Former President George W. Bush last week urged Washington lawmakers to continue to support the President's Emergency Plan for AIDS Relief (PEPFAR), an initiative he launched two decades ago against one of deadliest diseases at the time.
Bush made his initial plea before Congress at his State of the Union address in 2003, when nearly 30 million people in Africa had the AIDS virus, including 3 million children under age 15.
"I ask the Congress to commit $15 billion over the next five years, including nearly $10 billion in new money, to turn the tide against AIDS in the most afflicted nations of Africa and the Caribbean," Bush said at the time.
Fast forward to today: Bush, in Washington to mark his plan's 20-year anniversary, said he made the trip to remind people that American taxpayers' money is making a huge and measurable difference in providing lifesaving treatment to millions of people living with HIV/AIDS.
Check the results
"This program needs to be funded. And for the skeptics, all I ask is look at results. If the results don't impress you, then nothing will impress you," he told an audience February 24 at the U.S. Institute of Peace. PEPFAR is due for reauthorization this year.
Microsoft co-founder and philanthropist Bill Gates was in attendance as well.
"HIV is still a huge problem. We've cut the death rates down substantially, but if we don't continue to provide these medicines, then people's viral load goes up, they become infected, and you get that exponential increase that we saw with all infectious diseases, including COVID," Gates said.
The significance of the PEPFAR program boils down to the number of lives that have been affected, said David Kramer, executive director of the George W. Bush Institute in Dallas.
"Over 25 million lives have been saved as a result of President Bush's PEPFAR initiative. … And it was a vision that he [Bush] had to step in and help people that were in real need of help. He felt the U.S. was in a position to do so," Kramer told VOA.
The program has brought other benefits, Kramer said.
"The infrastructure that was set up over the 20 years under PEPFAR and also with the Global Fund [to Fight AIDS, Tuberculosis and Malaria] provided important assistance to health workers and officials in dealing with other crises such as the COVID pandemic."
Since the legislation was signed into law in May 2003, PEPFAR has benefited from bipartisan support in Congress, even though funding for its abstinence programs — a requirement later removed in 2008 — had drawn criticism. Former President Donald Trump unsuccessfully proposed to reduce PEPFAR's funding during his term.
Winnie Byanyima, executive director of the Joint United Nations Program on HIV/AIDS, or UNAIDS, recognizes PEPFAR's impact.
"When he announced PEPFAR 20 years ago, our people were dying, our countries were devastated. There was fear, there was pain and suffering. … So, we come here to honor President Bush, the American government, the American taxpayers for $100 billion that has been put in this program over 20 years and saved lives," she told VOA.
She also said it was the partnerships that formed between PEPFAR, the Global Fund, UNAIDS, civil societies, governments and others that helped to turn the tide.
Former President of Tanzania Jakaya Kikwete, who joined Bush at the event and whom Bush referred to as his "pal," recalled getting tested publicly to encourage others who were afraid to come forward.
"I remember the 14 of July, 2007, we launched this major campaign at a big square in Dar es Salaam. … The best thing is for my wife and I to lead by example, and we should not do it under a tent where no one sees it. It would be under the tent, but let's have TV cameras beam in, blood being drawn, being taken to the labs. Of course, my veins were easy, but my wife's had some problems. They pricked her several times. … I was very sorry for her, but I said, 'That's the price of leadership.'"
Kikwete was the first African leader to do so, a gesture that Bush saluted at the event.
With a worldwide target of ending AIDS by 2030, stopping new infections is a must, especially given 2021 data, Byanyima said.
"We had 1.5 million infections worldwide, most of these in sub-Saharan Africa. We had 650 thousand people who died in 2021 of AIDS-related illnesses. Not one of those new infections, not one of those deaths had to happen, because we have everything we need for prevention and for putting people on treatment," she said.
She pointed out that new infections are being noticed among girls and women between the ages of 14 and 24, gay men, sex workers and young people who inject drugs.
"We know what needs to be done," Byanyima said.
"For girls and young women, we know it's about gender inequalities and opportunities to be in school where it's safe," she said. As for "gay men, transgender women, sex workers … it's the criminal laws that are in place that stop them from coming forth to get prevention or treatment services. We know from our evidence that these laws that are there do not serve any purpose."