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 Home > News & Policies > December 2008

For Immediate Release
Office of the Press Secretary
December 1, 2008

President and Mrs. Bush Participate in Saddleback Civil Forum on Global Health
The Newseum
Washington, D.C.

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     Fact sheet In Focus: HIV/AIDS

10:41 A.M. EST

PASTOR 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.)

PASTOR WARREN: There are only three people in my life who call me "Ricky" -- my mother, my grandmother, and the President.

President George W. Bush speaks with Pastor Rick Warren Monday, Dec. 1, 2008, during President Bush's participation at the Saddleback Civil Forum on Global Health at the Newseum in Washington, D.C. White House photo by Eric Draper 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, an update on what's actually happened. Then I want us to talk about 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 five 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 pre-show 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. (Applause.)

THE PRESIDENT: Thank you so much. Thank you.

PASTOR WARREN: And 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 five 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 five years to get antiretrovirals.

PASTOR WARREN: From 50,000 to 2 million.

THE PRESIDENT: In five 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 five years, which is -- (applause.)

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.

President George W. Bush speaks with Pastor Rick Warren Monday, Dec. 1, 2008, during President Bush's participation at the Saddleback Civil Forum on Global Health at the Newseum in Washington, D.C. White House photo by Eric Draper PASTOR WARREN: You mentioned two of those things. I'm going to read you a quote. You once said this: "Africa's most valuable resource is not its soil 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: 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.

PASTOR WARREN: That didn't make some people happy. I mean, what about the people who say --

THE PRESIDENT: That's what happens sometimes in my line of work. (Laughter.)

PASTOR WARREN: Okay, now, you mention this -- because this is another innovation. The innovation of trusting leaders at the local level --


PASTOR 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 the 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, end corruption, to invest in the health and education of your people, to believe in market-oriented principles for the economy.

President George W. Bush and Mrs. Laura Bush react during a question and answer session Monday, Dec. 1, 2008, at the Saddleback Civil Forum on Global Health at the Newseum in Washington, D.C. White House photo by Eric Draper 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.

PASTOR 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 -- in Africa sharing their stories about what it's like to love a neighbor.

And so --

PASTOR WARREN: 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 applause.)

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.

PASTOR 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 it was just such an enormous, what they call a B-HAG -- a big, hairy, audacious 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?

President George W. Bush, joined by Mrs. Laura Bush, is presented with the International Medal of PEACE by Pastor Rick Warren, Monday, Dec. 1, 2008, following their participation at the Saddleback Civil Forum on Global Health in Washington, D.C. White House photo by Eric Draper THE PRESIDENT: Well, first of all, I believe in this admonition, this principle: To whom much is given, much is required. 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 Advisor, 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 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 speech maker. (Laughter.)

PASTOR WARREN: Plant a few seeds of thought. (Laughter.)

THE PRESIDENT: It's harder to take words out of a speech than put them in it. (Laughter.) Anyway, my only point is, I had a group of people around me, people who I trust, and people whose hearts I can 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 follow-through people. And anyway, it's been a fabulous experience working with them all.

PASTOR WARREN: It's been worth the scars.

THE PRESIDENT: Yes, look, I mean, absolutely. I don't -- I don't feel like I have scars.

PASTOR WARREN: Tell me about some personal experience that you've seen as you've traveled around the results, because there are always 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?

President George W. Bush, joined by Mrs. Laura Bush, is presented with the International Medal of PEACE by Pastor Rick Warren and his wife, Kay Warren, left, Monday, Dec. 1, 2008, following their participation at the Saddleback Civil Forum on Global Health in Washington, D.C. White House photo by Eric Draper 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 Mohamad 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 Laura and I met a lot of -- 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.

PASTOR 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 is we are involved in an ideological conflict against people 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. So it's in our national security interest to deal with hopelessness when 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. It was good to see them all waving with all five fingers, I might add. (Laughter.)

PASTOR WARREN: Well, Kay and I have been in most of those PEPFAR countries, and it is true. You know, I've discovered that when you help somebody get better who's been sick, they tend to like your country. (Laughter.)

THE PRESIDENT: 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.

PASTOR 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, a Sudanese former slave, the Burmese woman'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.)

PASTOR 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?

PASTOR 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 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, 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.

PASTOR WARREN: Now I've read many, many stories where PEPFAR gave people hope. It's all about hope.

THE PRESIDENT: Yes, it is.

PASTOR 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 up to it. At home, we spent about $99 billion since 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, to 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.

PASTOR 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 --


PASTOR 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, D.C., 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.)

PASTOR 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 script that they could redeem at a place that may be a faith-based institution where they call upon a higher being to help them from --

PASTOR 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.

PASTOR 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.

PASTOR 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.

(The video is shown.)

Well, would you welcome the First Lady of the United States, Mrs. Laura Bush, along with my wife, Kay Warren. (Applause.)

Well, thank you for joining us, Mrs. Bush --

MRS. BUSH: Thanks, Rick.

PASTOR WARREN: -- and it's been great to see you in action. And actually, Barbara is here today.

MRS. BUSH: That's right.

PASTOR WARREN: Where is she? There she is. Hi, Barbara.

THE PRESIDENT: Hi, Barbara. (Laughter.)

PASTOR WARREN: We're glad you're with us.


MRS. 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 -- one of the first times that we met in Rwanda. Our paths crossed and we happened to be in the same hotel; walked up the stairs together. And it's my moment -- I'm meeting my First Lady, Mrs. Laura Bush. I'm in awe, I'm enamored. And I tripped. (Laughter.) We're walking upstairs; I tripped, I fell, I smacked into the stairs. I dropped my purse. You came -- you came back, you picked up my purse, you handed it to me. You helped me up the stairs --

PASTOR WARREN: She flashed the Secret Service. (Laughter.)

MRS. WARREN: Oh, gosh. So embarrassing. And so I just imagined that if somebody said, do you know Kay Warren, you'd go, oh, yes, I think she's that lady that just fell all over the place in Rwanda. (Laughter.) You've forgotten it, but I have not. And this is my moment to thank you for being so gracious. You rescued my purse and my dignity and all of that. (Laughter.) Thank you very much.

But seriously, I love that we share a passion for people with HIV and for vulnerable children. But I'd just love to know, when did this grab your heart? When did this first start for you?

MRS. BUSH: Well, I guess really on those trips to Africa, the first ones. I remember very well when we were together in Rwanda and --

MRS. WARREN: I made an impression? (Laughter.)

MRS. BUSH: Well, the people we met made the impression, for sure. And I think that was -- one of those days, Jenna was with us, and we were in a church service. And this was -- this I think is really part of what you all are working on, and this was an attempt to get pastors or religious leaders across Africa to be tested and to admit if they were HIV-positive, to show their parishioners that anyone could have AIDS, and certainly encourage their parishioners to be tested.

And I'll never forget the pastor that spoke and how sweet that was. And Jenna and I had these precious children who were in the audience with us -- they were mainly AIDS orphans who came over to sit on our laps --

PASTOR WARREN: Sitting in your laps, I remember that.

MRS. BUSH: It was a very, very sweet moment. But I was very impressed by the idea of working with the clergy. This is another faith-based part, but this is a part where pastors can really pastor their -- the people in their churches because they can admit themselves if they're HIV-positive.

PASTOR 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.

MRS. BUSH: 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, Laura -- excuse me, baby.

MRS. BUSH: Go ahead.

THE PRESIDENT: I call her "baby." Anyway -- (laughter.)

MRS. BUSH: At least it's not written. (Laughter.)

MRS. WARREN: That's okay. I'm "Katie." That's "Katie," "Ricky," "Georgie," "Laurie." (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. Over 2 million for antiretrovirals, but 10 million have been affected -- 4 million of those are orphans.


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. And, you know, on one level, as a mom, I was looking at that thinking, oh, how cool that is to be traveling with your daughter and experiencing all that you were experiencing together at that moment. And at the same time, I was just, as an American citizen, I was really humbled and touched to know that -- because I know how much you and the President care about people with HIV. And you were demonstrating it actively, and it was very meaningful.

But you weren't just in Rwanda. You've traveled, as the video said, all across Africa. So what -- and you've seen some things that most people would never see. So what are some of the other things that you've seen and learned in --

MRS. BUSH: Well, I've seen so many really terrific things -- a lot of great programs started by Americans. One is the Mothers2Mothers program that Dr. Mitch Besser in California and Robin Smalley started, and that's a program where mothers who are HIV-positive mentor -- who deliver babies who are HIV-free, because they go on antiretrovirals while they're pregnant, and then they mentor new pregnant -- newly pregnant women to make sure those women are tested so they can deliver babies who are HIV-free.

One of the things they do is they encourage these new mothers or newly pregnant women to admit to their families that they are HIV-positive. And it's a way to fight the stigma. And one story I heard was one mother went -- or expecting mother went to her family and called all of her brothers and sisters and her mother together to tell them. And when she admitted that she was HIV-positive, so did all her brothers and sisters.

But there -- I read today an article in the newspaper, sort of a discouraging article, about a lot of people are concerned that we're spending so much money on HIV, only one disease, and ignoring other diseases. But what in fact happens, is the money that goes to PEPFAR or PMI ends up setting up a health infrastructure for many of these countries, so that every disease is treated, not just HIV.

PASTOR WARREN: That's a big, big point.

MRS. BUSH: And this ribbon that I'm wearing that's made out of beads was made by one of these mothers in the Mothers2Mothers program. So it ends up that there is microfinance. These mothers end up with jobs. They end up with being able to make things that can be sold. They deliver HIV-free babies. A lot of them have been employed to be the mentors of the next group of mothers. So there is a really very far-reaching effect from what -- one program that is supported in part by PEPFAR. But the money ends up really having a great cascading effect on the lives of all these mothers. And not just -- today in the article they mentioned pneumonia, a leading cause of death among babies in Africa -- but these babies are also getting health care.

PASTOR 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 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 n 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 --

PASTOR 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 when 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.)

MRS. BUSH: 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 -- how did you teach your daughters to this life of self-sacrifice?

MRS. BUSH: 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 nine 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 challenge their compassion.

PASTOR WARREN: When you become private citizens again in January, how are you going to continue this work? 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 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 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: That's not retirement, that's hell. (Laughter.)

THE PRESIDENT: That's right, yes.

MRS. BUSH: The golf course?

THE PRESIDENT: Exactly. Particularly if you're a lousy golfer. (Laughter.

MRS. WARREN: Which we are.

THE PRESIDENT: You must be. (Laughter.)

MRS. WARREN: 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 --

MRS. BUSH: Sure, and one of the other great initiatives that the President has started is the Africa Education Initiative. And we've supported countries to design their own textbooks, and they worked with mainly minority-serving universities in the U.S. to write textbooks for K-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.

MRS. BUSH: 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 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.


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.


MRS. WARREN: And, you know, what message do you -- you know, the two of you or as individual, 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, 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 -- 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.

PASTOR 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? (Applause.) 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.)

PASTOR WARREN: Well, and I know you don't like us to do this to you, but in the pre-show 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 pre-session.

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.

(The video is shown.) (Applause.)

PASTOR 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. (Applause.)

THE PRESIDENT: Thank you so much. (Applause.)

PASTOR WARREN: A lot has been done, but a lot still needs to be done. And I have talked several times privately with President-elect Obama, and I asked him to bring a greeting to you and about his commitment to dealing with AIDS, both here in America and around the world, and his commitment to continue PEPFAR. In fact, many of you who watched the Saddleback Civil Forum in August, when I interviewed President-elect Obama and John McCain for an hour each, that he publicly stated that he was supporting PEPFAR, would renew his commitment and his dedication to being a part of this. And I asked him to bring a greeting about where we need to go in the future. And so I want you to watch this from President-elect Obama.

(The video is played.)

END 11:28 A.M. EST