George W. Bush’s Africa Legacy

Bush_PEPFARFrom July, 2012, Eugene Robinson writes: This is an amazing accomplishment, especially because it wasn’t supposed to be possible.

Before PEPFAR, the conventional wisdom was that the drug-treatment regimens that were saving lives in developed countries would not work in Africa. Poor, uneducated people in communities lacking even the most basic infrastructure could not be expected to take the right pill at the right time every day. When the drugs are taken haphazardly, the virus mutates and becomes resistant. Therefore, this reasoning went, trying to administer antiretroviral treatment in poor African countries might actually be worse than doing nothing at all.

The Bush administration rejected these arguments, which turned out to be categorically wrong.

Africans are every bit as diligent about taking their HIV medications as are Americans or other Westerners. While there has been a “modest, contained and not alarming” rise in resistance to one class of drugs, according to a World Health Organization researcher who presented a study at this week’s AIDS conference, scientists no longer envision a nightmare scenario in which drug-resistant strains of the virus run rampant.

According to a survey by the charity Doctors Without Borders, 11 African countries — including some of the hardest-hit by the epidemic — are providing antire­troviral drug treatment to well over half of their citizens infected with HIV. Treatment not only extends the patient’s life but also decreases the likelihood that he or she will pass the virus to an uninfected person. The end of the AIDS epidemic is not yet in sight. But it is no longer unimaginable.

Bush’s initial multibillion-dollar commitment to PEPFAR was not really justifiable on grounds of national security, except perhaps in the broadest possible sense. The administration was motivated instead by altruism. It was the right thing to do.

So far, the United States has spent about $46 billion through the program. President Obama has been sharply criticized for proposing a cut of nearly 12 percent in PEPFAR funding for the 2013 fiscal year. Administration officials say they are actually just shifting money to complementary programs and that overall HIV/AIDS funding will rise to an all-time high. Advocates for the PEPFAR program argue that any way you look at it, fewer dollars will ultimately mean fewer people receiving lifesaving drugs — and, potentially, more new infections.

The Obama administration has a point when it complains that, at a time when the U.S. economy is struggling, it is only reasonable to expect other wealthy countries to bear more of the cost of providing antiretroviral treatment in Africa. Administration officials also have a point when they note that, under Bush, the biennial international AIDS conference could not even have been held in Washington — because HIV-positive individuals were denied visas to enter the country. Obama ended this discriminatory policy during his first year in office.

But if Africa is gaining ground against AIDS, history will note that it was Bush, more than any other individual, who turned the tide. The man who called himself the Decider will be held accountable for a host of calamitous decisions. But for opening his heart to Africa, he deserves nothing but gratitude and praise.

eugenerobinson@washpost.com

Washington Post


One Comment on “George W. Bush’s Africa Legacy”

  1. […] Pundit from another Planet From July, 2012, Eugene Robinson writes: This is an amazing accomplishment, especially because it […]


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