Wall Street Journal - May 29, 2002
Michael M. Phillips, Staff Reporter of The Wall Street Journal

In Ghana, he suggested farmers should use better seeds to grow plumper tomatoes. After visiting HIV-positive mothers in South Africa, he said some anti-AIDS money now used for prevention programs should be redirected toward treating infected mothers. In both Ghana and Uganda, he recommended digging better wells. And in Uganda, he offered this answer to a textbook shortage: Americans should pack up children's books and ship them here.

Mr. O'Neill's quick-fix suggestions worry activists who are looking for more attention to the complexities of uprooting entrenched poverty from the Treasury secretary. Meanwhile, Mr. O'Neill's traveling companion on the star-studded and MTV-covered tour, Irish rock star and antipoverty activist Bono, hasn't hesitated to express his own simple approach: more aid.

"We shouldn't make this into some cosmic thing about billions of dollars," Mr. O'Neill told teachers, students and Bono here in Wakiso. "We need to make this an individual, people thing."

"But Mr. Secretary," Bono interrupted, "it takes billions of dollars." Monica Naggaga, program officer for the Uganda office of the antipoverty group Oxfam, was dubious when she heard Mr. O'Neill call for a round of book donations rather than an enduring aid program. "That doesn't help," she said. "If Americans just donate them one-off, what happens next time?"

Instead, she says, the U.S. should give the government and local groups consistent annual grants that Ugandans can decide how to spend.

Mr. O'Neill, the former chairman of Alcoa Inc., is trying to turn his considerable business acumen on the problem of poverty in the developing world. President Bush's announced plan to increase foreign aid during three years has heightened the pressure on the secretary to find out what works and what doesn't. During the next few months, the administration plans to complete a list of criteria by which the new aid -- if approved by Congress -- will be distributed. In general, the administration plans to reward governments that it views as democratic, honest and committed to health and education.

Even Mr. O'Neill's critics praise him for training a spotlight on the notion that development agencies should have to prove that their projects actually work, that aid to education teaches children needed skills, that medical programs make people healthier. The World Bank -- Mr. O'Neill's favorite target -- has spent relatively little time assessing results. Sitting under a tree that serves as a classroom here for lack of indoor space, Mr. O'Neill promised a thoughtful approach to foreign aid. "This is not a problem that can be solved with a couple of silver bullets," he said. "If it was simple, it would have been solved long ago."

Still, he can't seem to stop suggesting quick fixes. A senior O'Neill aide said his boss is aware of the complexity of economic and social change, and is merely seeking "symbols of potential success."

But the presence of Bono has attracted carpet coverage of the O'Neill tour in the world's media. CNN, MTV and the camera crew for comic actor Chris Tucker, who joined the tour in Uganda, followed the secretary around Wakiso on Monday. Mr. O'Neill's off-the-cuff remarks are getting delivered to an unusually large audience. Activists worry the message has been that there are easy solutions to poverty, and that other people have been too caught up in their own greed, stupidity, or bureaucratic lethargy to notice them.

"What you're seeing is a guy who hasn't thought it all the way through yet," said Jamie Drummond, a Bono adviser and longtime advocate of greater debt relief.

Bono himself, pushing for more aid, is more optimistic. Mr. O'Neill "has the U.S. Treasury staff behind him to convert his instincts into policies," Bono said after leaving Wakiso. "If it stopped here, I would be worried."

Last week in Soweto, South Africa, the impoverished black township outside Johannesburg, Mr. O'Neill visited a clinic that treats pregnant mothers to prevent them from passing HIV to their newborns. The mothers get no treatment of their own for the disease. "If you just sit and talk for an hour with these wonderful people and hold their children, no one can say, 'No,' " Mr. O'Neill told the mothers. "So we need to say, 'Yes.' "

But his suggestion that such treatment could be paid for by using money earmarked for prevention alarmed activists. "I think it's dangerous to talk about treatment versus prevention," said Daniel Mullins, regional HIV/AIDS coordinator for Oxfam in Pretoria. Then in Uganda, Mr. O'Neill seemed to soften his position. Massive government-led education efforts here reduced HIV prevalence. One in 10 patients in a Kampala prenatal clinic now carries the virus compared with one in three a decade ago.

In Ghana last week, Mr. O'Neill toured a market where he saw stalls filled with small, irregular tomatoes. Ghanaians, he suggested, should use imported hybrid seeds that produce larger fruit. But his staff acknowledged they don't know much about Ghanaian agriculture. Many Third World farmers use local varieties of crops because they resist droughts or pests.

Clean water is one theme Mr. O'Neill has stressed repeatedly. In Ghana, he visited a 380-bed hospital with no running water. In Wakiso, he was impressed by a protected well that was cheap to build, and asserted that $25 million would provide clean water for everyone in the country. "It sounds to me like the clean water problem could be solved ... in less than a year," he announced. By contrast, he says, "most of the World Bank money is going to big-city projects."

The World Bank provides $150 million in bargain-rate loans directly to the Ugandan government for use in water, education and health programs. The bank doesn't tell the Ugandans where to dig wells; instead, it requires service improvement and local organization to ensure that projects don't collapse for lack of maintenance. "It's one thing to drill a bore hole," said Robert Blake, the bank's resident representative in Kampala. "But it's another to maintain it over time and make sure the bore hole is still producing safe water five years from now."

Antipoverty advocates hope Mr. O'Neill will awaken to such complexity before he decides how to distribute the new U.S. aid money. Development "is a really complicated process, to be fair," said Oxfam's Ms. Naggaga. "At least he's coming out here."

Write to Michael M. Phillips at michael.phillips@wsj.com

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