Front_2009.qxp
9/17/09
11:06 AM
Page 47
Connection
On January 20, one of Andover’s most famous alumni uploaded his vita on Monster.com and returned to the world of reunions, stickball games, and mingling with old friends in Dallas. In the weeks leading up to his move, a team led by his soon to be subpoenaed aide-de-camp, Karl Rove, began a campaign to cast the former president’s legacy in a more flattering light. You, gentle reader, will be shocked, shocked, that I—a product of the tumultuous ’60s who walked door to door gathering signatures for George McGovern and, yes, a card-carrying member of the ACLU—am going to sing W’s praises. Although I have never met the man nor benefited from his programs, if given the chance, I would give him a big hug, or at least a Texas fistbump, and thank him for being the first president, Democratic or Republican, to directly save hundreds of thousands of lives in Sub-Saharan Africa. After the fall of the Berlin Wall, the superpowers’ interest in Africa vanished. Other than the perennial search for minerals and oil by U.S. industry (which rarely benefited the local population), the continent disappeared off radar screens. Within days of assuming office in 2000, President Bush called the director of one of the National Institutes of Health to discuss AIDS in Africa and for guidance as to what he should do about the HIV crisis there. In 2003, he created the President’s Emergency Plan for AIDS Relief (PEPFAR). I believe this program is the most innovative foreign policy program ever created—and it now enjoys bipartisan support. My confidence in that statement rests on four unique characteristics of the PEPFAR program. First, never before has there been the amount of accountability for a foreign aid program of this size. Recipients of funding report quarterly on the number of people in treatment and the number of pregnant women who have been HIV-tested and receive treatment to prevent transmission to their babies. Second, two different federal departments are actually working in concert to make this program a success, namely the Department of State and the Department of Health and Human Services. Third, other U.S. aid programs often have been underfunded or short-lived. By focusing on just 15 countries and allocating huge sums of money, real, measurable change has occurred in life expectancy. Some of my fellow travelers have criticized the program as just another example of U.S. unilateralism on the global stage; they wish all of the money went to the U.N. Global Fund. However, the success of the Global Fund has been spotty at best, including long delays in implementing programs, money ending up in Swiss bank accounts, and patients developing HIV drug resistance due to the inadequate monitoring of patients on therapy.
AP Photo/J. Scott Applewhite
“Mr. President, on behalf of the thousands of families you have saved, a giant thank you.”
President George W. Bush ’64 greets local mothers affected by AIDS and their HIV-free children in the courtyard of the Abuja National Hospital and laboratory in Abuja, Nigeria, the last stop on his African tour in 2003.
Finally, the practical flexibility of PEPFAR, in terms of whom they fund, is a great strength. Essentially, any competent HIV care giver—whether a government agency, a private practitioner, a university clinician in the United States or Africa, or a faith-based organization—can receive funding if they have a proven track record. Certainly, there are flaws in the program. The ban on any funds going to an organization that practiced family planning, although a tiny percentage of the funding, was unnecessary. The aversion to support even rudimentary research to improve the program was just dumb. But a ray of hope: now that another illustrious Andover grad, James Steinberg ’70, has been appointed assistant secretary of state, I hope he advocates for continued support of this vital global program by the current administration—as well as its improvement and expansion. Since 2003, an estimated 2.1 million people are now living and 240,000 healthy babies were born HIV-free thanks to this program. So, Mr. President, on behalf of the thousands of families you have saved, a giant thank you. —Charles van der Horst, MD ’70 Professor of Medicine, University of North Carolina Visiting Professor, University of the Witwatersrand, South Africa, and University College Dublin
An article about Dr. van der Horst’s extensive HIV/AIDS research and prevention work in Africa since 2000 appeared in the Spring 2008 Andover Bulletin. 47