Thirty years ago this month, the first cases of what was to become known as AIDS were diagnosed. The World Health Organization estimates that more than 25 million persons have died from AIDS. More than 60 million people have been infected, and in southern Africa alone there are 14 million children orphaned because of AIDS.
The most important thing that has changed during the past 30 years is that efforts to fight the disease are meeting with some success. The leading role played in this by the United States often goes unappreciated, but the U.S. work to address AIDS and its effects provides diplomatic as well as medical lessons.
In what may be the greatest accomplishment of the George W. Bush administration, the United States in 2003 committed $15 billion over five years to the President's Emergency Plan for AIDS Relief (PEPFAR). Its goals were to provide antiviral treatment to 2 million HIV-infected persons, to prevent 7 million new infections, and to support care for 10 million people fighting the disease. In 2008, PEPFAR was renewed for another five years and expanded. Citizens of underdeveloped countries, almost all in Africa, are the recipients of this aid.
Like any big program, PEPFAR has attracted its share of criticism, and like any big program, PEPFAR could be improved. This should not, however, obscure the fact that it has saved countless lives. That cannot be said of many government projects.
Although not labeled as such, this is public diplomacy as it should be done. It is about service, not advertising. It improves (and protects) people's lives, and as a result wins friends and serves the diplomatic interests of the United States. Although the funds are passed through governments, the outcome is America directly touching the lives of citizens of other countries. The political impact is hard to measure, but it certainly exists at a significant level.
U.S. public diplomacy is sometimes wrapped in condescension and self-aggrandizement that detracts from its effectiveness. Responding to AIDS is too important for that. Doing it right, as PEPFAR has mostly done, will have its rewards: medical, moral, and diplomatic.