Bush Creates Legacy Battling HIV-AIDS

[Frodo]

Does anyone think this initiative will survive into the next administration?  It's hard for me to imagine that it won't:
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In Global Battle on AIDS, Bush Creates Legacy

By SHERYL GAY STOLBERG
Published: January 5, 2008

WASHINGTON — Dr. Jean W. Pape did not know what to expect in early January 2003, when he slipped away from his work treating AIDS patients in Haiti and flew to Washington for a secret meeting with President Bush.

Mr. Bush was considering devoting billions to combat global AIDS, a public health initiative unparalleled in size and scope. The deliberations had been tightly carried out; even the health secretary was left out early on. If President Bush was going to shock the world — and skeptical Republicans — with a huge expenditure of American cash to send expensive drugs overseas, he wanted it to be well spent.

“He said, ‘I will hold you accountable, because this is a big move, this is an important thing that I’ve been thinking about for a long time,’” recalled Dr. Pape, one of several international AIDS experts Mr. Bush consulted. “We indicated to him that our arms are totally broken as physicians, knowing that there are things we could do if we had the drugs.”

Nearly five years later, the President’s Emergency Plan for AIDS Relief — Pepfar, for short — may be the most lasting bipartisan accomplishment of the Bush presidency.

With a year left in office, Mr. Bush confronts an America bitterly split over the war in Iraq. His domestic achievements, the tax cuts and education reform, are not fully embraced by Democrats, and his second-term legislative agenda — revamping Social Security and immigration policy — lies in ruins.

The global AIDS program is a rare exception. So far, roughly 1.4 million AIDS patients have received lifesaving medicine paid for with American dollars, up from 50,000 before the initiative. Even Mr. Bush’s most ardent foes, among them Senator John Kerry of Massachusetts, his 2004 Democratic challenger, find it difficult to argue with the numbers.

“It’s a good thing that he wanted to spend the money,” said Mr. Kerry, an early proponent of legislation similar to the plan Mr. Bush adopted. “I think it represents a tremendous accomplishment for the country.”

Announced in the 2003 State of the Union address, the plan called for $15 billion for AIDS prevention, treatment and care, concentrating on 15 hard-hit nations in Africa and the Caribbean. An enthusiastic Congress has already approved $19 billion.

Mr. Bush is pressing for a new five-year commitment of $30 billion. He will travel to Africa in February to make his case — and, the White House hopes, burnish the compassionate conservative side of his legacy.

[Gabu]

Well, never thought I'd say these words, but good for Bush.

[Fmr President & Senator Polnut]

It's very commendable - but any program which doesn't deal with non-abstinence safe-sex programs and needle exchange programs will only do a small portion of the job.

But if the regressives in Washington have woken up to the realities, then it's something that would increase my estimation of him.

[JSojourner]

I agree.  Good for Bush.  But last time he got all fired up about fighting AIDS in Africa, a ton of money was actually gutted from the bill.  And he didn't even whimper. 

What kinds of AIDS prevention are we talking about? 

The unrealistic, conservative plan that says --  "Just keep it in your pants."

The self-defeating liberal plan that says --  "Here's a gross of rubbers.  Have fun."

Or something new, culturally-sensitive and effective?  Frankly, I am sick of both approaches.

[Lief 🗽]

While it's certainly good that he's spending money on this, on the other hand, he reinstated the global gag rule, which has hurt organizations that promote birth control methods (like condoms).

[A18]

Is every government expenditure of confiscated property a good and righteous act, so long as it is diverted toward some noble end?

One of the most irritating aspects of modern politics, is the utter inability of the average person to think in terms of trade-offs (i.e., to think at all). Every dollar spent fighting HIV/AIDS, could have been spent on innumerable other objectives. Why was HIV/AIDS the most worthy target? How about the goods not produced and the consumption forgone? These costs are of course invisible. We have no idea what this money would have been spent on had it not been borrowed/taxed away from the private sector, nor can we know the ultimate effect of such policies on income-incentives.

The point here is not that "battling AIDS" is a bad thing. Of course, it is not. But we do not simply "battle AIDS" in the abstract. We allocate scarce resources toward that end, and in the process forgo their other potential uses.

How is this decision to be made? The reality of the matter, is that governments are never in a position to compare societal costs and benefits in the way an individual might weigh personal costs and benefits. Even putting to the side the touchy subject of interpersonal utility comparisons, there is the knowledge problem. For government to reliably improve "social utility" to be above and beyond that of the natural market order, it would have to have a stunning degree of information that is simply not realistic or workable. Outside of the most extreme cases, it requires a giant leap of faith.

There is one thing we (and governments) can know, however. That is that government spending effects a redistribution of power and influence and society. I view that as a cost in and of itself.

I would allow free people to decide what portions of their incomes to devote to charitable purposes, as well as the proper object of that charity (AIDS, cancer, poverty, whatever). The incentives of the natural market order are undoubtedly "imperfect" in some sense or another, but God alone has enough information to improve upon it with any reliability.

[opebo]

Is every government expenditure of confiscated property a good and righteous act, so long as it is diverted toward some noble end?

Your view of 'property' is not a reasonable one, given that the State allocated and vouchsafed all the property their is.  If it takes a small amount of it back from those it privileges for its running and a few public health programs, it seems a bit much for those privileged to complain.

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Your public/private dichotomy is blindly unrealistic, Philip.  And besides, we know very well what this would have been spent on had it remained with the privileged - more $10,000 sofas, $150,000 bathrooms, multiple face-lifts.. maybe a few boats, etc.  Just a bunch of ticky-tacky.

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Haha, go drive around your city's richest neighborhood and continue this line about 'scarce resources'.  This society has enormous resources, they're just almost all allocated to the top 1%.

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My friend, under your system of extreme politically imposed inequality, the deaths of hiv sufferers who have no money has absolutely no 'societal cost'. 

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Perhaps you will admit that the power lies with the owners, Philip.  Why would you think it lies anywhere but with those who recieve the most?

[quote[I would allow free people to decide what portions of their incomes to devote to charitable purposes, as well as the proper object of that charity (AIDS, cancer, poverty, whatever). The incentives of the natural market order are undoubtedly "imperfect" in some sense or another, but God alone has enough information to improve upon it with any reliability.
[/quote]

No such thing as 'free people', Philip, 'the market' is just a politically imposed set of power relationships, and regardless no one is going to donate much.  Why should they if they've got theirs?

[Ebowed]

People only donate to charities which help things which directly affect them- their relative has HIV, so they care about AIDS charities (but not, say, bladder cancer), or things which are immediate and shocking- like the Red Cross, right after Hurricane Katrina.

Why aren't Red Cross donations at the same level now that everyone's forgotten about Katrina?  Because no one is charitable enough to care.

If you want something done, get the government to step in.

[memphis]

What I want to know is, why doesn't he want to "teach the controversy?"

http://en.wikipedia.org/wiki/AIDS_denial

These people have about as much credibility as the evolution deniers.

[Ebowed]

What I want to know is, why doesn't he want to "teach the controversy?"

http://en.wikipedia.org/wiki/AIDS_denial

These people have about as much credibility as the evolution deniers.

Actually, some of them are the same people!

Philip E. Johnson, creator of the modern 'intelligent design' movement, does not believe that HIV causes AIDS!  If only the creationists knew...

[A18]

After stressing the relevance (and existence) of trade-offs in a society with scarce resources, I concluded by saying that "I would allow free people to decide what portions of their incomes to devote to charitable purposes, as well as the proper object of that charity (AIDS, cancer, poverty, whatever)." My post explicitly states that the "incentives of the natural market order are undoubtedly 'imperfect' in some sense or another," but nevertheless adds that "God alone has enough information to improve upon [them] with any reliability."

Ebowed's supposed reply is in fact no reply at all. "People only donate to charities," he tells us, "which help things which directly affect them ... or things which are immediate and shocking." Yet even accepting this rather dubious proposition to be entirely and unassailably true (despite his citing no evidence for it whatsoever), it does not cast any doubt on what I said.

This response would be understandable if I had made the argument that humans are so wise, rational, informed, and virtuous, that whenever social utility might be maximized by a transfer of wealth, charity will follow; and that government intervention is therefore simply unnecessary. In fact, my argument is squarely grounded in the basic propositions that:
  (a) We live in a world of scarcity. The pursuance of a particular end, means that another end will either not be pursued at all, or at least will not be pursued as effectively. --AND--
  (b) Government is in no position, due to lack of knowledge (and even accepting the utilitarian assumptions of the "efficiency" worshipers), to effectively balance and compare the competing interests at stake when arranging a coercive diversion of resources.
--Hence, the maximize-social-utility justification for violent intervention in human affairs must be rejected here as without merit.

Even if there were no charity whatsoever, my argument would be unaffected. It is based on the general reliability of the voluntary, time-tested property-and-price mechanism, and the inability of improving upon it by violent means. Thus, I would not attempt to do so, and would instead condone only those non-commercial transactions that are not coercive.

Ebowed concludes by saying that "[i]f [I] want something done, [I should] get the government to step in." But as I have explained, it is not about the merits of a particular end as an abstract matter, but the concrete trade-offs involved, that matter from the standpoint of societal welfare. And even pretending, erroneously, that there would be no impact on the incentives of persons to earn income (depression of production), the question still remains whether it was worth taking these resources away from another end, and putting them toward this one. With government, cost-benefit analysis is virtually non-existent.

[Frodo]

An update:

House Approves Global AIDS Program
   
By JIM ABRAMS
The Associated Press
Wednesday, April 2, 2008; 4:22 PM

WASHINGTON -- The House voted Wednesday to triple to more than $10 billion a year U.S. humanitarian spending on fighting AIDS, malaria and tuberculosis in Africa and other stricken areas of the world.

About $41 billion of the $50 billion over five years would be devoted to AIDS, significantly expanding a program credited with saving more than 1 million lives in Africa alone in the largest U.S. investment ever against a single disease.

Every day another 6,000 people are infected with the HIV virus, said House Foreign Affairs Committee Chairman Howard Berman, D-Calif. "We have a moral imperative to act and to act decisively," he said.

The House voted 308-116 to extend and broaden the scope of the $15 billion President's Emergency Plan for AIDS Relief that President Bush promoted and Congress enacted in 2003. It has been hailed as a noteworthy foreign policy success of the Bush presidency.

The White House, which backs the House bill, said the program is supporting anti-retroviral treatment for about 1.45 million people and is on track to meet its goals of backing treatment for 2 million, preventing 7 million new infections and providing care for 10 million, including orphans and vulnerable children.

In 2007, 33 million people worldwide were living with HIV and AIDS, according to the United Nations.

Rep. Ileana Ros-Lehtinen of Florida, top Republican on the Foreign Affairs Committee, added that while the program is based on altruism, it has strengthened U.S. security.

Without addressing the AIDS pandemic, she said, it "will continue to spread its mix of death, poverty and despondency that is further destabilizing governments and societies, and undermining the security of entire regions."

The compromise bill was one of the last endeavors of the former Foreign Affairs Committee chairman, Tom Lantos, D-Calif., who died of cancer in February. The measure is named after Lantos and his predecessor as Foreign Affairs chairman, the late Rep. Henry Hyde, R-Ill., who worked together on the 2003 act.

The Senate Foreign Relations Committee has approved a similar $50 billion bill, and the legislation is seen as having a good chance of passing in an election year in which few major bills will reach the president's desk.

[2952-0-0]

$10 says some of this funding will fund abusive tactics employed by makers of ARVs to prevent some countries from making generic versions and increase access to those drugs.

[12th Doctor]

$10 says some of this funding will fund abusive tactics employed by makers of ARVs to prevent some countries from making generic versions and increase access to those drugs.

Just proof of what I have always know, even when Bush (or any Republican President) does something liberals should approve of, they will disagree with it.

I'm sure if Obama did this, the never ending orgasm would be intolerable.

[2952-0-0]

I'm sure if Obama did this, the never ending orgasm would be intolerable.

Nope. Politicians are politicians.

[Starbucks Union Thug HokeyPuck]

This is one thing that I like he's done.  1 for about a million isn't too bad right? 

[Beet]

I remember a PBS series on this in 2004. This was after Congress had complained that PBS had too much of a liberal bias. They produced this show and it showed Bush's accomplishments in the AIDS/HIV arena. He even got Jesse Helms to sign on. Quite impressive.

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Can you prove this lack of knowledge? And how do you define "effectively balance and compare"?

How many societies in history relied entirely on the voluntary, "time-tested" property-and-price mechanism and how were they superior to societies that balanced voluntary property exchange but were also influenced by other, coercive measures?

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Precisely... and that matter is entirely subjective. One must have some basic concept of a collective 'society' or a nation with something substantive collectively at stake, to accept that governments can be actors or decision-makers in this subjective choice.

It is my view that many people who are opposed to social welfare or suspicious of charity altogether (though these two may be separate), generally tend to take a darker and more suspicious view toward the goals or beneficiaries, which is shaded by a darker view toward human nature. And that is a perfectly legitimate perspective. Free a man of his shackles, and his next step may be to mug you! Still, this tendency can be taken too far as well, and we are not going to resolve the matter by pulling rhetorically around our end of the scale in the argument over human nature.

There are also other things to consider, like the attractiveness of an endeavor, its side-benefits, its aesthetic value, its capability of being carried forward successfully, etc. etc., all of which are subjective but also which most people will fall around a certain standard deviation, and it is these factors which generally determine whether social welfare or an act of charity will be carried out and be successful.

[JohnFKennedy]

How is this decision to be made? The reality of the matter, is that governments are never in a position to compare societal costs and benefits in the way an individual might weigh personal costs and benefits. Even putting to the side the touchy subject of interpersonal utility comparisons, there is the knowledge problem. For government to reliably improve "social utility" to be above and beyond that of the natural market order, it would have to have a stunning degree of information that is simply not realistic or workable. Outside of the most extreme cases, it requires a giant leap of faith.

The problem with that argument is that the individual is doing just that; weighing personal costs and benefits which is where my fundamental qualm lies with extreme libertarianism; it begins from the standpoint that we are all unconnected individuals which is simply not the case. While I do believe in the individual, I also believe that each and every individual one of us makes up a collective. I think John Donne put it best in the following passage:

'No man is an Iland, intire of itselfe; every man is a peece of the Continent, a part of the maine; if a Clod bee washed away by the Sea, Europe is the lesse, as well as if a Promontorie were, as well as if a Manor of thy friends or of thine owne were; any mans death diminishes me, because I am involved in Mankinde; And therefore never send to know for whom the bell tolls; It tolls for thee.'

Certainly the individual has to think about personal costs and benefits, but I would argue that under many circumstances an individual thinks on a very short term level (arguably governments do too) and thus is unlikely to consider personal long term benefits derived from the short and longer term benefits to the community.

Governments do not have perfect knowledge, but nor do individuals; under some circumstances it is my view that it is right and proper for the government to intervene and I very much hope that what Bush has done goes a long way towards tackling the problem although I worry - as JSojourner does - that present policy initiatives take a misguided view both on the left and the right. My position on this actually changed relatively recently following a discussion with an academic supervisor who specialises in African history. She told me that during one of her frequent trips to Tanzania she discussed the issue with someone who worked in the field. He told her that one of the problems was that many who sold/distributed condoms had no qualms about accepting 'dodgy' shipments that could likely contain defective ones and simply handing them out or selling them and if the people taking these are under the impression that they are protected because they are using condoms then they could be gravely mistaken and gravely endangered. I think what is needed here is a fundamental rethink of policy and I hope that some of this money goes towards that.

[opebo]

Kind of pointless providing this money on foreign shores where no one knows where it is going when americans with the ailment can't even get treated in the US due to lack of funding...

Wait a minute I guess that is the point - let it keep killing Them off at home, but use the 'aids epidemic' in Africa to funnel money to campaign donors, religious organizations, etc.  Genius.