With support from the Malaria Initiative, infection rates in the targeted countries began to decline. The most dramatic turnaround was in Zanzibar. Health officials adopted an aggressive campaign of spraying, bed net distribution, and medicine for malaria victims and pregnant women. On one Zanzibar island, the number of malaria cases dropped more than 90 percent in a single year.
On April 25, 2007, Laura and I hosted America’s first-ever Malaria Awareness Day in the Rose Garden. It was an opportunity to herald progress and show our citizens the results of their generosity.
At the end of my remarks, the KanKouran West African Dance Company performed a lively song. Caught up in the celebratory mood, I joined the dancers onstage. My moves were replayed on the national news and became a minor sensation on YouTube. The girls took great delight in teasing me: “I don’t think you should audition for Dancing with the Stars, Dad.”
“I told you my goal was to raise awareness,” I replied.
In 2006, Mark Dybul succeeded Randy Tobias as the coordinator of PEPFAR. As a medical doctor and respected figure in the AIDS community, Mark brought great credibility to PEPFAR. After one of his trips to Africa, he told me many on the continent were anxious about what would happen after PEPFAR’s five-year authorization expired in 2008. Governments were counting on our continued support, and so were the people. Mark told me he had asked a health clinic official in Ethiopia if anyone knew what the acronym PEPFAR stood for. “Yes,” the man said. “PEPFAR means the American people care about us.”
Mark believed we had a responsibility to continue the program—and an opportunity to build on our progress. By doubling PEPFAR’s initial funding level, we could treat 2.5 million people, prevent 12 million infections, and support care for 12 million people over the next five years.
Doubling funding would be a big commitment. But the AIDS initiative was working, and I decided to keep the momentum going. On May 30, 2007, I stepped into the Rose Garden and called for Congress to reauthorize the initiative with a new commitment of $30 billion over the next five years.
To highlight the progress, I invited a South African woman named Kunene Tantoh. Laura had met her two years earlier and shared her inspiring story with me. Kunene was HIV-positive, but thanks to medicine she received through the mother and child initiative, she had given birth to an HIV-free boy. After the speech I held four-year-old Baron in my arms and smiled at the thought that his precious life had been saved by the American taxpayers. He demonstrated his energy and good health by wiggling around and waving to the cameras. Then he gave me the international look for “Enough is enough. Put me down.”
Holding Baron Tantoh. White House/Eric Draper
The next step was to get other nations to join us. In the summer of 2007, Laura and I flew to Germany for the G-8 summit, hosted by Chancellor Angela Merkel. One key mission was to persuade my fellow G-8 leaders to match America’s pledges on HIV/AIDS and malaria.
Angela told me the summit’s primary topic would be global warming. I was willing to be constructive on the issue. In my 2006 State of the Union address, I had said that America was “addicted to oil”—a line that didn’t go over so well with some friends back in Texas. I had worked with Congress to promote alternatives to oil, including biofuels, hybrid and hydrogen vehicles, natural gas, clean coal, and nuclear power. I also proposed an international process that, unlike the flawed Kyoto Protocol, brought together all major emitters—including China and India—and relied on clean energy technologies to cut greenhouse gas emissions without stifling the economic growth necessary to solve the problem.
I worried that the intense focus on climate change would cause nations to overlook the desperate immediate needs in the developing world. “If world leaders are going to sit around talking about something that might be a problem fifty years from now,” I told Angela, “we’d better do something about the people dying from AIDS and malaria right now.”
With Angela’s help, the other G-8 leaders agreed to match the AIDS-relief goals America had set. Together, we would provide treatment for five million people, prevent twenty-four million more infections, and support care for twenty-four million additional people over the next five years. They also agreed to match the goals of our Malaria Initiative. Those historic commitments can make an enormous difference in the lives of people in Africa and around the world. It will be up to future administrations to ensure that nations follow through on their pledges.
The principles of accountability and partnership that guided PEPFAR were also behind the centerpiece of our new approach to economic development, the Millennium Challenge Account. To be eligible for MCA funds, countries had to meet three clearly defined criteria: govern free of corruption, pursue market-based economic policies, and invest in the health and education of their people. The change in approach was dramatic. Economic aid would be treated like an investment instead of a handout. Success would be measured by results produced, not money spent.
MCA drew support from some unexpected sources. One was Bono, the Irish lead singer of U2. Josh and Condi had gotten to know Bono and told me the star wanted to visit me in the Oval Office. I was skeptical of celebrities who seemed to adopt the cause of the moment as a way to advance their careers. But they assured me Bono was the real deal.
His visit was scheduled for the morning I announced MCA, March 14, 2002. Josh gave me a quick briefing on the issues likely to come up. Ever meticulous, he had one last question before showing our guest into the Oval Office. “Mr. President, you do know who Bono is, right?”
“Of course,” I said. “He’s a rock star.” Josh nodded and turned toward the door. “Used to be married to Cher, didn’t he?” I said. Josh wheeled around in disbelief. I kept a straight face for as long as I could.
Bono bounded into the Oval Office with his high-voltage personality and signature shades. He quickly dispelled the notion that he was a self-promoter. He knew our budgets, understood the facts, and had well-informed views about the challenges in Africa. He brought me a thoughtful gift, an old Irish Bible.
With Bono in the Oval Office. White House/Paul Morse
“Do you know that 2,003 verses of Scripture pertain directly to the world’s poor?” he asked. “People are quick to point out the obvious sins like marital infidelity,” he continued. “But sometimes we ignore the most serious ones. The only place the Bible speaks directly of judgment is in Matthew 25: ‘Whatever you did for one of the least of these brothers of mine, you did for me.’ ”
“You’re right,” I said. “The sin of omission is just as serious as the others.” I was pleased when he expressed his strong support for MCA, which he believed would revolutionize the way the world pursued development. I listened carefully as he urged me to do more on HIV/AIDS. “With a few pills you can save millions of lives. It would be the best possible advertisement for the United States. You ought to paint the things red, white, and blue.”
After our meeting, Bono joined me and Cardinal Theodore McCarrick, a gentle, spirit-filled man, for the limo ride to the speech at the Inter-American Development Bank. Bono participated in the event and praised our policy. I later learned that one of his major funders, ultra-liberal investor George Soros, had excoriated Bono for joining me at the MCA event without getting more in return. “You’ve sold out for a plate of lentils,” Soros told Bono.