The writer was the 43rd president of the United States.
When I took office in 2001, the situation with HIV/AIDS on the African continent and elsewhere was dire. A group of advisers including Condi Rice, Josh Bolten and Mike Gerson encouraged me to act before an entire generation was lost.
I believe that every life has dignity and value. I also believe that of those to whom much is given, much is required. So we developed a plan with clear objectives and accountability, and we got to work.
In 2003, Congress authorized the President’s Emergency Plan for AIDS Relief, or PEPFAR, with huge bipartisan support. Twenty years later, the results are clear: PEPFAR has saved more than 25 million lives and prevented millions of HIV infections. Members of Congress and American citizens from both parties should be proud.
Instead of celebrating this success and extending these gains, some in Washington have called the future of this program — which accounts for less than one-tenth of 1 percent of our federal budget — into question.
We are on the verge of ending the HIV/AIDS epidemic. To abandon our commitment now would forfeit two decades of unimaginable progress and raise further questions about the worth of America’s word.
The reauthorization is stalled because of questions about whether PEPFAR’s implementation under the current administration is sufficiently pro-life. But there is no program more pro-life than one which has saved more than 25 million lives. I urge Congress to reauthorize PEPFAR for another five years without delay.
In advocating for PEPFAR’s creation in 2002, Gerson told me, “If we can do this and we don’t, it will be a source of national shame.” That is now true of PEPFAR’s reauthorization. Sadly, my friend — who was a regular contributor to these pages — passed away last year. We are fortunate that he left behind great wisdom in his writing. I’ll let Mike’s words make the case why PEPFAR is worthy of our nation’s continued support.
“I remember my first visits to sub-Saharan Africa as a policy adviser to President Bush soon after the announcement. Of about 30 million people with HIV, perhaps 50,000 were receiving treatment. The pandemic had already produced 14 million orphans. Child-headed households were common; child-headed villages were not unknown. Walking through South African shantytowns, you mainly met grandparents and their grandchildren. The intervening generation had been nearly erased. Millions were dying at the same time and yet in total isolation, surrounded by the barbed wire of stigma. In the worst affected countries, life expectancy had fallen by 20 years.” — Feb. 11, 2013
“A memory from the AIDS crisis. It was 2005, the year that global AIDS deaths peaked at 2.3 million. At the end of a dirt road in Kericho, Kenya, I visited Sister Placida, an energetic nun caring for a few dozen equally energetic AIDS orphans. She showed me several ‘memory boxes’ that dying mothers had prepared for their children, holding photos, letters, a few mementos. The exercise struck me as forlorn — a short life poured into a shoebox — but also as defiant. Facing an absurd death sentence, these women wanted to be recalled not as victims but as humans. They wanted to leave a mark, to make a statement: Once there was such a life as mine.” — July 22, 2012
“As the International AIDS conference meets in Washington, D.C., the news on HIV/AIDS is not all encouraging. About 44 percent of people needing treatment still lack it. AIDS remains the world’s leading cause of death for women of reproductive age.
And yet: 8 million people in lower-income countries are now on AIDS medication. This includes 6.2 million in sub-Saharan Africa — more than a hundredfold increase in less than a decade.
How to comprehend such figures? An economist might calculate the productivity contained in more than 10 million cumulative life-years saved in the developing world by antiretroviral drugs since 1996. Not being an economist, I imagine millions of unfilled memory boxes. A lost generation, unexpectedly returned. A found generation.” — July 22, 2012
“It is extraordinary to watch a successful government program reinvent itself to follow the best data. In Tanzania, the PEPFAR pivot involves pulling resources from some areas and concentrating them on six regions. This strategy naturally creates tension with governments that view health equity as equal access for everyone. PEPFAR now defines health equity as concentrating resources where they are most needed — and have the best chance of bending down the curve of new infections.” — March 2, 2015
“In January of 2003 — as a cresting wave of death from AIDS swept across sub-Saharan Africa — George W. Bush proposed the President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative to fight a single disease in history. (I was one advocate for the plan within the Bush administration.) The legislation passed rapidly, with bipartisan support. The effort — including mass treatment, prevention and compassionate care — was continued and expanded under President Barack Obama.
On this World AIDS Day, the results are truly remarkable. PEPFAR supports 13 million people on lifesaving treatment. Thanks to PEPFAR, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the increasing contributions of countries themselves, more than half of people in the world needing AIDS treatment are getting it.” — Nov. 30, 2017
“Are Republicans in Congress prepared to squander a legacy of GOP leadership that has won the United States considerable goodwill around the world? Among evangelical Christians, what definition of being ‘pro-life’ does not include saving millions of lives from preventable disease and death?
There is only one AIDS strategy adequate to controlling this disease: full funding, and full speed ahead.” — Nov. 30, 2017
When I took office in 2001, the situation with HIV/AIDS on the African continent and elsewhere was dire. A group of advisers including Condi Rice, Josh Bolten and Mike Gerson encouraged me to act before an entire generation was lost.
I believe that every life has dignity and value. I also believe that of those to whom much is given, much is required. So we developed a plan with clear objectives and accountability, and we got to work.
In 2003, Congress authorized the President’s Emergency Plan for AIDS Relief, or PEPFAR, with huge bipartisan support. Twenty years later, the results are clear: PEPFAR has saved more than 25 million lives and prevented millions of HIV infections. Members of Congress and American citizens from both parties should be proud.
Instead of celebrating this success and extending these gains, some in Washington have called the future of this program — which accounts for less than one-tenth of 1 percent of our federal budget — into question.
We are on the verge of ending the HIV/AIDS epidemic. To abandon our commitment now would forfeit two decades of unimaginable progress and raise further questions about the worth of America’s word.
The reauthorization is stalled because of questions about whether PEPFAR’s implementation under the current administration is sufficiently pro-life. But there is no program more pro-life than one which has saved more than 25 million lives. I urge Congress to reauthorize PEPFAR for another five years without delay.
In advocating for PEPFAR’s creation in 2002, Gerson told me, “If we can do this and we don’t, it will be a source of national shame.” That is now true of PEPFAR’s reauthorization. Sadly, my friend — who was a regular contributor to these pages — passed away last year. We are fortunate that he left behind great wisdom in his writing. I’ll let Mike’s words make the case why PEPFAR is worthy of our nation’s continued support.
Michael Gerson on the global AIDS crisis
Return to menu“I remember my first visits to sub-Saharan Africa as a policy adviser to President Bush soon after the announcement. Of about 30 million people with HIV, perhaps 50,000 were receiving treatment. The pandemic had already produced 14 million orphans. Child-headed households were common; child-headed villages were not unknown. Walking through South African shantytowns, you mainly met grandparents and their grandchildren. The intervening generation had been nearly erased. Millions were dying at the same time and yet in total isolation, surrounded by the barbed wire of stigma. In the worst affected countries, life expectancy had fallen by 20 years.” — Feb. 11, 2013
“A memory from the AIDS crisis. It was 2005, the year that global AIDS deaths peaked at 2.3 million. At the end of a dirt road in Kericho, Kenya, I visited Sister Placida, an energetic nun caring for a few dozen equally energetic AIDS orphans. She showed me several ‘memory boxes’ that dying mothers had prepared for their children, holding photos, letters, a few mementos. The exercise struck me as forlorn — a short life poured into a shoebox — but also as defiant. Facing an absurd death sentence, these women wanted to be recalled not as victims but as humans. They wanted to leave a mark, to make a statement: Once there was such a life as mine.” — July 22, 2012
On PEPFAR’s impact
“As the International AIDS conference meets in Washington, D.C., the news on HIV/AIDS is not all encouraging. About 44 percent of people needing treatment still lack it. AIDS remains the world’s leading cause of death for women of reproductive age.
And yet: 8 million people in lower-income countries are now on AIDS medication. This includes 6.2 million in sub-Saharan Africa — more than a hundredfold increase in less than a decade.
How to comprehend such figures? An economist might calculate the productivity contained in more than 10 million cumulative life-years saved in the developing world by antiretroviral drugs since 1996. Not being an economist, I imagine millions of unfilled memory boxes. A lost generation, unexpectedly returned. A found generation.” — July 22, 2012
“It is extraordinary to watch a successful government program reinvent itself to follow the best data. In Tanzania, the PEPFAR pivot involves pulling resources from some areas and concentrating them on six regions. This strategy naturally creates tension with governments that view health equity as equal access for everyone. PEPFAR now defines health equity as concentrating resources where they are most needed — and have the best chance of bending down the curve of new infections.” — March 2, 2015
“In January of 2003 — as a cresting wave of death from AIDS swept across sub-Saharan Africa — George W. Bush proposed the President's Emergency Plan for AIDS Relief (PEPFAR), the largest initiative to fight a single disease in history. (I was one advocate for the plan within the Bush administration.) The legislation passed rapidly, with bipartisan support. The effort — including mass treatment, prevention and compassionate care — was continued and expanded under President Barack Obama.
On this World AIDS Day, the results are truly remarkable. PEPFAR supports 13 million people on lifesaving treatment. Thanks to PEPFAR, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the increasing contributions of countries themselves, more than half of people in the world needing AIDS treatment are getting it.” — Nov. 30, 2017
On attempts to cut PEPFAR
Return to menu“Are Republicans in Congress prepared to squander a legacy of GOP leadership that has won the United States considerable goodwill around the world? Among evangelical Christians, what definition of being ‘pro-life’ does not include saving millions of lives from preventable disease and death?
There is only one AIDS strategy adequate to controlling this disease: full funding, and full speed ahead.” — Nov. 30, 2017
