President Obama's State Of The Union Address 2016

Mr. Speaker, Mr. Vice President, Members of Congress, my fellow Americans:

Tonight marks the eighth year I've come here to report on the State of the Union. And for this final one, I'm going to try to make it shorter. I know some of you are antsy to get back to Iowa.

I also understand that because it's an election season, expectations for what we'll achieve this year are low. Still, Mr. Speaker, I appreciate the constructive approach you and the other leaders took at the end of last year to pass a budget and make tax cuts permanent for working families. So I hope we can work together this year on bipartisan priorities like criminal justice reform, and helping people who are battling prescription drug abuse. We just might surprise the cynics again.

But tonight, I want to go easy on the traditional list of proposals for the year ahead. Don't worry, I've got plenty, from helping students learn to write computer code to personalizing medical treatments for patients. And I'll keep pushing for progress on the work that still needs doing. Fixing a broken immigration system. Protecting our kids from gun violence. Equal pay for equal work, paid leave, raising the minimum wage. All these things still matter to hardworking families; they are still the right thing to do; and I will not let up until they get done.

But for my final address to this chamber, I don't want to talk just about the next year. I want to focus on the next five years, ten years, and beyond.

I want to focus on our future.

We live in a time of extraordinary change — change that's reshaping the way we live, the way we work, our planet and our place in the world. It's change that promises amazing medical breakthroughs, but also economic disruptions that strain working families. It promises education for girls in the most remote villages, but also connects terrorists plotting an ocean away. It's change that can broaden opportunity, or widen inequality. And whether we like it or not, the pace of this change will only accelerate.

America has been through big changes before — wars and depression, the influx of immigrants, workers fighting for a fair deal, and movements to expand civil rights. Each time, there have been those who told us to fear the future; who claimed we could slam the brakes on change, promising to restore past glory if we just got some group or idea that was threatening America under control. And each time, we overcame those fears. We did not, in the words of Lincoln, adhere to the "dogmas of the quiet past." Instead we thought anew, and acted anew. We made change work for us, always extending America's promise outward, to the next frontier, to more and more people. And because we did — because we saw opportunity where others saw only peril — we emerged stronger and better than before.

What was true then can be true now. Our unique strengths as a nation — our optimism and work ethic, our spirit of discovery and innovation, our diversity and commitment to the rule of law — these things give us everything we need to ensure prosperity and security for generations to come.

In fact, it's that spirit that made the progress of these past seven years possible. It's how we recovered from the worst economic crisis in generations. It's how we reformed our health care system, and reinvented our energy sector; how we delivered more care and benefits to our troops and veterans, and how we secured the freedom in every state to marry the person we love.

But such progress is not inevitable. It is the result of choices we make together. And we face such choices right now. Will we respond to the changes of our time with fear, turning inward as a nation, and turning against each other as a people? Or will we face the future with confidence in who we are, what we stand for, and the incredible things we can do together?

So let's talk about the future, and four big questions that we as a country have to answer — regardless of who the next President is, or who controls the next Congress.

First, how do we give everyone a fair shot at opportunity and security in this new economy?

Second, how do we make technology work for us, and not against us — especially when it comes to solving urgent challenges like climate change?

Third, how do we keep America safe and lead the world without becoming its policeman?

And finally, how can we make our politics reflect what's best in us, and not what's worst?

Let me start with the economy, and a basic fact: the United States of America, right now, has the strongest, most durable economy in the world. We're in the middle of the longest streak of private-sector job creation in history. More than 14 million new jobs; the strongest two years of job growth since the '90s; an unemployment rate cut in half. Our auto industry just had its best year ever. Manufacturing has created nearly 900,000 new jobs in the past six years. And we've done all this while cutting our deficits by almost three-quarters.

Anyone claiming that America's economy is in decline is peddling fiction. What is true — and the reason that a lot of Americans feel anxious — is that the economy has been changing in profound ways, changes that started long before the Great Recession hit and haven't let up. Today, technology doesn't just replace jobs on the assembly line, but any job where work can be automated. Companies in a global economy can locate anywhere, and face tougher competition. As a result, workers have less leverage for a raise. Companies have less loyalty to their communities. And more and more wealth and income is concentrated at the very top.

All these trends have squeezed workers, even when they have jobs; even when the economy is growing. It's made it harder for a hardworking family to pull itself out of poverty, harder for young people to start on their careers, and tougher for workers to retire when they want to. And although none of these trends are unique to America, they do offend our uniquely American belief that everybody who works hard should get a fair shot.

For the past seven years, our goal has been a growing economy that works better for everybody. We've made progress. But we need to make more. And despite all the political arguments we've had these past few years, there are some areas where Americans broadly agree.

We agree that real opportunity requires every American to get the education and training they need to land a good-paying job. The bipartisan reform of No Child Left Behind was an important start, and together, we've increased early childhood education, lifted high school graduation rates to new highs, and boosted graduates in fields like engineering. In the coming years, we should build on that progress, by providing Pre-K for all, offering every student the hands-on computer science and math classes that make them job-ready on day one, and we should recruit and support more great teachers for our kids.

And we have to make college affordable for every American. Because no hardworking student should be stuck in the red. We've already reduced student loan payments to ten percent of a borrower's income. Now, we've actually got to cut the cost of college. Providing two years of community college at no cost for every responsible student is one of the best ways to do that, and I'm going to keep fighting to get that started this year.

Of course, a great education isn't all we need in this new economy. We also need benefits and protections that provide a basic measure of security. After all, it's not much of a stretch to say that some of the only people in America who are going to work the same job, in the same place, with a health and retirement package, for 30 years, are sitting in this chamber. For everyone else, especially folks in their forties and fifties, saving for retirement or bouncing back from job loss has gotten a lot tougher. Americans understand that at some point in their careers, they may have to retool and retrain. But they shouldn't lose what they've already worked so hard to build.

That's why Social Security and Medicare are more important than ever; we shouldn't weaken them, we should strengthen them. And for Americans short of retirement, basic benefits should be just as mobile as everything else is today. That's what the Affordable Care Act is all about. It's about filling the gaps in employer-based care so that when we lose a job, or go back to school, or start that new business, we'll still have coverage. Nearly eighteen million have gained coverage so far. Health care inflation has slowed. And our businesses have created jobs every single month since it became law.

Now, I'm guessing we won't agree on health care anytime soon. But there should be other ways both parties can improve economic security. Say a hardworking American loses his job — we shouldn't just make sure he can get unemployment insurance; we should make sure that program encourages him to retrain for a business that's ready to hire him. If that new job doesn't pay as much, there should be a system of wage insurance in place so that he can still pay his bills. And even if he's going from job to job, he should still be able to save for retirement and take his savings with him. That's the way we make the new economy work better for everyone.

I also know Speaker Ryan has talked about his interest in tackling poverty. America is about giving everybody willing to work a hand up, and I'd welcome a serious discussion about strategies we can all support, like expanding tax cuts for low-income workers without kids.

But there are other areas where it's been more difficult to find agreement over the last seven years — namely what role the government should play in making sure the system's not rigged in favor of the wealthiest and biggest corporations. And here, the American people have a choice to make.

I believe a thriving private sector is the lifeblood of our economy. I think there are outdated regulations that need to be changed, and there's red tape that needs to be cut. But after years of record corporate profits, working families won't get more opportunity or bigger paychecks by letting big banks or big oil or hedge funds make their own rules at the expense of everyone else; or by allowing attacks on collective bargaining to go unanswered. Food Stamp recipients didn't cause the financial crisis; recklessness on Wall Street did. Immigrants aren't the reason wages haven't gone up enough; those decisions are made in the boardrooms that too often put quarterly earnings over long-term returns. It's sure not the average family watching tonight that avoids paying taxes through offshore accounts. In this new economy, workers and start-ups and small businesses need more of a voice, not less. The rules should work for them. And this year I plan to lift up the many businesses who've figured out that doing right by their workers ends up being good for their shareholders, their customers, and their communities, so that we can spread those best practices across America.

In fact, many of our best corporate citizens are also our most creative. This brings me to the second big question we have to answer as a country: how do we reignite that spirit of innovation to meet our biggest challenges?

Sixty years ago, when the Russians beat us into space, we didn't deny Sputnik was up there. We didn't argue about the science, or shrink our research and development budget. We built a space program almost overnight, and twelve years later, we were walking on the moon.

That spirit of discovery is in our DNA. We're Thomas Edison and the Wright Brothers and George Washington Carver. We're Grace Hopper and Katherine Johnson and Sally Ride. We're every immigrant and entrepreneur from Boston to Austin to Silicon Valley racing to shape a better world. And over the past seven years, we've nurtured that spirit.

We've protected an open internet, and taken bold new steps to get more students and low-income Americans online. We've launched next-generation manufacturing hubs, and online tools that give an entrepreneur everything he or she needs to start a business in a single day.

But we can do so much more. Last year, Vice President Biden said that with a new moonshot, America can cure cancer. Last month, he worked with this Congress to give scientists at the National Institutes of Health the strongest resources they've had in over a decade. Tonight, I'm announcing a new national effort to get it done. And because he's gone to the mat for all of us, on so many issues over the past forty years, I'm putting Joe in charge of Mission Control. For the loved ones we've all lost, for the family we can still save, let's make America the country that cures cancer once and for all.

Medical research is critical. We need the same level of commitment when it comes to developing clean energy sources.

Look, if anybody still wants to dispute the science around climate change, have at it. You'll be pretty lonely, because you'll be debating our military, most of America's business leaders, the majority of the American people, almost the entire scientific community, and 200 nations around the world who agree it's a problem and intend to solve it.

But even if the planet wasn't at stake; even if 2014 wasn't the warmest year on record — until 2015 turned out even hotter — why would we want to pass up the chance for American businesses to produce and sell the energy of the future?

Seven years ago, we made the single biggest investment in clean energy in our history. Here are the results. In fields from Iowa to Texas, wind power is now cheaper than dirtier, conventional power. On rooftops from Arizona to New York, solar is saving Americans tens of millions of dollars a year on their energy bills, and employs more Americans than coal — in jobs that pay better than average. We're taking steps to give homeowners the freedom to generate and store their own energy — something environmentalists and Tea Partiers have teamed up to support. Meanwhile, we've cut our imports of foreign oil by nearly sixty percent, and cut carbon pollution more than any other country on Earth.

Gas under two bucks a gallon ain't bad, either.

Now we've got to accelerate the transition away from dirty energy. Rather than subsidize the past, we should invest in the future — especially in communities that rely on fossil fuels. That's why I'm going to push to change the way we manage our oil and coal resources, so that they better reflect the costs they impose on taxpayers and our planet. That way, we put money back into those communities and put tens of thousands of Americans to work building a 21st century transportation system.

None of this will happen overnight, and yes, there are plenty of entrenched interests who want to protect the status quo. But the jobs we'll create, the money we'll save, and the planet we'll preserve — that's the kind of future our kids and grandkids deserve.

Climate change is just one of many issues where our security is linked to the rest of the world. And that's why the third big question we have to answer is how to keep America safe and strong without either isolating ourselves or trying to nation-build everywhere there's a problem.

I told you earlier all the talk of America's economic decline is political hot air. Well, so is all the rhetoric you hear about our enemies getting stronger and America getting weaker. The United States of America is the most powerful nation on Earth. Period. It's not even close. We spend more on our military than the next eight nations combined. Our troops are the finest fighting force in the history of the world. No nation dares to attack us or our allies because they know that's the path to ruin. Surveys show our standing around the world is higher than when I was elected to this office, and when it comes to every important international issue, people of the world do not look to Beijing or Moscow to lead — they call us.

As someone who begins every day with an intelligence briefing, I know this is a dangerous time. But that's not because of diminished American strength or some looming superpower. In today's world, we're threatened less by evil empires and more by failing states. The Middle East is going through a transformation that will play out for a generation, rooted in conflicts that date back millennia. Economic headwinds blow from a Chinese economy in transition. Even as their economy contracts, Russia is pouring resources to prop up Ukraine and Syria — states they see slipping away from their orbit. And the international system we built after World War II is now struggling to keep pace with this new reality.

It's up to us to help remake that system. And that means we have to set priorities.

Priority number one is protecting the American people and going after terrorist networks. Both al Qaeda and now ISIL pose a direct threat to our people, because in today's world, even a handful of terrorists who place no value on human life, including their own, can do a lot of damage. They use the Internet to poison the minds of individuals inside our country; they undermine our allies.

But as we focus on destroying ISIL, over-the-top claims that this is World War III just play into their hands. Masses of fighters on the back of pickup trucks and twisted souls plotting in apartments or garages pose an enormous danger to civilians and must be stopped. But they do not threaten our national existence. That's the story ISIL wants to tell; that's the kind of propaganda they use to recruit. We don't need to build them up to show that we're serious, nor do we need to push away vital allies in this fight by echoing the lie that ISIL is representative of one of the world's largest religions. We just need to call them what they are — killers and fanatics who have to be rooted out, hunted down, and destroyed.

That's exactly what we are doing. For more than a year, America has led a coalition of more than 60 countries to cut off ISIL's financing, disrupt their plots, stop the flow of terrorist fighters, and stamp out their vicious ideology. With nearly 10,000 air strikes, we are taking out their leadership, their oil, their training camps, and their weapons. We are training, arming, and supporting forces who are steadily reclaiming territory in Iraq and Syria.

If this Congress is serious about winning this war, and wants to send a message to our troops and the world, you should finally authorize the use of military force against ISIL. Take a vote. But the American people should know that with or without Congressional action, ISIL will learn the same lessons as terrorists before them. If you doubt America's commitment — or mine — to see that justice is done, ask Osama bin Laden. Ask the leader of al Qaeda in Yemen, who was taken out last year, or the perpetrator of the Benghazi attacks, who sits in a prison cell. When you come after Americans, we go after you. It may take time, but we have long memories, and our reach has no limit.

Our foreign policy must be focused on the threat from ISIL and al Qaeda, but it can't stop there. For even without ISIL, instability will continue for decades in many parts of the world — in the Middle East, in Afghanistan and Pakistan, in parts of Central America, Africa and Asia. Some of these places may become safe havens for new terrorist networks; others will fall victim to ethnic conflict, or famine, feeding the next wave of refugees. The world will look to us to help solve these problems, and our answer needs to be more than tough talk or calls to carpet bomb civilians. That may work as a TV sound bite, but it doesn't pass muster on the world stage.

We also can't try to take over and rebuild every country that falls into crisis. That's not leadership; that's a recipe for quagmire, spilling American blood and treasure that ultimately weakens us. It's the lesson of Vietnam, of Iraq — and we should have learned it by now.

Fortunately, there's a smarter approach, a patient and disciplined strategy that uses every element of our national power. It says America will always act, alone if necessary, to protect our people and our allies; but on issues of global concern, we will mobilize the world to work with us, and make sure other countries pull their own weight.

That's our approach to conflicts like Syria, where we're partnering with local forces and leading international efforts to help that broken society pursue a lasting peace.

That's why we built a global coalition, with sanctions and principled diplomacy, to prevent a nuclear-armed Iran. As we speak, Iran has rolled back its nuclear program, shipped out its uranium stockpile, and the world has avoided another war.

That's how we stopped the spread of Ebola in West Africa. Our military, our doctors, and our development workers set up the platform that allowed other countries to join us in stamping out that epidemic.

That's how we forged a Trans-Pacific Partnership to open markets, protect workers and the environment, and advance American leadership in Asia. It cuts 18,000 taxes on products Made in America, and supports more good jobs. With TPP, China doesn't set the rules in that region, we do. You want to show our strength in this century? Approve this agreement. Give us the tools to enforce it.

Fifty years of isolating Cuba had failed to promote democracy, setting us back in Latin America. That's why we restored diplomatic relations, opened the door to travel and commerce, and positioned ourselves to improve the lives of the Cuban people. You want to consolidate our leadership and credibility in the hemisphere? Recognize that the Cold War is over. Lift the embargo.

American leadership in the 21st century is not a choice between ignoring the rest of the world — except when we kill terrorists; or occupying and rebuilding whatever society is unraveling. Leadership means a wise application of military power, and rallying the world behind causes that are right. It means seeing our foreign assistance as part of our national security, not charity. When we lead nearly 200 nations to the most ambitious agreement in history to fight climate change — that helps vulnerable countries, but it also protects our children. When we help Ukraine defend its democracy, or Colombia resolve a decades-long war, that strengthens the international order we depend upon. When we help African countries feed their people and care for the sick, that prevents the next pandemic from reaching our shores. Right now, we are on track to end the scourge of HIV/AIDS, and we have the capacity to accomplish the same thing with malaria — something I'll be pushing this Congress to fund this year.

That's strength. That's leadership. And that kind of leadership depends on the power of our example. That is why I will keep working to shut down the prison at Guantanamo: it's expensive, it's unnecessary, and it only serves as a recruitment brochure for our enemies.

That's why we need to reject any politics that targets people because of race or religion. This isn't a matter of political correctness. It's a matter of understanding what makes us strong. The world respects us not just for our arsenal; it respects us for our diversity and our openness and the way we respect every faith. His Holiness, Pope Francis, told this body from the very spot I stand tonight that "to imitate the hatred and violence of tyrants and murderers is the best way to take their place." When politicians insult Muslims, when a mosque is vandalized, or a kid bullied, that doesn't make us safer. That's not telling it like it is. It's just wrong. It diminishes us in the eyes of the world. It makes it harder to achieve our goals. And it betrays who we are as a country.

"We the People."

Our Constitution begins with those three simple words, words we've come to recognize mean all the people, not just some; words that insist we rise and fall together. That brings me to the fourth, and maybe the most important thing I want to say tonight.

The future we want — opportunity and security for our families; a rising standard of living and a sustainable, peaceful planet for our kids — all that is within our reach. But it will only happen if we work together. It will only happen if we can have rational, constructive debates.

It will only happen if we fix our politics.

A better politics doesn't mean we have to agree on everything. This is a big country, with different regions and attitudes and interests. That's one of our strengths, too. Our Founders distributed power between states and branches of government, and expected us to argue, just as they did, over the size and shape of government, over commerce and foreign relations, over the meaning of liberty and the imperatives of security.

But democracy does require basic bonds of trust between its citizens. It doesn't work if we think the people who disagree with us are all motivated by malice, or that our political opponents are unpatriotic. Democracy grinds to a halt without a willingness to compromise; or when even basic facts are contested, and we listen only to those who agree with us. Our public life withers when only the most extreme voices get attention. Most of all, democracy breaks down when the average person feels their voice doesn't matter; that the system is rigged in favor of the rich or the powerful or some narrow interest.

Too many Americans feel that way right now. It's one of the few regrets of my presidency — that the rancor and suspicion between the parties has gotten worse instead of better. There's no doubt a president with the gifts of Lincoln or Roosevelt might have better bridged the divide, and I guarantee I'll keep trying to be better so long as I hold this office.

But, my fellow Americans, this cannot be my task — or any President's — alone. There are a whole lot of folks in this chamber who would like to see more cooperation, a more elevated debate in Washington, but feel trapped by the demands of getting elected. I know; you've told me. And if we want a better politics, it's not enough to just change a Congressman or a Senator or even a President; we have to change the system to reflect our better selves.

We have to end the practice of drawing our congressional districts so that politicians can pick their voters, and not the other way around. We have to reduce the influence of money in our politics, so that a handful of families and hidden interests can't bankroll our elections — and if our existing approach to campaign finance can't pass muster in the courts, we need to work together to find a real solution. We've got to make voting easier, not harder, and modernize it for the way we live now. And over the course of this year, I intend to travel the country to push for reforms that do.

But I can't do these things on my own. Changes in our political process — in not just who gets elected but how they get elected — that will only happen when the American people demand it. It will depend on you. That's what's meant by a government of, by, and for the people.

What I'm asking for is hard. It's easier to be cynical; to accept that change isn't possible, and politics is hopeless, and to believe that our voices and actions don't matter. But if we give up now, then we forsake a better future. Those with money and power will gain greater control over the decisions that could send a young soldier to war, or allow another economic disaster, or roll back the equal rights and voting rights that generations of Americans have fought, even died, to secure. As frustration grows, there will be voices urging us to fall back into tribes, to scapegoat fellow citizens who don't look like us, or pray like us, or vote like we do, or share the same background.

We can't afford to go down that path. It won't deliver the economy we want, or the security we want, but most of all, it contradicts everything that makes us the envy of the world.

So, my fellow Americans, whatever you may believe, whether you prefer one party or no party, our collective future depends on your willingness to uphold your obligations as a citizen. To vote. To speak out. To stand up for others, especially the weak, especially the vulnerable, knowing that each of us is only here because somebody, somewhere, stood up for us. To stay active in our public life so it reflects the goodness and decency and optimism that I see in the American people every single day.

It won't be easy. Our brand of democracy is hard. But I can promise that a year from now, when I no longer hold this office, I'll be right there with you as a citizen — inspired by those voices of fairness and vision, of grit and good humor and kindness that have helped America travel so far. Voices that help us see ourselves not first and foremost as black or white or Asian or Latino, not as gay or straight, immigrant or native born; not as Democrats or Republicans, but as Americans first, bound by a common creed. Voices Dr. King believed would have the final word — voices of unarmed truth and unconditional love.

They're out there, those voices. They don't get a lot of attention, nor do they seek it, but they are busy doing the work this country needs doing.

I see them everywhere I travel in this incredible country of ours. I see you. I know you're there. You're the reason why I have such incredible confidence in our future. Because I see your quiet, sturdy citizenship all the time.

I see it in the worker on the assembly line who clocked extra shifts to keep his company open, and the boss who pays him higher wages to keep him on board.

I see it in the Dreamer who stays up late to finish her science project, and the teacher who comes in early because he knows she might someday cure a disease.

I see it in the American who served his time, and dreams of starting over — and the business owner who gives him that second chance. The protester determined to prove that justice matters, and the young cop walking the beat, treating everybody with respect, doing the brave, quiet work of keeping us safe.

I see it in the soldier who gives almost everything to save his brothers, the nurse who tends to him 'til he can run a marathon, and the community that lines up to cheer him on.

It's the son who finds the courage to come out as who he is, and the father whose love for that son overrides everything he's been taught.

I see it in the elderly woman who will wait in line to cast her vote as long as she has to; the new citizen who casts his for the first time; the volunteers at the polls who believe every vote should count, because each of them in different ways know how much that precious right is worth.

That's the America I know. That's the country we love. Clear-eyed. Big-hearted. Optimistic that unarmed truth and unconditional love will have the final word. That's what makes me so hopeful about our future. Because of you. I believe in you. That's why I stand here confident that the State of our Union is strong.

Thank you, God bless you, and God bless the United States of America.

Nigeria Says Couple Of OPEC Members Have Requested Emergency Meeting

BY BY RANIA EL GAMAL AND MAHA EL DAHAN

REUTERS, TUESDAY JANUARY 12, 2016

The logo of the Organization of the Petroleum Exporting Countries (OPEC) is pictured at its headquarters in Vienna, Austria, August 21, 2015.  Image: Heinz-Peter Bader


Nigeria's oil minister said on Tuesday that a "couple" of members of the Organization of the Petroleum Exporting Countries (OPEC) had requested an emergency meeting, adding that current market conditions support the need to hold such a gathering.

Benchmark Brent crude oil futures LCOc1 were trading at less than $31 per barrel on Tuesday, their lowest level since April 2004, and have shed almost three-quarters of their value since mid-2014. [O/R]

Nigerian Minister of State for Petroleum Resources Emmanuel Ibe Kachikwu told reporters at an energy conference in Abu Dhabi that there was a lot of push from various blocs within ‎OPEC for the need of a meeting.

"A couple of countries, I don't want to mention names," he said when asked if any had requested holding an emergency meeting.

Any meeting that would take place would be to review OPEC's position to see if there was any need to change its strategy, Kachikwu said, adding that the meeting could take place in February or March.

Much will depend on the attitude of OPEC heavyweight Saudi Arabia, which has resisted calls for a cut in production to help boost prices.

"Saudi Arabia‎ has never held the position that it does not want to talk," Kachikwu said. "In fact, it was very supportive of a meeting before June, at the time when we held the December meeting, if (there was a) consensus call for it."

(Writing by David French; editing by Jason Neely)

Francis Lays Out Case For Mercy In 1st Book As Pope

 BY NICOLE WINFIELD

 Pope Francis kisses during statue of baby Jesus a Mass in St. Peter's Basilica, at the Vatican, to mark Epiphany, Wednesday, Jan. 6, 2016. The Epiphany day is a joyous day for Catholics in which they recall the journey of… Image: Gregorio Borgia, AP

VATICAN CITY (ASSOCIATED PRESS) — Pope Francis lays out his case for emphasizing the merciful face of the Catholic Church in his first book as pontiff, saying God never tires of forgiving and actually prefers the sinners who repent over self-righteous moralizers who don't.

"The Name of God Is Mercy," a 100-page conversation with Italian journalist Andrea Tornielli, is being published this week in 86 countries to help kick-start Francis' Holy Year of Mercy. A copy was provided in advance to The Associated Press on Sunday.

In the book, Francis condemns what he calls the "scholars of law" — the doctrinaire-minded rigorists who throughout the history of the church have challenged Jesus' message of unconditional love and mercy for even the most wretched of sinners. He says often these self-righteous Christians are hypocrites themselves, using the law to hide their own "deep wounds."

"These are men who live attached to the letter of the law but who neglect love; men who only know how to close doors and draw boundaries," Francis is quoted as saying.

Francis has rankled many conservatives with his frequent dismissals of theological and legalistic arguments stressing doctrine over his more pastoral message of welcome and mercy for society's most marginal. The clash in approaches has been particularly evident in recent church debates over marriage and divorce.

"We must avoid the attitude of someone who judges and condemns from the lofty heights of his own certainty, looking for the splinter in his brother's eye while remaining unaware of the beam in his own," Francis says. "Let us always remember that God rejoices more when one sinner returns to the fold than when 99 righteous people have no need of repentance."

The Vatican is officially launching the book Tuesday with a high-level panel discussion featuring Francis' secretary of state, Cardinal Pietro Parolin, and 'Life Is Beautiful' actor Roberto Benigni, signaling the importance Francis places on getting the message out.

In the book, Francis insists that his now-infamous "Who am I to judge" comment about gays was merely a repetition of the church's teaching on homosexuality. Francis won praise from gays with the comment, uttered during his first press conference in 2013. But many conservatives have criticized the remark as vague and incomplete since church teaching also holds that gay acts are "intrinsically disordered."

Francis says the church has long held that gays should be treated with dignity and respect and seen as individuals. And he goes to some length throughout the text to cite scripture and previous popes to make clear that his radical agenda is fully rooted in the church's basic teachings.

"People should not be defined only by their sexual tendancies: Let us not forget that God loves all his creatures and we are destined to receive his infinite love," he says. "I prefer that homosexuals come to confession, that they stay close to the Lord, and that we pray all together. You can advise them to pray, show goodwill, show them the way, and accompany them along it."

Francis has made clear from the start of his pontificate that his would be a papacy focused on mercy, and he called a jubilee year to emphasize it. Throughout the book, Francis refers repeatedly to his own ministry to prostitutes and prisoners in Argentina, showing how his own personal encounters with society's outcasts have shaped his view about the faith and formed the bedrock of his papacy.

As a confessor, Francis is quoted as saying, "I have always tried to find a crack, just a tiny opening so that I can pry open that door and grant forgiveness and mercy."

But Francis' opening isn't a free-for-all: He says of course prisons can't throw their doors open and let violent criminals out onto the streets. But he says once a debt is paid, prisoners must be reintegrated back into society and welcomed. And he distinguishes between ordinary and even repeat sinners and those who are corrupt, saying corruption is a condition, a state of life and often a hypocritical one incompatible with Christianity.

"The corrupt man often doesn't realize his own condition, much as a person with bad breath doesn't know they have it," he says.

Some conservatives have balked at Francis' mercy-over-morals priorities, saying it has sent confusing messages to the faithful especially after two previous popes spent so much time stressing doctrine. Even some cardinals have called on Francis to make clear-cut policy statements on certain hot-button issues, especially on the divisive question of whether divorced and civilly remarried Catholics can receive Communion.

Church teaching holds that, if these Catholics are living in sin, they cannot receive the sacraments.

Francis launched a two-year study on the issue and other matters related to Catholic family life, and is expected to weigh in this year with a document on whether any accommodation can be found.

In the book, Francis doesn't commit himself one way or the other, but he indicated that his ultimate decision may draw on a personal experience.

Francis recounts that one of his nieces wanted to marry a man who had children from a previous marriage but hadn't yet obtained an annulment, a church decree that his first marriage was null.

The couple got married in a civil ceremony and went on to have three children. Francis recalls that every Sunday when they went to Mass the man went to confession and told the priest that he knew he couldn't be absolved from the sin of adultery, but he asked for a blessing.

"This is a religiously mature man," Francis said.

Progressives, led by the German bishops, have said such religiously mature Catholics should be allowed to participate fully in the life of the church, including receiving the sacraments.

Follow Nicole Winfield at www.twitter.com/nwinfield

France Pays Tribute To 2015 Terrorism Victims In Silent Ceremony

BY GEERT DE CLERCQ

REUTERS, JANUARY 10, 2016

People attend a ceremony at Place de la Republique square to pay tribute to the victims of last year's shooting at the French satirical newspaper Charlie Hebdo, in Paris, France, January 10, 2016. Image: Charles Platiau



France honored the victims of Islamist militant attacks last year in a thinly attended silent ceremony on Sunday, almost a year to the day when more than a million people marched in Paris to protest killings at the satirical magazine Charlie Hebdo.

President Francois Hollande and Paris Mayor Anne Hidalgo laid a wreath by the statue of Marianne, symbol of the French republic, in central Paris. The statue has become a shrine to the 17 victims of the January 2015 attacks on Charlie Hebdo and a Jewish deli, and to the 130 people shot dead by militants on Nov. 13 at a concert, and in bars and restaurants in Paris.



"To the victims of the terrorist attacks in January and November ... In this place, the people of France pay their respect," read a metal plaque unveiled by Hollande and Hidalgo under a newly planted memorial oak tree on Place de la Republique in eastern Paris.

Neither Hollande or Hidalgo spoke at the ceremony, but veteran French rock star Johnny Hallyday, accompanied only by a guitar, sang a song about the march on Jan. 11 last year, which brought out the biggest crowds in Paris since the liberation of Paris from Nazi Germany in 1944.

The French army choir sang late Belgian singer Jacques Brel's "Les Prenoms de Paris" (the First Names of Paris) and "Le temps des cerises", a song associated with the socialist Paris commune movement in 1871, while two young actors read a speech by 19th century writer Victor Hugo.

The huge square in eastern Paris, the focal point of the January 2015 march attended by dozens of world leaders walking arm in arm, was relatively empty during the ceremony.

Hidalgo invited Parisians to come to the square with candles from 1700 Paris time (1600 GMT) and said the Marianne statue - covered with flowers, candles and pictures of the victims - will be permanently lit from now on.

"Paris is scarred, but we are still standing," she told French television after the ceremony.

Hollande, who stood stony-faced through the ceremony, later met with the families of the victims on the square.

Interior Minister Bernard Cazeneuve said security forces remain on high alert as there is a real threat of more attacks.

"We are facing an extremely high level of threat, higher than it has ever been," Cazeneuve said on iTELE television.





(Additional reporting by Marine Pennetier; Editing by Raissa Kasolowsky)

Health Minister: Lassa Fever Kills 35 In 10 Nigerian States

By HILARY UGURU

AP JANUARY 8, 2016

WARRI, NIGERIA (ASSOCIATED PRESS)  — Nigeria’s health minister is urging Nigerians not to panic over an outbreak of an organ-attacking fever that has killed 35 people, nearly half of suspected cases, in the past six weeks.

Dr. Isaac Adewole said in a statement Friday night that the government was containing the outbreak of Lassa fever, a hemorrhage-inducing fever caused by a virus commonly borne by vermin. Lassa fever is confined to West Africa, where the affliction thrives amid poor sanitation and crowded living conditions.

Adewole said doctors had identified 81 suspected cases since mid-November, with lab results confirming 17 cases as definitely Lassa fever.

The disease is named after a Nigerian town where it was first identified in 1969. It manifests similar symptoms to Ebola, ranging from headaches and sore throats to vomiting, diarrhea and bleeding from all orifices. Like Ebola, suspected Lassa cases require health workers to wear protective clothing and patients to be isolated.

While the World Health Organization estimates that only about about 1 percent of people who contract Lassa die from the pathogen, Adewole’s figures put Nigeria’s recent fatality rate at 43 percent.

Adewole said the government has deployed rapid response teams to 10 Nigerian states hit by the outbreak, distributed the ribavirin antiviral drug used to treat Lassa, and advised the public to ensure they store food in containers that rats cannot access.

Copyright 2016 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

More African And Asian Migrants Are Arriving In Mexico After Long Latin American Journeys

BY CONRAD FOX

VICE NEWS JANUARY 08, 2016

George left Cameroon on a Cargo ship. Photo by Conrad Fox

Sitting in a small cafe in the southern Mexican city of Tapachula, Gorjit recalled the harrowing experiences that led him there as he outlined his hopes and fears for the future.

The young man with chiseled features said he left his home in northern India after political strife took the life of his father and uncle. He sold his house and escaped first to Qatar, then to Brazil and on to Argentina where he worked for six months. Then he headed north with one destination in mind.

"Some guys told me there is a better life in the United States," he said in broken Spanish. "And that's where I'm going."

The cafe where Gorjit sat, that bears a sign in Bengali, lies across the street from the Hotel Palafox which is one of the main places where migrants from Africa and Asia who have made it to Mexico hang out, swapping stories from their odysseys and listening to music on mobile phones.

One of them, a Somali refugee called Ismael, said he was living in South Africa when a wave of xenophobic attacks swept the country last year.

"Every day they threatened us," he recalled. Going back to his war-torn homeland, he added, would have been tantamount to "just go and kill yourself."

Ismael paid a man in Kenya $5,000 dollars for a fake passport, a plane ticket to Brazil and introductions to a spidery network of human smugglers that eventually got him to Tapachula and the Hotel Palafox.

A few blocks away in the city's central plaza George smiled as he made a video on a tablet of a traditional Mexican dance troupe — all brassy music and swirling colors. He said he left his native Cameroon without a passport on board a cargo ship. He traveled from port to port until the ship docked in Colombia.

"I thought: Wow, this is the American continent, I used to think you could get a bus to America."

He slipped ashore and was immediately mugged. With what little he had left he began asking directions to the US. He laughs a little at his own naivete.

Tapachula has long been a temporary resting place for Central American migrants heading through Mexico on an effort to get to the United States. In recent years the small, sleepy and hot city has also become a hub for migrants from further afield, many of whom plan to seek asylum if they reach US soil.

Mexican migration authorities detained 1,300 African and Asian migrants in 2014, three times more than the previous year. The numbers were on track to at least double again in 2015.

Honduras, Guatemala, Panama and Colombia have all reported similarly dramatic increases in migrants from countries such as Bangladesh, Nepal, China, India, Pakistan, Tibet, Cameroon, Somalia, Eritrea, Ghana, and Sudan.

The rise of African and Asian migrants in Latin America reflects both the tightening of border restrictions in Europe and their loosening in some Latin American countries, such as Ecuador.

Migrants who would never be granted a visa to fly directly to the US, find Latin America an easier point of entry into the continent. And even where visas are required, corruption has made borders porous. In Tapachula, migrants reported that bribery is almost standard procedure along the route.

The journey is not only long and arduous. At some points it is outright dangerous as well.

In the grimy port town of Turbo, on Colombia's Caribbean coast, migrants mill about the wharves looking for clandestine boat operators to take them to Panama. The port is a bottleneck on the route north, and all migrants pass through here at some point.

"I couldn't sleep that night," George said of his first day in Turbo. The only way the Cameroonian made it out of the town was by handing over about $750 dollars in exchange for a night-long ride in a skiff packed to double capacity through waters controlled by paramilitary groups and the feared Clan Usaga drug trafficking gang.



With no life jackets, dozens of migrants have drowned on this leg of the route every year since 2013. According to locals,the smugglers robbed and then threw the migrants into the water.

"Two weeks ago we found 15 migrants just drifting alone in a boat," Rear Admiral Ricardo Hurtado of the Colombian Navy told VICE News in November. Hurtado's anti-drug patrols also interdict migrant traffic. "When the engine died, the smugglers just swam away and left them there."

Hurtado said that in the first 10 months of 2015 his patrols detained 538 migrants compared to 138 in the same period of the year before. "We're overwhelmed," he said.

For those who can't afford to take a boat all the way to Panama, the cheaper option is to get off on the Colombian coast and then hike through the famously in-hospital jungle of the Darien Gap that separates both countries, and through which no road has ever been built.

Some in Tapachula shuddered as they recalled the journey.

"If I had known there was jungle, I would never have left the ship," George, the Cameroonian said. "There are a lot of dead bodies in the jungle, you see their skeletons."

With his own strength waning, and food and water running out, he spent much of the journey assisting a pregnant woman who was traveling with him as they climbed muddy slopes and crossed fetid swampland. It took them two days to get out.

"I was seven days without food," says Gorjit, the young Indian whose feet were so badly damaged he still has difficulty walking. "I thought I was going to die."

Once they get to Panama the Asian and African migrants often turn themselves into the authorities looking for help, and hoping to get a visa that will enable them to travel legally through the country. They are held in military camps while their identity is checked by authorities.

"In the first camp, we sleep like dogs, outside on the stone. The food is the same, two times a day. For twenty-five days, dry rice. That is all they can afford to give us." said Ismael, the Somali. "But we say thank you. If we are still alive until now, we just say thank you to God."

Ismael, like most migrants on this route, was eventually granted a temporary exit visa and released. This is a pattern that becomes routine as the migrants move from country to country through Central America. For most governments in the region, establishing the nationality of undocumented migrants from half the world away — let alone deporting them home — is simply too slow and costly.

And then there are the smuggling rings that help move the migrants through the region in ways that avoid the authorities altogether — at a price.

When Guatemala's recently created human trafficking unit raided a small hotel in downtown Guatemala City in June of 2015, they found a diverse collection of foreign currency, as well as false passports, lists of flights and arrival times, and signs with people's names on for picking up clients at the airport. They also found a parrot that Asian asylum seekers at the US border had told Immigration and Customs Enforcement (ICE) agents that their Guatemalan smugglers kept in an office upstairs.

"These guys are so organized. They've got contacts in Africa... in South America," said Mynor Pinto, the Guatemalan officer who led the raid triggered by an ICE tip. "We're talking about a kind of confederation of criminal structures all working towards the same goal. Everyone has their fee and no one moves the migrants until they get their cut."

After Guatemala comes Mexico. They typically cross the border over the Suchiate river on the small flotilla of rafts made of inner tubes that are punted leisurely from bank to bank. They carry goods and livestock in a thriving cross border trade, as well as migrants nearing the end of their odyssey.

Wilson, one of the raftsmen at a popular crossing point, said he ferries about ten African and Asian migrants per week.

"Like four days ago there was a big group of them," he recalled. "And when we get to the other side, one of them says, 'Where am I?' I said 'you're in Mexico, man.' He said 'I don't believe it.' He jumped so high and so happy, like a kangaroo."

Tapachula in Mexico's southern border may not be their final destination, but it is the next best thing for many. After the trip throughout South and Central America they can finally easily find facilities for wire transfers and long-distance calls.

Migrants go relatively unmolested by police and gangs. Transit visas are relatively easy to get and a generous 21 days. Even the migration detention center — notorious for abuse and extortion of Latin American migrants — is considered relatively cushy.

When migrants are released from the immigration center and with their visa in hand, many hang around waiting for money to be sent by friends and family back home. A thriving business has built up around them here: the Hotel Palafox offers credit in exchange for exit visas.

For some, however, the road ahead is still daunting.

Having cross the world to get to Mexico from northern India Gorjit had no money for a flight, or even to take the long-haul busses that trundle up to the US border. He said he was planning to continue his journey via the clandestine routes taken by Central American migrants but was worried about Mexico's drug cartels. In 2010, an Indian was found dead among 72 migrants massacred by the Zetas drug gang in Tamaulipas state.

"I'm afraid, really afraid," he said. "At night sometimes I start crying thinking about my life. I have heard there are gangs up ahead that kill. All I've got is my life."

This story was produced in association with Round Earth Media. Manuel Ureste and Francisco Rodríguez contributed to the reporting.

What Obama Still Owes Africa -- A Visit To Nigeria For One Thing

BY JOHNNIE CARSON

ALL AFRICA JANUARY 4, 2016

Washington, DC —After seven years in office, President Barack Obama has already engaged more broadly on Africa than any previous American president, but with one year remaining in the White House, there are still a few things he should do before he leaves, writes Johnnie Carson, the United States' top policy-maker on Africa in the first Obama administration.

President Obama has significantly elevated and transformed America's engagement with Africa, traveling widely across the continent, championing the renewal of several old programs and launching a series of highly focused new initiatives that could help speed-up Africa's economic development.

He has been particularly active in promoting economic and development issues.

He fought successfully for the renewal and extension of the African Growth and Opportunity Act (AGOA), America's most important trade legislation with Africa; he hosted the first U.S.-Africa Leadership Summit, attended by 37 heads of state; and he has established several important new economic programs, including "Power Africa" - to expand significantly electrical access across the continent; "Feed the Future" - to increase household food production and to generate a green revolution throughout Africa, and "Trade Africa" - to expand substantially trade between Africa and the United States.

Recognizing the growing role of the continent's next generation of young leaders, President Obama established YALI - the Young African Leaders Initiative, a program that will bring 500 young African entrepreneurs, professionals and community organizers to the U.S. each year for the next several years for five weeks of leadership, organization and management training.

But what next?

Despite his rather impressive list of accomplishments, here are ten things the president should do before he leaves office in January 2017:

Visit Nigeria: President Obama has traveled to Africa five times during his presidency - but he has not visited Nigeria, the continent's economic, political, communications and petroleum giant, and its most important state. It is the continent's largest economy - almost twice the size of South Africa's and a third larger than that of Egypt.

It is also the continent's most populous state, with 180 million people, its largest Muslim country, and its largest democracy.

The president has visited every major country on the continent except Nigeria, and it would be a mistake for him to leave the White House without a stop in Lagos or Abuja.

Some have suggested that security may be a concern because of Boko Haram, but if the president can travel safely to Nairobi, where al Shabaab has carried out high profile attacks in the center of the city, he should be able to travel safely to Abuja or Lagos. He is bound to make one more trip to Europe, and a stop in Nigeria - similar to his 2009 visit to Ghana - would not be a major diversion.

Co-host a regional summit on democracy in west Africa:Strengthening democracy institutions, promoting good governance and supporting free and fair elections has been a major priority for the Obama administration in Africa.

During his first official visit to the continent as president in July 2009, President Obama spoke eloquently before the Ghanaian Parliament about the importance of democracy and good governance and the need to create "more strong institutions, not more strong men." With a growing number of African leaders attempting to extend their terms of office, democracy remains fragile across the continent. The president could give democracy in Africa a boost and reaffirm America's strong commitment to Africa's political progress by hosting a conference in West Africa with the democratically-elected leaders of Benin, Burkina Faso, Cape Verde, Liberia, Niger, Nigeria, Mali, Mauritania, Senegal, Sierra Leone and Togo.

Support Nigeria's permanent membership in the G20: President Obama has said that he wants to ensure that Africa has a place at the table to participate in the deliberations concerning major global political and economic issues. One way to accomplish that is to expand or reorganize the G20 group of nations to include Nigeria as a permanent member of this important global organization.

Nigeria is already more important than several of the current G20 members, notably Argentina and South Africa, and over the next two decades it will become one of the world's mega states, eclipsing several other G20 members in the size of its economy, population and regional influence. It would also be one of the G20's largest democracies. The administration should make the inclusion of Nigeria a priority over the next 12 months.

Press for the passage of the Electrify Africa legislation: Power Africa is one of President Obama's most important signature initiatives. In the world's most energy deficient and starved continent, it is intended to increase Africa's power output by 30,000 megawatts over the next decade or two.

But like a number of recent White House initiatives, Power Africa is not backed by any legislative mandate and could be easily brushed aside after the Obama administration leaves office. The program enjoys bi-partisan support in the Congress and the administration needs to work with congressional leaders to prioritize the passage of the Electrify Africa legislation. At the same time, the administration needs to create a senior level "Power Africa czar" to manage the program and consider moving interagency responsibility for oversight from USAID to a cabinet level department.

Instruct USAID to establish a permanent democracy fund: If democracy promotion is an important priority, it should be funded adequately and on a long-term basis. Today that is not the case. Funding for democracy has declined sharply during Obama's second term despite the president's recent speeches in Nairobi and Addis Ababa, and at the 70th session of the United Nations General Assembly in New York.

Dedicated and hard-to-reprogram funds should be allocated to strengthen African judiciaries and legislatures, to promote civil society groups and the media, to assist women's organizations and youth groups and to support domestic and international election monitoring. Funds should also be made available to assist local organizations to undertake parallel vote counts, to aid local election commissions and to prevent pre- and post-election violence.

Invite Tanzania's newly elected President John Magufuli to the White House:

Tanzania is the most populous state and the largest democracy in East Africa. It is also one of the largest recipients of U.S. development assistance and a participant in all of Washington's major economic initiatives.

In late October, Tanzania held presidential and parliamentary elections.The elections on the mainland went well, but those on the island of Zanzibar were disputed. President John Pombe Magufuli, a reform-minded academic-turned-politician, was elected without dispute, making him Tanzania's fifth democratically-elected president in a row. Although the Zanzibar election remains unresolved, it is important to reach out to Tanzania's new president early in his tenure to continue to foster the strong relationship between Dar es Salaam and Washington.

This is particularly important since President Magufuli does not have any major ties with the United States.Tanzania also has a critical role to play in East African peace-building issues, particularly in Burundi and the eastern Congo. Early political consultations with President Magufuli and his new foreign minister, Dr. Augustine Mahiga, could prove valuable in promoting stability in the Great Lakes region.

Send Secretary of State John Kerry to Rwanda, Burundi, the Democratic Republic of Congo (DRC), Uganda and the Republic of the Congo: The Great Lakes Region of Central Africa is one of the most volatile and unstable regions in Africa, with daily political and ethnic violence in Burundi, and with the leaders of Rwanda, the DRC and the Congo threatening to extend themselves in office in violation of their constitutions.

Although time is running out, there is still an opportunity to prevent further democratic backsliding and the serious instability and violence that will almost certainly be unleashed - as we are already seeing in Burundi. High level engagement with the leaders in the region is required.

An extended visit by Secretary Kerry to the DRC, Uganda, Rwanda and Burundi would be a strong signal of Washington's deep concern and interest in the region's negative political and security trajectory. Without serious engagement with the leaders on the ground, there will be no meaningful progress.

Open a U.S. consulate in northern Nigeria and a full embassy in Mogadishu: The establishment of a consulate in northern Nigeria is long overdue. More than half of Nigeria's 180 million people live in the northern part of the country, an area of serious political and security concern. It is also the largest Muslim region in Africa and the largest Muslim region in the world where there is no full-time U.S. diplomatic presence.

A U.S. diplomatic mission would advance long-term political, economic and security interests in the region and help Nigeria to deal with the economic, social and security challenges it faces there. A consulate in Kaduna, which once had one, or Kano would convey a strong signal to the Muslim community that Washington genuinely cares about the people in the region.

Once the global poster child of a failed state, Somalia has made significant progress over the past seven years. In recognition of the progress, the U.S. re-established formal diplomatic relations with the Somali government in Mogadishu in January 2013.

Before he leaves office, President Obama should take one more step. He should reaffirm Washington's commitment to Somalia and recognize the country's continuing progress by appointing a Senate-approved ambassador and opening a small, secure diplomatic embassy compound in downtown Mogadishu.

Elevate U.S. diplomatic relations with Sudan: Relations between Washington and Khartoum have been prickly and frequently difficult for over two decades and the U.S. has not had a fully accredited, Senate-approved ambassador in Sudan since 1997.

The Khartoum government has not been a good international actor. (Nor have Cuba, Myanmar or Iran.) The regime in Sudan has carried out mass atrocities in Darfur, prevented UN organizations from delivering food aid and humanitarian assistance to those in need and meddled in the affairs of several of its neighbors.

But U.S.-imposed comprehensive sanctions on Khartoum have not isolated the country nor weakened its government. The U.S. should review its current policies toward Khartoum, and consider elevating its diplomatic relationship to full ambassadorial status in order to expand America's dialogue and probe for new openings to resolve some of the country's domestic and regional issues. The U.S. can do this while maintaining its sanctions regime on the government and its demands that President Omar al-Bashir address the serious human rights charges against him.

Provide a status report on the results of the U.S.-Africa Leadership Summit: The U.S. Africa Leadership Summit has been one of the high points in the Obama administration's engagements in Africa.

Leaders from 50 different countries participated in this first-of-a-kind gathering in Washington. A number of new programs were announced and a major business conference associated with the summit brought dozens of senior American business leaders into direct contact - many for the very first time - with African heads of state and prominent business leaders from the continent.

The administration has never released a comprehensive report on the summit or a one-year progress report on the implementation of summit agreements. The issuance of some type of status report would be a useful vehicle for identifying summit objectives and initiatives as well as tracking the progress of the administration's efforts. The administration should do everything it can to sustain the goodwill and policy initiatives that emerged from the summit to help ensure that it does not become a one-off event.

The administration should be applauded for its continuing efforts to promote greater American trade and commerce with Africa. The president has already announced that he plans to host another U.S.-Africa Business Summit similar to the day-long event his administration hosted during the 2014 Leadership Summit. The Business Summit is important, but it should not be the only thing on President Obama's Africa agenda for 2016. He has time to do more, and he should. Twelve months is a long time in the life of an administration and his foreign policy team should be building a more robust African agenda for his last year in office.

Ambassador Carson was the U.S. Assistant Secretary of State for African Affairs from 2009 to 2012. He is currently a Senior Advisor at the United States Institute of Peace.

How Uganda Came To Earn High Marks For Quality Of Death

BY RAE ELLEN BICHELL

NPR, JANUARY 3, 2016

A elderly patient with chronic debilitating back pain receives a bottle of liquid morphine during a home visit from a representative of Hospice Africa Uganda. (Morgana Wingard/African Palliative Care Association)

Food coloring, water, a preservative and a pound of morphine powder. These are the ingredients in Dr. Anne Merriman's recipe for liquid morphine.

"It's easier than making a cake," says Merriman, a British palliative care specialist who founded Hospice Africa in Uganda in 1993 and helped design the formula that hospice workers in Uganda have used for 22 years to craft liquid morphine. The lightest dose, dyed green to indicate the strength and to make sure people don't confuse it with water, costs about $2 per bottle to make. Stronger doses are dyed pink and blue. A 16-ounce bottle is about a week's supply for most patients.

Those cheap bottles of green, pink and blue liquid morphine have changed the way people die in Uganda — and are a key reason why Uganda has the best quality of death among low-income countries, according to global Quality of Death Index published by the Economist Intelligence Unit.

Back in the 1990s, two of the biggest barriers to good death in Uganda were simple: not enough doctors and not enough morphine. Largely through Merriman's drive, Hospice Africa Uganda developed professional education in palliative care that would spread the responsibility to nurses, rather than relying on doctors. They helped make it mandatory for medical students in Uganda to study pain management – before Germany did. And Hospice Africa Uganda made liquid morphine.

"I had been one of the doctors who had said to people, 'Sorry, there is no more we can do. You have to go home,'" says Merriman, of the time she spent working with cancer patients in Singapore starting in the 1960s. There, she says, "I found that patients with cancer were getting every treatment possible with chemotherapy, and then when it didn't work they were sent home and they were dying in agony."

So she sat down with a couple pharmacists from the National University Hospital and came up with a formula to make a liquid from pure morphine powder.

Merriman would eventually be invited to Kenya to set up a hospice care program in Nairobi before founding her ownorganization in 1993, based in Uganda. At that time, palliative care in Africa only existed in Zimbabwe and South Africa, and the services, she says, were "started out by whites for whites." Medication was prohibitively expensive for most patients. "The strongest they had there was codeine — if you had money. But if you didn't have money, you only had aspirin and sometimes nothing at all," says Merriman.

Today, the organization's three hospice centers serve some 2,100 outpatients. "It's not always the pain that's their greatest worry," she says. "It's often 'What's going to happen to my children when I die?' It may be spiritual problems, it may be cultural — things they have to carry out before they die. We try to help with all those kinds of things."

Relieving pain is step one — and it has many benefits. Patients eat better, sleep better and live higher quality lives, even in their last days, says Merriman.

Cost was one obstacle to pain management that Merriman had to address. Another, which persists in many countries, was a deep-rooted fear of opioid painkillers.

Though morphine is considered the gold standard in palliative care for pain management, in many parts of the world fear of opioid addiction and misuse is so rampant it has a name: opiophobia.

Merriman ran up against opiophobia in Singapore and Uganda, where she says, people thought she was providing morphine so that patients could kill themselves. "And morphine can kill," she says. But with the right regulations in place, and the right explanation to the patient and their relatives, she says, "it's very safe."

For over a decade, the Ugandan government has provided morphine free to the patients of prescribers who are members of a special registry, all trained through Hospice Africa Uganda.

"You've got to be careful, everything has to be signed for and we have to follow the regulations," she says. "But for the last three years, we've been making morphine for the whole country."

Merriman says of the 24,000 patients in total that they have prescribed oral morphine to, "we've had no addiction, no diversions. And the patients keep the bottle at home."

In Uganda, she had to work hard to surmount the fear of opioids. For example, Hospice Africa Uganda worked with narcotics police, teaching them what morphine is and that it's a legal medication.

"They need to understand that patients can take morphine and that they are not addicted, that it is handed to patients after careful assessment, and that it is a safe medication," says Dr. Eddie Mwebesa, clinical director at Hospice Africa Uganda. Without police cooperation, he says, "there will be a lot of trouble with patients having their morphine in the home" and in transporting the drug between hospices or patient homes.

Clinicians prescribe the morphine and instruct patients to sip a dose from a marked cup. For adults, it's usually about a teaspoon every 4 hours. Merriman says hospice workers frequently have to warn people about morphine — not because of the risk of addiction but to explain that it will not wipe out their illness. She says they feel so good after it, they often feel normal again. "They think we've cured them," she says.

Even with the innovations in Uganda, there are still challenges. The organizationestimates that only 10 percent of Ugandan patients in need of palliative care can access it.

"The biggest challenge we have right now is the sheer number of patients who need palliative care," says Mwebesa — he puts the number at 250,000 to 300,000. But there is about one doctor for every 20,000 Ugandans, he says.

Mwebesa says palliative care can cost about $25 each week for one patient. "It doesn't sound like a lot," he says, "But actually most people can't afford it." Only 2 percent of Ugandans have health insurance, so many families have to pay out-of-pocket to care for sick relatives.

Even though Uganda is far from perfect, it remains in many respects a model country for its neighbors. "We had the minister of Swaziland visit Uganda to see how Uganda reconstitutes oral morphine and then when we went back, they started doing the same," says Dr. Emmanuel Luyirika, executive director of the African Palliative Care Association. He says the same happened with Rwanda and Malawi.

Merriman is now turning her attention to French-speaking countries in Africa. She says some countries in the region remind her a lot of Uganda back in the '90s. "They've got a fear of morphine. Doctors don't want to prescribe it because they think if they prescribe it, they'll be accused of being addicts themselves," she says. World Bank data shows the region has the world's highest maternal mortality and lowest national health budgets. And people there largely pay for health care out-of-pocket.

"If you haven't got money," says Merriman, "you can't even get an aspirin." At age 80, she's still determined to see that the dying don't have to face such dilemmas when they seek relief from pain.