died of aids and she herself was hiv positive. she could not tell her husband because he was afraid he would beat her, and she could not tell her family or friends because there is stigma and she was afraid they would reject her. she lived with this secret for two years until she became pregnant again two years later. she found out from the hospital there before that they did have a prevention of mother to child transmission, so she became enrolled in that program, and nine months later she delivered a beautiful baby boy. in the meantime, her husband died of aids just three months before her baby was born. her new baby boy was hiv free, and elizabeth lives today and is an incredibly active advocate for hiv counseling and

prevention and testing and she does work with the communities to work on the stigma against hiv and supports family members and families that are affected by hi sreufpv and she is a stor hope in her community. there was a time of no u.s. dollars available for hiv, and the prospects of her living and what she is doing now in her community, because those dollars are at work there in her community are tremendous. there are 5.5 million people approximately in the world in low and middle income countries that receive hiv virals because of the assistance by the united states and the other donor countries, especially the global fund. getting back to the title of our panel, to aid or not to aid. do i think we should aid? yes, i think it's in the best

interest of the country and it's the right as a global leader. could it be more effective? absolutely. should we fund more? i think so. but right now, we are living in a time in history when the world has changed more than ever before in terms of the development gains, and yet millions and millions of people still live in extreme poverty. we know social economic injustice breed terror. we are trying to fight violence and terror, and wouldn't it be better to invest in programs that improve -- that reduce poverty and improve the equality between people and really bring hope to the rest of the world? that's the thought that i would like to leave you with today. [ applause ]

>> thank you very much, carrie. heather hurlburt. >> thanks. so since unlike carrie and judith, i don't work for a governmental entity, i am more free to say provocative things and make blunt points and it's my role on the panel to take full sreupbg -- advantage of that. the reason why i think we are all here is because we think we all should aid. and one of the biggest problems the aid community and its supporters have had over the last couple decades is that we are always so intent on the righteousness on the idea that we should aid and of defending that fundamental idea against the very many vocal and often quite ignorant critiques of it that we have missed opportunity after opportunity to reform along the lines of some of the principles that carrie laid out

so that in fact our aid would be more defensible in the u.s. context and also in the international context and in the context of the folks who are on the receiving end of the aid. so i am going to walk through some of the common critiques and where i think we are still failing to respond to them where we are succeeding and how we as people who all support the idea of foreign aid need to change our thinking and need to be more honest about what we are up in the world we are living in, and i come to that from the perspective that carrie's story suggests. there's a three-pronged critique in my view as foreign aid as it exists now. the first one is the one you here, and i will call it the conservative critique. aid doesn't work. it's money down rat holes and goes to people who are

undeserving, and we should look out for ourselves or if we have problems abroad we should solve them with the military which is immediate and effective and it's not wait 20 years and see what happens when the kid grows up kind of thing. and the truth is some of the aid has been ineffective and counter productive, and some of it it promised to the american public that it will do one thing and it does something else. we promise aid as the solution to a political problem, which it isn't. that critique, although it's framed in repugnant terms, it often has prejudice attached to it, but it's not entirely wrong. you can't wish it away and say that isn't true. and there's a critique from the left, the american left and the global left that says aid is

actually in its form and delivery is as oppressive as the conditions it seeks to remedy, and it distorts local economy, and this critique would say it's too tied to u.s. foreign policy goals. the third critique, and i will call it the post 9/11 critique, and it says u.s. foreign assistance is not tied enough to the u.s. foreign policy goals. and the post 9/11 era is keeping our safe from terrorism and violent extremism, and therefore all money that is spent needs to be looked at how are they helping produce societies around the world that are less likely to produce terrorists.

each of those critiques have truth to it. the people that love aid have spent too much time wishing those critiques away, each of those, i believe, is fundamentally wrong. but they suggest also some real confusion about what aid actually is. what it is, what it isn't and what it does and what we are supposed to do, and it will do what we are promising the recipients it will do. carrie already laid this out and i will put more of an edge on it because that's the joy of not being in government, but we ourselves are very often trafficking in mixed messages about those things and we need to understand that. so you know, i as an advocate have for years used the same saw 'tissics about 1% being used on foreign aid, and it's closer to 25%.

and that's really mystifying. many people hear that and come away with a poor opinion of the american public. and that's actually not right because as far as we can tell from doing more research, the thought process is something like this. foreign aid is everything that helps other people. well, these programs that carrie is talking about help other people, but when we send our military somewhere, it's helping them, right, and it's hurting us. it's costing american lives. we say it's to help the next generation of afghans or iranians or whomever. and that's foreign aid. as carrie referenced there is now in the post 9/11 era an enormous amount of money that flows through the pentagon in what used to be called the humanitarian assistance, and the pentagon controls it for the specific purpose of making things easier and safer for our

soldiers to be on the ground and do the job they are there to do. but if you are a person sitting in colorado or virginia or whatever, that sounds like foreign aid to you. you hear your cousin in marines are building wells in afghanistan, and that sounds like foreign assistance even though it doesn't meet the criteria that carrie laid out. that's where the public is getting this idea, that whenever you turn on the tv you see an american soldier off someplace digging a well or helping a kid. that's mashed in as foreign aid in the public mind. again, not entirely incomprensiable. the story carrie told would

suggest is what many of us who come to the field from a faith-based perspective, and some of us grounded in the judeo christian ideas don't have as much as those that are demanded. there was a very interesting debate about this at the beginning of the obama administration which we can get into the q & a if people are interested. the decision was made that the u.s. gives foreign aid because it's in our enlightened self interest, to have healthy populations that both breed disease and pass them on to us and to have countries with a level of dignity and hope such that they don't breed violence and terrorism, and those are

perfectly good strategic principles for a country to engage in. but -- carrie can speak more to this, or judith may as well. there is also a fair amount of research that suggests that actually aid works better when the recipients don't think they are part of your grand plan. but actually aid works better when recipients thinks it's about them and not about you. which makes sense in your own life but on an individual level if you think about it. and i would argue that we have not quite hit the sweet spot of being able to explain to our fellow citizens that it's not naively throwing money down rat holes that it's in ourself interest, and part of our self interest is all truism. this ties back into a much

larger debate that i think you are seeing play out in the presidential election about how the u.s. should act in the 21st century world overall, and whether the kind of power that we have now requires that when we work with others, we consider their views and preferences in ways that can somehow be painful for us. or we have so much power that we can work with others and tell them what they want. a great many of the debates, we are not having a big debate about foreign assistance in the election and we have six months a to go so anything can happen, and the debates we are having, iran, israel, how to deal with democracy and china, and should the u.n. continue to exist. should we follow john bolton and a couple stories off that. and this is where we have the intent to do that, and you heard

carrie talk about principles and reforms, but we are not there yet. we are not there yet for a couple of reasons. and one is -- this is when i say obnoxious you can tell i am not in the military complex, and we have an aid industrial complex. this is not a bad thing necessarily, because you want to have experience and you want to have institutional memory over time, but we have a whole lot of groups in and out of government that are very invested in things going on the way they have always gone on. and it's been hard to go to the community and say we know you are constantly terrified about senator x slashing your budget by 25%, but you have to change in the fundamental ways. we have missed those opportunities time and again and we have to be honest with ourselves. at the same time, and carrie referenced this quite specifically, again, the folks in congress who have to face the

voters every two or six years, you know, the folks -- elizabeth doesn't get a vote. and the people who get a vote are the people who are employed when their rice is sold in countries that already produce rice, or are sold when we pay a 20% premium to ship relief supplies on a u.s. airline. or are employed when 40, 50% of an aid contract in afghanistan goes to washington-based contractors, and if that sounds like the pentagon to you, it should. and this is interesting as there is increased pressure on the budget, many of you that love the $1,000 toilet seats are moving into the economic realm. those are two really big sets of problems. what we all have to be honest about, and when we get into this aid conversation, it's really

easy to get mad about conservatives are racist and they hate africans and whatever, but we do have an aids structure in the u.s. that was developed in the 1950s and '60s for a cold war world and a world where the gap between the northern countries giving the aid and the southern countries receiving it was enormous. and, you know, as carrie said, when it comes cell phones, you encounter better technology in other worlds than here, and there are major centers of aid giving not connected to the u.s. government, both public entities, and bill gates gives more money to africa every year than quite a few wealthy countries do. when we were working on actually getting anti-retroviles to africa, and it was a nonprofit that bono started.

he said if coca-cola can deliver coca-cola all over the country, there's no reason we can't deliver chilled vials all over the country. well, and this is already happening on the ground. again, some of it is not good what is happening on the ground, but our thinking about aid and our talking about it has to take that into account. so i promised that mine would be the explicit and bomb-throwing segment of the panel, and i will now turn it over to judith to talk about the outside the u.s. perspective. [ applause ] >> thank you very much, heather. judith. >> thank you so much for the opportunity to talk with you this afternoon.

it's always a privilege to be at the world conference of affairs. i will address this as a u.s. citizen. i thought i would make remarks in response to the discussion that carrie and healther mentioned -- by the way, i think it's absolutely wonderful that we have three women on the panel talking about it. it also demonstrates this is an area where certainly for those who are students in the audience and considering career paths, we find there are many, many women should have taken strong leadership roles in the field and i ask that you to consider walking in their footsteps. carrie mentioned the conundrum of u.s. sourcing for aid, raw materials, whether it's food aid or relief but it's how aid is delivered. heather mentioned the aid

industrial complex which is what we call in washington the beltway bandits. this is u.s. contractors that implement aid programs on the ground and in many cases they are extremely large and important actors in providing foreign assistance. i think that there isn't -- when we talk about aid effectiveness, we have to be really honest about the fact that the u.s. idea is transparent in the sense of most of the foreign assistance budget is going to u.s. contractors. i think that's kind of a dirty little secret. it's a way that you can kind of promote and support u.s. business interests. it's also a way that some other countries have done this, and whether it's through peace corps or other mechanisms to get young people exposed to career possibilities or prospects, and that's the part is that not discussion discussed but it's part of the conversation.

i will focus most of my remarks on latin american which is the region i worked primarily in my career. when we think about something about the south com, it provides humanitarian assistance in the areas of health. this is something that has been promoted for several years now. the role of military and contractors providing aid cannot be de-linked. it's one of the challenges we face from the public perspective. i have worked many years in grassroots approaches. i was trained looking at grassroots approaches, actually northeast of brazil and worked closely with a mentor that followed albert hersberg that looked at local people and communities.

i worked over ten years in a career with grassroots involvement. i know that many of you go to developing countries and many have nonprofits and are involved in faith-based work or have your own institutions that are leading or running, and i think one of the challenges that we face is how to take some of the local initiatives and the grassroots approaches and really scale them up. i think that there's an urgency to do that scaling up for many reasons. we know governments often have a hard time with equity questions. i work extensively on looking at intkeupblg tphus countries, and these are the areas that are often most difficult to target.

i think one of the goals should always be to try to support one of the goals. so that's one of the things that i have been struggling with in my career. i made a transition from grassroots approaches to more international approaches and looking at approaches that can be taken on by governments and taken to scale. and there's a reason this is important in latin american. latin america is doing very well right now. it's one of the few reasons that is growing and weathered the economic storm and created innovative policy models. i want to give you one example. that's brazil. brazil is the only brick that has decreased in equality over the past five years. many of you may be familiar with

the brazil conditional cash tran first program. in brazil, it started out as a program, and it's now grown significantly. they have launched a new component of it that. behind the program it's to target the poorest of the poor in the country. so the previous conditional cash transfer programs essentially took people who are very -- who are lower income and moved many of them into the middle class. interestingly, when we think about development, out comes many of the middle class, these newly middle class brazilians. their first investment items, they are investing first in education for their children and then second they are investing in personal computers for education for their children. when you are giving people an opportunity to access financial resources they are prioritizing,

and prioritizing in the future generation. and brazil had a tremendous need for professionals. many individuals are making investment as well as the government making investments in human capital. now the conditional cash transfer program and there's one in mexico, and it's actually been modeled in some communities here in the united states. i know at one point chicago was looking at modeling conditional cash tran furs and new york as well. especially if students participated and attended schools families would receive a small subsidy to reward that good behavior. we see it in panama and other places. it's a direct cash transfer from government to low income communities. what is exciting is it's looking at the poorest of the poor. people who may not be registered

for government services and it's providing an incentive for the government to go out and idea those individuals. and to idea them in creative ways that perhaps goes beyond the traditional mechanisms for traditional cash transfer, which include health care. if you go to the doctor on a regular basis and if your children go to school you could receive food subsidies. and how do you sweeten that basket of goods so you are not changing community diets or values or principles. i think one of the main areas -- that's kind of an example of public aid. and public aid for the u.s. and latin america has traditionally been driven by goals of new neighbor policy. good neighbor policy combined with good citizen policy. i would argue -- i am speaking

as a u.s. citizen, our foreign policy has been driven by citizen security in the area of tphaur koe trafficking. the reason i say that, if you look at the discussions around aid, again we talk briefly about south com, and if you are thinking about foreign aid and you are thinking about how the u.s. engages latin american countries, it's often the military, and visa srae the military, and looking at immigration and looking at how you control borders and how do you control drug trafficking. and one of the missed opportunities in that is ultimately a lot of that discussion is based around a market and a demand for a product here in the united states and it's inefficient to deal with that demand only by engaging latin america. the trafficking problem has gone from the south and getting closer to the north and the more military aid and assistance that

you poor into one country, you push the bubble and it goes somewhere else. and there is another area of aid that i think is very, very new. it's the idea of strategic partnerships and assistance. i look at brazil as a wonderful example of that. i would love to hear about a conversation in the united states about how to eliminate poverty in our country. i think they are bold plans and models. i don't see the dichotomy between doing something bold like that, like eliminating poverty and valuing and recognizing local principles and practices. i see these as two things that have to go together. my family has been involved in community activities in the united states, and my family said why are you working overseas because there are problems here in the united states, and why do you have to go somewhere else? it's precisely the fact that i understand the situation and the situation of the grassroots

perspective in the united states that i can use that lens to look at national policy decisions and look at international policy decisions, and understand kind of more or less intoottively whether they are going to work or not. again, we don't have to see these two as being mutually exclusi exclusive. and this is a story of a movement that comes out of latin america that doesn't get a lot of discussion, but it's relevant to the debates in global warming, and countries like columbia, and in brazil. these are people who are recyclers, and in you are jarge

go into trash dumps to recycle materials. what they are picking is not trash. it's valuable resources that can be reused. as many of you know or should know that one of the wealthiest women in china deals in recycled alumin aluminum. it's commodity products these individuals are able to take from the trash. the movements that are the strongest at this moment in time are in latin america. they have been able to convene and work with local recyclers and work in places like india, and china and throughout all of africa to give value to this type of thing. and the biggest thing about recycling, there's a huge policy dimension to it. how do cities and municipalities decide to manage these. if they manage these through

local cooperatives of recyclers, they are getting a service and providing a service. they are also providing a service that generally they are not getting paid for. so instead of going with a large major international waste firm you can go with a local firm and create tremendous benefits for your own community and refuse those materials. when you think about the idea of public private partnership of grassroots interacting with government, i encourage you to look at what is happening with the recycler movements. in brazil, you have legislation that supports the dialogue. and how to create consciousness throughout the communities, so they can produce higher quality and recycled materials that leads to higher incomes for lower income people. when we are talking about higher incomes, we are