Can celebrities really get results?

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.

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