"Ending Poverty in Africa: The Hardest Case"

by Peter D. Bell
Clinton School of Public Policy
Little Rock, Arkansas
October 30, 2006

Almost exactly ten years ago, I awoke from my bed in a modest roadside hotel in Ruhengeri, Rwanda, to what sounded like the eerie sound of muffled clapping. I was hearing the footsteps of thousands upon thousands of barefoot Rwandans. They were trudging - without saying a word - along the road from the Democratic Republic of Congo, then called Zaire, back to their Rwandan communities. Anxious but intent, they maintained a rapid yet steady pace, and children struggled to keep up. The new Tutsi-dominated Rwandan government had invaded Zaire in search of Hutu militia. And Hutu who had sought safe haven in the camps of Zaire were now returning home.

A decade ago, Rwandans were enveloped by a collective sense of depression. Everyone had been affected by the genocide in 1994. Severe trauma and deep distrust were pervasive. Five out of six Rwandan children had witnessed the bloodshed. Many had seen their fathers killed and their mothers raped. Rape had been used as a weapon of war, and militia who had been HIV positive spread the virus at an alarming rate. Two years later, HIV/AIDS was still widely stigmatized. No one talked about it.

Rwanda © Christina Chan/CARE

Last year I returned to Rwanda. I watched men, women and children walk along the same road in Ruhengeri. It was a Sunday. And many were strolling home from church wearing their Sunday best. The mood was remarkably lighter.

That same day, I met with more than 100 Rwandan women. All were widows. All were HIV positive - most likely as a result of rape during the genocide. They were members of an association called "Don't Fear." With CARE's support, the group is raising awareness about HIV/AIDS. With arms and bodies swaying, the women greeted me with animated song. Their voices shook the room, and I was swept away by their energy and enthusiasm.

A leader of 'Do Not Fear', a group of l00 hundred Rwandan widows who had been raped and left HIV positive during the genocide and are now working to prevent the spread of AIDS in Rwanda.
© Christina Chan/CARE

Ten years ago, I could not have imagined that Rwandans might be capable of expressing such joy. The memory of violence and the grief over family and friends are, no doubt, still fresh. The distrust is still there. And the Tutsi-dominated government maintains tight control. But Rwandans smile more easily. Stigma and discrimination against people with HIV/AIDS have declined. More people are getting tested, and the government is offering anti-retroviral drugs free of cost to those in greatest need.

Peter with recently demobilized female combatant from a militia in Burundi

There are no easy answers to the challenges of Africa. But the fact that people in places like Rwanda are pulling together to support one another gives me reason to believe that a better world is possible. It also gives me purpose.

Today, I want to talk with you about the causes of extreme poverty in Africa, but I also want to point to some signs of progress. While I have no doubt that the African governments and people must bear the principal responsibility for their own development, I want also to focus on what we can do in this country to help the cause.

Poverty in Africa

Peter enjoying stories of local leader in Sierra Leone
about rebuilding in aftermath of war

Sub-Saharan Africa is the poorest region in the world. Half the population there somehow struggles to survive on less than 65 cents a day. Think of it! Less than what we pay for a can of soda. The average life span of an African is just 46 years. Every three seconds, an African child dies of a preventable disease.

Africa is the hardest development case. If you follow the news through television, you can hardly be blamed if you see Africa in a state of mayhem. Media coverage of Africa focuses on wars, famines and epidemics. Without context or analysis, such coverage contributes to a lack of understanding of why the crises are occurring and how they might be resolved. All too often, Africans are depicted as helpless, and their plight, as hopeless.

Villagers rebuilding a well in Sierra Leone destroyed during the civil war

Within CARE, we have tried to take a more systematic approach. We have given priority to three proximate causes of extreme poverty in the African context: the spread of HIV/AIDS, lack of access to basic education, and lack of access to safe water. I would like briefly to discuss each. I will then touch on three underlying causes of poverty in Africa: poor governance, violent conflict, and discrimination.

Let me start with HIV/AIDS. Of the 39 million people in the world with HIV/AIDS, an estimated 25 million live in sub-Saharan Africa. 1 HIV/AIDS is the most common cause of death in the region. A 15-year-old boy in South Africa has a 50-50 chance of dying from causes related to AIDS - the odds for a 15-year-old South African girl are even worse. In Africa, a staggering 75 percent of people ages 15 to 24 living with AIDS are women.

On a visit to Lesotho, in southern Africa, I met a former national soccer star who now works for CARE. He trains teenagers to educate their peers on how to prevent the spread of AIDS. What had motivated him to join CARE was the realization that the soccer leagues throughout Lesotho had been disbanded. Why? Because so many teenagers were going to two, three or more funerals on Saturdays. Coaches could no longer field complete teams.

The HIV/AIDS pandemic is the most devastating humanitarian crisis of our time - and possibly of all times. Stopping it is a precondition for development in sub-Saharan Africa.

Lack of access to basic education is another cause of extreme poverty. More than 115 million children in the world who should be in elementary school are denied the opportunity. 2 Three-fourths of them are in sub-Saharan Africa. Most are girls. Yet research has shown that no social investment brings greater returns than basic education, especially for girls. Each year of schooling for girls is associated with increases in family income, decreases in fertility rates, and decreases in infant, child and maternal death rates.

Burundi © Christina Chan/CARE

Lack of access to clean water is also a major cause of extreme poverty. Nearly half the people of sub-Saharan Africa have no access to safe water. 3 In the poorest communities, diarrhea is the biggest killer of children. Safe water, when accompanied by sanitation and hygiene, saves lives. Millions of African women and girls walk an average of three and a half miles a day to collect water. 4 The installation of potable water can release many hours of their time for other pursuits.

Let's turn to the underlying causes of poverty:

First, poor governance. It is often at the heart of Africa's problems. In many African countries, governments have failed to deliver public services, to create enabling environments for economic growth, and to protect basic human rights. Small groups of political elites have captured the power of the state, and used it for their own purposes. The results have included the concentration of wealth in the hands of a few, the breakdown of the rule of law, and the eruption of civil unrest and violence.

Democratic Republic of Congo © Christina Chan/CARE

Violent conflict is another underlying cause of extreme poverty. One African in five lives in a country torn by violent conflict. 5 These conflicts take the hardest toll on poor people, especially women and children. Rape is routinely used by combatants as a tool for humiliation. Victims of rape may be twice victimized, because, once raped, they are often shunned by their families and communities.

In the Congo last year, I met a 16-year-old girl named Yuwari. Rebels had attacked her village. Her mother and father ran in one direction; she, in the other. She was captured and brought into the bush. Yuwari was raped so frequently she now suffers from constant pain in her lower abdomen.

Throughout my travels to war-torn countries, I have met men, women and children who want nothing more than peace. They want to be able to walk to the market - or to school - without fear. They want to be connected to the rest of the world.

Discrimination and social exclusion is the other root cause of poverty that I would cite. While discrimination can take many forms, I want to focus here on gender inequity. As in other parts of the world, women in Africa are overburdened with work and often lack power and influence. They have less access to formal education than men. Women also have less access to productive assets, including land. And their potential to help reduce extreme poverty is largely untapped.

In the most impoverished African countries, the three proximate causes of poverty that I've cited - the HIV/AIDS pandemic, lack of access to basic education, and lack of access to water - reinforce one another. And these proximate causes are, in turn, reinforced by such underlying causes of poverty as bad governance, violent conflict, and discrimination. Efforts to reduce poverty must be systematic and integrated. And they must be taken up by a range of players, including African governments, the private sector, ordinary Africans, international NGOs, and the U.S. government.

Role of African Governments

Democratic Republic of Congo © Christina Chan/CARE

Africa's plight can seem overwhelming. Nevertheless, I have no doubt that the challenges facing Africans today can be met - not overnight, not even over the next few years, but over the coming decades, if all of those players do their part.

The governments of African countries bear a special responsibility. They must create policy environments that foster human rights, political participation, economic development and civic pride. They must give priority to basic education, safe water and healthcare, essential investments for people in extreme poverty.

Over recent years, governments of some African countries have made significant progress. Botswana and South Africa have reduced corruption, promoted democratic governance and raised the living standards of their people. Ghana, Benin and Mali have opened their political processes and built political stability. Liberia has elected the continent's first female president. Tanzania and Kenya have made education a top priority, eliminated school fees, and brought a flood of new students into their classrooms. Senegal and Uganda have reduced HIV/AIDS infection rates.

Five countries have ended long-standing civil wars and begun rebuilding. Thus, the economies of countries like Mozambique and Sierra Leone have grown at rates rivaling that of China. Rwanda has recently set out plans to become the information technology hub of central Africa. 6 After 12 years of civil war, the elected government of Burundi is more accountable. And just yesterday, the Democratic Republic of Congo held its run-off election for the presidency. When I visited there last year, everyone I met had planned to vote. Given the long Congolese nightmare that they had endured, I was moved by the hope they had vested in the electoral process.

Role of the Private Sector

In addition to government, the role of the private sector is, of course, indispensable to economic development. The private sector can create jobs and opportunities that lift people out of poverty. It can generate the tax revenues to fund public spending. It can provide employees with training. And it can transfer and adapt technology that may help Africans leapfrog their way into the 21st century.

Most African countries still have a long way to go in developing modern private sectors. Subsistence agriculture is still the mainstay of much of Africa. But we are seeing the signs of the dynamism of which Africans can be capable. Botswana has achieved one of the highest per capita savings rates in the world. The Ghana Stock Exchange has topped the list of the world's highest performing stock exchanges! Last year, Tanzania and Ghana ranked among the world's top ten pro-business reformers. Since 2000, African economic growth - at 4.8 percent - has been on a par with the rest of the world.

Do not underestimate the resourcefulness of ordinary Africans. People in Somalia, for instance, are buying and selling the latest satellite phone technology. During the recent war in the Congo, an ordinary citizen named Alieu Conteh welded scrap metal together into a cell phone tower. Today, the tower still stands. Conteh's company, Vodacom, is the largest phone company in the country. 7 Between 1999 and 2004, the number of mobile subscribers in Africa, no longer written off by the industry, jumped from 7.5 million to 76.8 million.

Role of Poor Communities Themselves

On our nightly television news, Africans may come across as besieged and helpless. In fact, when I visit African communities, I meet people who are courageous, determined to improve their lives, and energetic in the face of adversity. People in poor communities are organizing their own destinies. They are working together to overcome conflict, gain access to clean water, rebuild schools torn down by war, raise children orphaned by HIV/AIDS, and press governmental authorities to be accountable. It's just incredible to see their energy, ingenuity and courage. If more Americans could visit African villages, I know that they would have more hope for Africa and be more willing to invest in Africa's future.

In Tanzania, women now have choices they did not have before. I visited a CARE project called Hujakwama, which in Swahili means "you are not stuck." The name conveys to women that they have the power to improve their own lives. Some 1,200 women had obtained entrepreneurial skills and had gained access to clean water, sanitation, health care, education and cash income.

In Niger, possibly the poorest country anywhere, rural women are also proving that they are not stuck. With CARE's help, they are managing community-based savings and loan programs, and starting economic activities such as peanut oil production, food preparation and grain storage. With the income, they are paying their children's school fees and purchasing household items. Since 1991, 225,000 women have formed 6,000 savings and loan groups throughout Niger.

Though change may be slow and grudging, the results are worth the effort. With local leadership and outside support, advances are occurring in communities across Africa.

Role of International NGOs

If NGOs, like CARE, Save the Children, World Vision and Heifer International, have a core strength, it is our experience working in tens of thousands of the world's poorest communities. We assess the strengths and vulnerabilities of these communities and work with them so that they can establish their own priorities, expand their capacity to make progress and be owners of their own development. Where governments lack the capacity to meet people's needs, we fill the gap and provide services directly to poor communities. But, we also seek to strengthen the capacity of governments to fulfill their responsibilities - and the capacity of ordinary citizens to hold governments accountable.

In the U.S., we serve as a vehicle by which Americans can contribute financially to reducing poverty and human suffering. We also mobilize Americans to speak up in support of an expanded U.S. government role in fighting global poverty.

Role of the U.S. Government

There are four fronts on which the U.S. government can make critical contributions to reducing poverty in Africa:

  • First, through diplomacy. Where the United States is prepared to give sustained diplomatic attention, it can often contribute to resolving civil conflicts. For example, the Bush Administration quietly but effectively supported talks aimed at ending the 20-year civil war in Sudan that has killed two million Sudanese and displaced four million. In January 2005, the Government of Sudan and the Sudan People's Liberation Army finally signed a peace agreement. It marked a new beginning, not the end, of a complex process to secure lasting peace in Africa's largest country. I wish that the Bush administration had shown the same determination to finding a political solution to the crisis in Darfur.

  • Second, let's look at debt relief. It would allow poor countries to spend more on investments that help reduce poverty. In recent years, for every dollar that developing countries have received in aid, they have had to pay 50 cents to rich nations in debt service. Last year, the industrialized democracies that comprise the G-8 agreed to write off $40 billion in debts owed by the world's 18 poorest countries, including 14 in Africa. This agreement is an important step forward. But it is not enough. Many poor countries are still excluded.

  • Third, trade reform could boost economic growth in Africa. Opening the markets of the largest economy in the world could give a critical boost to the export growth and economic development of poor countries. In the year 2000, Congress virtually eliminated tariffs on textiles coming into the U.S. from some African countries. Four years later, the legislation had helped generate more than $340 million in investment and created hundreds of thousands of new jobs in both the U.S. and Africa. 8

    A political strategy to phase out U.S. agricultural subsidies more broadly could provide big opportunities for African economies. The World Bank estimated that ending trade-distorting subsidies and tariffs could, in fact, lift 150 million people around the world out of poverty by 2015! 9

  • A fourth front in fighting poverty is U.S. development assistance. That assistance is vital to the poorest countries becoming more self-reliant and engaging in the world economy.

In his first term in office, President Bush proposed the creation of a new Millennium Challenge Account. By this year, it was to be channeling $5 billion annually to countries that meet certain thresholds in terms of economic freedom, political liberty and the rule of law. Unfortunately, the Administration has been slow in getting the Millennium Challenge Account up and running, but it could yet mark the biggest expansion of development assistance since the 1960s.

In his first term, President Bush came forward with another bold initiative. To join the global battle against AIDS, he proposed a $15 billion program over five years. 10 The President's HIV/AIDS initiative directs significant new resources to address the pandemic in 15 countries - 12 of them in Africa. Unlike the Millennium Challenge Account, this initiative was off and running within months.

It is impressive that countries like Denmark, Luxembourg, the Netherlands, Norway and Sweden have met the goal of allocating point 7 percent of their gross national product to international development - a goal to which the industrialized democracies have long been committed in principle. 11 The U.S. still spends considerably less than point three percent of its GNP on foreign aid.

Democratic Republic of Congo © Christina Chan/CARE

I long for the day when reducing - indeed ending - extreme poverty is a U.S. strategic priority in its own right. The President's AIDS initiative, the Millennium Challenge Account, and his pledges at the G-8 summit last year are steps in the right direction. But we can - and we must - do more.

*   *   *

Role of Each Individual

I have talked about the roles that African governments, the private sector, ordinary Africans, organizations like CARE, and the U.S. government can play in reducing extreme poverty in Africa. I have also sought to highlight positive stories of African progress, because they are so often overlooked or downplayed.

Africa is the hardest development case. But I have no doubt that Africans can reduce - and eventually end - extreme poverty if we give it sufficient priority.

I want to conclude with a few words about the role that each of us in this room can play in the fight against extreme poverty.

The devastation of Katrina in the U.S. Gulf Coast last year brought home for Americans what it is like for people to lose everything. The tragedy also struck an all-too-familiar chord for those of us who work in the developing world: When it comes to disasters, the poor are hit hardest. They live each day on a razor's edge of crisis.

You may have read about a Zulu boy from South Africa named Nkosi Johnson. Nkosi died at age 12 in 2001 as a result of AIDS. His story touches me to this day. Nkosi had a mantra: "Do all you can with what you have in the time you have in the place you are." At an AIDS conference in Durban, Nkosi declared: "Care for us and accept us... We are all human beings. We are all the same."

We are all the same. And there is much we can do to help overcome extreme poverty.

I believe that each of us must be at once a citizen of the U.S. and a citizen of the world. I also believe that we already have the knowledge, technology and wealth in the world to end extreme poverty. What we lack is the political will. Given the interconnectedness of the world, each of us has a role to play.

Each of us must find the role that best suits us. Don't underestimate the difference collectively that we can make. Some of you may already be working 24/7 on these issues, and some of the students may aspire to devote their careers to reducing extreme poverty, whether through service in government, NGOs or elsewhere. Every one of us, however, can help in some way.

First, each of us can use our voice to put reducing extreme poverty in the world higher on our national agenda. I suspect that most of you know that Bono, the U2 rock star, is also the lead spokesperson for the ONE Campaign. What very few, if any, of you know is that I chair the ONE Campaign! Join the more than two million people who have signed the Campaign's declaration and committed themselves to become citizen activists to cut extreme poverty in half by 2015.

Deepen your understanding of how our actions in the U.S. affect Africa and the poorest parts of the world. Vote for political leaders with a broad and inclusive view of the world. Press our government to follow through on its commitments to poverty reduction and development assistance. Send a fax or phone your representative in Congress to support President Bush's Millennium Challenge Account and HIV/AIDS initiative. Use your voice to put reducing extreme poverty higher on our national agenda. Let people in Washington know that you care about the fate of people in Africa. If they hear from you, they will notice. In addition, become a donor to CARE, Heifer, or another NGO, and volunteer your time to advancing their cause. Make it your own.

Why is it important that we act to end extreme poverty, even where it may be hardest to do? Because, in the end, Nkosi was right: we are all the same. Or as Dr. Martin Luther King, Jr., wrote, "In a real sense, all life is interrelated. The agony of the poor impoverishes the rich. The betterment of the poor enriches the rich. We are inevitably our brother's keeper because we are our brother's brother." The final reason for acting to end extreme poverty is that, for the first time in history, we have the knowledge, technology and wealth to succeed. I urge each of you to do your part. You will make the world better - and safer - not just for poor communities in Africa and in other parts of the developing world, but for all of us, including our children, grandchildren and generations yet unborn. Think of it not as giving back, but as giving forward.


1 UNAIDS, 2006 Report on the global AIDS epidemic.
2 UNICEF, State of the World's Children 2005.
3 Adopted from WHO/UNICEF JMP 2004.
4 Our Common Interest: Report on the Commission for Africa. March 2005 (233).
5 World Bank, Conflict and Development in Africa, www.worldbank.org, March 2005.
6 Rice, Xan. "Poverty-stricken Rwanda puts its faith and future into the wide wired world" The Guardian August 1, 2006
7 "The Africa You Never See," Washington Post. April 17, 2005.
8 www.whitehouse.gov/news/...
9 New York Times editorial, December 30, 2003.
10 http://www.whitehouse.gov/infocus/hivaids/
11 OECD Factbook 2005.

(Peter's email is peter.bell@emory.edu.)