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For Immediate Release
Office of the First Lady
February 17, 2008

Press Gaggle by the First Lady
Kilimanjaro Hotel Kempinski
Dar es Salaam, Tanzania

3:09 P.M. (Local)

MRS. BUSH: Since you all were with the President this morning, I'd thought I'd come tell you what I did with Madame Kikwete.

MS. MCDONOUGH: And Nina could join us.

MRS. BUSH: Oh, that's right. You were with us, so you heard everything. Today was a very important day for Tanzania, because this was the official launch of their National Action Plan on Orphans and Vulnerable Children. And they're one of the first countries to develop their plan. They have about two and a half million orphans, which is really a lot, and about half of those children's parents lost their parents to AIDS. You're called an orphan even if you only lost one parent, so it doesn't mean that two and a half million children are without both parents. But the idea is, if you lose even one parent, you suffer, and a lot of times suffer especially economically, or you're left without anything.

Their new plan is very comprehensive. They pilot-tested it; the pilot-test was funded by PEPFAR. They are working with local governments, local village governments and local governments around the country to identify all of the children. They want local governments, teachers, other people in villages to literally list the names of children who are orphans in their villages.

Many are being raised by their grandparents. Some are being raised by their aunts and uncles, some of the ones that I met today were ones being raised -- three, actually, were being raised by their aunt. And then several grandmothers were there as well.

Some are shunned by their families, especially the ones whose parents died of AIDS or who are HIV positive themselves because of the stigma -- partly because people aren't really sure or aren't educated enough about how AIDS is transmitted and they're afraid to take these vulnerable children into their homes, or there's just the stigma associated with AIDS.

I know you've heard, if you've been with the President today, how last fall, when the President and First Lady of Tanzania were the first to be tested on national testing day, that it really did make a huge message to the people of Tanzania that it's okay to be tested and it's all right if you get a positive result.

And especially now -- and you would have heard this from the last roundtable -- whoever was in there, all of it, at the hospital -- before, if you got a positive result, then they just send you home, and there was no positive action that the doctor could take or the clinic could take. Now, because there are antiretrovirals and because people are seeing what's called the Lazarus effect among their friends and family members, people are more willing to be tested, because they know they can be treated and that they can live a positive life.

This morning at the launch -- first we had a roundtable with the ministers who are involved and doctors who are involved and the First Lady, and then at the actual launch, I was introduced by a girl who is an orphan -- she's 15, she's first in her class -- she introduced me in Swahili and English. And she lives with her aunt, her mother's sister, along with her brother. And she is HIV positive, and she's on antiretrovirals and she feels great.

So this is a landmark day, really, for Tanzania, and for all the other countries who are watching, because nearly every one of the sub-Saharan countries have huge numbers of orphans. And it means down the road, when you have adults who were raised without the direction or the attention or the nurturing that you get from a family of kids that are literally raised on the streets by themselves, then it's going to be a really huge problem for these countries when these children become adults. And that's what Tanzania wants to avoid. They want to make sure all these children get the nurturing they would get if their parents were alive.

And besides identifying all the orphans, which is the first step, then they'll work to make sure all the orphans and vulnerable children receive services. They have community support to make sure -- they have grief support from social workers, and then as well that their caretakers have parenting information, that they're instructed in parenting so that they will have a really good chance.

Then, of course, they will get from the government beds and mosquito nets and clothing and shoes and school tuition fees and all of the things that their parents would have supplied them so they won't be such a burden to caretakers who agree to raise them.

The President and the First Lady have also adopted an orphan. They have a baby that they've adopted. So besides being taken, they've taken an orphan into their home, which is a great example for Tanzanians.

Then after the launch, which took -- then I went around and looked at different stations that were set up to show me how the communities were actually going to identify the orphans and then the social services that the orphans would get, and then finally the basic needs that the orphans would get.

And one program that's USAID sponsored is called WORTH, and it's a program for women to help them, with microenterprise, be able to earn money. And that's one of the things they're trying to do, is to make sure that the women, the grandmothers or the aunts who take in these children have an opportunity to be educated in some way so that they can have a job and earn money. And WORTH is a great program. George's aunt, actually, Nancy Ellis, is on the board of it, and she kept calling my office until I agreed to see the head of it, one of the heads of it, in the United States.

But it's always been funded by PEPFAR -- I mean, by USAID -- and it's a microenterprise village program where women bank together; they have one little strongbox, three keys that are spread out among the women, and they put a little bit of money in their bank, and then they take their money out. They discuss their business strategies with each other, what they're going to do to make money, and these are just selling vegetables, or the most basic farming, the most basic things, and then they get loans from their little bank, and then as they make money, they repay their loans with interest so that their bank increases and more women can then get loans from them. And that is the basis of some of these village programs that will help women -- not just give women money to support orphans and vulnerable children, but actually give them a way to make money so they can be independent while they support them.

Then we went on from there to a meeting with religious leaders. I met the chief mufti in Tanzania, and two Episcopal -- one Episcopal and one Catholic priest in a religious group, because, as you know, a lot of the PEPFAR money is directed to faith-based groups, because they're the ones already on the ground, they're the ones people respect and trust, their priest or their imam in their village.

And this was a group of young people from a madrassa. It's not a permanent madrassa; these children go to school, go to a Tanzanian public school, but they also go to Sunday school at their madrassa, sort of Sunday school idea. And they have been learning about AIDS, about how you get it, about how you can protect yourself from it, about how you should treat people who have AIDS, and in fact they asked them to quote from the Koran, what the Koran would say about sick people and what the Koran would say responsibility of well people is to sick people.

And that was very interesting, and then at the end, the First Lady of Tanzania spoke to them. She, of course, is Muslim, but she talked to them about being faithful, about only having one partner, to protect yourself from AIDS, from HIV/AIDS. She was very candid with them, which I appreciated.

And then that's it. Do you have any questions?

Q I have one. You have been to Africa five times?

MRS. BUSH: This is my fifth. And I was here in 2005 to Tanzania.

Q Exactly. The message, or a good chunk of the message here, is to Congress to reauthorize PEPFAR. It occurs to me that you might be one of the best incentives (inaudible). Do you ever testify before Congress, to appeal for it, for reauthorization?

MRS. BUSH: I certainly will call congressmen, have congressmen over for coffee to talk about it. Tom Lantos, as you know, was working on one part of the bill. And I fully expect this to be reauthorized, and with the money doubled. But because of his death, there's a little setback, but I'm sure that it will be reauthorized. And sure, I'll be glad to talk to members of Congress. They know how I feel.

Q You'd do it individually, rather than --

MRS. BUSH: Probably individually. Probably individually. I mean, you can tell by the size of the crowds on the street that people here know, they know that this comes from the United States government. They really do. And it's this way -- it's been this way -- every time I've visited, people literally say, "Thank you. I've come back to life because I'm on antiretrovirals." They're very aware that the United States funds PEPFAR and PMI. And in this country, when you think of Zanzibar literally eradicating malaria, that's unbelievable.

One of the things the President just stopped to tell us as we were getting in the car when we left the hospital was this area around Lake Victoria that's a very, very high malaria area. And he said about 50 percent of the babies died before they were five in that area, and they'd just done serious spraying and handing out I think he said 270,000 mosquito nets, and dropped their malaria deaths below half of what they'd been.

So we know it can be done, and it takes a government that really is committed, and the Tanzanian government really seems to be that way.

Q Have you noticed any change since 2005 -- anything topical?

MRS. BUSH: Well, I mean, I'm very aware of the programs that are going on and that were going on then. I've seen some today; some of the people from the programs I saw before came -- the PASADA program, which is a Catholic program that I visited last time; the children today, a Salvation Army group of children sang and danced at the launch of the National Plan of Action, and one of them presented me with a memory book which was their book of pictures of me from the trip in 2005.

And another thing we looked at in these stations was a memory book that a child had made, and that's one of the things the social workers are working with them in villages to do, and that is make a memory book of your parent that you lost or your parents that you lost so that you would have this, and this little boy said, "I haven't forgotten. I haven't forgotten them; they're in my heart," and showed me a little present his mother had given him, and he had one photograph, himself with his grandmother.

Q I had two quick questions, please. Just to clarify, the National Plan of Action for Orphans that you described, that is a PEPFAR program?

MRS. BUSH: It's supported by PEPFAR and the Global Fund and UNAIDS and UNICEF. But the trial -- the pilot project was supported by PEPFAR. But yes, PEPFAR is one of the major supporters.

Q Okay, thank you. And I was curious if you get the feeling when you're back home whether the American people really understand what's happening here, and I mean by that, if they're struggling with their own lives, their own health care issues, whether all of this aid resonates with the people --

MRS. BUSH: I think the American people who know about it are very proud of it. But George and I had, on AIDS Days, International AIDS Day, December 10th, I guess -- 4th -- 1st -- we went to a church in Maryland, I think it was, that had some people, members of their church, who were getting ready to leave on trips to volunteer in Africa, and these were people who were very aware of what's happened. They'd done these sort of mission trips before. They had no idea about PEPFAR or PMI.

And I think -- I would say that most Americans do not know what they're doing -- how their taxpayer money is helping people. And that might be because you all don't get the message out. (Laughter.)

Q You say that to the people who are here?

MRS. BUSH: Okay, you all can get the message out.

Q With this being your fifth trip to the continent, and your husband's second, I'm wondering, with the growing successes of a lot of the U.S. initiatives here, how symbolic is this particular trip for you, and for the President?

MRS. BUSH: Well, it is very symbolic. I mean, it's very meaningful for us to have this chance; I know it is for him. And I've visited programs all of the five times I've been here with the whole purpose of getting the message to Americans also that this is what they're doing, this is the really good work that their government is doing. But for both of us, it's very meaningful to hear stories and to hear from the people at the roundtable today that we heard from at the hospitals whose lives have been dramatically changed, who would be dead if it weren't for PEPFAR and the support from the American people.

Q Can you talk a little bit about, in your five trips over those years and other learning opportunities in between how your knowledge and feelings about this whole continent have evolved, not just American aid, but the political situation and how things go here?

MRS. BUSH: Well, I know you all can see, as you drive around, the poverty, and that's stunning to Americans, I think. And just like you said, Americans are struggling and worrying over things, but it's nothing like what you see here. In fact, when you're here, you're so grateful for all the things we take for granted in the United States.

I really love Africa. I've loved having the chances to be here. I've been here with my girls -- Jenna came with me last time; they both really wish they could have come this time. Barbara worked in South Africa in the Red Cross hospital in Cape Town, and we -- one time when we were here, when Barbara was working here, we spent a three-day weekend, just the three of us, at a park and got to see a lot of animals on that one trip.

What I really love, particularly, about Africa is how warm people are to everyone and how generous they are. And when you think about their generosity under the circumstances, it's even more precious. George and I went -- the very first time we went to Africa -- not to northern Africa but to -- he'd been to Morocco before that -- but to the Gambia years ago when President Bush was President, we went for their 25th anniversary of their independence from Britain. And I went to a market, and every market person gave me something. I mean, it was embarrassing, I was embarrassed, because I couldn't turn it down. But it was really very -- the generosity and the warmth was very moving to me, and that's what we've experienced every time we've been here. I mean, now I wouldn't go to a market, because I know it would be that way. (Laughter.)

Q Do you think there's a -- you were talking about the symbolism of it and how American people don't know how their money is being spent. Do you think there's also almost a -- is there a negative feeling about it because they don't know? Is there a need to do some persuading that this is a good use of the money?

MRS. BUSH: No, I don't think so in the least. I think every American who does find out about it is very, very happy that they can be this -- that our country is this generous and that people are living because of being able to get antiretrovirals. I don't think there's a negative about that.

Q I guess I asked it wrong. Is there a negative gut instinct, based on -- among those who don't know how it's being spent? Is there a negative feeling towards assistance when they don't know --

MRS. BUSH: I don't see that, really. I mean, you read about that sometime in the paper, but I don't see that. I think Americans are very, very generous. I mean, we know that. Look at all the Americans who volunteer here. I mean, now there's actually -- I read this in the newspaper -- a special tourism niche now, where you can come volunteer; you can pay for a special trip to some part of the world to volunteer while you're there. And I think Americans genuinely want other countries to succeed. I think that that is one characteristic that's particularly American -- and that is we don't see everything as zero sum, that we want other countries to succeed. That's why I think Americans are so generous with their time -- besides with their money.

Q You seem very passionate about Africa and the AIDS programs, the U.S. providing for -- have you had to convince your husband to be as passionate about these sorts of issues as you are?

MRS. BUSH: No. I mean, this all came from him. This was -- when he announced it in the 2003 -- was it 2003 State of the Union -- it was his idea. He talked to Dr. Rice and Mike Gerson at the time, and knew that the United States could make a very big impact in a really good way by supporting antiretrovirals mainly, by dedicating money to a disease.

And let me say this, by making sure it was efficient, working through our government, through our own programs to make sure that it really was efficient, that it was not just aid to a leader -- which I think had been the case in some previous aid into Africa and into other countries, where it really ended up building palaces for a leader, rather than going to the people. And that's one of the most important reasons that this has been effective, and that is because it's been managed very, very well, and really does reach the people who need it, and not just leaders.

Q If you go out to the countryside -- as I know you have -- you go to small dispensaries in Tanzania, you don't find even basic antibiotics. You just really don't find anything. And yet, largely because of the success of PEPFAR you do, remarkably, find antiretrovirals in the middle of nowhere. You're pushing for a doubling in the backing for PEPFAR -- has it -- I often wonder, and I assume others have, whether it wouldn't make more sense to look at health care more holistically, to not simply --

MRS. BUSH: Well, people have looked at that a lot -- I mean, in the government. That's one thing that's been studied a lot and been discussed, and that is how to get this sort of health care first, to train health care workers. And these would be people that weren't MDs or registered nurses, but were just people in the communities who could get basic first aid training, for instance, and other training to be able to supply very basic health care in every single community.

And that has been looked at. I don't know exactly where it is -- we saw some of these centers in Zambia. A lot of you -- I mean, one of the things we're going to see -- or maybe it was today -- tomorrow -- are a lot of U.S. medical schools have projects here. And the very first time we went to Africa, when I went with the President in Botswana, there's a great center there that's run out of Baylor School of Medicine in Houston. And they train teachers from Botswana, and then their own -- their medical students come over and are trained treating AIDS. The center in Botswana was built very lovely, like the hospital we went today -- state of the art, very lovely -- built by a women from Houston whose child died of AIDS. And, you know, did that for the people of Botswana.

So there are a lot of partnerships, a lot all the way across Africa, between American medical schools -- and not just American medical schools, obviously, but also British and French and other medical schools around the world, international programs.

There's tons of work for everybody. I mean, everybody can work -- every NGO, every international group, all the different U.N. groups -- UNICEF, UNESCO, UNAIDS -- all of them can work here, either in education or in a disease. People we met today that are here that are based here from the CDC, did you see them as were leaving the CDC people that are -- live in Tanzania, that are based in Tanzania, working -- they're working specifically on AIDS and some malaria.

MS. McDONOUGH: I think from your last trip, the DIG program is another good example of how there's a spillover effect in maybe taking care of the --

MRS. BUSH: Yes, absolutely.

MS. McDONOUGH: -- the AIDS portion of it, but then helping the overall health.

MRS. BUSH: One thing we did today was USAID gave an ambulance, and I got to give the keys to the First Lady, and what had happened -- she had been with our USAID Director here, Pam White, and they were walking up to a hospital and a pregnant women was brought up in a basket on a bicycle to deliver. And so -- I mean, that was just the only way her husband could get her there. And so the head of the hospital said, you know what we really, really need is some kind of transportation. So Pam went back and begged and borrowed from USAID, and we got to give a four-wheel drive ambulance today. It was exciting and fun.

MS. McBRIDE: -- more about building capacity on the ground to deliver basic services. (Inaudible) faith-based communities (inaudible) faith-based organizations that are (inaudible) that have the trust of the people. They are providing (inaudible).

MRS. BUSH: Like the Catholic one I that I went to --


MRS. BUSH: PASADA here, which is sort of a hospital. But, yes, I went to it.

MS. McDONOUGH: Is Zambia one?

MRS. BUSH: Well, no, this is the trip before.


MRS. BUSH: Ghana maybe.

Q Eventually when you move back to Texas, how do you see yourself staying in touch with what's going on in this continent? Do you plan on coming back? How will you stay involved?

MRS. BUSH: We'll come back, for sure. I know we will -- I mean, I will. And there are a lot of things that -- out of the President's library that I'd be able to work on, to continue to work on. Barbara and Jenna say their dad promised them that they would go on a big safari. Like he promised --

Q Wait, after you leave office? (Laughter.)

MRS. BUSH: This is the promise that he made to take them to the Grand Canyon camping, too. (Laughter.)

Q Taj Mahal?

MRS. BUSH: But, no, he may really -- some friend was telling us, and George asked the President about it -- this, out of Arusha tomorrow, which is where we'll be, is the launching point for a lot of the very best of those safaris, the very high-end ones. Some friend told us he had gone on one in Tanzania, and it was so great.

Q Have you ever been on a safari?

MRS. BUSH: Yes, Barbara and Jenna and I went. And we went on -- the President and I went on that very short but very famous one in Botswana. (Laughter.)

Q Yes, right.

MRS. BUSH: There was one wild, young elephant.

Q I'm still counting the money from my daughter for Cross-Cultural Solutions, one of the groups that you mentioned, that do the --

MRS. BUSH: Oh, great.

Q -- they have something up near Kilimanjaro, where you go -- she stayed like five weeks. Me, and her aunts, and her grandfather, and everybody else (inaudible), but she did it. And it was a great time.

MRS. BUSH: Oh, great. American young people are amazing, they're everywhere. Our niece is in Tanzania at an orphanage right now working. It's great. And it really does -- it's a life-changing experience for them.

Q Mrs. Bush, back to authorization and reauthorization -- given the fact that (inaudible) and the tension between the White House and Congress, do you worry that some of the controversial things about PEPFAR, like the abstinence section, will get somehow caught up in politics and authorization -- reauthorization will be dragged out or maybe postponed or delayed? Do you worry about that at all?

MRS. BUSH: I don't think so -- I wouldn't worry about it -- kind of, but not really. I think everyone knows how effective PEPFAR has been, and the Congress ought to be proud of it, too. It's not just the President's initiative. They have worked hard on it. Believe me, they visit PEPFAR sites when they come on CODELs, I'm sure they do, and they know what's going on. So I think they'll -- I don't think there will be a problem.

Q Mrs. Bush, apologies for being late.


Q (Inaudible) an hour early. I also wanted to ask about the reauthorization. And I apologize if someone has asked this, but you might know that Democrats and some AIDS advocates are calling for $50 billion, instead of the $30 billion the President proposed. And I wonder what you would think of that. It seems to me an expression of support, that they would want to put so much money --

MRS. BUSH: It is an expression of support --

Q -- support them?

MRS. BUSH: -- and I think that's great, but I think for budget reasons, it should stay at $30 billion. But let me say another thing -- for capacity reasons. A lot of these countries really don't have the capacity to take huge amounts of money all at once. And one of the reasons PEPFAR has worked is because we've worked with the capacity building with each one of these governments. All of these programs are their programs. Before they got PEPFAR money, they had to devise their strategy for what they would do with PEPFAR money. The same with PMI, and the same on this National Plan of Action for Orphans and Vulnerable Children that we saw today. This is Tanzanian. They looked at it. It was supported by PEPFAR money, the test pilot projects, but they really looked at what they thought would work in all of their communities, and what they could really do.

And I think that's a very important part of it. And that's one reason that I think defeats the purpose to throw -- $30 billion is huge, that's huge. To even put more money in, when the capacity isn't there, really I think doesn't serve the taxpayer, the American taxpayer very well, or the governments that we're trying to help.

Q Thank you.

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