Can celebrities really get results?

Former President Bill Clinton is flying out of Malawi and into Zambia, absent-mindedly snacking on the in-flight samosas as he talks to the press. "Forget about Malawi. Think about where you were when you were 10 years old," he urges. "How did you get from being 10 ... to sitting in this plane?"

His aides have heard the talk – more than once. But even they tilt their heads to listen.

"You may have had a lot of adventures. You may have been very brave. There may have even been some accidental opportunities," Mr. Clinton says. "But ... we all believed with all our hearts that there was a critical connection between the efforts we exerted and the results we achieved."

In Africa, he says, that connection does not exist – and he wants to help create it.

He speaks in earnest, repeating his points, pressing on about systems, capacity building, and Africa in general – a place that fills him with a great sense of purpose.

Clinton, like many other famous figures who have thrown themselves into bettering the continent, is passionate about what he does here. His efforts bring both media attention and money. But assessing the long-term results of this effort is more difficult.

"There are so many dimensions to intervening in a different culture," points out Bruce Sievers, a visiting scholar at Stanford University in Palo Alto, Calif. "The question is, how well informed are all the celebrities trying to do a thorough job in Africa, let alone those who just travel over and are blown away by the poverty?"

And are celebrities willing, he wants to know, to stick with programs they start for the necessary "at least" 20 years to come?

Just pretty faces, deep pockets?

The answer, of course, is that it depends. Celebrity attention to Africa runs the gamut. Some stars show up for a single celebrity poker match in Las Vegas or a benefit cocktail party in New York to raise awareness for an issue. Others write large checks, lend their names, and even roll up their sleeves to help, but still court controversy along the way. And yet others get deeply involved, hiring advisers and studying to understand the challenges, before deciding on what role they can play most effectively.

The "best" sort of celebrity involvement comes from those who "know their limitations better and are usually more genuinely interested in discovering how best to use their status," says Myles Spar, an HIV/AIDS specialist in Los Angeles who advises Doctors Without Borders.

Actors George Clooney and Don Cheadle, for example, have taken on advocacy for Darfur, as has actress-activist Mia Farrow, who – working with the Sudan expert Eric Reeves – is spearheading the "Genocide Olympics" campaign aimed at shaming China into pressuring Sudan's government to prevent violence in the troubled western region of Darfur.

And, famously, "Tomb Raider"-action-heroine-turned-UN-High-Commission-for-Refugees- (UNHCR)-spokeswoman Angelina Jolie has taken dozens of trips to refugee camps around the world and donated more than $6 million to help them. Ms. Jolie has said that she gets paid a "ridiculous amount of money" for what she does, and donates one-third of it to charity.

"We cannot close ourselves off to information and ignore the fact that millions of people are out there suffering. I honestly want to help," Jolie explained at a press conference when joining UNHCR in 2001. "All of us would like to believe that if we were in a bad situation, someone would help us."

Not surprisingly, influential public figures who don't get much coverage in such magazines as People and Rolling Stone typically offer more consistent and serious involvement in Africa.

Former President Jimmy Carter, for example, has dedicated a good portion of his post-White House years to such activities as monitoring complicated elections (68 to date), building houses, and eradicating Guinea worm, hardly the most glamorous of projects.

Mr. Carter, who, like Clinton, left the White House while still in his mid-50s and set up a foundation, has set the bar high for post-presidential public service. But it's not a do-gooder contest, he notes.

"Every former president is just as different as two people that you might meet going down the street," he says in an interview in Johannesburg, South Africa. "It's very good to have some element of competition among former presidents, but I think it is also ... important for each former president not to try to duplicate what the others have done, but to carve out some new arena in which they can be most effective."

Clinton, during his presidency, was not particularly known for his attention to the continent. He made two long visits here, forgave the debts of several nations, and pushed for closer trade ties. But, by his own admission, he failed to do enough to fight the growing AIDS pandemic or to respond to the 1994 genocide of more than 800,000 Tutsis in Rwanda.

"If I had moved as soon as possible on Rwanda, we could have saved half or a third of those who were killed," he says. "We cared a lot about it, but we were obsessed with Bosnia and Haiti, and Congress was mad about what had happened in Somalia. It's something I will have to live with. It's hard to believe there would be that colossal a mess-up."

Clinton rubs his brow and continues. "But it's a sort of spur ... my relationship with the Rwandans is one of the most interesting and rewarding of my life." It seems, he concludes, "that they have forgiven me alongside forgiving one another."

Today, whether in order to make peace with this past or out of a sheer appreciation for the African people – Clinton is a man reinvented.

Working in 69 nations at once

The Clinton Foundation, created in 2002, works with 69 developing countries on initiatives ranging from expanding access to HIV/AIDS and malaria drugs to reducing big cities' greenhouse-gas emissions. The foundation prides itself on its passion (many of the 600-odd staff are volunteers), tight budgets (many of the senior employees take enormous pay cuts when joining and normally fly coach class), a high level of coordination with the host governments, and "private sector-style" impatience with getting things done right, and quickly.

The former president's ability to reach out to virtually any world or business leader, and the respect they accord him, has proved invaluable.

He bullies drug companies, pushes bureaucratic African governments, lures in top professionals, gets wealthy donors to open their wallets – and then brings all sides together and insists on immediate action.

"The foundation has one rock star," says Deepak Verma, CEO of the foundation's HIV/AIDS initiative. But, he stresses, the foundation has developed a serious name for itself that goes beyond the Clinton celebrity factor. "Today, we are both a real organization with a real management and infrastructure and, more importantly, we are recognized as a very serious foundation," he says.

Mr. Verma says that one of the foundation's greatest triumphs to date was taking a leading role in negotiating lower prices for antiretroviral AIDS drugs from the generic pharmaceutical companies. When the foundation entered this arena, the average cost of treatment ranged between $500 and $1,600 annually. Today, it's down to about $140 a year (with pediatric doses down to $60 per patient), making it easier for poor governments to purchase the drugs and allowing more people to take them – 750,000 to date, according to the foundation's calculations. This, points out Verma, is clearly an achievement with long-term benefits.

But in the often competitive aid community, some critics grumble about the Clinton Foundation's mode of operation. They say Clinton and his team are superficially involved in too many arenas, often fail to cooperate with or take advice from longer-serving aid organizations in the region, and take credit for more work than they do.

Other critics argue that the foundation's focus is misguided. In the HIV/AIDS arena, for example, they say that more attention, money, and time should be put into finding a vaccine against the scourge or into education. "It's fine to bring in medications, but that has actually never been our biggest problem," says Massoud Nassor, a social scientist at University of Dar es Salaam in Tanzania. "The real problem is how to properly distribute the medicine and how to educate people about not getting HIV in the first place."

But by and large, the foundation's efforts are well received. Clinton, says Doctors Without Borders' adviser Mr. Spar, is one of the most helpful celebrities on the continent. He uses his clout to "bring together groups who might otherwise not meet, which can be enormously important in helping to develop efficiencies, reduce reinvention of similar solutions, and even to broker negotiations."

On the ground, the average African finds hope in the high-profile attention. Innocent Richard, who hawks a collection of three-inch women's heels outside the luxury hotel where Clinton stays in Arusha, Tanzania, boasts that he managed to catch a glimpse of the man as he was whisked through the back entrance. "This is the president's second visit to Arusha, and both times I have seen him. I love him. I feel he is going to change things ... kidogo," says Mr. Richard, using the Swahili word for "a little." "And that is so wonderful," he adds.

Farewell photo ops

On the last day of the Africa journey, Clinton takes his entire entourage on safari. His wife and daughter had been to Tanzania's Ngorongoro crater when they visited Africa in 1997 and have been raving about it ever since. So, clearly, he wants to see it, too. Lions, hippos, elephants. A rhino and a leopard. The group emerges from the 2,000-foot-deep crater with a 100 square-mile floor, dusty, overexhausted, and overexcited.

The former president poses with the Safari guides. Snap. He poses again with the drivers. Snap. Snap. Again with the traditional Masai dancers and yet again with the white-aproned chefs, who have made a late-afternoon tea. Some Dutch tourists want a photo, too. No problem! "Just amazing, all of this, isn't it?" Clinton beams. "This has been one of the best days of my life!"

The sun is setting, and it's time to go back to the US. Conversation turns to his wife's performance at the YouTube democratic debate the previous night and then somehow segues to the upcoming refueling stop in Spain. Maybe, Clinton hopes, there will be time to speed into Madrid for some snacks at his favorite tapas bar.

Soon, the wealthy donor friends, aides, assistants, press, press handlers, doctor, and photographer are in their leather-cushioned airplane seats. The Zambian masks are loaded. The South Africa wood carvings are carefully hauled up. The plane doors close. And they disappear into the night sky.

"We should not have unrealistic expectations," says Clinton, at the conclusion of the interview in Zambia. "It's not easy to change societies ... but still, all of us can change lives."

"Celebrities are like other people who do this ... some of them will stay at it for a lifetime, some of them will quit. Real life will intrude on them just as it does on the rest of us. They will have children and want to spend more time with them ... or they will get bored or get sick. But on balance, these high-visibility, high-profile movie stars are part of a global movement of giving, which is a function of our interdependence."

The allotted time for the interview is up, and an aide is hemming and hawing. "It's a part of the zeitgeist," the former president says, paying no heed to the advancing hour, enthused by his own ideas and lost in his own words. "It's where we are at this moment in human history. It is where I am."