Good morning, Chairman Payne, Ranking Member Smith, and members of the Subcommittee. I appreciate the opportunity to appear before you today to discuss current conditions in the Great Lakes region and USAID's contributions to sustainable development in those countries.

My testimony today will add to that of Assistant Secretary Carson who has provided the Subcommittee with information on the U.S. Government policies in the region. Our work directly supports those policies, and focuses on a number of sectors, including economic growth, peace-building, democratic development, health, education, food security, and environmental protection. We also continue to respond to both man-made and natural humanitarian crises in many of these states. These countries represent a wide spectrum-some countries have achieved impressive economic growth statistics while others remain near the bottom of the human development index.

While significant progress has been made across the region, equally significant challenges persist; corruption, poor infrastructure, cross-border conflicts, sexual and gender-based violence and human rights abuses, poor health outcomes, high unemployment, climate-induced humanitarian crises, and food insecurity. These challenges are daunting, but we believe in the extraordinary potential of the Great Lakes region, both in terms of its human capital and natural resources. The resilience of its people is perhaps its greatest strength.

GREAT LAKES REGIONAL ISSUES

The political, economic, social and humanitarian problems associated with the Great Lakes region are complex. National issues frequently spill across borders to become regional concerns and crises, and there are issues that are common sources of conflict and instability in the region, such as land tenure. I would like to briefly outline some of these key issues and our response, along with additional information on our bilateral country programs in the region.

Of the regional issues that spillover to affect multiple countries, one of the most profound is the migration of the Lord's Resistance Army (LRA), a terrorist Ugandan rebel movement that has roamed ungoverned portions of the Democratic Republic of the Congo (DRC), southern Sudan, and the Central African Republic (CAR) since being ejected from northern Uganda in 2005. While the LRA threat has significantly diminished in northern Uganda, there are an estimated 350,000 internally displaced persons (IDPs) in LRA-affected areas of the DRC, and thousands of others displaced within the CAR and southern Sudan.

The focus of USAID assistance in LRA-affected areas has been on mitigating the humanitarian consequences of mass displacement by providing food and humanitarian relief. USAID has provided food assistance to LRA-affected populations in south Sudan, the DRC, and the CAR, as well as non-food emergency assistance such as water, sanitation, and hygiene programs, as well as provision of emergency relief supplies.

In common with much of the rest of Africa and the world, one of the largest issues that will affect development in the Great Lakes in the coming years is rapid population growth. This will further strain the ability of these governments to provide service delivery and sustainable economic growth; and increasing youth populations present a concomitant risk for instability and conflict. USAID programs across the sectors target youth in order to boost civic participation, improve livelihoods and increase access to education to provide an alternative to confrontation and violence. The recruitment of child soldiers remains a critical concern for youth populations - particularly the lasting damage caused to the social and cultural fabric of societies when their children become tools of destruction. Another issue is the abhorrent presence of sexual and gender-based violence, both as a tool of war and as part of the daily lives of women and children throughout the region. While most of the attention surrounding sexual and gender-based violence has been focused on eastern DRC, this is prevalent throughout the region. In particular, countries in the region that are emerging from conflict are still dealing with the impact of war on the breakdown of social norms. In addition to addressing the immediate care and needs of victims of sexual and gender-based violence, USAID has actively supported the drafting of critical legislation and subsequent prosecutions in cases of sexual and gender-based violence in the DRC and Rwanda, and we continue to seek opportunities to address this issue at all levels. Combating this issue is not solely about broadening access to legal, medical, psycho-social and economic services; it is integrally tied to changing perceptions of gender and empowerment of vulnerable populations within these cultures. This will require local support and initiative and a long-term approach to achieve lasting change.

Through the efforts of the Presidential Emergency Plan for AIDS Relief (PEPFAR) and the Presidential Malaria Initiative (PMI), advances have been made in overall health in the region, but in comparison to other regions in the world, the statistics are troubling. The lifetime risk of maternal death ranges from one in 13 in the DRC to one in 25 in Uganda; while women in the United States have a lifetime risk of one in 4,800. For children, the DRC had one of the highest under five mortality rates at 205 per 1,000 live births, and 39 percent of children in Burundi were classified as moderate or severely underweight. Malaria, a preventable and curable disease for relatively low cost, is nonetheless the leading cause of morbidity and mortality in Uganda.

With the projected rapid increases in population growth, food security is of paramount concern. In the DRC, 72 percent of the population is currently undernourished and surviving on less than the absolute minimum daily caloric requirement. The Administration's Feed The Future Initiative will boost production to attempt to meet the food needs for the growing populations of these states. Recognizing that higher production does not automatically translate directly into a better quality of life for the population, complementary activities to address nutrition and governance issues related to improved food stocks, distribution, and regulation are critical accompaniments. Activities will focus on market and road infrastructure, as well as linkages to the regionally-strong and very active Common Market for Eastern and Southern Africa and Economic Commission for Africa, to ensure there is a sustainable platform for trade. USAID programming is improving production and market efficiencies; investing in research and inputs, and supporting the engagement of women in agriculture.

Land tenure issues also continue to be an underlying source of many of the region's conflicts. With high population densities and the return of refugees in Rwanda and Burundi, the question of land distribution and access is critical to economic growth. USAID is working on innovative programs in Burundi to inclusively develop new land policy, in order to reduce the risk of conflict. In the DRC, there are mounting tensions over land tenure and property rights in eastern DRC, particularly in areas with internally displaced persons (IDP) and refugee returns. USAID is addressing these issues through peace-building and community mediation programs as well as supporting a UNHABITAT program to build local capacity to manage land tenure and working with the Government of the DRC to address the overall legal framework for land tenure which is one of the root causes of unresolved conflicts over land use. In Uganda, we have just launched an interagency conflict assessment to look at the sensitive issues of decentralization, proposed relocations of pastoralist communities to urban centers, and the discovery of oil. While the specific strategies to address these issues are country-specific, the benefits can be measured for the region in a reduction of conflict and resulting migration across or within borders as well as through the economic growth that potentially will occur when conflict is reduced.

Across the sectors in which we work, our assistance strategy is to help citizens of these countries build sustainable institutions to improve governance and reduce corruption, increase food security, and improve access to education, health services, and job opportunities to build better lives for their families. We will continue to provide humanitarian assistance to address immediate needs after natural disasters, such as the recent flooding in Uganda, and to respond to other crises such as conflict. However, we will also continue to proactively address the conditions that cause conflict through our programs and by focusing on local peace-building and stabilization initiatives.

Regional cooperation is also key to development of these countries. For example, as a result of USAID programs, DRC and eight other countries in the region are laying the foundation to trade carbon credits with larger industrial nations, providing a new source of financing community development while conserving tropical forests and biodiversity.

We believe that we are in a new era for development, focused on aid effectiveness and host-country ownership that will translate into meaningful progress towards the Millennium Development Goals. Building on the Paris Declaration and the Accra Agenda for Action, we are aligning our work to more directly support harmonization of aid strategies; results-based programs; and mutual accountability between donors and aid recipients. Our work in the Great Lakes is coordinated with both host-country action plans on a sectoral basis, and with broad-reaching poverty reduction strategic plans. Moreover, USAID programs are increasingly planned and carried out in conjunction with other donors and private sector partners. We are an integral part of the "Whole-of-Government" approach to United States foreign assistance, and the Presidential Initiatives in global health, global climate change, and food security are the hallmarks of this approach.

I'd like to highlight some of our bilateral country programs in the region, which demonstrate the active engagement of USAID in addressing these challenges, both through targeted emergency response and longer term developmental assistance.

BURUNDI

Burundi is at a pivotal point in its turbulent history, and the world will be watching the conduct and outcomes of the 2010 elections (at the local, parliamentary, and presidential level), which started May 24th and will continue through September. These elections could showcase the consolidation of Burundi's recent democratic gains or reveal a country backsliding into political chaos and/or violence. A land-locked nation in the Great Lakes Region, Burundi ranks among the world's poorest and least-developed countries and continues to struggle to regain its development momentum following years of devastating civil war that ended in 2005. It is the second most densely populated country in Africa, a fact exacerbated by a high population growth rate and a lack of arable land to support even the subsistence needs of its citizenry. Disputes over access to and ownership of land continue to present social and economic challenges, particularly as Burundian refugees return from Tanzania. Burundi faces additional challenges, including disarming, demobilizing, and reintegrating former rebels; strengthening governance; rebuilding the economy; and improving health and education service delivery. To date, much progress has been made in transitioning the country to a functioning multi-party democracy during this post conflict period.

The U.S. government has been at the forefront of the international community in preparing for Burundi's landmark elections, supporting an examination and update of the 2005 Electoral Code, the creation of an independent and permanent Election Commission (CENI) and the operational support of that Commission. In addition, USAID, working through its development partners IFES, Chemonics, and Search for Common Ground are actively encouraging the participation of women and minorities in the elections, working to reduce conflict between political party-supported youth groups, monitoring conflict flash points throughout the country, and training the CENI personnel that will manage the polling stations. USAID is supporting innovative radio programming with messages targeted at all levels of society with a special focus on youth. The U.S. Embassy and USAID are actively working with other donors to organize election observation, and USAID's East Africa Regional Mission is mobilizing to support the observation process from Nairobi to encourage the participation of staff from the other nearby USAID missions in countries that will be organizing national elections this year.

USAID's health program has several key components targeting five major health problems: poor maternal and child health, nutrition, malaria, HIV/AIDS, and family planning. In addition, USAID is supporting the government's first Demographic Health Survey in over 25 years, which will provide statistical health data necessary for the government to improve the delivery of essential health services to the communities they serve.

DEMOCRATIC REPUBLIC OF THE CONGO

Despite having vast economic potential, the Democratic Republic of Congo (DRC) is among the world's poorest and least-developed countries. Following decades of corruption and mismanagement sustained by external political, military, and economic support, the transportation, education, and health infrastructure is in ruins. Ongoing conflict continues to strip the country's natural resources and has led to the deaths of millions of its citizens. USAID programs support the overarching foreign policy goal of U.S. foreign assistance in the DRC to promote a stable democratic state that is at peace with its neighbors and provides for the basic needs of its citizens. USAID programs support the security conditions and governance structures necessary to improve social and economic sectors and to facilitate the extension of state authority across the country. USAID supports coordinated donor efforts to provide access to health and education services, build democratic structures, contribute to economic growth in ways that also improve food security, and protect natural resources. Given the vast size of the country, nearly half the size of the eastern United States, and the complexity of the challenges it faces, donor coordination is of paramount importance.

The eastern region of the DRC continues to be a largely ungoverned space that harbors illegal armed groups and continues to experience instability and violent conflict, often resulting in population displacement. Conflict in eastern DRC continues to hinder stabilization and reconstruction efforts and allows grave human rights abuses, including brutal and repressive violence against women and girls, to continue. Given the alarming levels of sexual and gender-based violence reported in eastern DRC, USG counseling, medical, legal, and economic programs provide care and treatment for survivors of sexual and gender-based violence and their families and build awareness among communities and local and national authorities on the severe consequences of allowing these abuses.

Since 2002, the United States Government has been the major bilateral donor to respond to severe and widespread sexual and gender-based violence in the Democratic Republic of the Congo. U.S. funded programs aim to improve access to care and treatment services for survivors, fight impunity for perpetrators through support for legal reform and strengthening of the civilian and military judicial systems, and promote community awareness of and response to sexual and gender-based violence. USAID implements programs in North and South Kivu Provinces, the Ituri District of Orientale Province, and Maniema Province to identify and deliver services to rape and abuse survivors as well as building capacity of local organizations. USAID also assists hospitals to provide fistula repair services. USAID currently works with more than 90 local NGOs for social protection programs - the overwhelming majority of whom are operative in eastern DRC.

Since 2002 USAID has allocated over $33 million for sexual and gender-based violence response and prevention programs in eastern DRC, as part of a broader effort for stabilization and protection. USAID programs have provided care and treatment services for well over 100,000 sexual and gender-based violence survivors, including access to medical care, counseling and family mediation, social and economic reintegration support, as well as legal aid. Community awareness activities educate and mobilize local communities, including traditional leaders and women's groups, to promote women's rights, acceptance of rape survivors, protection of the whole community, and outreach about available services through local providers. Health programs aim to improve medical treatment and prevention services for women and children. In addition, USAID programs aim to strengthen the rule of law to end the cycle of impunity and prevent would-be perpetrators from committing such crimes. In part as a result of USG efforts, there has been some progress in holding senior officers in the DRC military accountable. Recently, the Government of the DRC arrested and charged a brigadier general accused of rape-the highest ranking officer to be charged with sexual or gender-based violence in the current conflict. The image of a general facing charges should erode the perception that senior officers enjoy impunity, and may deter would-be perpetrators of human rights abuses.

USAID's programs increase stability in the DRC by addressing the root causes and mitigating the consequences of conflict. Recent agreements between the Government and armed groups, coupled with ongoing Government of the DRC military offensives, have weakened armed groups in eastern DRC, though security incidents persist, resulting in new population displacement. Resurgence of widespread conflict remains the biggest threat to stability in the DRC, especially in the East, with the potential to incite regional flare-ups. USAID responds to humanitarian need and promotes stability in eastern DRC through activities in peace process facilitation; community reconciliation; community-driven infrastructure and livelihoods recovery; disarmament, demobilization and reintegration; local governance and justice; and social protection.

U.S. assistance also seeks to improve good governance, expand the rule of law, and support the decentralization process through judicial and legislative strengthening at the national and provincial levels. While progress in achieving a democratic transformation is evidenced by the December 2005 Constitutional referendum, adoption of a new Constitution in 2006, holding of the DRC's first democratic elections in 40 years in 2006, and the establishment of new governmental institutions and implementation of decentralization, significant challenges remain. The Government of DRC is expected to hold national elections in 2011 as provided in the new Constitution. The elections are predicated on a new system of decentralized local government, a contentious issue given its history of separatist movements and conflict. USAID supports legal reforms, elections and decentralization, with technical support to Parliament, the Independent Elections Commission, and provincial administrations.

The United States also recognizes the importance of sustained investments to improve the Congolese people's access to quality social services in the areas of health and education, with an increased emphasis on preventing and treating HIV/AIDS and malaria. To address growing food insecurity and help the country increase its agricultural productivity, USG assistance focuses on cassava production and processing, support to small and medium enterprises, agricultural livelihoods support in conservation areas, and food aid development assistance.

Finally, the illicit exploitation and trade in natural resources from the DRC-particularly minerals-has prolonged the world's deadliest conflict since World War II by funding the Army and nongovernmental armed groups, led to widespread human rights abuses, and undermined the ability of the Congolese government and people to benefit from the country's vast mineral wealth. Mining sites and communities have been the site of killings, rape, exploitative child labor, debt bondage and forced prostitution. At roadblocks along trade routes, armed individuals and groups, including the Army, engage in rent-seeking behavior-exacting so-called "taxes" from traders (including legitimate traders) and lessening miners' and traders' income. Since minerals are frequently exported through unofficial border crossing points and according to unofficial methods, the Government of DRC is unable to effectively collect legal taxes and duties that it could otherwise use to aid the faltering economy and invest in key sectors. Even at official border crossings, poorly paid tax officials have little incentive to accurately value and tax the minerals trade.

USAID supports analytical work to create an evidence base around this complex set of issues and also supports key sectors such as improved governance, rule of law and economic development-essential components to addressing the underlying vulnerabilities fueling conflict. Moreover, a number of USAID programs in southern and eastern DRC address centrally related issues, such as reintegration of ex-combatants into conflict-affected communities and improved local governance of resource revenues. Comprehensive reintegration programs reduce the likelihood that ex-combatants will be recruited into illicit enterprises or re-recruited into armed groups that control much of illicit minerals trade.

Additionally, USAID implemented two innovative programs to improve governance and reduce conflict associated with the exploitation of mineral resources. The first was a public-private partnership in which modest USAID funds leveraged a larger private sector contribution by reputable mining companies operating in Katanga to foster corporate social responsibility and support alternative livelihoods for artisanal miners, who were operating in some cases illegally on private company land. The program also addressed critical human rights issues around the mining sites and strengthened conflict resolution mechanisms within the artisanal mining community to diffuse tensions before they spilled over into violent conflict. The project created local development funds, which were in line with Congolese local government reform processes, in order to ensure that taxes gleaned from legal mining were invested back into community-driven development programs.

The success of this intervention led to the establishment of a joint U.S.-DRC Development Credit Authority to encourage small and medium-scale investment in the key mining province of Katanga, where access to credit was very limited. In addition to work with artisanal miners done through the public-private partnership in Katanga, USAID has also supported stand-alone programs focused on the unique challenges of artisanal miners and implementation of the Voluntary Principles on Security and Human Rights. In the southern Katanga Copperbelt, these programs (1) promote reconciliation, cooperation, and understanding among artisanal and small-scale mining-related institutional actors; (2) prevent conflicts and risks to communities over resource access and use; (3) improve access to, and awareness of, pertinent mine legislation; and (4) establish a conflict resolution mechanism for disputes and conflicts. The lessons learned and best practices distilled from these two innovative and cutting-edge conflict mitigation programs in the artisanal and small-scale mining sector have been used to inform the design of a new multi-million dollar, multi-donor, multi-year program focused on the mining sector in the East. The new program is called PROMINES and is supported by the World Bank and the UK's Department for International Development.

USAID continues our strong humanitarian support for the DRC. In FY 2009, USAID's Office of Foreign Disaster Assistance provided approximately $33 million concentrated in North Kivu, South Kivu, and Orientale provinces. Support in Province Orientale was expanded during FY 2009 due to increased LRA attacks in the area. Activities included agriculture and food security, economic recovery and market systems, health, humanitarian coordination and information management, logistics and relief commodities, nutrition, protection, shelter and settlements, and water, sanitation, and hygiene. In addition, P.L. 480 emergency food aid for the DRC nearly tripled from 2007, to over $110 million in 2009.

RWANDA

Since the 1994 genocide, Rwanda has made extraordinary progress to improve the economic, health, and social well-being of its people. Relative to many of its neighbors, Rwanda is stable and performs well on measures of government effectiveness and control of corruption. At the national level, the country has the highest rates of female political participation in the world: nearly half of its parliamentarians are women. Rwanda continues to demonstrate impressive leadership on donor coordination and aid effectiveness. The focus of USAID programming in Rwanda has been to strengthen the government's ability to rule justly, provide basic services for the populace, and foster economic growth. Additionally, U.S. assistance in Rwanda supports regional economic integration, spurs business development and entrepreneurship, and improves democratic institutions and the rule of law. The health sector also remains a major focus of U.S. assistance, particularly through PEPFAR. In addition, economic growth - through investments in improved agricultural production and food security - has become a major objective of U.S. foreign assistance.

Despite impressive progress in governance effectiveness, democratic reforms have lagged. To ameliorate this, a $24.7 million Millennium Challenge Corporation Threshold Program was signed in September 2008, to assist Rwanda in improving its performance. The Threshold Program, managed by USAID, provides technical assistance and grants to local governments and civil society to enable greater citizen participation; increase the independence of the judiciary; expand media freedom; and improve police internal investigations and accountability. It also complements USAID's support for political party strengthening, land conflict mitigation, peace-building, legal aid, and policy reform.

Through the Administration's new Feed the Future Initiative, in partnership with the Government of Rwanda, the focus on programs will include: post-harvest handling and storage; a food fortification; and support to women and the very poor through a comprehensive package of micro-finance, entrepreneurship development, education, and nutrition services. The Government of Rwanda was the first to sign a National Compact under the Comprehensive Africa Agricultural Development Program-and has demonstrated a strong commitment to combat undernutrition.

Rwanda's programs in Global Health were exemplary models of coordination between donors and the host-government to build a strategic response to combat infectious diseases and to improve basic maternal and child health care. For example, since 2005, USAID has supported Rwanda's Decentralization and Health Program, known as Twubakane, providing financial and technical assistance to health facilities and communities in twelve of Rwanda's thirty districts. The program provides improved services for maternal and child health, family planning, nutrition, and prevention and treatment of malaria in 136 health centers.

UGANDA

Uganda has strong ties to both East and Central Africa, and is strategically vital to U.S. interests on the continent. It has partnered with the United States to address regional conflicts, several of which have the potential to undermine the security, and political and economic viability of large areas of sub-Saharan Africa. Uganda itself remains a fragile democracy facing a number of domestic security and socio-economic challenges. USAID programming in Uganda focuses on strengthening the country's capacity for a healthier, more educated population; a stronger democracy and sustainable economic growth. USG assistance in Uganda focuses on improving access to and quality of health and education services, strengthening governance, and promoting economic growth while improving food security and protecting natural resources. Resources are targeted primarily at the health sector-with a focus on combating malaria, reducing malnutrition, and improving maternal and child health-and toward improving the capacity and productivity of the agricultural sector.

The recent discovery of oil in Uganda presents a challenge for its development as it transitions from a highly aid dependent country to one relying on oil revenues. Lest Uganda experience the "resource curse" that has afflicted other countries, it will be essential to implement financial management and accountability reforms to ensure the transparent management of these resources for the benefit of the Ugandan people.

Uganda's population of 31 million is one of the fastest growing in the world, with an average live birth rate of 6.8 children per woman. Over 30 percent of the population is below the poverty line and 50 percent of the population is under the age of 15. Population growth and the "youth bulge" will challenge the ability of the country to provide basic social services within already-strained government budgets for the foreseeable future.

As it moves toward the 2011 presidential election, Uganda is going through a phase of extreme uncertainty. The reintroduction of multiparty politics in Uganda in 2005 provided an opportunity for more accountable and responsive government. However, governance remains poor and corruption rampant, threatening over the medium term the country's hard-won gains in terms of domestic stability and economic development-and thus also its reliability as a partner of the United States. USAID activities support a more representative parliament and local governments, increased civic participation in governance processes, and a strengthened multiparty political system. USAID is expanding programming directly related to the upcoming 2011 elections and will support the electoral process by providing technical assistance to political parties and civil society organizations to effectively engage in the elections. These activities seek to prevent election-related violence and to create the conditions for a peaceful electoral process.

Uganda is actively engaged in the Administration's Feed The Future Initiative, which will significantly increase foreign assistance in the sector. Uganda's Comprehensive Africa Agriculture Development Program Compact was signed in March 2010, which places Uganda at the forefront of the African agriculture development agenda in terms of its readiness to implement a tangible, results-based, Ugandan-led strategy that has strong broad-based support.

USAID support to northern Uganda is part of a U.S. Government-wide integrated approach to helping the people and the Government of Uganda achieve a successful transition from humanitarian assistance to sustainable development as outlined in the Government's Peace, Recovery, and Development Plan. The improved security situation in areas that suffered during a decades-long conflict has provided hundreds of thousands of internally displaced people with a chance to return to their homes and communities. The progress has led to a new focus by both the GOU and the international community on providing a path to post-conflict development. U.S. Government programs support the voluntary return of displaced citizens in northern Uganda and promote peace, recovery, and development in the region. The U.S. Government has increased its response across all programmatic sectors in the north, and mainstreamed a northern Uganda focus into all its programs. USAID programs enhance local governance capacity; increase education and livelihood opportunities for demobilized ex-combatants (and non-combatant supporters); improve social services in northern Uganda to include HIV/AIDS, malaria, water, sanitation, and health; and restore the environment.

CONCLUSION

The countries of the Great Lakes Region of Africa are linked by geography and history, by rich natural resources and ethnic allegiances that cross national boundaries. To build a sustainable future for these countries requires recognition of the unique challenges and opportunities in each country. We look forward to working with the Department of State and other U.S. Government agencies in continuing our partnership with these countries to realize their development goals.

Thank you, Mr. Chairman, Ranking Member Smith, and members of the Subcommittee for your continued support for USAID.