a defensive aggressiveness by a group of people who have been dominating the country, who see themselves as the image of the country, but who are now being challenged that the country is not what they think it is. Beyond the south, the Nuba Mountains and Darfur, the east is also bubbling and could explode any time. The Nubians in the extreme north are returning to pride in their ancient Nubian identity, and not what they have been made to believe—that they are Arabs.

How has the agreement addressed the issue? It has given the south the right of self-determination to be exercised after a six year interim period, including the right to secede. But within the six years, there is an arrangement where the south is virtually independent, has its own government, its own army, its own resource base. The hope is that peace will be made attractive and that unity will be made attractive, so that when southerners come to vote they will vote for the unity of the country. Now, many people think that they will vote for secession. I think it can be argued that what is going on in the country, what is going on in Darfur, what has already gone on in southern Blue Nile, is going to tell the southern Sudanese that they are indeed succeeding in changing the character of the country. And the country that is emerging, the New Sudan, is not a country that will marginalize them. It is a country where they will have the sense of belonging on equal terms with northerners. With this argument, there is a chance that they will vote for unity. But what has this agreement done to those areas of the north that are marginalized also? It has given the people of Nuba Mountains and Southern Blue Nile autonomy and a degree of self-determination within the framework of unity—internal self-determination, in other words. It has also been stipulated that the principles of the agreement in the south and these adjacent areas should also apply to Darfur and other marginalized areas of the north, even though not necessarily amounting to secession.

Let me end by saying that what has happened in the Sudan, although it is extreme, and you can say that Sudan is exceptional in many ways, is not unique. In my experience as Representative of the Secretary-General, going around the world, marginalization is the key—crises of identity where some people belong as dignifi ed citizens with all the rights of citizenship, others are so marginalized and excluded to the point of statelessness. I resonate very much with what the High Commissioner for Human Rights said about the responsibility to protect. In my Brookings Project on Africa, we developed, focusing on Africa, the notion of sovereignty as a responsibility; I used that concept in my dialogue with governments and the international community. I would go to a country, give the leadership the sense that I come with respect as Representative of the Secretary-General for IDPs for

62 their sovereignty, but that I regard sovereignty not as a barricade against international solidarity and involvement, but as a positive concept of state responsibility to protect its citizens.

My message to them was: If you need help, call on the international community to assist you, but if you lack the will and capacity and try to shield yourself from the international community in this day and age, when human rights and humanitarian values motivate the international community to get involved in internal affairs, nobody is going to be left alone to mistreat its people. The world will not see them suffering and dying, and yet do nothing. So the subtext, with a degree of comfort in the communication, would be: it is in your interest, it is the best way to protect your sovereignty, that you demonstrate your responsibility to protect your citizens. This concept has been reinforced by the Canadian-sponsored Commission on Intervention and State Sovereignty, whose report the Responsibility to Protect has been widely disseminated and positively received, albeit with controversy. It has been reinforced by what we just heard today and by many other statements from leaders around the world, particularly within the UN system. We have to go beyond that to tell governments that they must create frameworks where citizens generally belong, and where they deserve the dignity and respect of citizenship. Citizenship is not a paper value; it is the rights that accrue from being a citizen, and that is the message that should go along with the responsibility to protect—defi ning human rights, as the High Commissioner said, holistically, so that every citizen will feel a sense of belonging with the dignity of citizenship. Thank you.

63 Bineta Diop, Executive Director and founder of Femmes Africa Solidarité

Bineta Diop of Senegal began her career in human rights 27 years ago as Program Coordinator of the International Commission of Jurists, where she obtained extensive experience in human rights issues in Asia, Africa and Latin America. Ms. Diop has led Femmes Africa Solidarité in numerous peace-building programs, including the creation of a strong West African women’s movement, the Mano River Women’s Peace Network (MARWOPNET). In 2003, the General Assembly awarded MARWOPNET the UN Prize in the fi eld of Human Rights. Ms. Diop has observed elections in post- confl ict areas and facilitated peace talks, particularly for Burundian and Congolese women. In 1999, she was appointed General Rapporteur to the UNESCO Pan-African Women’s Conference on a Culture of Peace. As a member of the African Women’s Committee for Peace and Development (AWCPD), Ms. Diop played an instrumental role in achieving gender parity within the African Union Commission in 2003. These efforts culminated in July of 2004 as the African Union adopted the “Solemn Declaration on Gender Equality in Africa.” In 2005, FAS organized the African Gender Forum which promotes South-South dialogue between African and Arab women leaders. Furthermore, Ms. Diop chairs the United Nations Working Group on Peace in Geneva, which is part of the NGO Committee on the Status of Women. In this capacity, she will monitor the implementation of UN Security Council Resolution 1325 on Women, Peace and Security. Ms. Diop also serves as a member of the Group of International Advisors to the International Committee of the Red Cross (ICRC).

Why is Gender Still Not on the Peace and Security Agenda in Africa?

Thank you, I am very happy to be with you today. I remember fi ve years ago in this same room, I did ask the question why gender was not mainstream in peace and security. I think we still ask that same question, even though I congratulate the Hilton Foundation for taking this issue very seriously. I see the number of women present, I see the panelists, I see the gender issues in the humanitarian issues that we are discussing.

Today, we are focusing on vulnerable populations and the role and responsibility of the international community. I will briefl y discuss gender in the peace and security agenda in Africa. I am not here today to go back to what Francis Deng has said about the root causes of our confl icts. I think, for Africa, there is no time to lament. What we have observed is the changing nature of confl ict in Africa. In the ’90s, we can say it was transformed from the way it has been traditionally fought with an increasing predominance of civilians among the casualties. Right now what do we see? The number of confl icts has been decreasing—40% less in 2005 than in 1992—and there are fewer casualties right now, but this has not resulted in a decrease in human suffering.

It can even be said that human suffering and the lack of human security in Africa has increased, as is the case in Darfur. This is due to the fact that psychological warfare is practiced more and more, and this has resulted in the increase of psychological weapons against innocent civilians. For example, some of you have seen in Sierra Leone the amputee camp where you fi nd children and babies amputated. Women continue to suffer in distinct ways, not because of any intrinsic weakness, but because of their position in society. Rape, which has been mentioned several times today, is a very strong and powerful psychological weapon used by combatants to terrify and humiliate people and communities. For example, 5,000 cases of rape, corresponding to an average of 40 a day, were recorded in one area of the DRC [Democratic Republic of Congo] by women’s associations in 2003. Women are even more vulnerable to gender-based violence when they are internally displaced or refugees. For example, in Sierra Leone, 94% of the displaced households have experienced sexual assaults, including torture and slavery. However, it is unfair to relegate all the women to the status of victims. Their experiences are needed in the process of fi nding solutions for Africa.

Women advocates are demanding not to be only benefi ciaries, but active actors. One of the responses has been UN Secretary Council Resolution 1325 that some of you have heard, which has created three provisions—the three Ps, as

64 we say—prevention, protection and participation. Protection of women during armed confl icts by calling an end to impunity for gender-based abuses; integration of a gender perspective in peacemaking and peacekeeping; participation of women at all levels of decision-making. It calls for action from a large number of stakeholders—governments, civil society, UN Security Council, UN Secretary-General and all parties in confl ict. Five years after its negotiation, we can see that the international community has failed to implement this resolution.

Why is it that in peace negotiations we only recognize those holding the guns? I remember when the women of Somalia came to the peace negotiations, they explained that Somalia is divided into fi ve clans and they are all men, and these are the people that we are inviting to negotiate. The women have formed a sixth clan. It was a way to come to the negotiating table. Why is it that in peace mediation only men are appointed as peace facilitators, peace negotiators? Why is it that in transitional governments the sharing of power is simply between the elite, but excludes women? The Mano River Women’s Peace Network was in Accra, negotiating. They even signed the peace agreement of Liberia, and yet they were not recognized in the transitional government. Why is it that in peacekeeping operations, soldiers are not trained in gender issues to change their behavior? Why is it that violence against women has not been recognized as a crime against humanity in war tribunals? When the Rwanda Tribunal was set up, some of us were trying to bring up the issue of victims of rape. It took time before it was recognized. Why is it that in the Truth and Reconciliation Commission, women who make complaints about rape are not protected? Why are we not increasing the number of women as investigators in such settings? Why is it in disarmament and demobilization reintegration, male combatants are the main focus and women are not recognized? Why is that in post-confl ict reconstruction, there is a tendency to rebuild the roads and infrastructure and we do not address women’s specifi c needs? Trauma healing, support services, capacity building and economic empowerment are the last issues to go to the table.

We have a collective responsibility, as stipulated in the discussion today, in the MDGs. We—my organization, Femmes Africa Solidarité included—the feminist movement in Africa, have targeted some specifi c institutions. The Organization of African Unity, which has transformed into the African Union, used to be masculine in culture and practice. We try to put pressure on our leaders who created a new program, which is called the New Partnership for Africa’s Development (NEPAD). There is a little bit of light in our struggle, and we have to recognize it. We have gained gender parity in the commission of the African Union. We now have fi ve women and fi ve men serving as commissioners, leading the program of the African Union. We have been able to sit the heads of state of 53 countries around the table to discuss gender issues two years back in Addis Ababa. We have a woman heading the Pan-African Parliament, a woman heading the peer review mechanism. We had a woman, Wangari Maathai, heading ECOSOCC [Economic, Social, and Cultural Council of the African Union]. It is growing fast, and we are applying pressure continually. We have just recently seen the Protocol on Women’s Rights, which is specifi c to women of Africa, addressing our needs, which has been adopted and is going to enter into force in a month. This is African women’s struggle. The challenge to all of us is really to bring these changes that we have been talking about at the top level to the grassroots level. This is our collective responsibility: to ensure that human security transforms ordinary people’s lives.

I really thank the Hilton Foundation today for allowing me to share my experiences, but also I want to congratulate you for the resources that you are allocating to women in vulnerable populations. I am sure you will continue to target women’s groups as your partners in Africa. After all, gender is the center issue in peace and development in Africa, as my colleague from the World Bank said this morning. I thank you very much.

65 Olara A. Otunnu, Former United Nations Under-Secretary-General, Special Representative of the Secretary- General for Children and Armed Confl ict

In 1997, Olara A. Otunnu was appointed by UN Secretary-General Kofi Annan as his Special Representative to advocate and promote standards for the protection of children in times of war and confl ict. Before the conclusion of his appointment in 2005, the UN Security Council passed a historic unanimous resolution establishing a series of groundbreaking measures to ensure the protection of children exposed to armed confl ict. Included is the establishment of a comprehensive monitoring and reporting mechanism which will name all offending parties, both insurgents and governments. An outspoken advocate for millions of children, Otunnu is also widely recognized for his contributions to international peace and security, confl ict prevention, reform of multilateral institutions, human rights, and the future of Africa. In the 1970s, Otunnu played a leading role in the resistance against the regime of Idi Amin in Uganda. In 1979, he was elected a member of the interim administration in the post-Amin period. From 1980 to 1985, he served as Uganda’s Permanent Representative to the United Nations. During his tenure, he played a very active role, serving as President of the Security Council; Chairman of the Commission on Human Rights; Vice-President of the General Assembly; and Facilitator of Global Negotiations. Otunnu served as Minister for Foreign Affairs of Uganda from 1985 to 1986. He returned to the world of academia before being appointed to the UN. From 1987 to 1989, he was affi liated with the Institut Français des Relations Internationales (IFRI) as a Visiting Fellow, and with the American University in Paris as a Visiting Professor. From 1990 to the beginning of his mandate as Special Representative, Olara Otunnu was President of the International Peace Academy (IPA). He currently serves on the boards of several organizations, including the Carnegie Endowment for International Peace, the Aspen Institute, Carnegie Corporation of New York, the International Selection Commission of the Philadelphia Liberty Medal, Aspen France, and the Jury for the Conrad N. Hilton Humanitarian Prize. Otunnu has received several major awards, including the German Africa Prize (2002) and the prestigious Sydney Peace Prize in November 2005.

Ending Wars Against Children

It is wonderful to share this platform this afternoon with such good friends and colleagues. Much has already been said on the topic for this afternoon, so I will focus my remarks on two especially vulnerable categories of populations: on the one hand, children who are being destroyed in situations of war and, on the other, populations exposed to genocide.

The efforts within the United Nations over the last several years to put in place a more effective protection for children exposed to armed confl ict culminated in a historic resolution — Security Council Resolution 1612, adopted on July 26, 2005; this is a development of great consequence. Leading up to that, we proceeded to develop this in phases — four phases to be precise. The fi rst phase of our collective efforts — and there are many organizations in this room that contributed to the efforts, laying the foundation — consisted of defi ning and framing the “Children Affected by Armed Confl ict” (CAAC) agenda, gaining acceptance and legitimacy for the new agenda, establishing a network of stakeholders within and outside the UN, and laying the groundwork for broader awareness-raising and advocacy. In the second phase, I led initiatives and efforts (involving in particular UN entities, governments, NGOs and regional organizations) to develop concrete responses and actions — visiting on the ground and bearing witness to what children are experiencing, and telling the world about that and raising the issue on the ground as well.

We took the protection of children from being a peripheral issue to becoming an integral part of the international peace-and-security agenda, and therefore part of the Security Council agenda and also regional organizations. We have put in place the most comprehensive set of standards, conventions, protocols, resolutions relative to

66 the protection of children in situations of confl ict, ensuring that, more and more, in post-confl ict dispensation—for reconstruction, healing and rebuilding—that children become a particular priority. Ensuring that institutions within and beyond the United Nations seriously mainstream the protection of war-affected children within their programs, for example, we now have Child Protection Advisors placed in peacekeeping missions. And, with appropriate support and encouragement, war-affected children are coming into their own, through their active participation in rebuilding peace and “Voice of Children” programs. These efforts and initiatives created strong momentum.

These and other examples represent signifi cant gains at the formal and international levels. Yet in spite of these impressive gains, I remained deeply preoccupied by one phenomenon. Something became very clear, which is not unique to this sector; it’s a perennial problem in the efforts of the United Nations: the gap between the normative body of standards, international initiatives, and what is actually happening to children on the ground. On the one hand, we had now developed these clear and strong standards for protection and important concrete initiatives, particularly at the international level. On the other hand, atrocities and impunity against children continued on the ground. This is not unique to this sector. Words on paper are very important. We begin with words on paper. But words on paper alone do not protect children and women in danger. In effect, the international community and the children were now faced with a cruel dichotomy. Thus, I pushed for us to embark on a campaign for the “era of application”: how to ensure that these norms and initiatives are translated into a protective regime on the ground for children—that is what really matters. And resolution 1612 brings together all the necessary elements to ensure the “era of application.”

The third phase was to institute a “naming and shaming’ list” This also became the fi rst concrete step in the ‘era of application’ campaign. The purpose of the “naming and shaming list” was to institute a practice to identify, name, and publicly list offending parties for grave abuses against children. This would underscore accountability and exact public pressure on the offending parties. The idea was not only to publish the list but to submit it offi cially to the Security Council.

The fourth and last stage in our campaign was the task of developing a full-fl edged compliance regime. Two years ago, I embarked on an intensive process of designing, drafting and holding extensive consultations with all stakeholders, particularly, governments, UN agencies, regional organizations, and NGOs. Last January, I put forward a detailed action plan, proposing a structure and a series of measures necessary for a formal compliance regime.

It took six months of intensive and protracted negotiations within the Security Council and with other delegations before the Security Council, in a major and groundbreaking development, unanimously adopted Resolution 1612 on July 26, endorsing the structure and the series of far-reaching measures contained in the action plan. This marks a turning point of great consequence. For the fi rst time, the UN has established a formal, structured and detailed compliance regime of this kind.

The compliance regime breaks new ground in several respects. In that resolution, fi ve main things were decided upon and endorsed by the Security Council. First, the practice of identifying, naming, and shaming offi cially and publicly all offending parties that violate children. All offending parties, governments as well as insurgents, will continue to be identifi ed publicly, in what has been called the “naming and shaming” list, which I have prepared and submitted annually to the Security Council since 2003. As we meet here, there are 54 such parties before the Security Council and in the public domain, named with a listing of the violations for which they have been cited.

Second, unless we have in place a very systematic, structured, organized, detailed system for monitoring and reporting the conduct of parties in confl ict, the norms are not of great consequence. So the Security Council approved a very detailed, formal, structured monitoring and reporting mechanism so that we can tell, chapter and verse, who is doing what to children where, beginning at the community level—the theater of confl ict—to the national level with a task force, to the Security Council level. And when the Security Council receives a monitoring report, it is supposed to serve as a trigger for action. It is not for debate and fi ling, but a trigger for action. So that is the second element of this compliance regime.

67 The third element has been the Security Council ordering the named parties to work with UN country teams and come up with time-bound, specifi c action plans indicating exactly what measures have been taken to end the violations for which they have been cited. Fourth, where parties fail to stop their violations against children, the Security Council will consider targeted measures against those parties and their leaders, such as travel restrictions and denial of visas, imposition of arms embargoes and bans on military assistance, and restriction on the fl ow of fi nancial resources. And then, fi nally, the Security Council has agreed and now constituted in fact, a standing committee of the Council as a whole devoted to following up on these measures and assuring that they are being implemented. These fi ve elements together constitute what I call the compliance regime for the protection of children who are being destroyed in situations of war. This means that we have now embarked on the “era of application.”

Where do you come in, you as humanitarians? This is a historic development of great consequence—the fi rst time ever the Security Council of the UN has done this. We need your support and your pressure for the implementation of this regime of compliance; your pressure on the offending parties, most of whom are sensitive to public opinion; your pressure on the United Nations agencies to do the tasks assigned to them at the ground level—to gather and vet information and transmit it to the Security Council—and your pressure on member states that compose the Security Council, so that when they receive these reports, they will take action, crossing off the list those who have complied with the action plans, and taking more radical and targeted measures against those who remain recalcitrant. So in order for this to succeed—we have everything now in place—but now you must be engaged, you must be involved. That is my appeal to you.

My second big issue concerns populations exposed to genocide. If there is one issue that should immediately drive humanitarians, the United Nations, the Security Council into decisive action, it is the specter of genocide unfolding anywhere in the world. We have said before: “Never again” after the Holocaust in Europe, and “Never again” after massacres of children and women in the Balkans, and “Never again” after the genocide in Rwanda. But each time this has been after the fact. We have said, “Not on my watch,” but that was looking at somebody else’s watch. As we meet here, on our watch, a particularly horrendous humanitarian and human rights catastrophe is unfolding in northern Uganda. I know of no recent situation where all the elements of genocide provided in the genocide convention of 1948 have been brought together in such a diabolically comprehensive manner as in what is unfolding today in northern Uganda. This is on our watch, but nothing is being done about it.

Consider the following. The situation in northern Uganda has now gone on for 20 years non-stop; I mean 20 years non-stop. The past ten years have particularly defi ned the genocide: about two million people have been forcibly removed from their homes and land and herded into concentration camps—some 200 camps. 95% of the Acoli population is in these camps. Many of you saw and were horrifi ed by the scenes in the Superdome in New Orleans in the aftermath of hurricane Katrina. You couldn’t bear to watch such utter and complete vulnerability. Well, in northern Uganda, the government has warehoused two million people in 200 Superdomes; this has been going on for 10 years with the world fully aware of what is going on. As one relief offi cial put it, “People are living like animals. They do not have the bare minimum.” Or, as Gulu NGO Forum reported, “The camp population is not coping anymore, but only slowly, gradually dying.”

We have a situation in which by the most conservative estimate, a thousand people are dying, in excess of normal mortality rates, each week in these camps. Northern Uganda is the worst place in the world, by far, to be a child today. The infant mortality rate is the worst in the world. Over 20,000 children, unprotected, have been abducted over the last years. 40,000 children walk some 10 kilometers each evening to come and sleep in the open air, in what goes for safe areas, and then march back the following morning— the so-called “night commuters.” And for 20 years, children have been deprived of any schooling and education, as a matter of government policy. These children have now been deliberately condemned to a life of darkness and ignorance, as a matter of policy. The livelihood of this population has been taken away; fi rst, their livestock was simply taken away en masse, literally, and then they were removed from their land and not allowed to cultivate their lands, as a matter of policy. The

68 sanitation conditions in these camps are abominable, and health care is non-existent. And that is why people are dying at staggering rates.

People are exposed to atrocities by the rebel side and by the government side; they are in the middle. Not a single one of these atrocities over 20 years has ever been independently investigated, including situations where 300 to 500 people have been massacred in a single incident—none has been investigated. In Uganda, HIV/ AIDS is being used as a deliberate tool of genocide. The soldiers that are screened and found to be HIV positive are then especially deployed in the north with the clear understanding to wreak the maximum havoc on the local girls and women. And a place which barely had any HIV cases has now gone to staggering levels of 30%-50% compared to national infection rate of 5%. But this is happening on our watch, with the full knowledge of the international community.

I would like to say that, regarding the doctrine of “Responsibility to Protect,” that my good friend Louise Arbour spoke about, northern Uganda must be the fi rst test of the seriousness of the international community to live up to this commitment. If the international community is not able to apply this new doctrine objectively, based on the facts on the ground, as opposed to based on politics, then once again we shall have reason to despair, to lose credibility and to make populations in distress cynical of our efforts. This genocide is the fi rst test of “Responsibility to Protect.” You have a role. We have a role because this is happening on our watch. We can join in the reigning conspiracy of silence or we can say, “No, not on our watch, we will not accept this,” and mount a campaign to break the silence and end the genocide unfolding in northern Uganda. I thank you very much.

69 Melvin L. Cheatham, M.D., FACS, Samaritan’s Purse

Melvin L. Cheatham is a neurosurgeon and a member of the Board of Directors of Samaritan’s Purse and of the Billy Graham Evangelistic Association. Dr. Cheatham gave up his very successful neurosurgical practice to devote his full energies to medical relief work in developing countries and in areas of war and confl ict. He and his wife volunteer their time doing relief work around the world through World Medical Mission, the medical arm of Samaritan’s Purse. Dr. Cheatham is a Clinical Professor of Neurosurgery at the University of California (Los Angeles) Medical Center. He is past President of the California State Neurosurgical Society and a past President of the Western Neurosurgical Society, an organization of the top neurosurgeons from the Western United States and Canada. He is co-editor of an internationally renowned surgical textbook and has received prestigious awards from both the American and California Associations of Neurological Surgeons. Dr. Cheatham speaks nationally and internationally on humanitarian relief work, and is a special assistant to Dr. Franklin Graham, President of Samaritan’s Purse. He is the author of three books: “Come Walk With Me,” “Living A Life That Counts,” and “Make A Difference,” each book focusing upon our need to bring humanitarian assistance to vulnerable populations of the world. Because of Dr. Cheatham’s work, he has received an honorary Doctor of Humane Letters degree.

North Korea: An Unseen, but Vulnerable Population

I want to thank Steven Hilton, Judy Miller and the Conrad N. Hilton Foundation for holding this excellent international humanitarian conference and for extending this opportunity to me to speak concerning North Korea.

North Korea is a secretive, severely isolated and rigidly closed country and its twenty-two-and-a-half million people constitute a vulnerable population. It is a population that is almost completely unseen and unheard. The challenges that are presented by North Korea require an understanding of who the late, Great Leader Kim Il Sung was and, in fact, who he continues to be. Even though he died in July of 1994, he is still president of the Democratic People’s Republic of Korea (DPRK) for eternity and he is viewed by the people in that hermit kingdom as their deity. His importance is obvious upon arrival at Pyongyang International Airport on the only aircraft arriving and the only one that will be leaving on that day as part of the twice-weekly fl ights to and from Beijing.

A large photograph of Kim Il Sung is positioned on top of the airport terminal, and as visitors are driven into the city of Pyongyang, large mosaics and paintings of his likeness appear at frequent intervals. There are very few cars, in part due to the limited availability of petrol, and it is said that “in the DPRK petrol is more precious than blood.” Many people can be seen walking alongside the roads, many in military uniform. Once inside the city, Russian-style apartment buildings are seen lining the wide boulevards. Massive government buildings and monuments fi ll the city, and towering above everything is a tall pyramid building, unfi nished and with a rusting crane on its top. Kim Il Sung had envisioned this building to be the tallest hotel in the world, but it now stands as a rusting, decaying, unfi nished symbol of North Korea’s failed economy.

Passing under the huge marble arch, visitors see the 80-foot tall bronze statue of the Great Leader Kim Il Sung, at one time reportedly covered in gold. It was built at a cost of over sixty million dollars in the mid-1990s, at a time when two million North Korean people apparently starved because of a lack of food. Many scavenged for grass to eat and for roots to be dug from the ground in an attempt to satisfy their hunger. Along the banks of the river in the city, stands the tall Juche tower, built as the dream of the present Great Leader, Kim Jung Il. “Juche” is the philosophy espoused by Kim Il Sung and means “self-reliance,” but it is painfully obvious that North Korea is not self-reliant.

Outside the city, large numbers of people work in the rice paddies; men and women who labor from long before sunrise in the morning to far past sunset in the evening. As they work, mobile vehicles with large bullhorn

70 speakers mounted front and back play martial music and blare the party line. At night, those who do have access to radio or television can tune in only to broadcasts extolling the government system. Living conditions for people in the DPRK, especially those living in the countryside, are very basic, with most homes lacking indoor plumbing, and with no supply of safe water to drink.

Since the death of Kim Il Sung in 1994, North Korea has been ruled by his son, General Secretary Kim Jung Il. In this country, with large government buildings and monuments, and with a reported 28 or more palaces for the Great Leader, living conditions for most people appear to be poor. Hard currency is directed toward building structures for show in Pyongyang, as well as to support the third largest military force in the world, to build intercontinental ballistic rockets, and for development of nuclear weapons.

With a crumbling infrastructure many believe to be far beyond repair, North Korea is a country where mind control is exercised over its people from infancy and continued throughout their lifetimes, and where total discipline of mind, body and spirit is rigidly harnessed in order to bring praise and glory to only one person, and that is the Great Leader. In 1992, and again in 1994, the former Great Leader, General Kim Il Sung, invited Dr. Billy Graham to visit Pyongyang, North Korea. Dr. Graham accepted his invitation and, as a result of meetings between these two very different men, the Great Leader proclaimed that Dr. Billy Graham and the Billy Graham family were part of his family. This moved this very unusual relationship to a very high level in the eyes of the people of North Korea.

During the humanitarian crisis in the DPRK that developed in the mid-1990s, the doors of this secretive society were opened enough to allow critically needed food and humanitarian aid to be brought in by the United Nations, various governments and numerous humanitarian organizations. In 1997, I was asked to go to North Korea to represent Dr. Billy Graham and Reverend Franklin Graham in responding to the tuberculosis epidemic in that country, a disease infecting two million or more people there. Through Samaritan’s Purse, headed by Reverend Franklin Graham, a TB diagnostic and treatment program was begun and re-equipping of several TB hospitals was carried out. In addition, a dental program was started utilizing a mobile dental vehicle for bringing dental care to people in the countryside.

Since the mid-1990s, large quantities of food and humanitarian aid have fl owed into North Korea, but the North Korean leadership recently announced that all international aid agency staff are to leave the country by December 2005, and that the UN food program is to be halted. Fortunately, North Korean offi cials have reversed somewhat the government’s position in this regard by agreeing to accept assistance that can be classifi ed as “development work” rather than as humanitarian aid.

Like most of you, I have stood face to face with the suffering of humanity in Bosnia, Rwanda, Kosovo, Somalia, and the Congo, as well as in the Middle East, the Sudan and Iraq. The horror of human suffering we have seen in these countries and regions, as described by the speakers today, has been intensifi ed by the terrible suffering and the death in our time brought by HIV/AIDS. The vulnerable populations of our time can usually be easily identifi ed, easily seen, and their cries for help can be easily heard, but the vulnerable population that lives in the DPRK is largely unseen and unheard, and their suffering is essentially unknown.

Based upon the ten visits to North Korea I have made since 1997 on behalf of Samaritan’s Purse and the humanitarian assistance work being done there, I want to suggest fi ve major concerns for your consideration. These are concerns that I believe face us as a world community and as humanitarians, and they are concerns that have the potential to impact carrying out the UN Millennium Development Goals that have been addressed today.

First is the prospect of millions of North Korean people creating a humanitarian catastrophe by fl eeing across the borders of their country in search of food. Second, the possibility that with reunifi cation of North and South Korea, problems will occur that might impact peace and the ability to carry out humanitarian work in the rest

71 of the world. Third, the threat posed by North Korea’s nuclear weapons and missile programs, and the ongoing military tensions along the 38th Parallel. Fourth, the likelihood that North Korea will remain incapable of feeding and caring for the needs of its people. Fifth, the fear that Kim Jung Il’s continued rule and the lack of a designated heir has the potential to lead to even greater diffi culties for the world community in the future. These fi ve major concerns give us pause and cause us to search for possible answers.

The prospect of masses of North Korean people fl eeing across the borders of the DPRK in search of food makes it imperative that we do everything we can as an international community to provide food for the people who suffer from hunger there. As regards possible monumental problems should reunifi cation of the Koreas occur, careful diplomatic planning seems imperative. The only answer to the threat posed by North Korea’s nuclear weapons program appears to rest with the diplomatic process being pursued through the six-party talks in Beijing. With no likelihood of an imminent change in the current North Korean leadership or in its repressive system of government, the need for humanitarian assistance for the people in that country appears likely to continue. The fears that exist with the present leadership and political system in the DPRK and the fears of what might happen with a change in leadership both call for the best of efforts in diplomacy and humanitarian assistance.

Perhaps one fi nal question facing the international community is this: Why help North Korea? Why try to provide help to this isolated society with a leadership not open to change? Why even try to provide help for twenty-two- and-a-half million people who do not have a clue about what exists outside the borders of their country? The answer, I believe, is that bringing help to people in need is the right thing to do, and this should apply to North Korea just as it does to other countries. I thank you very much.

72 Afternoon Session — Question and Answer Session

Begleiter. I want to thank our entire panel, which is a long panel, but as you can see there is a lot of expertise here, and I am sure some of you have questions. So many of the panelists addressed comments or questions to High Commissioner Arbour that I would like to ask her to respond to a couple of them. You were challenged on the question of Uganda. Is it going to be your fi rst target of opportunity to exercise the new philosophy you expressed in your remarks? You were asked why women are not recognized in international war crime tribunals or truth and reconciliation commissions and so on. At the risk of extending your list too much, you also talked about using the General Assembly as a mechanism, should the Security Council become disabled, shall we say by political means, from acting. How would you implement Chapter Seven and the use of force in the UN under the authority of the General Assembly? How do you imagine that working without UN Security Council approval? So those are just a few small details for you to elaborate.

Arbour. Thank you very much. I will not take very much time because I am sure there may also be issues that others want to address. I think that a lot of the issues you have raised, certainly the fi rst two, would bring me fi rst to make a general remark, which is that even though there is a huge amount of work that remains to be done ahead of us, I think it is important not to understate some of the accomplishments fi rst of all by civil society, and frankly also by international organizations, and to be quite rigorous when we condemn the acts of others, or even when we include ourselves in this self-criticism. For instance, I am always very wary after hearing the description of some horrendous event, that we do nothing. Well, wait a minute. It depends what we mean by “we.” If we mean the United Nations, it is even unfair to characterize the United Nations as the United Nations. Decisions made by the Security Council certainly do not refl ect, I think, the views that members of the Secretariat and the various agencies, funds and programs would want to take and very often are taking within the ambit of their competence. So I think it is important to be very precise in calling to account those who are not doing enough, but also in recognizing the immense efforts of the many who are doing quite a bit in the face of, frankly, sometimes insurmountable odds and challenges.

Let me come back to Northern Uganda. Maybe that is a way of illustrating what I have in mind. Northern Uganda is very often referred to as the forgotten or hidden confl ict, the one that doesn’t make it to international news, but it is not true that nothing is being done. In fact, there are many NGOs that have been engaged for many years in trying to alleviate the suffering. But again, even if we elevate it to what is being done institutionally, I do not want to suggest for a minute that it is enough, but let us not forget that northern Uganda is the very fi rst case ever brought before the ICC. In fact, it is the very fi rst case in which the International Criminal Court has issued fi ve indictments. Some will say they are all against the same side, the LRA; it is not even-handed. My point is simply that there is a form of engagement in northern Uganda. My own offi ce has now opened a small fi e ld presence. The International Crisis Group has been trying to call attention to the IDPs. If it is known for anything, it is known for the exploitation of child soldiers and the terrible predicament of the plight of children in armed confl ict. I think Uganda will probably remain forever the epitome of this terrible form of abuse, but I just want to stress that when we embark on this kind of analysis, it is important to be extremely prudent.

The same thing is true in Darfur. Again, we are not doing nothing. There are thousands of NGOs, humanitarian workers that are engaged on the ground. I would like to see a lot more, but that is not the point. I think at the same time we have to recognize this, otherwise it cheapens and diminishes the efforts that so many are deploying because they cannot bring it to the level that we would all want to see.

As for the question of the treatment of women in armed confl ict generally, again I think it is important to recognize that even though we have a huge distance still to go, we have made incredible progress — fi rst, Resolution 1325 in the Security Council, just like the resolution now on children in armed confl ict. Five years ago, a High Commissioner for Human Rights would have never appeared before the Security Council, period, or would have never been invited. It would not have been forthcoming. I appear regularly now before the Security Council. The

73 Security Council is talking now about children and women in armed confl ict, at a time when they are examining threats to international peace and security. We have come some distance. Are they doing enough? No way. But have we made some progress? Huge progress.

The two international tribunals have rendered groundbreaking decisions regarding sexual violence, in particular the fi rst one in the Rwanda tribunal—rape and sexual violence is recognized as a crime against humanity. What was problematic was whether rape could be viewed as an act of genocide. Subsequently, the International Criminal Tribunal for the Former Yugoslavia (ICTY) has explicitly provided for that. Does that mean there are a suffi cient number of prosecutions for gender violence? No. When I was trying to do that work in these two tribunals, investigators would say, “We have hundreds of thousands of cases of extermination and murder, why do you insist that we also prosecute rape and sexual violence?” I believe that we had to because it was so important to make progress, and because of the prevalence of these predatory practices during war and confl ict against particularly vulnerable populations such as women and children. But again, we have to understand on the one hand, I think, how much remains to be done but at the same time, celebrate to some extent that, both through legal means and through a certain openness in the political process, we are moving in the right direction—not fast enough, but in the right direction.

The question of the role of the General Assembly is really a long shot. The General Assembly does not have Chapter Seven. It has no coercive powers, but between a Security Council totally paralyzed because of the anticipated use of a veto on the one hand and a totally unilateral, small group of powerful countries—in that I would include NATO—going along, as was the case in Kosovo on the other, at least a case could be made that a GA resolution triggered by a majority of members asking for an emergency session that has to be held within 24 hours getting a 2/3 majority—that is hard. It is a high threshold. But this would legitimize and validate multilateral initiatives short of the Security Council. It cannot order, but it could legitimize and validate regional efforts or coalitions that might not succeed because of a veto. So I recognize, once again, that there are limitations to that initiative but the Commission on Intervention that produced the concept of the responsibility to protect targeted that as one particular initiative we would want to encourage. Thank you.

Begleiter. OK, thank you very much. It is the audience’s turn and we have a bit of time here this afternoon to take some questions.

Q. Shazia Rafi a, Parliamentarians for Global Action. Good afternoon. I work for Parliamentarians for Global Action. We are a network of more than a thousand parliamentarians working on the campaign for ICC, and the reason why I am particularly happy to hear from Judge Arbour is that we try to make the link and to tell key parliamentarians in Latin America why it is important for them to ratify the ICC and how their ratifi cation is important for Uganda, for Sudan and for the Democratic Republic of Congo. In this respect, I have a question based on the proposition of Judge Arbour, but I guess it is also addressed to all the panelists who are somehow involved in confl ict resolution mechanisms in the countries they come from.

Judge Arbour explains how this revolution is starting through three steps. First, the prevention of the crimes and then the use of all means, and then if there is failure, we will have intervention. I want to ask your view, is the International Criminal Court or any other judicial means part of the second step that says “use of all means peaceful” or is it a form of intervention that should be the last resort? This is both in theory and in practice, in these complex situations where you have judicial proceedings and indictments going on in the midst of confl ict.

Begleiter. I’m going to just declare unilaterally here that we are not going to have all seven or eight panelists here answer every question, so who would like to respond?

Rusesabagina. When it comes to justice, it is a very sensitive issue and especially when it is done by the United Nations. We have an international court for Rwanda. That court was put up in 1995 and its main objective was

74 to try the leaders of the Rwandan genocide. So far, they have not tried any since 1995. There is one, who used to be our Prime Minister, who was nominated as Prime Minister in April 1994 when the genocide started. That tribunal, since 1995, has consumed many billions of dollars and since that time, in the last 10 years, I have met the prosecutor of that tribunal in Washington, DC on June 16 this year and they had convicted 25 people in the last 10 years. The same international community is the one that put up a tribunal for the Jewish Holocaust in Nuremberg, 1945. In less than three years, Hitler and his lieutenants were convicted and the whole world gathered $250 billion because justice was done. Today in Africa, justice is completely stopped. Justice is not working. The Rwandan issue is a very good example. The last 10 years, have been spent consuming, spending billions of dollars and convicting only 25 people. Here I say 25, not 200, just 25 and not the “big fi sh,” as you say.

Begleiter. OK, is there another panelist who would like to comment on this particular question?

Arbour. I think I need to come in on this issue, an issue plaguing the international community, the question of whether justice is too expensive, too slow, or worth the effort. It probably will be the case that when we have the luxury of historical review, we will have a lot to say about the Yugoslav and Rwandan tribunals. These were the fi rst created. I think that if the Security Council, which created the tribunals, had anticipated at the time what it would cost and how long it would take, frankly I believe they would not have moved forward. Having said that, I am very happy that they did. I think the reason we have an International Criminal Court today is largely based on the experiment of these tribunals. What will not change is that the ICC will never have the capacity to do much more than what the Rwanda tribunal will produce by the time it is over. It was never anticipated that it would convict large numbers—if it reaches 100, it will be viewed as a great success. It was meant to target the leadership of the Rwandan genocide. When I was the prosecutor for the Rwanda tribunal, we had at that time maybe 40 people incarcerated; there were 130,000 incarcerated in Rwanda on genocide-related charges. Now the 40 we had, mind you, I suspect the Rwandan government would never have been able to arrest them, and they were the leaders. They were all arrested outside Rwanda, in countries with which Rwanda had no extradition treaty, so the reach of international criminal justice can go way beyond the capacity of a single state. Now, if some of them could be prosecuted in Belgium as they have been, in France as they have been, under national laws at no cost to the international community, I think that is great too. But the ICC will be an infrastructure that will be, in a sense, a default jurisdiction when everything else fails.

Is it an all-peaceful means or is it a form of aggressive intervention? I believe justice is non-coercive fundamentally, and it is a peaceful form of intervention. It’s coercive against those who are the subject of an arrest warrant, but it is essentially the same as in our domestic jurisdiction. Criminal justice is a forum in which we reaffi rm our shared values and our denunciation of infringement of those values. I believe it is fundamentally a peaceful means of intervention and should be promoted despite its current shortcomings.

Q. Susannah Sirkin, Physicians for Human Rights. Just a quick observation and then a question about an area of vulnerable populations. It is strange and sad, I think, that we actually have to call women and children “populations.” They are the population and it’s just something I think we all ought to be aware of. It is very sad that we have to segment off more than half, two-thirds—maybe more, in many countries, three-quarters—as a vulnerable group. So it’s just an observation.

The question that I have for any of the panelists is how we think about—as many of us in this room are from Western Europe and North America—the vulnerable within our own societies. I think this panel absolutely touched on the most important categories, but there is one that we have not touched: there are many categories, but at home we have the issue of a group we might call the “politically despised,” or maybe that is too strong a word. We also have a retrenchment on the rights of asylum seekers, immigrants and so forth, especially in the United States since 9/11. A very large vulnerable group includes those people in countries where the war on terror has been used as a pretext to clamp down—including the use of torture on those groups. I am just wondering whether those of you who are working on vulnerable groups think about the obligations of those of us to protect the vulnerable groups within our midst, or where our own powerful countries may have some obligations to protect?

75 Begleiter. OK. Would anybody like to tackle that one? This is pretty much directly targeted at the U.S., I guess.

Rusesabagina. Let me touch on it; not exactly the way it was phrased, but in the whole notion of whether efforts should be made to protect people, assisting them within their countries, or whether we should encourage people to become refugees who want to be refugees, and then to receive them as vulnerable people in their refuge. There are some people who have argued that efforts to protect the internally displaced, in a sense undermine the refugee convention and the right to fl ee. I am of the opinion that there is a general assumption in the West that people in developing countries are all eager to leave their countries and to go abroad, and that anything we do to help them remain at home is impeding their desire to leave. I do not think so. Whatever the motive of Western countries to help vulnerable peoples within their own countries, I don’t care. What people normally want is to be protected and assisted within their own countries, and if we are able to do that so there is no desire to leave, all the better. Once they come abroad, you know, things do happen, and the mere fact that you are a refugee—despite all the help you can get—is a disability; being a foreigner who is fl eeing without the capacity or the resources or the ability to cope in this new situation. So you become inherently vulnerable. All the more reason, I think, for us to do all we can to help people remain.

Begleiter. Olara, do you want to come in on your other point?

Olara Otunnu. Thank you very much, Ralph. Let me be clear and explicit. In 2004, in his Easter message, Emmanuel Cardinal Wamala, Archbishop of Kampala warned, “There will be genocide in the north if the international community does not intervene to end the war.” In an anguished plea, Bishop Macleord Baker Ochola II, retired Anglican Bishop of Kitgum Diocese in northern Uganda, recently said “All these cries from the people of Uganda show very clearly that a slow, but sure genocide has been taking place in northern Uganda while the world is looking on, as was the case in the Rwandan genocide.” A Catholic missionary based in northern Uganda, Father Carlos Rodriguez, wrote an article which started with the sentence:, “Everything Acoli is dying.” MSF has reported, “The extent of suffering is overwhelming…according to international benchmarks this constitutes an emergency out of control.”

If one is facing a situation of genocide, that defi nes the kind of response that the international community should give. You do not respond to genocide by providing some water here, a little bit of food there, maybe a few latrines here and there—even though those are important as relief efforts. First order of business when faced with genocide is to recognize it and move to stop it. That is the fi rst order of business. That is what should have been done in Rwanda. That is what should have been done in the Balkans. This is what is not being done in northern Uganda today.

The second point is the reason why nothing is being done in northern Uganda. Again, we have to be very honest here: political considerations have trumped the “responsibility to protect.” It is not lack of knowledge, it is about political considerations, and I think nobody in this room can plead that they do not know this. And this has led to a scandalous double standard; let me again be quite specifi c. For example in 1996—the government of Burundi tried exactly the same project which the government of Uganda has carried out in northern Uganda. They went and forced rural populations, saying, “We want to put you in camps—‘camps de regroupement’—in order to protect you from rebels.” We all (i.e., the international community) protested vigorously and said, “No way; you cannot do this; it’s a road that leads to genocide.” The Burundi government was forced to dismantle the camps within months. At that same time, concentration camps were being established in northern Uganda—in 1996—and for 10 years, there has been no similar outrage, no similar protest from the international community. Another example: in recent years there have been investigations of massacres and atrocities in DRC and Burundi. In Uganda, for 20 years, all manner of atrocities have been committed with impunity, and we cannot cite a single example of an independent investigation that has taken place to say who is responsible or who is not responsible for these atrocities. And the reason at the bottom of this is political; it is double standards.

76 Finally, let me say that it is important how we choose to frame the narrative. If we frame the narrative in terms of a humanitarian crisis, some humanitarian crisis in Rwanda or northern Uganda, the response is accordingly determined. If we say that in northern Uganda the problem is simply some crazy group called LRA, who are committing atrocities and doing terrible things, which is true, the responsibility is attributed accordingly. According to this narrative, once you deal with the LRA you have solved the problem. In fact, the theater of genocide I am referring to is the camps, some 200 concentration camps with about two million people in them. This is the responsibility of the government; these camps were established and are controlled by the government. That is where there are 1,000 excess deaths every week. That is where the infant mortality rate is out of control. That is where suicide and depression have galloped beyond anything imagined before. These grim realities are not being addressed because of a received and carefully scripted narrative that is highly distorted for political reasons. This is what the people of northern Uganda have been facing. I hope that all of us in this room will face up to our responsibility in this regard.

Q. Cornelio Sommaruga, Geneva International Centre for Humanitarian Demining. I would like fi rst of all to say how much I was touched by the report on Rwanda, on the Rwandan genocide. As president of the International Committee of the Red Cross, I visited Rwanda at the end of 1993 and again in 1995, and I would like to express my admiration for Paul Rusesabagina for what he did in his hotel.

Now, the point that is of particular interest to me is the responsibility to protect. I was a member of this panel of the International Commission on Intervention and State Sovereignty (ICISS) and co-drafter of the report on the responsibility to protect. I think that one of the major problems that remains, despite the fact that I am so satisfi ed with what the summit has said, is that the only concrete result of the summit was the responsibility to protect. Despite that, there is remaining the problem of the veto of the big fi ve, which is not completely solved. We had proposed the Code of Conduct and we had in the proposal that one should only use the veto in a situation of vital interest. We were not able to defi ne the vital interest. But I would like to know if there is any progress on this question in New York, in the United Nations discussions. And I would like to conclude by saying that, fi nally, the discussion we have had here on the possible blockade of the Security Council because of the veto ride and the invoking of the General Assembly with a resolution of those united for peace is something that we had proposed because we thought that a resolution, united for peace, would give a sort of legitimacy for an intervention that would be made by a regional or sub-regional organization, despite the fact that there was no resolution before the Security Council.

Begleiter. Let’s hone it down to the simple question of whether any progress has been made toward defi ning the target or the defi nition of how one might respond if the Security Council is blockaded.

Arbour. As I understood, Mr. Sommaruga’s question on that particular point was whether or not there was any appetite by the veto holders to self-impose a curtailment on their use of the veto. I am sure it will come as no surprise to you that I see no sign of anybody yielding, for instance making the commitment as they were called upon, that they would never use the veto to prevent intervention in the case of genocide or crimes against humanity—there has been no such undertaking forthcoming—or that they would voluntarily curtail the exercise of this power. Frankly, I cannot see much hope in the near future for this.

Q. Tom Arnold, Concern Worldwide. The panel’s excellent contributions, I think, give a combination of hope and pessimism this afternoon. Hope in the sense that clearly there is some progress being made in the legal framework for protecting human rights and also taking account of Louise Arbour’s listing of achievements. And then we are faced with some deeply complex and intractable problems like Sudan and Darfur, northern Uganda and Congo. The way we seem to be saying these can be dealt with is a combination of change at the domestic political level, but also the international community somehow or other mobilizing itself. Now the international community, in terms of its possibilities to act, consists of, in African context, the African Union, the UN and NATO. The African Union is very weak and it will continue to be weak, I think, for the foreseeable future in terms of its capacity. The UN and NATO are deeply over-stretched. Now, the question is, given the so much

77 improved legal framework that is there in practical political terms, what are the priorities over the next couple of years to improve the capacity of the international community to act and make a difference?

Begleiter. Who would like to tackle that?

Thomas-Jensen. Well, I think in terms of looking at intervention and capacity within the African Union, the problem is that simply they do not have it right now to respond to a crisis as large as Darfur, which is not to say that they are not doing a good job where they are deployed. When you speak to people in Darfur, the people that the African Union is there to serve, they are not satisfi ed. In fact you hear them say, “We want NATO, we want Western troops, the AU is not getting it done.”

What can the international community do to build capacity? Well I think it must move beyond its antipathy for providing military assistance for African countries. I am not talking about providing them with weapons; I am talking about training and building capacity within African militaries to respond in these types of missions.

In speaking with people at various U.S. embassies, in a country like Nigeria—which has a large military and is providing troops to the African Union mission—there is a defense liaison offi cer at the U.S. embassy who works with the AU, goes out there, looks at the troops who have been offered up to work the mission, and decides whether they are or are not fi t to do the job. On a couple of occasions, the U.S. government has decided that no, in fact the troops that Nigeria has identifi ed to work in Darfur are simply not up for it. The question is, whether or not countries—and this is across the board from South Africa to Nigeria to other countries that are contributing—have, at this point, the numbers of troops with the skills needed in this type of mission—troops with the experience, logistical capacity, and intelligence capacity to get the job done. So I would say, assistance to African militaries of the capacity-building type, not the weapon-providing type.

Otunnu. I would like to add to that. First, in an area such as the protection of children exposed to war, where now we have a very detailed, structured, formal compliance system, which has been offi cially established, the priority there should be to ensure that that compliance regime is implemented—it is all in place; it should now be implemented. And that means, as I said earlier, support and pressure by the people who are gathered here. But at a more political level, whereas I agree that the issue of building capacity at the sub-regional level, the regional level, African Union, and the UN level is important, I think it is equally important for us to face up to the political gridlock, the political problems that make it diffi cult to use even the capacity which may be in place. And by that I mean two things. First, if any of the standards we are referring to are applied within the context of a double standard, they are dead. It is as simple as that: they are dead. If people see that the international community springs to action because you belong to this or that side of a political divide, you are not the friends of this or that group, then none of the things we are discussing here will go anywhere; then our discourse will only engender cynicism. So we must bring pressure to ensure that these standards and doctrines are applied objectively and consistently, informed by the facts on the ground, not by political considerations—this is a political project for all of us.

Secondly, in many of the situations that are being described here, certainly in situations of genocide where the government itself may be the instrument of that genocide, the only way of stopping the genocide is international pressure, because by defi nition that government is contemptuous of its own people and local public opinion. International pressure is what will get them to stop and respond. Fortunately, most of those governments are also heavily dependent on the international community, and therefore international pressure can modify their conduct. So, whereas capacity is very important, I do not want that to short-change the political project that is involved in realizing what we are discussing here.

Begleiter. Paul, would you like to comment on this?

Rusesabagina. Yes. I believe that as long as the United Nations peacekeeping mission is not redefi ned it will not be very easy to protect all those vulnerable people. One, the United Nations has no army and before their intervention, they have to go to donor countries, start asking for soldiers here and there. That in itself takes a lot

78 of time. They start activating the people who have never trained together, who do not know each other, who do not speak the same language and who are not really willing to protect the victims. Who are the UN soldiers? The most powerful countries, the super powers, are never involved in the peacekeeping process, so the peacekeeping process is becoming a kind of joke where people go to improve their per diem. I’m sorry for this language, but this is what I have noticed. You have seen people who in their mission are just observers, who come and watch people killing people and do not even defend civilians. That is a weakness; each and every person agrees with that.

The United Nations can never sit down with the Security Council and come up with a decision within a week or a day. They always decide on a consensus basis. As long as people only decide on a consensus basis, they will never come up with a solution. That is the United Nations. But when it comes to the African Union, the African Union is very weak and has no means. Besides, most of the African leaderships are dictatorships. How in the world could we see one dictator fi ghting another dictator in the name of democracy? Have we ever seen that? I doubt it. Again, to make it worse, they do not even make themselves respected. I saw it in Darfur. When we were in Darfur in January, the Sudanese government shot down an African Union airplane. Have you ever heard of that? What happened? Nothing. So the peacekeeping process, the whole system, as long as it is not reformed, can never provide hope of any protection for all of those vulnerable people.

Begleiter. Thank you, Paul. We are going to give the last word of the day to Francis Deng.

Deng. My word, that is quite a responsibility. Let me just say that we should try to learn something from the Sudanese experience. First of all, what you see happening in Darfur has been happening in southern Sudan for decades. And yet, let me say, Olara, the world did not rise up against the government of the Sudan. What actually happened is, the tenth anniversary of Rwanda raised the level of consciousness about Darfur. It means that maybe we are making progress. Next time we will feel even guiltier. Therefore, to some extent, norms are being set to help us raise the level of awareness and, in retrospect, the level of guilt might help us to act next time.

What made the difference in the Sudan is that the countries of the sub-regional organization, the Inter-Governmental Authority for Development (IGAD) decided to act. The way they acted was the soft way, not the hard way, by saying to the Sudan government, which was then an ally against Mengistu, if you want us to help, we will help you, but let us address the root causes of the problem. And they said, your problem is that the people of the south have never exercised the right of self-determination and they should have it. But we want the Sudan to remain united; so let’s work together to create conditions where Sudan can remain united voluntarily. And then they stalled because of differences among themselves until the international partners, the IGAD partners— mostly Western countries and, later on, Italy, the U.S., Norway and the UK—came in to help. And their active involvement came at a time of the war against terror. And I do believe that Sudan benefi ted from the war against terror because Khartoum was already targeted and labeled, and wanted to be on the right side of the ideological divide in the war against terror, and in particular to gain favor with the United States. So they bent over backwards to cooperate with the United States. The rebel movement, the SPLM/A, also did not want to be labeled as a terrorist organization, so they too bent over backwards. That, combined with the strong support from these other countries, made the Sudan peace process move forward. I am one of those who, when I visited Darfur, in my report to the Commission on Human Rights, strongly felt that the powerful countries of the West should not, and in any case would not, send in their troops. If they did, Darfur would be in an even greater mess. Therefore, the AU was a way out, a face-saving device for the Sudan government if it were helped to have the requisite capacity. I think we have to take more of a soft approach, but one that is more practical. I was going to ask Olara, if I were not being given the last word, why aren’t we getting IGAD involved in Uganda the same way we got them involved in the Sudan? And then, let’s mobilize the moral and political support, material too, to help this sub-region solve its problems, because they do have a vested interest. Refugees overfl ow across the borders into these countries, and whatever happens within one country affects them all. So there is a mutual interest in our fi nding regional solutions. We are doing it in the Sudan and in Somalia, why not in Uganda?

79

Conrad N. Hilton Humanitarian Prize Dinner Ceremony

Bâtiment des Forces Motrices (BFM) Geneva, Switzerland Welcome from Ambassador Walter Fust, Director-General, Swiss Agency for Development and Cooperation

It is an honor for the Swiss government to welcome the Conrad Hilton Humanitarian Prize to the city of Geneva, for the second time. Distinguished board members of the Conrad Hilton Foundation, I am particularly honored that you have chosen to celebrate the tenth anniversary of the Hilton Humanitarian Prize in Geneva. This Humanitarian Prize awarded each year is greatly encouraging to the efforts and work of all humanitarian organizations. What better place to award the Prize than the city of Geneva, the humanitarian capital of the world?

More than a century ago, Henry Dunant, founder of the Red Cross and honorary citizen of Geneva, received the fi rst Nobel Prize ever, for his lifelong commitment to war victims. Later, the International Committee of the Red Cross and the United Nations High Commissioner for Refugees were also awarded the same prize. The establishment of international rules aimed at protecting victims of confl ict and refugees is also closely linked to Geneva. The Offi ce of the High Commissioner for Human Rights is here in this city, and it plays a crucial and overarching role in protecting persecuted and destitute people. If I make this comparison between the Nobel Prize and the Hilton Prize, it is not because of the sum of money, but because of the targeted recipients who made such outstanding commitments and who served the international community so outstandingly.

The recipient of this year’s Hilton Humanitarian Prize, Partners In Health, is a humanitarian organization contributing daily to saving lives, alleviating suffering, and preserving human dignity. This place, the “building of motive power,” as we call it, used to be the main source of energy for the city of Geneva, transforming the power of water into electricity for the benefi t of all the citizens of Geneva and its surrounding areas. In much the same way, the commitment and dedication of all humanitarian international organizations and NGOs serve as a source of energy and hope for the poor, the ill, the outcasts and the victims of wars and natural disasters. Let us, therefore, pay a special tribute to the many humanitarian workers whose organizations are represented here tonight, demonstrating dedication, love and courage in their work. I thank you so much.

83 Dinner Keynote Address

PAUL RUSESABAGINA, Founder, Hotel Rwanda Rusesabagina Foundation

Paul Rusesabagina, former manager of the Mille Collines hotel in Kigali, Rwanda, was born in 1954 at Murama-Gitarama in the Central-South of the country. After fi n ishing school, he was employed by Sabena as a front offi ce manager in their new Hotel Akagera in a national park, where he discovered the tourism and hotel industry. In 1980, he pursued this fi eld at the Kenya Utalii College in Nairobi, where he studied Hotel Management until his graduation in 1984 in Switzerland. Upon his return to Rwanda, he joined Sabena again, as assistant general manager in the Mille Collines in Kigali until 1993, when he was promoted to general manager at the Diplomate hotel. When the genocide began, he returned to the Mille Collines and remained there for almost the entire span of the 100-day genocide. He took over as general manager after many of the hotel’s staff had fl ed, opting instead to shelter over 1,200 people threatened by the Hutu-led Interhamwe militias who were slaughtering the Tutsi population. Rusesabagina, a Hutu, chose to stay with his wife, a Tutsi, and their children, using his position and ingenuity to shelter orphans and refugees in the hotel. In 1996, he and his family went to Belgium as refugees and have lived there since. In 2004, his story was adapted for the big screen and was released as “Hotel Rwanda”. He recently set up the Hotel Rwanda Rusesabagina Foundation to help survivors of the Rwandan genocide. In June 2005, he was awarded the United Nations World Refugee Day Humanitarian Award.

Good evening, everybody. I am very grateful to the Hilton family who have made it possible tonight for all of us to meet again. Congratulations to Partners In Health, who have made it all the way from America to Russia and Haiti and now Africa. There are so many heroes in this world, but I am especially grateful to Partners In Health who have managed to move mountains.

Tonight, I would like to tell you a little bit about the real life behind the movie “Hotel Rwanda,” which all of you have seen on the screen. Behind that movie, there is a long story. Each and every minute, each and every second, each and every day had its own story.

When the President of Rwanda was killed, I was having dinner with my brother-in-law— the father of these two lovely girls present tonight—and his wife at the Diplomat Hotel. The Presidents of Rwanda and Burundi were both killed when their plane was shot down. My wife telephoned to tell me I should rush home, because she had heard something she had never heard before; something scary. I immediately took my car and, for the last time, I shook the hands of my brother-in-law and his wife.

I went home and was stuck there for many days. The very fi rst morning, my son—as seen onscreen—woke up very early and went to visit the son of a neighbor; a boy his own age. He was not a baby; he was a 14-year-old boy. When he arrived at our neighbor’s house, he saw the boy had been killed along with his mother, his six sisters and two other neighbors. Some of them were not yet completely dead. Our boy came running home, completely out of his senses, unable to understand the situation. He stayed in his room, traumatized for quite a long time, unable to talk.

That very same morning, we heard the Prime Minister—a lady, a moderate Hutu—describing how the soldiers were killing her bodyguards who were Belgian soldiers. She also said that after killing them, they were going to kill her. A few minutes later, she was also dead.

I saw our neighbors in military uniforms, in militia uniforms—carrying guns, machetes, spears, clubs, and anything else they could think of. These were men I used to consider as gentlemen, as wise men, as best friends;

84 the men I used to take as honorable. Those who were not able to join them came to my house. When they came to my house, I had no alternative but to accept them. Why my house? I cannot tell you; only God knows. We were stuck together for about three days, until April 9. At midday I saw soldiers climbing my gate. When I saw them climbing my gate, one of my guests, who was actually a stranger, told me, “Listen, Paul, these guys have come to kill me, they know I have three sons fi ghting on the rebels’ side. They know I’m here. Before they come in here and kill all of you, please let me turn myself in. At least your family and these people here will be safe.”

I told him, “Listen my friend, whoever comes to my house is not looking for you, but rather for me. Open the door, and show them in.” They entered the house. When I saw them, their leader came to me and asked me, “Sir, are you the manager of the Diplomat Hotel?” I said yes. “If you are the manager of the Diplomat, you should know that a new interim government has been set up. They have sent us to pick you up and bring you to the hotel, because we need you.” I accepted.

At that time, I told the soldiers I could not leave my family behind. The leader told me to bring everyone—my family consisted of six people: four children and two parents. We went to the car, piled everybody into my car, the hotel van, and into our neighbor’s car. We piled people just like sacks of beans or potatoes. A mile away—not at the hotel compound as you have seen on the screen—the same people stopped us. They came up to me and said, “Sir, you are a traitor; you are lucky we don’t kill you today.” He handed me a Russian-made gun, and told me to go and kill all of the people in the cars. “You are lucky we did not kill you today because we need you.”

I knew he was not joking. All along the streets were many dead people. I stayed speechless for about fi v e minutes. After fi ve minutes, I looked at him and told him, “Listen, my friend, I do not know how to use a gun, but even if I knew, I don’t see any good reason why I should kill these people.” I looked at him and told him, “You are a young man, about 25 years old. Do you see yourself moving throughout your life with these people’s lives on your conscience?” There were 32 people in those two cars. I told him I understood that they were hungry, thirsty, and stressed by the war, but that we could deal with this problem in other ways. We could fi nd another solution, which we did. We negotiated until we came to a compromise; then they drove us up to the Diplomat Hotel, and I immediately went to the safe and fulfi lled my promises.

That was only the beginning. Three days later, I joined the government convoy leaving the hotel. We went up to the Mille Collines Hotel. When we arrived there, the militia had already set up a roadblock at the main entrance. There was no security at the hotel at all. The main objective of setting up a roadblock was to prevent people from coming in, and to prevent others from escaping. The two things I had to do were to get my address book and then to phone all of the generals I knew, all over the country. At the end of the day, the roadblock was removed. The Mille Collines Hotel had its own troubles, each and every day.

We saw the whole international community closing their ears and eyes, turning their backs, running away, and leaving us on our own. That is when we started taking responsibilities, which were not supposed to be ours, but rather the responsibility of the government and the international community. We had no alternative. With my own eyes I saw the last journalist—a Newsweek journalist—also being evacuated. We saw soldiers, the so-called “peacekeepers”, who had come to keep peace and who had inspired confi dence and trust in us; we saw them also being evacuated. We saw people killing other people; piling them on the road to make roadblocks; sitting on them and drinking beers. We saw a lot of things.

In the meantime, daily life was becoming more diffi cult. Water was cut off. Electricity was cut off. Generators had broken down. Without food, without anything, we still survived. At this point, I would like to say thank you to a good friend of mine, Philippe Gaillard, who was working for the Red Cross, who used to supply me with some food, and who also sometimes was able to give me a satellite telephone. One day, mine broke down and he brought me his. You can imagine how bad the situation was and how some people can still be good.

On April 22, I went to sleep very late, at 4:00 a.m. Imagine a situation where you have cats and mice in the same cage. You have to take care of both, because both are supposed to belong to you. I went to sleep at 4:00 and I

85 was woken up at 6:00 by men with guns. At gunpoint, I was given the order to get all the people out of the hotel within half an hour. I negotiated a new deadline—an extra half hour to get up, have a shower, dress, and do what they wanted me to do. In that half hour, I noticed that the whole building was surrounded by militiamen, half of them in military uniforms and the others in militia uniforms. It was unbelievable: they had every weapon one can think of and, to make it worse, they also had traditional weapons. I immediately went downstairs, but it was too late. I went to my room and started phoning—at that time the phones were still working. It was too late to phone the United States—it was midnight in Washington, D.C. It was 6:00 a.m. in Paris and Brussels. Again, I had to rely on my local relations. I had to call my friends, the generals. Before my deadline, before my 30 minutes were up, I saw the Assistant General Chief of Staff come into the hotel himself, removing one of those guys. That was one of the worst days.

Three days later, one of the journalists in the hotel—Thomas Kamilindi, who is now at Michigan University— took the hotel phone and started describing how the rebels were advancing, winning, and how the army was losing; and yet we were on the army’s side. Immediately, I saw a colonel in the main entrance of the hotel, telling me, “Listen, Paul, I have come to pick up that dog.” I showed him into my offi ce and we sat down. Once again, we talked and dealt for many hours. After many hours, he left without Kamilindi.

The hotel switchboard immediately went dead, but, fortunately, thank God, the person who did it never knew that we had a separate line, our lifeline, which was a fax line. We installed it late, when we were installing the fi rst fax machine in the hotel. Now it was our lifeline, but no more accessible to each and every person. I was the only person using that line from that day onwards.

To be brief, on May 2, the United Nations’ few soldiers who had remained in Rwanda—260 soldiers in total—sat down with the army and the rebels and came to a conclusion: to exchange the Mille Collines refugees for refugees in the national cities. Lists were drawn up, and the whole of my family was included. At that time, I had to make the toughest decision I have ever made in my life. I was supposed to be evacuated with the others on May 3. I spent that afternoon doing lots of things, but also making a decision. That decision was not to be evacuated with my wife and children. When I went to our room, I told them that I was not going to be evacuated. Can you imagine? Try to put yourself in my wife’s position, in my children’s position, and just imagine their reaction that night. The following day, I escorted my wife and children to the trucks—fortunately, when doing “Hotel Rwanda” I saw that evacuation. I had made a decision not to be evacuated without knowing where my wife and children were going. But I escorted them, helped them to climb into the trucks and saw them off without knowing where they were going, without any hope of seeing them anymore, without any hope that they were going to survive, without any hope that I myself was going to survive.

They were beaten. Luckily, when they started shooting at the passengers, a militiaman—when he shot for the fi r st time—killed a soldier. Then the soldiers and militiamen started fi ghting among themselves, the soldiers said the militiamen were trying to kill them. That is when the United Nations soldiers—the few, without even a knife to defend themselves—started pulling the passengers up, throwing them into the trucks, bringing them back to the hotel. By the time my wife came back, she was not as she appeared on the big screen. She was lying fl at, in the back of the truck. Someone went to get her from the truck and carried her to bed, where she stayed for many weeks without even being able to move in bed. Life became so complicated; life became so long. A day was almost a century; it was unbearable.

On May 27 and 28, many people were evacuated. At that time we had made a different decision, so we were not evacuated at all. We remained until June 17, when, very early in the morning, I learned through my own “network” that militiamen were killing civilians and refugees in the compound in front of the church about 500 meters from the hotel. You could see what was going on; you could see what was going on in that church compound from the hotel windows. I saw that the militias were killing refugees at the church. Fortunately, I met the mayor and told him I needed soldiers to come and protect these people, to reinforce the existing protection.

86 He looked at me and said, “Listen, Paul, I don’t have soldiers. All the soldiers are fi ghting; all the policemen are protecting offi cial buildings.” Protecting buildings. I looked at him and told him, “Listen my friend, all of this will come to an end one day. If that day was to be today and suddenly you and I were facing history, are you sure that the answer you’re giving me today is the answer you’d give to history?”

I had offended him. He left. I had an appointment with his boss, General Bizimungu, at the Diplomat Hotel at midday, at noon. I went to meet him, and we were standing together in the Diplomat cellars when I was informed that after killing 150 people in the church, the militiamen came running to the General and told him to go down to the Mille Collines. He immediately came down to the hotel, where militiamen had broken many doors, and had already taken many people downstairs by the swimming pool—innocent civilians, kneeling down, hands up, ready to be slaughtered. The General told one of his bodyguards to go up and tell the militiamen at this hotel that, “Whoever kills someone, I’m going to kill him. Whoever beats someone, I’m going to kill him.” He got them all out although they were already in the rooms.

Immediately, the soldiers and rebels sat down and urgently decided to evacuate the hotel without any conditions this time, but again they made the decision at a late hour. I told them, “Let’s learn from the past. On May 3, we had a very bad experience; we evacuated people and they met an ambush. This time, why can’t we reinforce security around the hotel and wait until tomorrow, and then evacuate these people tomorrow?” And this is what we did on June 18: all the Mille Collines refugees were evacuated and all of them brought to a place of their own choice. Everybody was evacuated. Fortunately, the Mille Collines had a maximum of 1,268 people, and all of them were evacuated. Nobody was killed in the hotel, and nobody was even taken outside to be killed or tortured outside. Nobody was even beaten from the beginning to the end.

We went to the rebel side thinking that life might be better. When we arrived there, all the men were being invited to meetings. With irony, we say that those who went to the meetings are still waiting for the meeting to fi n ish. Those meetings will never end. We know those people have been killed and will never come back. Many young men were invited to join the rebels as soldiers. Those who were invited were killed and never found. Many people, even myself, were invited to go and train for what they called local defense. Some who went never came back. Myself, I say that I made a different decision. I have decided never to fi ght with a gun; that is my choice, so I do not need to learn how to shoot. I did not train. I came back and started cleaning again. I did not go to Tanzania, as you have seen on the big screen. I came back to town and started cleaning both hotels.

At that time, it was July 7. On July 12, my wife, a friend, and I decided to drive south to see what remained of our homeland. On the way—all along the way, all along the road—the whole country smelled of death. There was nothing else moving. You could not see a human being. There were no animals. There were only dead bodies and dogs. The only noise we heard was dogs’ barking, fi ghting for those dead bodies. We drove up to my home. By the time we arrived, I saw that my elder brother was there. When he saw me, he was very much concerned to see me there. But I did not have an idea of what was going on. I started to ask him where our neighbors were. He told me, “Those ones have been killed by the militia; others have been killed by the rebels; others have been burned by the rebels in the houses you see burning there.” At a certain point, he looked at me and told me, “My dear brother, please do me a favor and leave this place, because those trees and those woods have ears and eyes; they can see and understand.”

I had decoded his message. I drove down south to my mother-in-law’s. When we arrived, we noticed that her house had been destroyed. She had been killed with her daughter-in-law, six grandchildren, and many other people. All of them were thrown into a mass grave in a pit where we used to throw bananas to make banana juice and banana beans. We sat down and all of us cried just like kids; we could not understand. Had we learned nothing from history? All along the way, many houses were burning and people were being burned inside those houses. Today at lunchtime, I was talking to some friends about the “good guys” and the “bad guys.” That is when I went back in my memory and remembered history. I remembered that, before 1959, the international community, as

87 colonizers, supported Tutsis against Hutus, and helped them to oppress Hutus. In 1959, when the whole country was left to Hutus, who were not trained, who had no experience in administration, Tutsis were forced outside. Hutu power at that time had the backing of that same international community. In 1994, I again saw this kind of in-fi ghting: people occupying other people’s plantations; people breaking down other people’s doors, getting into their houses, remaining almost forever. Whoever showed up was killed for that. People breaking into other people’s shops, just jumping to the other side of the counter, stealing what they never bought. And this, again, backed by the international community.

Ladies and gentlemen, what I will tell you in my limited time is that, as human beings, we always look and never see; we always hear and never understand; we never learn from the past to plan a better future for future generations. I know this, because what I saw in Rwanda, I still see all over the world. I still see it in Darfur. We heard about it in Uganda where 1,800,000 people were displaced at gunpoint from their own houses and brought to refugee camps. We have seen a government send its own helicopters to destroy refugee camps, to kill them. All of this we have seen in Rwanda, where a government circled a refugee camp and killed 8,500 innocent civilians. Some of them had committed crimes, but even if they had, no one had convicted them. They were assumed to be innocent.

Ladies and Gentlemen, today we live in a world where people carry out their own justice. It is up to us humanitarians to fi ght against this. It is you, politicians and decision-makers to sit down and think about it and help Africa and the Third World. Thank you.

88 Partners In Health

Recipient of the 2005 Conrad N. Hilton Humanitarian Prize They opened for business in the early ’80s in a rural Haitian squatter settlement where life was a

stupefying cycle of poverty and disease.

Perfect. They could try their ideas: That modern medical care can prevail where nothing else is

modern. That untreatable disease shouldn’t be confused with untreated disease. That clean water,

shelter and nutrition are powerful medicines. And that the two most prominent carriers of infectious

disease are poverty and injustice.

Providing free antiretroviral AIDS treatment, training (and paying) the villagers—including

recent patients—they created an amazingly responsive health care delivery system.

Soon, using the same strategies, they were treating multidrug-resistant tuberculosis in Peruvian

slums, HIV/AIDS and TB in Russian prisons. And now, Rwanda.

Their successes have helped to change some long held medical and governmental notions about

what is possible and reconfirmed an old truth.

Margaret Mead said it: “Never underestimate the ability of a small group of committed individuals

to change the world. Indeed, they’re the only ones who ever have.”

The $1,500,000 Conrad N. Hilton Humanitarian Prize for 2005 is awarded to Partners in Health

Conrad N. Hilton Humanitarian Prize, 10100 Santa Monica Boulevard, Suite 1000 Los Angeles, California, USA 90067-4011 Te l ephone:(310) 556-8178 Facsimile: (310) 556-8130 e-mail: [email protected] Website: www.hiltonfoundation.org Paul E. Farmer, M.D., Founding Director, Partners In Health

Paul Farmer, a medical anthropologist and physician, has dedicated his life to treating some of the world’s poorest populations and in the process has helped to raise the standard of health care in underdeveloped areas around the world. Dr. Farmer is Presley Professor of Medical Anthropology at Harvard Medical School, an attending physician in infectious disease and chief of the Division of Social Medicine and Health Inequalities at Brigham and Women’s Hospital, and co-founder of Partners In Health. He has written extensively about health and human rights and the role of social inequalities in the distribution and outcome of disease. Dr. Farmer is the subject of Pulitzer Prize-winner Tracy Kidder’s “Mountains Beyond Mountains”. He received his undergraduate degree at Duke University and his M.D. and Ph.D. at Harvard University.

It’s my great privilege, tonight, to thank you on behalf of Partners In Health and the people we serve. In fact, my only job tonight is to convey two messages. First, to say thank you. Second, to introduce you to some of those you’ve chosen to honor. Ten minutes, two messages. It’s hard for a teacher-doctor-activist to refrain from preaching or exhorting, but I won’t dull our evening with a superfl uous lecture.

So fi rst, the inevitable and wholly appropriate gratitude. Thank you to the Hilton Foundation and to the Hilton family. The last will and testament of Conrad Hilton says a great deal about the notion of hospitality, a trait associated, in my country and around the world, with this family’s name. It has been instructive to learn more about Mr. Hilton and his family, and about what they have done with his injunction, to go forth and do good. This commitment to hospitality is mirrored in the work of the Foundation, which we’ve come to know well over the years.

We wouldn’t be here to accept this prize if not for the jurors. It’s diffi cult to know how best to thank the jurors for displaying their good taste by choosing us! Since it will appear self-important to thank them for their discernment, I will start by saying, or even bragging, that we’ve been nominated for this prize six times and concluded, a couple of years ago and incorrectly, that we’d be ever the bridesmaid, never the bride. We’ve been under the Hilton magnifying glass for more than half a decade, and every year it felt like a privilege to be included on the short list of organizations deemed worthy of the world’s largest humanitarian prize. We know how much is invested, every year, in assessing the huge number of nominations received. We will try our best to do you proud in the future, even though, as Steve Hilton noted earlier today, the Prize is bestowed in recognition of our past efforts.

I’d also like to thank the staff of the Foundation. The fact that you all spend so much time vetting the work means so much to us all. If there were a Hilton Prize for efforts made to award the Hilton Prize, we’d bestow it on the Foundation staff for your due diligence. We’re especially grateful to those of you who’ve visited us in our fi eld sites and have spent so much time scrutinizing our work and describing it to the jurors. I’d also like to note with pride that, although we did not win the Prize until 2005, we did win several PIH supporters. Several of you in this room, both Foundation staff and friends we’ve met through the staff, are important donors to PIH. This vote of confi dence means the world to us.

We’re extremely proud to join the other Prize winners because we respect, deeply respect, what they and this Prize stand for. What a great thing it is to constitute a family of organizations seeking to change the world! We’ve been scheming, already, about creating a coalition of awardees in order to do work that we could not do alone. It’s especially meaningful to receive the 10th Anniversary Hilton Prize, and not entirely, I confess, for sentimental reasons. There’s been one change in the Prize: a 50% bump in the size of the purse. So perhaps it was a good thing that PIH was a bridesmaid, rather than a bride, until 2005. Patience has its rewards!

91 Finally, we’re grateful to return to Geneva, a hospitable city we all know well. In fact, Jim Kim has been living here for the past two years, and all of us are in and out of Geneva often. I was surprised to learn, sitting next to the former mayor, that this beautiful building, which has the charming name of Forces Motrices, or “motor forces,” was not erected in our honor. Since we’ve spent two decades trying to serve as the “motor force” of a movement for health and social justice, we quite naturally concluded that the mayor and other city fathers here tonight had decided to build it in honor of the Hilton Prize.

So I’m done now with saying thanks, not because of a lack of gratitude but because I hope it’s obvious how grateful we are. We’ve had a wonderful day of talks and symposia, and I’m not going to add another. Instead I want to tell you a little bit about what it is like to work in an organization like Partners In Health, and part two of my comments will introduce you to some “PIHers” here tonight.

In the video you’ve just seen, you met Ophelia, Jim, Tom White, and me. But it’s no exaggeration to say that we accept this award on behalf of hundreds of co-workers and also, of course, on behalf of more than a million patients. When we say we’re all grateful, we want you to know that the “we” in question stands at almost 2500 PIHers, to use our own jargon, and counting.

Most of us cannot be here tonight. You’re able to meet those of us who have passports and can travel to Geneva. But many who constitute Partners In Health have never seen, much less been on, an airplane; most have never left their own countries. When I speak of 2500 PIHers, it’s important to add that the great majority don’t often travel farther than their feet can take them. That said, some of them are surely listening tonight. We’re told that the awards ceremony is being broadcast on the web, and part of what PIH does is to share the fruits of science and technology with the poor. It makes sense, then, that we would link all of our sites through the Internet. So before mentioning the PIHers gathered here tonight, I want fi rst to thank those who cannot attend. In Haiti alone, we have 936 accompagnateurs, community health workers who visit their sick neighbors every day, thereby embodying a solidarity much discussed but too seldom seen. Without their efforts, PIH would not be effective.

We are proud of the PIHers gathered here tonight and could speak volumes about each of them. You’ve already heard about Jim, Ophelia, and Tom White. Let me introduce you to others here without using their names. I’ll start by speaking about my close friend and co-worker, a Peruvian physician who has spent the last 11 years of his life working for the poor of his country. This doctor has built up what is probably Peru’s largest health-related NGO, not by only building our sister organization but by supporting the public health system. The example of our Peruvian team will be felt not only in Peru but across Latin America, where Socios En Salud has been active in sharing our model of comprehensive, community-based care. He has been a quiet and steadfast advocate for health and social justice for over a decade.

I could tell you about the woman who heads Partners In Health – Russia. She’s a cosmopolitan Muscovite who could have done anything she wanted with her life. She could have been a brilliant research scientist, which would have been, given her training and her gifts, the path of least resistance. Instead, we met her in the middle of a crowded prison in Siberia (and, no, she was not a prisoner). She’s spent the last several years fi g hting for the rights of people who are not warmly regarded in Russia or elsewhere — people who have committed crimes and now fi nd themselves in prison and sick. She decided that people go to prison as punishment rather than for punishment, and that getting tuberculosis as part of one’s sentence is not acceptable. She and her co-workers inspire all of us as they fi ght for the basic rights of those who many would prefer to forget.

I could talk about the director of our huge Haiti project, a woman who at 18 years of age survived a massacre inside her church during Mass. Instead of becoming a cynical and embittered refugee, she became the leader of an effort to deliver health care services in her country. Imagine that: a lifetime of thankless service to the poor as a response to an unspeakable aggression. For me, she is the epitome of a partner in health.

92 Less dramatically but no less signifi cantly, I could tell you about an American woman here tonight. To make a long story short, she raises money for Partners In Health. In comparison to our Haitian and Peruvian and Russian colleagues, she’s new to our organization, so it was only recently that I had a really good conversation with her and discovered she’s a historian and did her doctoral research at Harvard on slavery in the United States. After graduate school, she decided she didn’t want to be a full-time academic, but wanted instead to serve the destitute sick. So she joined Partners In Health and has brought our work with foundations up to speed.

I could speak about a French lawyer who would give even De Gaulle a run for his money in terms of organizing and who, after raising a family of her own, decided that she wanted to help in Haiti. She’s since become a passionate activist on behalf of food security and primary education for the most destitute. She is here tonight, too.

I could talk about a person who joins us from Rwanda, another American actually, who was a very successful businesswoman in Hollywood and then New York. She one day found herself walking through a supermarket and thinking about the genocide in Rwanda. She said to herself, “This cannot be true, this cannot have happened.” She decided right then to leave what she was doing, letting go of fi nancial security, and traveled to Sudan as a volunteer. Inevitably, she ended up in Rwanda, where she is working on behalf of people with AIDS in that country, the site of our newest project. She too is here tonight.

I could talk about the people we meet, like an American nurse who, as a young widow, found herself with a great deal of wealth. She had to decide how to raise a large family of her own children, but also how to be involved with the rest of the world, and ended up working on projects to bring basic health care to the African poor. She is here tonight as well as are other friends, some of them from Los Angeles and introduced to us by the Foundation. Thank you all for traveling across all of these time zones to be with us tonight.

I could talk about friends and supporters from the World Health Organization, based here in Geneva. One, an anthropologist, worked for years between Haiti and Harvard before deciding that he wanted to do something more than academic work as conventionally defi ned. He wanted to understand how poverty and inequality promote illness, and what we could do to study and understand that synergy. He is here tonight. Yet another PIHer with us here was a professor of religion at an affl uent American college. He decided, after having volunteered with us in Boston for many years, that he would accompany Jim Kim to Geneva to promote the right to treatment for AIDS.

And then there are the folks listening in our Boston headquarters. They work on procuring medications; on answering letters and the phone; on making sure that our partners in Haiti, Peru, Siberia, and Rwanda have the tools they need to do the work. Boston-based staff also conduct research and help us to teach medical students and to train physicians to serve the destitute sick more effectively. We’d like to offer special thanks to Howard Hiatt, who has done so much to help a public charity feel at home in one of the world’s largest research universities.

You’ve already met some of the founders of Partners In Health. They do not want me to talk about them, and that does not surprise me. Many of you heard Jim Kim talk today. Whenever we hear Jim talk and see his mind in action, we feel hope and see a way forward. I still do, after having worked with him for 20 years. Another founder is today the selfl ess director of Partners In Health. For 20-something years—Ophelia likes to change the dates — she has been working to promote the right to health care in Haiti and, indeed, in all of the sites in which we work. Finally, there is Tom White, now 86 years old. He is the only person we know who has followed through on his promise to share his once-considerable wealth — all of it — with the world’s poor. Without Tom and Lois and their family, we would not be standing here before you. It’s not just their generosity we salute, it’s also their vision.

Together, this group of people has fought back against poverty and inequality, which are, as we know, not God-given or created by nature. Just like the violence in Rwanda in 1994, these problems are created by us

93 humans. We know this; it has been pointed out by the other award winners and certainly comes through in the presentations today and in the materials gathered for tonight’s award. The good news about understanding the social origins of poverty and inequality is, of course, that as the authors of these problems we can reasonably hope to fi x them. Fixing the ills of the world is a tall order, but it’s been the mission of all of those involved in humanitarian work. When Judy introduced this evening’s program, she mentioned that there has never been a greater need for humanitarian work. She was echoed by Steve Hilton. Of course this is an enormous problem: if there is greater demand for humanitarian work it means that our world remains marred by social inequalities, poverty, and violence.

Only a vision inspired by social justice will permit us to heal our broken world. For Partners In Health to receive the Hilton Prize means a great deal not simply because it is such a generous award, but also because in order to advance social justice, which involves disrupting the way the world is today, we’re going to need all the help we can get. We’re going to need the support of people who, like you and me, are privileged — people who can board a plane and go to Geneva. People who have decided that they’re not satisfi ed with the world the way it is. People who have decided that we can and must address these social ills together. We are very proud to be part of this larger family of Hilton Prize winners and count on you all for your ongoing support.

Thank you so much for honoring Partners In Health.

94 2005 Symposium Attendees

Princess Salimah Aga Khan Mr. Daly Belgasmi International Children’s Ambassador Director SOS Children’s Villages United Nations World Food Programme, Geneva

The Honorable Susanna Agnelli Mr. Olaf S. Bonde Fondazione Il Faro, Italy Former Senior Vice President, Hilton Hotels International, Conrad Hilton Humanitarian Prize Juror Europe and Eastern Mediteranean

Dr. Frances M. Alguire Mr. Gerard Bradford, III President Emeritus Director World Methodist Council Center of Excellence in Disaster Management and Humanitarian Assistance

Ms. Louise Arbour (SPEAKER) Ms. Ingunn Brandvoll UN High Commissioner for Human Rights Director, Communications United Nations Offi ce of the High Commissioner SOS Kinderdorf International for Human Rights, Geneva

Mr. Tom Arnold Mr. Greg Brown CEO Program Offi cer Concern Worldwide, US International Rescue Committee, Geneva

Ms. Bilge O. Bassani Harry S. Brown, M.D. Chief Executive Offi cer Founder and Chairman Association Francois-Xavier Bagnoud SEE International

Mr. Sham Bathija Ms. Martine Brunschwig Graf (SPEAKER) Coordinator for Central Asia & ECO Region President United Nations Conference on Trade and Development State Council of the Republic and Canton of Geneva

Jaime N. Bayona, M.D. Robert Buckley, M.D. Director, Socios En Salud Member, Board of Directors Partners in Health, Peru Conrad N. Hilton Foundation

Mr. Ralph Begleiter (MODERATOR) Ms. Mayra Buvinic (SPEAKER) Distinguished Journalist in Residence Sector Director, Gender and Development, University of Delaware Poverty Reduction and Economic Management World Bank

95 Ms. Barbara Sayre Casey Ms. Ophelia Dahl Chairman/ CEO Executive Director Casey, Sayre and Williams, Inc. Partners In Health

Ms. Wendy Chamberlin Ms. Tatjana Darany UN Deputy High Commissioner for Refugees Secretary-General United Nations High Commission for Refugees Geneva Foundation

Melvin L. Cheatham, M.D. (SPEAKER) Mr. Guy Demole with Member, Board of Directors Mrs. Francoise Demole Samaritan’s Purse Foundation for the Refugee Education Trust

Mr. Julius E. Coles Francis M. Deng, Ph.D. (SPEAKER) President Distinguished Visiting Scholar at the Kluge Center Africare U.S. Library of Congress

Ms. Beth Collins Ms. Jessica Derder, JD Rwanda Director Program Manager Clinton HIV/AIDS Initiative International Centre for Missing and Exploited Children

Mr. Michael Collins Mr. Alain Dick Director-Hilton/Perkins Program Board Member Perkins School for the Blind Operation Smile

Mr. Gregory R. Dillon Ms. Olivia Cosgrove Vice Chairman Emeritus, Hilton Hotels Corporation Independent Humanitarian Consultant Member, Board of Directors Conrad N. Hilton Foundation Ms. Susan Crowley Senior Director, International Organization Relations Mrs. Bineta Diop (SPEAKER) Merck, Sharp & Dohme (Europe) Inc. Executive Director Femmes Africa Solidarité

Mr. David R. Curry Mr. Roberto Dotta Managing Principal Project Offi cer davidcurry Associates Business Humanitarian Forum

Ms. Nicole Dagnino Ms. Tania Dussey-Cavassini Delegate Counsellor, Humanitarian Affairs Enfants Refugies du Monde Permanent Mission of Switzerland to the International Organizations 96 Ms. Myriam Ernst Ms. Sukey Garcetti with Coordinator Mr. Gil Garcetti Casa Alianza, Switzerland Author and Photographer Former District Attorney, Los Angeles

Ms. Homayra Etemadi Mr. Thomas Getman External Relations Division Director of Humanitarian Affairs and Int’l Relations International Federation of Red Cross and World Vision International, Switzerland Red Crescent Societies, Switzerland

Paul Farmer, M.D. His Excellency Blaise Godet Medical Director, Co-Founder Permanent Representative Partners In Health Permanent Mission of Switzerland to the International Organizations

Mr. Lloyd Feinberg Ms. Barbara Gothard Manager, Patrick J. Leahy War Victims Fund, Vice President Displaced Children and Orphans Fund and Jackie Robinson Foundation Victims of Torture Fund United States Agency for International Development

William H. Foege, M.D., M.P.H. Baroness Mary T. Goudie Chairman, Global Health Council Member of the House of Lords Senior Advisor, Bill and Melinda Gates Foundation United Kingdom Juror, Conrad Hilton Humanitarian Prize

Mr. Frank Franke Ms. Marion Harroff-Tavel Journalist, AFRA-Press Political Advisor Co-founder and Vice President International Committee of the Red Cross Aviation w/o Borders (Luftfahrt Ohne Grenzen)

Jean F. Freymond, Ph.D. Ms. Dyanne M. Hayes Nash Director Former Vice President, Programs Centre for Applied Studies in Int’l Negotiations Conrad N. Hilton Foundation

His Excellency Walter Fust Ms. Kathy D. Hendrix Director-General Senior Advisor Swiss Agency for Development and Cooperation Conrad Hilton Humanitarian Prize

Ms. Constance Francesca Gabor Hilton Mr. Patrick Hernusi Hilton Family Project Assistant Business Humanitarian Forum

Mr. James R. Galbraith Dr. Otto Hieronymi Member, Board of Directors Head, Program on International Relations Conrad N. Hilton Foundation and Migration and Refugee Studies Juror, Conrad Hilton Humanitarian Prize Webster University

97 Mr. William (Barry) Hilton, Jr. Member, Board of Directors Jim Yong Kim, M.D., Ph.D. (SPEAKER) Conrad N. Hilton Foundation Director of the HIV/AIDS Department World Health Organization Co-Founder, Partners In Health

Mr. Conrad N. Hilton III Member, Board of Directors Ms. Dorothy W. Knapp Conrad N. Hilton Foundation Deputy Director, Afghanistan Future Generations

Mr. Steven M. Hilton President, CEO and Chairman Ms. Diana Kutlow Conrad N. Hilton Foundation Program Offi cer Joan B. Kroc Institute for Peace & Justice University of San Diego

Mr. Larry Hollingworth Humanitarian Program Director Mr. Eric Laroche Center for International Health and Cooperation Deputy Director, Offi ce of Emergency Programmes United Nations Children’s Fund, Switzerland

Dr. Alec Irwin Health Equity Team Mr. Kevin J. Lessard Offi ce of the Assistant Director-General Former Director World Health Organization Perkins School for the Blind

Mr. Fadi Itani Head of the International Relations Unit Mr. Philippe Lizop Islamic Relief Special Advisor to the Princess Aga Khan

Mr. Sam K. Jackson Manager, Foundation and Corporation Development Dr. Jeremiah J. Lowney, Jr. World Vision, Inc. President Haitian Health Foundation

Ms. Joyce Jett Director Ms. Marilyn Lowney Advance Development International Executive Director Haitian Health Foundation

Musimbi Kanyoro, Ph.D. General Secretary Mrs. Virginia Lowney World YWCA Haitian Health Foundation

Salmaan Keshavjee, M.D. Ms. Jo Luck Clinician, Division of Social Medicine President and CEO and Health Inequalities Heifer International Brigham and Women’s Hospital

98 Mrs. Ann Lurie Professor Monica McWilliams President Chief Commissioner Ann and Robert Lurie Family Foundation Northern Ireland Human Rights Commission

Mr. Maurice Machenbaum Ms. Lisa Meadowcroft Member of the Advisory Board Executive Director Casa Alianza, Switzerland African Medical and Research Foundation, U.S.A.

Mrs. Kathy Magee Ms. Chantal Meili President and Co-Founder Consultant Operation Smile Constellartis Independent Consultants

William Magee, M.D. Sister Joyce Meyer Co-Founder and CEO Executive Director Operation Smile Conrad N. Hilton Fund for Sisters

Ms. Christine Manula Ms. Judy M. Miller Government Relations Offi cer Director, Hilton Humanitarian Prize Landmine Survivors Network, Geneva Conrad N. Hilton Foundation

The Honorable John J. Maresca (SPEAKER) Mr. Andre Mollard President of the Executive Committee Humanitarian Issues Business Humanitarian Forum Delegation of the European Commission to the United Nations, Geneva

Ms. Caitlin Martin Mr. Richard Morford (SPEAKER) Business Humanitarian Forum Managing Director, Donor and Multilateral Relations Millennium Challenge Corp.

Ms. Maude Montani The Honorable Pierre Muller (SPEAKER) Focal Point for UNHCR Matters Administrative Councilor, Head of Finance United Nations World Food Programme, Geneva and General Administration Department City of Geneva

Jean-Luc Maurer, Ph.D. Mr. Anthony J. Murdoch Professor Partner Graduate Institute of International Studies, Geneva Constellartis Independent Consultants

Mrs. Hawley McAuliffe with Mrs. Christine Murray Mr. John McAuliffe President, Zanmi Lasante Hilton Family Partners In Health, Paris

99 Namposya Nampanya-Serpell, Ph.D. Maria Piniou-Kalli, M.D. Consultant and HIV/AIDS Activist Medical Director Medical Rehabilitation Center for Torture Victims

The Honorable Stephan Nellen Mr. Michael S. Piraino Director Chief Executive Offi cer Geneva International Centre for Humanitarian Demining National CASA Association

Joyce Neu, Ph.D. Dr. Oksana Ponomarenko Executive Director Director Joan B. Kroc Institute for Peace & Justice Partners In Health, Russia University of San Diego

Mr. John L. Notter Mr. Richard R. Rand Member, Board of Directors Rand Resources, LLC Conrad N. Hilton Foundation

Mr. John O’Shea Serge Resnikoff, M.D., Ph.D. Executive Director Director, Prevention of Blindness and Deafness GOAL World Health Organization

Mr. Olara A. Otunnu (SPEAKER) Joseph Riverson, M.D. Former Special Representative for Children Medical Specialist & Armed Confl ict, United Nations World Vision, Ghana Juror, Conrad Hilton Humanitarian Prize

Ms. Mercia Padrovich Ms. Casey Rogers Senior Policy Manager Senior Program Offi cer Islamic Relief Conrad N. Hilton Foundation

Ms. Patrizia Palmiero Mr. Laurence Roth Permanent Mission of Switzerland to the International President Organizations Casa Alianza, Switzerland

Mr. Simon Panek Mr. Steven M. Rothstein Chairman President Czech National Platform Perkins School for the Blind

Ms. Kristine Pearson Ms. Deborah Ruiz Verduzco Executive Director Consultant Freeplay Foundation Parliamentarians for Global Action

100 Mr. Paul Rusesabagina Dr. Johannes Sommerfeld (Hilton Prize Ceremony KEYNOTE SPEAKER) Scientist, Research Manager Founder World Health Organization Hotel Rwanda Rusesabagina Foundation

Feride Rushiti, M.D. Ms. Inky Song Medical Director Senior Development Offi cer Kosova Rehabilitation Centre for Torture Victims American Foundation for the Blind, Inc.

Professor Jeffrey Sachs (SPEAKER) Richard South, M.D. Director of the Earth Institute at Columbia University Director, HIV & Malaria Programmes Special Advisor to the UN Secretary General Glaxosmithkline

The Honorable Mohamed Sahnoun Mr. Fred Spielberg Special Advisor on Africa to the UN Secretary-General Project Offi cer, Emergency Preparedness United Nations United Nations Children’s Fund, Switzerland

Mr. Jeff Schaffer Mr. Meinrad Studer Assistant Vice President – Grant Programs Permanent Mission of Switzerland to the Conrad N. Hilton Foundation International Organizations Senior Advisor, Multilateral Affairs Swiss Agency for Development and Cooperation

Anders R. Seim, M.D., M.P.H. Mrs. Brita Sydhoff Executive Director Secretary-General Health and Development International International Rehabilitation Council for Torture Victims

Bhogendra Sharma, M.D. Mrs. Emily Talmon-l’Armée President, Centre for Victims of Torture, Nepal Head of Operations International Programme Advisor Business Humanitarian Forum Medical Foundation for the Care of Victims of Torture

Padma Shetty, M.D. Fred Tanner, Ph.D. Public Health Offi cer Deputy Director, Head of Academic Affairs Coordination of Macroeconomics and Health Support Geneva Centre for Security Policy World Health Organization

Ms. Susannah Sirkin Mr. Simon Taylor Deputy Director Director Physicians for Human Rights Global Witness

Dr. Cornelio Sommaruga Mr. Colin Thomas-Jensen (SPEAKER) President Advocacy and Research Offi cer for Africa Geneva International Centre for Humanitarian Demining International Crisis Group

101 Mr. Mark Thomson Ms. Amina Wali Secretary General Webster University Association for the Prevention of Torture

Ms. Vanessa J. Tobin (SPEAKER) The Honorable George Ward, Jr. Chief, Water, Environment and Sanitation Section Senior Vice President for International Programs United Nations Children’s Fund World Vision

Ms. Liv Ullmann Douglas Weil, Ph.D. with Vice Chairman – International Ms. Diana Weil International Rescue Committee Sr. Policy Advisor, Stop TB Conrad Hilton Humanitarian Prize Juror World Health Organization

Mr. Ian Vale Stephen G. Wells, Ph.D. Operations Manager President International Medical Corps, London Desert Research Institute

Ms. Annelien van Meer Dr. Suzanne Werder Communication and Media Offi cer Secretary General Femmes Africa Solidarite International E. Balzan Prize Foundation

Mr. Paul Vermeulen Mr. Gerard B. White Director Co-Founder and Executive Director Handicap International, Switzerland Landmine Survivors Network

Reverend Robert J. Vitillo Mr. Anthony J. Whitehouse Special Advisor on HIV and AIDS Maitland Switzerland S.A. Caritas Internationalis, Switzerland

Ms. Marilena Viviani Dr. David Carl Wilson Chief, Inter Agency Standing Committee Secretariat Dean, College of Arts & Sciences United Nations Offi ce for the Coordination Webster University of Humanitarian Affairs

Mr. Peter Voelker Mr. Samuel A. Worthington Deputy Secretary General CEO, Plan USA SOS Kinderdorf International Board Member, Hope for African Children Initiative

Mrs. Eva Von Oelreich Ms. Susan Wyly Executive Secretary Director of Foundation Development Steering Committee for Humanitarian Response Partners In Health

102 Ms. Kirsten Young Rights Advisor and Legal Counsel Landmine Survivors Network

Pat Youri, M.D. Former Executive Director Hope for African Children Initiative

Dr. Ernesto Zedillo (Symposium KEYNOTE SPEAKER) Director, Center for the Study of Globalization Yale University

Mr. Randall Zindler Chief Executive Offi cer MEDAIR

103