This is a tough column for a liberal to write. You may recall that I spent eight years hammering President George W. Bush for just about everything he did (and he deserved it!), yet one more thing must be said: Bush started the single best policy of any president in my lifetime.
This year marks the 20th anniversary of Bush’s mammoth program to fight H.I.V. and AIDS. That turned the tide of the epidemic and has saved 25 million lives so far.
Think of that: 25 million lives. That’s like saving every Australian. That’s more than all the Jews killed in the Holocaust and all the people killed in the genocides of Armenians, Cambodians, Rwandans, Bosnians, Darfuris and Rohingya; all the confirmed deaths from Covid worldwide; all the deaths of American troops in all wars in the country’s history back to 1776; all the gun deaths in the United States in the last half-century; and all the auto deaths in the United States in the last half-century — combined.
Bush’s initiative was called the President’s Emergency Plan for AIDS Relief, or PEPFAR. It paid for antiretroviral medicines for people with AIDS and for efforts to prevent the spread of the virus, including to newborns through childbirth. I knew how transformative PEPFAR had been when I interviewed coffin makers in Malawi and Lesotho and they fretted about the collapse of their business model: Because of Bush, many fewer people were dying.
“Genius plan; pretty crap acronym,” Bono called it. He also described it as “the most eloquent expression of American values anyone can think of in recent times.”
Sigh. It’s awkward for liberals when an earnest Irishman thanks us for a program created by Bush! How is it that the leading humanitarian initiative of our lifetime was engineered not by a globalist progressive but rather by a guy with whom we disagree on almost everything?
If your politics are like mine, this may be hard to acknowledge. After all, it was also 20 years ago that Bush began the catastrophe of the Iraq War, which claimed thousands of American lives and perhaps several hundred thousand Iraqi lives.
I opposed the Iraq War and then covered it, and I need no reminders about what a horrific miscalculation the invasion was. We in the media dropped the ball in both directions: We were insufficiently skeptical of the Iraq War, and then were insufficiently appreciative of something Bush did that was heroic.
Bush didn’t start PEPFAR because he was under pressure to do so. The only real push came from a few leaders of a constituency that I rarely agree with: conservative evangelicals. PEPFAR didn’t benefit Bush politically, and even after two decades and all those lives saved, many Americans have never heard of it.
That’s why I wanted to write this column: partly to be fair and give credit where it’s due, and partly because Bush’s lifesaving work with PEPFAR messes with our heads and forces us to face the world’s complexity.
Lyndon Johnson founded Medicare and pushed through landmark civil rights legislation while also expanding the cataclysm of the Vietnam War. I suspect that it’s easier for us to accept contradictions in someone like Johnson, who is now slipping into history, and more difficult with a figure like Bush, who still evokes raw fury.
My colleagues and I published a Times Opinion video about Bush and PEPFAR last month, and I was struck by the visceral anger from some fellow liberals who watched it, asking how we could possibly praise a war criminal — particularly around the anniversary of the Iraq War.
The answer is that I want to push back at oversimplified, single-arc narratives. We humans already suffer from a bundle of biases that lead us to information that will confirm our judgments rather than question them and that will reassure us about the moral purity of our side and the depravity of the other side; we’d get more done and find it easier to work with others if we acknowledged a world of grays.
How do we possibly weigh 25 million lives saved from AIDS against hundreds of thousands of lives squandered in war? We can’t: They are incommensurate yardsticks. A life saved in Uganda does not erase a life taken in Basra, but it’s equally true that senseless warfare in Iraq does not negate the most important humanitarian program in American history. Both are real, and if we experience cognitive dissonance, that’s because we inhabit a dissonant world.
I also worry that the failure to credit Bush for PEPFAR disincentivizes other presidents from starting grand programs. PEPFAR can and should be a model for other historic interventions. How about ensuring that every child worldwide can at least finish primary school? What about seeking to eliminate the curse of child poverty in America? How about ending cervical cancer worldwide?
By all means, let’s remember the lives lost in Iraq and thunder at Bush for his mistakes there and elsewhere. But let’s also honor a golden moment when a president did the right thing and provided American leadership to rein in one of the deadliest epidemics in history. While it may be hard for liberals like me to get these words out, let’s try: We Americans owe George W. Bush thanks for his leadership in saving 25 million lives in our name.
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