    [Public Papers of the Presidents of the United States: George W. Bush (2008, Book II)]
    [December 1, 2008]
    [Pages 1401-1411]
    [From the U.S. Government Publishing Office www.gpo.gov]

    Remarks at the Saddleback Civil Forum on Global Health
    December 1, 2008

        Richard D. Warren. Well, Mr.
    President, I want to start by admitting to the audience that you always
    call me ``Ricky.'' [Laughter]
        The President. Yes, you always call me ``Georgie.'' [Laughter]
        Mr. Warren. There are only three
    people in my life who call me ``Ricky'': my mother, my grandmother, and
    the President.
        So now we've got three purposes here this day. First, thanks for
    being here on the 20th anniversary of AIDS--World AIDS Day. We want to
    do a little information, we want to do a little celebration, and we want
    to do a little explanation.
        First, I want to get a progress report on PEPFAR and an update on
    what's actually happened. Then I want us to talk about

    [[Page 1402]]

    why you did it--why did you do it. And I want to talk about some of the
    stories you've heard, some of the things you've seen around the world in
    the last 5 years. And then we want to honor you for your efforts,
    because we think that this is one of the most amazing things. I
    mentioned earlier in our preshow that no man in history, no world leader
    has ever done more for global health than President George W. Bush. And
    I think we need to recognize that, and I thank you for that----
        The President. Thank you.
        Mr. Warren. ----so much. Thank you.
        Now I want to talk about the results of PEPFAR in five areas: saving
    lives; creating new partnerships--you don't have to write them down--
    [laughter]--trust in local leadership; encouraging behavior; and
    reducing stigma.
        Now, first, these are five things that as I watched this program
    develop from the ground, that are very unique, very unusual. For
    instance, insisting on accountability. When you established this, and
    you first announced it at the State of the Union 2003, you insisted on
    measurable goals. Most development is afraid to do that; they're scared
    to death to do that. But you did it.
        So how are we doing? Tell me about what's happened in the last 5
    years.
        The President. Well, Ricky--
    [laughter]--we're doing pretty good.
        I insisted upon measurable goals because I felt that lives needed to
    be saved. And if you don't have measurable goals, lives might not be
    saved. This is--we live in a process world in government. Oftentimes,
    people said, ``Well, what are the inputs?'' This is an administration
    that tried to get people to ask the question, ``Are we actually doing
    something?''
        And so we set a goal of saving 50,000--well, when we got started
    there were 50,000 people getting antiretrovirals in all sub-Sahara
    Africa. And we set a goal of 2 million by 5 years to get
    antiretrovirals.
        Mr. Warren. From 50,000 to 2 million.
        The President. In 5 years. And you know, thank you for setting this
    up, because today we're able to announce that we're over 2 million in
    less than 5 years, which is--[applause].
        Mr. Warren. That's fantastic.
        The President. You see, but setting goals is difficult for some.
    Bureaucracies tend to avoid goal-setting, in all due respect to
    bureaucracies. Foreign governments tended to want to avoid results.
    Nobody really wants to be held to account oftentimes. And so setting the
    goals also had to change the way we did development aid. In other words,
    we said to people, ``We want to help you.'' But rather than being
    paternalistic about our help, which basically says, ``We know better
    than you on how to achieve our goals.'' We expect you to be a partner in
    achieving the goals. Which was an attitudinal change, basically saying
    to African leaders, in this case, ``We trust you; we think you've got
    the capacity to be a good partner.'' And----
        Mr. Warren. Yes. Now, you mentioned
    two of those things, but I'm going to read you a quote. You once said
    this: ``Africa's most valuable resource is not its oil or its diamonds,
    but it's the talent and the creativity of its people.'' Now, a lot of
    politicians say that, but you insisted that the people who were going to
    do PEPFAR, that the decisions and the strategy actually be done by the
    people on the ground there, instead of a bureaucracy or centralized back
    here.
        And so this principle of trusting the local leaders is a pretty
    innovative thing when you think about it.
        The President. Well, actually, it's a timeless management principle
    of aligning authority and responsibility. If you disassociate authority
    and responsibility, you can't have accountability. And so we aligned
    responsibility and authority. And----
        Mr. Warren. That didn't make some
    people happy. I mean, what about the people who say----

    [[Page 1403]]

        The President. That's what happens sometimes in my line of work.
    [Laughter]
        Mr. Warren. Okay, now, you mention
    this because this is another innovation. The innovation of trusting
    leaders at the local level----
        The President. Right.
        Mr. Warren. ----instead of saying,
    ``We over here are going to tell you what to do.'' You let them
    determine the strategy in each country. And that's how you got to 2
    million.
        The President. Right, well, we actually helped them develop the
    strategy. But when they develop the strategy, therefore it's easier to
    hold the strategy developer to account. And so it's not all that
    profound to basically say responsibility and authority go hand in hand.
    What was different is that the United States believes that paternalism
    is destructive. And we believe partnership is constructive. And that's
    the basis of a lot of our foreign policy.
        For example, not to get off subject, but the Millennium Challenge
    Account basically said, we want to help you, but we expect you to do
    some fundamentals, such as govern justly, to end corruption, to invest
    in the health and education of your people, to believe in market-
    oriented principles for the economy.
        What's earthshaking about that is it basically says, we believe you
    can do better. We believe in setting high standards and helping you
    achieve high standards. That's different from, we're just going to give
    you money to make ourselves feel better, and that the results don't end
    up accomplishing our objectives.
        Mr. Warren. You know, that makes me
    think of the old Reagan statement, ``trust but verify,'' because you did
    both. You trusted the local leaders, but you also made accountability.
        Now, let's talk about this partnership for a minute, because you
    brought in a whole new group of partners in PEPFAR. PEPFAR was not just
    a model for AIDS, but it's a model for all kinds of programs, because
    you invited everybody to the table, including faith based.
        The President. Especially faith based. I say ``especially faith
    based,'' not ``including faith based,'' because I believe that when
    people join organizations to love their neighbor, that is a powerful,
    not only recruiting tool, but it's a powerful incentive for
    effectiveness on the ground. And one of the great things about our
    experience--I say ``our''--Laura is here, as you
    know--and we've traveled to Africa a couple of times, and we've seen
    people from the faith community share their--in Africa sharing their
    stories about what it's like to love a neighbor.
        And so----
        Mr. Warren. Well, I've heard you say
    many times, ``Government can't love.''
        The President. That's right, government is justice and law. Love
    is--love comes from a higher government and--or a higher calling or from
    God. [Laughter]
        And so it's--and so the whole purpose of including the faith
    organizations was frankly bring some order into that which was already
    happening. Your church, other churches, you know, synagogues, people
    from around America who are motivated by faith are involved in the
    process. So why not bring some order and focus, and that's a proper role
    of the government in this case.
        And it's working, it's paying off, people are--the interesting thing
    about people who are volunteering in Africa to save lives is they're
    actually saving their own life in many ways. They may not be saving it,
    but they're certainly strengthening it.
        Mr. Warren. Let me talk to you about
    your own personal motivation behind this. This was the largest
    initiative ever committed to a single disease, PEPFAR. And I mean, when
    people heard it, I know when I heard it in 2003, I thought, ``Will that
    ever get voted through?'' Because I--it was just such an enormous, what
    they call a B-HAG--a big, hairy, audacious

    [[Page 1404]]

    goal--[laughter]--and from a purely political viewpoint, you aren't
    going to get a whole lot of votes from that. So what was it that
    motivated you to do PEPFAR?
        The President. Well, first of all, I believe in this admonition,
    this principle: To whom much is given, much is required. It's what I
    believe.
        Mr. Warren. Yes. I've heard you say
    that many times.
        The President. Secondly, I would hope that when it's all said and
    done, people say this is a guy who showed up to solve problems. And when
    you have somebody say there's a pandemic that you can help, and you do
    nothing about it, then you have, frankly, disgraced the office.
        And finally, I was surrounded by people who were pushing hard on
    this initiative, people I trusted: Condi Rice, Mike Gerson. When I
    first got the--was talking to Condi about becoming the National Security
    Adviser, she said, ``I want you to make this promise to me that you will
    focus on Africa.'' I said, ``Okay.'' And then there's Gerson, who was
    very much involved with our policy on these issues, and he--I spent a
    lot of time with him; see, he was the speechwriter. And so the
    speechwriter got to spend a lot of time with the speechmaker. [Laughter]
        Mr. Warren. Plant a few seeds of
    thought. [Laughter]
        The President. It's harder to take words out of a speech than put
    them in at times. [Laughter] Anyway, my only point is, I had a group of
    people around me, people whose--I trust, and people whose hearts I came
    to admire, that helped forge the policy as well.
        So you know, you said you're going to give awards and all that--I
    don't deserve an award. The people that helped make this policy work
    deserve the award.
        And then, once we got going, Mark Dybul,
    who is our ambassador on AIDS--I think you call him coordinator for
    AIDS, one of these titles--but anyway, I like to be able to deal with
    Mark, because I can say, ``Mark, what are we doing? Are we making
    progress?'' And the answer is yes. But if the answer was no, I would
    say, ``Why not, Mark?'' And my only point there is that we've got a
    bunch of dedicated folks, once the initiative got going, who are
    followthrough people. And anyway, it's been a fabulous experience
    working with them all.
        Mr. Warren. So it's been worth the
    scars?
        The President. Yes, look, I mean, absolutely. I don't feel like I
    have scars.
        Mr. Warren. Tell me about some
    personal experience that you've seen as you've traveled around the
    results, because there are all these numbers, 2 million people, 2
    million lives that have been saved that wouldn't be on ARVs, wouldn't be
    getting any help. Can you tell me about one of them?
        The President. Yes. So in Uganda--we first went to Uganda--I was
    checking out the ABC program: abstinence, be faithful, condoms--kind of
    the comprehensive approach to prevention in the first place. And I met a
    guy named Mohamed in a clinic there, and
    he just looked terrible. It turns out, one of his dreams was to come to
    the United States. He got on antiretrovirals and was present in the East
    Room--where you were, by the way--when we signed the reauthorization
    bill of PEPFAR.
        Now, it is a moving experience to see a person go from near death to
    realizing the dream of being in the White House. That's why they call
    the effect that's taking place in Africa the Lazarus effect: people
    given up for dead now realizing there is life.
        And we, Laura and I, met a lot of people.
    What the American people have got to understand about this initiative
    is, it's in our national interest that we help save lives in Africa.
        Mr. Warren. It's good foreign policy.
        The President. Well, it's really good foreign policy. It's good
    national security policy too because the truth of the matter

    [[Page 1405]]

    is, we are involved in an ideological conflict against people that--who
    can only recruit when they find hopelessness. And there's nothing more
    hopeless than to be an orphan, for example, whose parents died of HIV/
    AIDS, wondering whether or not there's a future for them. And so it's in
    our national security interest to deal with hopelessness where we can
    find it. It's obviously in our economic interest to have a vibrant,
    growing group of consumers.
        But it's in our moral interest, it's in our moral interest. We're a
    better nation when we save lives. And I wish the American people could
    see what we have seen after this PEPFAR initiative has kicked in and
    brought results. I mean, people literally lining the roads in Tanzania,
    all waving and anxious to express their love and appreciation to the
    American President who represents the American people. And it was good
    to see them all waving with all five fingers, I might add. [Laughter]
        Mr. Warren. Well, Kay and I have been
    in most of those PEPFAR countries, and it is true. You know what I've
    discovered, that when you help somebody get better who's been sick, they
    tend to like your country. [Laughter]
        The President. Yes, they do, which is good. Look, I think it's
    important. Everybody wants to be liked. But being liked because you've
    actually done something constructive that's measurable is the best way
    to try to be liked. And it's very important for America to be humble in
    our aid, in this sense. In other words, we can't say, ``Okay, we're
    spending so much money, we demand this, or, we're going to make you do
    this.'' And that will end up making us not liked. But to be partners
    with people and to herald good government and focus on the individual
    will make us liked.
        Mr. Warren. I want to read you a
    quote. In a recent article I read, Mike Gerson wrote about you,
    referring to the malaria initiative. And he said: ``In the crucial
    policy meeting about malaria, one person supported it, the President of
    the United States, shutting off debate with moral certitude that others
    have criticized. And I saw how this moral framework led him to an
    immediate identification with a dying African child, a Chinese
    dissident, the Sudanese former slave, the Burmese women's advocate. It's
    one reason why I'll never be cynical about government or even President
    Bush.'' Is that an accurate description?
        The President. Yes. He was sitting in
    the meeting. [Laughter] Far be it from me to contradict him. [Laughter]
    After all, he now has the power to write another column. Anyway--
    [laughter].
        Mr. Warren. Okay, well, let me read
    you another----
        The President. I believe this, I believe this, and I have said this
    throughout my Presidency: First of all, a President must have a firm set
    of principles from which he will not deviate. And I believe in the
    universality of freedom, and I believe freedom is universal because of
    an Almighty God. And I believe that it's not just freedom from tyranny
    that the United States must become involved in, I believe it's freedom
    from disease, freedom from hunger, freedom from deprivation.
        And so if you believe in the universality of freedom, then you
    should not--then one should not shy away from doing your duty. I want
    to--can I share a story with you?
        Mr. Warren. Go right ahead.
        The President. So I've had a lot of amazing moments as President.
    One such moment came in the town square--a town square in Bucharest,
    Romania. I was coming to be the--welcome people into NATO--``An attack
    on one is an attack on all,'' which is something the Romanians wanted to
    hear from the U.S. President. In other words, their security was
    guaranteed.
        It's a rainy day, there was a lit balcony, and I asked, ``Why is
    that balcony lit?'' And it was because the tyrant Ceausescu had given
    his last speech in this balcony. Just as I stepped up to speak a full
    rainbow

    [[Page 1406]]

    appears. It was a stunning moment. Remember, it was a drizzly day, kind
    of dark. And I ad-libbed, ``God is smiling on Bucharest,'' because the
    rainbow ended exactly behind the balcony where the tyrant had given his
    last speech.
        And you can look at that any way you want to look at it. One way to
    look at it is, hey, pal, you've got a lot of influence, and you can use
    your influence for human liberty, for decency, and for justice, all
    times, all places.
        And so the PEPFAR initiative, or what Mike described in that article, has been a part of the freedom
    initiative, the freedom agenda. And the real challenge for the world is
    whether or not people have a view that freedom is universal or whether
    it just happens to be available for certain people. And it's kind of a
    moral relativist debate. I believe in the universality of freedom and
    have not deviated from that during my Presidency.
        Mr. Warren. Now I've read many, many
    stories where PEPFAR gave people hope. It's all about hope.
        The President. Yes, it is.
        Mr. Warren. Do you feel pretty hopeful
    that we can win this fight against AIDS?
        The President. Sure. I believe we can win a fight against anything
    when we get our minds set to it. At home, we've spent about 99 billion
    since my--I've been President; 20 billion on top of that for research.
    You know, I've gotten to know Anthony Fauci
    and some of the people at the NIH, who are working day and night to try
    to figure out a way to, you know, provide some kind of relief from this
    pandemic or this terrible disease. Yes, we can; sure, absolutely. And a
    lot of it has to do with people's individual--you know, being
    responsible for their behavior. People----
        Mr. Warren. All right. Let's talk
    about that for a minute. AIDS is primarily a behavior-based disease. I
    mean, you don't get it from water, you don't get it from the air----
        The President. Right.
        Mr. Warren. ----you can't just eat
    something and get it. And you supported, and PEPFAR supports, behavior-
    based training as part of a total package like ABC and all that. And yet
    there are some people who oppose--they don't think the Government should
    be trying to encourage healthy behavior. What do you say to those
    people?
        The President. They must not be results-oriented people. If you want
    to achieve results, if you actually want to solve the problem, then put
    strategies in place that work. Look, I mean, abstinence is a loaded word
    here in Washington, DC; it's become politicized. My only--my answer to
    that is it's a part of a comprehensive strategy and, by the way,
    abstinence works every time. [Laughter]
        Mr. Warren. All right, let me read you
    this quote out of the New York Times. I read this last January; it was
    an article titled ``In the Global Battle on AIDS Bush Creates a
    Legacy.'' And here's the quote: ``Even critics concede that Mr. Bush
    spawned a philosophical revolution. In one striking step he put to rest
    the notion that because patients were poor or uneducated, they did not
    deserve, or could not be taught to use, medicine that could mean the
    difference between life and death.''
        The President. Well, if you believe that we're all God's children
    and believe there is God-given talent for every single person, then
    that's--one should not be surprised by a policy that elevates the
    individual, that focuses on the individual, that doesn't focus on
    bureaucracies but tries to get help into the hands of, you know,
    individual people.
        It's really the heart of a lot of our policies in--out of the
    administration, whether it be PEPFAR, whether it be the faith-based
    initiative. For example, you know, some people need help from something
    other than a psychologist when it comes to drugs or drinking. And
    therefore, rather than force people into situations where it won't be
    effective, why not give them a scrip that they could redeem at a place
    that may be a faith-based institution where

    [[Page 1407]]

    they call upon a higher being to help them from----
        Mr. Warren. For their recovery.
        The President. Yes, absolutely. And my only point is, it's the
    empowerment of the individual that also yields the results that we
    initially talked about. And it's very important for America not to
    become, you know, have such a kind of a elitist view about himself or a
    snobbery where we don't trust the individual.
        Mr. Warren. You know, Mr. President,
    my wife has had a profound effect on me, and I know that's true with
    you.
        The President. That would be true.
        Mr. Warren. And the First Lady has
    been involved in this battle all along. Kay and I have been with her on
    trips in Africa, and seen that. I want the people to see a little bit of
    a video of Mrs. Bush speaking in Rwanda in one of her trips, dealing
    with people. Let's just watch this for a second.

    [At this point, a video was shown.]

        Mr. Warren. Would you welcome the
    First Lady of the United States, Mrs. Laura Bush, along with my wife Kay
    Warren?
        Well, thank you for joining us, Mrs. Bush----
        The First Lady. Thanks, Rick.
        Mr. Warren. ----and it's been great to
    see you in action. And actually, Barbara is here today.
        The First Lady. That's right.
        Mr. Warren. Where is she? There she
    is. Hi, Barbara.
        The President. Hi, Barbara. [Laughter]
        Mr. Warren. We're glad you're with us.
        Katie.
        Kay Warren. Well, Mrs. Bush, I have to start
    by saying thank you. This is my first opportunity to thank you for your
    graciousness to me.

    [Mrs. Warren, Mr. Warren, and the First Lady had a brief exchange,
    concluding as follows.]

        Mr. Warren. You know, that particular
    church that we were all in together was a small church of 300 people
    caring for 900 people with AIDS. That's how many they were caring for in
    the community, that one church.
        The First Lady. And we did meet one 12-year-
    old who was raising her little brothers. You know, it's just something
    that we don't think about here in the U.S., but that is these very young
    children themselves who are raising little children----
        The President. Yes, one of the--excuse me, baby.
        The First Lady. Go ahead.
        The President. I call her ``baby.'' Anyway--[laughter].
        The First Lady. At least it's not ``Ricky.''
    [Laughter]
        Mrs. Warren. That's okay. I'm ``Katie.'' So
    everybody's ``Katie,'' ``Ricky,'' ``Georgie,'' ``Laurie.'' So--
    [laughter].
        The President. One of the results that I did not talk about was the
    10 million people who have been affected--10 million people with HIV
    have been affected by the program. So over 2 for antiretrovirals, but 10
    million have been affected; 4 million of those are orphans.
        Mr. Warren. Wow.
        The President. And so my only point is, is that there's a lot of
    people----
        Mrs. Warren. There are.
        The President. ----whose lives are being touched by the program.
        Mrs. Warren. I remember that particular
    church, and just--I remember glancing up at just one point and seeing
    you and Jenna at that exact moment when some girls in little torn
    dresses climbed up in your laps.

    [Mrs. Warren, Mr. Warren, and the First Lady continued their exchange,
    concluding as follows.]

        Mr. Warren. It's all tied in together.
    I want to go back, Mr. President, to one of the things that Mrs. Bush
    said about there is a whole group of people who say, ``Well, should we
    be spending this money on developments?'' Particularly, say, the economy
    is bad right now, should we be

    [[Page 1408]]

    spending on--how does that--how do you justify spending that with the
    principle of to whom much is given, much is required, as you--as a
    foundation of your----
        The President. Because we're a rich nation, and we can do both. And
    the worst thing would be for our Government to make promises to people
    on the continent of Africa that we're here to help you and to be
    partners with you, and then all of a sudden turn our back on them. I
    couldn't think of anything----
        Mr. Warren. And let them die.
        The President. Well, that too. Yes, I mean, that would be terrible.
        You know, it's interesting that you were asking about stories.
    Remember we went to the school in Rwanda? So these were children whose
    parents had died because of AIDS. And I just happened to walk by and
    said, ``God is good.'' And without hesitation, they said, ``All the
    time.'' [Laughter]
        The First Lady. And that was so sweet.
        The President. And it was a very powerful, very sweet message.
        Mrs. Warren. President and Mrs. Bush, caring
    for the least of these is obviously something that's very important in
    your family. I mean, not only are the two of you very involved, but your
    daughters have been involved, and both have spent extended time
    volunteering, caring for people with HIV. So obviously, you did
    something right with them. And what--how did you teach your daughters to
    this life of self-sacrifice?
        The First Lady. Well, I think we both were
    very fortunate to have parents who modeled that behavior for us through
    our whole childhood, and I think we've done that with Barbara and Jenna
    as well. But one of the really, really interesting things and sweet
    parts of the work the President has done with PEPFAR and PMI is that our
    girls have been so engaged in it. Barbara worked for 9 months in a
    hospital in South Africa, a children's hospital in South Africa. Jenna
    worked with UNICEF in Central America and South America, and then came
    home and wrote a book about a girl that she met there who is an AIDS
    orphan who had a baby, became pregnant as a single young girl, a 17-year
    old, and was able to deliver an HIV-free baby.
        And one of the sweet things that happened when Jenna and I were
    together--I think we were in Zambia, but I may be wrong--and two young
    women were telling us their stories, and everyone around was really
    surprised that they told us this story in front of other people, because
    it was really a secret. But both of them had contracted AIDS because of
    sexual abuse. And so Jenna went over after--they wept while they told
    the stories, and so of course, we did too--but after it was finished,
    Jenna went over just to speak to them by herself. And she said, ``You
    know, this happens to girls all over the world; it's not just you.'' And
    she said, ``I wrote a book about a girl I met in Central America that
    has your same story.'' And they said, ``Oh, would you write a book about
    us?''
        The President. I think, first of all, there's nothing that makes a
    parent more proud when their child becomes a contributor. I suspect that
    if people got to see what our girls got to see, they would want to help
    save lives too. And so one of the real challenges is to make sure that
    America's conscience is raised, that people understand the plight of
    their fellow citizen.
        And your church has done a great job of this. Others need to be
    involved as well. And there's a lot of groups that are looking for a way
    to fulfill, you know, the calling. And it's helpful to challenge their
    compassion.
        Mr. Warren. When you become private
    citizens again in January, how are you going to continue this work?
    What--how will that change?
        The President. Well, we're going to build a policy center/freedom
    institute at Southern Methodist University, where Laura went to college. And the whole purpose of this
    institute is to promote freedom at

    [[Page 1409]]

    home and freedom abroad, based upon universal principles.
        And so I--even though I haven't had much time to think about it,
    since I've been interested in the free market system--[laughter]--by
    taking non-free market action to save the free market system--
    [laughter]--but when we get out of here, it will be to--this whole
    discussion we've had here is--will be a part of the institute. And I
    just can envision programs coming out of this place that will encourage
    young people to go to--to volunteer their time or to encourage--one
    interesting initiative that you ought to think about and I ought to
    think about is to say to baby boomers, retirement isn't a golf course;
    retirement, fulfilling retirement is to use your time and talent----
        Mrs. Warren. To me, that's hell. That's not
    retirement, that's hell. [Laughter]
        The President. That's right, yes.
        The First Lady. The golf course?
        Mrs. Warren.  Playing golf every day? Oh,
    sorry.
        The President. Exactly. Particularly if you're a lousy golfer.
    [Laughter]
        Mrs. Warren. Which we are.
        The President. You must be. [Laughter]
        Mrs. Warren. We are. Do you see any
    intersection--you also have a passion for literacy--do you see an
    intersection between your passion for literacy and for HIV/AIDS and this
    institute that you're----
        The First Lady. Sure, and one of the other
    great initiatives that the President has started is the Africa Education
    Initiative. And in--we've supported countries to design their own
    textbooks, and they worked with mainly minority-serving universities in
    the U.S. to write and--textbooks for K through 8. But a lot of those,
    and especially for adult literacy--illiteracy programs, where people--
    adults are learning to read, a lot of those early primers, those reading
    primers, are based on health education.
        And so were a lot of these textbooks that the AEI program helped
    each country develop, because if children know that you get malaria from
    a mosquito, they can go home and tell their parents. And if they know--
    they just learned in their little reader how to use a mosquito net or
    whatever, they can also educate their parents.
        And so there's a real combination between health and literacy:
    health education.
        The President. And there's a real combination between freedom and
    literacy.
        The First Lady. That's right.
        The President. Literacy is freedom. If you're a literate person, you
    become a better citizen, and you ask tough questions for governments,
    for instance, that may not listen to the needs of the citizens.
    Illiteracy locks people into, you know, a status quo that is
    unacceptable.
        And so absolutely, there's a big connection between literacy and
    what Laura described, and literacy and just the
    whole notion of freeing people to be able to realize their dreams.
        Mrs. Warren. I have one last question, and
    then you probably had one as well.
        Mr. Warren. Go ahead.
        Mrs. Warren. And it's, what--I mean, we've
    been talking a lot about PEPFAR and that's all--that's people in other
    parts of our world, but we're here in the United States today on World
    AIDS Day, and there are people in this audience who are HIV-positive.
        The President. Yes.
        Mrs. Warren. And you know, what message do
    you, you know, the two of you or as individuals, what do you want to say
    to people in this audience who are positive?
        The President. That PEPFAR is a part of a comprehensive strategy to
    deal both with AIDS both at home and abroad, and that the intention of
    PEPFAR was never to pirate money away from a domestic program. The
    intention for PEPFAR is to build on what we've learned here at home.
        And so the first question that people ought to ask is, ``What's the
    funding been like?'' In other words, funding equals commitment;
    sometimes it equals, you know,

    [[Page 1410]]

    effective programming, but it--at least the funding levels will give you
    a sense of how committed the country is. And as I mentioned, we're
    spending--we spent about 99 billion at home, which was a 40 percent
    increase from 2001 to today, which is positive.
        You know, it's--it turns out that--and in my State of the Union, by
    the way, I talked, you know, I think a couple of times about, you know,
    HIV in neighborhoods that weren't used to HIV, inner-city America, for
    example. And this is a issue that's going to require constant vigilance
    here at home, and that people that may think that they're safe, you
    know, have got to be reminded that, you know, care and--you know, and
    education is important.
        So yes, but people in America should not think that PEPFAR is----
        Mr. Warren. Over there.
        The President. ----means that we don't care about them, because we
    do. This Nation has--is dedicated to, you know, helping people whose
    lives have been severely affected by HIV/AIDS.
        Mr. Warren. I tried to introduce Dr.
    Mark Dybul, our Global AIDS Coordinator earlier, but he was with you
    coming in. But I see you sitting here next to Barbara. So, Mark, would
    you stand up and let us recognize the guy who's done all the work? Thank
    you so much. Thank you.
        The President. So, like, Mark doesn't like
    you to do that to him. [Laughter] He would rather be anonymous, wouldn't
    you, Mark? [Laughter]
        Mr. Warren. Well, and I know you don't
    like us to do this to you, but in the preshow before we went on the air
    with a number of the networks, we--I had written to--or called up eight
    different world leaders and I asked them what they'd like to say about
    PEPFAR, and every one of them wanted to give a video tribute, and we
    showed those in the presession.
        And I wanted to read you the list of--former President Clinton;
    President-elect Obama; Secretary-General Ban Ki-moon; Prime Minister
    Tony Blair; President Paul Kagame of Rwanda, representing all of the
    African Presidents saying thank you to you; all of the PEPFAR countries
    wanted to say thanks; Bill and Melinda Gates; Director Michael
    Kazatchkine; and a friend I met out on the street named Bono. [Laughter]
        We've played seven of these video tributes to you in our preliminary
    program, but I wanted you to hear just a short--kind of a--about a
    minute synopsis of some of these. And so let's watch this for just a
    second.

    [A video was shown.]

        Mr. Warren. Mr. President, we talked
    earlier about how all of these problems are connected: literacy,
    poverty, disease, education. And that's what the PEACE plan is all
    about. PEACE stands for ``promote reconciliation, equip leaders, assist
    the poor, care for the sick, and educate the next generation.''
        And this year, the PEACE coalition of churches--over 400,000
    churches in 162 countries--and businesses and individuals, part of the
    PEACE coalition decided that we wanted to begin a tradition of
    presenting an award called the International Medal of PEACE for the most
    outstanding contribution in attacking what we call the five global
    goliaths: spiritual emptiness, corruption, extreme poverty, pandemic
    diseases, and illiteracy.
        And the consensus was unanimous that the first International Medal
    of PEACE would be presented to President George Bush on the 20th
    anniversary of World AIDS Day. And it is with great honor and great
    humility and respect that we give you this award on the behalf of all of
    those in the PEACE coalition, representing 162 countries. And we thank
    you, sir, for your commitment.
        The President. Thank you.
        Mr. Warren. Thank you so much.

    [Mr. Warren then presented the medal and made concluding remarks, after
    which a video was shown.]

    [[Page 1411]]

    Note: The President spoke at 10:41 a.m. at the Newseum. Participating in
    the forum were Richard D. Warren, pastor, and Kay Warren, executive
    director of the HIV/AIDS initiative, Saddleback Church, Lake Forest, CA.
    In his remarks, the President referred to Michael Gerson, columnist and
    former speechwriter for the President; Mohamed Kalyesubula, HIV/AIDS
    activist, Uganda; and Anthony S. Fauci, Director, National Institute of
    Allergy and Infectious Diseases, NIH. Mr. Warren referred to Secretary-
    General Ban Ki-moon of the United Nations; former Prime Minister Tony
    Blair of the United Kingdom; William H. Gates III and Melinda French
    Gates, cochairs, Bill & Melinda Gates Foundation; Michael Kazatchkine,
    executive director of the secretariat, The Global Fund; and musician and
    activist Paul D. ``Bono'' Hewson. The Office of the Press Secretary also
    released a Spanish language transcript of these remarks.