PEPFAR, the President's Emergency Plan for AIDS Relief, is among the most visible legacies of George W. Bush's two terms as president, says a Duke University global health expert.
Since 2003, the Bush Administration has provided more than $15 billion in aid to fight the HIV/AIDS epidemic in Africa through PEPFAR.
"Even with this success, more people are infected with HIV every day," says Michael Merson, the director of the Duke Global Health Institute and an international AIDS researcher. "The Obama administration should continue to support PEPFAR and make changes in policy that places more emphasis on prevention" and less on abstinence.
But Merson, who has served on the Institute of Medicine Committee for the Evaluation of PEPFAR Implementation, says Bush deserves credit for funding the program, the largest commitment ever made by a country for a global health activity dedicated to a single disease.
"That point is not disputable. Regardless of what you think about some of the policies that guide the use of PEPFAR funds, no one can argue with the enormity of the investment and that 2 million people in Africa have received life-saving antiretroviral drugs as a result of the program.
"It will thus be unfortunate if the current global economic crisis will impact PEPFAR funding. In addition to saving lives, PEPFAR has also helped strengthen the health care infrastructure and antiretroviral therapy or ART delivery system in Africa, including those managed by governments, faith-based organizations, and the private sector. These efforts will serve as a foundation for future investment."