Bush in Africa

This week, the cameras are following President Bush on his first visit to Africa in five years. It's a trip that may prompt some cynicism and sneers among critical observers. When lame duck presidents reach their final year of service, they traditionally embark on public relations campaigns designed to solidify their legacies. President Bush, like others before him, has set out to identify his presidency with humanitarian aid.

But to the surprise of many, his trip is not merely part of a tightly choreographed final year in office which includes racking up mileage on Air Force One. A fact that most Americans will not realize is that his administration has invested more in African public health and economic development programs than any other.

Bush's week-long agenda takes him to Benin, Tanzania, Ghana, Liberia and Rwanda, where I live and work. So far, he has see the profound effect of his commitment on this part of the world. Just seven years ago, not a single person here had been treated for AIDS with US taxpayer dollars; today, the number well exceeds one million. A few years ago, the battle against malaria appeared abandoned; in just two years, increased funding has put the disease back on the political map. Since 2003, the president's programs -- such as PEPFAR (the Presidential Emergency Plan for AIDS Relief) -- have dedicated nearly $19 billion to African aid programs addressing health care improvement, economic development and prosperity building. Global AIDS spending in 1996 was approximately $300 million; this year it will come close to $10 billion with nearly half coming from the US.

In Rwanda, administration and donor support have altered the landscape, helping government build the critical foundations of a public health system. Just five years ago, there were merely four sites in the entire country where a person could be tested for HIV. Today, there are well over one hundred.

The Bush administration has demonstrated that seemingly intractable public health challenges can be met with adequate resources. The next step is to learn from that experience and build on current momentum.

While Bush spending is largely positive, its emphasis on treating diseases rather than their underlying causes is short-sighted. While AIDS remains a killer, there are other areas of health and development which deserve increased attention; addressing these will also help fight AIDS. Over the years I've seen AIDS programs where patients took drugs costing hundreds annually that were ineffective because they were starving. Funds targeting agricultural productivity, business loans, and infrastructure improvement would go a long way in health care.

It's likewise not unusual to come across health centers with superb AIDS testing and treatment, but little ability to handle equally life-threatening infections and accidents. Neglected Tropical Diseases -- including horrors such as intestinal worms (which afflict a billion world-wide yet cost a mere 50 cents to treat) -- remain grossly neglected in spite of the fact that treating them makes treating AIDS easier. Strengthening these programs will improve global public health, but family planning, maternal health, and child health have suffered terribly under this administration due to ideologically-driven policies; PEPFAR is the funding source for controversial abstinence education programs.

One initiative supported by the administration -- though not at high enough levels -- is the Global Fund to Fight AIDS, Tuberculosis and Malaria. Unlike Bush administration direct funding, which flows through a costly and circuitous stream of recipients and sub-recipients, the Global Fund directly supports governments in addressing disease. While the Global Fund and the administration present themselves as partners, their different approaches reveal a critical split on development ideology. By reinforcing government programs, the Global Fund lowers implementation costs, and taxpayer dollars are often better leveraged than by administration initiatives. For its part, the administration has helped a wider group of implementers (particularly non-governmental organizations) put drugs to use on the front lines. The president and his successors should study the pros and cons of each program.

It's important that our tax dollars in global health be viewed as investments which will pay dividends for decades to come. The president has called on Congress to reauthorize a $30 billion, five-year extension of his AIDS program, which would treat 2.5 million people, prevent 12 million new infections and provide care for 12 million more. This is necessary to save lives, and it advances the Bush legacy in a meaningful, productive way that will help the region become self sufficient and begin to eradicate poverty, which must be the real target of the president's and our fight. Activists are seeking an additional $20 billion to enable the program to adopt a more comprehensive approach. The president should seriously consider their request as his African journey comes to its conclusion at the end of the week.

Enormous challenges remain, but our presidential candidates will do well to build upon the administration's legacy in Africa. U.S. dollars can be leveraged more effectively and measures more holistic in approach can turn recipients and their nations into productive, globally integrated economies which will ultimately be able to manage their disease burdens without international support. The success of the Bush years should not leave government feeling complacent or settled on approach. Rather, this should be viewed as the time when Africa landed back on the policy map as a place where well-managed programs in committed nations could truly yield missions accomplished -- and lives saved -- by the millions.

Comments

[GH]

The question today is: Is Michelle Obama proud of America, when they save millions of lives in Africa?

The second question is: will the media take the stab from Bob Geldof and invite him on to talk about the good news, or is that just reserved for Bill Clinton fawning, or for other celebrities when they trash Bush? It's a one-way street for our media, regardless of the facts.

Bob Geldof in Rwanda gives Bush his props


KIGALI, Rwanda " Bob Geldof has parachuted into the White House travel pool here in Rwanda, and will join us on the flight from Air Force One to Ghana tonight.


[..]


Mr. Geldof is an Irish rock and roll singer and longtime social activist who has helped, along with U2 rocker Bono, raise awareness about need in Africa. His most well known achievement is organizing the Live Aid concert in 1985, which raised money for debt relief for poor African countries.


But Mr. Geldof has remained closely engaged with African affairs since then, and he spoke off the cuff to reporters today who were waiting for a press conference with Mr. Bush and Rwandan President Paul Kagame.


Mr. Geldof praised Mr. Bush for his work in delivering billions to fight disease and poverty in Africa, and blasted the U.S. press for ignoring the achievement.


Mr. Bush, said Mr. Geldof, "has done more than any other president so far."


"This is the triumph of American policy really," he said. "It was probably unexpected of the man. It was expected of the nation, but not of the man, but both rose to the occasion."


"What's in it for [Mr. Bush]? Absolutely nothing," Mr. Geldof said.


Mr. Geldof said that the president has failed "to articulate this to Americans" but said he is also "pissed off" at the press for their failure to report on this good news story.


"You guys didn't pay attention," Geldof said to a group of reporters from all the major newspapers...

[realpolitic]

What good news shall Bob Geldof speak of- the good news concerning our economy, the good news concerning our deficits, the good news in Iraq or Afghanistan, the good news surrounding our torture policies and vanishing civil liberties? There is so much good news with the Bush administration it feels like Christmas.

[lastams]

Yes, I suppose that many are cynical when it comes to George W. Bush.
Go figure.
In fact, some of the more cynical types might actually wonder if pharmaceutical giants were making huge profits on these drugs.
Shame on them!
I"m sure all these items were donated free of charge and no one would even think of making a profit on the sick and infirm.
In any case we can conclude that condom manufactures will not be benefited.
Mr. Bushes "abstinence only" program will undoubtedly catch on in much the same way that Nancy Reagan"s "Just say no" program was so effective in eliminating illegal drug use.
In the end we are all just somewhat surprised that G.W. had such a soft spot for the poverty stricken in Africa, when afterall he has worked so hard to CREATE poverty here at home.
How nice to know that our President is indeed such a true humanitarian.
Leave us hope that his efforts keep him abroad for some time to come.

[Wilson33]

He's creating poverty here? Really? What proof do you have? Poverty was here long before Bush was in office and will be here long after he leaves. Actually, handouts create poverty, handouts prolong poverty, handouts, handout, handouts. And guess who is in favor of all of those handouts and wants to give more handouts? DEMOCRATS.

And the pharmaceutical companies give away PLENTY of drugs and money...and oh yeah, without those drug companies, there would be no drugs and millions more people would be dead and dying as a result. But I know how you libs hate corporations that improve lives.

So who really is creating and prolonging poverty in America?

[realpolitic]

The income gap is widening more than ever given Bush tax policies. Real wages did not increase, but declined, through the first five years of his administration. There is a greater percentage of the population beneath the poverty line due to Bush economic policies.

The only thing Bush gives away is no-bid contracts to his wealthy friends and tax cuts to the top 1% of society, who do not need it.

[LeftRight]

Please present your proof that handouts cause, prolong, and worsen poverty. Because every study that I've ever seen says that handouts help. That's why there are homeless shelters, and soup kitchens, and habitat for humanity. Now then, handouts don't help as much as JOBS, that's true, but I suppose that you'd bitch that the gov't was getting too large if they were to hire all the people who are at the bottom and sued them to inprove our national infrastucture.

[wiltmellow]

Why celebrate the same old crap?

Where does the money come from? (US taxpayers)

Where does it end up? (Multinational corporations like Sumitomo Chemicals or GlaxoSmithKline.)

What happens along the way? (Children inhale insecticide, aids cases increase because of abstinence program, GSK sells more abacavir.)

Bush carries the white man's burden from photo op to photo op. (Where else than Africa can he find supporters of another color?)

If he's serious about reducing childrens' suffering, how about just NOT using deplete uranium munitions. Or, better, how about NOT invading Iraq.

Bush's legacy is a million dead in Iraq with 4.5 million refugees, an eternally toxic environment, the destruction of the American middle class, the revocation of habeas corpus and the US bill of rights, and the transfer of billions of dollars from ordinary people to multinational corporations and their overseers and owners.

So handing out insecticide-laden mosquito nets and tut-tutting about sex should somehow compensate???

[sophie]

Well that's all so nice but if he has all this money to give, either to Africa or to Saudi Arabia or to Isreal, how come he doesn't have any to give to those STILL suffering from Hurricane Katrina? Billions are given to Isreal, Saudi Arabia (like that Kingdom doesn't have enough already) or India or Pakistan with NO accountability. Oh I forgot, more money is being spent in Iraq to fight that occupation and without any oversight or accountability. Like throwing money into the wind. So to ask again, why is it that all this money is readily available to these nations and continents but not a whole lot for his own country? Healthcare for the poor and middle-income families is scrapped but HE'S allowed to have government-sponsored healthcare?

As far as I'm concerned, all these trips abroad now are only for show so that he can have nice pictures to hang on the walls of his presidential library. You can almost see the dread he has when posing alongside a black child, pretending to smile and be "sincere". What he's doing is trying to rewrite his "history" so that he can brainwash future generations into thinking he was great. I hope people WITH brains don't buy his shit when he tries to sell his so-called legacy.

[Rumplestiltskin]

There has been a bunch of money allocated for Katrina. The local/state/federal bureaucrats just have made it very difficult to access. BTW, it is the Congress that ultimately controls how money is spent.

[LeftRight]

First, the money allocated for Katrina relief is nowhere NEAR enough to actually help. Second, it's not the bureaucrats who are holding it up, it's the rules that bush and the republican congress of the time instituted that are making it difficult to get the relief to those who need it.

[GH]

I think over $100 billion has been spent in the Katrina effort so far. Also, approx. 90,000 individual (families) have received an average of $61,000 "each," in cash grants. This is not a loan. It is received tax free.

An unheard of handout. It's so unheard of, because the entire media has blacked out - and will not tell the public about it. No good news is generally allowed to flow to the public unless it is good news for Democrats.

The Federal money is being distributed by a state agency, The Road Home.
http://www.road2la.org/newsroom/stats.htm

[politicalreacharound]

While you can give Bush some props for helping Africa we the US as a whole need to do more. $1M of aid in Africa is about as effective as $1B of aid in the middle east. I really do believe we need to spend more money in Latin America and Africa to start rebuilding strong friendships abroad. I bet we give more money to Israel than we do all of Africa and that relationship is often more trouble than its worth. Lets start giving more to Africa but with the oversight to fight corruption and failed states.

[Fathoms]

$19-Billion wasted on an abstinence program . . . Whoopie!

[GH]

Fathoms - can you fathom this: The abstinence % of the funds is only 6.7% of the total funding. 20% of the total is for prevention. 1/3 of that is reserved for abstinence. That's my official take. The Wa Post broke it down differently last year citing the source as the CBO;

The Office of the U.S. Global AIDS Coordinator requires that 20 percent of all AIDS spending go for prevention. Half the prevention budget must be spent to stop sexual transmission of HIV. Two-thirds of that spending, in turn, must be used promoting abstinence and fidelity.

Or, 2/3'rds of 1/2 of 20% which ='s 6.7%. Same number - a small % of the total. Seems reasonable enough -- except the media, and hateful activsits folks don't fathom the art of reading and telling the truth.

[klmebane]

you can't promote abstinence in a country with enormous occurrences of rape. rape is used as warfare, and they do it indiscriminately, they don't care if it is a 6 month old baby or a 100 year old woman.

what about the married women who aren't permitted to abstain? bush's idea of prevention IS abstinence, which obviously doesn't work here so why would it work in a continent completely different from ours with completely different problems?

abstinence and fidelity are nice ideas, but in many instances a pie in the sky dream as opposed to reality. focus on what is, not what you wish something to be. treating aids is nice, but there are other problems that contribute to aids, and telling people don't have sex is not going to help those problems.

[Fathoms]

Part 1:
I Fathom plenty, I Fathom that the whole debacle is a racket. I Fathom that the Bush administration hobbled the NGO's in Africa with abstinance to the point where many had to walk away from the table because the restrictions were too onerous. I Fathom that it's a far deeper economic game that's being played and that this figure of $19-Billion is smoke and mirrors anyway. I Fathom that the problem is systemic and the system that's failing here is capitalism. I Fathom that an unregulated free market and medicine don't mix. Here's an analysis from a few years back by African observers that speaks to the root of the problem:

A closer look at what could be done, unfortunately, vindicates the truly cynical. African countries spend more than $15 billion per year servicing illegitimate external debt. This is money that was borrowed and spent by previous governments or dictators, but which the people are now forced to pay, with interest. Most scenarios indicate that African nations will never get out of debt if current conditions continue. And yet, all the rich countries would need to do to prevent the worst humanitarian disaster of our time would be to cancel those debts.

[Fathoms]

Part 2:

Instead, they have done the opposite. Through the IMF and World Bank--in which the US has an effective veto, and which are dominated by the G8 nations--many African nations have been forced to make drastic spending cuts to health services, services which might have slowed or stopped the AIDS crisis over the past decade. "Development" deals like the recent NEPAD appear to provide funding for economic development, but mostly serve as subsidies to corporations from rich countries and levers with which to manipulate policy to the advantage of foreign investors. For example, what the US calls "food aid" consists in buying unsalable genetically modified food with taxpayer's money and dumping it into third world markets. Economic development does occur, but mostly for those who design the development process; African countries only benefit to the extent that their well-being coincides with the corporations doing business with them--which is to say: superficially, but not in any long term sense. Finally, the timing of this sudden change of heart in the Bush Administration is worth examining. Less than a month before Bush announced new AIDS relief funds, the US had finally caved in on WTO deal allowing poor countries with health crises to bypass international patents laws and produce generic drugs, rendering medication available those who would not otherwise afford it. The plan, which was unanimously supported by WTO member countries (but strongly opposed by the US) was passed after the Americans caved to international pressure at the last minute and agreed to a severely limited version of the agreement. On the morning before US negotiators finally signed on, one frustrated NGO representative joked that the US "couldn't make a decision because the CEOs of Merck and Pfizer were still in bed."

[Fathoms]

Part 3:

Due to its uncanny timing, some critics have said that the new AIDS plan is simply a subsidization of pharmaceutical companies to compensate for political battles lost in the WTO. "What looks like a moment of heartfelt generosity on the part of the Bush regime is, in fact, a hard-nosed recognition that pharmaceutical companies around the world aren't winning the PR battle to justify their monopolies," said Raj Patel, a policy analyst and visiting fellow at UC Berkeley. That Bush's plan has earmarked only $200 million per year for the Global AIDS Fund, and prefers to use most of the money on terms set by the White House is consistent with Patel's claim. For example, no health organizations that advocate or perform abortions will receive funding. Even more strangely, the Bush administration appears to be lobbying to deemphasize distribution of condoms, which are widely considered the most effective method of preventing transmission of HIV.

But the amount of research involved with verifying what money gets spent on is one of the root problems with "development" funding. Since the media (and as a result, it's audience) has such a short attention span, politicians can gain points by announcing ambitious plans, and remain unscathed when followthrough is cynically calculated or nonexistent.

Fathom? . . . Is any of this getting thru to you? Read, "Confessions of an Economic Hit Man" by John Perkins. He was one of the operatives peddling our predatory loans for the World Bank. He's written a biography that lays out the whole scheme in detail. Clearly, you would be amazed . . .

[darker]

Bush's administration invested more in African public health and economic development programs than any other?

Bush-Cheney invested NOTHING for public health and economic development programs in THE UNITED STATES OF AMERICA.

Next time Bush sports that US Flag lapel pin "for show", somebody should RIP IT OFF HIS JACKET!!

Bush is a TRAITOR TO THE U.S.A. He never served his country as a reservist or USPresident.
Bush is a criminal and a hypocrite.

[Wilson33]

Angry much? Facts are facts and the man has done more for AIDS and Africa than any other president. And your statement of doing NOTHING for America is more anger with no facts to back it up.

Crazy liberals...

[klmebane]

ok, tell me wilson, what has bush done for america?? and im not talking about corporate welfare (which conservatives are so quick to ignore while railing against helping people who ACTUALLY need it) im talking about helping the average american who has to choose between paying rent, buying food, or paying a financially crippling hospital bill.

[MGhamma]

Well,maybe he did something right......Wait,,,Africa is still f%#^ed up.

[PatriotActor]

"Global AIDS spending in 1996 was approximately $300 million; this year it will come close to $10 billion with nearly half coming from the US."

Wow. We're spending $4.8 billion on abstinence programs?

(Sorry, just an uneducated snark. I hope you're right... it would be nice to think that this administration accomplished _something_ that wasn't entirely evil.)

[Hollyse]

Let's call it like it is! Basic hand to hand American dollars to Africa is Reality's awareness of continued genocide. Bush wants global appreciation for HIS contribution to so called positive health contributing to Africans, but in knowing Bush's ..."God Damn piece of paper" called the Constitution... ya think through the back door genocide isn't a recipe ordered for population control? Ask Henry Kissinger. Genocide and dollars go hand and hand. Ask Henry Kissinger who now heads a major bank in China. He's the Godfather to the birthing of global genocide. What a christening gift to Africa as the Godfather of African genocide. Kissinger stated 2/3rds of global population needs elimination. Don't let the FRONT of Bush's visit nor promise of $$$ fool you. This administration is like cancer a close cousin to aides.

[GH]

PatriotActor -- so you did good in the arts, heh? Need to work on your math. 6.7% of this program goes to abstinence. Now you can let go of your frustration. That much frustration can cause abstinence, on it own account.

[klmebane]

abstinence causes frustration, not the other way around.

[Not Blind]

It's nice that our president spends money and is concerned about the poor, and providing healthcare for Africans. So, why didn't he and his congressional lackeys approve the S-CHIP bill to help American families with children?
Any health problem (AIDS, cancer, heart disease, etc.) can be cured with adequate resources or effort. Again, it is wonderful he's committed to Africans who are suffering from debilitating diseases, and is willing to commit the money necessary to erradicate them. So, why does he not want to invest in healthcare for Americans who work and pay taxes?

[Wilson33]

Because if morons like you can't see the difference between being poor in America and being poor and dying of AIDS in Africa, you are hopeless.
Because these Americans have MANY, MANY avenues to choose from when it comes to their family's healthcare, unlike in Africa.
Because the S-CHIP program is working as it is and did not need to be EXPANDED to cover people who don't necessarily need it.
Because that's what America is all about, helping the helpless.

Do I need to go on?

[klmebane]

so we have to choose between helping africa and making sure all americans can have the same basic standard of living? must be all that money we're pissing away in iraq with nothing to show for it.

[realpolitic]

I have lived in Chicago and San Francisco and see many, many homeless people each day I leave my apartment. If you think seriously poor people are only found in third world countries you are mistaken. There are people dying of AIDS in America, people who die of exposure, people who die of hunger. We have an extreme poverty problem here, especially compared with Europe where it is not as serious.

[oncethere]

Right. There is a curious disconnect there (keep in mind many of these Republicans are fairly bizarre individuals with highly compartmentalized personalities). There has to be some variable that explains it. Here are some possibilities: One,these people pose no threat to him and he can feel he is fullfilling God's will in Africa. Two, Bush et all are the type of individuals who can feel some semblance of sympathy, in a one-up one down- kind of way for starving and sick people; at the same time, he has no capacity to empathize (actually a more moral act) with Americans who are screwed by his beloved System. Three, his opening his pocket-book for AIDS treatment may have something to do with latent, but denied homosexual sympathies and tendencies. We have certainly seen how homosexuality is well-represented in thes far right-wingers.

[Wilson33]

Huh? Yeah, that took a lot of thought. Stereotyping Republicans....how intellectual!

[realpolitic]

The whole Republican mindset may not be opposed to donating funds to Africa to help with the AIDS epidemic. They certainly defend any of the hundreds of billions we are spending in Iraq. But when it comes to spending in America this idea conflicts with their odeology of social Darwinism. They oppose investments even in our infrastructure to keep America competitive in this new century. Any spending on the poor is seen by Republicans as rewarding indolence. Crony capitalism and tax breaks for the top 1% are incentives and thus are good.

[iPolitics]

Contratulations to President Bush. Africa is in desparate need of help in healthcare and economics. Any help is great. It's probably the only thing he got right in 8 years so give it to him.

[rjean]

wrong....w got terrorism right...something you demwits are CLUELESS about................

he got tax cuts right too..........

and he got DEMOCRATS....he beat you twice...

[LeftRight]

How exactly did he get terrorism right? You mean he got it right by CAUSING more of it, correct? Cause that's the only thing that I've seen him do right about terrorism.

Tax cuts, yeah, he got them right, right into the hands of those who already have more money than they could spend in 30 lifetimes!

[HAP]

Great post. Keep up the good work.

[CAPTAINSKIPPY]

And who, I ask, will gather the rewards from his channeling of our taxes into his programs for Africa? (Review history of Bush/Walker family ties to oil, Nazi bankers, Bush family "mental health for American Indians" etc) Will be looking for your revised report. Thanks.

[Mack20]

Please, Captain Jiff, don't forget the Castupians from Rigel 6 and the Dumbassians from the center of Earth. They both may be expecting rewards soon!

[realpolitic]

Where is Rigel 6 anyway?

[moodyring]

I appreciate your post, Josh, and pointing this out.

"A fact that most Americans will not realize is that [Bush's] administration has invested more in African public health and economic development programs than any other."

I think it's interesting that some people consider Bill Clinton to be the "first black president", which is a bunch of crap, when George Bush has invested much more than Clinton ever did.

Sure, it'd be great to put contraceptive/ safe-sex education in the funding, but I'd rather dedicate money without those provisions than not send money at all.

[MikeMidCity]

Really better no condoms for AIDS prevention and it is okay?

Bush is a crap head who is so clueless that the world would be much better off if he had never been born.

[LeftRight]

Actually, in this case, not sending the money at all is slightly better. Absitnence-only teachings fare worse than no teachings at all, and people who've been through the training tend to have sex younger, more often, with more partners, and with less protection.

[realpolitic]

Where can I go through the training?

[learn2learn]

Nice propaganda Josh.

Try reading The Secret History of the American Empire: Economic Hit Men, Jackals, and the Truth about Global Corruption
by John Perkins

[Mack20]

I'd rather read "Green Eggs and Ham" than the lousy propaganda you"re selling. Can you set aside your hatred for Bush for 5 seconds and listen with objectivity to what this man has to say? You"ve managed to prove your complete loathing of GWB is stronger than anything good or decent he has done. Don"t mistakenly think for a moment he"s done it for show or some kind of legacy building. Only liberals believe in symbolism over substance. It"s part of their flawed character makeup. Here is a perfect example everyone of can relate to: You can always spot the liberals driving down the highway. They have more than three bumper stickers (normally 6 or more) and they strive to show everyone they care more than anyone else. Or they spout how they hate everyone they disagree with. Either way I"ll wager your bumper is full of opinions.

[MikeMidCity]

Bush's insistence that condoms be left out of any AIDS prevention program has killed millions.

His programs have been tainted by the lunatic fringe of his own making.

[LeftRight]

First, no my bumper is not covered in stickers, in fact the cars that I see with more than 2 are almost all conservative bumper stickers.

Second, when the man is "helping" by causing more harm than was at a location before he got there, I'm going to be opposed.

[realpolitic]

If Bush does not believe in "symbolism over substance" why did he say that Palestinians should have their own state and then do nothing to bring it about? Why does he label himself a compassionate conservative and not react to Hurricane Katrina? Why does he do nothing about Darfur after saying a genocide like that observed in Rwanda would not happen on his watch? Just wondering!