GW Bush and AIDS in Africa
* What: GW Bush's efforts to end AIDS in Africa, pushed largely by his own conservative Christian convictions, have won the praise even of his strongest opponents on the opposite side of the political aisle.
* The Number of Lives Saved: As many as 46 million Africans were treated, tested, counseled, or in other ways helped by anti AIDS programs. This includes treatment for 5 million people, testing and counseling for 11 million pregnant women, and support for 15 million orphans and vulnerable children.
* How many lives were saved by prevention is often difficult to predict, despite the vague but likely true claim that “millions” were saved. What is clear is that many AIDS survivors have much better lives. One clear statistic we can point to is the use of retro viral drugs on pregnant women that allowed 230,000 children to be born AIDS free.
* Who Also Gets the Credit:
* This program is a tribute to the successful use of government intervention, run by the Office of the Global AIDS Coordinator, USAID, the Center for Disease Control and Prevention, and the Department of Health and Human Services. The Departments of Commerce, Defense, and Labor, and the Peace Corps all help provide support.
* Obama expanded the program to serve as many as four times as many people thanks to increasing efficiency.
* GW Bush was one of the blindest presidents, ideologically, and often an incredibly incompetent one. But one of the most unfair and untrue claims against him is that he is racist. As the Governor of Texas, Bush came out against the anti immigration hysteria in his own party back in the early 1990s. In part this was due to his own party's history in Texas, where business leaders long recognized more of their profits depend on trade with Mexico than on trade with the rest of the US, and much of the workforce is made up of immigrant labor. Bush also has Latinos within his own family, in laws, nieces, and nephews.
* Where the most despicable actions Bush did have to do with the Mideast, the most admirable actions of his presidency have to do with Africa. AIDS has hit that continent harder than anywhere else in the world. Poverty, weak underfunded governments, lack of healthcare, and even lack of basic prevention like condoms all combine to make AIDS even deadlier than elsewhere.
* AIDS prevention is something that Bush has somewhat shown, for the only time in his presidential career, a strong lack of ideological blindness. A conservative is supposed to think of market solutions first. A religious conservative such as Bush would naturally turn to greater support for charities, perhaps at most getting government funding for church run charities.
* Bush, to his credit, turned to the solution that works best for healthcare, government programs. The President's Emergency Plan for AIDS Relief or PEPFAR is a program most conservatives would oppose had it been proposed in the US, or by anyone not a conservative. It is also international in scope, and many conservatives hold international projects in suspicion unless they are military or favor US trade. Finally, it directly helps millions of poor people with money, often financially supporting them. Had this been done in the US, many conservatives would accuse these poor of being lazy and demanded they get a job, perhaps even blame their illness on the victims.
* On top of all this, AIDS prevention in Africa was not a project that benefited Bush politically. While it was begun early in his presidency, it did not receive much attention until well after his re election. PEPFAR showed no sign it would help his party.
* PEPFAR is not without its critics. The first head of PEPFAR was the former head of drug company Eli Lilly, which also make drugs that treat AIDS, a clear conflict of interest. The program also drained away medical professionals from Third World countries through its higher salaries. PEPFAR also emphasizes abstinence as prevention, and abstinence programs generally do not work. Abstinence programs often lead simply to more unprotected sex.
* PEPFAR also has a circumcision program, based on the premise that circumcision makes it more difficult to get infected. A simpler solution, one that does not involved genital mutilation, would be to make condoms available. It also would be far cheaper and humane, since a lifetime of condoms is less expensive than a circumcision and not physically traumatic, nor have the intent of making sex and masturbation less pleasurable as circumcision originally did. But birth control contradicts some conservative Christians' beliefs.
* A more disturbing criticism is who PEPFAR largely excludes because of its focus on abstinence. Gays, prostitutes, and IV drug users are often left out, the people often most at risk. But they are also, from some fundamentalists’ point of view, those who are most guilty by their own behavior. Program users have to sign an anti prostitution pledge, one that may drive away sex workers who are most in need of treatment. PEPFAR also does not use needle exchanges, a proven way of dropping the AIDS infection rate.
* All the criticisms add up the program not working as well as it potentially could. But PEPFAR undoubtedly does help millions, has helped limit the epidemic in Africa, and may even eventually defeat it. That is enormously praiseworthy by any measure. A side benefit to Bush is that Africa may be one of the few places in the world he can travel to without fear of arrest for his torture program. It remains to be seen which Bush will be more remembered for, devastation in the Mideast and the end of American empire, or lives saved in Africa.