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By Arthur O’Sullivan

George W. Bush’s international legacy is—let’s just say—controversial. His global war on terror and tyranny appeared to increase both, especially to his enemies on the right and left. He famously entered the presidency with a budget surplus and a functioning economy, and left it with ballooning debt and a severe recession, the effects of which still resound in countries such as Greece. Regardless of his own culpability, such crises tarnished his reputation, with the public consciousness remembering him as simultaneously a weak-willed RINO agent of “globo-homo” (the right-wing crackpot idea that free trade is turning us into gays), and also a bible-thumping, racist-Christo-crypto-fascist war criminal who wouldn’t save a black life if his own depended on it: To quote the now disgraced rap-star, 

“George Bush doesn’t care about black people” -Kanye West

Such an accusation proves calumnious, however, when it comes to the Bush administration’s unquestionable foreign policy victory: PEPFAR. Such an initiative, announced at a State of the Union Address in 2003, and soon to celebrate its twentieth anniversary, has garnered praise from people as disparate as Anthony Fauci and Mike Pompeo. If you can find a lefty who’s heard of this program, even they will begrudgingly concede that this was undoubtedly a good thing (though they may harp on Trump for cutting its budget). 

What is this strange phenomenon? How could an international program founded by George W. Bush survive four Presidents, ten congresses, and the intense public and academic scrutiny that characterizes all of his administration’s global endeavors? Somehow, this program funded by tax dollars survives even the skepticism of Ron and Rand Paul among the libertarian right, as well as their Tea Party congress. How good could this plan be? Does it cure AIDS or something? 


The astute reader would notice that I failed to expand the name of this program, lest it give away the entire purpose of this pre-ramble. PEPFAR stands for the President’s Emergency Plan for AIDS Relief: a program, by all reports, borne entirely of the Christian values by which Dubya lived (especially Charity). Human Immunodeficiency Virus (HIV) originated from Africa, and continues to most affect the poorest regions of Africa. Access to antiretroviral drugs and other immunodeficiency treatments, already expensive in the west, were virtually unobtainable for the average person in the sub-Sahara. Other regions, such as Vietnam and parts of South America faced a similar condition. In a stroke of humanitarian intervention—not through soldiers but doctors—Bush established a program to facilitate the transport of shipments and supplies to those areas, in hopes of saving lives.

But did it work? All of Bush’s other interventions “failed” (at least according to the left and the Trump-aligned right), so surely this bright-eyed, optimistic, and expensive plan with no direct benefit to the U.S. would do the same. Following the logic of other critiques of Bush’s interventions, the obliquely racist contingent of American society: leftist academics, liberal technocrats, and right-wing isolationists (well, some of these might not be so oblique), would argue that for one reason or another, the people PEPFAR intends to help would simply reject it, (somehow) choosing AIDS’ long and painful death rather than western biomedical treatment. In the spirit of common sense, however, PEPFAR prevailed in its task. 

By 2021, roughly 20 million people were given access to, and were actively receiving life-saving antiretroviral treatment for HIV (out of over thrice that number who had access to testing), allowing roughly 3 million babies to be born without infection. 1 million people were put on prophylactic care; almost 3 million girls received preventive education and services against HIV; over 7 million orphans affected by AIDS—either with respect to themselves or their families—received important healthcare and social support for their condition. At least 20 of the countries which the AIDS epidemic once ravaged have now achieved epidemic control. In every conceivable way—humanitarian, economic, or even diplomatic—these countries now have a greater chance to flourish, or at least deal with the other crises which beset them.

There is an old truism people absentmindedly repeat when talking about the news: “If it bleeds, it leads.” Nothing is more annoying than a stock phrase actually being true. So often, our media focuses on the poverty, misery, and violence which oppresses sub-Saharan Africa. The phenomenon has even been given the name “poverty porn” in reference to the cynical attempts at guilt-tripping baked into the media coverage of these events. In only focusing on the evil, and never on the good, compassion gives way to despair. Therefore, in the spirit of Thanksgiving—both the holiday and the virtue—we should celebrate the PEPFAR program, alongside the millions of lives it’s already saved. 

All statistics for the were taken from the State Department report on PEPFAR for 2021 report to Congress:

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