The Real Bush Legacy May Be in Africa

Last week, leaders of the House and Senate forged an agreement with the White House to reauthorize the President's Emergency Program for AIDS Relief (PEPFAR) at the level of $50 billion over five years -- $20 billion more than the White House was originally seeking. This watershed announcement may signal that the promising start on combating AIDS made seven years ago will be built upon in a meaningful way: literally millions of lives will be saved.

President Bush's February trip to Africa was not covered with exactly the enthusiasm and interest his first trip there engendered five years ago, and that's a shame. Africa -- as it so often can be -- became a mere backdrop for several of the President's press conferences concerned with headier geopolitical matters (notably, Castro's retirement).

As I have stated here before, the Bush administration has done much to celebrate in Africa, and has set a bold path for scaling up interventions in health and development that can improve the lives of hundreds of millions. And while last week's PEPFAR announcement was indeed exciting, perhaps the president's most overlooked recent accomplishment was his plan to bring Neglected Tropical Diseases (NTDs), which afflict one billion people, under control.

In my field, pleasant surprises are sometimes hard to come by. Usually, they're small triumphs, the kind that you can chart individually. Seeing the face of just one patient who's been successfully treated at a local health center for an NTD ranks as an important development. You've seen the images of children and adults the world over who suffer from NTDs -- kids with bellies full of worms, kids and adults blinded by treatable disease, the disfigurement of elephantitis and leprosy. These diseases impact human development at all levels. They ensure that even kids receiving enough calories are malnourished since worms rob them of their food. They make treating AIDS, malaria and other disease more complex since they work in tandem to exacerbate illness. Most importantly, they contribute to keeping people poor by lowering their productivity, increasing day-to-day illness, and lowering quality of life.

President Bush, like other presidents before him, recognized that the situation is utterly needless and could be addressed for as little as two cents per patient. Years ago, Former President Carter decided to tackle a horrible NTD -- guinea worm: as a result, cases have fallen from one million in 1989 to about 25,000 last year. President Clinton has devoted much of the last several years to providing financing and support for the fight against AIDS -- something he laments having been unable to do at scale while in office.

President Bush's announcement signals that we will see more of these triumphs in the years to come. While visiting Ghanaian President John Kufour -- the outgoing chair of the African Union - for a meeting that focused on an anti-malaria effort and Darfur, Mr. Bush took the opportunity to announce the effort, a new, five-year, $350 million initiative targeting NTDs.

One of the ironic developments in international public health during the past decade is that expensive treatments have garnered enormous attention and resources while simpler interventions -- from beefing up the number and training of health workers, to delivering emergency medical obstetrical care, to fighting NTDs -- have fallen by the wayside. The best example of this than I can cite is that it takes a mere 50 cent treatment to cure intestinal worms, compared to $300-$1,200 per year to treat HIV/AIDS.

That's been frustrating, but the good news is that there need no longer be a choice between treating the easy diseases versus treating the challenging pandemics of the day: we can do it all. In fact, it's far easier today with new computerized tracking, disease surveillance, and improved health facilities across Africa to get the whole job done and end the preventable tragedy of death and illness, which takes a devastating toll.

$350 million is not $50 billion, but it will go a long way to bringing NTDs under control, as they need to be, and when the president said this will "help save lives and to bring hope to families", it was not merely rhetoric. What a fresh change for this administration and for the U.S.'s role in promoting development worldwide. Let's hope that the presidential contenders pay attention to this aspect of the Bush legacy and choose to address these issues early in the term rather than trying to garner good will at the end. Millions the world over are counting on it.

Comments

[Rule Of Law]

"President" Bush's legacy will be partly in Africa, and will consist of Genocide

Now, what other 20th Century Leaders share that distinction?

[Thorn]

Clinton going back to every other 20th century president since and including McKinley.

[TommyMcCarthy]

I commend the President for his African health policies

While the levels of suffering are not comparable, I can't help but wish that he might have become interested in the health and well-being of some AMERICANS too!....................................tm

[BeeOplentee]

I seem to recall that the extremist lefties who haunt this site love to denigrate Dubya's legacy with shrill hoots and derision. They mock his conviction that history will vindicate him.

I guess history is starting now!

[maddogbitesback]

History is a trillion dollar debt, about fifty million Americans who can't afford doctors or drugs. Or fuel or food.. History is Bill Gates was working on AIDS long before Bush. History is the devastation of Iraq and the devastation of America. History is saying that global warming wasn't happening. History is trashing the Constitution. History is that it is romantic to fight in Afghanistan. History will look at Bush and wonder what came over Americans when they allowed a liar from a family of crooks, to be appointed president by the Supreme Court. History is that it is a joke when Americans go0 to supervise the elections of other countries. Their own are a travesty. That's history. The money thrown at AIDS in Africa is a spit in the ocean.

[Leda]

Yeah the Real Bush Legacy is going to be right here in the U.S of A. We've inherited a rotten mess & he is directly responsible-- although never has he really been held accountable. He is leader of U.S. not Africa. ... & the more we discover natural resources in Africa-- well there will be more aid.

[FirstShirt]

Finally. A positive blog amidst the vitriol and superficiality. Thank you.

[Durango]

Bush's legacy will be destruction on a global scale.

The most ill conceived and incompetent war in our nations history.

The deaths of tens, if not hundreds of thousands of innocent Iraqi people. Who died for the most ignorant of American Presidents. Willfully ignorant.

The gutting of Constitutional principals that have stood for over two centuries.

Over seeing the destruction of our economy.

Corruption on a scale unimaginable even in the worst of times Corruption that would make Boss Tweed envious.

The politicization of the government to an unprecedented level. All for short term partisan political advantage.

Legal precedents that will give a future dictator a roadmap of how to subvert the Constitution and our freedoms.

And most devastating. A legacy of lies that will haunt our Republic for years. Possibly generations.

[SonnyBono]

Ah, no - the only Bush legacy is the war in Iraq and the nearly 4000 dead Americans and counting and the over 40,000 seriously wounded and the nearly 4 million Iraqi refugees and the tens of thousands of dead Iraqi men, women and children.

Oh, by the way, I didn't even mention the waste of billions and billions of dollars in this sink hole of a war.

Anything that Bush does - other than shooting Dick Cheney in the head and immediately resigning is like putting lipstick on a pig - no matter the color, it's still a pig.

[mike53]

Josh: You broke the golden rule here at Huffpo. NEVER say anything good about Bush. Bush is doing it for oil or Haliburton..blah blah blah. On a side note, anyone know how many barrels of oil we have taken from Iraq? Everyone here says thats why we are there.

[Phaedrusnyc]

And maybe if you were a little more well-informed you would realize it was never about "taking Iraq's oil," and that most of those who call this a "War for Oil" do not mean it in that sense. This was all about making sure that Iraq's ability to pump oil was kept at a mandated minimum so that oil prices could continue to reach all-time highs. And he's succeeded.

[CommanderWhitehead]

It's got to do with two things: strategic military positioning and oil.

Bush couldn't care less if the entire continent of Africa succumbed to disease and deprivation.

Get real about this administration.

[elakelaiset]

The real Bush legacy may be in Africa, but no--it's actually in Iraq.

[hyjanks]

. . . and then there's the often overlooked, "minor" detail of pressing his abstinence only perquisite before giving aid. And, oh yeah, add Catholic missionaries to the mix who condemn the use of condoms while preaching the love of Jesus (presumably, Jesus hated the useof birth control--can't find that quirk of his in the bible, however).
One of the other commentaries on this column is entirely correct: Bush's love for Africans goes no further than his love for oil.
Just look as his record in politics: pathologically vicious, arrogant, lying, greedy, cynical . . . and then think to yourselves: In this one instance is he REALLY being a humanitarian?
Common sense suggests otherwise.

[darcy]

What a crock. I don't want my tax dollars poured into Africa. Let the Africans solve their own problems, and all the rest of the world for that matter. We have serious problems in this country that need our attention NOW.

[Jennysaypa]

Sorry, he doesn't get any applause for that line either. Despite efforts by the State Department and people like J. Fraizer, he has effectively allowed the Chinese to take over Africa and lock down its resources.

[Valkyrie]

I'm sorry to be cynical towards all the wonders coming from Bushco, but we should get one thing straight. He isn't doing this because he cares about AIDS or Africans, he's doing this because it goes towards the United States long term designs on African Oil.

Why do you think we recently established the African Command? It's all for the oil, baby.

But I guess, we'll help the Africans before we rape them for their resources. That way, we can say, "Look at all the wonderful things we're doing."

[kingshmoopy]

I'm not saying you are wrong about his motives, certainly it isn't as if he deserves the benfit of the doubt. But, what else is to be done right now? I just cannot see saying that aid to help people in Africa is a bad thing because I suspect that the Bush administration has less than honorable motives.

I'm sure if I asked any West Africans I know if we should we not support the gov'ts programs for Africa because we suspect that their motives are questionable they would look at me like I was high.

This is an emergency, but much of this emergency can be helped. We cannot predict what future US administrations may or may not do with Africa's natural resources, but, right now, we have to do whatever we can to stop people from dying from preventable diseases.

[FirstShirt]

Did he do it or not? Is it good or not? Who cares who did it?

What happened to the "world is a village" ? That must have been the "old" democrats, not the new, self-centered ones lacking is even a scintilla of compassion or objectivity.

[darcy]

It's not a lack of compassion on my part, FirstShirt; it's the utter uselessness of trying to solve the problems in Africa by throwing money at them. Only the people of Africa can change conditions there, and I'm speaking as someone who lived there.

[kingshmoopy]

Thank you for this post. I am anything but a Bush fan but have been impressed by what his administration has done with Africa.

For others who respond with cynicism, or say what about this genocide, or that other problem: it is all well and good to sit in our comfortable living rooms and question Bush's "real" intentions, or point at things we haven't done enough about. We don't have to watch our children die because of a mosquito bite, or worms that live in their bellies.

As someone who has lived in West Africa, has sat with friends after they've lost loved ones to entirely preventable diseases, or to illnesses that went undiagnosed and untreated, or had been given improper medication, or for a million other reasons I can't imagine how anyone can belittle or disregard anything that helps the people who need it most.

We only lived in W. Africa for 2 years but, in that time, we saw more death and suffering than I care to think about. We also saw incredible grace, joy, courage, and love. We have an obligation to help in whatever way we can. Try to just remember that, no matter what else his administration has done, or what you think his motives are, we are making a difference. It might be a drop in the bucket but it is a bigger drop than before, and it matters to REAL people. No parent should ever have to watch their child die from a preventable disease, anything that we do to stop that from happening is good.