GSPIA Health Policy Seminar Seminar One Dr. Louis A. Picard Professor of Public and International Affairs and African Studies Graduate School of Public and International Affairs University of Pittsburgh Pittsburgh, PA USA

Readings for Seminar-1  Paul Theroux, “Tarzan is an Expatriate”  Laurie Garrett, “The Challenge of Global Health”

Readings for Seminar-2  William Easterly, The White Man’s Burden, esp. Chapters 1-3  Paul Collier, The Bottom Billion, esp. Chapters 1-5

Readings for Seminar-3 Supplementary Reading  Daniel Bergner, In the Land of Magic Soldiers (Picador, 2003)  John le Carre, The Constant Gardener (Scribner, 2005)

Readings of Seminar-4 Supplemental Reading  Peter Godwin, Mukiwa: A White Boy in Africa (Grove Press, 2004)  Aminatta Forna, The Devil that Danced on the Water (Atlantic Monthly, 2002)

Overview of Picard Thesis  Social Development must focus on the Bottom Billion  Over 70% of the Bottom Billion are located in Africa

Overview of Thesis-2  U.S. Foreign Policy will center on Africa more than the Middle East in the next Decade  If you are concerned about Social Development (Health and Education), U.S. Foreign Policy will Define your Working Environment

Foreign Aid-Seminar Objectives Seminar One Objectives  Examine Contemporary Debates  Review Health and Social Policy Issues  Debate the Role of External “Experts”

Key Theme: Poverty and Health  Original Foreign Aid Focus: Economic Development  Ultimately, as a number of economists have noted, “universal models of growth [did] not work well.”  Quote David Sogge, Give and Take: What’s the Matter with Foreign Aid? (London: Zed Books, 2002), p. 8.

Twenty First Century Concerns  Social Development  Education  Health Systems  Governance

Foreign Policy Motivations 1.Foreign Aid is an Extension of Foreign and Security Policy 2.In the bridge between security and foreign aid, there is a disproportion of power between LDC states and Western, and especially American Power

Motivations, Two 3.There is often very little public recognition to the commercial needs met by foreign aid 4. Ultimately foreign aid organizations, like their counterparts in other areas of contracting, are in a struggle to capture influence and retain resources

Motivations, Three 5.It is also said that part of the motivation for foreign aid has been ethical and humanitarian in nature. 6. Policy makers in more developed countries, and especially in the United States, have tended to see their action in terms of the their generosity and to justify the use of force and unilateral action in order to meet ideological and developmental goals.

U.S. Policy Post Sept. 11  Debate between Unilateralism and Multilateralism  Triangulation: “Three Ds”- Defense, Diplomacy and Development  “Hearts and Minds”

Sub-Themes  Armed Health and Social Worker  “Whole of Government” approach  DOD/State Department/USAID  “Staying in your Lane,” and “Stove-piping”- Defending Turf through Departmentalism

Whole of Government-1  Focus on Humanitarian Responses  Health Crisis- especially HIV/AIDs  Joint Civilian/Military Reconstruction Teams

Test of Whole of Government- AFRICOM  Mixture of Military: Counter-Terrorism, Energy, and Concern about China  Non-Military Response: Health Crisis (AIDs), Fragile States, and Support for Democratic Governance

Discussion Questions  The Chicken or Egg Question: Economic Development vs. Social Development (HRD)  Commercialism vs. Ethicalism- The Cases of Testing, Medicine and Changes of Behavior (eg. Abstinence)

The Role of U.S. Foreign Policy: Assessment  Assessment of Unilateralism  The Legitimacy of Triangulation

Debate: The Expatriate is Still Tarzan The Expatriate is Still Tarzan Group One: Yes Group One: Yes Group Two: No (Fifteen Minutes Prep.)