The Real Jimmy Carter

America’s 39th president was not the weak and ineffective leader of popular caricature. But Barack Obama could still learn from his failings.

The hottest new trend of 2010, it seems, is making half-baked comparisons between Jimmy Carter and Barack Obama. Writing in Foreign Policy, historian Walter Russell Mead warns us, "[T]he conflicting impulses influencing how [Obama] thinks about the world threaten to tear his presidency apart -- and, in the worst scenario, turn him into a new Jimmy Carter." There are some real similarities between the two U.S. presidents, it's true. Both men came to office following deeply unpopular Republican presidencies and were outsiders with relatively little national security experience. Both had to depend heavily on their staff for policy advice and direction. But beyond these superficial observations, the comparisons are generally based on the conventional wisdom that Carter was an idealistic but weak president.

The reality was far more complex than that. Carter had a number of notable foreign-policy successes -- the return of the Panama Canal, the normalization of relations with the People's Republic of China, and of course, the establishment lasting peace between Egypt and Israel with the Camp David Accords. Getting both sides to sign the accords was undoubtedly Carter's crowning achievement, and he invested his full prestige in the job. Displaying the intense attention detail for which he was often mocked, Carter personally led the negotiations and absorbed all the facts relevant to Israeli and Egyptian concerns about settlements, airfields, and oil reserves in the Sinai.Israeli Prime Minister Menachim Begin noted at the signing of the accords that "the president took a great risk for himself and did it with great civil courage."

So why is Carter remembered today as a dithering weakling? He may have cemented his own legacy in the history books after the Soviet invasion of Afghanistan in 1979, when he ill-advisedly told Frank Reynolds of ABC News that the event had "made a more dramatic change in my opinion of what the Soviets ultimate goals are than anything they've done in the previous time I've been in office." The statement, as Hedley Donovan, a distressed senior adviser later wrote, opened Carter up to the charge of political "naiveté." The charge has continued to dog his legacy ever since.

The president's statement to Reynolds was an instance of his tendency to exaggerate. Carter had never been "soft" in his views of the Soviet Union. At the 1972 Democratic Convention, he led the "Anyone But McGovern" movement and even nominated the uber-hawkish Washington senator Henry "Scoop" Jackson for president. A reference to the Soviet Union as a "warlike power" in the l974 speech announcing his own run for the presidency was dropped only after one of his aides told him the phrase sounded too "Jacksonian."

It's also unlikely Carter was surprised by the 1979 Soviet invasion of Afghanistan. After all, it was he who first authorized U.S. covert operations to aid the mujahadeen the summer of 1978. And in the fall that year, he had received several warnings from the State Department and other sources suggesting the Soviets might invade.

If anything, Carter could be too aggressive with Moscow, and it may have undermined his efforts to reach a deal on atomic-weapons reductions. His first proposal for deep cuts in both powers' nuclear arsenals would have asymmetrically limited Soviet land-based missiles, without corresponding U.S. cuts. Not only that, he unveiled the proposal in a speech before the U.N. General Assembly and then announced increased funding for Radio Free Europe and Radio Liberty shortly before Secretary of State Cyrus Vance was to present the U.S. arms-reduction proposals at a conference to be held in Moscow in spring 1977. Additionally, he invited Soviet dissidents to meet with him at the White House over Kremlin objections. In these instances, Carter went against the advice of the outgoing secretary of state, Henry Kissinger, who warned that confronting the Soviets directly over their human rights violations would be counterproductive. At the Moscow meeting, the Soviets dismissed Carter's proposals, and an embarrassed U.S. team went home empty-handed.

Eventually, the Carter administration embraced what then CIA Director Stansfield Turner described as a "series of policies on nuclear weapons that laid the whole foundation for Reagan's expansion of nuclear weapons, and war-fighting, and war-winning capabilities." He pushed plans to develop the MX first-strike missile system, proposing that it be made mobile by running the warheads on a rail network linking a series silos in Utah and Nevada. After cancelling deployment of the neutron bomb, he backed a new medium-range nuclear system in Europe that could reach Soviet territory. He also increased the defense budget by 5 percent.

That same year, following National Security Advisor Secretary Zbigniew Brzezinski's advice, Carter moved the U.S. into a more prominent role in the Middle East. He promoted security agreements with Egypt, Saudi Arabia, Turkey, and Pakistan, and the creation of a rapid-deployment force that could be used against new Soviet incursions around the world. Brzezinski even suggested calling the proposal the "Carter Doctrine.

Carter also provided somewhat better management of the Iranian hostage crisis than he is usually given credit for. He did make mistakes in admitting the shah into the United States, hyping the issue for almost six months and launching an ill-fated rescue mission. But he avoided the temptation for military action, and skillfully used the Iranian assets he froze in the United States as a bargaining chip to secure the hostages' release. His efforts were eventually successful and the fact that the plane carrying the American diplomats only left Iran right after Ronald Reagan was sworn in office was just a final bit of Iranian defiance.

If his opponents remember him for his purported weakness, Carter's supporters often hold him up as a rare president who made the promotion of peace and international morality a centerpiece of his foreign policy. But Carter's legacy in the field of human rights is actually quite mixed. His concerns were not evident during the U.S. civil rights movement. In fact, Carter, as a state senator in Atlanta, sat on the sidelines during civil rights marches, which occurred in nearby Americus and Albany in the mid 1960s. When he ran for governor in 1970, he criticized his opponent, Carl Sanders, for praising Martin Luther King, Jr. and promised that he would not seek the "block" vote, subtly slurring the word so that it sounded like "black." It was only after he was elected governor that he became a vocal opponent of racial discrimination. Carter's deeper commitment to human rights more likely emerged from the exigencies of the 1976 presidential campaign than from prior conviction. International human rights, as his advisor Stuart Eizenstat advised him at the time was an issue that would unite disparate factions within the Democratic Party: Baptists in the south, Americans of Eastern European ancestry, and members of the Jewish community.

During his term in office, Carter spoke a great deal about human rights and the United States did act in accordance with international and national legal obligations.  But this campaign was mainly employed as a public relations tool against the Soviet Union. Other despots got off relatively easy. Carter never put meaningful pressure on Chilean strongman Augusto Pinochet, a staunch anti-communist. He never campaigned on behalf of dissidents in the Peoples' Republic of China, an equally, if not more repressive regime than the Soviet Union. Nicolae Ceausescu, Romania's brutal dictator, was welcomed at a White House dinner in 1978 and that country held "Most Favored Nation" status throughout Carter's presidency. Even critiques of Cambodian dictator Pol Pot were muted after Soviet-allied Vietnam invaded his country to end one of the most brutal genocides in modern history.

Most tragically, Carter's early embrace of Soviet human rights giant Andrei Sakharov was not accompanied by support for another heroic figure, Archbishop Oscar Romero of El Salvador. Rather, as documented for the first time in my book, An Outsider in the White House, the administration sought the help of John Paul II to quiet the archbishop's outspoken opposition to a government supported by the United States, but loosely tied to right-wing death squads. Without U.S. or papal backing, the archbishop became an easy target for an assassin's bullet. He was murdered while saying mass in San Salvador in March 1980.

Like Carter's, Obama's presidency will face complications. As a Nobel Peace Prize laureate whose most notable foreign-policy decision so far has been further committing the United States to a war in Afghanistan, Obama is well aware that U.S. interests don't always correspond with a universally recognized moral standard. Carter had to face the fanaticism of Khomeini and an aroused Iranian people. Obama must deal with the Islamist extremism inspired by Osama bin Laden, and the temptation will always exist to address such problems through military action. Obama acknowledged as much in his Nobel address. But the prudent statesman, as Carter discovered, will know that the decision to use force always places a nation onto morally uncertain terrain in which power is limited and losses may sometimes have to be absorbed. Despite the many challenges that arose during his presidency, Carter avoided putting the United States in that position. This was not weakness; it was shrewd statecraft, and a worthy example for Obama to follow.

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Gandhi's Hookworms

The spread of neglected tropical diseases haven't just created a health crisis in the developing world -- they have spurred conflicts in some of the most unstable places on the planet.

Toward the end of his life, Mohandas Gandhi suffered from a hookworm infection. This disease, caused by blood-feeding worms in his intestine, is associated with severe anemia, lethargy, and fatigue. The fact that Gandhi's vigorous efforts to wage peace in India may have been slowed because of hookworms is only one of the more dramatic examples of the deep connection between medical health and the promotion of international peace and security.

Today almost all of the 1.4 billion people who live below the World Bank's poverty line are infected with hookworms or related parasites. Taken together, there are seven high-prevalence Neglected Tropical Diseases (NTDs) that particularly afflict low- and middle-income countries: six parasitic worm infections, which each afflict up to 1 billion people, and a bacterial infection known as blinding trachoma, which infects 60 to 80 million people.

In addition to their disproportionate impact on the poor, NTDs differ from the type of infections common in the developed world because, in the absence of treatment, they can persist for years or decades. NTDs produce chronic and disabling effects on child development and farm worker productivity, and they increase the risks of pregnancy. In doing so, these infections actually trap people in poverty -- chronic hookworm infections in childhood reduce cognition, school performance, and future wage-earning potential by 40 percent or more.

India loses almost $1 billion annually in worker productivity because of elephantiasis, which is caused by filarial worms in the lymphatic system and genitals. Africa suffers similar economic losses from elephantiasis -- as well as river blindness caused by larval worms in the eyes and skin, and schistosomiasis from worm eggs in the intestines, liver, bladder, or female genitals.

The people at highest risk for acquiring these NTDs also live in areas of greatest concern to the global security interests of the United States. As much as one half of the world's poor who suffer from NTDs live in the nations that comprise the Organization of the Islamic Conference, including Yemen, Sudan, Somalia, and Afghanistan. Almost as many live in pockets of poverty in middle-income countries that either hold and maintain nuclear weapons stockpiles or aspire to produce them, including India, Pakistan, China, Iran, and North Korea. In these countries, people are not only trapped in poverty because of their health conditions, they are also trapped in conflict.

As NTDs spread throughout impoverished areas of Islamic countries and nuclear weapons states, they can promote global insecurity by increasing poverty and the possibility for radicalization. The security risks created by high endemic rates of NTDs argue strongly for seeking low-cost solutions for their control and elimination.

Fortunately, such measures are available and can be implemented for a tiny fraction of the cost of treating HIV/AIDS and other higher profile diseases. Several major pharmaceutical companies have agreed to provide many of the most important drugs used to combat NTDs free of charge, through well-orchestrated donation programs. Moreover, the drugs are effective even if they are given just once a year, making it possible to treat large populations in integrated, nationwide campaigns. Studies have demonstrated the feasibility and safety of simultaneously delivering three of the most commonly used drugs that target all six major worm infections at one time, while an antibacterial drug for trachoma can be administered at a later date.  In many cases, large-scale annual treatment campaigns can be conducted at a cost of $0.50 per person. There is also evidence that several rounds of annual treatments may actually eliminate some of these NTDs as a public health problem.

The initial funds for the first large-scale NTD control effort were provided under George W. Bush's administration. These efforts are now being expanded by Barack Obama's administration in order to treat tens of millions of people through annual mass drug administration at a cost of $65 million in 2010 -- a sum that will possibly increase to $200 million in 2011.

Such funds represent less than 1 percent of White House's annual global health budget, which is now focused heavily on HIV/AIDS treatment and prevention through the President's Emergency Plan for AIDS Relief (PEPFAR). However, the health impact of NTD control is almost equivalent to that of HIV/AIDS, and, given the geography of where NTDs are most highly endemic, the modest costs required, and the potential for promoting global security, linking NTD control and elimination with U.S. foreign-policy goals makes a lot of sense. Because not all NTDs can be eliminated with existing drugs, there are further opportunities for joint research projects to develop new drugs, diagnostics, and vaccines between global health research scientists in the United States and in the nuclear weapons states where NTDs are endemic.

The low cost for NTD control and elimination efforts and the potentially high return in terms of global security suggest that such activities could eventually be integrated into the missions of the Department of State and the Department of Defense, especially as their policies relate to the OIC and nuclear weapons states. NTD "medical diplomacy" presents an opportunity of enhancing the technical expertise of American embassies abroad to provide support for national health ministries in the most affected areas, providing debt relief in exchange for attaining high drug treatment coverage, or encouraging ceasefires in areas of conflict in order to deliver essential NTD drugs. As we move into the 2010s, the medical community and the diplomatic corps must work together to translate global public health victories in NTD control and elimination into diplomatic rapprochement with the countries that make up the Muslim world and nuclear weapons states. Success in this important cause, it is fair to say, would be an achievement worthy of Gandhi.