[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.