Which United States president will go down in history as the greatest humanitarian to have served in the office? The Republican Herbert Hoover is often known as the "Great Humanitatarian" for his work administering famine relief in post-World War I Europe (and Bolshevik Russia) in the 1920s -- but he did all that before he actually became president. Others might make the case for Franklin Delano Roosevelt, the Democrat who succeeded Hoover in the White House, whose New Deal initiatives relieved poverty and sickness on a grand scale within the United States.
But I'd suggest that there's one president whose contribution dwarfs all the others. Unlike Hoover, he launched his program while he was in office, and unlike FDR, he received virtually no votes in return, since most of the people who have benefited aren't U.S. citizens. In fact, there are very few Americans around who even associate him with his achievement. Who's this great humanitarian? The name might surprise you: it's George W. Bush.
I should say, right up front, that I do not belong to the former president's political camp. I strongly disapproved of many of his policies. At the same time, I think it's a tragedy that the foreign policy shortcomings of the Bush administration have conspired to obscure his most positive legacy -- not least because it saved so many lives, but because there's so much that Americans and the rest of the world can learn from it. Both his detractors and supporters tend to view his time in office through the lens of the "war on terror" and the policies that grew out of it. By contrast, only a few Americans have ever heard of PEPFAR, the U.S. President's Emergency Plan for AIDS Relief, which President Bush announced in his State of the Union address in 2003.
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Fast forward a decade later, and in his own State of the Union address on Tuesday night, President Barack Obama only briefly mentioned the goal of "realizing the promise of an AIDS-free generation" -- an allusion to the long-term aim of PEPFAR. Yet President Obama's most recent budget proposals actually propose to cut spending on the program. That's a pity. This might have been a good moment to celebrate ten years of an unprecedented American success in fighting one of the world's most pernicious and destructive diseases.
In his 2003 speech, President Bush called upon Congress to sponsor an ambitious program to supply antiretroviral drugs and other treatments to HIV sufferers in Africa. Since then, the U.S. government has spent some $44 billion on the project (a figure that includes $7 billion contributed to the Global Fund to Fight AIDS, Tuberculosis, and Malaria, a multilateral organization). By way of comparison, America's most recent aircraft carrier -- which will join the 10 we currently have in service -- is set to cost $26.8 billion. One medical expert calls PEPFAR the "largest financial commitment of any country to global health and to treatment of any specific disease worldwide."
It's impossible to tell exactly how many lives the program has saved, though Secretary of State John Kerry recently claimed that 5 million people are alive today because of it. That's probably as good an estimate as any.