New News Out of Africa: Rethinking Media Coverage of Africa

Originally published June 30, 2006 for the Center for American Progress

With better media coverage, the United States and the world would realize that there is more to Africa than death, disease, disaster, and despair. Charlayne Hunter-Gault delivered that message in a discussion Friday at the Center for American Progress.

Hunter-Gault, an award winning journalist currently working for NPR, talked about her new book, New News Out of Africa, with Gayle Smith, senior fellow at the Center. Touching on a wide range of African issues, the event focused on the impact of how Africa is treated in the American media.

“We don’t know enough about Africa,” Smith said, because our current media coverage is reactionary and piecemeal, suffering from the “if it bleeds, it leads” syndrome. As a consequence, the American public has become apathetic to the continent. The perception, according to Hunter-Gault, is that if conditions never change than the issues are not a good investment of time, emotions, and money.

The lack of consistent media attention is obscuring important positive developments in Africa. The most interesting stories, for Hunter-Gault, are not Africa’s problems but the hope and heroism throughout the continent in the face of those problems. “Today there is a second wind of change blowing across Africa,” she said. Pointing to tentative but consistent democratic progress and a growing confidence that Africa can be active in improving itself, Hunter-Gault expressed hope that a more positive image of Africa in the media could emerge.

Hunter-Gault emphasized that understanding the day-to-day stories of Africa means abandoning preconceived notions. Reporters covering Africa should “try to portray people in ways that are recognizable” to Africans. To gain the right perspective, she said, “You have to go there to know there.” With that message, Hunter-Gault’s new book hopes to bring the right kind of media coverage to a dynamically growing continent.

Medicine and the Market: Equity v. Choice

Originally published June 6, 2006 for the Center for American Progress

Improvements in American health care cannot be made without addressing the fundamental assumptions that underpin our ideas about what health means. That conclusion was the product of a spirited panel discussion on the role of market forces in American health care, hosted on Thursday by the Progressive Bioethics Initiative at the Center for American Progress (CAP).

Panelist Daniel Callahan, Director of International Programs for the Hastings Center, led off the discussion by talking about his new book Medicine and the Market: Equity v. Choice, coauthored with Angela Wasunna. Joining him on the panel were Willis Goldbeck, consulting director for Global Public Health Policy and Government Affairs at UCB, and Jeanne Lambrew, Senior Fellow at CAP. Susan Lee, CAP Vice President for Economic Policy, moderated.

Callahan, whose book took a comparative look at different health care systems from around the world, found that the best systems had “universal health care with carefully introduced and carefully tested market practices.” Key to his understanding is moving past the false choice between markets and government involvement. A better way of framing the issue, according to Callahan, is to view market forces as a set of tools to achieve overall social goals. Under that conceptual model, the value of particular market forces can be tested against a higher standard of equitable access to quality health care.

Callahan pointed out that in many European countries, where universal care is held as a fundamental social value, health care systems are clearly effective. He listed lower costs, higher life expectancies, broad popular support, and quality of care at least equal to the U.S. as the advantages of a comprehensive, universal approach to health care.

By contrast, according to Goldbeck, “The U.S. does not have a system of health anything.” Goldbeck characterized the U.S. approach as a “medical care and repair model” that is fragmented and disjointed. Medical care, meaning specific responses to specific conditions, is emphasized at the expense of health, a broader concept incorporating prevention and overall well-being. Shifting the public discourse to that broader concept could facilitate progress on some substantial fundamental health issues facing the country. For example, distinguishing medical necessity from medical enhancement would enable us to draw some lines around what types of treatments the health system should and should not promote.

All panelists observed that America’s market-influenced emphasis on constantly improving medical technology — called the “infinity model” because it assumes no limit to useful medical progress — has raised the costs of health care across the board. While health care has improved as a result of technology, Callahan said, “The greater the improvement, the more we spend.” An increasingly expensive medical industry raises serious questions about equality of access and long-term sustainability. The basic issue is whether advancing high tech medicine is the best way to allocate limited health care resources that might be better spent on prevention or basic treatment.

Settling the questions will not be an easy task, according to Goldbeck. “We don’t know how to define basic health care,” he said, because we expect basic care to include coverage for every medical contingency. The panelists agreed that if the expectations of the health care system are going to change, the fundamental assumptions of health policy must also change. Lambrew, for one, is optimistic about the possibility for a positive shift. Pointing to growing calls for health coverage from businesses and encouraging developments on the state level, she said that the time for universal health care as a meaningful political issue “might be sooner than you think.”

Mexico's Presidential Election Results: What do they mean for the United States?

Originally published June 7, 2006 for the Center for American Progress

The close and contentious results of Mexico’s recent presidential election should help cast a spotlight on the importance of the United States’ relationship with its southern neighbor. The Americas Project at the Center for American Progress convened a panel of experts to discuss its impact and implications for U.S.-Mexico relations.

Jorge Castañeda, former Foreign Minister of Mexico, gave the keynote address that sparked a lively exchange. Panelists included Arturo Valenzuela, Director of the Center for Latin American Studies in the Edmund A. Walsh School of Foreign Service at Georgetown University, and James R. Jones, Co-Chairman of ManattJones Global Strategies and former Ambassador to Mexico. Joining them were Joy Olson, Executive Director of the Washington Office on Latin America, and Armando Guzmán, Washington bureau chief for TV Azteca. Dan Restrepo, head of The Americas Project at the Center, moderated the exchange.

Castañeda began by addressing the results of the election. “I don’t think there is any doubt,” he said, “nor should there be any doubt, that [Felipe] Calderón won,” an assessment echoed by the other panelists. He pointed to the already twice recounted votes and the strength of Mexico’s electoral system as reasons for considering the election results final. Valenzuela supported that assessment, calling Mexico’s electoral system “one of the best in the world.”

Castañeda used the controversy surrounding the election, particularly the protests of second-place candidate Andrés Manuel López Obrador, to make a case for a fundamental change in Mexico’s political system. The other panelists supported him in his analysis. “The problem,” he said, “is not the size of the mandate. The problem is the nature of the institutions.” He pointed out the inherent tensions in a non-parliamentary system that has three parties, as well as the difficulties of a weak president working with a divisive legislature that has little institutional incentive to cooperate with the executive branch. Castañeda also observed the absence of a run-off system, which would help immensely in building national consensus in the face of such a split election. Most importantly, he emphasized that the outcomes of the official electoral system must be respected because building the rule of law is critical for Mexico’s future.

Overhauling Mexico’s democratic institutions is important, Castañeda said, because without a better governance structure the crucial questions facing the country cannot begin to be answered effectively. Like the others on the panel, he said that poverty is the most pressing issue facing Mexico, but in the current system potential solutions are lost in a swirl of political infighting. “It’s not enough to do it with just good intentions,” Castañeda said. “The country cannot be governed under these circumstances.”

For the short term Castañeda said that, “Calderón’s victory will mean a great deal of continuity with U.S. relations.” For the long term, as the other panelists emphasized, the lessons for the U.S. to take away from the election point to a broader shift in U.S.-Mexican relations.

“The U.S. has vital interests with Mexico,” said Valenzuela, as evidenced by its status as the second largest trade partner and oil supplier. This election was the most recent step in what he called Mexico’s “complex and difficult transition” from a rural economy to an industrial power. Yet despite these forces at work, Valenzuela said, “We don’t think about Mexico strategically.” Rather than a comprehensive framework with Mexican stability and growth as a foundation, the U.S. tends to engage Mexico haphazardly over particular domestic and economic issues.

To that end, the panelists called for U.S. strategic interest in an improved, functional Mexico. Olson pointed out that the election controversy and López Obrador’s strong showing, along with elections in other Latin American countries, illustrate “incredibly divided societies” and the need for “hearing the voices of the people.” Poverty, it was agreed, should be a strategic priority for the U.S. because it is at the root of so many other issues, including immigration, trade, and political stability.

U.S. leadership in regional growth was emphasized by Jones. “Canada and the U.S. have a big obligation,” he said, “to have a serious development fund” that would be tied to needed political reforms. Observing that too many people in Mexico have not seen tangible benefits from free markets and democracy, many of whom voted for López Obrador, he said that “a system of hope has to be built in” if those economic and political institutions are going to succeed.

Political leadership and increased awareness are necessary to remaking U.S.-Mexico relations. Right now, as Guzman observed, “You don’t hear about Mexico at all,” except in regards to immigration issues. As the election reminded us, however, a broader and more comprehensive approach is needed for the U.S. to develop a strong and productive partnership with its neighbor.