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What will be President Bush’s legacy?

How will history judge President Bush? Right now, with Iraq enveloped in sectarian violence, he is most likely to be remembered for presiding over this foreign policy disaster. However, on the positive side, the President’s legacy on HIV/AIDS and Africa may be judged far more kindly. Indeed, I’m getting the sense that the Administration recognizes this and is going to make HIV/AIDS, malaria, and support for global public health the centerpiece of the Bush Administration’s legacy. Today, President Bush announced an expansion of his malaria initiative, announced last summer in the lead up to Gleneagles.

“It is possible to eliminate malaria,” he said. “Allowing Africa to continue on that path is just simply unacceptable.”

While the souring of the U.S. fiscal position has capped spending on this initiative at $1.2bn, the malaria effort is an important indication of the significance of this dimensions of American foreign policy to this administration. With the recent finding that malaria and HIV make each other worse, this announcement was timely.

The countries added to the initiative today were Benin, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Mali and Zambia, the White House announced. Angola, Tanzania and Uganda were the first three countries in the program, followed by Malawi, Mozambique, Rwanda and Senegal.

There are some fears that the Congress, now in Democratic control and no longer populated by champions like Rick Santorum and Mike Dewine, may not fully fund this initiative and contributions to the Global Fund, where malaria spending totals twenty-six percent of the fund’s total grants. Ruth Levine of the Center for Global Development has a post on this today. While she is heartened by donor commitment to this disease that a few years ago nobody cared about, she is worried that this initiative may not lead yield as much progress as quickly or as much as boosters hope:

That’s why we have to do better this time, learning from history that to succeed will require big-time funding over the long haul, and a willingness to pay attention to emerging evidence about which combination of strategies is working or failing in different settings. In the past, the bugs have adapted faster than we have, costing untold lives. Much as we might see potential in the use of bednets, the application of pesticides, the scale-up of ACT use or other strategies, an over-reliance on one approach versus others combined with unrealistic promises about very rapid progress is likely to lead us down the road to nowhere that others have followed before.

With the President and his administration needing a major accomplishment to balance what arguably is a disaster in Iraq, I am hopeful that the Administration takes pains to get this one right.

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2 Responses to “What will be President Bush’s legacy?”

  1. […] One of the things that Bush is not getting credit for is aid to Africa. As I posted recently, this might be the only good thing his administration is ultimately remembered for. Today, a Washington Post article noted that the Administration has quietly tripled aid to Africa. With PEPFAR and the Millennium Challenge Account, aid to Africa has increased from $1.4 bn to $4bn. It’s ironic, but a recent New York Times article suggested that American influence in Africa has deteriorated in recent years, in part because of the rising role of the Chinese but also the perceived sense of inattention. Not only are the Africans not giving the U.S. credit for this renewed aid, but the American public doesn’t either. A poll earlier in 2006 of the American public asked which world leaders have done the most to combat AIDS. Only 25% of the American public regarded President Bush as a leader on global AIDS, trailing Bill Clinton (50%), Nelson Mandela (50%), and Bono (47%). […]

  2. […] Political¬†commentators muse that malaria control may be one of the key points in Presiden Bush’s legacy.¬† This will only happen if there is greater leadership and advocacy for malaria programs, and if a true bipartisan spirit prevails, putting the long term interests of children, pregnant women and workers in malaria-endemic countries ahead of short term political gains.¬† Malaria needs to be mentioned more than once for this interest to develop. […]