This year marks the 25th anniversary of 9/11, a moment to pause and solemnly reflect upon all that happened that day—and all that has happened ever since.

I was a Member of Congress in September 2001. I can still picture sitting in a subcommittee hearing when a young staffer came forward and said softly to Chairman Bob Barr, “A second plane just hit the World Trade Center…” Later that day, I was one of those who stood on the steps of the Capitol and sang, “God Bless America.” In the days and weeks that followed, I travelled with others to survey the awful scenes at the Pentagon and Ground Zero.

When I think back to that dark chapter, however, my memories don’t begin with that Tuesday morning in September. They begin days earlier in a place about as different from New York City and Washington, DC, as one can imagine: Kaukauna, Wisconsin.

Before violent extremists would turn commercial airliners into weapons of terror that would strike the World Trade Center and the Pentagon, before a handful of heroic Americans would force one of those planes away from its intended target of the US Capitol, President George W. Bush traveled to my Northeast Wisconsin congressional district to help celebrate Labor Day and the opening of a newly constructed Council of Carpenters Training Center.

I can still see him strapping on a carpenter’s apron and hanging drywall for the assembled crowd. He was cracking jokes, shaking hands, and the cameras were rolling. I also remember clearly the drive we had together back to the airport and Air Force One. It was my first one-on-one time with the first-year president, and after a few observations from the event we had just attended, I asked him for the issues he hoped to prioritize and tackle.

“Well, Green,” he answered in a jovial tone, “I want to work on energy and education. I want to get the economy moving, and take on immigration reform. . .” He went on to tick off an impressive list of other items. As I look back on that conversation, what I now find most striking is that all of the issues he mentioned were domestic.

Eight days later was 9/11.

Later that fall, I would speak with the President again, when I was part of a small group meeting with him at the White House. When it was my turn to shake hands, I asked if he recalled our drive together near Kaukauna and all the issues we discussed. He paused, looked me in the eye, and shook his head. “Blown clear out of the water,” he said softly.

President Bush didn’t plan on being a wartime president. He didn’t plan on being a president who would dramatically reshape our tools of soft power. On the contrary, he was a conservative governor from Texas. He had a natural skepticism of foreign assistance and, in particular, institutions like USAID.

Not so long after the attacks of 9/11, New York Mayor Rudy Giuliani was asked by a reporter to comment on how much the world had changed on 9/11. He softly pushed back. “The world didn’t change that day,” he said, “it’s just that we understand it a little better.”

Perhaps driven by that “better understanding” of the world, led by President Bush and with bipartisan support in Congress, America created programs that quite literally changed the course of human history in many parts of the developing world. The President’s Emergency Plan for AIDS Relief (PEPFAR), the Millennium Challenge Corporation, the President’s Malaria Initiative, the Global Fund to Fight AIDS, Tuberculosis, and Malaria, and other key initiatives were all created after Al Qaeda struck New York and Washington, DC. Of course, Leaders across Europe responded as well with boosted support for global health and poverty relief programs, and in particular, support of multilateral institutions like the World Health Organization and the Global Fund.

While some from the Bush White House have pointed out that internal conversations on the HIV/AIDS epidemic in Africa began well before 9/11, fears of a growing terrorist threat gave political momentum to tackling what the President sometimes called the “drivers of despair” in parts of the developing world. In my work on the House International Relations Committee (as we called it in those days), I often said, “while poverty doesn’t cause terrorism, abject poverty, left unaddressed, can lead to despair. And despair is a condition bad guys know how to exploit.”

Less than six years after 9/11, I was asked by President Bush to serve as the US Ambassador to Tanzania. The role not only gave me the extraordinary honor of serving as the voice of the American people in that beautiful country, but it provided the opportunity that few policymakers ever receive. Since Tanzania was home to the largest Millennium Challenge Corporation program as well as one of the largest PEPFAR programs, I was able to oversee some of the very programs I helped author and enact while in Congress. I went from reading words on a page to seeing medicine, power generation, and more actually become reality for people in need.

In the final year of his presidency, President Bush visited Tanzania. I was at his side when President Kikwete leaned over and said that many Tanzanians would not be alive “if not for PEPFAR.” I saw President Bush get misty eyed after he met —and embraced— a young HIV positive mother holding her baby in a clinic waiting room.

9/11 was a terrible moment in American history. I’ll never forget the rubble at Ground Zero or the giant gash in the Pentagon. The thousands of innocent lives lost or the pain in the eyes of their loved ones. But I’ll also remember American resilience and resolve…from the courage of our first responders to the innovative global health and development programs that brought hope to lands that had been left behind or left out… lands that extremists hoped to move into their column.

Twenty-five years on, Americans can be forgiven if they sometimes tire of the “burden of leadership” that our country is often called upon to carry. But based upon what I saw that day, and all that I’ve seen and felt ever since, I’m certain of this: the world doesn’t get better —it doesn’t become safer— if America steps back.

ONE Stubborn Thing: In 2008, 59 countries were involved in one or more external conflicts. In 2025, that number had risen to 103.

As IMF Managing Director Kristalina Georgieva puts it, we are living in “an increasingly shock-prone world.” Weather disasters seem to be occurring with greater and greater frequency. Infectious disease outbreaks —from COVID-19 to various strains of hemorrhagic fever— are straining public health systems.

And then there is war…

For 20 consecutive years, the non-partisan Institute for Economics and Peace (IEP) has published an annual report of its Global Peace Index (GPI) ranking “163 independent states and territories according to their peacefulness” as measured by “23 qualitative and quantitative indicators.” The purpose of the IEP and its index is “identifying and measuring the factors that drive peace.”

Many of the 2026 report’s top line takeaways come, sadly, as little surprise. The current number of state-based conflicts is greater than at anytime since World War II. Worldwide military spending is up for the tenth straight year, and the total number of conflict-driven deaths has reached its second highest level in at least two decades.

But the shock, to use Ms. Georgieva’s term, may lie in something beyond those numbers. The IEP finds that it’s not merely the overall number of conflicts that is increasing, but their complexity and scope as well. Many of the world’s conflicts are becoming, in essence, gathering storms. The number of outside parties adding fuel to each of these conflicts is rising —as well as the number of countries bearing their brunt.

The IEP sees the world’s geopolitical landscape as increasingly shaped by “conflict clusters.” There are eight such clusters in the world right now, and nearly all of the 103 countries involved in external conflict are part of at least one of those clusters with “people, weapons, and money” regularly moving across borders. Unsurprisingly, the fighting across the Horn of Africa is characterized as the most notable —and brutal— such conflict cluster. In IEP’s words, “The Horn of Africa is no longer a set of separate conflicts. The conflicts in Sudan, Ethiopia, Eritrea, South Sudan and Somalia are now interlocked through every channel, causing the conflicts to spread.”

Sudan, whose civil war in many ways anchors this cluster, is ranked near the bottom in “peacefulness” (162nd of 163 countries) per the GPI. As neighboring countries —South Sudan (158th on the GPI), Somalia (153rd), Ethiopia (138th), and Eritrea (128th)— are drawn into the cluster through the movement of weapons and people across their territory, Sudan’s conflict becomes only more intense, costly, and complex. The accelerant for the cluster is the fuel of external actors supporting competing factions, including China, Russia, Iran, Egypt, the United Arab Emirates, Chad, and Libya. The theater of conflict is expanding—and so is the theater of external contributors.

Why does this matter?

For one thing, as more parties are drawn into the conflict —either as part of the battlefield or contributors to the combatants— more will obviously need to be part of its eventual resolution. Each of these parties may have its own interests and make its own calculations as to what constitutes a satisfactory outcome.

For another, as a cluster grows, so does its fallout in very real, very human terms. This is a part of the world that has long had huge humanitarian needs… all made worse by the spreading conflict. But the conflict has profound development implications as well. The IEP estimates that conflict reduced the world’s overall GDP by more than 10 percent in 2025, and the 10 countries most affected by conflict experienced an average GDP reduction of 23 percent. Unsurprisingly, a number of these countries are in the Horn of Africa.

Communities in the Horn are experiencing delays, if not reversals, in their economic development, and people there are becoming more vulnerable to poverty and despair. Even some countries not technically within the cluster —countries like Kenya and Uganda— are being impacted by its collateral consequences, such as a rapid influx of displaced families seeking a haven from the fighting and fallout.

Africa is a land of remarkable promise and boundless hope. And yet, its rise could be slowed by the costs of Ms. Georgieva’s shock-prone world —costs either not of their making (fighting in the Middle East) or made worse by what external actors are bringing to fight. The IEP’s 2026 report serves as a warning: at a time when Africa’s horizon of opportunity should be quickly approaching, in some places, the gathering storm of widening conflict threatens to push it further and further away.

ONE Stubborn Thing: Of the 20 countries with the greatest incidence of child mortality, all are in Africa.

Just after sundown, on our very first day in the little Kenyan village where Sue and I taught school, Thomas, the school’s headmaster, picked me up in his old white Toyota. As we drove over the bumpy mud roads of the surrounding hills, he softly told me there was something he wanted me to see.

There was little electricity in our settlement in those days, so the only light helping our headlights find the way came from the moon and stars of the clear African skies. We eventually reached a clearing where a crowd of people, mostly dressed in white, was gathering. The kerosene lamps and small cooking fires in and around the open area gave it almost a theatrical look.

We pulled the car slowly to one side, quietly got out, and began walking towards the crowd. As we got closer, I could hear an eerie moaning sound drifting upwards from the gathering…a sound I’ll never forget, but one that I would hear more than once in the months that followed. Not crying or screaming, but wailing…a melodic pouring out of sadness, grief, and despair. Some were hugging each other. Some were hugging themselves and slowly rocking from side to side.

As we got near the front, I saw what had drawn so many villagers from their homes that evening—the bodies of two small children, wrapped in white sheets, lying on a single bed-like platform. There was a woman seated on a small stool just in front of them, and several other women rested their hands on her shoulders. The wailing continued, while some softly sang.

We stood there quietly for a few moments, and then Thomas stepped forward and put some money in a small basket placed off to one side. After he returned to my side, he nodded to me, and we slowly returned to our car.

As we drove back home, Thomas said, “Mwalimu (teacher), I wanted you to see this.” He went on to say the gathering was a remembrance ceremony for one year-old twin boys who had just died after several days of illness. “What was it?” I asked, seeking clarity on the illness. He shrugged his shoulders, and said, “They died because they were poor.”

I’ve never forgotten that moment.

There are lots of reasons why donor nations dedicate the largest part of their foreign assistance towards global health. There are lots of reasons why Africa receives the largest part of that support.

The Trump Administration’s America First Global Health Strategy (AFGHS) asserts its support for global health is part of making the U.S. “safer, stronger, and more prosperous.” They’re right. In the most obvious sense, investing in health infrastructure overseas is a way of preventing or containing outbreaks of terrible diseases like Ebola closer to their source. And since American private enterprise —from pharmaceutical research and production to innovative delivery mechanisms like San Francisco-based Zipline drones— is playing an increasingly important role in our global health initiatives, these funds foster new growth and investment opportunities for American business.

The Administration also emphasizes that our support for global health makes sense because it builds on proven success and things we’re good at. As the AFGHS states, “Over the last 25 years, the United States global health programs have…saved over 26 million lives through the President’s Emergency Plan for AIDS Relief (PEPFAR) and millions of additional lives through other global health programs, [and] prevented 7.8 million babies from being born with HIV/AIDS.”

But there are countless other reasons to support generous funding for global health programs. Some are economic: businesses in the developing world need a healthy workforce to be productive partners in trade and economic growth. Some are strategic: helping partner governments attack “drivers of despair” can help stabilize countries and reduce sources of conflict.

Many of us are simply moved by conscience and calling. Mike Gerson, who served in the Bush White House as PEPFAR was being created and later served as a Policy Fellow with ONE, used to say that our assistance overseas is “good for our soul.”

In my case, it’s even more personal than that. It goes back to a small village in Africa. I will never forget what I saw and heard that first night in Kenya. Bono is right: where children live shouldn’t determine whether they live.

ONE Stubborn Thing + a Moment of Clarity: At the 2026 International AIDS Conference, attendees learned that HIV-related deaths in Africa fell below 400,000 in 2024. They also learned that the dismantling of global health budgets and institutions by the U.S. and Europe in 2025 had caused the closure of 1,700 AIDS health centers.

In my days as Ambassador to Tanzania (2007-09), I invited my parents to come and stay with us in Dar es Salaam. My dad, a practicing physician for more than fifty years, joined me and a small number of US and Tanzanian health officials in making home visits to families that had been ravaged by the scourge of HIV/AIDS that still burned bright in many parts of the country.

Our purpose was to check on those families, bring some basic food and medicine, and generally help them realize that they hadn’t been entirely abandoned or forgotten.

One of our stops was a rickety structure on the outskirts of town. It looked more like an abandoned farm shed than a place where human beings could live. There were no windows, but a few rays of sunlight reached in through holes in the walls. The floor was dirt.

As we entered the house, and after our eyes adjusted to the darkness, we saw an old lady, and wearing threadbare clothes, sitting on an old crate. She was a little overwhelmed by our visit, even though she knew we were coming, but she seemed to relax as we opened our boxes of food. A few of her children, dressed in tattered shorts and shirts, stood by, eyeing us carefully.

The poor woman’s breathing was labored and noisy as she sat on that old crate, but she wanted to talk. Through a translator, and little emotion, she told us that her husband and one child were already dead from AIDS and, as Dad would later confirm, she was in the homestretch herself. She went on to explain that she was once a successful businesswoman, but now she was down to her final shillings.

Through that translator, and with little emotion, she said to me, “Ambassador, I have a question.” She was looking off into the distance as she spoke. “With this last little money, should I buy books for my children who are healthy or medicine for the ones who are not?”

She wasn’t asking her question for effect… it was a sincere question from a woman deflated by life’s challenges. And, of course, I had no answer. None.

As Dad and I quietly walked back to our car, he said to me, “Mark, can’t the government do something?”

“Dad,” I answered, “There’s no Medicaid here or disability or welfare. If we don’t do this, it won’t happen. That’s the simple truth.”

It’s never been about the numbers.

Note: A version of this essay ran on the blog in February 2026.

ONE STUBBORN THING: Aid to the Church in Need has concluded that 2025 saw “grave violations of religious freedom” in some 62 countries, affecting over 5.4 billion people—nearly two-thirds of humanity.

Ladies and gentlemen, we’ve come a long way since Ambassador Sam Brownback hosted the first State Department Ministerial on Religious Freedom back in 2018. Back then, I think it’s fair to say that Washington’s initial reaction was a stark blend of skepticism & criticism.

Few would attend, said the skeptics. Few should attend, said the critics.

But people responded by turning out in droves. All told, 130 nations and a range of faith traditions were represented. It became the largest human rights-related gathering ever hosted at the State Department.

And now the spirit of that ministerial lives on in these summits, and I’m sure the skeptics will wonder why. It’s pretty simple: we come together because we realize the need to protect religious liberty and the right to worship freely has never been more essential… or fragile.

The International Monetary Fund warns that we are living in an “increasingly shock prone world,” ranging from natural disasters to a growing number that are man-made and even regime driven.

We come together because in a shock prone world, the ability to pursue one’s faith can be a matter of survival—enabling us to hold onto our humanity in the face of a world that is too often inhumane.

The story of my friend and former colleague, John Thon Majok, makes this point all too well.

A few decades back, John Thon was one of the thousands of young people who survived Sudan’s second civil war —with all of its brutality & darkness— by walking barefoot to safety more than a thousand treacherous miles across battlefields and international borders.

The world would come to know him and his fellow refugees as the “Lost Boys.” John Thon openly says they only made it —across the miles and despite unthinkable obstacles— because of their faith.

“In our suffering,” he said, “we related to the Jews whose biblical account resembled ours.

“Although the children of Israel were exposed to oppression, tragedy of exodus, horrors of war, wandering in the wilderness, and the loss of loved ones, God did not abandon them.

“Just so,” he said, “our faith in God sustained us by giving us the needed strength to face adversity.”

In these uncertain times, when we sustain religious freedom, we protect the right to be sustained ourselves, but there’s still another reason why we gather.

The right to worship openly, the right for people and organizations to hold onto their faith character as they fulfill their purpose, enables us to unlock the vast power of a global faith network.

A network dedicated to lifting lives and strengthening communities. A network whose very purpose is to reach those who have been left behind or left out.

Its members seek not money, or glory, or even thanks. They seek only to answer the timeless call of some of history’s greatest teachers and texts.

In the Gospel of Luke, the crowds call out to John the Baptist asking, “What then shall we do?”

He answers by saying that whoever has two tunics should share with him who has none. Whoever has food should do the same.

The Rev. Billy Graham liked to put it simply and directly: “God has given us two hands, one to receive with and one to give with.”

St. John Paul the Great used to say, “Every generation […] needs to know that freedom consists not in doing what we like but in having the right to do what we ought.”

I sense a common theme here, don’t you?

Ancient Jewish sages wrote in the Talmudic texts that the world depends upon three things: Torah, the law; service to God and others; and acts of loving kindness.

Included in the sayings of the Prophet Muhammad is the following: “That man is not from me who sleeps contentedly while his neighbor sleeps hungry.”

Mahatma Gandhi told us, “The best way to find yourself is to lose yourself in the service of others.”

And the Dalai Lama has written, “It is under the greatest adversity that there exists the greatest potential for doing good, both for oneself and others.”

We defend the right to worship because it quietly reveals to each of us the fingerprints of God. The guidance we each need as we strive to keep our world from losing its moral bearings.

I have been blessed to meet a number of amazing people over the years who have surely found the fingerprints of God, like Maggie Gobran.

When I visited Cairo in 2019, I encountered the extraordinary work of a humble lady known to millions simply as “Mama Maggie.”

Guided by her Coptic Christian faith, she has dedicated her life to working in some of Cairo’s poorest slums, providing health care, education, and hope to vulnerable Christian and Muslim families alike.

She is especially known for her work with Cairo’s Zabbaleen people—whom many simply call the “garbage collectors.”

When I visited a small center where her team was teaching former street girls skills like sewing and weaving, instead of diplomatic niceties, she greeted me by washing my feet to emphasize her humility.

Mama Maggie’s faith calls her to find, and preserve, each and every person’s human dignity. Protecting religious freedom gives her the space to do so—to bring hope to people in the shadows.

Ladies and gentlemen, we are also gathered because, sadly, there are those who would seek to destroy religious freedom precisely because it offers hope. These forces are hope’s enemies.

In its most recent Religious Freedom in the World Report, Aid to the Church in Need (ACN) found that 2025 brought “grave violations of religious freedom” in some 62 countries, together affecting over 5.4 billion people, almost two-thirds of humanity.

ACN noted that, “Article 18 of the Universal Declaration of Human Rights may enshrine freedom of thought, conscience, and religion… [but that] fundamental right is not [only] under pressure, it is increasingly disappearing.”

A recent UN report found that armed groups were committing “grave human rights violations” against Muslim communities in the Central African Republic, including summary executions and widespread sexual violence.

A Vatican report has reported on a resurgence in attacks by Islamic State-aligned forces in Mozambique’s Cabo Delgado Province. Churches have been set on fire, and priests and nuns and church workers have been forced to flee.

There are simply too many examples, too many violations against the faithful to begin to cover them here today. And of course, religious intolerance is hardly confined to Africa and the Middle East.

The old scourge of anti-Semitism seems to be once again rearing its ugly head in Europe and the US. Violence and threats of violence against Muslims in the US is on the rise as well.

The group I help lead, ONE, gets its name because as one of our founders put it, “we just need one thing to agree on in order to work together.”

Today, surely, we have one of those points of agreement—the right of people around the world to worship freely. And with it, the right to unlock the power of the faith community to help the most vulnerable among us.

One thing… one powerful thing.

In many ways, Morocco is the perfect place for today’s summit. It’s a beautiful country with warm, hospitable people. But also, because its history contains many touch points in religious freedom.

Eighty-five years ago, during those days when Morocco was but a protectorate and Mohammed V served as sultan, the Nazi-aligned government in France imposed a sweeping series of anti-Semitic laws upon this beautiful land.

But the sultan courageously pushed back. He famously said to French authorities, “There are no Jews in Morocco. There are only Moroccan subjects!”

His words back then gave hope to so many, and they live on in the reign of his grandson, King Mohammed VI, our host.

It’s often said that the greatest measure of one’s devotion to religious liberty is the willingness to defend it for those of other faiths. The king, through his hospitality and policies, and his grandfather, through his resistance, are making Morocco’s devotion clear.

It’s true that we live in an uncertain world, a chaotic world, a noisy world. There are countless demands on our time, our attention, and yes, our resources.

But religious freedom and the right to worship help us in our precious few quiet moments to reflect upon what we have been given and what we owe.

Religious freedom helps us to hear that call from John the Baptist, and others. The call to “share a tunic with him who has none.”

One Stubborn Thing: In 2003, China was the largest trading partner for 18 African countries. It’s now the top partner for 52.

Trade between Africa and China has been growing steadily for more than two decades. In 2023 alone, according to Johns Hopkins’s China-Africa Research Institute, it grew by nearly 18 percent, rising to almost $350 billion. With Beijing’s extension of tariff free access for 53 of 54 African nations now taking effect, China-Africa trade will likely grow even faster in coming months.

But the significance of those growing trade ties goes well beyond dollars and cents —and yuan.

In my time as a teacher in a small African village, I relished my weekly trips to the nearby open market or soko. Walking through a sea of grass mats, where villagers (usually old women) were hawking pyramids of vegetables, piles of various spices, mounds of dried fish, and more, I loved the sites and sounds and smells.

But what made these visits so memorable wasn’t merely the goods being offered: it was the human interactions at the heart of that marketplace. Buyers, sellers — even “mzungus” (white people) like me-- were communicating with each other in the most basic and human of ways. When I stopped in front of an individual mat that caught my eye, a ritual began that would be repeated by others over and over in every corner of the soko, and every soko in the land.

Marshaling (and butchering) my best kiswahili, I’d ask “mama” how much she wanted for those tomatoes. She would come in way too high —we both knew it — and I would chuckle and she’d break into a smile. When I gently pushed back, she would talk about the exceptional quality of those tomatoes or the costs and hardships that she faced in her shamba (gardens). We slowly and smoothly reached an agreement on price. I’d been in the area long enough to know the right way to close the deal. Switching to her mother tongue of kiluhya, I’d ask her if she could please, please add just a little bit more to her offering. She’d slowly shake her head in laughter (after all, I am an mzungu), and then add in another tomato. The deal was done.

Neither of us had won or lost. The transaction didn’t necessarily make us best friends —or even friends at all— but it did bind us together in an important, yet unspoken way. Each of us was glad the other had been there, and each of us was satisfied that a need had been met. In all of my trips to that soko, I never once saw a buyer and seller end up in a fight. I rarely even heard a harsh word or raised voice.

The legion of policymakers who waved the banner of “trade not aid” in 2025 got many things wrong about what the dismantling of development programs would mean in terms of hunger, illness, and weaker economic growth. But the need to accelerate the transition to private enterprise-centered policies wasn’t wrong.

If I had simply walked through the soko each week handing out large sums of cash, or if I had avoided the marketplace altogether and had my food shipped in from elsewhere, I would have weakened the sense of community and shared humanity that made the soko the centerpiece of village life. My neighbors would likely have grown to resent my money, my presence and the message of superiority that such activities would have sent, intentionally or not.

America needs to expand true, meaningful trade relationships for a wide range of reasons. Trade helps us grow, and exports to far off lands support good paying jobs back here at home. After all, 95 percent of the world’s population lives outside the United States, and many of them are potential consumers for what our farmers grow and for what our companies make.

But broad trade relationships also matter because they softly bind countries together in ways we often take for granted. Trade deals don’t always turn enemies into allies or strangers into friends, but they can build trust and respect. Just like that old woman in the market, we can each be glad of the role the other played in supporting order and stability, commerce and economic growth.

For years, when western policymakers complained that China was striking deal after deal in Africa, many leaders on the continent were dismissive, saying they knew full well what they were getting through their transactions with Beijing. But as China expands its diplomatic presence across the continent (it’s now larger than America’s) and takes steps like granting tariff-free access for nearly every African country, it’s increasingly clear that, like that old woman in the market, they are glad China is there and Beijing is only too pleased to play its part.

Trade deals are more than transactions. Done well, the parties aren’t mere vendors and buyers, but respectful economic collaborators. This approach has been at the heart of America’s longstanding global leadership.

These days, 52 of 54 African countries have China as their largest trading partner. What’s our next move?

ONE Stubborn Thing: On average, 500 nurses leave Ghana each month to work in the West.

About twenty years ago, the World Health Organization (WHO) found that while African countries face about one-quarter of the world’s disease burden, they only have about three percent of the world’s health care workers. Unfortunately, things haven’t improved very much since then.

According to the WHO health workforce support and safeguards list 2023, some 55 countries have significant health staffing shortages—by the numbers, that means fewer than the median of 49 health workers per 10,000 people. Forty of those countries are in Africa. In other words, roughly 80% of Africa is experiencing medical staff shortages and high rates of healthcare professionals leaving to work in other countries.

Unfortunately, high rates of healthcare professionals leaving the continent is neither a new phenomenon, nor limited to Ghana. Egypt’s former health minister recently lamented that 65% of Egyptian doctors are working abroad, and a report from the UK’s House of Commons found that more than 3,000 Ghanaian health professionals had left that country for the United Kingdom from 2018 to 2021. At least 9,000 doctors left Nigeria to work in the UK, United States, and Canada from 2016 to 2018. And, when looking at 2015 data, the WHO found that Liberia had a mere 51 doctors for a population of 4.5 million, and Sierra Leone only had 136 doctors for 6 million people, making the doctor-to-population rate 0.1 and 0.2 per 1,000 people respectively.

One reason for the mass exodus is recruitment campaigns by Western countries targeting healthcare professionals from low-income countries, a practice that has only grown in the aftermath of the COVID-19 pandemic. When the WHO health workforce list came out, the UK updated its code of practice for international healthcare recruitment, announcing it would stop recruiting from “red list” countries without government-to-government agreements in place for a more managed approach.

The harsh reality is that even if every wealthy nation followed the UK’s lead and ceased recruiting healthcare workers from lower income ones without meeting specific conditions—or even took it further—the problem is unlikely to go away anytime soon. Low government funding for healthcare, as well as poor pay and working conditions are the main reasons that many healthcare professionals look for work elsewhere. A typical nursing salary in Ghana is roughly $150-300 a month, many aren’t paid regularly, and working conditions are, to put it mildly, less than optimal. “I couldn’t afford many basics. Nurses suffer low and sometimes delayed salaries. Sometimes you don’t have some basic things like gloves to work with but in the UK, things are totally different,” one nurse who left for the UK after working for seven years in Ghana’s Korle-Bu Teaching Hospital told The Africa Report. The average doctor’s salary in Egypt is $120 a month—in Saudi Arabia, they can earn $2,140 on average, with more experienced doctors earning close to $6k a month.

In 2001, countries within the African Union pledged to allocate at least 15 percent of their annual budgets to improving healthcare conditions in their countries. Unfortunately, ten years on, only Mauritius, Seychelles, and Eritrea had met that target. An example of how far off some countries remain: in 2022, only 3.9% of the Nigerian budget was allocated to healthcare.

The Trump Administration has undertaken an ambitious redesign of its approach to global health called the America First Global Health Strategy (AFGHS). The foundation of AFGHS are its bilateral health compacts with partner countries —essentially joint ventures between the US and its partners aimed at building their commitment and capacity to fully “own” their public health systems. While each compact varies, most feature investments in biotech and innovation.

As the Administration looks to build on its approach and investments, working with partners to tackle the “brain drain” of health care professionals —from doctors and nurses to lab workers— is essential. This will mean investments in higher education, incentives to stay in home countries, and so much more.

Africa is young and vibrant. Its rising youth generation is full of big dreams and great ideas. In many ways, these young people lead the world in their ability to adapt frugal technology in ways that lift lives and break down barriers of distance. Let’s invest in them—for their sake and ours!

“Facts are stubborn things; and whatever our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.” —John Adams

A NOTE TO READERS/SUBSCRIBERS: Thank you for being loyal readers to Stubborn Things. Stubborn Things began in 2022 as a way for me to elevate important truths, share modest insights on the world around us, and scratch my writing “itch.” I’ve really appreciated the feedback I’ve received and the ideas you’ve offered for new essay topics.

Earlier this year, I was honored to join the ONE Campaign as its global president and CEO. In my early days in Congress, ONE —and yes, Bono— played a key role in building the support for initiatives like debt relief, the President’s Emergency Plan for AIDS Relief (PEPFAR), and the Millennium Challenge Act (which created the MCC). It helped with the intellectual ammunition and political coalition building that made those and other important initiatives possible—I know, I was an assistant whip at the time.

Those initiatives changed the course of human history. They helped to lift millions of lives and build countless communities. But there are new challenges on the world stage today and new opportunities. ONE is as dedicated as ever to the causes that led to PEPFAR, MCC, and the Global Fund to Fight AIDS, TB and Malaria. And once again, there is an urgent need for clear thinking and smart analysis.

I want to do my part. That’s why I hope you’ll continue to read my work, share whatever you find useful with others, and subscribe (free of charge) if you haven’t already to “ONE Stubborn Thing.”

If there’s an ebb and flow to human events, then history’s pages seem to be turning a little more quickly these days. The pace of change we’re seeing is testing our ability to process what’s happening and to “make sense of it all.” That challenge is frequently made worse by political actors who, driven by the insatiable hunger of the 24-hour news cycle and social media tools with global reach, work to bend news narratives to serve their own interests.

Nowhere is that more true than with much of what we see —through both traditional and nontraditional media coverage— about Africa. Africa is the youngest continent in demographic terms, and while it has many challenges, there are also exciting developments and opportunities emerging there.

Sometimes it feels as though we’re simply treading water in a sea of misinformation and disinformation about Africa. But accurate numbers, objective accounts, precise images, etc., can pierce through the fog like a lighthouse well-lit. Some of these actualities not only stand for themselves, but they hint at broader truths that influencers and policymakers both in Africa and the West can use to help shape the future.

As Founding Father John Adams said two and a half centuries ago, “facts are stubborn things.” ONE Stubborn Thing is a modest attempt to elevate those stubborn things, ONE at a time.

Stubborn Thing: Seventy percent of African countries have never received an official US presidential visit.

When President Joe Biden visited Angola in December 2024, it was Angola’s first ever visit by a sitting US president. It would be his only presidential trip to Sub-Saharan Africa, and it came only after his reelection bid was over.

In contrast, when President Clinton visited Africa in 1998, he visited six African nations on a historic eleven-day swing across the continent. In 2008, President George W. Bush visited five nations in his trip to Africa His stop in Tanzania was both the first presidential visit to that country and the longest-ever presidential visit to any African country (parts of four days).

But what African leaders may remember most is that seventy percent of African countries have never received an official visit by a US president. Not Côte d'Ivoire, the world’s largest exporter of cocoa beans. Not the Democratic Republic of Congo, which holds the world's largest cobalt reserves or Guinea, which holds one of the world’s largest bauxite reserves. Not Zimbabwe, which holds the world’s second largest platinum reserves and its sixth largest lithium reserves, or Namibia, one of the world's largest uranium producers. Not even Djibouti, which hosts America’s largest permanent military base in Africa and is strategically located at the mouth of the Red Sea.

By 2050, 1 in 4 people in the world will be African —including 1 in 3 working adults. According to the IMF, by some measures, 4 of the world’s fastest growing economies are in Africa, and that trend will broadly continue in the decades ahead.

So the irony is that even as Africa rises in its economic importance, we seem to be dedicating less in the way of high-level diplomatic resources there. In recent Stubborn Things, I’ve noted that the leaders of France, Turkey, and China are increasing their visits to Africa and their engagements with African leaders.

When Clinton and Bush made their presidential trips to Africa, they were front page news. Wouldn’t it be nice to get to a time when they aren’t?

A Zipline Drone Takes Off in Kisumu Kenya

Stubborn Thing: Africa has a space agency.

Space exploration is making news again. NASA is basking in the glow of its Artemis II success, and has reaffirmed plans for, first, a permanent base on the moon and, second, a manned mission to Mars. Elon Musk’s SpaceX has carried out multiple to-space-and-back missions, and pledged itself to the “ultimate goal of enabling people to live on other planets.” Jeff Bezos’s Blue Origin, with its New Shepherd rockets, has carried nearly a hundred high profile “space tourists,” ranging in age from 18 to 90, to the edge of space. China has secured its place among the world’s top space powers with its “Long March” rockets, Shenzhou crewed spacecraft, and Tiangong space station.

But while all of these developments have rightly captured the public’s attention and imagination, another space program is making rapid progress on a path that, while not immediately extending mankind’s reach upward into the heavens, is quietly bringing the fruits of that reach to hundreds of millions of people back on earth.

 Africa has a space agency. And just as African entrepreneurs have led the world in finding smart, cost-effective, and innovative applications of frugal technologies like civilian drones, 3-D printing, and smart phone apps to improve lives and livelihoods in rural communities across the continent, African space entrepreneurs are doing the same with space technologies. (You can read my previous Stubborn Thing on the subject here.)

CONTINENT-WIDE COORDINATION

The African Union Assembly formally adopted its African Space Policy and Strategy in 2016 in an effort to help coordinate the many space-related initiatives that were springing up in parts of the continent. By early 2025, African Union (AU) leaders moved to formally establish the African Space Agency (ASA) and place its permanent headquarters in Cairo.  

They built the ASA around three broad purposes: continent-wide coordination of space activities, maintaining strategic autonomy from other space powers, and establishing a unified regulatory framework that would welcome private investment. The ASA’s governance rests with both elected scientific advisors and political representatives from  AU’s member states. The overriding objective in all of the ASA’s policies and practices is to reduce unnecessary duplication of resources and efforts among African states.

AFRICA’S SPACE INVESTMENTS ARE PICKING UP SPEED

Africa’s moves in space aren’t simply the “paper exercise” of establishing the ASA. Already,19 African nations have launched 69 satellites into space, and according to the ASA, another 120 are slated for launch by 2030. To keep this pipeline going, the Egypt-based African Development Satellite Initiative (AfDev-Sat) has trained more than 70 engineers from across the continent on designing and assembling satellites.

The ASA is working to coordinate how space resources —in particular, satellites and satellite data— are applied to development challenges in environmental and disaster management, agricultural and food insecurity, communication services for rural communities, the extension of education and health care to rural areas, and conflict mapping and mitigation.

The early results are encouraging. For example, thanks to African space programs:

• Farmers are able to receive by SMS/text message satellite-driven  weather forecasts accurate down to an acre. Agricultural leaders are turning to satellite data to significantly strengthen the accuracy and timeliness of early warning systems for extreme weather.

• Satellites are helping authorities monitor deforestation, predict breeding sites for locust swarms, and map out optimal locations for water wells and sites for extracting oil and critical minerals.

• Law enforcement officials are using satellites to detect illegal mining, monitor territorial waters for illegal fishing, and conduct border surveillance.

• Private internet providers are using satellites to expand the reach of broadband in rural areas and help students and teachers access online learning platforms.

• Public officials are turning to satellite-based technology to bring telemedicine services to remote communities and link remote health centers with health care specialists.

CONCLUSION

President George W. Bush used to speak of the “soft bigotry of low expectations” that causes people to be left out of important conversations and opportunities. In some ways, it’s that soft bigotry that has kept African leaders —both public and private sector— from being included in the global push to explore and better understand outer space. But while most of the world is focused on the headline-grabbing accomplishments of the biggest space powers, Africa’s space industry is rapidly producing space breakthroughs that create real-world benefits for real-world people. In a very real sense, we have much to learn from their ingenuity. While we look to the heavens, they bring the heavens to earth.

Stubborn Thing: Türkiye’s President Erdogan has made more than 50 visits to 30 different African countries.

When high level US officials announce plans for an Africa trip, I’m often asked by the media for my reaction. I always begin the same way: “I’m looking forward to the day when these trips are so frequent, so regular,  they’re no longer news.”

President Biden didn’t visit Sub-Saharan Africa until after Election Day in 2024. Kamala Harris traveled just once to Africa as vice president, visiting Ghana, Tanzania, and Zambia in 2023. President Trump didn’t travel to Africa in his first term, though he has already made one trip, to Egypt, in his second. Egypt is also where Mike Pence made his only visit to Africa as vice president.

Türkiye’s engagement with Africa has been strikingly different.

Recep Tayyip Erdoğan, in his time as prime minister (2003-14) and now as president, has made more than 50 visits to 30 different African countries throughout the continent. He has made trips to oil and gas producers like Nigeria, Angola, and Senegal (five times). He has visited countries with large critical mineral and precious metals reserves like South Africa, the Democratic Republic of Congo, and Guinea (Bauxite). He has visited countries that are major customers for his country’s technology, like Ethiopia and Algeria.

President Erdogan’s intentions are refreshingly clear. As noted in an Al Jazeera analysis a few years back, Türkiye is seeking “to increase its influence in the continent by using every channel of diplomacy, trade, investment, education, health, security and military cooperation along with soft power tools like culture and history.”

Türkiye’s outreach to Africa has gone well beyond President Erdogan’s visits. During the COVID pandemic, Ankara pledged 15 million vaccine doses to the continent.  Türkiye’s Cooperation and Coordination Agency (TIKA) has already carried out an estimated 2,000 infrastructure projects across Africa. The country has established at least 37 military affairs offices on the continent, and launched more than 20 cultural centers (Yunus Emre Institutes) and 200 schools (Maarif Foundation schools) that offer language training and cultural activities.

In the years since Erdogan first became prime minister, the number of their embassies in Africa has grown from 12 to 44, and Ankara says it has plans for seven more. Since 2003, trade volume between Türkiye and Sub-Saharan Africa has risen from $5.4 billion to roughly $50 billion in 2025 —and Ankara has vowed to reach $75 billion in the next several years. There are reportedly at least 48 Türkiye — Africa Business Councils on the continent.

At a time when the West seems to be paying less attention to Africa, Türkiye is clearly paying more. What do they see that we apparently do not?

Stubborn Thing: Each year, Kenya spends $1 billion just to service its debt to China for a railway project that is still hundreds of kilometers short of its intended destination.

A quarter century ago, the “Drop the Debt” movement brought together a broad coalition of leaders —Pope John Paul II to Billy Graham, Bill Clinton to Tony Blair, Muhammad Ali to Bono (or as Clinton dubbed it, the “Pope to the Pop Star”) —to demand debt forgiveness for many of the world’s poorest countries. Part of the broader Jubilee 2000 campaign, the logic of the cause was simple and compelling: foreign debt in many of these countries had risen so high that it was threatening their ability to meet the basic needs of citizens.

The movement helped produce impressive results. More than three dozen countries received significant debt relief, and some of the poorest —like Sierra Leone, Liberia, and Malawi— saw nearly all of their external debt cancelled. Just as importantly, the debt relief was provided conditionally: in order for countries to see significant portions of their debt forgiven, the “savings” had to go towards health, education, and other essential public services.

Back Against…and Bigger Than Ever

Sadly, just twenty five years later, public debt levels are soaring once again. In Africa, reports the New York Times, total foreign debt has surpassed $1.1 trillion—many times higher than the days of Jubilee 2000. And that debt has been made even more painful by a series of economic shocks that have hindered economic growth and fed inflation…shocks like the fallout from COVID-19 and disruptions in fuel and fertilizer caused by war in Ukraine (and, now, the Middle East). According to global think tank ODI Global, Africa’s median public debt is approaching 60 percent of GDP.

All of which means that leaders in high-debt nations are once again facing painful choices as they struggle to simultaneously provide basic services, invest in job growth for their young citizenry AND service their debt obligations. In 2024, Kenya’s William Ruto tried to meet the challenges of a multibillion dollar debt to China by through a package of modest spending cuts and tax increases. Huge crowds (many of them young people) took to the streets and, at one point, the parliament building. They essentially brought their country to a halt. Ruto quickly withdrew his fiscal package, but officials have already made plans to reintroduce some of the measures in an effort to stave off default and late payment fees.

While China is far from the only creditor for most high debt nations, it is easily the largest public creditor. Beijing holds over 70 percent of Kenya’s foreign debt and over 80 percent of Nigeria’s.

Each year, Kenya spends $1 billion just to service its debt to China for a yet-to-be-completed railway project that was to link the port city of Mombasa with Kisumu on Lake Victoria and, eventually, the Ugandan border. While the dream of linking Mombasa to Lake Victoria and Central Africa has always been alluring, the reality to date has been deeply disappointing. The railway project has been over budget and behind schedule, and ridership revenues for the completed portion have done little to offset costs (though officials argue that will change once Kisumu is connected).

In other words, at a time when citizens are grappling with unemployment and inflation, the government finds itself forced to pay off the lingering costs for a project the public believes has already failed. And Beijing has shown little interest in helping out with debt forgiveness for Kenya —or anywhere else.

The Role of Debt Relief: An Essential “Grand Gesture”

PEPFAR (the President’s Emergency Plan for AIDS Relief) is rightly regarded as the most successful international development program since the Marshall Plan. As one of those who helped to secure its passage through Congress, I wonder if we could have been successful without the enactment of debt relief —and the global movement which forced it onto the agenda of donor nations. As debt relief became a reality, PEPFAR was created…so too the Millennium Challenge Corporation and other key initiatives. World leaders instinctively understood that if poor nations were to have any hope of tackling poverty, conquering terrible diseases, or providing education and opportunity for their citizens, then easing the crushing debt burden many countries faced was a necessary first step

Just as we were a quarter century ago, many leaders are talking about a new approach to international development. But can a new approach succeed —can any approach succeed— when many leaders in the developing world are feeling the weight of massive external debt? Are creditors, especially China, prepared to make the kind of grand gestures that helped make so much possible twenty-five years ago?

In 2000, when he signed legislation that forgave $435 million of US-held  public debt, President Clinton proclaimed his belief that the move would “put our country squarely on the side of humanity for a very, very long time.” Are others ready to join humanity’s side these days?

Stubborn Thing: Under its recently finalized health compact with the US, Nigeria will receive $2.1 billion in assistance over 5 years. At the same time, Nigeria’s bilateral debt with China stands at approximately $5.2 billion and its debt with the World Bank is $18.7 billion.

America has traditionally provided foreign assistance for a range of reasons.

National security. Done right, foreign assistance can advance our national security interests by, among other things, strengthening stability in fragile states and at-risk regions.

Economic security. Assistance can be used to improve the enabling environment for US trade and investment, and expand overseas markets for US goods and services.

Reaffirming American values. Assistance —especially our humanitarian assistance— also serves as the embodiment of our values and generosity. Michael Gerson, the late presidential speech writer and columnist, liked to say that helping others in need overseas was “good for our soul.”

But there has always been another reason for providing assistance…one we rarely talk about, but which is clearly on the ascendancy these days. We also provide assistance because it expands our influence with other countries and in international organizations.

Focused Influence: Incentivizing the Policies of Others

When the Millennium Challenge Corporation (MCC) enters into compacts with qualifying nations, it provides conditional assistance that not only funds identified programs and projects, but incentivizes partner countries to undertake important reforms. Countries have to meet objectively identified benchmarks of good governance in order to qualify for compacts. Projects at the heart of each compact are identified and shaped by objective “constraints to growth” analyses and, when complete, they help to improve the enabling environment for both economic growth and US trade and investment. The manner in which funded projects are carried out also strengthens the capacity of partners to fund and implement their own future programs and projects. In other words, each step of the way, our assistance shapes the policies and practices of our partners.

The Trump Administration’s “America First Global Health Strategy” (AFGHS) uses a compact approach as well. AFGHS bilateral agreements condition assistance upon greater investments in public health systems and infrastructure, increased utilization of innovative technologies, and stronger diagnostics and infectious disease response capacity. While the completion of a compact doesn’t necessarily mean a country has achieved the ability to fully fund and be solely responsible for its public health, it does bring partners closer to that goal.

Broad Influence: “Know that You Care Before…”

But it isn’t just policy reforms that our international assistance can influence. Sometimes our assistance works to polish our “brand” and remind audiences of America’s role as a global force for good. One of my political inspirations, Jack Kemp, liked to say, “People need to know that you care before they care what you know.” Sometimes our assistance works to show that we care —and our leadership is worth listening to. Put another way, many nations want to work with us because we are powerful. They are even more likely to work with us when they see that we apply our power to causes beyond our immediate self-interest…challenges like international food insecurity and forced human displacement.

Is Our Assistance Still Enough to Incentivize and Influence?

But in a time when foreign assistance represents a smaller and smaller part of the broad economic forces shaping the developing world, is our assistance still “influential?” It’s a question worth asking.

Consider the case of Nigeria, an increasingly important player in world affairs. It’s the most populous country in Africa, one of its most diverse (over 500 indigenous languages), its largest oil producer, holds vast reserves of several critical minerals, and is Africa’s second largest economy. Analysts believe Nigeria will become one of the world’s twenty largest economies by the end of the decade and one of its ten largest in two and a half decades. We want to be close to, and influential with, Nigeria.

Under its recently signed health compact with the US, Nigeria is set to receive $2.1 billion in assistance over five years. That assistance is conditioned upon Nigeria dedicating greater amounts of its own resources to public health and taking steps to strengthen key aspects of its public health infrastructure.

While $2.1 billion is a lot of money, there are much larger numbers at play in Nigeria as well—numbers that its leaders need to keep in mind as they make policy decisions. As of 2023, Nigeria owed more than $5.16 billion to China for its past deals with Beijing. The US has increased foreign direct investment in Nigeria to $7.9 billion (as of 2024), and US-Nigeria bilateral trade recently surpassed $13 billion. Nigeria’s debt with the World Bank stands at $18.7 billion (one of the world’s highest amounts). Its annual trade with China is estimated at $22.3 billion (Note: on May 1, Nigeria’s exports to China will become tariff and duty free). Each year, Nigerians receive more than $23 billion in remittances from their diaspora abroad, and Nigeria recently struck a $24.6 billion infrastructure deal with China for projects in Nigeria’s Delta State.

Show Me the Money… and More

We’re living in a time when foreign assistance (often referred to as official development assistance or “ODA”) represents a smaller and smaller portion of the financial landscape impacting African nations. These days, we’re rightly insisting that our assistance helps to make America stronger and more prosperous, but we shouldn’t lose sight of our goal to make America more influential too. Can we target our assistance to maximize its impact—including the “influence” impact? Can we redesign our assistance tools to include other parts of American life that are the envy of the world—the research capabilities of our universities and entrepreneurial spirit that drives innovation everywhere from Silicon Valley to the launchpads in our space program?

How much we spend does matter when it comes to diplomacy, commerce, and development. But in a time when lots of money is moving through lots of channels, how and where we spend it has never mattered more.

Stubborn Thing: When people hear the term “critical minerals,” the digital economy and its growing hunger for rare earths, lithium, and cobalt usually comes to mind. The Middle East conflict’s growing impact on the global food economy reminds us why phosphate and potash are on that list too.

In 2022, Russia's full scale invasion of Ukraine caused havoc and pain in many farming economies because the theater of conflict was also the source of a significant share of the world’s supply of fertilizer and related products. In those days, 20 percent of overall fertilizer supplies came Russia and Belarus, including 40 percent of the world’s potash and 20 percent of urea, the most widely used nitrogen-based fertilizer. As a result, many countries, especially in the developing world, saw food production go down and food costs go up. Even the World Food Program was impacted—their funding for humanitarian assistance simply couldn’t reach as many hungry people.

In 2025, the Trump Administration, perhaps with that experience in mind, added both phosphate and potash—key fertilizer elements— to the US Geological Survey’s official list of critical minerals. With that move, the Administration signaled its willingness to boost domestic research, production, and stockpiling of phosphate and potash to reduce the vulnerability in fertilizer supply chains. The European Union and Canada also designated those substances as “critical minerals.”

But if the war on Ukraine reminded us where many of our most important agricultural inputs are produced, the war in the Middle East has made clear  that every part of the supply chain needs to be stable and secure. Western media has reported that 20 percent of the world’s oil passes through the Strait of Hormuz. But UN Trade and Development reports that 30 percent or more of the world’s nitrogen-based fertilizers and 45 percent of granular sulphur (a key ingredient in phosphate-based fertilizers) go through there as well. As the conflict continues, Fitch Ratings foresees potential price increases for urea (the most widely used nitrogen-based fertilizer) and ammonia of nearly 25 percent this year. Food prices themselves will likely reflect these cost increases later on as fertilizer and fuel costs make their way through the farm-to-market chain. As Fitch notes, fertilizer costs make up nearly half of overall grain production costs.

As it did in 2025, when it added to the critical minerals list, the Trump Administration has moved to lessen the cost impacts of the conflict upon American farmers. It recently waived provisions of the Jones Act, which requires that certain goods shipped between U.S. ports be moved only on U.S.-flagged vessels. The Administration hopes its move will lessen some of the cost impacts for American agriculture.

According to the UN, in agricultural terms, nowhere is more impacted by restrictions on movement through the Strait of Hormuz than Africa. Of the world’s 10 countries most dependent on fertilizer coming from or through the Persian Gulf, 5 are in Africa. Over half of Sudan's fertilizer supplies passes through Hormuz and nearly a third of Somalia's— both countries are already among the world’s most food insecure nations.

It’s a longstanding principle of international law that food should never be used as a weapon of war. But conflicts in the Middle East and Eurasia remind us that even when food isn’t a weapon of war, it’s very often a victim of it.

And so where does that leave us? Many of the development programs, budgets, and institutions that we’ve known for years are gone or have been sharply reduced. Not just here in the U.S., but across Europe and at the United Nations (including institutions like the World Food Program and the UN Development Program). But all of these changes pale in comparison to the broader, more impactful changes that have been taking place out there —in the field and around the world.

Technology and innovation. We have new medicines, new treatments, new tests…new seed varieties, irrigation methods, weather forecasting tools, and more. And we have the frugal technologies (like mobile phones, civilian drones, and 3-D printers) to extend them to remote places.

Evolving Financial Flows. Official Development Assistance, better known as foreign aid or “ODA,” used to make up well over 80% of the monies flowing into the developing world from America and the “donor community.” Even before the cuts of 2025, ODA had fallen to below 10%. It’s been surpassed by foreign direct investment and, more than anything else, international remittances. If we only debate ODA levels, aren’t we “losing the forest for the trees?”

Rising Debt. For every $1 China provides in ODA, it lends $35…which is just one reason why, according to World Bank figures, 32 African nations are now spending more on debt service than they do on health or education.

Rising Youth. Africa is young, very young, with a median age in places like Tanzania of only 16. This “youth bulge” is challenging the ability of leaders to create enough good jobs and rewarding economic opportunities for a generation that is better educated  —and better informed— than their parents.

To be clear, none of this, including the relative decline in ODA, is an argument for further deep cuts to assistance or ending all of the programs assistance has powered. It’s an argument for spending it more strategically…in ways that unlock the full development impact of the other flows…investment, commerce, remittances, etc. It’s an argument to fill in the gaps —the areas not addressed by other financial sources— and to incentivize reforms that attract more private investment, especially catalytic investment.

In the first Trump Administration, we planted some of the seeds for a new approach. Our “Journey to Self-Reliance” framework (which relied upon objective, outcome-based metrics) was designed to focus our attention on those attributes countries needed for strong economic growth, impactful development, and “self-reliance.” We expanded the tools and reach of the Overseas Private Investment Corporation (even giving it a new name, the US Development Finance Corporation, or DFC). With the launch of our “Private Sector Engagement Strategy” (the first ever official strategy), we made it easier for private enterprise to participate in development and endorsed the use of innovative financing tools like development impact bonds. The Biden  Administration and the second Trump Administration planted more seeds by expanding the pool of countries that the Millennium Challenge Corporation (MCC) can work with—countries that would see their investment enabling environment improved through the MCC model.

Of course, there’s so much more that a new approach to development could include, for example:

• Conducting constraints to investment analyses (along the lines of MCC’s Constraints to Growth Analysis) to identify, country by country, the barriers holding our partner countries back from receiving even greater levels of American business investment.

• Helping partner countries expand their domestic resource mobilization so they can more effectively capture revenues, reduce their “informal economy,” and better turn revenues into essential government services.

• Offering to lend or “embed” American business talent (perhaps recent business school graduates or retired business executives) in partner countries to help them with strategic planning, policy reforms, and capacity building.

• Encouraging partner countries in their efforts to develop refining and manufacturing capacity closer to the sites of strategic resources (something China is doing in places like Zimbabwe). This will help them go from being mere vendors of resources to true strategic partners—AND create more of the jobs that their growing workforce demands.

When I joined USAID in the first Trump Administration, I reminded everyone that the purpose of our assistance “should be ending its need to exist.” I proclaimed that we wanted our friends go from being aid recipients, to partners, to fellow donors and contributors. All of that is even more true today… and more possible as well.

That’s why we need a new approach to development and why America should continue to lead.

In order to meet international development’s “crossroads moment,” we should start by recognizing how much the world has changed since the days when our most notable assistance programs were first created. What are some of those changes?

First, and most obviously, technology. There have been headline-grabbing breakthroughs, from new vaccines and medical treatments to satellites and generative AI. But there have also been tech-related innovations that, while making little news back here, have also lifted lives in much of the world. They’re affordable, impactful, and within reach of everyday communities and families…the innovations driven by “frugal technology.”

In villages across Africa, mobile phones are being used by family farmers to get real time prices for their crops and receive satellite-guided weather forecasts accurate to the square mile. Health officials are using phones to send test results to patients and share those results with distant specialists. Inexpensive drones are being used to transport fresh blood supplies and medicines to distant villages and hard-to-reach urban neighborhoods. 3D printers are being used to produce components for water pumps, prosthetics for special needs patients, and even micro weather stations. [For a Stubborn Thing on frugal innovation in Africa, see https://open.substack.com/pub/ambmarkgreen1/p/critical-minerals-critical-minds-1a9?r=2a16ct&utm_medium=ios.]

A second major change —one that has quietly reshaped the incentives for many governments and businesses— is the evolving composition of financial flows into the developing world. For decades, government aid (often called official development assistance, or “ODA”) made up more than eighty percent of those monies. Even before the deep cuts of 2025, ODA had fallen to below ten percent…because other components have risen dramatically by comparison. Trade and investment is on the rise, thanks to expanding transportation and communication networks and improved incomes in many parts of Africa, Asia, and the rest of the Americas.

Remittances — the funds workers overseas send to families and individuals back home— are expanding even more rapidly than foreign direct investment. According to the World Bank, in 2023, nearly $660 billion flowed through remittances into low and middle income countries—and that’s just the money flowing through official or formal channels. That same year —obviously well before Trump Era cuts— remittances were several times larger than all of the ODA provided by Organization for Economic Cooperation and Development (OECD) donor nations.

A third major change is that, for developing world governments looking for financial assistance and foreign investment, the U.S. and Europe are no longer the only “game in town.” For a growing number, China has become, if not the partner of choice, then the partner of immediate availability. Beijing has a larger diplomatic presence in the developing world than the U.S. does, and for more than three decades, Chinese foreign ministers have made their first overseas trip of the year to somewhere in Africa.

China’s arrival on the scene doesn’t simply change the geographic source of the money flowing, it also changes its form and long term consequences. According to analysis from William and Mary’s AidData research lab, for every one dollar that China provides in ODA, it now lends $35. Its financing portfolio, AidData says, has reached $2.1 trillion, making it the world’s largest official creditor. [For a recent Stubborn Thing on China’s role, see https://open.substack.com/pub/ambmarkgreen1/p/stubborn-thingsself-reliance-vs-debt?r=2a16ct&utm_medium=ios]

A fourth change, one that will shape the policies and decision making of developing world leaders for years to come, is the changing nature of their human landscape. Seventy percent of Africans are now under the age of 30, and in some countries, the median age is only about 16. Over the next decade, according to the World Bank, 450 million Africans will become of working age, while the continent is on track to create for them only 100-150 million jobs. In many places, the population is not only younger, but it’s increasingly in motion as well. Worldwide, the level of forced human displacement has now reached approximately 120 million people. In each of the last several years, approximately 340,000 people were born displaced. And forced displacement is higher in Africa than anywhere else. [For a Stubborn Thing on Africa’s changing human landscape, see https://open.substack.com/pub/ambmarkgreen1/p/stubborn-things-more-jobs-but-what?r=2a16ct&utm_medium=ios.]

How can we possibly hope for our approach to international development to succeeds unless it takes these changes into account?

Next, Pt. 3, “Looking ahead.”

[For Pt. 1, see https://open.substack.com/pub/ambmarkgreen1/p/stubborn-things-stubborn-thought?r=2a16ct&utm_medium=ios]

There’s little doubt that 2025 was the most significant year for international development in a generation. In the name of “trade not aid,” governments from Europe to the U.S. made deep cuts to international assistance and dismantled a range of programs, including the U.S. Agency for International Development (USAID) itself.

But as consequential as last year was, the year ahead will be much more important: it’s when policymakers will determine whether “trade not aid” was merely political cover for doing “less with less” or, instead, a sincere down payment on an innovative new framework.

Those of us who truly care about American global leadership should help the Administration shape the latter…or else we’ll all be consigned to the former.

The abruptness of DOGE’s termination of development programs and professionals shook many observers and raised questions about America’s reliability and commitment in many parts of the world. But that doesn’t mean the Administration’s underlying premise was wrong —that it was past time to modernize, reform, and reset international assistance. In other words, regardless of how we got here, we should seize this opportunity to build something new for these times —a framework that builds on the extraordinary accomplishments of programs like PEPFAR and the Millennium Challenge Corporation (MCC), but also recognizes how much the world has changed.

What are some of those changes? I’ll lay out several in part 2 of Stubborn Things, Stubborn Thoughts.

Stubborn Thing: 32 African countries spend more on debt service than they do on basic health.

In my days as Ambassador to Tanzania (2007-09), I invited my parents to come and stay with us in Dar es Salaam. I didn’t just want them to experience the country’s extraordinary natural beauty, I wanted them to better understand why I so loved representing the United States there…being the face and voice of the American people in a country that naturally looked our way.

I remember how proud I was when I was able to invite my dad, who’d been a practicing physician for more than fifty years, to join me for a ribbon cutting event at a US-supported health care center a few hours from Dar. As we got into our car, I said, “Dad, let’s go do rounds!”

Opening the newly expanded center was a truly joyous occasion. There was singing and dancing —there was always singing and dancing— and a grand tour of the facilities. Of course, the place was modest by American standards, but it was a godsend to those who otherwise had little access to care. After the public ceremonies, we walked the hallways, chatting with nurses and hospital workers. I remember how Dad loved to ask them questions and compare notes on how various afflictions would be treated. Local officials were bursting with pride and spoke glowingly about how this new center was a downpayment on lifting the lives of countless families.

After the festivities were over and we had driven away from the crowds, I took Dad to another US-supported project—one with a very different feel.

We joined a small number of US and Tanzanian health officials in making home visits to families that had been ravaged by the scourge of HIV/AIDS that still burned bright in many parts of the country. Our purpose was to check on those families, bring some basic food and medicine, and generally help them realize that they hadn’t been entirely abandoned or forgotten. All of our stops that afternoon were moving and poignant, but there was one in particular…

The home was a rickety structure on the outskirts of town. It looked more like an abandoned farm shed than a place where human beings could live. There were no windows, but a few rays of sunlight reached in through holes in the walls. The floor was dirt.

As we entered the house, and after our eyes adjusted to the darkness, we saw an old lady, and wearing threadbare clothes, sitting on an old crate. She was a little overwhelmed by our visit, even though she knew we were coming, but she seemed to relax as we opened our boxes of food. A few of her children, dressed in tattered shorts and shirts, stood by, eyeing us carefully.

The poor woman's breathing was labored and noisy as she sat on that old crate, but she wanted to talk. Through a translator, and little emotion, she told us that her husband and one child were already dead from AIDS and, as Dad would later confirm, she was in the homestretch herself. She went on to explain that she was once a successful businesswoman, but now she was down to her final shillings.

Through that translator, and with little emotion, she said to me, “Ambassador, I have a question.” She was looking off into the distance as she spoke. “With this last little money, should I buy books for my children who are healthy or medicine for the ones who are not?”

She wasn't asking her question for effect… it was a sincere question from a woman deflated by life’s challenges. And, of course, I had no answer. None.

As Dad and I quietly walked back to our car, he said to me, “Mark, can't the government do something?” “Dad,” I answered, “There's no Medicaid here or disability or welfare. If we don't do this, it won't happen. That's the simple truth.”

Programs like PEPFAR (the President’s Emergency Plan for AIDS Relief) and the President’s Malaria Initiative, powered by the generosity of the American people, have changed the course of human history. Simply put, countless Africans are alive today who would not be if American taxpayers hadn’t mobilized their compassion through these and other programs.

The success of these initiatives —and the basic health care infrastructure they helped create— means that achieving true self-reliance in sectors like public health and food security is possible, and even within reach, for many African countries. The America First Global Health Strategy emphasizes shared technologies and joint investments in order to boost sustainability. It prioritizes  innovation and private enterprise in order to foster new economic opportunities for a very young population.

While AFGHS is very different than traditional programs which depended almost entirely on traditional foreign assistance, it continues an important American principle: it doesn’t resort to the Chinese-style lending that has made the continent’s debt distress so much worse. According to ONE Data, a project powered by Google’s Data Commons and the ONE Campaign, 32 African countries are spending more on debt service these days than they do on public health. Put another way, according to ONE Data, African countries spent approximately $89 billion in debt payments in 2025— significantly exceeding the highest level of development assistance they’ve received ($60 billion in 2023). The last thing the continent’s leaders need is anything that exacerbates their debt challenges.

American compassion is our “brand advantage” in so much of the world. From the Peace Corps to PEPFAR, our helping hand has been extended further than any other country in history. In this new chapter of that story, combining the value of compassion with the spirit of innovation and the power of private enterprise, we can take our brand to new heights.

I’ll never forget how proud I was when I took my dad to that ribbon cutting. I’ll never forget how moved he was when we visited that poor dying lady. And I’m excited for what continued American leadership will mean for so many lives in the years to come.

EXCERPTS OF RECENT AFRICAN  “STUBBORN THINGS” (and other assorted tales)

“Facts are stubborn things; and whatever our wishes, our inclinations, or the dictates of our passion, they cannot alter the state of facts and evidence.” —John Adams

(Note: Stubborn Things is available on my Substack; older posts are at WilsonCenter.org)

1. AFRICA’S HUMAN LANDSCAPE

Stubborn Thing: By 2050, Nigeria will likely have the world’s third largest population (surpassing the US) and one of its ten largest economies.

One of every five Africans is Nigerian, and Nigeria boasts Africa’s largest economy. It has the world's second largest film industry (“Nollywood”), is a major producer of oil and gas, has significant reserves of lithium and other critical minerals, and has rapidly expanding IT and financial services sectors. A Nigerian start up recently beat out an Israeli consortium for a drone-based security services contract….Despite its size and significance, there hasn’t been a U.S. presidential visit to Nigeria in 10 years….

(https://substack.com/@ambmarkgreen1/note/c-125642325?r=2a16ct&utm_medium=ios&utm_source=notes-share-action)

Stubborn Thing: Malaria kills roughly 600,000 people each year, and is now present in four US states. Yet it’s largely preventable, and an affordable new vaccine is ramping up in production.

As anyone who has lived or worked in Africa can tell you, malaria has long been a terrible challenge for the continent, imposing considerable human and economic costs. The disease kills more than 600,000 people annually, and Africa accounts for 95% of all malaria cases—and 96% of its deaths. Among Africans, pregnant women and young children, who have lower natural immunity, are hit hardest. About 80% of malaria-related deaths are from children under the age of five.…When the US government’s President’s Malaria Initiative (PMI) came on to the scene in 2005, it dramatically expanded the world’s access to proven interventions (e.g., insecticide treated bed nets, indoor residual spraying, rapid diagnostic tests, and more), and boosted training for vital health care workers. Together with the Global Fund to Fight AIDS, TB and Malaria, (known as the Global Fund), and other partners, PMI has helped save an estimated 7.6 million lives, and prevented more than 1.5 billion malaria cases….

https://www.wilsoncenter.org/blog-post/malaria-largely-preventable-and-yet

Stubborn Thing: On average, 500 nurses leave Ghana for the West every month.

According to the World Health Organization’s WHO health workforce support and safeguards list 2023, some 55 countries have significant health staffing shortages—by the numbers, that means fewer than the median of 49 health workers per 10,000 people—and 40 of them are in Africa. In other words, roughly 80% of Africa is experiencing medical staff shortages and high rates of healthcare professionals leaving to work in other countries….Unfortunately, high rates of healthcare professionals leaving the continent is neither a new phenomenon, nor limited to Ghana. Egypt’s former health minister recently lamented that 65% of Egyptian doctors are working abroad, and a report from the UK’s House of Commons found that more than 3,000 Ghanaian health professionals had left that country for the United Kingdom from 2018 to 2021. At least 9,000 doctors left Nigeria to work in the UK, United States, and Canada from 2016 to 2018. And, when looking at 2015 data, the WHO found that Liberia had a mere 51 doctors for a population of 4.5 million, and Sierra Leone only had 136 doctors for 6 million people, making the doctor-to-population rate 0.1 and 0.2 per 1,000 people respectively.  https://www.wilsoncenter.org/blog-post/africas-healthworker-brain-drain

Stubborn Thing: At the end of 2024, only 10% of the US Representatives who voted to create PEPFAR were still in office—and none of the legislation’s original co-authors  remain.  

In 2008, Tanzania President Jakaya Kikwete implored, “Let me just make an appeal: Let PEPFAR continue...Can you imagine if this program is discontinued or disrupted? There would be so many people who lose hope, and certainly there will be death. You create more orphans… for PEPFAR not to continue, it's a recipe for disaster for us.” Standing next to him at a joint public appearance, US President George W. Bush said, “It appalled me very early on in my administration to realize that an entire generation of people could be lost to HIV/AIDS, and that those of us who were comfortable weren’t doing much about it…” 

https://www.wilsoncenter.org/blog-post/pepfar-looking-back-looking-ahead

2. AFRICA’S ECONOMIC LANDSCAPE

Stubborn Things: A study by the Infrastructure Consortium of Africa shows that poor infrastructure—roads, railways, harbors, etc.—adds 30-40% to the costs of goods traded among African countries.

….Part of what holds Africa back in its journey to self-reliance is that many countries there lack the reliable infrastructure that private investment often needs. An analysis by Deloitte shows that the lack of physical infrastructure in Sub-Saharan Africa is still keeping many investors at bay. Large commodity finds—such as oil, gas, iron ore, platinum, coal, and copper—are driving the need for infrastructure. Yet, at the same time, investment in infrastructure needed to extract and transport these commodities to the global market is also driving Africa’s economic growth….African leaders are striving to accelerate infrastructure improvements and are looking to both China and the West for assistance. As we read about nearly every day, China is answering their call. Are we?

https://www.wilsoncenter.org/blog-post/why-africa-talks-so-much-about-infrastructure

Stubborn Thing: Nearly 1,000,000 Tanzanians are entering the workforce each year, but only 100,000 new jobs are being created in the country’s formal economy.

Why makes Tanzania a special place? Sone would point to its extraordinary natural beauty…wonders from Mt. Kilimanjaro to the Serengeti, the sparkling waters of the Indian Ocean to Jane Goodall's beloved Gombe Stream Park. Others would point to its rich cultural heritage that can be seen in the fishing dhows off Dar es Salaam and the fish-and-spice markets of Zanzibar. Still others, to its vast mineral wealth…everything from gold to Tanzanite, cobalt to graphite.

But what really makes Tanzania special are its young people…full of big dreams, as well as the willingness to work hard to achieve them. They long to shape the future—their own and their country’s.

But what happens if those dreams are out of reach and their voice isn’t being heard?

https://open.substack.com/pub/ambmarkgreen1/p/stubborn-things-more-jobs-but-what?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

Stubborn Thing: As of 2023, the total sum of international remittances was four times greater than all of the “official development assistance” provided by OECD donor countries.

Decades ago, "official development assistance” (ODA), defined by the Organization for Economic Cooperation and Development (OECD) as “government aid that promotes and specifically targets the economic development and welfare of developing countries,” made up over three-quarters of the international financial flows into such countries. More recently, however, despite the growth of programs like Feed the Future and PEPFAR, ODA’s relative share of such flows has fallen to less than 10%—and that’s before this year’s cuts in foreign assistance budgets.

One reason is the growth in foreign direct investment (FDI). FDI is defined by the Congressional Research Service as “a type of cross-border investment that occurs when a resident of one country obtains a lasting interest in and degree of influence over the management of a business in another.” As the OECD puts it, FDI is at the “heart of globalization.”

But the more significant reason for the relative decline of ODA is the rapid rise in the level of international remittances. Remittances are defined by the Migration Data Portal as “financial or in-kind transfers made by migrants to friends and relatives back in countries of origin.” And they’re growing even more rapidly than FDI….

https://open.substack.com/pub/ambmarkgreen1/p/the-long-shifting-ground-in-international?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

Stubborn Thing: Over 80% of the world's “least developed countries” are commodity dependent.

Using United Nations data, countries with “low levels of human assets" (limited health and education capacities) and significant vulnerability to economic shocks are classified not merely as low income, but “least developed countries (LDCs).” The UN suggest they’re the “poorest and weakest segment of the international community.” And of the 44 countries that are on the list of LDCs, over 80% of them depend upon commodities (energy, mining, or agriculture) for 60% or more of their exports….

Analysis from the United Nations Conference on Trade and Development (UNCTAD) reminds us, however, that not all trade and investment is created equal. More to the point, not all trade and investment produces the development impacts which meet human needs and lessen, if not eliminate, the need for humanitarian support. According to UNCTAD, countries for which  trade in commodities makes up most of their exports are (a) less economically stable because of inherent unpredictability in price swings, (b) slower to economically diversify, and (c) more likely to be mired in economic inequality and multigenerational poverty due to the low wages usually paid to farmers and workers (even those employed in strategically important supply chains)….

https://substack.com/@ambmarkgreen1/note/c-199700539?r=2a16ct&utm_medium=ios&utm_source=notes-share-action

Stubborn Thing: In 2022, Zimbabwe banned the export of unprocessed lithium. Yet, thanks in part to quick moves by China, lithium exports continue to rise —with Harare's approval.

Lithium. It's a vital ingredient in everything from rechargeable batteries for consumer electronics and electric vehicles to broad energy grid storage….

And yet, in 2022, Zimbabwe imposed a sweeping export ban on its unprocessed lithium ore and an additional ban on exports of lithium concentrate that will go into effect in 2027. Why? Because, like their counterparts in many parts of Africa, leaders in Harare are facing demographics-driven pressures that go beyond their broad need for revenue….

https://substack.com/@ambmarkgreen1/note/c-154325644?r=2a16ct&utm_medium=ios&utm_source=notes-share-action

Stubborn Thing: The world’s first widely used mobile money service was invented in Africa.

It’s hard not to be inspired by Africa’s young people.

Those who have spent much time there are often overflowing with stories of moving encounters with African youth in remote villages or big city neighborhoods. The stories speak to the optimism and resilience visitors sense in those young people, and express amazement at how youth have found ways to persevere, even flourish, in the face of material challenges and disadvantages that would quickly discourage many of us in the West. Tourists often return to the US with souvenirs made from discarded household items that African children have somehow turned into toys or even beautiful works of art. Tin cans transformed into toy cars and trucks. Old wire and batteries become animal figurines. Broken glass and thatching magically transformed into jewelry.

Now imagine if those same young Africans had frugal technologies —mobile phones, civilian drones, etc.— at their fingertips. That’s actually what’s happening in many places…and it represents one of the most hopeful —and least reported— stories unfolding in Africa. And it’s also one of the many reasons why I firmly believe it’s in America’s strategic interest to stay close to Africa and Africans….

https://open.substack.com/pub/ambmarkgreen1/p/critical-minerals-critical-minds-1a9?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

Stubborn Thing: 95% of the animals in Gorongosa National Park were destroyed in Mozambique’s civil war. Investments in the people and the communities surrounding the park are bringing the wildlife back—102,000 animals at last count.

Mozambique’s Gorongosa National Park has been called “Africa’s most successful rewilding effort.” Ironically, it’s the investments made in the people and communities that are key to that success being sustained.…large swaths of the Gorongosa ecosystem were engulfed in the Mozambican civil war that erupted in 1977—a war which caused nearly a million deaths, and the forced displacement of millions more. Fighters often took refuge in the park, killing vast quantities of animals for food, or for money; selling items like elephant tusks helped finance their operations.

The war’s end only brought partial relief to Gorongosa as economic fallout and ongoing political instability left the area vulnerable to poachers. By 2001, the wildebeest population haddropped from 5,500 to 1, hippos declined from 3,500 to 44, and both elephant herds and lion prides were reduced by 90%.…Gorongosa’s fortunes finally took a turn for the better when, in 2004, the park captured the attention (and the heart) of American entrepreneur and philanthropist Greg Carr. “The Gorongosa Project” is now the largest employer in central Mozambique. In addition to traditional conservation operations, a growing number of Mozambicans have jobs with innovative SDZ projects that both pay good salaries and incentivize ecosystem preservation….

https://www.wilsoncenter.org/blog-post/rewilding-investing-people

3. THE OTHER TEAM

Stubborn Thing: Even before President Trump took office this year, China had a larger diplomatic presence in Africa than the US.

China is Africa’s largest trading partner, and has been for more than a dozen years. And the momentum in the China-Africa relationship seems to be building.…But it’s also important to understand the broader story of how we got to this point. Beijing has been paying attention to Africa for years and making serious investments in its relationships on the continent. Its diplomatic presence now surpasses that of any other country —including the US. According to the Lowy Institute’s 2024 Global Diplomacy Index (https://globaldiplomacyindex.lowyinstitute.org/), China has now established sixty diplomatic posts in Africa. That’s 4 more than the US and over 20 more than Russia….Every official sent out by Beijing in support of a diplomatic post represents Chinese eyes and ears in the field. Each is a Chinese voice on the continent and a new channel for China to spot economic opportunities, press its interests, and pitch for its businesses….

https://substack.com/@ambmarkgreen1/note/p-167806122?r=2a16ct&utm_medium=ios&utm_source=notes-share-action

Stubborn Thing: As of 2020, Africa’s natural resources were pledged to back nearly $66 billion in loans made for the most part from China’s state-controlled Development and Exim Banks. 

Africa has enormous economic potential. It is the youngest continent in the world, and nearly half of the world’s working-age population will be African in 30 years. With that youth comes not only a vast source of ready labor, but also a potential treasure trove of new ideas and innovations. The continent is also home to a large portion of the world’s most valuable natural resources: 40% of global gold, nearly 90% of chromium and platinum and, overall, about a third of the world’s known critical minerals supply. The value of these natural resources will only grow as the global search for new sources of energy and components for ever-faster microchips intensifies. The International Monetary Fund (IMF) estimates demand for nickel will likely double by 2050, triple for cobalt, and increase ten times for lithium. Given these demand projections, the IMF estimates that African countries could reap 10% of cumulative global revenues from copper, nickel, cobalt, and lithium—which together are estimated to reach $16 trillion dollars—over 25 years….

(https://www.wilsoncenter.org/blog-post/africas-natural-resources-africans)

Stubborn Thing: 40% of the world’s cocoa beans are produced in Côte d’Ivoire. In February, China opened that country’s largest cocoa factory. 

Nearly everyone loves chocolate. Increasingly, that includes those living in China, the world’s second most populous nation….Meanwhile, China has been proactively keeping up with increased domestic demand for chocolate products. In 2019, China signed a deal with Côte d’Ivoire to open two cocoa processing facilities in San Pedro and Abidjan, the country’s economic capital. Each plant can produce 50,000 metric tons of chocolate end-products each year and can store up to 300,000 tons. The Abidjan plant, built by the Chinese company China Light Industry Nanning Design Engineering, is now the largest cocoa bean processing facility in the entire country….Interestingly, when China loaned Côte d’Ivoire $200 million to build these two factories, it negotiated for part of the loan to be repaid in cocoa beans. Accordingly, 40% of the output from both plants will be dedicated to China...

https://www.wilsoncenter.org/blog-post/china-and-chocolate-factory

Stubborn Thing: As of 2020, nearly 40,000 more African students were choosing China for their university education than the US.

As we’ve noted many times, Africa is by far the world’s youngest continent. The overall median age is only about nineteen, in some places far lower than that, and all ten of the world’s youngest nations are in Africa.

But who will shape the young minds of Africa? Who will give them the skills, education, and experiences they’ll need to take their rightful place at the world’s economic table?

More striking, as more and more of Africa’s best young minds look for overseas institutions to pursue post-secondary learning and research, more and more are looking to places other than the US. According to Carnegie research and analysis, as of 2020, more than 81,000 African students were attending university in China, while only 48,000 were going to the US for their studies.    

Something for us to ponder….

https://substack.com/@ambmarkgreen1/note/c-145260164?r=2a16ct&utm_medium=ios&utm_source=notes-share-action

Stubborn Thing: For more than three decades, every Chinese foreign minister has made his first overseas trip of the year to somewhere in Africa.

As one of my mentors, the late Cong. Jack Kemp, used to say, “People need to know that you care before they care.

Consider this, not only does each Chinese Foreign Minister kick off the year with a trip to Africa, but Chinese leaders have made nearly 80 visits to over 40 African countries over the last decade.  https://qz.com/africa/1335418/chinese-leaders-visit-africa-more-often-than-you-think-and-not-always-the-places-you-expect.

https://www.wilsoncenter.org/blog-post/30-years-every-chinese-foreign-minister-visits-africa-first. https://substack.com/@ambmarkgreen1/note/c-133833336?r=2a16ct&utm_medium=ios&utm_source=notes-share-action

Stubborn Thing: For every $1 China sends overseas in grants, it lends 35.

The world of international development continues to grapple with the uncertainties left by deep cuts to foreign assistance budgets in Europe and the US, as well as the dismantling of various assistance programs and institutions.

But as a new report from AidData, an innovative research lab at William and Mary College, reminds us, China largely abandoned “official development assistance” (ODA) years ago in favor of an aggressive loan-based strategy. As “Chasing China: Learning to Play by Beijing’s Global Lending Rules” puts it, “The percentage of [China’s] overseas lending and grant-giving portfolio that qualifies as aid (ODA) plunged from 22% in 2000 to 1% in 2023.” (https://www.aiddata.org/publications/chasing-china)….

https://open.substack.com/pub/ambmarkgreen1/p/stubborn-thingsself-reliance-vs-debt?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

4. UPHEAVAL AND POTENTIAL UPHEAVAL

Stubborn Thing: A larger share of the world’s terrorism-related deaths come from Africa’s Sahel region than South Asia and MENA combined.

Each year, the Australia-based Institute for Economics and Peace (IEP) produces Global Terrorism Index, or GTI, for 163 separate countries. The most recent GTI finds that, by the numbers, terrorism deaths dropped slightly during 2022. However, much of that “decline” is a result of the Taliban takeover in Afghanistan: since the Taliban is now the government, it isn’t included in GTI’s terrorist calculations.

But the index’s most eye-opening finding? The Sahel now accounts for 43 percent of the world’s terrorism deaths—more than South Asia and the MENA region combined. That percentage is on the rise. According to GTI, two Sahel countries—Mali and Burkina Faso—are among the world’s five countries most impacted by terrorism deaths. With 1,135 terrorism deaths in 2022, Burkina Faso now accounts for more terrorism deaths annually than any other country…

https://www.wilsoncenter.org/blog-post/sahel-now-accounts-43-global-terrorism-deaths

Stubborn Thing: At the end of October, officials in Cameroon and Tanzania shut off internet access in the days surrounding their national elections. Unfortunately, these moves were hardly unprecedented. In 2024, African governments shut off the internet at least 21 times, impacting 15 countries and many millions of people. Tanzania’s actions were its third of this year.

When I taught school in an African village in the late 1980s, my students didn’t know they were poor. How could they? Our community had but one telephone, a wind up phone mounted on a wooden box in the school’s main office. It could barely carry long distance calls, and only then intense operator assistance. The radio stations we could pick up and the newspapers we could find in the local market did little more than run government pronouncements and well staged photos and pronouncements.

It’s hard to overstate how much the arrival of affordable mobile phones has changed life in the developing world—and how citizens relate to the communities and countries around them….

https://open.substack.com/pub/ambmarkgreen1/p/stubborn-thingsthe-internet-and-african?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

Stubborn Thing: Since 1950, forty-five African countries have experienced at least one coup attempt.

In October 2025, Madagascar’s president was forced to flee his country when its military took effective control of the government. In November, Guinea-Bissau’s president was arrested and its military seized power just as the government was to announce presidential election results. In December, Benin’s president faced a coup attempt (unsuccessful) staged by a small group of military officials….

An October 2023 Voice of America report estimated that of the nearly 500 coup attempts that have occurred across the world since 1950, more than 220 were in Africa….

As a friend of mine likes to say, “The thing about autocratic regimes is that they are stable…until they’re not. And when they’re not, all bets are off.”

https://open.substack.com/pub/ambmarkgreen1/p/stubborn-things-to-coup-or-not-to?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

OTHER TALES

THANKS, BUT WHAT I REALLY NEED IS…

On my first overseas trip as USAID administrator, I was able to take part in a food distribution in Ethiopia that we were sponsoring through our partners, the World Food Program (WFP). WFP workers were distributing sacks of grain to families in a drought-stricken village in the country’s Somali Region, and I joined WFP’s dynamic leader David Beasley as we interacted with villagers carrying those sacks back to their modest homes.

I will never forget a wonderful Ethiopian woman who reached out to me.

She said, “I have a question. First off, I really appreciate this food. We need this grain. But my question is, can you help me with irrigation so that I never have to ask you for food again?”

https://substack.com/@ambmarkgreen1/note/c-156527715?r=2a16ct&utm_medium=ios&utm_source=notes-share-action

“CHASING” AND THE “JOURNEY TO SELF-RELIANCE”

So much of who I am has its roots in a small Kenyan village where Sue and I taught school nearly three decades ago…

In our little school, which ran largely off community donations, many of our classes had only one textbook for every half dozen students. That meant that we had to write out daily lessons word on the thick black paint that served as a chalkboard….

I remember my first encounter with “chasing” like it was yesterday. It was just days before an exam, and 7 or 8 students had their name called. While others kept their head down and continued to take notes —they had clearly grown accustomed to this process— these poor kids quietly stood up and slowly left the room. 

I stood there for a moment, not quite sure what to do. I eventually turned back to the chalkboard, and began writing once again, only to hear a soft noise over my shoulder.

When I stole a glance, I saw some of those same students carefully sneaking back into my class. My thoughts drifted back to my days at Edison Junior High. Students sneaking in to school?

https://open.substack.com/pub/ambmarkgreen1/p/moments-along-the-way-seeds-of-the?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

JULY 4TH IN AFRICA

There are a few greater privileges for an ambassador posted overseas than being able to host an Independence Day celebration.

When I served as our ambassador to Tanzania in 2008, I was determined to make our July 4th festivities a thrill for both our embassy family and Dar es Salaam’s broader diplomatic community. I made sure we had plenty of Americana on hand: hot dogs and hamburgers, family games, red-white-blue face painting, patriotic music — even a dunk tank….

When the Tanzanian cabinet member came forward to the podium to give his government’s official response to my remarks, he pulled out the pages of his prepared remarks, and began with formal acknowledgements of those present. But as he looked around at the families and those pieces of Americana, he paused.

He slowly rolled up his prepared text, put it back in his coat pocket, and struck a more relaxed pose. As he looked around his audience, he said very simply, “We want to be who you are. We want to have what you have.” Then he stepped back.

That was the best July 4th speech I’ve ever heard. It was certainly superior to mine —vastly so…

https://open.substack.com/pub/ambmarkgreen1/p/moments-along-the-way-celebrating?r=2a16ct&utm_medium=ios&shareImageVariant=overlay

Stubborn Thing: The world’s first widely used mobile money service was invented in Africa.

It’s hard not to be inspired by Africa’s young people.

Those who have spent much time there are often overflowing with stories of moving encounters with African youth in remote villages or big city neighborhoods. The stories speak to the optimism and resilience visitors sense in those young people, and express amazement at how youth have found ways to persevere, even flourish, in the face of material challenges and disadvantages that would quickly discourage many of us in the West. Tourists often return to the US with souvenirs made from discarded household items that African children have somehow turned into toys or even beautiful works of art. Tin cans transformed into toy cars and trucks. Old wire and batteries become animal figurines. Broken glass and thatching magically transformed into jewelry.

Now imagine if those same young Africans had frugal technologies —mobile phones, civilian drones, etc.— at their fingertips. That’s actually what’s happening in many places… and it represents one of the most hopeful —and least reported— stories unfolding in Africa. And it’s also one of the many reasons why I firmly believe it’s in America’s strategic interest to stay close to Africa and Africans.

We’ve all made this complaint before. We do get news about Africa these days, but it’s almost always coverage of humanitarian crises like Sudan and South Sudan, or record-breaking investment deals for critical minerals. Such topics are important. After all, more than half the countries on the International Rescue Committee’s 2026 Emergency Watchlist are in Africa. In terms of natural resources, the UN Environmental Program estimates that the continent is home to 12% of the world’s oil reserves, 40% of its gold, 90% of its chromium and platinum, and the list goes on.

But while that news coverage is accurate, it’s also incomplete. It lacks context, and it fails to pick up on some of the exciting possibilities emerging on the so-called “Dark Continent.”

In early 2007, Kenya’s Safaricom (partnering with South Africa’s Vodaphone) launched a mobile money service, M-Pesa, which opened the door of financial access to vast “unbanked” communities. In the months and years that followed, countless other mobile money entrepreneurs —in Africa and beyond— created their own versions of M-Pesa’s framework. Those services are now everywhere… a revolution in finance.

But M-Pesa was just scratching the surface of mobile phone-powered possibilities. We now have Find-a-Med, an app that helps users locate their nearest health care facility, and Vula Mobile, which helps health care workers find specialists for referrals and consultations. M-Farm and iCow, among others, help farmers stay on top of crop prices and other key agricultural inputs. Safari Tales helps students access African stories and books that are not widely available. Slimtrader is an e-commerce app that helps users purchase goods and services. The list goes on and on (and grows, quite literally, by the day).

Civilian drone use in Africa is also flourishing, and it’s showing the world what can be done with innovative minds at the helm. Zipline, an American company, made headlines when the Trump Administration turned to it for key projects in the American First Global Health Strategy. Zipline proved its value with its successful work in delivering fresh blood and key medicines to both remote villages in Africa and targeted urban neighborhoods. The company is now training young African engineers and designers to not only expand Zipline’s work, but to develop other applications and ventures.

Drones are being used in Africa to fight poaching in national parks.  They’re being used for precision crop spraying. Forest and farmland mapping. Humanitarian relief, and anti-malaria larvacide spraying. In Kenya, entrepreneurs are exploring the use of high altitude drones to increase connectivity in rural areas.

Tourists come back from Africa amazed by the creativity and optimism of the kids they meet. Now imagine what happens when those kids, and their kids, have technology to turn their dreams and ideas into inventions that can  advance the human condition. So… we want access to critical minerals, to be sure, but we need access to their critical minds.

Additional notes:

According to the World Economic Forum, by 2030, over 42% of the world’s young people will be African. By 2035, there will be more young Africans entering the workforce each year than the rest of the world combined. By 2050, more than 1 in 4 people in the world will be African.