Press Briefing

Mr. Crowley

: Good evening. I think today can very aptly be described as a very powerful day. I think in a day we saw Nigeria as it exists today -- about 70 percent of Nigerians live in villages such as Ushafa, that you saw this morning. We also learned more about the challenge that Nigeria faces at the National Center for Women's Development, where you heard the extraordinary story of John Ibekwe and his family as they confronted the AIDS disease. And then the President's remarks at the U.S.-Nigerian commercial dialogue focused on Nigeria's future and the fact that, as the President said, we're on this boat together and let's sail.

So we covered a lot of ground today. We have a group of our experts back in to help you finish today, and if you've got questions we can help, to the extent that we can, set up tomorrow. So opening our briefing this evening will be Sandy Thurman, who is the Presidential Envoy for AIDS Cooperation. And then as we go into questions, joining her will be the Assistant Secretary of State for African Affairs, Dr. Susan Rice -- who got a nice plug from Jesse Jackson, well deserved. Also we have Laura Efros, Senior Advisor for International Health Strategy; and Rick Samans, Special Assistant to the President for International Economic Policy.

So, hopefully, if you've got questions, we've got answers. But we'll start off with Sandy Thurman.

Ms. Thurman: Thank you. I think during the visit today, and reading all the briefing materials and hearing all the numbers, we all are beginning to understand in a very real way that AIDS is a plague of biblical proportion. It's been declared the worst public health crisis since the bubonic plague. I think that's absolutely true. In fact, at the end of the day, public health experts think that the AIDS crisis will make the bubonic plague of the Middle Ages pale in comparison.

We have 34 million people infected with HIV worldwide; more than 22.5 million of those people live on the continent of Africa. Each and every day, 11,000 people become infected in Africa. That's one every 8 seconds. Each and every day, Africa buries 5,500 people -- 5,500 men, women and children to AIDS. By the end of the next decade, we expect to have 40 million children orphaned by AIDS in Africa -- that's losing one or both parents to AIDS.

Nigeria, to put this in context, is really at a pivotal point in the progression of the epidemic in this country. We have a great window of opportunity, however, to turn the tide in the epidemic in Nigeria. Nigeria has one of the highest prevalence rates in all of West Africa at just at 5 percent. And while that's not very big compared to most sub-Saharan African nations, many of which are looking at 20 percent of all adults infected, when you consider the fact that Nigeria is the most populous country in all of Africa, and then begin to do the arithmetic, we can see -- and when we look back at what happened, for instance, in South Africa, that had a very low percentage of infection just five or six years ago and now is looking at almost 20 percent of all adults infected -- when you begin to do the arithmetic you can see that what we have is a real potential for disaster here in this country.

When we analyze all of the successful programs around the world, we understand that there are two common denominators in the successful programs that have begun to address this epidemic and turn infection rates around -- like Senegal in West Africa, like Uganda in East Africa -- and that's leadership and resources.

And what we saw today is both of those. We saw a $9.4 million commitment on the part of the United States that triples our funding from last year, which was $2.7 million for Nigerian AIDS programs, and leadership -- I mean real leadership on the part of President Clinton, and real leadership on the part of President Obasanjo. And that's what it's going to take if we're going to really have an impact and begin to slow the spread of infection in Nigeria.

As we looked around the crowd today and saw all the different faces and the representatives of all different segments of society, it reflects the fact that AIDS is no longer just a health crisis, that it's a fundamental development crisis, it's an economic crisis, it's a crisis of security and stability and, in addition to that, that it's going to take all sectors of all societies pulling together if we're going to really begin to turn the epidemic around.

Governments can't do it alone. The United States government certainly can't do it alone. It's going to require partnership with the private sector and with the multinational organizations. And probably most importantly, it's going to require partnership with communities. And, again, we saw that reflected today in all of the community-based organizations that were at the health event. We understand clearly that this epidemic or the battle against AIDS will be won or lost at the community level.

Most importantly, though, today helps us remember that this is not about numbers, but about names; and not about facts and figures, but about faces. And I think John's story and Tayo's story today really help us reflect on that in a very concrete fashion.

What we have when we look at the young people and the women in the audience today is an entire generation in jeopardy. But the good news is, in this epidemic, that we know what works. Our challenge is to bring the programs that we know work, like the ones we witnessed today, to scale if we're going to really turn this epidemic around.

So it was an exciting day for so many of us who have worked in AIDS for a long time to see those two Presidents stand up and speak so passionately to this issue -- and their comments reflected, and the person living with AIDS and the young peer educator who shared their story with us.

So let me stop there and ask my colleagues to come forward, and see if anyone has any questions.

Question: It's my recollection that two years ago the President didn't have an address purely addressed on AIDS. Is that -- when he came to Africa. Is that right, and if so, why did he think that now is the time to give such an address? There were, clearly, lots of AIDS problems in the countries he visited two years ago.

Ms. Thurman: Well, we certainly talked about HIV and AIDS on the last trip. We didn't do an AIDS-specific event on the last trip. The sort of theme of the event was economic development, and most of our events were focused on economic development, although we did talk about HIV and AIDS.

I think there's been so much attention and focus on the global pandemic in the last 18 months, a growing understanding that what we see in Africa today is just the tip of the iceberg; that 15 years from now we'll be looking at the epicenter of the epidemic in Asia, mostly in India and, on down the road, other parts of the world. So there's just a growing understanding that we are facing a pandemic of unparalleled proportion. And that's why I think this trip was a great opportunity to focus on that.

The other is that Nigeria does have a great opportunity to keep their infection rates low; that we know if we're out there and aggressive early with prevention messages, like Senegal, as an example, that we can keep infection rates low. And that's very, very important to the future of Nigeria and the future of Africa.

Question: Does the U.S. still discriminate on visa applications by AIDS?

Ms. Thurman: The United States has never discriminated, no.

Question: What about that story that we heard today?

Ms. Thurman: Well, yes, what happens -- and I'm not sure in John's story how he wound up being tested. When people apply for visas to come to the United States they're asked if they have an infectious disease. There's no requirement for testing for HIV. If they do say that they have HIV, then the embassies work with them to provide some sort of proof of health care coverage, in case there are health -- an ability to pay their health costs if they come to the United States.

There was a great debate in Congress, back in the late '80s, about this because there was a feeling on the part of AIDS activists that HIV ought to be -- HIV status ought to be removed from the infectious diseases portion of a visa application, because people living with HIV can be healthy for so many years without ever having a symptom. So they didn't think it was appropriate. That was brought up in the Congress and soundly defeated in the Congress. So it's still a little gray, but we don't flat out discriminate against people living with HIV, although, it's difficult, makes it difficult for people to obtain a visa.

Question: So to clarify it, you say you don't discriminate based on HIV, but if they don't have health coverage you don't let them in?

Ms. Thurman: They work with the individual embassies, but their visa applications can be denied if they can't show that they have the ability to pay for their health care coverage. So it's a little gray, but we don't discriminate based on HIV status.

Question: -- require them to be tested?

Ms. Thurman: No.

Question: So what John said doesn't seem to jive --

Ms. Thurman: No, it didn't jive with our policy. We've never required testing for HIV. We require testing for yellow fever and a couple of other diseases. But we've never required testing for HIV, although, the question is on the application, so I don't know if -- again, I don't know what his particular story is, but we've never had a requirement for testing.

Question: My question is, first about the AIDS announcements today, and then goes a little broader to the other economic announcements today. We're having a very hard time figuring out how much of this money is new. The thing you put out today said that Clinton announced more than $20 million to deal with polio, AIDS and other infectious diseases, but it doesn't sound like any that's actually new money today. Most of it sounds like it's wrapped into to the FY 2000 budget and the FY 2001 budget request. As you get into the other economic issues, it goes further that we're not clear on whether it is $1.2 billion in Ex-Import loan guarantees. We're having a very hard time figuring out how much new money the President brought with him from America this week and dropped off in Nigeria.

Assistant Secretary Rice: Let us try to parse this a bit. And I'm going to ask Rick Samans to help out on the Ex-Im numbers, and Sandy can give you more detail on the infectious disease money. As I said yesterday, prior to the President's trip to Africa, we had committed close to $109 million in Fiscal 2000 to Nigeria. That's a substantial increase over the $7 million for Fiscal '98 -- so already a manifold increase in both the size and the breadth of our assistance programs.

The President, during the course of his time here in Nigeria this weekend, has announced in various forms or fashions new cooperation, new development, new assistance programs worth close to $20 million. That's on top of the $109 million. That's money that is new to Nigeria, although this is not necessarily new to the United States government and doesn't require any additional appropriation. And, obviously, some of it we will look to be working with Congress for reprogramming and other sorts of support.

In addition to that, the value of the training and equipping of the five Nigerian battalions for peacekeeping is estimated to be $42 million. That's additive on top of the roughly $129, which is where I got the figure yesterday of roughly $170 million.

Now, for the details.

Ms. Thurman: The HIV money, the $9.4 million is actually new money, but it's, again, new to Nigeria this year. It's not brand new money, but, again, it triples our funding from last year. And we hope to work with Nigeria to increase funding again next year, because we just think this is a really important investment for us to make.

Mr. Samans: For the other part of your question regarding trade, promotion and financing, the Ex-Im Bank has announced today a number of facilities that will facilitate the financing and consummation of transactions that could be worth ultimately hundreds of millions and, possibly, billions of dollars. The precise figure is, of course, hard to know at this stage of the game.

In addition, the Trade and Development Agency has consummated some transactions for some project feasibility studies which, depending upon the results of the project feasibility studies, could result also in transactions in Nigeria worth as much as a billion dollars.

Question: So, to clarify, on the AIDS money, the fact sheet here, we've got $9.4 million, that's the new money that you are saying today is going to come from somewhere --

Ms. Thurman: No, no. It's money that we're already spending in FY 2000. It's part of the $109. So it's --

Question: But it wasn't promised to Nigeria before today, or it was?

Ms. Thurman: No, it was. It was. So that piece is included in the $109 that Susan was talking about.

Question: And the $8.7 million was already promised, as well?

Assistant Secretary Rice: That's right. The brand new money in the $20 million -- excuse me?

Question: Why did you put out a statement that says you announced today this $20 million of AIDS money?

Assistant Secretary Rice: That's not --

Question: That's what it says on the statement that we've had all day long to tell our editors what stories to expect.

Assistant Secretary Rice: Well, let me give you the breakout, roughly. Of the $20 million, the categories include -- I'm talking about the $20 million that's over and above the $109 -- is in a variety of categories, including digital divide, education, democracy, governance, agriculture, labor and trade and investment, and a small quantity in the health sector. The money that Sandy was describing is fiscal 2000 money, previously programmed for Nigeria.

Ms. Thurman: Again, the $20 million includes -- it's not just HIV and AIDS, but it includes polio and tuberculosis.

Question: Did Nigeria get any of that yet?

Assistant Secretary Rice: I'm sorry? Do you mean, has the money been obligated and is it out the door? I can't answer that. Do you know that answer to that?

Ms. Thurman: I know that some -- I don't know if all the AIDS money is spent, but I know some of the AIDS money has already been spent and is obligated and is on the ground now. But I don't know how much of our AIDS money -- I don't know about the malaria or polio money, but I do know about the AIDS money.

Assistant Secretary Rice: Whether it's actually been obligated and expended, it's all fiscal 2000 money and will be this fiscal year.