President Bush headed home on Thursday from his five-day, five-country tour of Africa. Not since Thanksgiving 2003, when he showed up at the Baghdad Airport with a fake turkey for US troops have we seen such saccharine Presidential photo ops. And most of the media can’t get enough. The New York Times describes Bush in Africa as “a little like Santa Claus, a benevolent figure from another land handing out gifts — American foreign aid — and generating smiles wherever he goes.”
Among the goodies that Bush offered Africans this week was renewal of his flagship international AIDS initiative, PEPFAR. Named for none other than Bush himself, the President’s Emergency Plan for AIDS Relief is hardly a benevolent gift. Like all US aid, it comes with strings attached. To put it bluntly, Bush’s AIDS program prioritizes Christian fundamentalist dogma over African lives.
PEPFAR poses a particular danger to African women, who were a majority of the 1.7 million sub-Saharan Africans infected with HIV last year. With the program set to expire in 2008, Bush made use of images of HIV-positive African babies to demand that federal AIDS policy continue to devote one-third of all AIDS prevention funding to programs that promote abstinence.
This is Bush’s ill-conceived “ABC” strategy: “Abstain, Be faithful, use Condoms.” But abstinence is not a choice for women who are raped or coerced into sex, like the millions of women in the war-zones of Sudan, Liberia, Sierra Leone, Cote d’Ivoire, and Congo. Faithfulness is irrelevant for women whose husbands have multiple partners (for African women, marriage is actually a risk factor for contracting HIV). And condoms depend on men’s willingness to use them and both partners’ willingness to forgo having children. Of course, promoting condoms at least acknowledges a basic fact that the rest of Bush’s strategy denies, namely, that people have sex. Maybe that’s why Bush considers condoms to be a “last resort” in the fight against AIDS.
At the end of 2007, both the World Health Organization and UNAIDS released reports that show that AIDS is still ravaging Africa, but that as programs in Tanzania, Uganda, and Kenya show, the spread of the disease can be controlled with the right policies. In the fantasy world of Christian fundamentalists, AIDS prevention programs are an opportunity to stamp out extra-marital sex. In the real world, prevention programs need to build on what we know works: education and access to condoms within a framework that promotes women’s rights to negotiate sex and make the best choices for their well-being.
After another 1.6 million AIDS deaths in sub-Saharan Africa last year, the Bush Administration still shamelessly prioritizes pharmaceutical industry profits over ensuring people’s access to medicine. Patents that allow US drug companies to control the manufacture and sale of AIDS drugs bar countries in Africa (home to more than two-thirds of people with AIDS) from providing cheaper, generic alternatives. In 2006, PEPFAR purchased almost 75 percent of its anti-retroviral drugs from brand name manufacturers, even though far cheaper generic equivalents are available.
Bush’s trip to Africa was supposed to reinforce his legacy of “compassionate conservatism.” But it feels like a very long time ago—before Bush killed a million Iraqis, before he authorized torture, before he condemned so many more families at home and abroad to poverty—that “compassionate conservatism” had any cachet at all. In fact, Bush’s AIDS initiative has been a lot like his presidency: dogmatic, corporate-driven, and self-serving.