Republicans saved Africa from AIDS. Conservatives want to hobble that accomplishment.
George W. Bush did one decent thing. Don't take that away from him.
Before Donald Trump was the worst president of my lifetime, George W. Bush was the worst president of my lifetime. The Iraq War, torture, the Great Recession — I thought that was as bad as a Republican president could get. Shows what I know.
But George W. Bush did one decent thing as president: PEPFAR. It’s the American program that has, by all accounts, saved millions of lives — largely in Africa — from the scourge of HIV/AIDS.
Only now the program is in trouble.
Why? Because right-wing groups believe — without much evidence, as far as I can tell — that PEPFAR money is being used to promote abortions in foreign countries. The Biden Administration has denied that, but it’s a whole thing.
So much so that Bush himself weighed in with an op-ed in the Washington Post this week:
We are on the verge of ending the HIV/AIDS epidemic. To abandon our commitment now would forfeit two decades of unimaginable progress and raise further questions about the worth of America’s word.
The reauthorization is stalled because of questions about whether PEPFAR’s implementation under the current administration is sufficiently pro-life. But there is no program more pro-life than one which has saved more than 25 million lives. I urge Congress to reauthorize PEPFAR for another five years without delay.
A lot of the coverage of the controversy over PEPFAR pointed to The Heritage Foundation, a right-wing think tank, as the source of the complaints. So I checked out what Heritage had to say about the program — and it’s awful.
Although created by a Republican President, and despite generally receiving bipartisan support in Congress, PEPFAR has always been controversial. Except in cases of rape or maternal transmission, HIV/AIDS in the U.S. and in developing countries is primarily a lifestyle disease (like those caused by tobacco) and as such should be suppressed though education, moral suasion, and legal sanctions. For conservatives committed to personal responsibility, it also should not enjoy greater priority than deadlier and more unavoidable diseases receive in the allocation of public funds.
Let them have abstinence or let them die, apparently.
But there’s something more at work than “people should stop having sex” at work here.
Political contribution analysis explains why the supposedly neutral and nonpartisan development agencies and government-funded development contractors and NGOs all seem to promote a leftist agenda even when that agenda comes at the expense of the overall health of the marginalized beneficiaries of our foreign assistance. Almost all political contributions from employees of PEPFAR agencies and assistance providers have gone to Democratic candidates and causes, revealing that PEPFAR is in fact an entirely Democrat-run program.
And not to put too fine a point on it, Heritage’s very first bullet point for PEPFAR reform is … pressure agencies into hiring more Republicans.
That suggests that something other than public health is behind Heritage’s concerns about the program.
But … well, there’s a lot going on here:
Congress should resist the Biden Administration’s effort to poison bipartisan support for PEPFAR by misusing it to promote abortion under the guise of sexual and reproductive health and transgenderism. This politicizes what has been a targeted and bipartisan health program, disrespects the traditional values of the communities we support, and stokes anti-Americanism with negative foreign policy implications in places where Communist China seeks to displace American influence and power.
PEPFAR might be one of the few highly public programs that shows American power to be benevolent. From the right’s point of view, though, that’s stoking anti-Americanism and transgenderism. Whatever.
One really good thing came out of George W. Bush’s otherwise-awful presidency. Now right-wing Republicans want to undo that accomplishment — or at least hobble it — because of some questionable Culture War silliness.
Of course they do.
Excellent. PEPFAR was by far the best thing (only?) to come out of the Bush years. These nuts are determined to make everything they touch turn to shit in a quest to see who can be more holier-than-thou. Pure nonsense.
I just don't know that I find this argument persuasive at all.
The case against PEPFAR seems to be motivated much more by a desire to return to fiscal austerity and cut spending than about political bias. Over the past two decades, from Bush to Obama to Trump, interest rates in America were very low; Republicans like Bush and Trump were able to cut taxes without having to reduce spending and Democrats like Obama were able to increase spending without raising taxes. But I think we have seen pretty clearly over the past few years that that period is over now. If you want to keep PEPFAR, you need to pay for it by cutting spending elsewhere, raising taxes or accepting that it will (modestly) increase inflation.
Now, you might certainly point out that the cost of PEPFAR isn't astronomical, in the fiscal year 2022 it cost about $7 billion, a pretty small share of the overall budget which was in the trillions. The backlash to Rick Scott's entitlement proposals shows that Republicans probably aren't eager to cut social security either. And with the rise of China as a military threat, cutting defense is probably a non-starter to. Biden has proposed raising taxes on the rich, which seems quite sensible to me. But obviously Republicans aren't going to back this. So if you can't raise taxes but you also can't cut most spending, you have to focus on smaller programs, like PEPFAR.
Aid to Ukraine (which has become astronomically expensive, Biden is pushing for another $24bn on top of the $100bn all ready spent) is another easy target. Setting aside the desirability of arming Ukraine, it is objectively the case that Ukrainian aid has to be paid for with higher taxes, cuts to other domestic spending or just more inflation by juicing the money supply.
You might certainly argue that PEPFAR is a good program that America should continue, but that doesn't negate the clear fiscal and monetary reality.