Bushs agenda is Africa
WASHINGTON, 15 February: Faced with wars in Iraq and Afghanistan, terrorism in Lebanon and Pakistan and nuclear threats in Iran and North Korea, US President George W. Bush will spend the next week focused on another part of the world: Africa.
It is a continent that has been at the forefront of his “compassionate conservative” agenda since 2003, when he launched the Presidents Emergency Plan for AIDS Relief (PEPFAR).
The United States has spent 18,8 billion US dollar from 2004 to 2008 to help reverse the scourge of HIV infection and AIDS in more than 100 countries. Most of the money has gone to 15 hard-hit nations, including 12 in Africa. With little fanfare, 1,4 million people have received lifesaving treatment.
– This work of healing and redemption (løskøbelse/forløsning) is both a matter of conscience and a wise exercise of American influence. The changes taking place in Africa do not always make the headlines. The work is quiet, but it is not thankless, Bush said Thursday.
Friday, the president and first lady Laura Bush left on a six-day trip to Africa intended to highlight the program as it comes up for renewal in the US Congress. The trip will focus attention on what some experts say is Bushs greatest achievement as president.
– When history books get written, the Presidents Emergency Plan for AIDS Relief will go down as the major positive legacy of his eight years, says Laurie Garrett, senior fellow for global health at the Council on Foreign Relations, adding: – It has been a fantastic investment, unparalleled in human history.
“Lazarus effect”
Since it was recognized in 1981, HIV/AIDS has killed more than 25 million people and infected more than 60 million worldwide. About two-thirds of the cases are in Africa, home to 12 million AIDS orphans.
– Just a few years ago, there were fears that HIV/AIDS could wipe out much of the continents population, with death rates that would rival the Black Plague of the Middle Ages, Bush stressed Thursday.
When he visited Africa in 2003, 50.000 people were being treated. Today, that has grown to more than 1,3 million. More than 6,6 million have received preventive care, including 2,7 million children.
And more than 33 million have received counseling and testing.
– Across Africa, people have begun to speak of the “Lazarus effect”, where communities once given up for dead are coming back to life. Some call this a remarkable success. I call it a good start, Bush noted.
The program has critics. They say the 30 billion dollar Bush wants for the next five years represents no increase from this years level.
Critics also object to a requirement that one-third of all money for prevention goes to programs that stress abstinence (seksuel afholdenhed) and fidelity (troskab). The independent Institute of Medicine reported last year that the mandate stymied (kommer i vejen for) local control.
Paul Zeitz, executive director of the Global AIDS Alliance, says the ideological approach to the program is “extremely flawed” and the fund insufficient.
Saving lives, creating hope
When Bush touches down in Dar es Salaam, Tanzania, on Saturday, he will be in a country where almost no one received antiretroviral treatment for HIV/AIDS five years ago. Today, more than 100.000 Tanzanians do.
– AIDS no longer is a death sentence, says Anja Giphart, Tanzania director for the Elizabeth Glaser Pediatric AIDS Foundation, adding: – We would never have been able to do that if there was not a major focus.
Similar advances have been made in other African nations:
– Rwanda, another Bush stop, had two places where people could be tested for the virus in 2003; today there are more than 150. Bush “put the international AIDS pandemic on the US foreign policy map,” says Josh Ruxin, director of the Access Project.
– On weekends in Uganda before treatment programs became widespread, the streets of Kampala were clogged with caskets (kister), says Ambassador Mark Dybul, the US global AIDS coordinator. Today, the streets are clear. – The most significant thing is creating hope,” he notes.
– In Vietnam, Jane Aronson used to buy drugs to treat orphans in Ho Chi Minh City. Now that she gets PEPFAR money, “we are lucky ducks,” she says. Her Worldwide Orphans Foundation has had less success in Ethiopia. – It is about who you know, she says.
Officials involved in delivering drugs and prevention services say much more is needed.
In Botswana, Lesotho and Swaziland in Southern Africa, about one in four citizens are HIV-positive. Ethiopia has three doctors for every 100.000 people. The Health Global Access Project wants 140.000 more health workers on the continent.
Some experts say Bush should invest less in his own program and more in the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has committed 10 billion dollar to 136 countries.
The United States is its biggest contributor, providing about one-third of the money. Richard Feachem, professor of global health and former executive director of the fund, says: – The fight against the global pandemic cannot be won in 15 countries.
More money, controversy
Many in Congress want to do more. Democrats on the House Foreign Affairs Committee are poised to approve 50 billion dollar over five years, 67 per cent more than the presidents proposal.
Democrats want to end the guarantee of funding for programs stressing abstinence and fidelity to one sexual partner. They want more coordination with family-planning groups. Republicans say that threatens to shatter the programs bipartisan support and lead to “a network of abortion mills”.
Global health advocacy groups push for more money, spent with fewer directives.
Even after five years, only 11 per cent of mothers who need therapy to prevent transmitting the virus to their babies receive it, leaving nearly nine in 10 newborns exposed, says Brook Baker, a Law professor and chairman of Health GAP.
– AIDS is going to be with us a long time. We have got to get a lot smarter and more efficient with our money, he says.
Rick Warren, a Californian pastor and author of The Purpose Driven Life, says the presidents program not only saves lives but improves Americas image in the world.
– When you help people get well, they tend to like your country, he concludes.
Kilde: the Push Journal
