PEPFAR and George W. Bush’s Great Humanitarian Legacy in Africa

In George W. Bush’s 2003 State of the Union Address he announced his bold plans for what became known as PEPFAR (President’s Emergency Plan for AIDS Relief).  The program would become reality and go on to save millions of lives.  It is one of George W. Bush’s greatest legacies and it is often overlooked.

In his State of the Union Address, Bush stated, “Today, on the continent of Africa, nearly 30 million people have the AIDS virus, including 3 million children under the age of 15. There are whole countries in Africa where more than one-third of the adult population carries the infection. More than 4 million require immediate drug treatment. Yet across that continent, only 50,000 AIDS victims—only 50,000—are receiving the medicine they need.”  Bush went on to explain that in Africa being diagnosed with AIDS was a death sentence where care was virtually nonexistent.  For those who seek help they are often turned away. “Many hospitals tell people, ‘You’ve got AIDS.  We can’t help you.  Go home and die.’  In an age of miraculous medicines, no person should have to hear those words.”

Bush continued, “Seldom has history offered a greater opportunity to do so much for so many…. To meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief, a work of mercy beyond all current international efforts to help the people of Africa…. I ask the Congress to commit $15 billion over the next five years…. To turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean.”

By May 1^st, the PEPFAR package was voted for in the House of Representatives and passed overwhelming 375-41.  The Senate also overwhelming passed the legislation by voice vote. The President signed the legislation into law soon after.

PEPFAR became a massive success.  In its first three years, it has been estimated that the program prevented 1.1 million deaths.  The death rate from AIDS of those who received help fell by 10 percent.  When the five years for the program was coming to an end in 2007, President Bush asked Congress to renew it and double the amount of funding for the program from $15 billion to $30 billion for another five years.  Again, Congress overwhelmingly supported the effort and even expanded it to also include treating tuberculosis and malaria for a total of a $48 billion package.  It became the largest program of its kind ever.

There were some minor flaws in the program that were eventually fixed, such as a dependence on only using brand-name drugs instead of the cheaper generic versions.  Also the legislation included provisions that organizations receiving funding pledge to oppose prostitution and sex traffic.  Those provisions were struck down by the Supreme Court in 2013 in a decision citing the First Amendment.

By the time Bush left office PEPFAR supported treatment for 2.1 million people and had cared for 10 million.  Fifty-seven-million had benefited from AIDS testing and counseling.  Twenty-five-million people were treated for malaria with medicine and bed netting treated with insecticides.  Bush often said that the program was helping bring many African communities back to life and referred to it as the “Lazarus effect.”

Condoleezza Rice said in her memoir that PEPFAR will always “be remembered as one of the greatest acts of compassion by any country in history.”  To this day the program is still saving millions of lives.  In an age when America seems unsure of its place in the world and is flirting with its isolationist tendencies, PEPFAR is a reminder of how much good America does for the world.  George W. Bush rightfully deserves credit and a place in history for saving the lives of so many.