Global HIV/AIDS: Bush Does the Right Thing

January 21, 2008

Most of us are all too familiar with the tragic foreign policy misjudgments of the Bush administration. Yet, one of his positive legacies will undoubtedly be his administration’s leadership in the global battle against HIV/AIDS. This recent NY Times story outlines some of the major accomplishments of Bush’s five-year (2003-2008) $15-billion PEPFAR (President’s Emergency Plan for AIDS Relief) initiative to combat the global HIV/AIDS pandemic. (For more background info., see the Global AIDS Alliance web page on Pepfar here.)

So far, roughly 1.4 million AIDS patients have received lifesaving medicine paid for with American dollars, up from 50,000 before the initiative. Even Mr. Bush’s most ardent foes, among them Senator John Kerry of Massachusetts, his 2004 Democratic challenger, find it difficult to argue with the numbers…

In Haiti, about 13,000 patients are now receiving anti-retroviral drugs. That is only half the estimated 26,000 who need them, but far more than the 100 being treated five years ago…

In Uganda, a country already far along on its own AIDS initiative when Mr. Bush began his, 110,000 people are under treatment, and 2 million have H.I.V. tests each year, up from 10,000 treated and 400,000 tested before, according to Dr. Alex Coutinho, a top AIDS expert there. The money comes mostly from Pepfar, but also from a United Nations fund to which the United States contributes.

Dr. Coutinho said Ugandans were terrified that when Mr. Bush left office, “the Bush fund,” as they call it, would go with him. “When I’ve traveled in the U.S., I’m amazed at how little people know about what Pepfar stands for,” he said. “Just because it has been done under Bush, it is not something the country should not be proud of.”

Despite these accomplishments, there have been strong criticisms of the program’s ideological focus on abstinence as a preventive HIV/AIDS strategy (among many other criticisms, which include the need for less ambiguity, more local control, and to rely on WHO instead of USFDA standards for treatment approval). Yet, given the fact that these abstinence programs account for only about 7% of the total monies being spent and given the importance of this abstinence approach to Bush’s conservative religious base, which was in turn crucial to the wide bi-partisan support for this program, it seems that “abstinence” was a necessary compromise to get the program funded.

The Bush administration has already asked for US$ 30 billion to fund the next 5-year phase of the program. Few observers doubt that he will get this. Instead, the debates are centering around how to revamp the program (ex, dropping the ideological focus on abstinence in favor of evidence-based approaches towards prevention), and whether Democrats will be successful in asking for even more money (as much as US$50 billion). In the grand scheme of things, this is good news for the 33 million infected with HIV/AIDS around the world.

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5 Responses to “Global HIV/AIDS: Bush Does the Right Thing”

  1. Sandeep Says:

    The fear of the Ugandans seems rather justified seeing as how the presidential candidates have focused almost solely on the war in Iraq and stimulating the (almost-in-recession) economy.

    But seeing as how this program has so little fan fare in the states anyway, could it be expected that the new president would continue with it or maybe look to steer funds away to more “pressing” issues: those that the public will want?

  2. lmcinhk Says:

    Good question.

    There is a fairly strong US advocacy community, one that works across partisan divisions, which will continue to push for US leadership on this issue after Bush.

    For example, here is a link from Africa Action, a well respected US NGO, on what the current crop of candidates have said about US funding to fight against global HIV/AIDS.

    http://www.africaaction.org/resources/page.php?op=read&documentid=2632&type=6&issues=1

    That said, Bush’s personal leadership was crucial to the success of Pepfar and one wonders if the next president will invest as much personal political capital. Obama might, Clinton maybe, but I doubt other candidates would make this effort an important part of their foreign policy platform.

  3. Sandeep Says:

    its curious that its the republicans who didn’t sign the plan nor have a plan on their own…while the democrats do

    Giuliani(even doh his chances seem minute now) seems to be contradictory in that he’s fully supportive yet seems to indicate that he’d prefer to help them help themselves…and yet would continue with PEPFAR(probably)…i think he’s confused

    McCain is another one…but then I kinda like that he would admit that he’s never thought about it…which perhaps underlines how low-key this has been perhaps?

    Finally…Romney disappoints me if he’s just gonna continue the plan to improve USA’s “image”…thats, forgive me, retarded

    Being a John Edwards supporter…i’m glad he has a plan =D


  4. […] Global HIV/AIDS: Bush Does the Right Thing Global HIV/AIDS: Bush Does the Right Thing January 21, 2008 Most of us are all too familiar with the tragic foreign policy misjudgments of the Bush administration. Yet, one of his positive legacies will undoubtedly be his administration s leadership in the global battle against HIV/AIDS. This recent NY Times story outlines some of the major accomplishments of Bush s five-year (2003-2008) $15-billion PEPFAR (President s Emergency Plan for AIDS Relief) initiative to combat the global HIV/AIDS p […]


  5. […] Global HIV/AIDS: Bush Does the Right Thing Global HIV/AIDS: Bush Does the Right Thing January 21, 2008 Most of us are all too familiar with the tragic foreign policy misjudgments of the Bush administration. Yet, one of his positive legacies will undoubtedly be his administration s leadership in the global battle against HIV/AIDS. This recent NY Times story outlines some of the major accomplishments of Bush s five-year (2003-2008) $15-billion PEPFAR (President s Emergency Plan for AIDS Relief) initiative to combat the global HIV/AIDS p […]


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