President Bush and his development legacy

By John Norris 05 July 2016

U.S. President George W. Bush shakes hands as he greets a large cheering crowd on his arrival to the State House in Dar es Salaam, Tanzania on Feb. 17, 2008. Photo by: Eric Draper / The White House

EDITOR’S NOTE: The Bush and Obama administrations oversaw unprecedented changes to U.S. global development programs and institutions during the last 16 years. With the next U.S. presidential election underway, this two-part series takes a close look at the legacy of the last two administrations to help inform our community’s thinking about what’s in store for the next administration  something we will be covering extensively in the coming months. In commissioning this work, Devex has relied on the author’s informed analysis based on interviews with more than a dozen development experts and our editors have made every effort to produce an objective and nonpartisan analysis. Still, we realize any attempt to assess government performance is subject to critique and dispute so we welcome additional perspectives and comments from our readers. For the many development professionals around the world impacted by American development policy, we hope this chronological history provides an opportunity to reflect on past successes and failures and anticipate the future direction of the world’s largest donor country.

For most supporters of development, the end of the Clinton administration and beginning of the George W. Bush term felt like a decided nadir. The nation’s primary development agency, USAID, had been battered during protracted turf and budget battles during the mid- and late-1990s, forcing the agency to make deep staff cuts and leaving it a hollowed out shell of its former self.

While Bush had campaigned on a platform of “compassionate conservatism,” few expected global development to be a high priority for the incoming administration — although the internationalist bent of his father’s presidency was encouraging to many in the development community.

But expectations, the global strategic order, and much of American political life were profoundly upended by the terror attacks of Sept. 11, 2001. Leaders of both parties quickly recognized that development was an important and undermaintained part of the U.S. international posture, ushering in a period of dramatically increased budgets for development, and perhaps even more importantly, a renewed desire to rethink how the country advanced development and economic growth.

It is important to stress the historical context of the moment after Sept. 11: the Congress and the American public were exceedingly willing to give Bush what he wanted when it came to international affairs, whether it related to military commitments or long-term development efforts. The Pentagon became an active booster for reinvigorated development programs, providing important cover for lawmakers that would normally be reluctant to boost aid budgets. Nongovernmental organizations in Washington quickly got in the habit of quoting defense officials about the importance of development.

Bush and his advisers shrewdly realized they had a unique “Nixon to China” moment when it came to development. The administration launched two new, and massive, development initiatives that ran directly counter to the popular perception that Republicans either did not care about development or only cared about it for purely security purposes. These two new efforts, the Millennium Challenge Corp. and the President’s Emergency Plan for AIDS Relief are absolutely central to Bush’s development legacy. And importantly, neither would be directly managed by USAID.

The data-driven MCC

President Obama and his development legacy

Despite all the sturm and drang, President Barack Obama successfully maintained the historic increase of U.S. assistance levels made during the Bush administration, a rather remarkable feat considering a global recession, ongoing turmoil in the Middle East and Afghanistan, and a Republican-led Congress that at times seemed to veer into nihilism.

In a speech on March 14, 2002, at the Inter-American Development Bank, coming just days in advance of a major international conference on development finance to be held in Monterey, Mexico, Bush announced a bold new plan to create the MCC to work in low- and lower-middle income countries that scored well on a strictly applied set of indicators including ruling justly, investing in people, and pursuing sound economic policies.

The MCC represented a remarkably data-driven approach to development, and Bush committed to back his plan with major resources, saying that the MCC would be funded $5 billion annually within three years.

There is now near universal appreciation regarding the degree to which the MCC strategy, with its heavy reliance on analytics, has changed the development community’s approach. The appeal of clear and measurable benchmarks is considerable, and the willingness to use data to inform decision-making has brought an important rigor to development debate and practice, as has the use of positive pressure to improve key benchmarks in a way that has largely avoided the heavy-handed “conditionality” debates of earlier years.

As David Ray of Care argues, the MCC represents, “In the broadest sense, a success for the reform principles of transparency and accountability, and to some degree, local ownership.” And while USAID remains a far larger development entity, it has increasingly adopted the MCC’s model where it can, with fragile and conflict torn states being an obvious exception.

By almost any measure, the MCC stands out as one of the most important development initiatives of the last 15 years, and its strong bipartisan backing ensured its continuation through the Obama years — and likely into the next administration. Lex Rieffel and James W. Fox of the Brookings Institution have gone so far as to call the MCC, “one of the brilliant innovations of the eight-year Bush presidency.”

Yet there is also one important caveat on what are the mostly very positive reviews of the MCC in looking back at the Bush development tenure: The MCC never reached the spending levels initially envisioned by Bush. Indeed, instead of being a $5 billion a year agency, its highest appropriated budget was $1.7 billion in both 2006 and 2007, slipping down to the $900 million level in 2015. The MCC may have transformed the general approach to development, but lower budgets have meant that it never achieved the transformational results on the ground for which the administration hoped.

Why?

The MCC was slow off the mark in its initial work, and it underestimated the difficulty of getting its first compacts in place, a process that tended to take 18-24 months to carry out effectively. In 2006, Sheila Herrling of the Center for Global Development wrote of “mounting frustration” with the MCC, and argued, “it has taken a long time to become operational.”

That slow start certainly dampened congressional enthusiasm for larger MCC budgets, and the hard cap on staffing at the MCC (it can have no more than 300 personnel) made managing larger budgets difficult. But if one was looking for a direct culprit in the MCC’s lack of larger budgets, you would need to look no further than President Bush’s second major development initiative: PEPFAR.

Tackling AIDS with PEPFAR

With planning for the Iraq invasion in full swing, Bush surprised the nation with his dramatic announcement of a bold plan to tackle the global HIV and AIDS pandemic in his 2003 State of the Union address.

“I propose the Emergency Plan for AIDS Relief, a work of mercy beyond all current international efforts to help the people of Africa,” Bush said. “This comprehensive plan will prevent 7 million new AIDS infections, treat at least 2 million people with life-extending drugs and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS.”

Citing the dramatically falling prices of antiretroviral drugs, Bush argued, “seldom has history offered a greater opportunity to do so much for so many.”

Bush asked the Congress to commit $15 billion over the coming five years, including close to $10 billion in new money, to tackle AIDS in the hardest-hit countries in Africa and the Caribbean.  Given lingering resistance in some Republican quarters to acknowledge the severity of the pandemic, this is a move that would have been very difficult for a Democrat to pull off with nearly the same level of support.

As one Hill insider who wished to remain anonymous observed, “This was an extraordinary crisis, and the president’s response showed American leadership. The money and follow up were unprecedented. It almost became a competition between Congress and the executive branch to see who could spend more on PEPFAR.” While there was some initial skepticism that Congress would support such large levels of spending on HIV and AIDS, those concerns have long since been dispelled, and cumulative spending on PEPFAR passed $65 billion in 2015. In its sheer scale alone, clearly PEPFAR was one of the most important presidential development initiatives of the last two presidencies.

The structure of PEPFAR, like the MCC, was set up as an end run around USAID, with its head, the global AIDS coordinator, an ambassador sitting in the U.S. State Department reporting directly to the Secretary of State and charged with coordinating programs carried out by USAID and the Centers for Disease Control. The program’s emphasis on numbers and impact was key, and the Bush administration established numeric targets for care, treatment and prevention from the onset. The health community was organized, forceful, and effective, and the compelling demonstration of the number of lives saved gave them powerful fodder to make their case.

But this is not to say that PEPFAR was without controversy. Development experts tended to view some of its initial, and more ideological components, as what one senior NGO official called, “the price of admission for conservative support.”

This included requirements that a third of funding for prevention programs through PEPFAR be dedicated to abstinence-until-marriage efforts and an insistence that NGOs working through PEPFAR sign an “anti-prostitution” pledge. (A 2009 study by the Conference on Retroviruses and Opportunistic Infections found no evidence that PEPFAR’s funding of abstinence and faithfulness programs reduced high-risk sexual behavior, and the anti-prostitution pledge was struck down by the U.S. Supreme Court as unconstitutional in 2013 after a protracted and expensive legal battle.)

U.S. President George W. Bush meets patients and their families in the reception room of the Amana District Hospital in Dar es Salaam, Tanzania. Photo by: Eric Draper / The White House

Because of its strong congressional support, massive funding, and the seriousness of the pandemic, PEPFAR soon became something of an elephant in the room with regard to U.S. development programs, both good and bad. A former USAID staffer noted, there has always been “a lot of negativity about PEPFAR at USAID,” in part because PEPFAR ended up being such a large portion of the development budget in many developing countries, particularly in Africa.

Getting the overall approach to development right was very difficult when 70 percent of the U.S. assistance for a country such as Nigeria or Ethiopia was going into the health program. In some cases, the U.S. government and an army of contractors came to serve as de facto ministries of health, hardly a recipe for sustainability.  

Many development experts, while loudly singing the praises regarding the number of lives saved by PEPFAR, have a cool view of the program during the Bush years as an overall approach to development. (Most of these concerns are expressed on background rather than on the record, and it is easy to get the sense that development professionals walk on eggshells when talking about PEPFAR.)

The heart of this criticism was expressed by one NGO official who said, “This was a humanitarian response that hung around to become a development program even though it was very ill-suited for it.” For many observers, PEPFAR was the poster child for a disease-specific approach often disconnected from consideration of broader health systems.

Still, PEPFAR’s accomplishments are considerable, and would not have been possible without Bush’s leadership. A recent PEPFAR report to Congress notes: “As of September 2014, 7.7 million people have received lifesaving ART due to PEPFAR support. Over 1 million babies have been born HIV-free to HIV-positive mothers.”

As Democratic Rep. Karen Bass observed, “Every place I have traveled in Africa, President Bush is an absolute hero and is credited with saving millions of people’s lives.” That is no small thing.

“Bush did more to stop AIDS and more to help Africa than any president before or since,” argued New York Times correspondent Peter Baker. “He took on one of the world's biggest problems in a big, bold way and it changed the course of a continent.”

The bottom line on PEPFAR as a legacy: It has been grandiose, often flawed, and it has saved the equivalent of a large city of human lives.

But if PEPFAR and the MCC loom large in the collective memory of Bush’s development legacy, one would be remiss to look past the third major area of spending during Bush’s terms: massive reconstruction and nation-building efforts in Iraq and Afghanistan. Both, by almost any fair measure, were dismal failures (despite occasional bright spots.)

Reconstruction efforts in Iraq and Afghanistan

Findings from George Washington University note that the United States has now invested more than four times the amount in reconstructing Iraq and Afghanistan than it did rebuilding Germany after World War II (in today’s dollars).

Although aid experts have sometimes taken exception to the methods of the special inspector generals appointed to review reconstruction efforts in both countries, the litany of schools and hospitals built only to be abandoned, white elephant infrastructure projects, and plans backed by more money than sense is far too lengthy to ignore.

Particularly in Iraq, the Bush administration aggressively ignored the advice of U.S. and international reconstruction experts, disbanded the old Iraqi army with no plan for reintegrating these former fighters, and appointed political cronies to positions on the ground for which they were manifestly unqualified. The fallout from these bad decisions is still with us today, and helped fuel insurgency and radicalization that will take years to get back in the box.

As James Kunder, now a senior fellow at the German Marshall Fund and who was director of relief and reconstruction in Afghanistan in 2002 observed, “The hard lesson from both Afghanistan and Iraq was that development programs are not a good substitute for an effective diplomatic and military strategy, and we didn’t really have that in either place.”

The legacy of the Afghanistan and Iraq wars is even deeper than the obvious loss of blood and treasure. There is now growing skepticism that the U.S. government can get post-conflict reconstruction right anywhere, and that cynicism increasingly constrains policymakers from interventions in even in the most glaring cases of governments unleashing violence upon their own citizens.

This is all the more unfortunate since the years before the Bush administration had brought a string of post-conflict reconstruction efforts — in Bosnia, Sierra Leone, Kosovo and East Timor — that while far from perfect had brought a genuine measure of stability on that ground.

The F bureau

Another important legacy for the Bush administration related to the architecture of foreign aid. In 2006, the State Department created the “F bureau” to consolidate state and USAID budgeting. In the words of the administration, “Ensure the strategic and effective use of foreign assistance resources to respond to global needs, make the world safer, and help people better their own lives.”

Almost every high-level effort to look at aid reform over the last 30 years has agreed that there should be a serious plan to coordinate all aspects of the international affairs budget, but to most in the development community the creation of the F bureau was, as one aid watcher described, “clearly designed to marginalize USAID.”

The move made the USAID administrator both the head of USAID and the director of foreign assistance through the F bureau. This left the USAID administrator, embarrassingly, splitting time between sitting in a State Department office and running their own agency. The reviews for the F bureau, coming on top of efforts to create the MCC and PEPFAR as standalone entities, were not kind.

The late Carol Lancaster, who has served as deputy USAID administrator in the Clinton administration, weighed in: “No time since the administration of President John F. Kennedy has seen more changes in the volume of aid, in aid’s purposes and policies, in its organization, and in its overall status in U.S. foreign policy. If ‘transformation’ in politics is taken to mean fundamentally changing existing systems, President Bush has initiated one. But the notion of ‘transformation’ also implies radical change in pursuit of a broad new vision. Such a vision has been absent from the numerous changes in aid implemented by the Bush administration, leaving an aid system — already in considerable disarray — in chaos.”

A far less powerful F bureau still exists to this day with the Obama administration simply leaving the director of foreign assistance position unfilled.

President’s Malaria Initiative and food aid reform

Two other initiatives by the Bush administration deserve to be singled out for praise. The President’s Malaria Initiative which launched in 2005, and is far well less known than PEPFAR, but it consistently gets very good grades from those familiar with its operations, particularly for its general management. The malaria initiative took basically the opposite approach than PEPFAR, and it was embedded in country health systems from its onset.

And like the little engine that could, U.S. bilateral support for combating malaria has grown by leaps and bounds, and malaria funding is now almost as large as the MCC’s entire annual budget at a time when many people aren’t even sure if the President’s Malaria Initiative still exists.

The other area of important reform by the Bush administration was in making the initial case for food aid reform and taking on vested interests in the agricultural and shipping lobbies to do so. The push by the administration did not generate a great deal of traction, but it opened the door for subsequent food aid reform efforts, and it took some genuine political courage.

On balance the Bush administration brought great sweeping, almost operatic, successes and failures and a nearly unrivaled boom in resources. It was a track record that naturally lent itself to discussions of legacies both good and bad. America’s official development assistance leapt from $9.95 billion in 2000 to $26.84 billion in 2008 in what Nellie Bristol of the Center for Strategic and International Studies called, “the largest volume increase in foreign aid since the Marshall Plan.” If fortune does indeed favor the bold, most historians will be kind to the Bush development legacy.

But the 2008 global financial crisis and festering conflicts in Iraq and Afghanistan ensured that Bush’s successor, Barack Obama, would be facing a very different world and a very different playing field for development.

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About the author

John norris
John Norris

John Norris is the executive director of the Sustainable Security and Peacebuilding Initiative at the Center for American Progress. He previously served as the executive director of the Enough Project at the Center for American Progress and was chief of political affairs for the U.N. Mission in Nepal back when the country was emerging from a decadelong war. Earlier in his career, John worked at the State Department and USAID.


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