Bobert: "I mean, lets give credit where it is due..."


Here, his administration has saved millions of lives," Geldof wrote in Time Magazine as he accompanied Bush on an Africa trip last February.


CAPE TOWN, South Africa — In her AIDS-scarred South African township, Sweetness Mzolisa leads a chorus of praise for George W. Bush that echoes to the deserts of Namibia, the hills of Rwanda and the villages of Ethiopia.

Like countless Africans, Mzolisa looks forward to Barack Obama becoming America's first black president Jan 20. But — like countless Africans — Mzolisa says she will always be grateful to Bush for his war on AIDS, which has helped to treat more than 2 million Africans, support 10 million more, and revitalize the global fight against the disease.

"It has done a lot for the people of South Africa, for the whole of the African continent," says Mzolisa, a feisty mother of seven. "It has changed so many people's lives, saved so many people's lives."

Mzolisa, 44, was diagnosed with the AIDS virus in 1999 and formed a women's support group to "share the pain." In 2004 she received a U.S. grant to set up office in a shipping container and start a soup kitchen from the group's vegetable garden. She stretches her $10,000 in annual funding to train staff to look after bedridden AIDS victims, feed and clothe orphans, and do stigma-busting work at schools and taxi ranks.

Hundreds of similar small grass-roots projects are being funded by the President's Emergency Plan for AIDS Relief, or PEPFAR, alongside higher-profile charities and big state clinics.

Bush launched the $15 billion plan in 2003 to expand prevention, treatment and support programs in 15 hard-hit countries, 12 of them African, which account for more than half the world's estimated 33 million AIDS infections. The initiative tied in with a World Health Organization campaign to put 3 million people on AIDS drugs by 2005 — a goal it says was reached in 2007.

Congress last year passed legislation more than tripling the budget to $48 billion over the next five years, with Republicans and Democrats alike hailing the program as a remarkable success.

But the task remains enormous. More than 1.5 million Africans died in 2007 (the U.S. death toll is under 15,000), fewer than one-third had access to treatment, and new infections continued to outstrip those receiving life-prolonging drugs.

In most African countries, life expectancy has dropped dramatically, and only a few, like Botswana, have started to turn the corner again.

And with no end in sight to the global financial crisis, there are fears about whether all the funding approved by Congress will be delivered.

There continue to be detractors who say the U.S. administration should have channeled the money through the U.N.; that it has placed too much emphasis on faith-based groups and abstinence; that it has trampled on women's health by shunning anything associated with abortions; that it has concentrated on AIDS treatment at the expense of prevention; and that it has diverted attention away from bigger killers like pneumonia and diarrhea.

Helen Epstein, an AIDS expert who has consulted for the U.N. and the World Bank, says both the U.N. and PEPFAR have failed disastrously on prevention by preaching abstinence until marriage and failing to recognize that in some African cultures it is the norm to have several simultaneous long-term relationships.

Critics say money could be better spent
She says the money would be better spent on strengthening African health care systems rather than focusing on a single disease.

Johanna Hanefeld at the London School of Hygiene and Tropical Medicine says her research in Zambia indicated that the U.N. Global Fund to Fight AIDS, TB and Malaria was more effective in using HIV programs as a lever to improve health care and staff training, rather than scattering cash among many non-governmental groups, faith-based or other.

PEPFAR ambassador Mark Dybul dismisses criticism that the funding is too narrowly focused.

"In Africa you can't tackle development goals unless you tackle HIV/AIDS," he says, citing the devastation wreaked on professions like nursing and teaching.

Besides PEPFAR, Bush has launched a five-year, $1.2 billion initiative to cut malaria deaths in 15 African nations by half.

Dybul also says it is unfair to accuse the U.S. of overemphasizing abstinence because PEPFAR is a major supplier of condoms to the targeted African countries. For instance, PEPFAR figures show 60 million condoms going to Zambia, 40 million to Rwanda, 145 million to Ethiopia in the past five years.

Some critics, like rockers-turned-advocates Bono and Bob Geldof, have become admirers.

"The Bush regime has been divisive ... created bitterness — but not here in Africa. Here, his administration has saved millions of lives," Geldof wrote in Time Magazine as he accompanied Bush on an Africa trip last February.

"The administration and Bush himself deserve a lot more credit than they received for getting this job done," says Josh Ruxin, assistant professor of public health at Columbia University.

Desperately poor Rwanda, where Ruxin runs a health care project, now has more than 100 centers where people can receive AIDS testing, counseling and treatment, up from just two in 2002.

"I am heartbroken overall by the Bush administration," Ruxin said in a telephone interview. "But from my perch here in Rwanda, it is impossible to deny the results and achievements of PEPFAR. Many Rwandans were made Republicans because this was the first administration that has taken an interest and done something here."

Ruxin hopes Obama will learn lessons from PEPFAR's first five years — in particular to end the emphasis on abstinence and start funding groups who work with prostitutes and carry out abortions.

PEPFAR's biggest single success story is the fortyfold increase in the number of Africans receiving life.