it's important in terms of what they are. the first is country ownership and the countries themselves to find their own development goals and objectives creating their own strategies and taking leadership. associated with that is increasing donor alignment with the plans. the degree to which they allow countries to take leadership. harmonization is between donors and the simplification of the processes that can be owneresque, the multilateral institutions and the banks although perhaps people have something to say about that. harmonizing donor assistance among the donor agencies and making sure that there not gaps or overlaps. another is a focus on results.

there common indicators that virtually all of them adhere to that enables us to better measure and monitor the effectiveness of foreign 88. the last is accountability, a commitment by both donors. they are accountable to the people and world at large. i wanted to throw out a few provocative ideas that have been raised particularly and related to the federal budget. these were most recently articulated and many people have mentioned them over the years. they just wrote an article that i thought was interesting. they estimate they they could save two billion a year. if we did the following things related to eliminating

ridiculous regulations and laws changing that don't support our foreign assistance program. the first is ending cargo preferences for foreign or food aid in particular. demanding that u.s. fight vessels or ships registered in the united states. the second is eliminating monitized food aid, a program that the united states gives de vries or wheat or what have you. american agricultural products. they earned from the sale of those commodities and to offset the cost of distributing food aid. the third is cutting

agricultural subsidies that largely favor producers such as monsanto or other large agricultural producers in our country. the fourth is removing limitations on local and regional procurement of food aid. it's american products produced here and shipped overseas. that's wasteful and expensive. the fifth is eliminating earmarks on foreign aid programs which really does limit flexibility and makes it difficult for the foreign 88 decision makers and they are important to make in the time of crisis as changing continues are involved. those are some issues that could develop the effectiveness. to hear what others think about

this, i want to end with a story. it's easy to forget that they are human faces attached. i want to tell you the story of elizabeth, a concern i met in 1999. before there was foreign assistance in the area, hiv in africa although and certainly there was treatment that was limited in africa. as another point. it's been on the aspect viral list and he would be dead if he lived in africa. this is a story of elizabeth. she was a young mother and monogamous wife to a man who she knew was unfaithful to her. she was not able to leave him because she was economically

completely dependent on him and divorce was frowned upon in her community. she had hiv and fearful that she was exposed to the virus and she became pregnant and wanted to find out if she was hiv positive testify and whether or not she heard about mother and child transmission. it was relatively new in that day, but she heard did b it. she boarded a bus to get from her home in the slums outside into the clinic and the center of town. when she got there, she found out they were stocked out of the rapid tests. no tests were available. she was told to return. she had to take her two buses back to the community and did the same thing. it took her own. they were off testing military. again, she wasted her time and

the scarce resources to get there. she was pregnant and frankly she didn't go back to the clinic because she had a poor result. a couple months later she delivered a beautiful baby girl who was very sick. right away from the beginning of her life. five months later she died. as she held her dying baby in her arms at the hospital, she found out her baby died of aids and she herself is hiv positive. she was devastated. she could not tell her husband because she was afraid he beat her. she could not tell family or friends because there was so much stigma and she was afraid they would reject her. she lived with this secret until she became pregnant again. this time she was determined she would not let this happen and she had found out from her time at that hospital before that they did have a prevention of mother to child transmission program.

it was easy to prevent. she became enrolled in the program and nine months later delivered a beautiful baby boy. in the meantime, her husband died of aids three months before her baby was born. her baby boy was hiv-free. she was put on a treatment program and elizabeth lives today and is an incredibly active advocate for counseling, testing, prevention. she does a lot of programs with communities to reduce the stigma against hiv and supports family members against families affected by hiv and an incredible passionate story of hope and a hero in her community. the difference in her life from the time when there was no foreign assistance or u.s. dollars or global fund dollars available and the prospekts of her living and what she is doing now in her community because those dollars are at work are

tremendous. 5.5 million people in the world in low and middle income countries because of the program funded by the united states and by other donor countries, especially the dploebl fund. when we watched the question, getting back to the title, to aid or not to aid, i think we have to aid. it is in our best country and it is our right and responsibility as one of the world's global leaders. could it be more effective? absolutely. should we find more? i think so. we are living in a time where the world changed more than ever before in terms of gains and millions of people still live in extreme poverty. we know that extreme poverty and social and economic injustice and terror frankly. we spend billions in foreign

assistance and military aid trying to fight violence and terror. wouldn't it be better to invest in programs that improve the equality between people and bring hope to the rest of the world. that's the thought i would like to leave you with today. >> thank you very much. heather? >> thanks. since unlike carey and judith, i don't work for a governmental entity, i say provocative things and make blunt points. it's my to take full advantage of that. i'm here for the same reason many of you are here. we are all sure that the answer is yes, of course, we should

aid. in my view, the biggest problems that the aid community and supporters had over the last couple of decades is that we are so intent on the righteousness of the idea that we should aid and of defending that fundamental idea against the very many vocal critiques that we missed opportunity after opportunity to reform along the lines of the principals that carrie laid out. they would be defensible both in the u.s. political context, but the international context than in the context of the folks on the receiving end of the aid. i am going to walk through the critiques and where i think we are failing to respond to them and where we are succeeding. we as people who support the idea of foreign aid need to change our thinking and need to be more honest about what we are up against in the world that we are living in. i come to that very much from

the perspective that carrie's story suggests. i want to start by saying there is a three-pronged critique that i face in u.s. foreign aid as it exists now. the first one is the one you hear that i will for laziness call the conservative critique. aid doesn't work. it's money down rat holes and goes to people who are undeserving. it's a poor investment and we should look out for ourselves or if we have problems, we should solve them with the military that is immediate and effective and not wait 20 years and see what happens when the kid grows up. some of our aid is effective and some is counterproductive and some is distorted. some of it is promised to the american public that it will do one thing and does something else. that critique is not -- we

promised that aid is the solution to a political problem, which it isn't. that critique to me is framed in repugnant terms. very often has elements of prejudice attached to it. it's not entirely wrong and you can't wish it away and say that isn't true. there is a critique from the left, both the american left and the global left that says 88 is in form and delivery as oppressive as the conditions it seeks to remedy. it distorts local economies and perpet yuts control over the societies to which aid is given. and this critique would say it's too tied to u.s. foreign policy goals. the third that is the post 9/11 critique, it said foreign

assistance is not tied enough to u.s. foreign policy goals. the paramount u.s. goal in the post 9/11 era is keeping ourselves safe from violent extremism and therefore all money that we spend and programs we have need to be looked at through the lens of producing societies that are less likely to produce terrorists. each one of the critiques has elements of truth to it. the aid community and the people who love it spent too much time wishing each of those critiques away frankly, even though each of them is i believe fundamentally wrong. they suggest also some real confusion about what aid actually is. what it is, what it isn't and what it's supposed to do and what we are promising the american people and what we are promising the recipients it will do. carrie laid this out and i will

put more of an edge on it because that's the joy of not being in government. we are often trafficking in missed messages and we need to understand that. i as an advocate have for years used the same statistics that carrie used about 1% of the budget being spent on foreign aid and they think it's closer to 10% and closer to 25%. that's really mystifying and many people hear that and come away with a really poor opinion of the american public. that's actually not right. as far as we can from doing more research, the thought process is something like this. foreign aid is what helps other people. these programs that cary is talking about help other people. when we send our military somewhere to get rid of terrorists that, is helping them anding us. it is costing us american lives and we say we are doing it to help the next generation of

afghans or iraqis or whoever. that's foreign aid. as carrie referenced, there is now in the post 9/11 era money that flows into what used to be called humanitarian post conflict assistance that development bureaucrats and people who have long experienced this country don't control and the pentagon controls for the purpose of making things easier and safer for the soldiers to do the job. if you are a certain in colorado, that sounds like foreign aid to you. you hear your cousin in the marines is building wells in afghanistan. that doesn't meet the community buy in. that's where the public is getting this idea that you see an american soldier off digging a well and helping a kid. that's all mashed in as foreign

aid and not entirely incomprehensibly. if you don't have a clear sense of what is foreign aid for. it's a core debate about how much we do because it's the right thing to do. certainly what the story that carrie told about many of us who come to this field from a faith-based perspective and those of us grounded in the judeo christian traditions are grounded in the idea of those who have much, much is demanded. that has never been and certainly not now in the post 9/11 era the rational behind u.s. and foreign assistance. there was an interesting debate at the beginning of the obama administration. we can get into that if people are interested, but coming down

to the decision made. it's in our healthy economies we can trade with and don't breed disease and have countries with a level of social stability, dignity and hope such that they don't breed terrorism, but come back to bite us. those are perfectly good principals for a country to speak to. 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 the grand plan. they think they are on an individual level if you think about it. since i have the luxury, we

haven't hit the sweet spot of being able to explain to our citizens that it's not throwing money out windows and down rat holes, et cetera, etc. part of our self interest is al truism. our self interest is lies and in doing what's good for other people. this ties back on the debate you see play out about how the u.s. should act in the 21st century world overall. the kind of power we have now and we consider their views and preferences. we have power to work with others and still tell them what we want. a great many of the debates were not having a big debate over foreign assistance but we got

months to go. anything can happen. the foreign policy debates we are having, iran, israel and how to deal with democracy and china, they are really all about -- should the un continue to exist and should we follow him with a couple of stories off of it, they are really all about do you have to take and carrie talk about principals and reforms. we are not there yet for a couple of reasons. this is where i say the obnoxious you can tell i'm not in government thing, you heard from the complex and we have an aid industrial complex. this is not even a bad thing because you want to have experience and you want to have institutional memory over a period of time, but we have a lot of groups that are very invested in things going on the

way they have always gone. as i said, it's very hard to go to that community and say look, we know you are terrified aboutd about senator x slashing your budget by 25%, but you've also got a change in these fundamental ways. we've missed those opportunities time and again and we have to be honest with ourselves. at the same time, and carrie referenced this, the folks in congress that have to face the vote every two years, the people that get a vote 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 80, 90% of an aid contract in afghanistan goes

to washington based contractors. as there's increased pressure on the pentagon budget, many of the contractors you know and love are moving into the development re re realm. we're going to see more of this rather than less. those are two really big sets of problems. when we get into this aid donate conversation, it's easy to get mad about conservatives are racist and hate africans. we have an aid structure in the u.s. that was developed in the 1950s and 1960s 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. when it comes to cell phone, you encounter better technology in the developing world than you do

here. as you'll here from judith, there are other major centers that aren't connected to the public but also bill gates gives more money to africa than quite a few wealthy countries do. when we were working on getting it to africans, i was working on the non-profit that bono star d ed. he had this line that if coca-cola can deliver cold cokes all over africa, don't tell me we can't deliver chill ee eed vaccin vaccines. this is already happening on the ground and some of its not very good but our thinking about aid and our talking about it has to take that into account.

i promised that mine would be the explicit and bomb-throwing segment of the panel. i will turn it over to judith to talk about the outside the u.s. perspective. >> thank you very much. >> thank you so much for the opportunity to talk to you this afternoon. it's always a privilege to be at the conference zone world affairs. i will be addressing this in my personal capacity as a u.s. citizens. i thought i'd start off making some remarks in response to discussions that were mentioned. it's absolutely wonderful that we have three women on this panel. i think it also demonstrates this is an area where certainly for those of kwlou are studeyou

the audience that are taking positionings in the field and i'd encourage you to follow in their footsteps. when we look at aid and we look at aid in the u.s., carrie mention mentioned conondrum of u.s. fied aid. heather mentioned the aid industrial complex which is what we call the beltway bandits. these are u.s. aid contractors that implement aid programs on the ground and in many cases they are extremely large and important actors in providing for assistance. i think when we talk about aid effectiveness we have to be really honest about the fact that usaid is transparent that most of the budget is going to

u.s. contractors. i think that's a dirty little secret because it's way you can promote and support u.s. business interest and it's way some other countries have done this whether through peace corps. it's very much part of the discussion and should be kind of front and center. the other thing i wanted to mention, and i'm going to focus much of my discussion on latin america, which is where i have worked. when we think about south com, it's gotten much more involved in providing humanitarian assistance. this has been promoted for several years now. the role of the military and the role of contractors in providing aid cannot be delinked. i think it's one of the challenges we face when we think about aid from the public sector

perspective. i've worked many, many years in grassroots approaches. i was trained looking at grassroots approaches northeast of brazil and worked closely with a mentor who followed albert hershman looking at pow to empower local people. i worked for over ten years in a foundation that specialized in grassroots developments. i began to see many of the approaches, i know that many you have go to developing countries and many of you have nonprofits or involved and have your own institutions that you are leading or running. i think one of the challenges we face is how to take the grass root approaches and scale them. there's an urgency to do that

scaling up for a number of reasons. we know that government has a hard time with equity questions. i work at indigenous communities and gender and region in latin america. these are precisely the areas that are most difficult to target. they're not able to deliver in the way we are. one of the goals should be to try to support it because the needs are so great. that's one of the things i've been kind of struggling with in my career as i have made a transition from grassroots approaches to looking at international approaches and approaches that can be taken on by government and taken to

scale. latin america is doing very well right now. as many of you know, latin america is one of few regions that's growing, that's weathered the economic storm. it's created innovative policy models. i want to give you one example and that's brazil. brazil is the only brick that has decreased in equality over the past five years. many you have may be familiar with the brazil conditional cash transfer program. in brazil it started out as a program. it's growing. they have launched a new component. the idea behind the program is to target the poorest of the poor in the country. the previous conditional cash transfer programs took people who were very, who were lower

income and moved many of them into the middle class. interestingly when we think about development outcome, many of these middle class, they're first investment items, they are investing first in education for their children and second they are investing in personal computers for education use for their children. when you're giving people an opportunity to access financial resources, they know how to prioritize and they are prioritizing the future generation and in place like brazil that's had a tremendous economic boom, many individuals are making investments as well as the government makes investments in human capital. these are some of the very first investments that people make the there's one in mexico. it's been modelled in some communities here in the united states. i know at one point chicago was looking at modelling