• George Bush is popular for his notorious Middle East wars and the discord he sowed in the region during his tenure as American President.

    Yet despite all his shenanigans, other scholars argue that he did more for Africa than Barack Obama who is of Kenyan descent.

    In 2001, the HIV/AIDS crisis in Africa had reached new heights. Death tolls were in the tens of millions. Hospitals were overwhelmed. And the infection rates continued to rise. 

    An unlikely hero emerged in the midst of the storm that was rocking Africa - George W. Bush, the 43rd President of the United States.

    Bush enjoys popularity in some sections of Africa and a Financial Times article credits this "enduring popularity" to the health initiative he personally championed with the unpromising acronym of Pepfar. The President’s Emergency Plan for Aids Relief, one of the biggest global health initiatives in history, eclipsing many humanitarian interventions by his predecessors and successors. 

    “The president who stood up and said ‘I am going to do this’ was Bush,” Joyce Banda, a former president of Malawi, told Financial Times in what is a familiar show of gratitude. “Because of Pepfar, Bush is my best president.”

    At the time Bush took office, the United Nations was projecting that AIDS could be the worst epidemic since the bubonic plague of the Middle Ages.

    In his memoir Decision Points, President Bush on how when he first took office he decided to “make confronting the scourge of AIDS in Africa a key element of my foreign policy.” He adds that he hoped that PEPFAR would “serve as a medical version of the Marshall Plan,” referring to the United State’s economic assistance to help rebuild Western European economies after the end of World War II. 

    President George W. Bush called on Dr. Anthony Fauci, an HIV/AIDS expert at the National Institutes of Health who had already advised Bush’s father on the disease. The president wanted officials from the NIH and the Department of Health and Human Services to visit Africa and put together a program to reduce mother-to-child transmission with these affordable drugs.

    The job was simple: They would design the program, he would take care of the funding. “The president expressed this feeling that we need to see if we could do something for the developing world,” Fauci said. “His words will stick with me forever: ‘We as a rich nation have a moral obligation to help people who don’t have access because of lack of resources.’ He felt it was a moral obligation.”

    Fauci presented the initial results to the president, proposing a relatively modest $500 million program to prevent mother-to-child transmission. The presentation went well, and Fauci prepared to leave the Roosevelt Room. But as he turned to go, the president pulled him aside. Fauci remembers Bush saying the U.S could do something even more “transformative, yet accountable.”

    “I got goose pimples,” Fauci said. Bush wanted to lead the global HIV/AIDS response on scale that no other nation would even dare to imagine.

    The current budget for PEPFAR is $6.75 billion, with the total spending on the program since its inception being $72.7 billion. Since the start of PEPFAR, new HIV infections have declined between 41 percent (in Swaziland) and 76 percent (in Malawi). 

    The programme has had far reaching impacts going beyond combating the HIV/AIDS crisis.

    A recent report to Congress observed, PEPFAR’s investments in countries with sizable HIV/AIDS burdens have “bolstered their ability to swiftly address Ebola, avian flu, cholera, and other outbreaks, which ultimately protects America’s borders.” The program has also enhanced global health security, accelerating the progress toward a world more secure from infectious disease threats.

    PEPFAR supports more than 14 million people on HIV treatment globally, and it has enabled more than 2.2 million babies to be born HIV-free to HIV-positive women. It’s a familiar refrain in the HIV/AIDS care community that it is nearly impossible to travel without seeing the benefits of PEPFAR, sometimes accompanied with fine print that says “sponsored by the American people.”

    What Bush proved is that foreign policy goes beyond talking about democracy but should be centred on creating tangible solutions that create stability.

    Header Image Credit: Reuters