A Legacy

Katharine Jefferts Schori, the Presiding Bishop of the Episcopal Church, issued a statement about World AIDS Day. (In keeping with the Church's antiquated internet policies, I can't seem to find it anywhere online.) About the broad fight against HIV, she highlights one interesting point.

American leadership since 2003 has brought life-saving treatment to more than 1.7 million people in sub-Saharan Africa (in contrast to 50,000 in 2002), while supporting more than 33 million counseling and testing sessions and providing prevention services for nearly 13 million pregnant women. Still, more than 6,000 people continue to die each day as a result of the pandemic, and infection rates in some of the hardest-hit places continue to grow. Earlier this year, Congress and the President pledged significantly increased funding, and renewed strategies, for the global fight against AIDS. It will be up to the new Congress and Administration to keep the promises that have been made by their predecessors.

I am glad the “American leadership” got a plug. It is my understanding - and this is certainly worth noting - that the life-saving anti-retroviral drugs that have been a major pre-occupation of my time here are funded by American tax dollars. I frequently see signs from PEPFAR - the (American) President’s Emergency Plan for AIDS Relief - around the clinic that distributes the ARVs. I’ve written a lot about various patients' struggles to get on ARVs. Those whose lives have been transformed because of them owe it in large part to PEPFAR. There are still hurdles to overcome - like the bureaucracy - but we’d be almost nowhere without the millions of dollars it takes to fund the treatment programs.

And here’s something worth noting. Patients on ARVs take the pills every day for the rest of their lives. As more and more patients start taking the pills - and that is undeniably a good thing - it’s not like the first patients will have been “cured” and can stop taking their pills. Because of the nature of the treatment, the number of patients - and hence the cost - is going to continue to rise. With most aid programs, donors like to gradually be able to wind down their commitment over time. That cannot happen here (except by sharing more of the burden with the local government). This is why it was so important for Congress to approve an increase in the amount of money dedicated to PEPFAR this year and why I’m so glad I did.

Left unsaid in all this is that the American President in question is none other than George W. Bush, who, gauging by opinion polls is soon to be a late and little-lamented occupant of the Oval Office. But PEPFAR - and the life-prolonging treatment it funds - is one reason that I, in the future, will not regard his tenure with complete opprobrium and dismay.