Anyone who cares about the global fight to end AIDS—the most complex disease and global health issue in modern history—should celebrate the millions of lives saved in the developing world this month, and give a big round of applause to President George W. Bush, whose bold and visionary leadership spurred the most comprehensive anti-AIDS initiative in history.
Dr. Goosby, the U.S. Global AIDS Coordinator, gave an update on the President’s Emergency Plan for AIDS Relief (PEPFAR) at the Brookings Institution and spoke about lessons learned from the first decade of PEPFAR, focusing on success stories that could be useful in future efforts.
“The United States has challenged the conventional wisdom on really what is possible, our response to the global aids crisis has also transformed the health sector,” said Ambassador Goosby, who oversees implementation of PEPFAR as well as U.S. government engagement with the Global Fund to Fight AIDS, Tuberculosis and Malaria. “ A tide that once overwhelmed the world is now a tide that is uniting the world. Hope is truly taking the place of despair.”
Ten years ago President George W. Bush announced PEPFAR to combat global HIV/AIDS. Bush, on June 19, 2002, stepped into the Rose Garden to announce what at the time was a groundbreaking idea—especially from a conservative Republican president who earlier had cast doubt on the effectiveness of foreign aid—a $500 million program to stop the transmission of HIV passed from mothers to children during birth.
During Bush’s 2003 State of the Union address he proposed a $15 billion global AIDS program for the next five years, the most sweeping US global humanitarian effort since the Marshall Plan in the aftermath of World War II. Bush’s plan doubled what the Clinton administration spent to combat the global AIDS epidemic.
In the years since, PEPFAR, the largest international health initiative in history to fight a single disease, is saving millions of lives, most of them in Africa.
AIDS was an inferno burning through sub-Saharan Africa and the disease brought economic growth to a halt in many countries. The disease was “wiping out a generation and reversing health gains in Africa. Hospitals were completely overwhelmed by the massive volume of dying patients. There were routinely multiple people in a bed, people on the floor. They weren’t getting the antiretroviral that was available here in the United States and Europe, so HIV infection was truly a death sentence,” Goobsy said.
“It wiped out people in the prime of their lives when they should have been caring for their families. It created millions of orphans unable to attend school without the support provided by their parents,” continued Goobsy. “That in turn created societal instability leading the U.N. Security Council to identify AIDS as a security issue in 2001.”
Ten years later, a series of scientific discoveries, primarily funded by the United States, have become game changers over the course of the past year. Recent advances include a promising vaccine, microbicide and treatment research.
Now HIV/AIDS is no longer a certain death sentence thanks to a number of factors, including greater access to life saving drugs, a compelling cultural conversation about sexual practices, American money promoting abstinence, fidelity and the use of condoms.
People with immune systems badly weakened by HIV are given anti-retroviral drugs that stop the progression of the disease. Mothers and newborns are given drugs that stop the transmission of the virus from one generation to the next. New clinics have been built, while doctors, nurses and lay workers continue to receive training.
“Now 6.6 million men, women and children are on antiretroviral therapy in developing countries with the vast majority of them being in sub-Saharan Africa. it's almost impossible to overstate America’s contribution,” said Goobsy.
“In countries with substantial PEPFAR investments, we've seen reductions in maternal, child, tb-related mortalities, increased use of anti-natal care, wider availability of safe blood just to mention a few. All of this helps explain why PEPFAR remains a true example of bipartisanship.”
President Obama and Secretary of State Clinton have said that an AIDS-free generation is within reach and Dr. Goosby is leading the effort to reach that goal.
Goobsy also explained that the United States needs to address the difficult barriers to ‘country ownership’ and hold accountable governments that are devoting too little money to health or are not investing anything at all. African nations agreed they would devote at least 15% of their national budgets to health at the summit in 2001, but to date few have.
“As external partners, we must acknowledge that we have a long history of playing the leadership roles, often creating an unhealthy relationship of dependence,” he said. “Over time this diminishes the capacity of the country to insure that services persist and most importantly remain at high quality, we must choose to step back and support country leadership rather than reserving that role for ourselves.”
The U.S., to date, has earmarked more than $38 billion for global AIDS since the beginning of Bush’s PEPFAR initiative
The United States will host the world’s largest AIDS conference for the first time in more than 20 years in Washington, DC, and over twenty thousand people are expected to attend. The last time the U.S. hosted the International AIDS Conference was in 1990 in San Francisco. A major reason for that was the travel ban the U.S. imposed on those infected with HIV. President Bush began action to lift the ban and President Obama took the final steps when he took office.
President Bush, who was repeatedly slandered as a racist by liberals, set out to spend an unprecedented amount of money—literally billions of dollars—on AIDS in Africa, citing his faith as a primary motivation.
He ultimately saved more than a million lives. It is rare when history irrefutably credits a president for a specific, undeniable policy achievement — a genuinely generous one spawned by his compassion for the suffering of others. Yet the former president continues to not receive the credit he deserves, even from conservative supporters, for this noble program.
PEPFAR”s success was never front-page news and never headlined on CNN, MSNBC or any of the Network evening news programs
Millions of lives have been saved and improved due to President Bush’s intervention. But while the policy was a huge success, it never did anything to help George W. Bush’s low approval ratings — and still hasn’t to this day, primarily due to a lack of media coverage. This is a classic example of bias by omission.
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