Bush's AIDS Claims Fall To Scrutiny

U.S. President George W. Bush, left, looks on as Ghana's President John Kufuor, right, speaks at a joint news conference at Osu Castle, Accra, Ghana, Wednesday, Feb. 20, 2008. President Bush is pushing trade and aid in this tropical land of gold and diamonds, the latest stop on what he's dubbed his "mission of mercy" to Africa. (AP Photo/Charles Dharapak) AP/Charles Dharapak

This column was written by Joshua Kurlantzick

With the nation's press corps consumed by the election and the economy shuddering, President Bush headed to Africa last week. It was his latest in a series of efforts to claim some positive legacy for his presidency. On his five-nation trip, Bush mostly avoided Iraq, terrorism, and his other normal themes. Instead, he visited supposed success stories like Rwanda and Ghana and touted his administration's generous commitment to aiding these nations as loudly as he could. "I'm here to really confirm to the people of Benin and the people on the continent of Africa that the United States is committed to helping improve people's lives,'' Bush declared on his first stop. To showcase compassion in action, and highlight his administration's focus on HIV, Bush visited a hospital in Tanzania for a photo opportunity and then declared that his aid programs were "God's work."

On the ground, however, Bush's Africa record hardly looks divine, which might come as a shock to those, including Democrats, who feel as if Africa has been one of the few successes of the Bush presidency. In a column entitled "Bush, A Friend of Africa," New York Times columnist Nicholas Kristof wrote, "Mr. Bush has done much more for Africa than Bill Clinton ever did," citing Bush's new African aid programs. And there's no question that Bill Clinton's Africa legacy is weak. He intervened disastrously in Somalia and then did not intervene, also disastrously, during the genocide in Rwanda. But Clinton at least generally tried to promote democratic reform in Africa, building links to emerging democrats like South Africa's Thabo Mbeki, helping promote democratic change in strife-torn nations like Mozambique, and making good governance and political reform centerpieces of his Africa policy.

Consumed by the war on terror, Bush has taken a far different approach. Rather than supporting democratic institutions and criticizing a new generation of African authoritarians, the Bush administration has backed whatever African leader claims to be battling militant Islam. For example, the White House has developed a close relationship with Ethiopia's thuggish leader Meles Zenawi, supposedly an ally in the war on terror and a partner in battling militancy in neighboring Somalia. The administration has provided military aid to Ethiopia with virtually no conditions on the assistance. It has also offered advisers to support Ethiopia's invasion of neighboring Somalia, an invasion which only led to more chaos in that benighted nation. Meanwhile, in recent years Zenawi's government has overseen a massive crackdown on opposition activists and a brutal offensive in the country's Ogaden region; in 2005, after disputed elections, the Ethiopian government arrested over 30,000 of its own people.

As in Ethiopia, so too across the continent. In building a string of counterterrorism allies, the White House has strengthened its links with some of Africa's most brutal regimes, from Algeria to Chad.

At the same time, desperate to wean America off Middle Eastern oil, the administration has courted West African nations with substantial offshore deposits. A worthy goal, but only up to a point. The White House's welcome for Equatorial Guinea tyrant Teodoro Obiang, for one, casts shame on Bush's vow to spread a "freedom agenda" around the world. Though Obiang ranks among Parade magazine's list of the world's worst dictators -- he allegedly oversees prisons that are torture factories and has been accused (rather outlandishly) of eating his rivals -- in 2006, Secretary of State Condoleezza Rice publicly hosted him at Foggy Bottom, saying, "You are a good friend."

Even on aid to Africa, Bush's claims do not stand up to scrutiny. The president has made foreign aid a priority of his administration, nearly tripling the overall budget for foreign assistance from where it stood in 2000. And many in his administration, like former speechwriter Michael Gerson, as well as aid advocates in Congress, like Kansas Senator Sam Brownback, have increased conservatives' interest in Africa. But the administration has spent much of the aid money on unilaterally created programs that neither learn from existing efforts nor respond effectively to Africans' real needs.

And it shows. One of the White House's major aid initiatives, the President's Emergency Plan for AIDS Relief (PEPFAR), has wasted much of its funds on scientifically questionable programs designed to please American religious conservatives. Though studies show that only a comprehensive approach, including condom distribution, sexual education, and antiretrovirals, could reduce HIV, the White House insisted that PEPFAR spend one-third of its behavioral prevention budget on programs that promote abstinence until marriage. It also refused to let PEPFAR money go for programs like needle exchanges and aggressive condom promotion. Recipient nations had to sign an American pledge vowing to oppose prostitution, even though prostitutes are major carriers of HIV in Africa, and signing the pledge could scare PEPFAR recipients out of helping sex workers. Virtually no other major multinational donor agreed with PEPFAR's strategy. Even the administration's own inspector general responsible for overseeing aid couldn't prove that its methods had worked. (As a footnote, Randall Tobias, the administration official responsible for overseeing AIDS programs, including the prostitution pledge, resigned after his number was discovered on the D.C. Madam's infamous call lists.)

The White House's other major new aid initiative hasn't proven to be much more effective. The Millenium Challenge Corporation, first launched in 2002, was supposed to be a new kind of aid program, one that selected recipient nations based upon a range of indicators that show their ability to govern well. But MCC has also suffered from going it alone. According to one study by the Center for Global Development, the leading Washington think-tank focusing on aid, although experience had shown that donors worked best when they coordinated their efforts in a country, "MCC tended to steer clear ... much to the dismay and frustration of other donors." With few staff and little organization, the MCC moved very slowly. In fiscal year 2007, according to another analysis by the Center for Global Development, the MCC only disbursed 6.8 percent of the money it was allocated. Worse, it clearly has drained funds from longtime, critical aid programs: In 2007 the administration slashed aid for extreme poverty programs, like child survival initiatives in Africa.

Because of the MCC's poor results, Congress has grown less supportive of the program. In the most recent congressional appropriations cycle, Republican Senator Richard Lugar tried to write a provision that would give the MCC only half of its appropriated money upfront, because of skepticism that it wouldn't spend its whole allocation. In the long run, this skepticism might threaten Congress' broader support for African aid. God's work, indeed.
By Joshua Kurlantzick
Reprinted with permission from The Nation

Comments