By Ashley Hickey
Access to basic health care is extremely challenging for people living in many parts of Africa, such as this remote village in the mountainous Kingdom of Lesotho in the southeast part of the continent. According to the U.S. State Department, nearly 25 percent of Lesotho’s 2 million citizens is living with HIV, and U.S. development assistance provides antiretroviral treatment there for more than 56,000 people so they can stay healthy and provide for their families. (Ashley Hickey)
WASHINGTON –The United States program to address HIV and AIDS in developing nations has significantly improved those nations’ perceptions of the U.S., according to a recent academic study, but does countries liking us more mean we’re actually any safer?
Military leaders, government officials and advocates believe there is a link between development assistance abroad and the nation’s security at home, but the connection has been hard to prove to those who are skeptical of sending American taxpayer dollars abroad when the country must reign in spending to address a massive national debt.
“If you could draw a straight line between development and security, we’d be funded like the Defense Department,” said Tom Hart, U.S. executive director of ONE, a campaigning and advocacy organization focused on ending extreme poverty and preventable disease. “It’s a much more nuanced link, but we believe the link is there and believe we’re starting to see some evidence of impact in the perception of the United States – to the extent that helps solidify our national security.”
The study conducted by professors at Dartmouth College, the University of Sydney and the Australian National University found robust evidence that the U.S. President’s Emergency Plan for AIDS Relief – known as PEPFAR – has had a strong positive effect on how U.S. leadership is perceived in recipient countries.
The U.S. has committed $52 billion to PEPFAR and related initiatives since former President George W. Bush launched the initiative in 2003. President Barack Obama has continued to scale up PEPFAR during his presidency with additional funding, some of which has been spread to the multilateral Global Fund to Fight AIDS, Tuberculosis and Malaria.
PEPFAR supports life-saving antiretroviral treatment for 6.7 million people living with HIV around the world. These medicines suppress the HIV virus, allowing an infected person to live a relatively normal and healthy life. And taken during pregnancy, they can help an HIV-positive mother prevent transmission of the virus to her unborn child.
Before PEPFAR’s inception, fewer than 400,000 people were receiving medication for a disease that has killed more than 30 million men, women and children.
Hart said PEPFAR’s launch coincided with a post-9/11 shift in national security strategy to incorporate development into the traditional tactics of defense and diplomacy because of the risk posed by unstable and impoverished nations.
Although poverty alone doesn’t create extremism, Hart said it can take hold where there is desperation, hopelessness, hunger and disease. Effective development programs that provide food, access to health care and economic assistance can provide people with hope and a stake in their own futures, making them less likely to turn to extremist groups that claim to deliver security and stability.
“National security experts and military officials looked hard at how work that is firstly intended to do good might have benefits to the long-term stability of the United States,” Hart said.
Advocates must, however, combat public perception that 25 percent of the U.S. budget is spent on foreign aid. It’s actually less than 1 percent of federal spending, and there has been a measurable return on investment.
Global development assistance has helped more than 700 million people move out of extreme poverty – measured by those living on less than $1.25 per day – years before a U.N. target set at the turn of the millennium to cut in half extreme poverty by 2015.
“The effective programs we support are making an incredible difference for just pennies,” Hart said. “When we are looking to change hearts and minds, and for a very small investment we can make a world of difference, it’s not only the right thing to do but the smart thing to do … To get rid of these programs can create the kind of instability that can only be dealt with with our military – the most expensive option.”
Military leaders from former Gen. David Petraeus to former Secretary of Defense Robert Gates and former head of U.S. Central Command James Mattis have defended the effectiveness of development programs and warned that slashing such budgets would be penny-wise, pound-foolish.
“If you don’t fund the State Department fully, then I need to buy more ammunition ultimately,” Mattis said in his March 2013 testimony to the House Armed Services Committee in response to threats to foreign aid spending by legislators looking to balance the budget by cutting any potentially noncritical programs.
While development assistance may be an effective element of national security policy, Hart underscored it cannot be done for that reason and should not be handled by the military.
“If development is seen as a tool for national security, it doesn’t work,” Hard said. “It’s only when our good will is seen as such that there are knock-on effects of good will toward the U.S. and more prosperous and stable nations.”
