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George W. Bush's anti-HIV program is hailed as 'amazing' — and still crucial at 20

PEPFAR is the "most amazing thing in the history of HIV," says Dr. Sharon Lewin, president of the International AIDS Society. Bush himself came to Washington this month to urge reauthorization..
In 2003, President George W. Bush created PEPFAR to help countries tackle the HIV/AIDS crisis. Four years later, he spoke at the Rose Garden to urge lawmakers to set aside $30 billion for the cause over the next 5 years. Joining him were Kunene Tantoh of South Africa and her 4-year-old son (pictured). Tantoh, who is HIV-positive, coordinated a U.S.-funded mentoring program for mothers with HIV.

By 2003, the global HIV/AIDS situation was reaching its deadliest peak. The previous year, 4.8 million people contracted HIV and 2.75 million died, making it one of the worst years of the HIV epidemic.

It wasn't due to a lack of treatments. In the '90s, effective medications had been developed that made HIV a manageable condition rather than a death sentence. But these drugs were available almost exclusively in richer countries. So the burden of illness and death shifted to lower-resource countries.

People living with HIV in those countries, which were often the hardest-hit by the epidemic, had "no chance of accessing treatments at all," Dr. Wafaa El-Sadr, director of ICAP at Columbia University and professor of epidemiology and medicine at Columbia Mailman School of Public Health, told NPR. (The global health group ICAP was originally founded to address the HIV/AIDS epidemic.) "There was really absolutely no hope."

Then, in his January 2003 State of the Union address, President George W. Bush made an announcement: The United States would undertake a massive investment to combat HIV/AIDS around.

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