mounted one of his female counterparts on live international TV. Our advance team turned pale under the hot African sun. Laura, Barbara, and I burst out laughing.
The trip was Barbara’s first to Africa, and it touched her deeply. After graduating from college and volunteering on my 2004 campaign, she went to work for a pediatric AIDS clinic at the Red Cross War Memorial Hospital in Cape Town, South Africa. Inspired by her experience, she later founded a nonprofit, Global Health Corps. Based on a model similar to Teach for America, her organization sends recent college graduates to clinics in three African countries and two American inner cities. They support care for patients with AIDS and other diseases, strengthening the health infrastructure and helping people live with dignity and hope.
Jenna also discovered a passion for working with AIDS patients. She volunteered for UNICEF in several Latin American countries. When she got home, she wrote a wonderful book, a bestseller called
Laura and I are very proud of our daughters. They have become professional women serving a cause greater than themselves. They are part of a larger movement of Americans who devote their time and money to helping the less fortunate. These good souls are part of what I call the armies of compassion. Many come from faith-based organizations and seek no compensation. They receive payment in another form.
One of the most important early decisions on PEPFAR was who should run it. I wanted a proven manager who knew how to structure an organization that would focus on results. I found the right man in an experienced Indiana businessman, former Eli Lilly CEO Randall Tobias.
Randy’s first reports were discouraging. A year after I signed PEPFAR, fewer than one hundred thousand patients were receiving antiretroviral drugs. “That’s it?” I snapped. “We’re a long way from two million.”
Randy assured me PEPFAR was on track. The most important tasks during the first year were to get partner countries to devise their strategies, mobilize manpower, and start establishing infrastructure. Once we had this foundation in place, the number of people receiving drugs would ramp up dramatically.
By the fall of 2005, our African partners were fully engaged. Faith-based and other groups supported by PEPFAR, both African and American, helped staff clinics and spread prevention messages to millions across the continent. Orphans and the dying were receiving compassionate care. Some four hundred thousand people were taking antiretroviral drugs. We were on pace to reach our goal.
Unfortunately, AIDS wasn’t the only disease ravaging Africa. By 2005, malaria was killing approximately one million Africans a year, the majority of them children under the age of five. Transmitted by a mosquito bite, malaria accounted for 9 percent of all deaths in Africa, even more than AIDS. Economists estimated that the disease cost Africa $12 billion a year in medical expenses and lost productivity, a crippling blow to already fragile economies.
Every one of those deaths was unnecessary. Malaria is treatable and preventable. The United States had eradicated malaria in the 1950s, and there was a well-established strategy for battling the disease. It called for a combination of insecticide sprays, bed nets, and medicine for infected patients. The remedies were not particularly expensive. Bed nets cost $10 each, including delivery.
In June 2005, I announced a five-year, $1.2 billion program that would fund malaria-eradication efforts in fifteen countries. Like PEPFAR, the President’s Malaria Initiative would empower Africans to design strategies to meet their needs. We would work toward a measurable goal: cutting malaria mortality rates by 50 percent over the next five years.
I named Rear Admiral Tim Ziemer, a retired Navy pilot with experience in international relief efforts, to lead the Malaria Initiative. In its first two years, the initiative reached eleven million Africans. It also generated a passionate response from the American people. Boys and Girls Clubs, scout troops, and school classes donated money in ten-dollar increments to buy bed nets for African children. Faith-based organizations and major corporations, especially those doing business in Africa, gave generously to the cause.
With support from the Malaria Initiative, infection rates in the targeted countries began to decline. The most dramatic turnaround was in Zanzibar. Health officials adopted an aggressive campaign of spraying, bed net distribution, and medicine for malaria victims and pregnant women. On one Zanzibar island, the number of malaria cases dropped more than 90 percent in a single year.
On April 25, 2007, Laura and I hosted America’s first-ever Malaria Awareness Day in the Rose Garden. It was an opportunity to herald progress and show our citizens the results of their generosity.
At the end of my remarks, the KanKouran West African Dance Company performed a lively song. Caught up in the celebratory mood, I joined the dancers onstage. My moves were replayed on the national news and became a minor sensation on YouTube. The girls took great delight in teasing me: “I don’t think you should audition for
“I told you my goal was to raise awareness,” I replied.
In 2006, Mark Dybul succeeded Randy Tobias as the coordinator of PEPFAR. As a medical doctor and respected figure in the AIDS community, Mark brought great credibility to PEPFAR. After one of his trips to Africa, he told me many on the continent were anxious about what would happen after PEPFAR’s five-year authorization expired in 2008. Governments were counting on our continued support, and so were the people. Mark told me he had asked a health clinic official in Ethiopia if anyone knew what the acronym PEPFAR stood for. “Yes,” the man said. “PEPFAR means the American people care about us.”
Mark believed we had a responsibility to continue the program—and an opportunity to build on our progress. By doubling PEPFAR’s initial funding level, we could treat 2.5 million people, prevent 12 million infections, and support care for 12 million people over the next five years.
Doubling funding would be a big commitment. But the AIDS initiative was working, and I decided to keep the momentum going. On May 30, 2007, I stepped into the Rose Garden and called for Congress to reauthorize the initiative with a new commitment of $30 billion over the next five years.
To highlight the progress, I invited a South African woman named Kunene Tantoh. Laura had met her two years earlier and shared her inspiring story with me. Kunene was HIV-positive, but thanks to medicine she received through the mother and child initiative, she had given birth to an HIV-free boy. After the speech I held four-year-old Baron in my arms and smiled at the thought that his precious life had been saved by the American taxpayers. He demonstrated his energy and good health by wiggling around and waving to the cameras. Then he gave me the international look for “Enough is enough. Put me down.”
Holding Baron Tantoh.
The next step was to get other nations to join us. In the summer of 2007, Laura and I flew to Germany for the G-8 summit, hosted by Chancellor Angela Merkel. One key mission was to persuade my fellow G-8 leaders to match America’s pledges on HIV/AIDS and malaria.
Angela told me the summit’s primary topic would be global warming. I was willing to be constructive on the issue. In my 2006 State of the Union address, I had said that America was “addicted to oil”—a line that didn’t go over so well with some friends back in Texas. I had worked with Congress to promote alternatives to oil, including biofuels, hybrid and hydrogen vehicles, natural gas, clean coal, and nuclear power. I also proposed an international process that, unlike the flawed Kyoto Protocol, brought together all major emitters—including China and India—and relied on clean energy technologies to cut greenhouse gas emissions without stifling the economic growth necessary to solve the problem.
I worried that the intense focus on climate change would cause nations to overlook the desperate immediate needs in the developing world. “If world leaders are going to sit around talking about something that might be a problem fifty years from now,” I told Angela, “we’d better do something about the people dying from AIDS and malaria right now.”
With Angela’s help, the other G-8 leaders agreed to match the AIDS-relief goals America had set. Together, we would provide treatment for five million people, prevent twenty-four million more infections, and support care for twenty-four million additional people over the next five years. They also agreed to match the goals of our Malaria Initiative. Those historic commitments can make an enormous difference in the lives of people in Africa and around the world. It will be up to future administrations to ensure that nations follow through on their pledges.
